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Sample records for association international specialty

  1. Association of American Geographers, Remote Sensing Specialty Group Special Issue of Geocarto International

    NASA Technical Reports Server (NTRS)

    Allen, Thomas R. (Editor); Emerson, Charles W. (Editor); Quattrochi, Dale A. (Editor); Arnold, James E. (Technical Monitor)

    2001-01-01

    This special issue continues the precedence of the Association of American Geographers (AAG), Remote Sensing Specialty Group (RSSG) for publishing selected articles in Geocarto International as a by-product from the AAG annual meeting. As editors, we issued earlier this year, a solicitation for papers to be published in a special issue of Geocarto International that were presented in RSSG-sponsored sessions at the 2001 AAG annual meeting held in New York City on February 27-March 3. Although not an absolute requisite for publication, the vast majority of the papers in this special issue were presented at this year's AAG meeting in New York. Other articles in this issue that were not part of a paper or poster session at the 2001 AAG meeting are authored by RSSG members. Under the auspices of the RSSG, this special Geocarto International issue provides even more compelling evidence of the inextricable linkage between remote sensing and geography. The papers in this special issue fall into four general themes: 1) Urban Analysis and Techniques for Urban Analysis; 2) Land Use/Land Cover Analysis; 3) Fire Modeling Assessment; and 4) Techniques. The first four papers herein are concerned with the use of remote sensing for analysis of urban areas, and with use or development of techniques to better characterize urban areas using remote sensing data. As the lead paper in this grouping, Rashed et al., examine the usage of spectral mixture analysis (SMA) for analyzing satellite imagery of urban areas as opposed to more 'standard' methods of classification. Here SMA has been applied to IRS-1C satellite multispectral imagery to extract measures that better describe the 'anatomy' of the greater Cairo, Egypt region. Following this paper, Weng and Lo describe how Landsat TM data have been used to monitor land cover types and to estimate biomass parameters within an urban environment. The research reported in this paper applies an integrated GIS (Geographic Information System

  2. Association of American Geographers, Remote Sensing Specialty Group Special Issue of Geocarto International

    NASA Technical Reports Server (NTRS)

    Allen, Thomas R. (Editor); Emerson, Charles W. (Editor); Quattrochi, Dale A. (Editor); Arnold, James E. (Technical Monitor)

    2001-01-01

    This special issue continues the precedence of the Association of American Geographers (AAG), Remote Sensing Specialty Group (RSSG) for publishing selected articles in Geocarto International as a by-product from the AAG annual meeting. As editors, we issued earlier this year, a solicitation for papers to be published in a special issue of Geocarto International that were presented in RSSG-sponsored sessions at the 2001 AAG annual meeting held in New York City on February 27-March 3. Although not an absolute requisite for publication, the vast majority of the papers in this special issue were presented at this year's AAG meeting in New York. Other articles in this issue that were not part of a paper or poster session at the 2001 AAG meeting are authored by RSSG members. Under the auspices of the RSSG, this special Geocarto International issue provides even more compelling evidence of the inextricable linkage between remote sensing and geography. The papers in this special issue fall into four general themes: 1) Urban Analysis and Techniques for Urban Analysis; 2) Land Use/Land Cover Analysis; 3) Fire Modeling Assessment; and 4) Techniques. The first four papers herein are concerned with the use of remote sensing for analysis of urban areas, and with use or development of techniques to better characterize urban areas using remote sensing data. As the lead paper in this grouping, Rashed et al., examine the usage of spectral mixture analysis (SMA) for analyzing satellite imagery of urban areas as opposed to more 'standard' methods of classification. Here SMA has been applied to IRS-1C satellite multispectral imagery to extract measures that better describe the 'anatomy' of the greater Cairo, Egypt region. Following this paper, Weng and Lo describe how Landsat TM data have been used to monitor land cover types and to estimate biomass parameters within an urban environment. The research reported in this paper applies an integrated GIS (Geographic Information System

  3. Associated Specialty Contracting Co. Information Sheet

    EPA Pesticide Factsheets

    Associated Specialty Contracting Co. (the Company) is located in Glenn Mills, Pennsylvania. The settlement involves renovation activities conducted at property constructed prior to 1978, located in Philadelphia, Pennsylvania.

  4. Rotating Interns' Images of Practitioners of Five Medical Specialties.

    ERIC Educational Resources Information Center

    Sangal, Rahul

    1979-01-01

    A study of rotating interns' images of medical practitioners focuses on what images the interns have of obstetrician-gynecologists, pediatricians, internists, psychiatrists, and surgeons, and seeks to determine whether these images differ according to choice of specialty for postgraduate work. (JMD)

  5. Part-time careers in academic internal medicine: a report from the association of specialty professors part-time careers task force on behalf of the alliance for academic internal medicine.

    PubMed

    Linzer, Mark; Warde, Carole; Alexander, R Wayne; Demarco, Deborah M; Haupt, Allison; Hicks, Leroi; Kutner, Jean; Mangione, Carol M; Mechaber, Hilit; Rentz, Meridith; Riley, Joanne; Schuster, Barbara; Solomon, Glen D; Volberding, Paul; Ibrahim, Tod

    2009-10-01

    To establish guidelines for more effectively incorporating part-time faculty into departments of internal medicine, a task force was convened in early 2007 by the Association of Specialty Professors. The task force used informal surveys, current literature, and consensus building among members of the Alliance for Academic Internal Medicine to produce a consensus statement and a series of recommendations. The task force agreed that part-time faculty could enrich a department of medicine, enhance workforce flexibility, and provide high-quality research, patient care, and education in a cost-effective manner. The task force provided a series of detailed steps for operationalizing part-time practice; to do so, key issues were addressed, such as fixed costs, malpractice insurance, space, cross-coverage, mentoring, career development, productivity targets, and flexible scheduling. Recommendations included (1) increasing respect for work-family balance, (2) allowing flexible time as well as part-time employment, (3) directly addressing negative perceptions about part-time faculty, (4) developing policies to allow flexibility in academic advancement, (5) considering part-time faculty as candidates for leadership positions, (6) encouraging granting agencies, including the National Institutes of Health and Veterans Administration, to consider part-time faculty as eligible for research career development awards, and (7) supporting future research in "best practices" for incorporating part-time faculty into academic departments of medicine.

  6. [Training in internal medicine and its specialties: universities' proposals].

    PubMed

    Norero, C

    1996-04-01

    Medical School graduates can enter a medicine subspecialty training program upon completion of a 3 year Internal Medicine residency. The Ministry of Health has contributed to postgraduate training by defining the type of physician the country needs, and by financial support of specially (Internal Medicine) training. Before 1995, when applicants began being charged a fee, finding for subspecialty training was provided exclusively by the universities. Currently, 450 training post are available for 550 graduates from all medical schools. Of these, 59 are in Internal Medicine and 58 in its subspecialties. A quantitative analysis of 40 years of training programs in Internal Medicine by the traditional medical schools shows that only the Catholic University of Chile Medical School privileges subspecially training whereas all other schools favor general Internal Medicine training. A high number of Internal Medicine trainees never take final examination. Nevertheless, training through practice, not necessarily in a university setting, accounts for 67% of Autonomous National Corporation for Certification of Medical Specialties. CONACEM accredited subspecialists. About 63% of those who finish an Internal Medicine training program decide to go into subspecialization. It is felt that subspecialization involves technical as well as non-professional aspects, such as a philosophical stance towards the search for truth through research and creativity. An integral education in a subspecialty can only be given by the university. Non-university centers, however, can contribute to subspecialization by allowing trainees to gain access to newer technology or to larger numbers of patients. A critical question is how many subspecialists should exist in relation to the number of generalists and according to the country's health requirements. In my personal view, the proportion of subspecialists is excessive. The decision to subspecialize should not be exclusively a personal choice, but

  7. Predictors of final specialty choice by internal medicine residents.

    PubMed

    Diehl, Andrew K; Kumar, Vineeta; Gateley, Ann; Appleby, Jane L; O'Keefe, Mary E

    2006-10-01

    Sociodemographic factors and personality attributes predict career decisions in medical students. Determinants of internal medicine residents' specialty choices have received little attention. To identify factors that predict the clinical practice of residents following their training. Prospective cohort study. Two hundred and four categorical residents from 2 university-based residency programs. Sociodemographic and personality inventories performed during residency, and actual careers 4 to 9 years later. International medical school graduates (IMGs) were less likely to practice general medicine than U.S. graduates (33.3% vs 70.6%, P < .001). Residents with higher loan indebtedness more often became generalists (P = .001). A corresponding trend favoring general internal medicine was observed among those who perceived General Internists to have lower potential incomes (69.0% vs 53.3%, P = .08). There was a trend for generalists to have lower scores on scales measuring authoritarianism, negative orientation to psychological problems, and Machiavellianism (0.05 < P < .10). In a logistic regression, graduation from a U.S. medical school (odds ratio [OR] 3.02; 95% confidence interval [CI], 1.00 to 9.10, P = .049) and perception of low future income (OR 1.65; 95% CI, 1.06 to 2.56, P = .03) predicted entry into general medicine, with trends apparent for higher debt (P = .05) and greater comfort caring for patients with psychological problems (P = .07). Recruitment of IMGs may not increase the supply of General Internists. Prospects of lower income, even in the face of large debt, may not discourage residents from becoming generalists. If increasing generalist manpower is a goal, residencies should consider weighing applicants' personal attributes during the selection process.

  8. Predictors of Final Specialty Choice by Internal Medicine Residents

    PubMed Central

    Diehl, Andrew K; Kumar, Vineeta; Gateley, Ann; Appleby, Jane L; O'Keefe, Mary E

    2006-01-01

    BACKGROUND Sociodemographic factors and personality attributes predict career decisions in medical students. Determinants of internal medicine residents' specialty choices have received little attention. OBJECTIVE To identify factors that predict the clinical practice of residents following their training. DESIGN Prospective cohort study. PARTICIPANTS Two hundred and four categorical residents from 2 university-based residency programs. MEASUREMENTS Sociodemographic and personality inventories performed during residency, and actual careers 4 to 9 years later. RESULTS International medical school graduates (IMGs) were less likely to practice general medicine than U.S. graduates (33.3% vs 70.6%, P<.001). Residents with higher loan indebtedness more often became generalists (P = .001). A corresponding trend favoring general internal medicine was observed among those who perceived General Internists to have lower potential incomes (69.0% vs 53.3%, P = .08). There was a trend for generalists to have lower scores on scales measuring authoritarianism, negative orientation to psychological problems, and Machiavellianism (0.05

  9. Exercise counseling of primary care physicians in metabolic syndrome and cardiovascular diseases is associated with their specialty and exercise habits.

    PubMed

    Morishita, Yoshiyuki; Miki, Atushi; Okada, Mari; Tsuboi, Satoshi; Ishibashi, Kenichi; Ando, Yasuhiro; Nagata, Daisuke; Kusano, Eiji

    2014-01-01

    We investigated the practice of exercise counseling of primary care physicians in metabolic syndromes and cardiovascular diseases and its association with their age class, specialty, work place, and their own exercise habits. The subjects were 3,310 medical doctors who had graduated from Jichi Medical University in Japan. The study instrument was a self-administered questionnaire to investigate their age class, specialty, workplace, exercise habits, and exercise counseling for their patients. Overall, 839 completed responses were analyzed from a total of 933 that were received (28.2%). The primary care physicians whose specialties were internal medicine and general medicine significantly more often recommended exercise in diabetes mellitus, hyperlipidemia, heart failure, and hypertension cases than those whose specialties were surgery and pediatrics. The primary care physicians whose specialty was pediatrics recommended exercise less often in apoplexia cases than those whose specialties were internal medicine, general medicine, and surgery. Their exercise habits were positively associated with their recommendation of exercise in hyperlipidemia, heart failure, and hypertension cases; however, these associations were not observed in diabetes mellitus and apoplexia. The primary care physicians' age class and work place showed no association with their exercise recommendations in metabolic syndrome and cardiovascular diseases. The primary care physicians whose specialties were internal medicine and general medicine significantly more often recommended exercise in diabetes mellitus, hyperlipidemia, heart failure, and hypertension cases. In addition, their own exercise habits were positively associated with their recommendation of exercise in hyperlipidemia, heart failure, and hypertension cases.

  10. Beliefs and attitudes of interns at Ibadan General Hospitals concerning ten medical specialties.

    PubMed

    Ohaeri, J U; Akinyinka, O O; Asuzu, M C

    1994-12-01

    Fifty-two interns at Ibadan general hospitals (89% response rate), participated in a study of their attitudes towards ten medical specialties. This involved completing a 40-item questionnaire. The highly preferred specialties (surgery, paediatrics, obstetrics and gynaecology, internal medicine) were those in which there was expectation of material rewards, societal appreciation, quick response of patients to treatment, and inspiration by teachers. The less preferred specialties were viewed negatively in these regards. The findings support the suggestion that, in order to give medical graduates a greater chance to see that the less preferred specialties can provide career fulfillment, interns should be allowed to spend part of their one year clinical rotation in radiology, pathology, psychiatry, anaesthesia and community medicine.

  11. [Criteria for a medical specialty in crisis: a case study of general surgery and internal medicine].

    PubMed

    Nirel, Nurit; Birkenfeld, Shlomo; Benbassat, Jochanan

    2008-06-01

    Several clinical specialties in Israel appear to be experiencing an ongoing crisis. Recently, a Public Committee addressed this problem and recommended its further study. In this paper, the authors report a pilot case study of general surgery and internal medicine, which have been identified as "clinical specialties in crisis" in the medical literature, in the testimonies presented to the Public Committee, and during our preliminary interviews. to identify (a) the criteria for a "medical specialty in crisis" and (b) measures for the assessment of the extent of the crisis. (a) Qualitative analysis of interviews and written testimonies of hospital directors, departmental heads of general surgery and internal medicine, and key personnel in the health care system; (b) Analysis of data derived from national administrative data databases and (c) Secondary analysis of data from a nationwide survey of board certified Israeli specialists. We identified five criteria of "medical specialties in crisis": shortage of "good" applicants for residency training; difficulties in filling vacant positions; excessive workload due to the limited number of staff physician and residents; a perceived low remuneration and limited opportunities for additional income; poor quality of professional working life. Some of these criteria can be used as a proxy for measuring the extent of the crisis. It is possible to identify criteria defining clinical specialties in crisis, as well as its extent, as a first step toward identification of possible ways of coping with it. The findings of this pilot study justify a broader survey of additional medical specialties and a larger number of physicians.

  12. Specialty Certification Status, Performance Ratings, and Disciplinary Actions of Internal Medicine Residents.

    PubMed

    Lipner, Rebecca S; Young, Aaron; Chaudhry, Humayun J; Duhigg, Lauren M; Papadakis, Maxine A

    2016-03-01

    Little is known about the attrition of physicians trained in internal medicine (IM). The authors sought to examine career paths, disciplinary actions, and American Board of Medical Specialties (ABMS) certification status of IM residents. Three datasets were combined to study 66,881 residents in Accreditation Council for Graduate Medical Education-accredited IM residency programs nationwide from 1995 to 2004. Group differences (among an American Board of Internal Medicine [ABIM]-certified cohort; an ABMS-certified cohort (but not ABIM-certified); and a noncertified cohort) in IM residency performance ratings, specialty certification status, year of initial IM training, and medical board disciplinary actions were examined. Analyses included chi-square tests, analysis of variance, pairwise comparisons, and logistic regressions. Ninety-five percent of IM residents obtained ABIM certification; 1.6% received ABMS certification in another specialty; 3.4% received no ABMS specialty certification, of which 74.3% have a current medical license; and 66.6% self-reported IM as their primary specialty. During residency, the ABIM cohort performed better than those who never obtained ABIM certification. Disciplinary actions were lowest for the ABIM cohort (1.2%), 2.4% for the ABMS cohort, and highest and more severe for the noncertified cohort (6.0%). Only 5% of IM residents do not achieve IM certification. IM resident attrition minimally impacts physician supply, though those without certification appear to contribute disproportionately to poor physician performance indicators. Improved tracking of the U.S. physician workforce could aid policy makers in predicting manpower shifts in certain specialty areas, both during and after residency training.

  13. Consumer Specialty Products Association Letter and EPA Response re: Minimum Risk Pesticide Exemption Petition

    EPA Pesticide Factsheets

    The Consumer Specialty Products Association petitioned EPA to exclude from the minimum risk pesticide exemption pesticides claiming to control “pests of significant public health importance” and require registration. View the petition and EPA's response.

  14. Longitudinal Association of Registered Nurse National Nursing Specialty Certification and Patient Falls in Acute Care Hospitals.

    PubMed

    Boyle, Diane K; Cramer, Emily; Potter, Catima; Staggs, Vincent S

    2015-01-01

    Researchers have studied inpatient falls in relation to aspects of nurse staffing, focusing primarily on staffing levels and proportion of nursing care hours provided by registered nurses (RNs). Less attention has been paid to other nursing characteristics, such as RN national nursing specialty certification. The aim of the study was to examine the relationship over time between changes in RN national nursing specialty certification rates and changes in total patient fall rates at the patient care unit level. We used longitudinal data with standardized variable definitions across sites from the National Database of Nursing Quality Indicators. The sample consisted of 7,583 units in 903 hospitals. Relationships over time were examined using multilevel (units nested in hospitals) latent growth curve modeling. The model indices indicated a good fit of the data to the model. At the unit level, there was a small statistically significant inverse relationship (r = -.08, p = .04) between RN national nursing specialty certification rates and total fall rates; increases in specialty certification rates over time tended to be associated with improvements in total fall rates over time. Our findings may be supportive of promoting national nursing specialty certification as a means of improving patient safety. Future study recommendations are (a) modeling organizational leadership, culture, and climate as mediating variables between national specialty certification rates and patient outcomes and (b) investigating the association of patient safety and specific national nursing specialty certifications which test plans include patient safety, quality improvement, and diffusion of innovation methods in their certifying examinations.

  15. International dermatology: the many faces and challenges of the specialty in the global village.

    PubMed

    Lotti, Torello; Handog, Evangeline B; Hercogová, Jana; Ramos-E-Silva, Marcia

    2008-04-01

    The technical advances of the last century changed the understanding of the science of cutaneous physiology and pathology and the role of the dermatologist. The major challenges the international dermatologic community faces today are the lack of a common, logical, and accepted language within the specialty; long-accepted but questionable policies to advance academic careers; and the marginalization of dermatology. Methods for communicating and circulating data and ideas also have changed radically. The distribution of knowledge and essential/practical tools in different regions of the world is inequitable, and developing countries must cope with the challenges of high-impact skin diseases.

  16. Association of gender and specialty interest with video-gaming, three-dimensional spatial analysis, and entry-level laparoscopic skills in third-year veterinary students.

    PubMed

    Bragg, Heather R; Towle Millard, Heather A; Millard, Ralph P; Constable, Peter D; Freeman, Lyn J

    2016-06-15

    OBJECTIVE To determine whether gender or interest in pursuing specialty certification in internal medicine or surgery was associated with video-gaming, 3-D spatial analysis, or entry-level laparoscopic skills in third-year veterinary students. DESIGN Cross-sectional study. SAMPLE A convenience sample of 68 (42 female and 26 male) third-year veterinary students. PROCEDURES Participants completed a survey asking about their interest in pursuing specialty certification in internal medicine or surgery. Subsequently, participants' entry-level laparoscopic skills were assessed with 3 procedures performed in box trainers, their video-gaming skills were tested with 3 video games, and their 3-D spatial analysis skills were evaluated with the Purdue University Visualization of Rotations Spatial Test. Scores were assigned for laparoscopic, video-gaming, and 3-D spatial analysis skills. RESULTS Significantly more female than male students were interested in pursuing specialty certification in internal medicine (23/42 vs 7/26), and significantly more male than female students were interested in pursuing specialty certification in surgery (19/26 vs 19/42). Males had significantly higher video-gaming skills scores than did females, but spatial analysis and laparoscopic skills scores did not differ between males and females. Students interested in pursuing specialty certification in surgery had higher video-gaming and spatial analysis skills scores than did students interested in pursuing specialty certification in internal medicine, but laparoscopic skills scores did not differ between these 2 groups. CONCLUSIONS AND CLINICAL RELEVANCE For this group of students, neither gender nor interest in specialty certification in internal medicine versus surgery was associated with entry-level laparoscopy skills.

  17. Association of the 2011 ACGME Resident Duty Hour Reform with Postoperative Patient Outcomes in Surgical Specialties.

    PubMed

    Rajaram, Ravi; Chung, Jeanette W; Cohen, Mark E; Dahlke, Allison R; Yang, Anthony D; Meeks, Joshua J; Ko, Clifford Y; Tarpley, John L; Hoyt, David B; Bilimoria, Karl Y

    2015-09-01

    The 2011 ACGME resident duty hour reform implemented additional restrictions to existing duty hour policies. Our objective was to determine the association between this reform and patient outcomes among several surgical specialties. Patients from 5 surgical specialties (neurosurgery, obstetrics/gynecology, orthopaedic surgery, urology, and vascular surgery) were identified from the American College of Surgeons NSQIP. Data from 1 year before and 2 years after the reform was implemented were obtained for teaching and nonteaching hospitals. Hospital teaching status was defined based on the percentage of operations with a resident present intraoperatively. Difference-in-differences models were developed separately for each specialty and adjusted for patient demographics, comorbidities, procedural case-mix, and time trends. The association between duty hour reform and a composite measure of death or serious morbidity within 30 days of surgery was estimated for each specialty. The unadjusted rate of death or serious morbidity decreased during the study period in both teaching and nonteaching hospitals for all surgical specialties. In multivariable analyses, there were no significant associations between duty hour reform and the composite outcomes of death or serious morbidity in the 2 years post-reform for any surgical specialty evaluated (neurosurgery: odds ratio [OR] = 0.90; 95% CI, 0.75-1.08; p = 0.26; obstetrics/gynecology: OR = 0.96; 95% CI, 0.71-1.30; p = 0.80; orthopaedic surgery: OR = 0.95; 95% CI, 0.74-1.22; p = 0.70; urology: OR = 1.16; 95% CI, 0.89-1.51; p = 0.26; vascular surgery: OR = 1.07; 95% CI, 0.93-1.22; p = 0.35). Implementation of the 2011 ACGME resident duty hour reform was not associated with a significant change in patient outcomes for several surgical specialties in the 2 years after reform. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Longitudinal Association of Registered Nurse National Nursing Specialty Certification and Patient Falls in Acute Care Hospitals

    PubMed Central

    Boyle, Diane K.; Cramer, Emily; Potter, Catima; Staggs, Vincent S.

    2015-01-01

    Background Researchers have studied inpatient falls in relation to aspects of nurse staffing, focusing primarily on staffing levels and proportion of nursing care hours provided by registered nurses (RNs). Less attention has been paid to other nursing characteristics, such as RN national nursing specialty certification. Objective The aim of the study was to examine the relationship over time between changes in RN national nursing specialty certification rates and changes in total patient fall rates at the patient care unit level. Methods We used longitudinal data with standardized variable definitions across sites from the National Database of Nursing Quality Indicators. The sample consisted of 7,583 units in 903 hospitals. Relationships over time were examined using multilevel (units nested in hospitals) latent growth curve modeling. Results The model indices indicated a good fit of the data to the model. At the unit level, there was a small statistically significant inverse relationship (r = −.08, p = .04) between RN national nursing specialty certification rates and total fall rates; increases in specialty certification rates over time tended to be associated with improvements in total fall rates over time. Discussion Our findings may be supportive of promoting national nursing specialty certification as a means of improving patient safety. Future study recommendations are (a) modeling organizational leadership, culture, and climate as mediating variables between national specialty certification rates and patient outcomes and (b) investigating the association of patient safety and specific national nursing specialty certifications which test plans include patient safety, quality improvement, and diffusion of innovation methods in their certifying examinations. PMID:26049719

  19. Factors Associated with Intern Fatigue

    PubMed Central

    Vidyarthi, Arpana R.; Baron, Robert B.; Katz, Patricia P.

    2008-01-01

    ABSTRACT BACKGROUND Prior data suggest that fatigue adversely affects patient safety and resident well-being. ACGME duty hour limitations were intended, in part, to reduce resident fatigue, but the factors that affect intern fatigue are unknown. OBJECTIVE To identify factors associated with intern fatigue following implementation of duty hour limitations. DESIGN Cross-sectional confidential survey of validated questions related to fatigue, sleep, and stress, as well as author-developed teamwork questions. SUBJECTS Interns in cognitive specialties at the University of California, San Francisco. MEASUREMENTS Univariate statistics characterized the distribution of responses. Pearson correlations elucidated bivariate relationships between fatigue and other variables. Multivariate linear regression models identified factors independently associated with fatigue, sleep, and stress. RESULTS Of 111 eligible interns, 66 responded (59%). In a regression analysis including gender, hours worked in the previous week, sleep quality, perceived stress, and teamwork, only poorer quality of sleep and greater perceived stress were significantly associated with fatigue (p < 0.001 and p = 0.02, respectively). To identify factors that may affect sleep, specifically duty hours and stress, a secondary model was constructed. Only greater perceived stress was significantly associated with diminished sleep quality (p = 0.04), and only poorer teamwork was significantly associated with perceived stress (p < 0.001). Working >80 h was not significantly associated with perceived stress, quality of sleep, or fatigue. CONCLUSIONS Simply decreasing the number of duty hours may be insufficient to reduce intern fatigue. Residency programs may need to incorporate programmatic changes to reduce stress, improve sleep quality, and foster teamwork in order to decrease intern fatigue and its deleterious consequences. PMID:18807096

  20. Factors associated with intern fatigue.

    PubMed

    Friesen, Lindsay D; Vidyarthi, Arpana R; Baron, Robert B; Katz, Patricia P

    2008-12-01

    Prior data suggest that fatigue adversely affects patient safety and resident well-being. ACGME duty hour limitations were intended, in part, to reduce resident fatigue, but the factors that affect intern fatigue are unknown. To identify factors associated with intern fatigue following implementation of duty hour limitations. Cross-sectional confidential survey of validated questions related to fatigue, sleep, and stress, as well as author-developed teamwork questions. Interns in cognitive specialties at the University of California, San Francisco. Univariate statistics characterized the distribution of responses. Pearson correlations elucidated bivariate relationships between fatigue and other variables. Multivariate linear regression models identified factors independently associated with fatigue, sleep, and stress. Of 111 eligible interns, 66 responded (59%). In a regression analysis including gender, hours worked in the previous week, sleep quality, perceived stress, and teamwork, only poorer quality of sleep and greater perceived stress were significantly associated with fatigue (p < 0.001 and p = 0.02, respectively). To identify factors that may affect sleep, specifically duty hours and stress, a secondary model was constructed. Only greater perceived stress was significantly associated with diminished sleep quality (p = 0.04), and only poorer teamwork was significantly associated with perceived stress (p < 0.001). Working >80 h was not significantly associated with perceived stress, quality of sleep, or fatigue. Simply decreasing the number of duty hours may be insufficient to reduce intern fatigue. Residency programs may need to incorporate programmatic changes to reduce stress, improve sleep quality, and foster teamwork in order to decrease intern fatigue and its deleterious consequences.

  1. E-cigarette specialty retailers: Data to assess the association between retail environment and student e-cigarette use.

    PubMed

    Bostean, Georgiana; Crespi, Catherine M; Vorapharuek, Patsornkarn; McCarthy, William J

    2017-04-01

    The retail environment is a major social determinant of health, yet little is known about the e-cigarette specialty retailer environment. The e-cigarette specialty retail environment may be associated with e-cigarette use by middle and high school students, an issue that was addressed in a recent article entitled, "E-cigarette use among students and e-cigarette specialty retailer presence near schools," by Bostean and colleagues (G. Bostean, C.M. Crespi, P. Vorapharuek, W.J. McCarthy, 2016 [1]). We present data relating to e-cigarette specialty retailers in Orange County, California. We describe the data collection method (including the search methodology to identify e-cigarette specialty retailers), present descriptive retailer data including school proximity, and provide data from multi-level regressions predicting individual-level student use of e-cigarettes based on presence of an e-cigarette specialty retailer in proximity to schools.

  2. International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres

    PubMed Central

    2010-01-01

    Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Methods Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. Results We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations. Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. Conclusions The improved

  3. International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres.

    PubMed

    van Lent, Wineke A M; de Beer, Relinde D; van Harten, Wim H

    2010-08-31

    Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations.Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found. The improved benchmarking process and the success

  4. Gender Associated with the Intention to Choose a Medical Specialty in Medical Students: A Cross-Sectional Study in 11 Countries in Latin America.

    PubMed

    Ng-Sueng, Luis Fernando; Vargas-Matos, Iván; Mayta-Tristán, Percy; Pereyra-Elías, Reneé; Montenegro-Idrogo, Juan José; Inga-Berrospi, Fiorella; Ancalli, Felix; Bonilla-Escobar, Francisco; Diaz-Velez, Cristian; Gutierrez-Quezada, Erick; Gomez-Alhach, Jennifer; Muñoz-Medina, Carlos E; Sanchez-Pozo, Adriana; Vidal, Milisen

    2016-01-01

    The selection of a medical specialty has been associated with multiple factors, such as personal preferences, academic exposure, motivational factors and sociodemographic factors, such as gender. The number of women in the medical field has increased in recent years. In Latin America, we have not found any studies that explore this relationship. To determine whether there is an association between gender and the intention to choose a medical specialty in medical students from 11 countries in Latin America. Secondary analysis of the Collaborative Working Group for the Research of Human Resources for Health (Red-LIRHUS) data; a multi-country project of students in their first year and fifth year of study, from 63 medical schools in 11 Latin American countries. All students who referred intention to choose a certain medical specialty were considered as participants. Of the 11073 surveyed students, 9235 indicated the name of a specific specialty. The specialties chosen most often in the fifth year were General Surgery (13.0%), Pediatrics (11.0%), Internal Medicine (10.3%) and Obstetrics/Gynecology (9.0%). For women, the top choices were Pediatrics (15.8%), Obstetrics/Gynecology (11.0%), Cardiology (8.7%), General Surgery (8.6%), and Oncology (6.4%). In the adjusted analysis, the female gender was associated with the choice of Obstetrics/Gynecology (RP: 2.75; IC95%: 2.24-3.39); Pediatric Surgery (RP: 2.19; IC95%: 1.19-4.00), Dermatology (RP: 1.91; IC95%:1.24-2.93), Pediatrics (RP: 1.83; IC95%: 1.56-2.17), and Oncology (RP: 1.37; IC95%: 1.10-1.71). There is an association between the female gender and the intention to choose Obstetrics/Gynecology, Pediatrics, Pediatric Surgery, Dermatology, and Oncology. We recommend conducting studies that consider other factors that can influence the choice of a medical specialty.

  5. Filling the gaps: immersing student nurses in specialty nursing and professional associations.

    PubMed

    Vioral, Anna N

    2011-09-01

    The national nursing shortage demands innovative strategies to attract students to the nursing profession. This article provides a potential solution for recruiting and retaining nurses for specialty areas of nursing as well as professional nursing associations by pairing student nurses with professional nurses who belong to nursing associations. An immersion program such as the one described in this article provides a strategy that addresses the nursing work force shortage and professional association membership. The experiential knowledge gained through this type of program may advance the profession throughout the country.

  6. [Principles of cooperation between the specialties of internal medicine, pathology and clinical biochemistry].

    PubMed

    Hölzel, W; Baumgarten, R; Fiedler, H; Zimmermann, S

    1985-12-01

    The optimal utilization of the knowledge and possibilities of pathological and clinical biochemistry presumes a close cooperation between it and the clinical specialties. The common working team of the GDR Society of Internal Medicine and the GDR Society for Clinical Chemistry and Laboratory Diagnostics makes theses of the central points of the cooperation in care, education, further education and postgraduate study and in research a subject for discussion. As essential tasks in the process of medical care are regarded the balance of the examination programme standing at the disposal, the establishment of diagnostic programmes, the establishment of organisational measures, the ascertainment of a use according to indication, the guarantee of the representance of examination material, the control of plausibility and the interpretation of test results. Since the realization of the tasks to a large extent depends on the cooperation of the specialities in education, further education and postgraduate study during the further education the clinician should become acquainted with the possibilities, the limits and the prerequisites for the performance of laboratory diagnostic investigations, the clinical biochemist with the problems of medical care and the value of the laboratory diagnosis in the total process of the treatment. In the field of research the result is a necessary cooperation in the clarification of patho-biochemical mechanisms, in the search for suitable laboratory diagnostic parameters for diagnostics and control of the course as well as in the statement of the validity of laboratory diagnostic parameters and parameter combinations taking into consideration the factors expenses, benefit and risk as well as further diagnostic possibilities.

  7. Association Between Use of Specialty Dietary Supplements and C-Reactive Protein Concentrations

    PubMed Central

    Kantor, Elizabeth D.; Lampe, Johanna W.; Vaughan, Thomas L.; Peters, Ulrike; Rehm, Colin D.; White, Emily

    2012-01-01

    Laboratory evidence suggests that certain specialty dietary supplements have antiinflammatory properties, though evidence in humans remains limited. Data on a nationally representative sample of 9,947 adults from the 1999–2004 cycles of the National Health and Nutrition Examination Survey were used to assess the associations between specialty supplement use and inflammation, as measured by serum high-sensitivity C-reactive protein (hs-CRP) concentration. Using survey-weighted multivariate linear regression, significant reductions in hs-CRP concentrations were associated with regular use of glucosamine (17%, 95% confidence interval (CI): 7, 26), chondroitin (22%, 95% CI: 8, 33), and fish oil (16%, 95% CI: 0.3, 29). No associations were observed between hs-CRP concentration and regular use of supplements containing methylsulfonylmethane, garlic, ginkgo biloba, saw palmetto, or pycnogenol. These results suggest that glucosamine and chondroitin supplements are associated with reduced inflammation in humans and provide further evidence to support an inverse association between use of fish oil supplements and inflammation. It is important to further investigate the potential antiinflammatory role of these supplements, as there is a need to identify safe and effective ways to reduce inflammation and the burden of inflammation-related diseases such as cancer and cardiovascular disease. PMID:23139249

  8. Specialty and Associate Specialist doctors: still the dependable backbone of genitourinary medicine.

    PubMed

    Lee, J D; Carlin, E M; Robinson, A

    2013-05-01

    Workforce planning is an inexact science. Specialty and Associate Specialist (SAS) doctors are rarely included in workforce analyses. Past studies have shown that SAS doctors are significant contributors to the work in genitourinary (GU) medicine clinics. This survey confirms the large amount of clinical work undertaken by SAS doctors. It appears that 51% of SAS doctors in GU plan to retire in the next 15 years and it is uncertain what effect the 2008 SAS contract will have on SAS recruitment. This information should be taken into consideration in future GUM workforce planning.

  9. International Radiosurgery Support Association

    MedlinePlus

    ... January 2003 IRSA® -- International RadioSurgery Association Since 1995, IRSA® , an independent organization, has dedicated itself ... went into remission. Read More... © Copyright IRSA® 1995-2017 Terms of Service | Medical Advisors | Resources | About ...

  10. Endoscopist Specialty Is Associated with High-Quality Endoscopy in Korea

    PubMed Central

    Cha, Jae Myung; Lee, Hang Lack; Kim, Young Ho; Chung, Il-Kwun; Kim, Hyun Soo; Moon, Jeong Seop; Cho, Yu Kyung

    2012-01-01

    Purpose The present study was aimed to determine whether endoscopist specialty is associated with high-quality endoscopy. Materials and Methods We prospectively collected endoscopy quality related data based on the Endoscopy Quality Rating Scale (EQRS) of 277 endoscopy units in a hospital setting from the National Cancer Screening Program of Korea in 2009. Gastroenterology medical professors (n=154) from university hospitals visited each endoscopy unit and graded the unit according to the EQRS. The scores from the EQRS were analyzed and compared in relation to endoscopy training during residency and endoscopy subspecialist certification. Results After excluding data from 3 endoscopy units, EQRS data from 274 endoscopy units were analyzed: 263 esophagogastroduodenoscopy (EGD) screening units and 90 colonoscopy screening units. There were no significant differences in the scores of EQRS with respect to endoscopy training during residency (p=no significance), except for scores of EGDs for "Facility and Equipment" (p=0.030). However, EQRS scores were significantly higher in the endoscopy units where endoscopy subspecialists performed the endoscopies than those where Endoscopy Subspecialists did not perform the endoscopies (p<0.05, except p=0.08 for the "Process" criteria of EGD). Conclusion Endoscopist specialty is an important determinant of high-quality endoscopy in Korea. PMID:22318818

  11. Association between Physician Specialty and Risk of Prescribing Inappropriate Pill Splitting

    PubMed Central

    Chou, Chia-Yu; Hsu, Chia-Chen; Chiang, Shu-Chiung; Ho, Chin-Chin; Chou, Chia-Lin; Wu, Min-Shan; Chang, Yuh-Lih; Tsai, Han-Yi; Chen, Tzeng-Ji; Chou, Yueh-Ching

    2013-01-01

    Background Prescription errors that occur due to the process of pill splitting are a common medication problem; however, available prescription information involving inappropriate pill splitting and its associated factors is lacking. Methods We retrospectively evaluated a cohort of ambulatory prescriptions involving extended-release or enteric-coated formulations in a Taiwan medical center during a 5-month period in 2010. For this study, those pill splitting prescriptions involving special oral formulations were defined as inappropriate prescriptions. Information obtained included patient demographics, prescriber specialty and prescription details, which were assessed to identify factors associated with inappropriate pill splitting. Results There were 1,252 inappropriate prescriptions identified in this cohort study, representing a prescription frequency for inappropriate pill splitting of 1.0% among 124,300 prescriptions with special oral formulations. Among 35 drugs with special oral formulations in our study, 20 different drugs (57.1%, 20/35) had ever been prescribed to split. Anti-diabetic agents, cardiovascular agents and central nervous system agents were the most common drug classes involved in inappropriate splitting. The rate of inappropriate pill splitting was higher in older (over 65 years of age) patients (1.1%, 832/75,387). Eighty-seven percent (1089/1252) of inappropriate prescriptions were prescribed by internists. The rate of inappropriate pill splitting was highest from endocrinologists (3.4%, 429/12,477), nephrologists (1.3%, 81/6,028) and cardiologists (1.3%, 297/23,531). Multivariate logistic regression analysis revealed that the strongest factor associated with individual specific drug of inappropriate splitting was particular physician specialties. Conclusion This study provides important insights into the inappropriate prescription of special oral formulation related to pill splitting, and helps to aggregate information that can assist

  12. Clays, specialty

    USGS Publications Warehouse

    Virta, R.L.

    1998-01-01

    Part of a special section on the state of industrial minerals in 1997. The state of the specialty clay industry worldwide for 1997 is discussed. The specialty clays mined in the U.S. are ball clay, fuller's earth, bentonite, fire clay, and kaolin. Sales of specialty clays in the U.S. were around 17 Mt in 1997. Approximately 53 kt of specialty clays were imported.

  13. 1st college of physicians lecture: the role of internal medicine as a specialty in the era of subspecialisation.

    PubMed

    Chee, Y C

    2004-11-01

    This paper is divided into 4 parts. The first deals with the definition of specialties and traces its roots from the early 20th century in the United States of America with the formation and growth of Specialty Boards. The second is a reflection on the scene in Singapore from the 1960s to the present, describing the change from public healthcare institutions run by the civil service to the autonomous restructured public service hospitals towards the end of the 20th century. The third section deals with what the 4ps have expressed about changes necessary to the Singapore system in the 21st century. The 4ps are the politicians, the payers, the patients and the public. It is about value for money, better coordination and better communication. Finally, just what is Internal Medicine - its competencies and its practice. A review of the systems in Australia, New Zealand, and the USA is presented. The idea of the "hospitalist" is discussed. Concluding remarks deal with the viability of Internal Medicine because of low reimbursement, administrative burdens and brief patient visits.

  14. Physicians' intention to stay in or leave primary care specialties and variables associated with such intention.

    PubMed

    Xu, G; Veloski, J J; Hojat, M; Fields, S K

    1995-03-01

    A national mail survey of primary care physicians was conducted in 1993 to examine the differences between those who planned to leave and those who planned to stay in primary care disciplines. The physicians who planned to stay in primary care were those who, at the time of choosing primary care specialties, were more influenced by factors such as personal social values, religion, and the presence of a role model prior to medical school. Physicians' race, sex, workload, debt, place where they grew up, family income as a child, and timing when they made the decision to enter primary care disciplines are not associated with their plans to stay in or leave primary care disciplines. Findings indicated that personal social values, religious beliefs, and the presence of a role model prior to medical school not only influenced physicians' choice of primary care, but had a lasting effect on their commitment to such choice.

  15. [Certification of internal medicine specialists in Chile by the autonomous corporation for certification of medical specialties].

    PubMed

    López M, José M

    2013-05-01

    Since 1984, 12.294 different medical specialists have been certified in Chile by the Autonomous Corporation for Certification of Medical Specialties (whose Spanish acronym is CONACEM). Infernal Medicine certification started in 1985, approving 1364 candidates thus far. Certification can be obtained in three ways. Sixty one percent of applicants were approved by a reputable university specialization program. Thirty five percent of applicants fulfilled the requirements of a five years practical training program and less than 5% were approved in a training program from another country which was validated in Chile. There are 13 university training programs for medical specialties, lasting three years each. These programs can receive a total of 110 students per year. Half of these programs are not carried out in Santiago. Applicants, who have not completed a certified university training program, must go through a five days practical examination. Since 2002 a written test was added, whose approval is a requisite to gain access to the practical examination. Sixty one percent of applicants have approved the theoretical test. Certifications last 10 years initially and seven years, there after. When certifications expire, a recertification mechanism is required, whose requirements are informed. According to the current legislation, certifications must be done by recognized accrediting agencies. CONACEM has been accepted by the authority and its definitive legal recognition should be a reality soon.

  16. Specialties and the specialty boards.

    PubMed

    Holden, W D

    1976-06-01

    As specialism has developed in the United States, multiple specialty societies and specialty boards have been created. Although they, in a very realistic fashion, have established the general standards for the delivery of specialty care and for graduate medical education, they, with other national medical organizations such as the American Medical Association, the Association of American Medical Colleges, and the American Hospital Association, function with a considerable degree of independence. There is lacking a cohesive and integrated effort to develop unified attitudes, postures, and policies that represent the medical profession and the health care industry in general. Recently the Coordinating Council on Medical Education and the Liaison Committee on Graduate Medical Education have been established. These two agencies represent a significant attempt to integrate policies for medical education and to identify a single accrediting agency that will apply uniform standards to the process of accrediting programs of graduate medical education. The federal government for the past several years has had an increasing interest in the health care industry and medical education. Many legislative bills have been passed which have imposed more and more regulations on medicine and have established more bureaucratic control over the professional activities of physicians. Insidiously the medical profession is being socialized. If accountability for the public welfare cannot be exercised by medicine, at least in the perspective of the federal government, more and more legislation and regulation are inevitable. The pluralistic structure of organized medicine will ultimately be self defeating. Cohesive policies on behalf of the medical profession must be developed if leadership in medicine is to remain in the private sector. The Coordinating Council on Medical Education is unquestionably a significant attempt to demonstrate public accountability. It is, however, only the first

  17. Association of prescription abandonment with cost share for high-cost specialty pharmacy medications.

    PubMed

    Gleason, Patrick P; Starner, Catherine I; Gunderson, Brent W; Schafer, Jeremy A; Sarran, H Scott

    2009-10-01

    In 2008, specialty medications accounted for 15.1% of total pharmacy benefit medication spending, and per member expenditures have increased by 11.1% annually from 2004 to 2008 within a commercially insured population of 8 million members. Insurers face increasing pressure to control specialty medication expenditures and to rely on increasing member cost share through creation of a fourth copayment tier within the incentive-based formulary pharmacy benefit system. Data are needed on the influence that member out-of-pocket (OOP) expense may have on prescription abandonment (defined as the patient never actually taking possession of the medication despite evidence of a written prescription generated by a prescriber). To explore the relationship between prescription abandonment and OOP expense among individuals newly initiating high-cost medication therapy with a tumor necrosis factor (TNF) blocker or multiple sclerosis (MS) biologic agent. This observational cross-sectional study queried a midwestern and southern U.S. database of 13,172,480 commercially insured individuals to find members with a pharmacy benefit-adjudicated claim for a TNF blocker or MS specialty medication during the period from July 2006 through June 2008. Prescription abandonment was assessed among continuously enrolled members newly initiating TNF blocker or MS therapy. Prescription abandonment was defined as reversal of the adjudicated claim with no evidence of a subsequent additional adjudicated paid claim in the ensuing 90 days. Separate analyses for MS and TNF blocker therapy were performed to assess the association between member OOP expense and abandonment rate using the Cochran-Armitage test for trend and multivariate logistic regression. Members were placed into 1 of the 7 following OOP expense groups per claim: $0-$100, $101-$150, $151-$200, $201-$250, $251-$350, $351-$500, or more than $500. The association of MS or TNF blocker abandonment rate with OOP expense was tested with logistic

  18. Gender Associated with the Intention to Choose a Medical Specialty in Medical Students: A Cross-Sectional Study in 11 Countries in Latin America

    PubMed Central

    Mayta-Tristán, Percy; Pereyra-Elías, Reneé; Montenegro-Idrogo, Juan José; Inga-Berrospi, Fiorella; Ancalli, Felix; Bonilla-Escobar, Francisco; Diaz-Velez, Cristian; Gutierrez-Quezada, Erick; Gomez-Alhach, Jennifer; Muñoz-Medina, Carlos E.; Sanchez-Pozo, Adriana; Vidal, Milisen

    2016-01-01

    Introduction The selection of a medical specialty has been associated with multiple factors, such as personal preferences, academic exposure, motivational factors and sociodemographic factors, such as gender. The number of women in the medical field has increased in recent years. In Latin America, we have not found any studies that explore this relationship. Objective To determine whether there is an association between gender and the intention to choose a medical specialty in medical students from 11 countries in Latin America. Methods Secondary analysis of the Collaborative Working Group for the Research of Human Resources for Health (Red-LIRHUS) data; a multi-country project of students in their first year and fifth year of study, from 63 medical schools in 11 Latin American countries. All students who referred intention to choose a certain medical specialty were considered as participants. Results Of the 11073 surveyed students, 9235 indicated the name of a specific specialty. The specialties chosen most often in the fifth year were General Surgery (13.0%), Pediatrics (11.0%), Internal Medicine (10.3%) and Obstetrics/Gynecology (9.0%). For women, the top choices were Pediatrics (15.8%), Obstetrics/Gynecology (11.0%), Cardiology (8.7%), General Surgery (8.6%), and Oncology (6.4%). In the adjusted analysis, the female gender was associated with the choice of Obstetrics/Gynecology (RP: 2.75; IC95%: 2.24–3.39); Pediatric Surgery (RP: 2.19; IC95%: 1.19–4.00), Dermatology (RP: 1.91; IC95%:1.24–2.93), Pediatrics (RP: 1.83; IC95%: 1.56–2.17), and Oncology (RP: 1.37; IC95%: 1.10–1.71). Conclusions There is an association between the female gender and the intention to choose Obstetrics/Gynecology, Pediatrics, Pediatric Surgery, Dermatology, and Oncology. We recommend conducting studies that consider other factors that can influence the choice of a medical specialty. PMID:27519055

  19. High mercury seafood consumption associated with fatigue at specialty medical clinics on Long Island, NY

    PubMed Central

    Kothari, Shivam; Kruse, Danielle; Karimi, Roxanne; Silbernagel, Susan; Gursoy, Nurcan; Jaber, Raja; Roppelt, Heidi; Awan, Rina; Gold, Avram; Meliker, Jaymie R.

    2015-01-01

    We investigated the association between seafood consumption and symptoms related to potential mercury toxicity in patients presenting to specialty medical clinics at Stony Brook Medical Center on Long Island, New York. We surveyed 118 patients from April–August 2012 about their seafood consumption patterns, specifically how frequently they were eating each type of fish, to assess mercury exposure. We also asked about symptoms associated with mercury toxicity including depression, fatigue, balance difficulties, or tingling around the mouth. Of the 118 adults surveyed, 14 consumed high mercury seafood (tuna steak, marlin, swordfish, or shark) at least weekly. This group was more likely to suffer from fatigue than other patients (p = 0.02). Logistic regression confirmed this association of fatigue with frequent high mercury fish consumption in both unadjusted analysis (OR = 5.53; 95% CI: 1.40–21.90) and analysis adjusted for age, race, sex, income, and clinic type (OR = 7.89; 95% CI: 1.63–38.15). No associations were observed between fish intake and depression, balance difficulties, or tingling around the mouth. Findings suggest that fatigue may be associated with eating high mercury fish but sample size is small. Larger studies are needed to determine whether fish intake patterns or blood mercury tests warrant consideration as part of the clinical work-up in coastal regions. PMID:26844152

  20. Estimated cost savings associated with the transfer of office-administered specialty pharmaceuticals to a specialty pharmacy provider in a Medical Injectable Drug program.

    PubMed

    Baldini, Christopher G; Culley, Eric J

    2011-01-01

    A large managed care organization (MCO) in western Pennsylvania initiated a Medical Injectable Drug (MID) program in 2002 that transferred a specific subset of specialty drugs from physician reimbursement under the traditional "buy-and-bill" model in the medical benefit to MCO purchase from a specialty pharmacy provider (SPP) that supplied physician offices with the MIDs. The MID program was initiated with 4 drugs in 2002 (palivizumab and 3 hyaluronate products/derivatives) growing to more than 50 drugs by 2007-2008. To (a) describe the MID program as a method to manage the cost and delivery of this subset of specialty drugs, and (b) estimate the MID program cost savings in 2007 and 2008 in an MCO with approximately 4.6 million members. Cost savings generated by the MID program were calculated by comparing the total actual expenditure (plan cost plus member cost) on medications included in the MID program for calendar years 2007 and 2008 with the total estimated expenditure that would have been paid to physicians during the same time period for the same medication if reimbursement had been made using HCPCS (J code) billing under the physician "buy-and-bill" reimbursement rates. For the approximately 50 drugs in the MID program in 2007 and 2008, the drug cost savings in 2007 were estimated to be $15.5 million (18.2%) or $290 per claim ($0.28 per member per month [PMPM]) and about $13 million (12.7%) or $201 per claim ($0.23 PMPM) in 2008. Although 28% of MID claims continued to be billed by physicians using J codes in 2007 and 22% in 2008, all claims for MIDs were limited to the SPP reimbursement rates. This MID program was associated with health plan cost savings of approximately $28.5 million over 2 years, achieved by the transfer of about 50 physician-administered injectable pharmaceuticals from reimbursement to physicians to reimbursement to a single SPP and payment of physician claims for MIDs at the SPP reimbursement rates.

  1. Factors associated with general practice specialty training satisfaction - results from the Finnish Physician Study.

    PubMed

    Aine, Tiina; Sumanen, Markku; Heikkilä, Teppo; Hyppölä, Harri; Halila, Hannu; Vänskä, Jukka; Kujala, Santero; Virjo, Irma O; Mattila, Kari

    2014-07-01

    In Finland, achieving licensure as a specialist in general practice takes six years, with four years of training in primary care. Usually training arrangements are evaluated by trainees and their trainers. In this study the opinions of licensed GPs with experience of working in practice were specifically addressed. Our aim was to evaluate Finnish general practitioners' satisfaction with their specialty training and with the training programme. Correlations between these evaluations were investigated using logistic regression analyses. Participants comprised 416 GPs and 131 GP trainees, who responded to the Finnish Physician 2008 Study (response rate 53.7%). The respondents were asked how satisfied they were with their own specialty training in general, how satisfied they were with 12 items in their specialty training programme, and how well specialty training matched the requirements of GP work. Two-thirds of GPs and GP trainees were satisfied with their specialty training. Almost three in four felt that GP training succeeded in matching the requirements of work in general practice. Good ratings of diagnostic skill learning during GP training were predictive of overall training satisfaction. Clinical training relevant to GP work is the key element in ensuring satisfaction with general practice specialty training. The views of qualified GPs with experience gained in work provide a valuable addition to the total transformational quality management of GP training.

  2. Association Between Physician Specialty and Uptake of New Medical Technologies: HPV Tests in Florida Medicaid

    PubMed Central

    2010-01-01

    BACKGROUND It is well established that specialists often adopt new medical technologies earlier than generalists, and that racial and ethnic minority patients are less likely than White patients to receive many procedures and prescription drugs. However, little is known about the role that specialists or generalists may play in reducing racial and ethnic disparities in uptake of new medical technologies. Human papillomavirus (HPV) DNA tests, introduced as a cervical cancer screening tool in 2000, present a rich context for exploring patterns of use across patient and provider subgroups. OBJECTIVE To identify patient characteristics and the provider specialty associated with overall and appropriate use of HPV DNA tests over time, and to examine the associations between clinical guidelines and adoption of the test in an underserved population. DESIGN Retrospective longitudinal study using Florida Medicaid administrative claims data. PARTICIPANTS Cervical cancer screening test claims for 415,239 female beneficiaries ages 21 to 64 from July 2001 through June 2006. MAIN MEASURES Overall and appropriate use of HPV DNA tests. KEY RESULTS Although minority women were initially less likely than White women to receive HPV DNA tests, test use grew more rapidly among Black and Hispanic women compared to White women. Obstetricians/gynecologists were significantly more likely than primary care providers to administer HPV DNA tests. Release of the first set of clinical guidelines was associated with a large increase in the use of HPV DNA tests (adjusted odds ratio: 2.46, p < 0.0001); subsequent guidelines were associated with more modest increases. CONCLUSIONS Uptake of new cervical cancer screening protocols can occur quickly among traditionally underserved groups and may be aided by early adoption by specialists. PMID:20582485

  3. Association between physician specialty and uptake of new medical technologies: HPV tests in Florida Medicaid.

    PubMed

    Price, Rebecca Anhang

    2010-11-01

    It is well established that specialists often adopt new medical technologies earlier than generalists, and that racial and ethnic minority patients are less likely than White patients to receive many procedures and prescription drugs. However, little is known about the role that specialists or generalists may play in reducing racial and ethnic disparities in uptake of new medical technologies. Human papillomavirus (HPV) DNA tests, introduced as a cervical cancer screening tool in 2000, present a rich context for exploring patterns of use across patient and provider subgroups. To identify patient characteristics and the provider specialty associated with overall and appropriate use of HPV DNA tests over time, and to examine the associations between clinical guidelines and adoption of the test in an underserved population. Retrospective longitudinal study using Florida Medicaid administrative claims data. Cervical cancer screening test claims for 415,239 female beneficiaries ages 21 to 64 from July 2001 through June 2006. Overall and appropriate use of HPV DNA tests. Although minority women were initially less likely than White women to receive HPV DNA tests, test use grew more rapidly among Black and Hispanic women compared to White women. Obstetricians/gynecologists were significantly more likely than primary care providers to administer HPV DNA tests. Release of the first set of clinical guidelines was associated with a large increase in the use of HPV DNA tests (adjusted odds ratio: 2.46, p<0.0001); subsequent guidelines were associated with more modest increases. Uptake of new cervical cancer screening protocols can occur quickly among traditionally underserved groups and may be aided by early adoption by specialists.

  4. Anaesthesia-associated hypersensitivity reactions: seven years' data from a British bi-specialty clinic.

    PubMed

    Low, A E; McEwan, J C; Karanam, S; North, J; Kong, K-L

    2016-01-01

    Our bi-specialty clinic was established to systematically investigate patients with suspected peri-operative hypersensitivity reactions. Four hundred and ten patients were studied; 316 following an intra-operative reaction ('postoperative' group) and 94 with a previous history of reaction, referred before undergoing anaesthesia ('pre-operative' group). In the postoperative group, 173 (54.7%) were diagnosed with IgE-mediated reactions: 65 (37.6%) to neuromuscular blocking drugs; 54 (31.2%) antibiotics; 15 (8.7%) chlorhexidine and 12 (6.9%) patent blue dye. Reactions were severe in 114 patients (65.9%). All reactions to patent blue dye were severe. We identified IgE sensitisation in 22 (13.2%) cases with isolated mucocutaneous reactions. Only 173 (54.7%) patients had serum tryptase samples taken. Referrers' suspected causal agent was confirmed in only 37.2% of patients. Of 94 patients reviewed 'pre-operatively', 29 (30.8%) were diagnosed with IgE-mediated hypersensitivity reactions, reinforcing the importance of investigating this group of patients. Knowledge of the range of causative agents identified in our study should guide the investigation of suspected peri-operative hypersensitivity reactions. © 2015 The Association of Anaesthetists of Great Britain and Ireland.

  5. Surgical residency training and international volunteerism: a national survey of residents from 2 surgical specialties.

    PubMed

    Matar, Wadih Y; Trottier, Daniel C; Balaa, Fady; Fairful-Smith, Robin; Moroz, Paul

    2012-08-01

    Many low- and middle-income countries (LMICs) lack basic surgical resources, resulting in avoidable disability and mortality. Recently, residents in surgical training programs have shown increasing interest in overseas elective experiences to assist surgical programs in LMICs. The purpose of this study was to survey Canadian surgical residents about their interest in international volunteerism. We sent a web-based survey to all general and orthopedic surgery residents enrolled in surgical training programs in Canada. The survey assessed residents' interests, attitudes and motivations, and perceived barriers and aids with respect to international volunteerism. In all, 361 residents completed the survey for a response rate of 38.0%. Half of the respondents indicated that the availability of an international surgery elective would have positively influenced their selection of a residency program. Excluding the 18 residents who had volunteered during residency, 63.8% of the remaining residents confirmed an interest in international volunteering with "contributing to an important cause," "teaching" and "tourism/cultural enhancement" as the leading reasons for their interest. Perceived barriers included "lack of financial support" and "lack of available organized opportunities." All (100%) respondents who had done an international elective during residency confirmed that they would pursue such work in the future. Administrators of Canadian surgical programs should be aware of strong resident interest in global health care and accordingly develop opportunities by encouraging faculty mentorships and resources for global health teaching.

  6. Surgical residency training and international volunteerism: a national survey of residents from 2 surgical specialties

    PubMed Central

    Matar, Wadih Y.; Trottier, Daniel C.; Balaa, Fady; Fairful-Smith, Robin; Moroz, Paul

    2012-01-01

    Background Many low- and middle-income countries (LMICs) lack basic surgical resources, resulting in avoidable disability and mortality. Recently, residents in surgical training programs have shown increasing interest in overseas elective experiences to assist surgical programs in LMICs. The purpose of this study was to survey Canadian surgical residents about their interest in international volunteerism. Methods We sent a web-based survey to all general and orthopedic surgery residents enrolled in surgical training programs in Canada. The survey assessed residents’ interests, attitudes and motivations, and perceived barriers and aids with respect to international volunteerism. Results In all, 361 residents completed the survey for a response rate of 38.0%. Half of the respondents indicated that the availability of an international surgery elective would have positively influenced their selection of a residency program. Excluding the 18 residents who had volunteered during residency, 63.8% of the remaining residents confirmed an interest in international volunteering with “contributing to an important cause,” “teaching” and “tourism/cultural enhancement” as the leading reasons for their interest. Perceived barriers included “lack of financial support” and “lack of available organized opportunities.” All (100%) respondents who had done an international elective during residency confirmed that they would pursue such work in the future. Conclusion Administrators of Canadian surgical programs should be aware of strong resident interest in global health care and accordingly develop opportunities by encouraging faculty mentorships and resources for global health teaching. PMID:22854155

  7. Associations of herbal and specialty supplements with lung and colorectal cancer risk in the VITamins and Lifestyle study.

    PubMed

    Satia, Jessie A; Littman, Alyson; Slatore, Christopher G; Galanko, Joseph A; White, Emily

    2009-05-01

    Millions of Americans use dietary supplements with little knowledge about their benefits or risks. We examined associations of various herbal/specialty supplements with lung and colorectal cancer risk. Men and women, 50 to 76 years, in the VITamins And Lifestyle cohort completed a 24-page baseline questionnaire that captured duration (years) and frequency (days per week) of use of commonly used herbal/specialty supplements. Dose was not assessed due to the lack of accurate potency information. Supplement exposure was categorized as "no use" or "any use" over the previous 10 years. Hazard ratios (HR) were estimated by multivariate Cox regression models. Incident lung (n = 665) and colorectal cancers (n = 428) were obtained from the Surveillance, Epidemiology, and End Results cancer registry. Any use of glucosamine and chondroitin, which have anti-inflammatory properties, over the previous 10 years, was associated with significantly lower lung cancer risk: HR 0.74 [95% confidence interval (95% CI), 0.58-0.94] and HR 0.72 (95% CI, 0.54-0.96) and colorectal cancer risk: HR 0.73 (95% CI, 0.54-0.98) and HR 0.65 (95% CI, 0.45-0.93), respectively. There were also statistically significantly inverse associations of fish oil: HR 0.65 (95% CI, 0.42-0.99), methylsulfonylmethane: HR 0.46 (95% CI, 0.23-0.93), and St. John's wort: HR 0.35 (95% CI, 0.14-0.85) with colorectal cancer risk. In contrast, garlic pills were associated with a statistically significant 35% elevated colorectal cancer risk. These results suggest that some herbal/specialty supplements may be associated with lung and colorectal cancer risk; however, these products should be used with caution. Additional studies examining the effects of herbal/specialty supplements on risk for cancer and other diseases are needed.

  8. Wilson's Disease Association International

    MedlinePlus

    Administration Connect with Wilson Disease Association Send Email Physician Contacts List of Physicians and Institutions in Your Area View Contacts Support Contacts Individuals who can offer Support ...

  9. [The Brazilian Association of Workers' Medicine: a space for the constitution of occupational health as a medical specialty in Brazil in the 1940s].

    PubMed

    Almeida, Anna Beatriz de Sá

    2008-01-01

    This article analyzes the Brazilian Association of Workers' Medicine, created in the end of 1944 as a space for consolidating occupational health as a medical specialty in Brazil. The Association was founded by the first group of specialists in the field of occupational hygiene and medicine with seat at the facilities of the proper Ministry of Work, Industry and Commerce, where the founders were working. Counting on an initial core group of 35 physicians and five engineers, all of them coming from the Ministry, the main objective of the Association was to study, discuss and promote the issues related to workers' medicine. Among the most relevant activities promoted by the Association were the monthly scientific meetings (with lectures held by invited physicians and physicians and engineers of the Ministry itself), the organization of scientific events and the publication of a specialized periodical. In 1945, only one year after its foundation, the Association passed to make part of the International Bureau of Safety at Work, with seat in Montreal, Canada, and the International Bureau of Work of the International Labor Organization. In December 1945, on occasion of the election of the new board of directors, the Association created the Journal of Workers' Medicine, whose first issue was published in 1946.

  10. Health Care Delivery Practices in Huntington's Disease Specialty Clinics: An International Survey.

    PubMed

    Frich, Jan C; Rae, Daniela; Roxburgh, Richard; Miedzybrodzka, Zofia H; Edmondson, Mary; Pope, Erika Bjorklund; Goodman, LaVonne; Haddad, Monica S; Giuliano, Joe; Nelson, Eugene C; Guttman, Mark; Nance, Martha

    2016-06-27

    Little is known about the organization of clinical services for Huntington's disease (HD). To describe how health care services are organized and delivered in HD-clinics taking part in or eligible for the Enroll-HD study. In 2014, a 69-item survey was administered to sites taking part in or eligible for the Enroll-HD study. Of 231 sites surveyed, 121 (52.2%) sites in Europe, North America, Latin America, and Oceania responded. Most sites in the sample serve large populations, with 61.1% serving more than 1.5 million people, and a further 33% serving >500,000. Almost all (86.0%) centers see patients from outside their region. The majority of centers (59.7%) follow 50-199 patients, 21.9% care for more than 200. Most centers provide care in all stages of HD, and nearly all review pre-symptomatic cases. Multidisciplinary case reviews are offered in 54.5% of sites, with outreach clinics offered by 48.1%. Videoconferencing and telemedicine are used by 23.6%. Separate consultations for caregivers are offered in more than half of the centers. Most centers (70.4%) report following published guidelines or local care pathways for HD. Most centers serve a large population and use a multidisciplinary approach. The survey gives insight into factors underpinning HD service delivery globally. There is a need for more in-depth studies of clinical practice to understand how services are organized and how such features may be associated with quality of care.

  11. Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcus: Comparison of Diagnosis and Treatment in the Community and at a Specialty Clinic

    PubMed Central

    Gabbay, Vilma; Coffey, Barbara J.; Babb, James S.; Meyer, Laura; Wachtel, Carly; Anam, Seeba; Rabinovitz, Beth

    2009-01-01

    OBJECTIVES This study aimed to examine whether pediatric autoimmune neuropsychiatric disorders associated with streptococcus were appropriately diagnosed in the community and to determine subsequent rates of unwarranted use of antibiotic treatment for tics and obsessive-compulsive symptoms without the identification of an infection. METHODS The design was a retrospective, cross-sectional, observational study of 176 children and adolescents who were evaluated in a specialty program for tics, Tourette's disorder, and related problems. Previously published diagnostic criteria were used to establish the diagnosis of pediatric autoimmune neuropsychiatric disorders associated with streptococcus in our clinic. RESULTS Subjects were significantly less likely to receive a diagnosis of pediatric autoimmune neuropsychiatric disorders associated with streptococcus at the specialty clinic than in the community. In the community, subjects were significantly more likely to be treated with antibiotics or immunosuppressant medication if they received a diagnosis of pediatric autoimmune neuropsychiatric disorders associated with streptococcus. Of the 27 subjects with a community diagnosis of pediatric autoimmune neuropsychiatric disorders associated with streptococcus who were treated with antibiotics, 22 (82%) were treated without laboratory evidence of an infection; 2 were treated with immunomodulatory medications. CONCLUSIONS Our results support our hypothesis that pediatric autoimmune neuropsychiatric disorders associated with streptococcus are frequently diagnosed in the community without the application of all working diagnostic criteria. This phenomenon has resulted in unwarranted use of antibiotic treatment for tics/obsessive-compulsive disorder without evidence of laboratory infection. PMID:18676543

  12. [Presence of Nuclear Medicine in the Spanish journals of Internal Medicine and other specialties (2000-2009)].

    PubMed

    Durán-Ferreras, A; Sabaté-Díaz, J; Espigares-Jiménez, M

    2014-01-01

    This article aims to provide a quantitative and qualitative description of the publications on Nuclear Medicine (NM) in journals from other disciplines, between 2000 and 2009. A retrospective descriptive study was carried out including the years 2000-2009 in three internal medicine journals (IM) and in three related specialty journals (RS). The criteria used are that some of the authors were located professionally in a Service, Unit or Central MN and/or that the title of the article or at least its content made a reference to some specific aspect of NM. Date of publication, the magazine section, thematic, data of the authors, province and referral hospital were collected. A total of 186 articles were found, 81 in IM journals and 105 in RS. The IM journal articles came from 43 different hospitals. Vall d'Hebron (Barcelona, Spain) was the hospital with the largest volume. Twenty-four provinces were identified, Barcelona and Madrid standing out among them with 20 and 17 articles, respectively. In the RS journals, 59 hospitals/centers had participated, Vall d'Hebron standing out with 51 articles. There were 9 foreign articles. The articles were distributed into 19 provinces, Barcelona and Madrid standing out with 32 papers and 20 papers, respectively. There are at least twice as many articles in the RS Journals than in the IM ones. «Original» articles are the most frequent. The Clinical and Translational Oncology journal in RS and Medicina Clínica in IM stand out with the highest number of articles. No specific topic prevailed. Copyright © 2013 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  13. Specialty treatments

    Treesearch

    Rebecca E. Ibach

    2010-01-01

    Many specialty treatments can be applied to wood to either improve its performance or change its properties. Treatments addressed in this chapter are those that make permanent changes in the shape of a wood product, improvements in dimensional stability, or improvements in performance through combinations with nonwood resources

  14. Specialty treatments

    Treesearch

    Roger M. Rowell

    1999-01-01

    Many specialty treatments can be applied to wood to either improve its performance or change its properties. Treatments addressed in this chapter are those that make permanent changes in the shape of a wood product, improvements in dimensional stability, or improvements in performance through combinations with nonwood resources.

  15. International Association of School Librarianship.

    ERIC Educational Resources Information Center

    Genco, Peter J.

    1993-01-01

    Describes activities of the International Association of School Librarianship (IASL) that were conducted at the annual conference in Belfast (Northern Ireland), including the keynote address on managing school library change; talks about and tours of Belfast schools; professional awards; IASL objectives; board members; and future plans. (LRW)

  16. International Association of School Librarianship.

    ERIC Educational Resources Information Center

    Genco, Peter J.

    1994-01-01

    Reports on the International Association of School Librarianship (IASL), including an overview of organizational history; a review of the 1993 annual conference in Adelaide (Australia); descriptions of professional awards; lists of 1994-97 conference sites and board members; an address to contact for more information about the organization and its…

  17. International Association of School Librarianship.

    ERIC Educational Resources Information Center

    Genco, Peter J.

    1993-01-01

    Describes activities of the International Association of School Librarianship (IASL) that were conducted at the annual conference in Belfast (Northern Ireland), including the keynote address on managing school library change; talks about and tours of Belfast schools; professional awards; IASL objectives; board members; and future plans. (LRW)

  18. International Association of School Librarianship.

    ERIC Educational Resources Information Center

    Genco, Peter J.

    1994-01-01

    Reports on the International Association of School Librarianship (IASL), including an overview of organizational history; a review of the 1993 annual conference in Adelaide (Australia); descriptions of professional awards; lists of 1994-97 conference sites and board members; an address to contact for more information about the organization and its…

  19. The International Big History Association

    ERIC Educational Resources Information Center

    Duffy, Michael; Duffy, D'Neil

    2013-01-01

    IBHA, the International Big History Association, was organized in 2010 and "promotes the unified, interdisciplinary study and teaching of history of the Cosmos, Earth, Life, and Humanity." This is the vision that Montessori embraced long before the discoveries of modern science fleshed out the story of the evolving universe. "Big…

  20. The International Big History Association

    ERIC Educational Resources Information Center

    Duffy, Michael; Duffy, D'Neil

    2013-01-01

    IBHA, the International Big History Association, was organized in 2010 and "promotes the unified, interdisciplinary study and teaching of history of the Cosmos, Earth, Life, and Humanity." This is the vision that Montessori embraced long before the discoveries of modern science fleshed out the story of the evolving universe. "Big…

  1. [Publication rates of Turkish medical specialty and doctorate theses on Medical Microbiology, Clinical Microbiology and Infectious Diseases disciplines in international journals].

    PubMed

    Sipahi, Oğuz Reşat; Caglayan Serin, Derya; Pullukcu, Hüsnü; Tasbakan, Meltem; Köseli Ulu, Demet; Yamazhan, Tansu; Arda, Bilgin; Sipahi, Hilal; Ulusoy, Sercan

    2014-04-01

    Writing a thesis is mandatory for getting a postgraduate medical degree in Turkey. Publication of the results of the thesis in an indexed journal makes the results available to researchers, however publication rate is usually low. The aim of this retrospective observational study was to investigate the publication rate of Turkish Infectious Diseases and Clinical Microbiology, Medical Microbiology specialty theses and Microbiology doctorate theses in international peer-review journals. On August 17th 2007, the thesis database of the Council of Higher Education of the Republic of Turkey (YOK) where all specialization and doctorate theses are recorded obligatorily, was searched for Infectious Diseases and Clinical Microbiology and Medical Microbiology specialty and Microbiology doctorate theses. Assuming that publication of a thesis would last at least six months, theses dated to February 2007 and after were excluded. The publication rate of those theses was found out by searching Science Citation Index-Expanded database for thesis author and supervisor between August 17-September 12, 2007. Chi-square test was used for statistical analysis. Our search yielded a total of 834 theses dated from 1997 to 2007, however 10 of them were excluded, since they were dated to February 2007 or after. It was found that the overall publication rate was 11.4% (94/824). The publication rates for Microbiology doctorate, Medical Microbiology and Infectious Diseases and Clinical Microbiology specialty theses were 13.7% (34/249), 10.7% (33/309) and 10.2% (27/266), respectively, with no statistical significance (p> 0.05). It was determined that nine (9.6%) of the 94 published theses belonged to 1997-2001 period, whereas 85 (80.4%) were in 2002-2007 period (p< 0.05). The probable reason for this increase was thought to be related with the updated criteria of YOK carried out in 2000 for academic promotions, nevertheless the publication rate of the investigated theses in international peer

  2. The economics of specialty hospitals.

    PubMed

    Schneider, John E; Miller, Thomas R; Ohsfeldt, Robert L; Morrisey, Michael A; Zelner, Bennet A; Pengxiang Li

    2008-10-01

    Specialty hospitals, particularly those specializing in surgery and owned by physicians, have generated a relatively high degree of policy attention over the past several years. The main focus of policy debates has been in two areas: the extent to which specialty hospitals might compete unfairly with incumbent general hospitals and the extent to which physician ownership might be associated with higher usage. Largely absent from the debates, however, has been a discussion of the basic economic model of specialty hospitals. This article reviews existing literature, reports, and findings from site visits to explore the economic rationale for specialty hospitals. The discussion focuses on six factors associated with specialization: consumer demand, procedural operating margins, clinical efficiencies, procedural economies of scale, economies (and diseconomies) of scope, and competencies and learning. A better understanding of the economics of specialization will help policy makers evaluate the full spectrum of advantages and disadvantages of specialty hospitals.

  3. Changes in U.S. medical students' specialty interests over the course of medical school.

    PubMed

    Compton, Michael T; Frank, Erica; Elon, Lisa; Carrera, Jennifer

    2008-07-01

    Studies have examined factors affecting medical students' specialty choice, but little research exists on stability of these specialty interests. To describe patterns of change in specialty interests during medical school and examine associations between specialty change patterns and gender, desire for a high-prestige career, and interest in prevention. Medical students (Class of 2003) at 15 representative US schools were invited to complete surveys during freshman orientation, entry to wards, and senior year. This analysis used data from 942 students who completed all 3 surveys. In addition to a number of other items, students were asked to choose the 1 specialty they were most interested in pursuing. The most common specialty choices among freshman students were pediatrics (20%) and surgery (18%); least common choices were psychiatry and preventive medicine (1% each). General internal medicine was the initial specialty choice for 8%. Most students changed their specialty choices, regardless of initial interest. Only 30% of those initially interested in primary care (PC) remained interested at all 3 time points, compared to 68% of those initially interested in non-PC. Female versus male students were more commonly interested in PC at all 3 time points. Senior students interested in non-PC specialties were more likely to desire a high-prestige career (48%) than those interested in PC (31%). Medical students may benefit from more intensive introduction to some specialties earlier in pre-medical and medical education. In addition, increasing the prestige of PC fields may shape the physician workforce.

  4. History of Medical Specialty Interest Assessment

    ERIC Educational Resources Information Center

    Burns, Stephanie T.

    2016-01-01

    Medical specialties require decidedly different abilities, skills, and talents; which results in divergent experiences, lifestyles, skill sets, and income levels. To help medical students select their preferred medical specialty and alleviate shortages in medical specialty staffing, US medical schools and associations invest time and money in…

  5. Social dominance theory and medical specialty choice.

    PubMed

    Lepièce, Brice; Reynaert, Christine; van Meerbeeck, Philippe; Dory, Valérie

    2016-03-01

    Understanding how medical students select their specialty is a fundamental issue for public health and educational policy makers. One of the factors that students take into account is a specialty's prestige which hinges partly on its focus on technique rather than whole person. We examine the potential of a psychological framework, social dominance theory, to explain why some students, and not others, are drawn to more prestigious, technique-oriented specialties, based on their desire for hierarchy. We conducted a cross-sectional study among medical students at Institution X (N = 359). We examined the link between medical students' characteristics i.e. social dominance orientation (SDO), gender, age, and their career intention. We also examined level of medical students' SDO at different stages of the curriculum. SDO scores were significantly associated with technique-oriented career intentions (OR 1.56; 95 % CI [1.18, 2.06]; p = 0.001). The effect was independent of gender. Medical students' SDO scores were significantly higher in later stages of the medical curriculum (F = 6.79; p = 0. 001). SDO is a significant predictor of medical students' career intention. SDO scores are higher in students during the clinical phase of the curriculum. Medical socialization, involving the internalization of implicit and explicit norms, particularly in hospital settings, is likely to underpin our findings. This theory illuminates consistent findings in the literature on specialty prestige and the influence of medical school on career choice.

  6. The influence of temperament and character profiles on specialty choice and well-being in medical residents

    PubMed Central

    Sievert, Martin; Zwir, Igor; Cloninger, Kevin M.; Lester, Nigel; Rozsa, Sandor

    2016-01-01

    Background Multiple factors influence the decision to enter a career in medicine and choose a specialty. Previous studies have looked at personality differences in medicine but often were unable to describe the heterogeneity that exists within each specialty. Our study used a person-centered approach to characterize the complex relations between the personality profiles of resident physicians and their choice of specialty. Methods 169 resident physicians at a large Midwestern US training hospital completed the Temperament and Character Inventory (TCI) and the Satisfaction with Life Scale (SWLS). Clusters of personality profiles were identified without regard to medical specialty, and then the personality clusters were tested for association with their choice of specialty by co-clustering analysis. Life satisfaction was tested for association with personality traits and medical specialty by linear regression and analysis of variance. Results We identified five clusters of people with distinct personality profiles, and found that these were associated with particular medical specialties Physicians with an “investigative” personality profile often chose pathology or internal medicine, those with a “commanding” personality often chose general surgery, “rescuers” often chose emergency medicine, the “dependable” often chose pediatrics, and the “compassionate” often chose psychiatry. Life satisfaction scores were not enhanced by personality-specialty congruence, but were related strongly to self-directedness regardless of specialty. Conclusions The personality profiles of physicians were strongly associated with their medical specialty choices. Nevertheless, the relationships were complex: physicians with each personality profile went into a variety of medical specialties, and physicians in each medical specialty had variable personality profiles. The plasticity and resilience of physicians were more important for their life satisfaction than was

  7. The association between Myers-Briggs Type Indicator and Psychiatry as the specialty choice.

    PubMed

    Yang, Chong; Richard, George; Durkin, Martin

    2016-02-06

    The purpose of this pilot study is to examine the association between Myers-Briggs Type Indicator (MBTI) and prospective psychiatry residents. Forty-six American medical schools were contacted and asked to participate in this study. Data were collected and an aggregated list was compiled that included the following information: date of MBTI administration, academic year, MBTI form/version, residency match information and student demographic information. The data includes 835 American medical students who completed the MBTI survey and matched into a residency training program in the United States. All analyses were performed using R 3.1.2. The probability of an introvert matching to a psychiatry residency is no different than that of an extravert (p= 0.30). The probability of an intuitive individual matching to a psychiatry residency is no different than that of a sensing type (p=0.20). The probability of a feeling type matching to a psychiatry residency is no different than that of a thinking type (p= 0.50). The probability of a perceiving type matching to a psychiatry residency is no different than that of a judging type (p= 0.60). Further analyses may elicit more accurate information regarding the personality profile of prospective psychiatry residents. The improvement in communication, team dynamics, mentor-mentee relationships and reduction in workplace conflicts are possible with the awareness of MBTI personality profiles.

  8. The association between Myers-Briggs Type Indicator and Psychiatry as the specialty choice

    PubMed Central

    Richard, George; Durkin, Martin

    2016-01-01

    Objectives The purpose of this pilot study is to examine the association between Myers-Briggs Type Indicator (MBTI) and prospective psychiatry residents. Methods Forty-six American medical schools were contacted and asked to participate in this study. Data were collected and an aggregated list was compiled that included the following information: date of MBTI administration, academic year, MBTI form/version, residency match information and student demographic information. The data includes 835 American medical students who completed the MBTI survey and matched into a residency training program in the United States. All analyses were performed using R 3.1.2. Results The probability of an introvert matching to a psychiatry residency is no different than that of an extravert (p= 0.30). The probability of an intuitive individual matching to a psychiatry residency is no different than that of a sensing type (p=0.20). The probability of a feeling type matching to a psychiatry residency is no different than that of a thinking type (p= 0.50). The probability of a perceiving type matching to a psychiatry residency is no different than that of a judging type (p= 0.60). Conclusions Further analyses may elicit more accurate information regarding the personality profile of prospective psychiatry residents. The improvement in communication, team dynamics, mentor-mentee relationships and reduction in workplace conflicts are possible with the awareness of MBTI personality profiles. PMID:26851600

  9. Trends in Dental Specialty Education and Practice, 1990-99.

    ERIC Educational Resources Information Center

    Neumann, Laura M.; Nix, Judith A.

    2002-01-01

    Describes findings from a comprehensive study of American Dental Association-recognized dental specialties, including specialty practice and the practice environment, membership in specialty organizations, requirements and trends in board certification, advances in research and technology, and trends in advanced specialty education. (EV)

  10. [Risk factors associated with neonatal tumors. Experience of a pediatric environmental health specialty unit in Valencia (Spain)].

    PubMed

    Berbel Tornero, O; Ferrís i Tortajada, J; Donat Colomer, J; Ortega García, J A; Verdeguer Miralles, A

    2006-05-01

    Neonatal tumors (NT) result from a variable combination of constitutional and environmental determinants. Multiple risk factors (RF) are involved in their development, although most are unknown. To document the constitutional, environmental, preconceptional and transplacental RF associated with the development of NT with greater or lesser scientific evidence. We investigated known RF in NT diagnosed at La Fe University Children's Hospital from January 1990 to December 1999, using a questionnaire completed by parents in a personal interview, either at the Pediatric Environmental Health Specialty Unit (PEHSU-Valencia) or at their home. RF associated with NT and childhood cancer were identified through a literature review of the last 25 years through Medline, Cancerlit, Science Citation Index, and Embase. The questionnaire was completed in 59 of 74 NT diagnosed during the period studied. All patients were Caucasians born in Spain. Constitutional-genetic factors were identified in 13.6 %: dominant hereditary syndromes in 5 (familial retinoblastoma in 1 and tuberous sclerosis in 4), and non-hereditary chromosomal syndromes in 3 (trisomy 21). Notable environmental factors were: a) ionizing radiation: preconceptional exposure in 32.2 % and in utero exposure in 6.8 %; b) non-ionizing radiation; 54.2 % reported preconceptional exposure and in utero exposure at home; c) pregnancy-related problems: infections in 13.6 % (8 patients) and a prior history of miscarriage in 20.3 %; d) drugs/chemicals administered during pregnancy: capillary dye in 42.4 %, daily facial make-up in 45.8 %, antacids in 30.5 %, acetaminophen in 34 %, hormone therapy in 10 %, cocaine and marijuana consumption in 11.7 %; e) tobacco: exposure to active smoking in 93.2 % of patients; f) alcohol: in utero exposure in 6.8 %; g) occupational exposure in parents: paternal in 49 % of cases (hydrocarbons in 15, metal in 3, chemical in 2, timber in 2, and agriculture in 7). Four were exposed to pesticides, 3 to

  11. VHA Patient-Centered Medical Home Associated With Lower Rate of Hospitalizations and Specialty Care Among Veterans With Posttraumatic Stress Disorder.

    PubMed

    Randall, Ian; Mohr, David C; Maynard, Charles

    The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH) model, termed Patient Aligned Care Teams (PACT), in 2010. We assessed the association between PACT and the use of health services among U.S. veterans with posttraumatic stress disorder (PTSD). VHA clinical and administrative data were obtained for the pre-PACT period of April 1, 2009 to March 31, 2010 and post-PACT period of June 1, 2011 to May 31, 2012. Outcomes included hospitalizations, primary, specialty and mental health visits, and emergency department and urgent care visits. We utilized negative binomial regression and extended estimating equation models for the full sample. The analysis contained 696,379 unique veterans in both pre- and post-PACT periods. We estimated the linear incremental effect of PACT on utilization outcomes. PACT were associated with a decrease in hospitalizations (incremental effect [IE]: -0.02; 95% confidence interval [CI]: -0.03, -0.01), a decrease in specialty care visits (IE: -0.45; 95% CI: -0.07, -0.23), and an increase in primary care visits (IE: 0.96; 95% CI: 0.67, 1.25). The period following PACT implementation was associated with a lower rate of hospitalizations and specialty care visits, and a higher rate of primary care visits for veterans with PTSD, indicating enhanced access to primary care.

  12. VHA Patient-Centered Medical Home Associated With Lower Rate of Hospitalizations and Specialty Care Among Veterans With Posttraumatic Stress Disorder.

    PubMed

    Randall, Ian; Mohr, David C; Maynard, Charles

    2015-11-12

    The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH) model, termed Patient Aligned Care Teams (PACT), in 2010. We assessed the association between PACT and the use of health services among U.S. veterans with posttraumatic stress disorder (PTSD). VHA clinical and administrative data were obtained for the pre-PACT period of April 1, 2009 to March 31, 2010 and post-PACT period of June 1, 2011 to May 31, 2012. Outcomes included hospitalizations, primary, specialty and mental health visits, and emergency department and urgent care visits. We utilized negative binomial regression and extended estimating equation models for the full sample. The analysis contained 696,379 unique veterans in both pre- and post-PACT periods. We estimated the linear incremental effect of PACT on utilization outcomes. PACT were associated with a decrease in hospitalizations (incremental effect [IE]: -0.02; 95% confidence interval [CI]: -0.03, -0.01), a decrease in specialty care visits (IE: -0.45; 95% CI: -0.07, -0.23), and an increase in primary care visits (IE: 0.96; 95% CI: 0.67, 1.25). The period following PACT implementation was associated with a lower rate of hospitalizations and specialty care visits, and a higher rate of primary care visits for veterans with PTSD, indicating enhanced access to primary care.

  13. Gender difference in preference of specialty as a career choice among Japanese medical students.

    PubMed

    Kawamoto, Ryuichi; Ninomiya, Daisuke; Kasai, Yoshihisa; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Kumagi, Teru; Abe, Masanori

    2016-11-10

    In Japan, the absolute deficiency of doctors and maldistribution of doctors by specialty is a significant problem in the Japanese health care system. The purpose of this study was to investigate the factors contributing to specialty preference in career choice among Japanese medical students. A total of 368 medical students completed the survey giving an 88.2 % response rate. The subjects comprised 141 women aged 21 ± 3 (range, 18-34) years and 227 men aged 22 ± 4 (range, 18-44) years. Binary Logistic regression analysis was performed using specialty preferences as the criterion variable and the factors in brackets as six motivational variables (e.g., Factor 1: educational experience; Factor 2: job security; Factor 3: advice from others; Factor 4: work-life balance; Factor 5: technical and research specialty; and Factor 6: personal reasons). Women significantly preferred pediatrics, obstetrics & gynecology, and psychology than the men. Men significantly preferred surgery and orthopedics than the women. For both genders, a high odds ratio (OR) of "technical & research specialty" and a low OR for "personal reasons" were associated with preference for surgery. "Technical & research specialty" was positively associated with preference for special internal medicine and negatively for pediatrics. "Work-life balance" was positively associated with preference for psychology and negatively for emergency medicine. Among the women only, "technical & research specialty" was negatively associated with preference for general medicine/family medicine and obstetrics & gynecology, and "job security" was positively associated for general medicine/family medicine and negatively for psychology. Among men only, "educational experience" and "personal reasons" were positively, and "job security" was negatively associated with preference for pediatrics. For both genders, "work-life balance" was positively associated with preference for controllable lifestyle specialties. We

  14. [Influence of personality and learning styles in the choice of medical specialty].

    PubMed

    Bitran, Marcela; Zúñiga, Denisse; Lafuente, Monserrat; Viviani, Paola; Mena, Beltrán

    2005-10-01

    Several studies indicate that doctors who work in the same area of the medical profession tend to behave somehow similarly. Thus, it has been suggested that personality relates to the medical specialty choice. However, it is not known whether people self-select into the medical specialties according to their personality or the professional practice in a particular field influences their behavior. To explore the possible association between the graduate's personality features and learning styles and their chosen specialty. The psychological preferences and learning styles of 65 students of the 2001-graduating cohort of the Pontificia Universidad Católica de Chile School of Medicine were evaluated with the Myers Briggs Type Indicator and the Kolb Learning Style Inventory, respectively. These variables were correlated with the information of their specialty choice or occupation two years after graduation. Graduates distributed unevenly in different areas of the medical profession. Surgical specialties concentrated a larger proportion of extraverted, intuitive and structured doctors, whereas in Pediatrics and Internal Medicine predominated intuitive and people-oriented MD's. Primary Care concentrated individuals with introverted, intuitive and flexible attitudes. Convergent learners (interested in problem-solving) preferred Surgery and Primary Care whereas Assimilator learners (abstract-reflexive) chose more frequently Internal Medicine, Pediatrics and Psychiatry. According to their personality and learning style, graduates tend to self-select into different medical specialties. This information may help medical graduates to guide their specialty choice process, and medical educators to develop learning experiences that take into account the individual differences of their residents.

  15. Factors Influencing Internal Medicine Resident Choice of Infectious Diseases or Other Specialties: A National Cross-sectional Study

    PubMed Central

    Bonura, Erin M.; Lee, Eun Sul; Ramsey, Katrina; Armstrong, Wendy S.

    2016-01-01

    Background. Only 49% of infectious diseases (ID) fellowship programs were filled in 2015 through the national match, but little is known about internal medicine (IM) resident perceptions of ID and factors related to IM resident career choice. Methods. We conducted 25 interviews and disseminated a Web-based survey to graduating IM residents in the United States utilizing a 2-stage sampling strategy. Participants were categorized into 3 groups based on interest in ID: (1) applied/intended to apply to ID; (2) interested in ID but did not apply; (3) never interested in ID. We conducted all analysis using poststratification adjustment weights with survey data analysis procedures. Results. Of the 590 participants, 42 (7%) selected category 1, 188 (32%) category 2, and 360 (61%) category 3. Most (65%) developed an interest in their ultimate career before residency. Of those interested in ID, >52% rated their ID medical school curriculum as very good and influential on their interest in ID. Ninety-one percent of category 2 participants felt mentorship was influential on career choice, although 43% identified an ID mentor. Category 2 chose salary as the most dissuading factor and the most likely intervention to increase ID interest. Conclusions. In this nationally representative sample of graduating IM residents, most develop an interest in their ultimate career before residency. Factors influencing this decision reside in both medical school and residency, which is consistent with career decision-making constructs. By identifying career determining factors and understanding how they fit into medical training frameworks, we can develop targeted initiatives to reinvigorate interest in ID. PMID:27126345

  16. Health Care Delivery Practices in Huntington’s Disease Specialty Clinics: An International Survey

    PubMed Central

    Frich, Jan C.; Rae, Daniela; Roxburgh, Richard; Miedzybrodzka, Zofia H.; Edmondson, Mary; Pope, Erika Bjorklund; Goodman, LaVonne; Haddad, Monica S.; Giuliano, Joe; Nelson, Eugene C.; Guttman, Mark; Nance, Martha

    2016-01-01

    Background: Little is known about the organization of clinical services for Huntington’s disease (HD). Objective: To describe how health care services are organized and delivered in HD-clinics taking part in or eligible for the Enroll-HD study. Methods: In 2014, a 69-item survey was administered to sites taking part in or eligible for the Enroll-HD study. Results: Of 231 sites surveyed, 121 (52.2%) sites in Europe, North America, Latin America, and Oceania responded. Most sites in the sample serve large populations, with 61.1% serving more than 1.5 million people, and a further 33% serving >500,000. Almost all (86.0%) centers see patients from outside their region. The majority of centers (59.7%) follow 50–199 patients, 21.9% care for more than 200. Most centers provide care in all stages of HD, and nearly all review pre-symptomatic cases. Multidisciplinary case reviews are offered in 54.5% of sites, with outreach clinics offered by 48.1%. Videoconferencing and telemedicine are used by 23.6%. Separate consultations for caregivers are offered in more than half of the centers. Most centers (70.4%) report following published guidelines or local care pathways for HD. Conclusions: Most centers serve a large population and use a multidisciplinary approach. The survey gives insight into factors underpinning HD service delivery globally. There is a need for more in-depth studies of clinical practice to understand how services are organized and how such features may be associated with quality of care. PMID:27372053

  17. Specialty guidelines for forensic psychology.

    PubMed

    2013-01-01

    In the past 50 years forensic psychological practice has expanded dramatically. Because the practice of forensic psychology differs in important ways from more traditional practice areas (Monahan, 1980) the "Specialty Guidelines for Forensic Psychologists" were developed and published in 1991 (Committee on Ethical Guidelines for Forensic Psychologists, 1991). These Specialty Guidelines for Forensic Psychology were developed by the American Psychology-Law Society (Division 41 of the American Psychological Association [APA]) and the American Academy of Forensic Psychology. They were adopted by the APA Council of Representatives on August 3, 2011.

  18. Changes in U.S. Medical Students’ Specialty Interests over the Course of Medical School

    PubMed Central

    Frank, Erica; Elon, Lisa; Carrera, Jennifer

    2008-01-01

    Background Studies have examined factors affecting medical students’ specialty choice, but little research exists on stability of these specialty interests. Objective To describe patterns of change in specialty interests during medical school and examine associations between specialty change patterns and gender, desire for a high-prestige career, and interest in prevention. Design Medical students (Class of 2003) at 15 representative US schools were invited to complete surveys during freshman orientation, entry to wards, and senior year. Participants This analysis used data from 942 students who completed all 3 surveys. Measurements In addition to a number of other items, students were asked to choose the 1 specialty they were most interested in pursuing. Results The most common specialty choices among freshman students were pediatrics (20%) and surgery (18%); least common choices were psychiatry and preventive medicine (1% each). General internal medicine was the initial specialty choice for 8%. Most students changed their specialty choices, regardless of initial interest. Only 30% of those initially interested in primary care (PC) remained interested at all 3 time points, compared to 68% of those initially interested in non-PC. Female versus male students were more commonly interested in PC at all 3 time points. Senior students interested in non-PC specialties were more likely to desire a high-prestige career (48%) than those interested in PC (31%). Conclusions Medical students may benefit from more intensive introduction to some specialties earlier in pre-medical and medical education. In addition, increasing the prestige of PC fields may shape the physician workforce. PMID:18612751

  19. Surgical Specialty Residents More Likely to Receive the Arnold P. Gold Humanism and Excellence in Teaching Award.

    PubMed

    Falcone, John L

    2015-01-01

    The Arnold P. Gold Humanism and Excellence in Teaching Awards are given by medical students to residents. The aim of this study is to evaluate the distribution of this award based on residency specialty. The hypothesis is that surgical residents more commonly receive this award. This was a retrospective study from 2004 to 2013. All award recipients were obtained from the Arnold P. Gold Foundation website. The specialties of award recipients were tabulated. The number of award winners per thousand specialty residents was estimated using the Accreditation Council for Graduate Medical Education Data Resource Book, adjusting for the number of awarding schools and resident specialties. All statistics used an α = 0.05. There were 2489 awards given during the study period, with 52.6% in medical specialties and 47.4% in surgical specialties (p = 0.45). The specialties most commonly awarded were General Surgery (22.3%), Internal Medicine (20.9%), and Obstetrics/Gynecology (20.4%). Adjusting for the number of eligible residents, there were 59.9 awards/1000 Obstetrics/Gynecology residents, 43.1 awards/1000 General Surgery residents, and 20.2 awards/1000 Internal Medicine residents (p < 0.001). Controlling for the number of eligible residents, the Arnold P. Gold Humanism and Excellence in Teaching Awards are more commonly given to surgical specialty residents. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  20. An International Urogynecological Association (IUGA) / International Continence Society (ICS) Joint Report on the Terminology for Female Pelvic Organ Prolapse (POP).

    PubMed

    Haylen, Bernard T; Maher, Christopher F; Barber, Matthew D; Camargo, Sérgio; Dandolu, Vani; Digesu, Alex; Goldman, Howard B; Huser, Martin; Milani, Alfredo L; Moran, Paul A; Schaer, Gabriel N; Withagen, Mariëlla I J

    2016-02-01

    The terminology for female pelvic floor prolapse (POP) should be defined and organized in a clinically-based consensus Report. This Report combines the input of members of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted at intervals by external referees. Appropriate core clinical categories and a sub-classification were developed to give a coding to definitions. An extensive process of fourteen rounds of internal and external review was involved to exhaustively examine each definition, with decision-making by collective opinion (consensus). A Terminology Report for female POP, encompassing over 230 separate definitions, has been developed. It is clinically-based with the most common diagnoses defined. Clarity and user-friendliness have been key aims to make it interpretable by practitioners and trainees in all the different specialty groups involved in female pelvic floor dysfunction and POP. Female-specific imaging (ultrasound, radiology and MRI) and conservative and surgical managements are major additions and appropriate figures have been included to supplement and clarify the text. Emerging concepts and measurements, in use in the literature and offering further research potential, but requiring further validation, have been included as an appendix. Interval (5-10 year) review is anticipated to keep the document updated and as widely acceptable as possible. A consensus-based Terminology Report for female POP has been produced to aid clinical practice and research. © 2016 Wiley Periodicals, Inc., and The International Urogynecological Association.

  1. Specialty, Political Affiliation, and Perceived Social Responsibility Are Associated with U.S. Physician Reactions to Health Care Reform Legislation.

    PubMed

    Antiel, Ryan M; James, Katherine M; Egginton, Jason S; Sheeler, Robert D; Liebow, Mark; Goold, Susan Dorr; Tilburt, Jon C

    2013-06-25

    Little is known about how U.S. physicians' political affiliations, specialties, or sense of social responsibility relate to their reactions to health care reform legislation. To assess U.S. physicians' impressions about the direction of U.S. health care under the Affordable Care Act (ACA), whether that legislation will make reimbursement more or less fair, and examine how those judgments relate to political affiliation and perceived social responsibility. A cross-sectional, mailed, self-reported survey. Simple random sample of 3,897 U.S. physicians. Views on the ACA in general, reimbursement under the ACA in particular, and perceived social responsibility. Among 2,556 physicians who responded (RR2: 65 %), approximately two out of five (41 %) believed that the ACA will turn U.S. health care in the right direction and make physician reimbursement less fair (44 %). Seventy-two percent of physicians endorsed a general professional obligation to address societal health policy issues, 65 % agreed that every physician is professionally obligated to care for the uninsured or underinsured, and half (55 %) were willing to accept limits on coverage for expensive drugs and procedures for the sake of expanding access to basic health care. In multivariable analyses, liberals and independents were both substantially more likely to endorse the ACA (OR 33.0 [95 % CI, 23.6-46.2]; OR 5.0 [95 % CI, 3.7-6.8], respectively), as were physicians reporting a salary (OR 1.7 [95 % CI, 1.2-2.5]) or salary plus bonus (OR 1.4 [95 % CI, 1.1-1.9) compensation type. In the same multivariate models, those who agreed that addressing societal health policy issues are within the scope of their professional obligations (OR 1.5 [95 % CI, 1.0-2.0]), who believe physicians are professionally obligated to care for the uninsured / under-insured (OR 1.7 [95 % CI, 1.3-2.4]), and who agreed with limiting coverage for expensive drugs and procedures to expand insurance coverage (OR 2.3 [95 % CI, 1

  2. Specialty preferences: trends and perceptions among Saudi undergraduate medical students.

    PubMed

    Mehmood, Syed Imran; Kumar, Ashish; Al-Binali, Ali; Borleffs, Jan C C

    2012-01-01

    The exploration of specialty choices by medical students is a hot debate as it affects several important determinants of health care delivery. This study was carried out to determine variation in specialty preferences during medical school training and the perceptions that affect students' specialty choice. A cross-sectional questionnaire-based study was performed on 590 students with a 93.22% response rate and covered queries on demography, specialty choices, and perceptions influencing specialty choices. Class-wise analysis of specialty choices was carried out. The most preferred specialty expressed by male students was surgery, followed by internal medicine and orthopedics, while most preferred by female students were surgery, followed by pediatrics and ophthalmology. Male students' emphasized factors like less competitive field, shortage of specialists, and diversity of patients while the prestige of specialty and teaching opportunities had a greater impact on female students. Surgery, internal medicine, pediatrics, orthopedics, and ophthalmology were the most preferred specialty choices. Gender preference was observed to affect choices of few specialties such as orthopedics and obstetrics/gynecology. Perceptions which have an impact on specialty selection of male and female students may reflect a different tempo of growing up in men and women.

  3. Clinical toxinology specialty training.

    PubMed

    White, Julian

    2013-07-01

    Clinical toxinology is the medical discipline dealing with the diagnosis, treatment and prevention of toxin diseases caused by exposure to venomous animals and poisonous animals, plants and mushrooms. Currently there is no national or international organisation accrediting or training doctors in this discipline, but the role of the IST in this area is the subject of a recently approved revised Constitution. A few courses covering some aspects of clinical toxinology exist, either with limited curricula, or with only a minor clinical focus, or with a very regional, non-global focus. The only comprehensive clinical toxinology course is the one provided in Adelaide, Australia, running regularly since 1997. This course may form the nucleus from which IST can develop a global accredited training scheme in clinical toxinology. Such a scheme will require input from diverse global regions and will be far more comprehensive and over a much longer time than the current Short Course, though may incorporate the Short Course in some way, or a derivative of it. Accreditation of medical expertise in clinical toxinology will be required at the national level and this might be accomplished by the IST working with existing national medical specialty organisations and governments, with the IST supervising the training and accreditation requirements and the national organisations providing the framework for registration of medical expertise at the local level.

  4. The Medical Library Association's international fellowship programs.

    PubMed Central

    Poland, U H

    1978-01-01

    This article describes the two international fellowship programs administered by the International Cooperation Committee of the Medical Library Association: (1) the program supported by the Rockfeller Foundation from 1948 to 1963; (2) the Eileen R. Cunningham program, supported by Mrs. Cunningham's bequest to the association, from 1971 to date. Comments and suggestions received from Cunningham Fellows in response to a letter sent to each by the author in the summer of 1977 are listed. The cost of the fellowship program, not only in terms of financial support but also in terms of human resources, is documented. While the program receives enthusiastic support from the International Cooperation Committee and many members of MLA, the membership needs to examine its mission with regard to the training of medical librarians from other countries, to determine whether future funding is to be sought. PMID:708961

  5. Specialty, political affiliation, and perceived social responsibility are associated with U.S. physician reactions to health care reform legislation.

    PubMed

    Antiel, Ryan M; James, Katherine M; Egginton, Jason S; Sheeler, Robert D; Liebow, Mark; Goold, Susan Dorr; Tilburt, Jon C

    2014-02-01

    Little is known about how U.S. physicians’ political affiliations, specialties, or sense of social responsibility relate to their reactions to health care reform legislation. To assess U.S. physicians’ impressions about the direction of U.S. health care under the Affordable Care Act (ACA), whether that legislation will make reimbursement more or less fair, and examine how those judgments relate to political affiliation and perceived social responsibility. A cross-sectional, mailed, self-reported survey. Simple random sample of 3,897 U.S.physicians. Views on the ACA in general, reimbursement under the ACA in particular, and perceived social responsibility. Among 2,556 physicians who responded (RR2: 65 %), approximately two out of five (41 %) believed that the ACA will turn U.S. health care in the right direction and make physician reimbursement less fair (44 %). Seventy-two percent of physicians endorsed a general professional obligation to address societal health policy issues, 65 % agreed that every physician is professionally obligated to care for the uninsured or underinsured, and half (55 %) were willing to accept limits on coverage for expensive drugs and procedures for the sake of expanding access to basic health care. In multivariable analyses, liberals and independents were both substantially more likely to endorse the ACA (OR 33.0 [95 % CI, 23.6–46.2]; OR 5.0 [95 % CI, 3.7–6.8], respectively), as were physicians reporting a salary (OR 1.7 [95 % CI, 1.2–2.5])or salary plus bonus (OR 1.4 [95 % CI, 1.1–1.9)compensation type. In the same multivariate models, those who agreed that addressing societal health policy issues are within the scope of their professional obligations (OR 1.5 [95 % CI, 1.0–2.0]), who believe physicians are professionally obligated to care for the uninsured / under-insured (OR 1.7 [95 % CI,1.3–2.4]), and who agreed with limiting coverage for expensive drugs and procedures to expand insurance coverage (OR 2.3 [95 % CI, 1.8

  6. American Dietetic Association and the National Kidney Foundation Standards of Practice and Standards of Professional Performance for registered dietitians (generalist, specialty, and advanced) in nephrology care.

    PubMed

    Brommage, Deborah; Karalis, Maria; Martin, Cathi; McCarthy, Maureen; Benner, Deborah; Goeddeke-Merickel, Catherine M; Wiesen, Karen; Byham-Gray, Laura; House, Jennie Lang; Pavlinac, Jessie; McCann, Linda

    2009-09-01

    The American Dietetic Association (ADA) Renal Dietitians Practice Group (RPG) and the National Kidney Foundation Council on Renal Nutrition (NKF CRN), under the guidance of the ADA Quality Management Committee and Scope of Dietetics Practice Framework Sub-Committee, have developed the Standards of Practice (SOP) and Standards of Professional Performance (SOPP) for Registered Dietitians (Generalist, Specialty, and Advanced) in Nephrology Care (Supplementary Figures 1, 2, and 3 are available only online at www.jrnjournal.org). The SOP and SOPP documents are based upon the 2008 Revised Standards of Practice in Nutrition Care and Standards of Professional Performance for Registered Dietitians (RDs)(1), which are part of ADA's Scope of Dietetics Practice Framework(2). The 2008 Revised SOP in Nutrition Care and SOPP, along with the Code of Ethics(3), guide the practice and performance of RDs in all settings.

  7. Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate.

    PubMed

    Sitkin, Nicole A; Pachankis, John E

    2016-12-01

    Sexual and gender minorities (SGMs) in medicine experience unique stressors in training. However, little is known about SGM specialty choice. This study examined predictors of SGM specialty choice, associations between specialty prestige and perceived SGM inclusion, and self-reported influences on specialty choice. Medical trainees and practitioners (358 SGM, 1528 non-SGM) were surveyed online. We operationalized specialty choice at the individual level as respondents' specialty of practice; at the specialty level, as a percentage of SGM respondents in each specialty. We examined specialty prestige, perceived SGM inclusivity, and medical school climate as predictors of SGM specialty choice, and we compared additional influences on specialty choice between SGM and non-SGM. The percentage of SGM in each specialty was inversely related to specialty prestige (P = 0.001) and positively related to perceived SGM inclusivity (P = 0.01). Prestigious specialties were perceived as less SGM inclusive (P < 0.001). Medical school climate did not predict specialty prestige (P = 0.82). SGM were more likely than non-SGM to indicate that sexual and gender identity strongly influenced specialty choice (P < 0.01). SGM most frequently rated personality fit, specialty content, role models, and work-life balance as strong influences on specialty choice. Exposure as a medical student to SGM faculty did not predict specialty prestige among SGM. Specialty prestige and perceived inclusivity predict SGM specialty choice. SGM diversity initiatives in prestigious specialties may be particularly effective by addressing SGM inclusion directly. Further research is needed to inform effective mentorship for SGM medical students. Exposure to SGM in medical training reduces anti-SGM bias among medical professionals, and SGM in medicine often assume leadership roles in clinical care, education, and research regarding SGM health. Supporting and promoting SGM diversity across the

  8. Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate

    PubMed Central

    Pachankis, John E.

    2016-01-01

    Abstract Purpose: Sexual and gender minorities (SGMs) in medicine experience unique stressors in training. However, little is known about SGM specialty choice. This study examined predictors of SGM specialty choice, associations between specialty prestige and perceived SGM inclusion, and self-reported influences on specialty choice. Methods: Medical trainees and practitioners (358 SGM, 1528 non-SGM) were surveyed online. We operationalized specialty choice at the individual level as respondents' specialty of practice; at the specialty level, as a percentage of SGM respondents in each specialty. We examined specialty prestige, perceived SGM inclusivity, and medical school climate as predictors of SGM specialty choice, and we compared additional influences on specialty choice between SGM and non-SGM. Results: The percentage of SGM in each specialty was inversely related to specialty prestige (P = 0.001) and positively related to perceived SGM inclusivity (P = 0.01). Prestigious specialties were perceived as less SGM inclusive (P < 0.001). Medical school climate did not predict specialty prestige (P = 0.82). SGM were more likely than non-SGM to indicate that sexual and gender identity strongly influenced specialty choice (P < 0.01). SGM most frequently rated personality fit, specialty content, role models, and work–life balance as strong influences on specialty choice. Exposure as a medical student to SGM faculty did not predict specialty prestige among SGM. Conclusion: Specialty prestige and perceived inclusivity predict SGM specialty choice. SGM diversity initiatives in prestigious specialties may be particularly effective by addressing SGM inclusion directly. Further research is needed to inform effective mentorship for SGM medical students. Exposure to SGM in medical training reduces anti-SGM bias among medical professionals, and SGM in medicine often assume leadership roles in clinical care, education, and research regarding SGM health

  9. Role of the International Rett Syndrome Association.

    PubMed

    Hunter, K

    1988-01-01

    Since 1984, the International Rett Syndrome Association has brought together families of girls with Rett syndrome, disseminated information about the syndrome, and supported research efforts. Through its computerized records, the Association can match parents most able to provide support for one another, refer parents to physicians familiar with Rett syndrome, keep accurate statistical records of the disease, and connect researchers with subjects willing to participate in investigations. The Association helps families adjust emotionally and practically to living with a Rett syndrome patient and works toward long-term answers by promoting understanding and improved treatment for the condition.

  10. Dentistry's oldest specialty: orthodontics and dentofacial orthopedics.

    PubMed

    George, Raymond

    2009-01-01

    The American Association of Orthodontists (AAO) has 15,500 members worldwide and is the oldest and largest of the recognized dental specialties. A strategic planning process has identified six key challenges, and this article describes the progress that is being made in the areas of (a) consumer education, (b) volunteer leadership development, (c) recruitment and retention of orthodontic educators, (d) relationships with ADA and other healthcare organizations, (e) the AAO's role in international orthodontics, and (f) advocacy. The AAO is working for freedom of choice in dental healthcare providers; fee-for-service dental care; orthodontic insurance coverage as a benefit of employment, with direct reimbursement as the preferred plan; self-referred access to specialists; private and public funding that promote quality orthodontic care; and the retention of tax deductibility of dental healthcare benefits, including orthodontic care.

  11. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female anorectal dysfunction.

    PubMed

    Sultan, Abdul H; Monga, Ash; Lee, Joseph; Emmanuel, Anton; Norton, Christine; Santoro, Giulio; Hull, Tracy; Berghmans, Bary; Brody, Stuart; Haylen, Bernard T

    2017-01-01

    The terminology for anorectal dysfunction in women has long been in need of a specific clinically-based Consensus Report. This Report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted on Committee by experts in their fields to form a Joint IUGA/ICS Working Group on Female Anorectal Terminology. Appropriate core clinical categories and sub classifications were developed to give an alphanumeric coding to each definition. An extensive process of twenty rounds of internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). A Terminology Report for anorectal dysfunction, encompassing over 130 separate definitions, has been developed. It is clinically based with the most common diagnoses defined. Clarity and user-friendliness have been key aims to make it interpretable by practitioners and trainees in all the different specialty groups involved in female pelvic floor dysfunction. Female-specific anorectal investigations and imaging (ultrasound, radiology and MRI) has been included whilst appropriate figures have been included to supplement and help clarify the text. Interval review (5-10 years) is anticipated to keep the document updated and as widely acceptable as possible. A consensus-based Terminology Report for female anorectal dysfunction terminology has been produced aimed at being a significant aid to clinical practice and a stimulus for research.

  12. An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP).

    PubMed

    Haylen, Bernard T; Maher, Christopher F; Barber, Matthew D; Camargo, Sérgio; Dandolu, Vani; Digesu, Alex; Goldman, Howard B; Huser, Martin; Milani, Alfredo L; Moran, Paul A; Schaer, Gabriel N; Withagen, Mariëlla I J

    2016-02-01

    The terminology for female pelvic floor prolapse (POP) should be defined and organized in a clinically-based consensus Report. This Report combines the input of members of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted at intervals by external referees. Appropriate core clinical categories and a sub-classification were developed to give a coding to definitions. An extensive process of fourteen rounds of internal and external review was involved to exhaustively examine each definition, with decision-making by collective opinion (consensus). A Terminology Report for female POP, encompassing over 230 separate definitions, has been developed. It is clinically-based with the most common diagnoses defined. Clarity and user-friendliness have been key aims to make it interpretable by practitioners and trainees in all the different specialty groups involved in female pelvic floor dysfunction and POP. Female-specific imaging (ultrasound, radiology and MRI) and conservative and surgical managements are major additions and appropriate figures have been included to supplement and clarify the text. Emerging concepts and measurements, in use in the literature and offering further research potential, but requiring further validation, have been included as an appendix. Interval (5-10 year) review is anticipated to keep the document updated and as widely acceptable as possible. A consensus-based Terminology Report for female POP has been produced to aid clinical practice and research.

  13. Relative importance of metaphor in radiology versus other medical specialties.

    PubMed

    Baker, Stephen R; Partyka, Luke

    2012-01-01

    The acquisition of competence in radiology often entails referring to other realms of knowledge, by which insights are acquired through the use of metaphor. One way in which compelling associations are made and retained is by linking anatomic structures and pathologic conditions with objects, places, and concepts, and codifying these relationships as metaphoric signs. An aggregate of specialty-specific signs were obtained from two general medical dictionaries and from encyclopedic texts in radiology and six other specialties: internal medicine, dermatology, pathology, general surgery, orthopedics, and pediatrics. The signs were then separated into two categories: eponymous (bearing the name of an individual or place) and metaphoric (extending meaning from one context to another). A total of 375 metaphoric signs were collected from citations in the researched dictionaries and texts, the overwhelming majority (66%) of which were radiologic in reference. In every other specialty, eponymous signs outnumbered metaphoric signs. In contrast, eponymous signs were comparatively infrequent in radiology. The striking difference observed in the data highlights the importance of metaphors for discourse and instruction in radiology. In image interpretation, the meaning of perceptual input is often discerned through associations with pictures previously encountered and understood both concretely and metaphorically. The inherent nature of radiologic images as simulacra of both normal anatomy and disease entities makes imaging findings well suited to explanation by means of named patterns borrowed from other realms of knowledge. © RSNA, 2012.

  14. Reflections on the Medical Library Association's international activities.

    PubMed Central

    Poland, U H

    1982-01-01

    An overview of the Medical Library Association's past international activities is given with emphasis on the international fellowship program, international exchange of materials, participation in the International Federation of Library Associations, and international congresses on medical librarianship. Problems presented by cultural and educational differences, as well as governmental, political, and economic influences affecting international activities are enumerated. Lastly, continuation of the association's current international activities is endorsed, especially the extension of bilateral agreements with health sciences library associations of other countries, and increased activity in comparative medical librarianship. PMID:7150824

  15. The primary-specialty care interface in chronic diseases: patient and practice characteristics associated with co-management.

    PubMed

    Larochelle, Jean-Louis; Feldman, Debbie Ehrmann; Levesque, Jean-Frederic

    2014-11-01

    Specialist physicians may act either as consultants or co-managers for patients with chronic diseases along with their primary healthcare (PHC) physician. We assessed factors associated with specialist involvement. We used questionnaire and administrative data to measure co-management and patient and PHC practice characteristics in 702 primary care patients with common chronic diseases. Analysis included multilevel logistic regressions. In all, 27% of the participants were co-managed. Persons with more severe chronic diseases and lower health-related quality of life were more likely to be co-managed. Persons who were older, had a lower socioeconomic status, resided in rural regions and who were followed in a PHC practice with an advanced practice nurse were less likely to be co-managed. Co-management of patients with chronic diseases by a specialist is associated with higher clinical needs but demonstrates social inequalities. PHC practices more adapted to chronic care may help optimize specialist resources utilization. Copyright © 2014 Longwoods Publishing.

  16. Physician wages across specialties: informing the physician reimbursement debate.

    PubMed

    Leigh, J Paul; Tancredi, Daniel; Jerant, Anthony; Kravitz, Richard L

    2010-10-25

    Disparities in remuneration between primary care and other physician specialties may impede health care reform by undermining the sustainability of a primary care workforce. Previous studies have compared annual incomes across specialties unadjusted for work hours. Wage (earnings-per-hour) comparisons could better inform the physician payment debate. In a cross-sectional analysis of data from 6381 physicians providing patient care in the 2004-2005 Community Tracking Study (adjusted response rate, 53%), we compared wages across broad and narrow categories of physician specialties. Tobit and linear regressions were run. Four broad specialty categories (primary care, surgery, internal medicine and pediatric subspecialties, and other) and 41 specific specialties were analyzed together with demographic, geographic, and market variables. In adjusted analyses on broad categories, wages for surgery, internal medicine and pediatric subspecialties, and other specialties were 48%, 36%, and 45% higher, respectively, than for primary care specialties. In adjusted analyses for 41 specific specialties, wages were significantly lower for the following than for the reference group of general surgery (wage near median, $85.98): internal medicine and pediatrics combined (-$24.36), internal medicine (-$24.27), family medicine (-$23.70), and other pediatric subspecialties (-$23.44). Wage rankings were largely impervious to adjustment for control variables, including age, race, sex, and region. Wages varied substantially across physician specialties and were lowest for primary care specialties. The primary care wage gap was likely conservative owing to exclusion of radiologists, anesthesiologists, and pathologists. In light of low and declining medical student interest in primary care, these findings suggest the need for payment reform aimed at increasing incomes or reducing work hours for primary care physicians.

  17. Factors affecting membership in specialty nursing organizations.

    PubMed

    White, Mary Joe; Olson, Rhonda S

    2004-01-01

    A discouraging trend in many specialty nursing organizations is the stagnant or declining membership. The research committee of the Southeast Texas Chapter of the Association of Rehabilitation Nurses (ARN) collected data and studied this trend to determine what changes would be necessary to increase membership. Using Herzberg's motivational theory as a framework, a review of the literature was initiated. There were few current studies on this issue, but relevant information was found about nursing's emerging workforce, as well as implications of the growth of magnet hospitals, which affect whether nurses join specialty nursing organizations. A multifaceted data-collection approach using convenience samples was designed. First, relevant literature was reviewed. Second, a survey was sent by e-mail to other ARN chapters. Third, a telephone survey on other specialty organizations in the geographic region was completed. Finally, members of the local ARN chapter and four other specialty organizations, as well staff nurses in the geographic area, were given questionnaires to complete. Descriptive statistics and cross tabulations were used to determine why nurses do and do not join specialty organizations (N = 81). The most frequent reasons for joining an organization were to increase knowledge, benefit professionally, network, and earn continuing education units. Reasons for choosing not to participate were family responsibilities, lack of information about these organizations, and lack of time. Ways to reverse the decline in membership are discussed.

  18. Barriers to specialty care and specialty referral completion in the community health center setting.

    PubMed

    Zuckerman, Katharine E; Perrin, James M; Hobrecker, Karin; Donelan, Karen

    2013-02-01

    To assess the frequency of barriers to specialty care and to assess which barriers are associated with an incomplete specialty referral (not attending a specialty visit when referred by a primary care provider) among children seen in community health centers. Two months after their child's specialty referral, 341 parents completed telephone surveys assessing whether a specialty visit was completed and whether they experienced any of 10 barriers to care. Family/community barriers included difficulty leaving work, obtaining childcare, obtaining transportation, and inadequate insurance. Health care system barriers included getting appointments quickly, understanding doctors and nurses, communicating with doctors' offices, locating offices, accessing interpreters, and inconvenient office hours. We calculated barrier frequency and total barriers experienced. Using logistic regression, we assessed which barriers were associated with incomplete referral, and whether experiencing ≥ 4 barriers was associated with incomplete referral. A total of 22.9% of families experienced incomplete referral. 42.0% of families encountered 1 or more barriers. The most frequent barriers were difficulty leaving work, obtaining childcare, and obtaining transportation. On multivariate analysis, difficulty getting appointments quickly, difficulty finding doctors' offices, and inconvenient office hours were associated with incomplete referral. Families experiencing ≥ 4 barriers were more likely than those experiencing ≤ 3 barriers to have incomplete referral. Barriers to specialty care were common and associated with incomplete referral. Families experiencing many barriers had greater risk of incomplete referral. Improving family/community factors may increase satisfaction with specialty care; however, improving health system factors may be the best way to reduce incomplete referrals. Copyright © 2013 Mosby, Inc. All rights reserved.

  19. Personality and Medical Specialty Choice: A Literature Review and Integration.

    ERIC Educational Resources Information Center

    Borges, Nicole J.; Savickas, Mark L.

    2002-01-01

    Synthesizes studies categorized by medical specialties and using the following instruments into the Five Factor Model of personality: Adjective Check List, California Psychological Inventory, 16 Personality Factor Questionnaire, and Myers-Briggs Type Indicator. Suggests a loose association between personalty factors and medical specialties and…

  20. Personality and Medical Specialty Choice: A Literature Review and Integration.

    ERIC Educational Resources Information Center

    Borges, Nicole J.; Savickas, Mark L.

    2002-01-01

    Synthesizes studies categorized by medical specialties and using the following instruments into the Five Factor Model of personality: Adjective Check List, California Psychological Inventory, 16 Personality Factor Questionnaire, and Myers-Briggs Type Indicator. Suggests a loose association between personalty factors and medical specialties and…

  1. Differential prescribing of opioid analgesics according to physician specialty for Medicaid patients with chronic noncancer pain diagnoses.

    PubMed

    Ringwalt, Chris; Gugelmann, Hallam; Garrettson, Mariana; Dasgupta, Nabarun; Chung, Arlene E; Proescholdbell, Scott K; Skinner, Asheley Cockrell

    2014-01-01

    Despite >20 years of studies investigating the characteristics of patients seeking or receiving opioid analgesics, research characterizing factors associated with physicians' opioid prescribing practices has been inconclusive, and the role of practitioner specialty in opioid prescribing practices remains largely unknown. To examine the relationships between physicians' and other providers' primary specialties and their opioid prescribing practices among patients with chronic noncancer pain (CNCP). Prescriptions for opioids filled by 81,459 Medicaid patients with CNCP in North Carolina (USA), 18 to 64 years of age, enrolled at any point during a one-year study period were examined. χ2<⁄span> statistics were used to examine bivariate differences in prescribing practices according to specialty. For multivariable analyses, maximum-likelihood logistic regression models were used to examine the effect of specialty on prescribing practices, controlling for patients' pain diagnoses and demographic characteristics. Of prescriptions filled by patients with CNCP, who constituted 6.4% of the total sample of 1.28 million individuals, 12.0% were for opioids. General practitioner⁄family medicine specialists and internists were least likely to prescribe opioids, and orthopedists were most likely. Across specialties, men were more likely to receive opioids than women, as were white individuals relative to other races⁄ethnicities. In multivariate analyses, all specialties except internal medicine had higher odds of prescribing an opioid than general practitioners: orthopedists, OR 7.1 (95% CI 6.7 to 7.5); dentists, OR 3.5 (95% CI 3.3 to 3.6); and emergency medicine physicians, OR 2.7 (95% CI 2.6 to 2.8). Significant differences in opioid prescribing practices across prescriber specialties may be reflective of differing norms concerning the appropriateness of opioids for the control of chronic pain. If so, sharing these

  2. Differential prescribing of opioid analgesics according to physician specialty for Medicaid patients with chronic noncancer pain diagnoses

    PubMed Central

    Ringwalt, Chris; Gugelmann, Hallam; Garrettson, Mariana; Dasgupta, Nabarun; Chung, Arlene E; Proescholdbell, Scott K; Skinner, Asheley Cockrell

    2014-01-01

    BACKGROUND: Despite >20 years of studies investigating the characteristics of patients seeking or receiving opioid analgesics, research characterizing factors associated with physicians’ opioid prescribing practices has been inconclusive, and the role of practitioner specialty in opioid prescribing practices remains largely unknown. OBJECTIVE: To examine the relationships between physicians’ and other providers’ primary specialties and their opioid prescribing practices among patients with chronic noncancer pain (CNCP). METHODS: Prescriptions for opioids filled by 81,459 Medicaid patients with CNCP in North Carolina (USA), 18 to 64 years of age, enrolled at any point during a one-year study period were examined. χ2 statistics were used to examine bivariate differences in prescribing practices according to specialty. For multivariable analyses, maximum-likelihood logistic regression models were used to examine the effect of specialty on prescribing practices, controlling for patients’ pain diagnoses and demographic characteristics. RESULTS: Of prescriptions filled by patients with CNCP, who constituted 6.4% of the total sample of 1.28 million individuals, 12.0% were for opioids. General practitioner/family medicine specialists and internists were least likely to prescribe opioids, and orthopedists were most likely. Across specialties, men were more likely to receive opioids than women, as were white individuals relative to other races/ethnicities. In multivariate analyses, all specialties except internal medicine had higher odds of prescribing an opioid than general practitioners: orthopedists, OR 7.1 (95% CI 6.7 to 7.5); dentists, OR 3.5 (95% CI 3.3 to 3.6); and emergency medicine physicians, OR 2.7 (95% CI 2.6 to 2.8). CONCLUSIONS: Significant differences in opioid prescribing practices across prescriber specialties may be reflective of differing norms concerning the appropriateness of opioids for the control of chronic pain. If so, sharing these norms

  3. [Medical specialties in crisis: causes of the crisis and possible solutions].

    PubMed

    Nirel, Nurit; Matzliach, Ronit; Birkenfeld, Shlomo; Benbassat, Jochanan

    2008-06-01

    Several clinical specialties in Israel appear to be experiencing an ongoing crisis. In this paper the authors report a pilot case study of general surgery and internal medicine, which have been identified as "clinical specialties in crisis" in the medical literature, during preliminary interviews and in the testimonies presented to a Public Committee appointed by the Prime Minister (the Amorai Committee) that addressed this problem in 2002. To identify the causes of the crisis and possible solutions. Qualitative analysis of interviews and written testimonies of hospital directors, departmental heads of general surgery and internal medicine, key personnel in the Israeli health care system and heads of scientific associations abroad. The causes of the crisis in general surgery and internal medicine appear to be at three different levels: those related to the health system and its environment; causes related to the organizational structure of the hospitals; and causes inherent to the characteristics of the relevant medical specialty. The solutions proposed by the respondents in Israel, Europe and the United States should be considered at each of these levels: at the system-wide level (such as increase in tenured positions, and improvements in the residency programs); at the hospital level (such as the addition of auxiliary paramedical employees with a view to reduce the administrative burden of the physicians); and at the level of the specific medical specialty (such as the development of new subspecialties, e.g., acute care surgeons). It is possible to identify the perceived causes of the crisis and possible ways of coping with their consequences. The findings of this pilot study justify a broader survey of additional medical specialties and a larger number of physicians.

  4. Sex, role models, and specialty choices among graduates of US medical schools in 2006-2008.

    PubMed

    Jagsi, Reshma; Griffith, Kent A; DeCastro, Rochelle A; Ubel, Peter

    2014-03-01

    Undergraduate education studies have suggested instructor sex can influence female students to pursue a discipline. We sought to evaluate a similar hypothesis in medical students. We obtained Association of American Medical Colleges (AAMC) data about the specialization of 2006-2008 graduates of US medical schools, the sex of their faculty and department chairs, and sex of residents in the residency programs in which they enrolled. We used logistic regression to examine associations between faculty and leadership sex and female students' pursuit of 5 surgical specialties along with 3 nonsurgical specialties for context. We used Wilcoxon rank-sum tests to evaluate whether women entered residency programs with a higher proportion of female residents. In 2006-2008, US medical school graduates included 23,642 women. Women were substantially under-represented among residents in neurosurgery, orthopaedics, urology, otolaryngology, general surgery, and radiology; women constituted 47.4% of US graduates specializing in internal medicine and 74.9% in pediatrics. We found no significant associations between exposure to a female department chair and selection of that specialty and no consistent associations with the proportion of female full-time faculty. Compared with male students, female students entered residency programs in their chosen specialty that had significantly higher proportions of women residents in the year before their graduation. Although we did not detect consistent significant associations between exposure to potential female faculty role models and specialty choice, we observed that female students were more likely than males to enter programs with higher proportions of female residents. Sex differences in students' specialization decisions merit additional investigation. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Transition to Specialty Practice Program characteristics and professional development outcomes.

    PubMed

    Morphet, Julia; Kent, Bridie; Plummer, Virginia; Considine, Julie

    2016-09-01

    Transition to Specialty Practice Programs was introduced to facilitate the transition of nurses to specialty practice, and is recognised as preparatory for emergency nurses. Emergency nursing Transition to Specialty Practice Programs and their characteristics have developed locally in response to unit needs. The aim of this study was to examine the characteristics of emergency nursing Transition to Specialty Practice Programs in Australia, and identify which characteristics were associated with improved professional development outcomes. An explanatory sequential design was used. Data were collected via online surveys and interviews of emergency Nurse Managers and Nurse Educators. Transition to Specialty Practice Program characteristics were compared using Mann Whitney U and Chi-Square tests. Content analysis was used to analyse qualitative data. Survey data were collected from 118 emergency departments, and 13 interviews were conducted. Transition to Specialty Practice Programs were offered in most emergency departments (n=80, 72.1%), with one or two intakes per year. Transition to Specialty Practice Program characteristics varied; duration ranged from 5-12months, clinical preparation time ranged from 7-22days, and the number of study days provided ranged from 2-6. When Transition to Specialty Practice Programs of 6 and 12months duration were compared, there was no difference in the content covered. Emergency departments with 12month Transition to Specialty Practice Programs had lower percentages of Clinical Specialists (9% vs 18%, p=0.03) and postgraduate qualified nurses (30.5% vs 43.8%, p=0.09). The target participants, duration and clinical preparation of Transition to Specialty Practice Programs participants varied, impeding workforce mobility and articulation to postgraduate study and there were no professional development advantages from longer programs. There is an urgent need for a nationally consistent, evidence-based and fiscally responsible approach to

  6. Physician Specialty and Variations in Adoption of Electronic Health Records

    PubMed Central

    Grinspan, Z. M.; Banerjee, S.; Kaushal, R.; Kern, L.M.

    2013-01-01

    Objective Efforts to promote adoption of electronic health records (EHRs) have focused on primary care physicians, who are now expected to exchange data electronically with other providers, including specialists. However, the variation of EHR adoption among specialists is underexplored. Methods We conducted a retrospective cross-sectional study to determine the association between physician specialty and the prevalence of EHR adoption, and a retrospective serial cross-sectional study to determine the association of physician specialty and the rate of EHR adoption over time. We used the 2005–2009 National Ambulatory Medical Care Survey. We considered fourteen specialties, and four definitions of EHR adoption (any EHR, basic EHR, full EHR, and a novel definition of EHR sophistication). We used multivariable logistic regression, and adjusted for several covariates (geography, practice characteristics, revenue characteristics, physician degree). Results Physician specialty was significantly associated with EHR adoption, regardless of the EHR definition, after adjusting for covariates. Psychiatrists, dermatologists, pediatricians, ophthalmologists, and general surgeons were significantly less likely to adopt EHRs, compared to the reference group of family medicine / general practitioners. After adjustment for covariates, these specialties were 44 – 94% less likely to adopt EHRs than the reference group. EHR adoption increased in all specialties, by approximately 40% per year. The rate of EHR adoption over time did not significantly vary by specialty. Conclusions Although EHR adoption is increasing in all specialties, adoption varies widely by specialty. In order to insure each individual’s network of providers can electronically share data, widespread adoption of EHRs is needed across all specialties. PMID:23874360

  7. Using relationship styles based on attachment theory to improve understanding of specialty choice in medicine

    PubMed Central

    Ciechanowski, Paul S; Worley, Linda LM; Russo, Joan E; Katon, Wayne J

    2006-01-01

    Background Patient-provider relationships in primary care are characterized by greater continuity and depth than in non-primary care specialties. We hypothesized that relationship styles of medical students based on attachment theory are associated with specialty choice factors and that such factors will mediate the association between relationship style and ultimately matching in a primary care specialty. Methods We determined the relationship styles, demographic characteristics and resident specialty match of 106 fourth-year medical students. We assessed the associations between 1) relationship style and specialty choice factors; 2) specialty choice factors and specialty match, and 3) relationship style and specialty match. We also conducted mediation analyses to determine if factors examined in a specialty choice questionnaire mediate the association between relationship style and ultimately matching in a primary care specialty. Results Prevalence of attachment styles was similar to that found in the general population and other medical school settings with 59% of students rating themselves as having a secure relationship style. Patient centeredness was directly associated, and career rewards inversely associated with matching in a primary care specialty. Students with a self-reliant relationship style were significantly more likely to match in a non-primary care specialty as compared to students with secure relationship style (OR = 5.3, 95% CI 1.8, 15.6). There was full mediation of the association between relationship style and specialty match by the specialty choice factor characterized by patient centeredness. Conclusion Assessing relationship styles based on attachment theory may be a potentially useful way to improve understanding and counsel medical students about specialty choice. PMID:16405723

  8. Orofacial pain emerging as a dental specialty.

    PubMed

    Rosenbaum, R S; Friction, J R; Okeson, J P

    2001-01-01

    The emerging field of orofacial pain was considered by the American Dental Association for full status as a new dental specialty. While the recognition of orofacial pain as a specialty was denied, the American Academy of Orofacial Pain plans to continue its efforts. Many recent advances in the neuroscience of orofacial pain have led to treatments that provide significant relief for patients with chronic orofacial pain disorders. However, access to this care has been limited, leaving many patients to suffer. Dentists are generally supportive of the efforts to develop oral pain treatment into a specialty because the field will provide benefits for both dentists and their patients. A recent survey of 805 individuals who reported having a persistent pain disorder revealed that more than four out of 10 people have yet to find adequate relief, saying their pain is out of control--despite having the pain for more than five years and switching doctors at least once. "This survey suggests that there are millions of people living with severe uncontrolled pain," says Russell Portenoy, MD, president of the American Pain Society. "This is a great tragedy. Although not everyone can be helped, it is likely that most of these patients could benefit if provided with state-of-the-art therapies and improved access to pain specialists when needed." Development of the field of orofacial pain into a dental specialty has been moved primarily by the fact that historically, patients with complex chronic orofacial pain disorders have not been treated well by any discipline of healthcare. Recent studies of chronic orofacial pain patients have found that these patients have a higher number of previous clinicians and have endured many years with pain prior to seeing an orofacial pain dentist (see Figure 1). Complex pain patients and the clinicians who see them are often confused about who they should consult for relief of the pain. Treatment for those patients within the existing structure of

  9. Medical Specialty Choice and Related Factors of Brazilian Medical Students and Recent Doctors

    PubMed Central

    Correia Lima de Souza, Ligia; Mendonça, Vitor R. R.; Garcia, Gabriela B. C.; Brandão, Ediele C.; Barral-Netto, Manoel

    2015-01-01

    Background Choosing a medical specialty is an important, complex, and not fully understood process. The present study investigated the factors that are related to choosing and rejecting medical specialties in a group of students and recent medical doctors. Methodology and Findings A cross-sectional survey of 1,223 medical students and doctors was performed in Brazil in 2012. A standardized literature-based questionnaire was applied that gathered preferable or rejected specialties, and asked questions about extracurricular experiences and the influence of 14 factors on a Likert-type scale from 0 to 4. Specialties were grouped according to lifestyle categories: controllable and uncontrollable, which were subdivided into primary care, internal medicine, and surgical specialties. Notably, the time period of rejection was usually earlier than the time period of intended choice (p < 0.0001, χ2 = 107.2). The choice mainly occurred during the internship period in medical school (n = 466; 38.7%). An overall large frequency of participation in extracurricular activities was observed (n = 1,184; 95.8%), which were highly associated with the respective medical area. Orthopedic surgery had the highest correlation with participation in specialty-specific organized groups (OR = 59.9, 95% CI = 21.6-166.3) and psychiatry was correlated with participation in research groups (OR = 18.0, 95% CI = 9.0-36.2). With regard to influential factors in controllable lifestyle specialties, “financial reason” (mean score ± standard deviation: 2.8 ± 1.0; median = 3) and “personal time” (3.1 ± 1.3; median = 4) were important factors. In primary care, these factors were less important (1.7 ± 1.3 and 1.7 ± 1.5, respectively; median = 2 for both), and higher scores were observed for “curricular internship” (3.2 ± 1.1, median = 4) and “social commitment” (2.6 ± 1.3, median = 3). Conclusion The present findings provide important insights into developing strategies to stimulate

  10. Magnetic Noise Associated with Ocean Internal Waves

    DTIC Science & Technology

    2010-06-01

    earth’s magnetic field. Movement of sea water in the earth’s magnetic field produces an electromotive force with an associated electric current and... series of measurements were taken with the objective to measure and characterize the observable magnetic field of ocean dynamics and to compare these

  11. Gender difference and specialty preference in medical career choice.

    PubMed

    Lee, Chang Woo

    2013-03-01

    We are entering a new era of medicine in which an equal number of men and women are becoming doctors. Many factors combine in complex and poorly understood ways to influence a medical student's career and choice of specialty. This study investigated the preferences of medical students with regard to specialty and examined differences between genders. We administered a survey to medical students at the end of their third- or fourth-year clinical clerkships. In addition to demographic data and specialty choice, medical students selected factors that were importance to their choice of specialty. One hundred forty-one medical students completed the survey (81 males, 57%). For medical students who had chosen a specialty, the most common specialty was internal medicine (20.5%). Significant gender differences were observed in choosing orthopedic surgery and family medicine-17 male students chose orthopedic surgery (10.5%) versus 3.3% of female students (p=0.02), and 11 females (9.2%) were drawn toward family medicine compared with 4 male students (2.5%). More female medical students chose lower workloads (19.9%) and low-risk work (14%) than male students (p<0.05). Lifestyle and income have become more important to medical students regarding their choice of specialty. There were significant gender differences concerning the choice of medical specialty. Controllable lifestyle remains an important factor for female medical students who are choosing a specialty. We must begin to make meaningful and thoughtful changes in medical center policies that affect a balance between work and home.

  12. What determines the selection of undergraduate medical students to the specialty of their future careers?

    PubMed

    Abdulghani, Hamza Mohammad; Al-Shaikh, Ghadeer; Alhujayri, Abdulaziz K; Alohaideb, Nawaf S; Alsaeed, Habeeb A; Alshohayeb, Ibrahim S; Alyahya, Mossaed M; Alhaqwi, Ali Ibrahim; Shaik, Shaffi Ahamed

    2013-01-01

    It is important to understand the factors that influence the undergraduate medical students' specialties choice for the post-graduation. To identify the number of undergraduate medical students who decided their post-graduate specialty career, factors that may influence their decision to select a particular specialty, and their career specialties preference. A self-administered questionnaire was used to achieve the objectives. Less than half of the students (40.2%) showed a future specialty preference. Senior students and having background about specialties were the significant factors for career choices. General Surgery (27.4%), ENT-Ophthalmology (24.6%) and Internal Medicine (22%) were preferred specialties. Male students preferred General Surgery (15.7%), Internal Medicine (15%), ENT-Ophthalmology (12%) and Orthopedics (9.1%). Female students showed interest in ENT-Ophthalmology (12.1%), Surgery (11.7%), Pediatrics (10.8%) and Dermatology (8.2%). The least popular specialties were Community Medicine, (6.6%), Anesthesia, (6%) and Forensic Medicine (4.6%). Obstetrics and Gynecology (Ob/Gyne) was a less popular branch even in female students. General Surgery, ENT-Ophthalmology and Internal Medicine were the most preferred specialties, while Community Medicine, Forensic and Ob/Gyne, even for female students were least selected specialties. Proper information and counseling should be offered to students about the challenges and opportunities to select their future careers.

  13. Psychiatric specialty training in Greece.

    PubMed

    Margariti, M; Kontaxakis, V; Ploumpidis, D

    2017-01-01

    specialty, the European Board of Psychiatry. In the US, the supervising bodies are the Accreditation Council on Graduate Medical Education (ACGME) and the American Board of Psychiatry and Neurology, in the United Kingdom the Royal College of Psychiatrists, in Canada the Royal College of Physicians and Surgeons, etc. In our country, the debate on the need to reform the institutional framework for Psychiatric training has been underway since the mid-90s, with initiatives especially by the Hellenic Psychiatric Association, aiming to raise awareness and concern among psychiatrists while responding to requests from competent central bodies of the state, as well as establishing Panhellenic training programs for psychiatric trainees and continuing education programs. But what is the situation of the educational map in the country today, what would be the objectives, and how might we proceed? These questions we will try to answer in an effort initiated by Hellenic Psychiatric Association (HPA) and the journal "Psychiatriki" with the publication of thematic articles starting by presenting in the next issue of "Psychiatriki"a comparative study of the training in the specialty of psychiatry at two distinct periods of time (2000 and 2014). These time-frames are of great importance, since the first is a period that in retrospect can be considered as wealthier yet missing robust priorities, while the second, at the peak of the economic crisis, constitutes a difficult environment with limited resources. Already in the year 2000, psychiatric residency training in our country had major difficulties due to its outdated framework and its fragmentation. All areas in which training is assessed (clinical experience, theoretical training and training in psychotherapy exhibited inadequacies and limited convergence with European golden standards, in the absence of a plan and the implementation of a national education curriculum. Certain university clinics constituted an important exception, though

  14. Recent trends in specialty pharma business model.

    PubMed

    Ku, Mannching Sherry

    2015-12-01

    products are what the big pharma wants. The understanding of intellectual properties and international drug regulations are the key for specialty pharma to have a workable strategy for product registration worldwide. Copyright © 2015. Published by Elsevier B.V.

  15. International Ergonomics Association Activities and Constituent Societies

    DTIC Science & Technology

    1988-05-01

    SCIENCE & TECHNOLOGY PUBLICATION FEDERATED, AFFILIATED, AND ASSOCIATED MEMBER SOCIETIES AUSTRALIA AUSTRIA BELGIU M BRAZIL 4 CANADA CHINA COLOMBIA DENMARK...Comite ProAsociacion Colombiana de Ergonomia:Z Apartado A~reo No. 094802 Bog6ta, 8 [ Colombia Comite Pro-Asociacion Colombiana de Ergonomia, headed by...of Psychology: Ergonomics Section J. Mallart Instituto Nacional de Psicologia , Aplicada y Psiotechnia Juan Huarte de San Juan Ciudad Universitaria

  16. [The professional burnout syndrome in resident physicians in hospital medical specialties].

    PubMed

    Belloch García, S L; Renovell Farré, V; Calabuig Alborch, J R; Gómez Salinas, L

    2000-03-01

    To evaluate the existence of burnout among medicine residents of hospitality specialties, and the relationship with sundry factors. A transversal study was made among internal medicine residents of La Fe Hospital with more than one year in their job. For this purpose two questionnaires were used: a) the Maslach Burnout Inventory and a general questionnaire about social, demographic, residency, laborer and economic factors. Fifty-six (81.1%) internal medicine residents participated. Comparing with Spanish sample established with medical specialists, we found 7.1% or the residents with high scores on emotional exhaustion, while 17.8% scored high on depersonalization and 23.2% scored low on personal accomplishment. But the levels were lower on residents sample than in the medical specialties sample. Factors associated with burnout were social and demographic compass (be single), like on residency compass (the chosen specialty was not the first option), like properly laborer (low laborer satisfaction, to feel low recognition from boss or patients). We didn't find relationship with economic factors. There are hospitality internal medicine residents who suffer burnout and exist relationship with social, demographic, residency and laborer factors.

  17. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction.

    PubMed

    Bo, Kari; Frawley, Helena C; Haylen, Bernard T; Abramov, Yoram; Almeida, Fernando G; Berghmans, Bary; Bortolini, Maria; Dumoulin, Chantale; Gomes, Mario; McClurg, Doreen; Meijlink, Jane; Shelly, Elizabeth; Trabuco, Emanuel; Walker, Carolina; Wells, Amanda

    2017-02-01

    Introduction and hypothesis There has been an increasing need for the terminology on the conservative management of female pelvic floor dysfunction to be collated in a clinically based consensus report. Methods This Report combines the input of members and elected nominees of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted at intervals by many external referees. An extensive process of nine rounds of internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus). Before opening up for comments on the webpages of ICS and IUGA, five experts from physiotherapy, neurology, urology, urogynecology, and nursing were invited to comment on the paper. Results A Terminology Report on the conservative management of female pelvic floor dysfunction, encompassing over 200 separate definitions, has been developed. It is clinically based, with the most common symptoms, signs, assessments, diagnoses, and treatments defined. Clarity and ease of use have been key aims to make it interpretable by practitioners and trainees in all the different specialty groups involved in female pelvic floor dysfunction. Ongoing review is not only anticipated, but will be required to keep the document updated and as widely acceptable as possible. Conclusion A consensus-based terminology report for the conservative management of female pelvic floor dysfunction has been produced, aimed at being a significant aid to clinical practice and a stimulus for research.

  18. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP).

    PubMed

    Haylen, Bernard T; Maher, Christopher F; Barber, Matthew D; Camargo, Sérgio; Dandolu, Vani; Digesu, Alex; Goldman, Howard B; Huser, Martin; Milani, Alfredo L; Moran, Paul A; Schaer, Gabriel N; Withagen, Mariëlla I J

    2016-04-01

    The terminology for female pelvic floor prolapse (POP) should be defined and organized in a clinically-based consensus Report. This Report combines the input of members of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted at intervals by external referees. Appropriate core clinical categories and a sub-classification were developed to give a coding to definitions. An extensive process of fourteen rounds of internal and external review was involved to exhaustively examine each definition, with decision-making by collective opinion (consensus). A Terminology Report for female POP, encompassing over 230 separate definitions, has been developed. It is clinically-based with the most common diagnoses defined. Clarity and user-friendliness have been key aims to make it interpretable by practitioners and trainees in all the different specialty groups involved in female pelvic floor dysfunction and POP. Female-specific imaging (ultrasound, radiology and MRI) and conservative and surgical managements are major additions and appropriate figures have been included to supplement and clarify the text. Emerging concepts and measurements, in use in the literature and offering further research potential, but requiring further validation, have been included as an appendix. Interval (5-10 year) review is anticipated to keep the document updated and as widely acceptable as possible. A consensus-based Terminology Report for female POP has been produced to aid clinical practice and research.

  19. Connecting Patients With Specialty Products

    PubMed Central

    MCCAIN, JACK

    2012-01-01

    Previously, this series described distribution channels through which specialty drugs move to patients. This installment discusses changes and challenges that lie ahead, especially at the dispensing end. PMID:23091429

  20. Public policy regarding specialty hospitals.

    PubMed

    Dowd, Bryan E

    2008-10-01

    Why do we need "public policy" regarding specialty hospitals? What is the rationale for government involvement in decisions by the private sector to invest in specialty hospitals? Two possibilities are reduced access to services primarily by the uninsured (a fairness concern) and changes in the types of patients receiving care resulting from poor consumer information (an efficiency concern). The fairness argument faces logical and empirical difficulties, and even if it proved to be true, it is not clear that limiting the growth of specialty hospitals would be an efficient way to address the problem. However, there is some empirical evidence to support the efficiency concern, and if specialty hospitals result in the treatment of patients with lower expected net benefits from treatment, then it is possible that physician-owned facilities could result in an increasingly inefficient allocation of health care resources, higher insurance premiums, and higher rates of uninsurance.

  1. Transition from chief residency to specialty training: issues and solutions.

    PubMed

    Nakayama, Don K; Phillips, Linda G; Newsome, R Edward; Fuhrman, George M; Tarpley, John L

    2010-01-01

    Three fourths of chief residents in general surgery receive further specialty training. The end to start-of-year transition can create administrative conflicts between the residency and the specialty training program. An Internet-based questionnaire surveyed general surgery and surgical specialty program directors to define issues and possible solutions associated with end to start-of-year transitions using a Likert scale. There was an overall response rate of 17.5 per cent, 19.6 per cent among general surgery directors, and 15.8 per cent among specialty directors. Program directors in general surgery felt strongly that the transition is an administrative problem (P < 0.001). They opposed extra days off at the end of the chief resident year or ending in mid-June, which specialty directors favored (P < 0.001). Directors of specialty programs opposed starting the year 1 or 2 weeks after July 1, a solution that general surgery directors favored (P < 0.001). More agreement was reached on whether chief residents should take vacation week(s) at the end of the academic year, having all general surgery levels start in mid-June, and orientation programs in July for specialty trainees. Program directors acknowledge that year-end scheduling transitions create administrative and patient care problems. Advancing the start of the training year in mid-June for all general surgery levels is a potential solution.

  2. Commercial production of specialty chemicals and pharmaceuticals from biomass

    SciTech Connect

    McChesney, J.D.

    1993-12-31

    The chemical substances utilized in consumer products, and for pharmaceutical and agricultural uses are generally referred to as specialty chemicals. These may be flavor or fragrance substances, intermediates for synthesis of drugs or agrochemicals or the drugs or agrochemicals themselves, insecticides or insect pheromones or antifeedants, plant growth regulators, etc. These are in contrast to chemicals which are utilized in large quantities for fuels or preparation of plastics, lubricants, etc., which are usually referred to as industrial chemicals. The specific utilization of specialty chemicals is associated with a specific important physiochemical or biological property. They may possess unique properties as lubricants or waxes or have a very desirable biological activity such as a drug, agrochemical or perfume ingredient. These unique properties convey significant economic value to the specific specialty chemical. The economic commercial production of specialty chemicals commonly requires the isolation of a precursor or the specialty chemical itself from a natural source. The discovery, development and commercialization of specialty chemicals is presented and reviewed. The economic and sustainable production of specialty chemicals is discussed.

  3. The promise of specialty pharmaceuticals: are they worth the price?

    PubMed

    Sullivan, Sean D

    2008-05-01

    Specialty pharmaceuticals have evolved beyond their status as niche drugs designed to treat rare conditions and are now poised to become the standard of care in a wide variety of common chronic illnesses. Due in part to the cost of these therapies, payers are increasingly demanding evidence of their value. Determining the value of these medications is hampered by a lack of robust pharmacoeconomic data. To outline emerging strategies and case study examples for the medical and pharmacy benefits management of specialty pharmaceuticals. The promise of specialty pharmaceuticals: increased life expectancy, improved quality of life, enhanced workplace productivity, decreased burden of disease, and reduced health care spending comes at a significant cost. These agents require special handling, administration, patient education, clinical support, and risk mitigation. Additionally, specialty drugs require distribution systems that ensure appropriate patient selection and data collection. With the specialty pharmaceutical pipeline overflowing with new medicines and an aging population increasingly relying on these novel treatments to treat common diseases, the challenge of managing the costs associated with these agents can be daunting. Aided by sophisticated pharmacoeconomic models to assess value, the cost impacts of these specialty drugs can be appropriately controlled. Current evidence suggests that when used in targeted patient populations, specialty pharmaceuticals may represent a good health care value.

  4. ANCC clarifies specialty criteria for CM credential.

    PubMed

    1998-04-01

    The Washington, DC-based American Nurses Credentialing Center has revised its controversial eligibility requirements for the nursing case management credential. The revised requirements allow nurse case managers who lack a core specialty to take the examination if they already hold an active RN license and a baccalaureate degree in nursing, and have functioned as a registered nurse for 4,000 hours, with at least 2,000 of those hours as a nurse case manager within the past two years. An additional requirement is that, besides taking the nursing case management exam, those lacking a core specialty must also take and pass a 50-question test based on the American Nurses Association's Standards of Clinical Practice Nursing.

  5. Setting the stage for the AJO-DO: the haphazard times before orthodontic specialty journals.

    PubMed

    Peck, Sheldon

    2015-01-01

    The professional distinction of "surgeon-dentist," created in France in the 18th century, stimulated dentistry's early advance as a learned profession. By 1841, Pierre-Joachim Lefoulon coined the term "orthodontosie," which was the root of "orthodontics and dentofacial orthopedics" as a distinct academic field and a specialty. In 1907, the American Orthodontist became the first scientific journal in the world completely devoted to orthodontics. Its failure after 5 years of publication prompted former editor Martin Dewey to find a new publisher for an orthodontic specialty journal. In 1915, the International Journal of Orthodontia was created with Dewey as editor. After some years, its name was changed to the American Journal of Orthodontics, which later became the American Journal of Orthodontics and Dentofacial Orthopedics, or AJO-DO. Today, the AJO-DO at 100 years is a mainstay of scientific advancement in orthodontics. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  6. Factors associated with pharmacy student interest in international study.

    PubMed

    Owen, Chelsea; Breheny, Patrick; Ingram, Richard; Pfeifle, William; Cain, Jeff; Ryan, Melody

    2013-04-12

    OBJECTIVES. To examine the interest of pharmacy students in international study, the demographic factors and involvement characteristics associated with that interest, and the perceived advantages and barriers of engaging in international opportunities during pharmacy school. METHODS. A self-administered electronic survey instrument was distributed to first-, second-, and third-year pharmacy students at the University of Kentucky College of Pharmacy. RESULTS. There were 192 total respondents, for a response rate of 50.9%. Seventy-two percent reported interest in international study. Previous international study experience (p=0.001), previous international travel experience (p=0.002), year in pharmacy school (p=0.03), level of academic involvement (p<0.001), and level of diversity involvement (p<0.001) were associated with international study interest. Positive influences to international study included desire to travel and availability of scholarships. Perceived barriers included an inability to pay expenses and lack of foreign language knowledge. CONCLUSIONS. The needs and interests of pharmacy students should be considered in the development and expansion of internationalization programs in order to effectively optimize global partnerships and available international experiences. Colleges and schools of pharmacy should engage students early in the curriculum when interest in study-abroad opportunities is highest and seek to alleviate concerns about expenses as a primary influence on study-abroad decisions through provision of financial assistance.

  7. Factors Associated With Pharmacy Student Interest in International Study

    PubMed Central

    Owen, Chelsea; Breheny, Patrick; Ingram, Richard; Pfeifle, William; Cain, Jeff

    2013-01-01

    Objectives. To examine the interest of pharmacy students in international study, the demographic factors and involvement characteristics associated with that interest, and the perceived advantages and barriers of engaging in international opportunities during pharmacy school. Methods. A self-administered electronic survey instrument was distributed to first-, second-, and third-year pharmacy students at the University of Kentucky College of Pharmacy. Results. There were 192 total respondents, for a response rate of 50.9%. Seventy-two percent reported interest in international study. Previous international study experience (p=0.001), previous international travel experience (p=0.002), year in pharmacy school (p=0.03), level of academic involvement (p<0.001), and level of diversity involvement (p<0.001) were associated with international study interest. Positive influences to international study included desire to travel and availability of scholarships. Perceived barriers included an inability to pay expenses and lack of foreign language knowledge. Conclusions. The needs and interests of pharmacy students should be considered in the development and expansion of internationalization programs in order to effectively optimize global partnerships and available international experiences. Colleges and schools of pharmacy should engage students early in the curriculum when interest in study-abroad opportunities is highest and seek to alleviate concerns about expenses as a primary influence on study-abroad decisions through provision of financial assistance. PMID:23610472

  8. Association: A Framework for International Interaction. Report POL-13.

    ERIC Educational Resources Information Center

    Bazin, M-P

    This paper examines the concept of "associated membership" in international organizations, specialized agencies, and regional organizations. Organizations that allow countries or territories to enter as associated members provide for cooperation and interaction, although these countries do not have the rights and obligations of full membership.…

  9. [Differences in medical specialty choice and in personality factors among female and male medical students].

    PubMed

    Pawełczyk, Agnieszka; Pawełczyk, Tomasz; Bielecki, Jan

    2007-11-01

    This study was designed to investigate the connection between medical students' gender and their medical specialty preference, empathy and personal values. The sample of 199 students was obtained from Medical University of Łódz, 124 were female and 75 were male. Distribution by class was 45.23% fifth year and 54.77% sixth year. The mean age of the students was 24.07 years (SD = 0.92). They had demographic survey and reliable tests performed. Empathy was examined with Empathy Questionnaire by A. Weglinski and personal values by Allport-Vernon-Lindzey Study of Values and Scheler's Personal Values Scale by P. Brzozowski. In the research medical students' gender was associated with medical students' specialty preference (p < 0.001). Men favoured surgery whereas women preferred gynaecology and internal medicine. In this study female students scored higher in empathy (p < 0.001) and in the Religious Values (p < 0.01). Male students scored higher in the Economic Values (p < 0.05). There was no significant association between medical students' gender and other personal values. There is the connection between medical students' gender and their medical specialty preference. Medical students gender is associated with their empathy, religious values and economic values.

  10. [Determinants of primary care specialty choice].

    PubMed

    Pawełczyk, Agnieszka; Pawełczyk, Tomasz; Bielecki, Jan

    2007-03-01

    This paper analyzes and synthesizes the literature on primary care specialty choice. Motivation for choosing medicine and its impact on recruitment to different types of medical work has been presented. Factors that influence medical students and young doctors to change specialty preference have also been explored. Variables, such as gender, martial status, age, income expectations and prestige, that affect medical students' specialty selection decisions for primary care, have been examined. Personality profiles of primary care physician have been evaluated and the influence of communication skills and knowledge of social psychology on his/her work have been analyzed. It is presented that other traits, such as patient-centeredness, needs to serve society and value orientation, is also associated with increases in numbers of students choosing primary care. The analyze shows that the preference for primary care is connected with being interested in diverse patients and health problems and also with being people-orientated. A survey conducted into Polish medical students' attitudes to primary care and family medicine is presented. There is a negative perception of family medicine among Polish students and doctors because of its long work hours and less time for family, insufficient diagnostic possibilities and monotony It is chosen because of lack of other possibilities, difficulties in employment and opportunity to become 'a specialist' in short time.

  11. [International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Hebrew edition].

    PubMed

    Diangelis, A J; Andreasen, J O; Ebeleseder, K A; Kenny, D J; Trope, M; Sigurdsson, A; Andersson, L; Bourguignon, C; Flores, M T; Hicks, M l; Lenzi, A R; Malmgren, B; Moule, A J; Pohl, Y; Tsukiboshi, M

    2014-04-01

    Avulsion of permanent teeth is one of the most serious dental injuries, and a prompt and correct emergency management is very important for the prognosis. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the task group. The guidelines represent the current best evidence and practice based on literature research and professionals' opinion. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of avulsed permanent teeth. The Hebrew Edition is part of the IADT global effort to provide a worldwide accessibility to these guidelines. This scond part of the guidelines will focus on avulsion of permanent teeth.

  12. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth.

    PubMed

    Andersson, Lars; Andreasen, Jens O; Day, Peter; Heithersay, Geoffrey; Trope, Martin; Diangelis, Anthony J; Kenny, David J; Sigurdsson, Asgeir; Bourguignon, Cecilia; Flores, Marie Therese; Hicks, Morris Lamar; Lenzi, Antonio R; Malmgren, Barbro; Moule, Alex J; Tsukiboshi, Mitsuhiro

    2012-04-01

    Avulsion of permanent teeth is one of the most serious dental injuries, and a prompt and correct emergency management is very important for the prognosis. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the task group. The guidelines represent the current best evidence and practice based on literature research and professionals' opinion. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion or majority decision of the task group. Finally, the IADT board members were giving their opinion and approval. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of avulsed permanent teeth. © 2012 John Wiley & Sons A/S.

  13. [Research competencies in nursing specialties].

    PubMed

    Oltra-Rodríguez, Enrique; Rich-Ruiz, Manuel; Orts-Cortés, María Isabel; Sánchez-López, Dolores; González-Carrión, Pilar

    2013-01-01

    Since nursing became an university degree in 1977, there have been several regulations to develop specialties, all of them agreeing on the need to include skills in research. Indeed, the relevance of acquiring these skills in all current disciplines has led to Royal Decree 99/2011, which regulates the official PhD courses, and recognises specialist nurses as qualified to access PhD studies. Nowadays, students from six of the seven specialties included in the Royal Decree 450/2005 on nursing specialties, are performing their training. The acquisition of research skills is seen as an opportunity and a challenge. However, the organizational structure of training facilities (multiprofessional teaching units) and the incorporation of nurses as clinical tutors, who initiated this teaching activity, deserve special attention to ensure the correct acquisition of research skills in the training of specialist nurses.

  14. The International Mycological Association: its history in brief with summaries of its International Mycological Congresses and diverse international relationships.

    PubMed

    Simmons, Emory G

    2010-06-01

    This history presents a review of International Mycological Association activities, its international congresses, and its relationships with regional mycological associations as well as with international organizations of other scientific disciplines. The IMA was organized in 1971 during the First Mycological Congress (IMC-1) convened at Exeter, U.K. In the period 1971 to 2010, nine international congresses have been held, each with its own organizational structure but under the guidance of one of the successive inter-Congress management groups of IMA officers and executive committee members. The congress list includes Exeter, U.K.; Tampa, U.S.A.; Tokyo, Japan; Regensburg, Germany; Vancouver, Canada; Jerusalem, Israel; Oslo, Norway; Cairns, Australia; and Edinburgh, Scotland. Inter-congress activities of each IMA executive group are summarized. The characteristics of each congress are surveyed as to organization, programming, attendance numbers, finances, and satellite meetings.The IMA has sponsored the establishment of Regional Mycological Associations beginning in 1977 and has lent operational funding. Regional associations currently are functional and hold their own regional congresses in Africa, Asia, Australasia, Europe, and Latin America. The relationships of the IMA with other organizations recognized within the supra-national International Council of Scientific Unions are discussed.

  15. Building a Vehicle To Control Specialty Pharmacy Costs

    PubMed Central

    HAVENS, JANE

    2004-01-01

    The trend lines skewing those reports on your desk indicate an ominous upward arc in specialty drug expenditures. Top management at the health insurer you work for tells you, ‘Do something about it.’ The author and her team responded with an innovative approach that effectively addresses coding issues, internal buy-in, and keeping members happy. PMID:23397403

  16. Orthopaedic Physical Therapy: Update to the Description of Specialty Practice.

    PubMed

    Johanson, Marie A; Miller, Michael B; Coe, Jean Bryan; Campo, Marc

    2016-01-01

    Descriptive, cross-sectional observational study. In the physical therapist profession, the outcomes of specialty practice analyses are used to determine content areas for specialty board examinations and for American Physical Therapy Association (APTA)-accredited residency curricula. To maintain currency for specialty practices, the American Board of Physical Therapy Specialties (ABPTS) requires any approved specialty area to revalidate its Description of Specialty Practice (DSP) a minimum of every 10 years. The purpose of this article was to describe the most recent practice analysis process and to report revisions to the DSP for orthopaedic physical therapists. A survey instrument was developed by a group of subject matter experts, following guidelines established by the ABPTS. The survey was sent electronically to a random sample of 800 orthopaedic certified specialists (OCSs). The survey contained 5 sections: (1) knowledge areas (eg, human anatomy and physiology); (2) professional roles, responsibilities, and values (eg, consultation); (3) patient/client management model (eg, examination); (4) percentage of body regions treated; and (5) demographic information. A total of 224 completed surveys and 43 partially completed surveys were submitted, for a response rate of 33.4%. Based on a priori decision rules regarding survey data, consensus of the group of subject matter experts, and ABPTS suggestions, the DSP for orthopaedic physical therapy was revised. The revised DSP will be used to reconstruct the blueprint for future OCS examinations, APTA-accredited orthopaedic residency program curricula, as well as professional development activities related to recertification in orthopaedic physical therapy.

  17. Specialty Guidelines for Forensic Psychology

    ERIC Educational Resources Information Center

    American Psychologist, 2013

    2013-01-01

    In the past 50 years forensic psychological practice has expanded dramatically. Because the practice of forensic psychology differs in important ways from more traditional practice areas (Monahan, 1980) the "Specialty Guidelines for Forensic Psychologists" were developed and published in 1991 (Committee on Ethical Guidelines for Forensic…

  18. Specialty Guidelines for Forensic Psychology

    ERIC Educational Resources Information Center

    American Psychologist, 2013

    2013-01-01

    In the past 50 years forensic psychological practice has expanded dramatically. Because the practice of forensic psychology differs in important ways from more traditional practice areas (Monahan, 1980) the "Specialty Guidelines for Forensic Psychologists" were developed and published in 1991 (Committee on Ethical Guidelines for Forensic…

  19. Analysis of Services Received Under Medicare by Specialty of Physician

    PubMed Central

    Pine, Penelope L.; Gornick, Marian; Lubitz, James; Newton, Marilyn

    1981-01-01

    This paper examines use of physicians' services by Medicare beneficiaries according to the specialty of the physician providing care. The major objectives of this study were to determine which types of physicians are most frequently used, the average charge per service by specialty, the mix of physicians (by specialty) that patients saw during the year, and the amount Medicare reimburses in relation to total physician income. Data were studied for the total Medicare population and by age, sex, race, and geographic area. Claims data for 1975 and 1977 were used from the Part B Bill Summary System. This system collects information from bills for a 5 percent sample of Medicare enrollees. Major findings from this study indicate: (1) Physicians in general practice and internal medicine provided about the same number of services and each far outranked all other types of physicians in numbers of Medicare beneficiaries with reimbursed services. (2) There were marked differences by census region in the use of certain specialists, particularly pathologists, podiatrists, dermatologists, and the specialty group otology, laryngology, rhinology. (3) Average charges per service varied considerably by specialty. Internists' charges averaged 35 percent higher per service than charges by general practitioners. Charges submitted by the surgical specialties far outranked all others and showed the greatest increase during the period under study. (4) Of the total persons with reimbursed physicians' services in 1977, 85 percent saw a primary care physician during the year, while the remaining 15 percent received services from specialists only. (5) Of the total reimbursements made by Medicare, internists received 20 percent, general practitioners received 14 percent, and general surgeons 12 percent. Medicare's payments were estimated to be 21 percent of total gross income for internists, 20 percent for anesthesiologists, and 18 percent for surgical specialties. PMID:10309476

  20. Internship and Empathy: Variations Across Time and Specialties.

    PubMed

    Avasarala, Sameer K; Whitehouse, Sarah; Drake, Sean M

    2015-10-01

    To assess whether any differences exist in Interpersonal Reactivity Index (IRI) scores among postgraduate year 1 (PGY-1) residents across specialties. PGY-1 residents representing 11 specialties at our academic institution were invited to take a Web-based IRI survey at three time points. The specialties were condensed into several binary groups for analysis: internal medicine (IM) versus non-IM; primary care (IM, family medicine) versus nonprimary care; emergency medicine (EM, including the combined IM/EM) versus non-EM; surgical specialties (general surgery, obstetrics and gynecology, otolaryngology, orthopedics, urology) versus nonsurgical specialties (EM, family medicine, IM, neurology, pathology, and psychiatry); men versus women; and age groups. A repeated-measures generalized-estimating equations approach was taken to analyze the effect of specialty and time on each of the four IRI subscales. Of 94 PGY-1 residents invited to participate at each time point, 74 (77.1%) completed the survey at least once. Response rates at each time point were similar (mean 47.9%). When comparing the IM (n=35) and non-IM (n=39) groups, the perspective-taking subscale was found to be significantly lower in the non-IM group (P=0.006). Among male (n=46) versus female residents (n=26), the personal-distress subscale was significantly different overall (P=0.041) but not among time points. No other significant differences were found between groups. The conglomerate subscale scores throughout the year did not show a dramatic change. Our study of IRI subscales in PGY-1 residents showed no major difference among specialties across 1 year except for IM residents, who scored significantly higher (more favorably) in the perspective-taking subscale. Contrary to previous studies, we did not observe a substantial decline in the empathic concern subscale IM residents over their first year.

  1. Analysis of services received under Medicare by specialty of physician.

    PubMed

    Pine, P L; Gornick, M; Lubitz, J; Newton, M

    1981-09-01

    This paper examines use of physicians' services by Medicare beneficiaries according to the specialty of the physician providing care. The major objectives of this study were to determine which types of physicians are most frequently used, the average charge per service by specialty, the mix of physicians (by specialty) that patients saw during the year, and the amount Medicare reimburses in relation to total physician income. Data were studied for the total Medicare population and by age, sex, race, and geographic area. Claims data for 1975 and 1977 were used from the Part B Bill Summary System. This system collects information from bills from a 5 percent sample of Medicare enrollees. Major findings from this study indicate: (1) Physicians in general practice and internal medicine provided about the same number of services and each far outranked all other types of physicians in numbers of Medicare beneficiaries with reimbursed services. (2) There were marked differences by census region in the use of certain specialists, particularly pathologists, podiatrists, dermatologists, and the specialty group otology, laryngology, rhinology. (3) Average charges per service varied considerably by specialty. Internists' charges averaged 35 percent higher per service than charges by general practitioners. Charges submitted by the surgical specialties far outranked all others and showed the greatest increase during the period under study. (4) Of the total persons with reimbursement physicians' services in 1977, 85 percent saw a primary care physician during the year, while the remaining 15 percent received services from specialists only. (5) Of the total reimbursements made by Medicare, internists received 20 percent, general practitioners received 14 percent, and general surgeons 12 percent. Medicare's payments were estimated to be 21 percent of total gross income for internists, 20 percent for anesthesiologists, and 18 percent for surgical specialties.

  2. Progress report to the International Fruit Tree Association

    USDA-ARS?s Scientific Manuscript database

    This report provides an update on several projects that are fostered by the International Fruit Tree Association which covers some aspects of rootstock development, performance in the orchard and to address nursery industry needs. The report highlights results from graft union strength experiments,...

  3. A Brief Background of the ICA (International Communication Association) Audit.

    ERIC Educational Resources Information Center

    Krivonos, Paul D.

    This paper examines the International Communication Association (ICA) audit, the aim of which is to establish an integrated communication audit system and a multimethod approach to the auditing of the communication of an organization. Many of an organization's communication variables and concepts are examined so that strengths and weaknesses in…

  4. International Reading Association 1977-1978 Annual Report.

    ERIC Educational Resources Information Center

    International Reading Association, Newark, DE.

    The introductory section of the International Reading Association (IRA) annual report briefly discusses recent developments concerning the organization, including its deficit budget, the establishment of an IRA Washington representative, an account of the debate concerning the holding of conventions in states which have not ratified the Equal…

  5. Survey of New Horizons International Music Association Musicians

    ERIC Educational Resources Information Center

    Coffman, Don

    2009-01-01

    This study analysed survey responses from 1652 New Horizons International Music Association (NHIMA) musicians in the United States and Canada to better understand older adults' experiences in making music. The purpose of this study was threefold: (a) ascertain the extent of NHIMA musicians' musical backgrounds and their current involvement in…

  6. Frontiers of Challenge: Association for Childhood Education International 1985.

    ERIC Educational Resources Information Center

    Wortham, Sue C.

    1985-01-01

    Traces development of the Association for Childhood Education International from its founding in 1892 to the present, emphasizing historical events, social trends, and educational philosophies which have influenced its organizational endeavors. Examines current social problems and their influences on the educational and administrative direction of…

  7. Conference Proceedings of the International Association of School Librarianship.

    ERIC Educational Resources Information Center

    International Association of School Librarianship, Kalamazoo, MI.

    The 1976 International Association of School Librarianship conference focused on crucial issues in school library development and professional education. Complete texts of the keynote address, Crucial Issues in School Library Development and Professional Education by Frances Henne, and the following presentations are included: The School…

  8. Survey of New Horizons International Music Association Musicians

    ERIC Educational Resources Information Center

    Coffman, Don

    2009-01-01

    This study analysed survey responses from 1652 New Horizons International Music Association (NHIMA) musicians in the United States and Canada to better understand older adults' experiences in making music. The purpose of this study was threefold: (a) ascertain the extent of NHIMA musicians' musical backgrounds and their current involvement in…

  9. Working for Change across International Borders: The Association of Headmistresses and Education for International Citizenship

    ERIC Educational Resources Information Center

    Goodman, Joyce

    2007-01-01

    This article contributes to the retrieval of the "lost history" of interwar internationalism that is increasingly receiving attention from historians of education. It traces the involvement of the English Association of Headmistresses (AHM) in a range of organizations that networked women educationists with women's organizations, with…

  10. [Upon scientific accuracy scheme at clinical specialties].

    PubMed

    Ortega Calvo, M

    2006-11-01

    Will be medical specialties like sciences in the future? Yes, progressively they will. Accuracy in clinical specialties will be dissimilar in the future because formal-logic mathematics, quantum physics advances and relativity theory utilities. Evidence based medicine is now helping to clinical specialties on scientific accuracy by the way of decision theory.

  11. Engineering Students' Perceptions of Engineering Specialties

    ERIC Educational Resources Information Center

    Shivy, V.A.; Sullivan, T.N.

    2005-01-01

    The field of engineering is defined by a number of specialty areas, thus most engineering students must decide upon an educational specialty track within the engineering major. Data on familiarity with, and perceptions of similarity among 11 engineering specialties were collected from 129 undergraduate engineering students from a public urban…

  12. Medical students' career indecision and specialty rejection: roads not taken.

    PubMed

    Kassebaum, D G; Szenas, P L

    1995-10-01

    The authors used data from the AAMC Matriculating Student Questionnaire and Medical School Graduation Questionnaire to ascertain how closely the specialty or subspecialty choices of the 1991 and 1994 graduates of U.S. medical schools matched the preferences they had declared when they were matriculated; the extent to which these students strongly considered and then rejected choices that arose during medical school; and the graduation choices of the substantial number of students in both cohorts who were undecided about their careers when they entered medical school. Approximately 80% of the graduates in both classes rejected the specialty intentions they had declared when they began medical school. However, matriculation interests in the generalist specialties--family practice, general pediatrics, and general internal medicine--were more enduring for the 1994 cohort, while interests in the medical, surgical, and support specialties were less so. Large percentages of the 1991 and 1994 cohorts were undecided about their careers at matriculation (20.8% and 26.2%, respectively), and nearly the same proportions remained undecided at graduation. However, more of the graduates in the 1994 cohort who had initially been undecided reached decisions favoring one of the generalist specialties than was true for the 1991 cohort. Nearly half the 1994 graduates had strongly considered and then rejected an alternative to their matriculation interest that arose during medical school. Within the generalist specialties, both early and later interests in family practice were more durable than were those in general pediatrics and general internal medicine: for every student who retreated from tentative interest in family practice, another student's interest was reinforced or kindled.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Functional severity and Latino ethnicity in specialty services for children with autism spectrum disorder.

    PubMed

    Magaña, S; Parish, S L; Son, E

    2016-05-01

    Children with autism spectrum disorder (ASD) experience a range of severity levels characterised as levels of support they need for everyday functioning. By this definition, greater levels of severity should warrant greater use of services and supports among children with ASD. In previous studies, Latino children with ASD in the USA have been shown to have lower access to diagnosis and treatment services than White children. However, none have examined service use in relation to severity. In this study, we examined whether there are ethnic disparities between Latino and White children with ASD in specialty autism-related services, and whether functional severity moderates the relationship between ethnicity and receipt of autism services. We used data from the Survey of Pathways to Diagnosis and Services, a supplement to the National Survey of Children with Special Health Care Needs and analysed four specialty services commonly used by children with ASD, adjusting for demographic variables. We found that Latino children with ASD who had severe limitations received fewer specialty autism-related services than White children with similarly severe conditions. These disparities were evident despite the fact that the sample of Latino children in these data were more privileged than the general US Latino population. Assertive policy initiatives are needed to address these disparities and ensure that these highly vulnerable children with severe functional limitations receive appropriate services and supports. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  14. Determinants of primary care specialty choice: a non-statistical meta-analysis of the literature.

    PubMed

    Bland, C J; Meurer, L N; Maldonado, G

    1995-07-01

    This paper analyzes and synthesizes the literature on primary care specialty choice from 1987 through 1993. To improve the validity and usefulness of the conclusions drawn from the literature, the authors developed a model of medical student specialty choice to guide the synthesis, and used only high-quality research (a final total of 73 articles). They found that students predominantly enter medical school with a preference for primary care careers, but that this preference diminishes over time (particularly over the clinical clerkship years). Student characteristics associated with primary care career choice are: being female, older, and married; having a broad undergraduate background; having non-physician parents; having relatively low income expectations; being interested in diverse patients and health problems; and having less interest in prestige, high technology, and surgery. Other traits, such as value orientation, personality, or life situation, yet to be reliably measured, may actually be responsible for some of these associations. Two curricular experiences are associated with increases in the numbers of students choosing primary care: required family practice clerkships and longitudinal primary care experiences. Overall, the number of required weeks in family practice shows the strongest association. Students are influenced by the cultures of the institutions in which they train, and an important factor in this influence is the relative representation of academically credible, full-time primary care faculty within each institution's governance and everyday operation. In turn, the institutional culture and faculty composition are largely determined by each school's mission and funding sources--explaining, perhaps, the strong and consistent association frequently found between public schools and a greater output of primary care physicians. Factors that do not influence primary care specialty choice include early exposure to family practice faculty or to

  15. Competency revalidation study of specialty practice in sports physical therapy.

    PubMed

    Mulligan, Edward P; Weber, Mark D; Reinking, Mark F

    2014-12-01

    Every ten years the American Board of Physical Therapy Specialties conducts a practice analysis to revalidate and revise the description of specialty practice for sports physical therapy (SPT). The primary purpose of this paper is to describe the process and results of the most recent analysis, which defines the competencies that distinguish the subspecialty practice of (SPT). Additionally, the study allowed for the comparison of responses of board certified specialists in SPT to respondents who were not specialists while reflecting on demographic changes and evolving trends since the previous analysis of this physical therapy specialty practice was conducted 10 years ago. A survey instrument based on guidelines from the American Board of Physical Therapy Specialties was developed by the Sports Specialty Council (SSC) and a panel of subject matter experts (SME) in SPT to re-evaluate contemporary practice. The instrument was pilot tested and following revisions, was sent to 1780 physical therapists, 930 of whom were board certified specialists in SPT and 850 of whom were randomly selected members of the Sports Physical Therapy Section (SPTS) who were not board certified specialists in SPT. 414 subjects returned completed surveys for a 23% response rate. 235 of the respondents were known to be board certified sports specialists, 120 did not indicate their specialty status, and 35 were non-specialists in SPT. All were members of the SPTS of the American Physical Therapy Association. The survey responses were analyzed using descriptive statistics. Univariate comparisons were performed using parametric and nonparametric statistical tests in order to evaluate differences between specialist and non-specialist item responses. The survey results were reviewed by the SSC and a panel of SME. Using a defined decision making process, the results were used to determine the competencies that define the specialty practice of SPT. Survey results were also used to develop the SPT

  16. Beliefs and attitudes of clinical year students concerning medical specialties: an Ibadan medical school study.

    PubMed

    Akinyinka, O O; Ohaeri, J U; Asuzu, M C

    1992-12-01

    In order to understand their attitudes to 10 medical specialties, a 40-item self-report questionnaire was administered to the first and final year clinical students of the University of Ibadan. One hundred and twenty-one first year and 150 final year students participated, constituting 81% response rates respectively, in the two classes. The findings indicate that many factors influence specialty choice, the principal ones being: expectation of material rewards; societal appreciation of specialty and specialists; response of specialty patients to treatment; and the role of specialty teachers. It seems that specialties viewed positively in these dimentions (such as surgery, paediatrics, internal medicine, and obstetrics and gynaecology) are more highly favoured than the others (such as radiology, pathology, psychiatry, anaesthesia and community medicine), which were viewed rather negatively in this regard. Generally speaking, opinion on specialties was similar, not only between the two classes, but also between this cohort and comparable groups in developed nations. In order to enhance the spread of specialty manpower development to meet the goal of health care for all, suggestions are made about how to improve the positive appreciation of the less favoured specialties among undergraduates.

  17. The future of specialty practice.

    PubMed

    Albers, John W

    2008-01-01

    The delivery of veterinary care to companion animals by board-certified clinical specialists in private practice in the United States has grown dramatically since 1990. Virtually all mid-sized to large metropolitan areas are served by clinical specialists, frequently in multiple locations. Private specialty practice is highly fragmented, and very few data exist regarding the dynamics of this segment of the profession. This article is based on the personal opinions of the author, acquired through observation and experience.

  18. Improving access to specialty care.

    PubMed

    Murray, Mark F

    2007-03-01

    Waits and delays plague health care systems worldwide, and wait times for most specialists exceed those for primary care practices. In office-based practices, the provider office presence is not diluted by competing indispensable activities, and the demand for service is most often for a single type, or stream, of office-based appointment demand. In the more complex specialty practices, however, the demand streams for office visits and other services compete for provider time and dilute the supply of office visits. Seven strategies for reduction of delay can be applied, not only at all steps in patient flow and for all demand streams but also at all steps (for example, office visit, diagnostic procedure, surgery, follow-up) and within all specialty care types and ranges of practice. Each specialty care practice will need to discover how to use the basic principles and implement customized solutions within its own unique environment. Although it is ultimately critical to eliminate the delays in all streams of service, the focus is on the application of change strategies at the initial step between primary care and all specialty care practice types. The strategies are (1) balance supply and demand at each step in the chain, (2) work down the backlog, (3) reduce appointment types, (4) independent contingency planning for all variation, (5) reduce the demand for visits, (6) increase the supply, and (7) improve the efficiency of the office work flow. Specialists support various, distinct demand streams that require demand/supply balance to achieve optimal system performance. If demand/supply balance exists within any stream, waits can be minimized, and the practice can choose time frames within which to balance workload.

  19. Specialty Pharmacy at a Crossroad

    PubMed Central

    ADAMS, KATHERINE T.

    2005-01-01

    Consolidation of the specialty pharmacy business indicates a repositioning to buy new market channels, reduce costs, and compete in a burgeoning market. The challenge for SP is to prove its value to payers. Some companies are doing that on the basis of price or by offering care management services. Here’s a look at a business in transition as it redefines itself for the biologics era. PMID:23424307

  20. Specialty and Full-Service Hospitals: A Comparative Cost Analysis

    PubMed Central

    Carey, Kathleen; Burgess, James F; Young, Gary J

    2008-01-01

    Objective To compare the costs of physician-owned cardiac, orthopedic, and surgical single specialty hospitals with those of full-service hospital competitors. Data Sources The primary data sources are the Medicare Cost Reports for 1998–2004 and hospital inpatient discharge data for three of the states where single specialty hospitals are most prevalent, Texas, California, and Arizona. The latter were obtained from the Texas Department of State Health Services, the California Office of Statewide Health Planning and Development, and the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Additional data comes from the American Hospital Association Annual Survey Database. Study Design We identified all physician-owned cardiac, orthopedic, and surgical specialty hospitals in these three states as well as all full-service acute care hospitals serving the same market areas, defined using Dartmouth Hospital Referral Regions. We estimated a hospital cost function using stochastic frontier regression analysis, and generated hospital specific inefficiency measures. Application of t-tests of significance compared the inefficiency measures of specialty hospitals with those of full-service hospitals to make general comparisons between these classes of hospitals. Principal Findings Results do not provide evidence that specialty hospitals are more efficient than the full-service hospitals with whom they compete. In particular, orthopedic and surgical specialty hospitals appear to have significantly higher levels of cost inefficiency. Cardiac hospitals, however, do not appear to be different from competitors in this respect. Conclusions Policymakers should not embrace the assumption that physician-owned specialty hospitals produce patient care more efficiently than their full-service hospital competitors. PMID:18662170

  1. The specialty choices of graduates from Brighton and Sussex Medical School: a longitudinal cohort study.

    PubMed

    Woolf, Katherine; Elton, Caroline; Newport, Melanie

    2015-03-13

    Since 2007 junior doctors in the UK have had to make major career decisions at a point when previously many had not yet chosen a specialty. This study examined when doctors in this new system make specialty choices, which factors influence choices, and whether doctors who choose a specialty they were interested in at medical school are more confident in their choice than those doctors whose interests change post-graduation. Two cohorts of students in their penultimate year at one medical school (n = 227/239) were asked which specialty interested them as a career. Two years later, 210/227 were sent a questionnaire measuring actual specialty chosen, confidence, influence of perceptions of the specialty and experiences on choice, satisfaction with medicine, personality, self-efficacy, and demographics. Medical school and post-graduation choices in the same category were deemed 'stable'. Predictors of stability, and of not having chosen a specialty, were calculated using bootstrapped logistic regression. Differences between specialties on questionnaire factors were analysed. 50% responded (n = 105/277; 44% of the 239 Year 4 students). 65% specialty choices were 'stable'. Factors univariately associated with stability were specialty chosen, having enjoyed the specialty at medical school or since starting work, having first considered the specialty earlier. A regression found doctors who chose psychiatry were more likely to have changed choice than those who chose general practice. Confidence in the choice was not associated with stability. Those who chose general practice valued lifestyle factors. A psychiatry choice was associated with needing a job and using one's intellect to help others. The decision to choose surgical training tended to be made early. Not having applied for specialty training was associated with being lower on agreeableness and conscientiousness. Medical school experiences are important in specialty choice but experiences post-graduation remain

  2. Factors considered by undergraduate medical students when selecting specialty of their future careers

    PubMed Central

    Alawad, Awad Ali Mohamed Ahmed; Khan, Waleed Shabeer; Abdelrazig, Yousif Mohammed; Elzain, Yamin Ibrahim; khalil, Hassan Osman; Ahmed, Omer Bakri Elsayed; Adam, Omeralfaroug Ahmed Ibrahim

    2015-01-01

    Introduction Medical students are the source of a country's physicians. Determining how medical students select their areas of specialization is the key to achieve a balanced distribution of doctors among all specialties. The objective is to identify the number of medical students who have decided their postgraduate specialty career, their career specialties preference, and factors that may influence their decision to select a particular specialty. Methods A facility based cross-sectional study was conducted in September 2013 at Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan. A self-administered semi-structured questionnaire comprising demographic data and questions about future specialties preferences and factors influencing those preferences was distributed to 887 male and female students, (from first to fifth academic years) recruited in the study. Results Response rate was 73% with 647 questionnaires collected, out of 887 eligible medical students. Of the returned questionnaires, 604 were valid. The majority of students (541, 89.6%) have chosen a specialty. Surgery, medicine, paediatrics and obstetrics and gynecology were the most selected specialties. The least selected specialty was anaesthesiology. A significant association was found between gender and specialty choice using Chi-square test (p = 0.00). There was no association between undergraduate level and specialty choice (p = 0.633). The most common reason for choosing a specific specialty was “Personal Interest” (215, 39.7%) followed by being “Helpful to the community” (144, 26.6%). Conclusion Surgery, medicine, paediatrics and obstetrics and gynecology were the most selected specialties. PMID:26090050

  3. Design and implementation of population-based specialty care programs.

    PubMed

    Botts, Sheila R; Gee, Michael T; Chang, Christopher C; Young, Iris; Saito, Logan; Lyman, Alfred E

    2017-09-15

    The development, implementation, and scaling of 3 population-based specialty care programs in a large integrated healthcare system are reviewed, and the role of clinical pharmacy services in ensuring safe, effective, and affordable care is highlighted. The Kaiser Permanente (KP) integrated healthcare delivery model allows for rapid development and expansion of innovative population management programs involving pharmacy services. Clinical pharmacists have assumed integral roles in improving the safety and effectiveness of high-complexity, high-cost care for specialty populations. These roles require an appropriate practice scope and are supported by an advanced electronic health record with disease registries and electronic surveillance tools for care-gap identification. The 3 specialty population programs described were implemented to address variation or unrecognized gaps in care for at-risk specialty populations. The Home Phototherapy Program has leveraged internal partnerships with clinical pharmacists to improve access to cost-effective nonpharmacologic interventions for psoriasis and other skin disorders. The Multiple Sclerosis Care Program has incorporated clinical pharmacists into neurology care in order to apply clinical guidelines in a systematic manner. The KP SureNet program has used clinical pharmacists and data analytics to identify opportunities to prevent drug-related adverse outcomes and ensure timely follow-up. Specialty care programs improve quality, cost outcomes, and the patient experience by appropriating resources to provide systematic and targeted care to high-risk patients. KP leverages an integration of people, processes, and technology to develop and scale population-based specialty care. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  4. International Association for Promoting Geoethics (IAPG): an update on activities

    NASA Astrophysics Data System (ADS)

    Di Capua, Giuseppe; Bobrowsky, Peter; Kieffer, Susan; Peppoloni, Silvia; Tinti, Stefano

    2016-04-01

    The International Association for Promoting Geoethics (IAPG: http://www.geoethics.org) was founded on August 2012 to unite global geoscientists to raise the awareness of the scientific community regarding the importance of the ethical, social and cultural implications of geoscience research, education, and practice. IAPG is an international, multidisciplinary and scientific platform for discussion on ethical problems and dilemmas in Earth Sciences, promoting geoethical themes through scientific publications and conferences, strengthening the research base on geoethics, and focusing on case-studies as models for the development of effective and operative strategies. IAPG is legally recognized as a not-for-profit organization. It is a non-governmental, non-political, non-party institution, at all times free from racial, gender, religious or national prejudices. Its network continues to grow with more than 900 members in 103 countries, including 20 national sections. IAPG operates exclusively through donations and personal funds of its members. The results achieved since inception have been recognized by numerous international organizations. In particular, IAPG has obtained the status of affiliated organization by the International Union of Geological Sciences (IUGS), American Geosciences Institute (AGI), Geological Society of America (GSA), and the Geological Society of London (GSL). IAPG has enlarged its official relationships also through agreements on collaboration with other organizations, such as the American Geophysical Union (AGU), EuroGeoSurveys (EGS), European Federation of Geologists (EFG), Association of Environmental & Engineering Geologists (AEG), International Geoscience Education Organisation (IGEO), African Association of Women in Geosciences (AAWG), and others. IAPG considers publications as an indispensable activity to strengthen geoethics from a scientific point of view, so members are active in the publication of articles and editing of books on

  5. The value of independent specialty designation for interventional cardiology.

    PubMed

    Blankenship, James C; Powell, Wayne A; Gray, Dawn R; Duffy, Peter L

    2017-01-01

    Interventional cardiology has finally completed, after 26 years of advocacy, a professional hat trick: independent board certification, membership as a unique specialty in the American Medical Association House of Delegates (AMA HOD), and recognition by the Centers for Medicaid and Medicare Services (CMS) as a separate medical specialty. This article points out how these distinctions for interventional cardiology and its professional society, the Society for Cardiovascular Angiography and Interventions (SCAI), have led to clear and definite benefits for interventional cardiologists and their patients. We focus on the least understood of these three-recognition by CMS and its implications for reimbursement and quality assessment for interventional cardiologists. © 2016 Wiley Periodicals, Inc.

  6. Broad support sought for emerging specialty of orofacial pain.

    PubMed

    Gelb, M L; Fricton, J R; Okeson, J P; Messing, S

    2000-10-01

    The American Dental Association is considering giving the emerging field of orofacial pain full status as a new dental specialty. Many recent advances in the neuroscience of orofacial pain have lead to treatments by orofacial pain dentists that provide significant relief for patients with chronic disorders. However, access to this care has been limited, leaving many patients to continue to suffer. Recent efforts to improve this situation by developing the field into a specialty have received broad support among dentists and have increased awareness of the benefits this field can provide for dentists and their patients.

  7. [Unwillingness or overconfidence. Orthodontics as a dental specialty].

    PubMed

    Meijer, N A

    2003-01-01

    January 31st 1953, fifty years ago, orthodontics was the first dental specialty to be recognized in The Netherlands. This article describes the development to this. After the Second World War the dentist emancipated rapidly and dentistry became an academic profession in 1947. At that time the dentist was assumed to have knowledge of every field in dentistry and for orthodontics as a specialty there was no role to play. A few years later the Board of the Dutch Dental Association had to conclude--with some distaste--that a specialty in orthodontics was inevitable. As the chairman of the subcommittee for orthodontics the Groningen professor of orthodontics K.G. Bijlstra (1905-1985) had an important role in this process. November 16th, 1953 the first fifteen orthodontists were registered in The Netherlands.

  8. Bioterrorism and disaster preparedness among medical specialties.

    PubMed

    Lane, Joshua E; Dimick, Jacob; Syrax, Michael; Bhandary, Madhusudan; Rudy, Bruce S

    2012-01-01

    A core priority of all medical specialties includes information for members regarding inherent priorities and principles. The authors sought to investigate the priority and contribution of various medical specialties to the fields of bioterrorism, terrorism, disaster preparedness, and emergency preparedness. A mixed study design (quantitative and qualitative) was used to identify pertinent characteristics of various medical specialties. A scored survey analysis of resources available from the representative organizations and/or societies of the primary medical specialties and select subspecialties was examined and scored based on availability, ease of accessibility, updated status, and content. A MEDLINE search completed through PubMed using the medical subject headings bioterrorism, terrorism, disaster preparedness, and emergency preparedness coupled with specific medical specialties was conducted to assess the involvement and contribution of each to the medical literature. The primary study outcome was to evaluate the priority of and existing resources available to members for bioterrorism/terrorism and disaster/emergency preparedness among various medical specialties as reflected by their representative organizations and scientific publication. The search of individual medical specialties and of the medical literature (2000-2010) revealed that these topics (via keywords bioterrorism, terrorism, disaster preparedness, and emergency preparedness) are indeed a priority topic for the majority of medical specialties. A number of specialties with expectant priority in these topics were confirmed. All seven primary care specialties demonstrated a core priority of these topics and offered resources. The MEDLINE (PubMed) search yielded 7,228 articles published from 2000 to 2010. Bioterrorism/terrorism and disaster/ emergency preparedness are priority topics of most medical specialties. This core priority is demonstrated by both the medical specialty resources in addition

  9. Preliminary Risk Assessment Associated with IGSCC of BWR Vessel Internals

    SciTech Connect

    A. Ware; K. Morton; M. Nitzel; N. Chokshi; T-Y. Chang

    1999-08-01

    BWR core shrouds and other reactor internals important to safety are experiencing intergranular stress corrosion cracking (IGSCC). The United States Nuclear Regulatory Commission (NRC) has followed the problem, and as part of its investigations, contracted with the Idaho National Engineering and Environmental Laboratory (INEEL) to conduct a risk assessment. The overall project objective is to assess the potential consequences and risks associated with the failure of IGSCC-susceptible BWR vessel internals, with specific consideration given to potential cascading and common mode effects. The paper presents an overview of the program, discusses the results of a preliminary qualitative assessment, and summarizes a simplified risk assessment that was conducted on sequences resulting from failures of jet pump components of a BWR/4 plant.

  10. Broad support evident for the emerging specialty of orofacial pain.

    PubMed

    Fricton, J R; Okeson, J P

    2000-07-01

    The emerging field of orofacial pain is being considered by the American Dental Association for full status as a new dental specialty to improve the care for these patients. The broad support among dentists for this initiative stems from an awareness of the benefits the field can provide for dentists and their patients.

  11. The Forum of the International HCH and Pesticides Association--a platform for international cooperation.

    PubMed

    Vijgen, John; Aliyeva, Gulchohra; Weber, Roland

    2013-04-01

    The unsustainable life cycle management of pesticides in the last 60 years has created large pesticide stockpiles. The two major working areas of the International HCH and Pesticide Association (IHPA; www.ihpa.info ) address a part of these legacies and are shortly introduced here: (1) The assessment and support of the management of the worlds single largest POPs stockpile: the globally dumped 4 to 7 million tonnes hexachlorocyclohexane (HCH) wastes from lindane production, and (2) the support for the management of the obsolete pesticides legacy in Eastern Europe, the Caucasus and Central Asia (EECCA) countries of ~240,000 t, leaving these pesticides in unregulated storages without adequate safety control being a huge risk to the environment and human health. The integrative approach IHPA takes-promoting international cooperation and the exchange of knowledge and experiences-is shortly explained. IHPA has developed various supporting tools for its work: the IHPA web page and newsletter informing on the threats and challenges, but also on the progresses of managing pesticide stockpiles; the joint GIZ-PAN-IHPA exhibition on awareness of the pesticide stockpile challenge; and the 'International HCH and Pesticides Forum' as most important tool to progress the integrative work and mission of IHPA. Finally, a summary of the 11th International HCH and Pesticides Forum held in Gabala, Azerbaijan is given which brought together more than 120 scientists, policy-makers, non-governmental and international organisations, industry and students from more than 40 countries to progress the obsolete pesticides and hazardous chemical waste challenge in EECCA countries. The event finished with adoption of 'Gabala Declaration', which aims to mobilise efforts of all stakeholders for prevention and elimination of POPs, obsolete pesticides, and hazardous chemical waste in the region.

  12. Emotional intelligence and medical specialty choice: findings from three empirical studies.

    PubMed

    Borges, Nicole J; Stratton, Terry D; Wagner, Peggy J; Elam, Carol L

    2009-06-01

    Despite only modest evidence linking personality-type variables to medical specialty choice, stereotypes involving empathy and 'emotional connectedness' persist, especially between primary care providers and surgeons or subspecialists. This paper examines emotional intelligence (EI) and specialty choice among students at three US medical schools. Results from three independent studies are presented. Study 1 used the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) administered to a single cohort of 84 Year 4 medical students. Study 2 used the Trait Meta-Mood Scale (TMMS) and Davis' Interpersonal Reactivity Index (IRI) administered to three cohorts (n = 250) of Year 3 medical students. Study 3 used the Bar-On Emotional Quotient Inventory (EQ-I) administered to two cohorts of Year 1 medical students (n = 292). Results were linked to specialty choice data retrieved from the National Residency Match Program (NRMP). Classifications of specialty choice included: (i) primary care (family practice, internal medicine, paediatrics) versus non-primary care (all others), and (ii) primary care, hospital-based specialties (anaesthesiology, emergency medicine, pathology, radiology), and technical and surgical specialties (neurology, obstetrics and gynaecology, ophthalmology, and all surgical fields). Across all three studies - and using both classifications of specialty choice - no significant differences in EI were found between students entering primary care and non-primary care specialties. Limitations are acknowledged, and future directions for research involving EI are identified.

  13. Career satisfaction of surgical specialties.

    PubMed

    Deshpande, Satish P; Deshpande, Sagar S

    2011-05-01

    To examine the factors that impact career satisfaction for various surgical specialties. An acute shortage of surgeons is anticipated in the future. Career dissatisfaction can make this already difficult situation worse. It is important to understand and address factors that influence career satisfaction of surgeons to prolong tenure of existing surgeons and understand anticipated needs of future surgeons. The Center for Studying Health System Change 2008 Health Tracking Physician Survey data were used in this study. Regression analysis was done to examine the impact of various practice-related factors, compensation-related factors, practice location, extent of minority patient, and various demographics on career satisfaction of various surgical specialties (n = 762). Among practice related factors, although threat of malpractice had a significant negative impact on career satisfaction, ability to provide quality care to patients and time with patients had a significant positive impact on career satisfaction of surgical specialists. Among compensation related factors, income and financial incentives to expand services had a significant positive impact on career satisfaction. Among practice location factors, those who primarily worked in medical schools were significantly more satisfied with their careers than others. Among minority factors, those treating a large proportion of Hispanic patients were significantly less likely to be satisfied with their careers. Ability to provide quality care, time with patients, income, and financial incentives had a significant positive impact on career satisfaction. Similarly, threat of malpractice and high proportion of Hispanic patients had a negative impact on career satisfaction.

  14. Resilience in international migrant women following violence associated with pregnancy.

    PubMed

    Gagnon, Anita J; Stewart, Donna E

    2014-08-01

    Exposure to violence associated with pregnancy (VAP) is an underrecognized public health and social problem that has an enormous impact on the physical and mental health of women and their children. Our recent study of 1,127 new mothers living in two urban areas of Canada found refugees and asylum-seekers to be more likely to have experienced VAP than immigrant or Canadian-born women. Interestingly, some migrants who had experienced VAP had low rates of postpartum depression risk on the Edinburgh Postpartum Depression Scale, suggesting that resilience may play an important role in maintaining their mental health. Hence, we sought to explore processes which enhance migrants' resilience to VAP. We conducted in-depth interviews with ten women who had been identified as experiencing VAP and having low risk of postpartum depression and performed thematic analyses. International migrant women found internal psychological and coping resources, external social supports, and systemic factors including government policies to be vital to their resilience. Participants perceived differences in resilience by gender and immigration status. International migrant women used a range of processes to maintain and enhance their resilience after VAP, and these may be helpful to less resilient women who are vulnerable to postpartum depression.

  15. Why medical students choose orthopedic surgery as a specialty?

    PubMed Central

    Erraji, Moncef; Kharraji, Abdessamad; Abbasi, Najib; Najib, Abdeljawad; Yacoubi, Hicham

    2015-01-01

    Before the crisis announced the Moroccan surgery, the objectives of this study were to analyze the choice of specialties newly appointed to the internal review and the guidance of medical students and to determine the factors influencing this choice. Data on specialty choice students were analyzed and a questionnaire was offered to students of Morocco at the beginning of academic year 2013-20014 The form consisted of questions on the year of study. sex, professional guidelines and reasons for choice. candidates were male, the average age of our residents was 28 years. We also noted the importance of the passage as well as external service trauma. Care provided to patients, lifestyle and income reported by 85% of respondents to be the most important factors to pursue orthopedics as a career. The TR-Orth is now a specialty that responds to a positive choice. The choice of TR-Orth by students at the end of medical school curriculum is reinforced by teaching and practicing the specialty during the internship. The overall training is unsatisfactory overall. Students would deepen in some areas. This study confirms that there is currently a shift in trauma surgery, mostly induced by an a priori negative for particular workloads. PMID:26185556

  16. Status of oncologic specialties: global survey of physicians treating cancer.

    PubMed

    Komiya, Takefumi; Mackay, Christine B; Chalise, Prabhakar

    2017-04-01

    In the United States, medical oncologists play a central role in the management of systemic therapy for cancer patients. Medical oncology as a specialty is not as established in Japan and several other European nations according to recent surveys, and little is known about this specialty in developing nations. We aimed to identify global differences in the roles of physicians treating cancer; specifically, how the management of advanced disease differs among nations. In March 2016, a self-administered internet survey was conducted with degreed physicians who prescribed systemic agents for adult cancer treatment within the past 5 years. Physicians were identified from the American Society of Clinical Oncology active member online directory. Among 3907 members in 55 nations, 376 (9.6%) responded to the survey. The 310 respondents who provided an answer to the recognition of medical oncology were dominated by male MDs that have practiced for more than 5 years at academic centers, and ~60% were medical oncologists. A majority of the respondents in all four regions reported that medical oncology was established in their corresponding nations. However, there are several outlying nations where oncologic specialties play a minimal role in the management of systemic therapy. Despite general recognition of medical oncology, the role is not globally established as the primary point of care for delivery of systemic therapy. Nations lacking this specialty should be assisted by the international community to develop medical oncology.

  17. Nurse Specialty Certification, Inpatient Mortality, and Failure to Rescue

    PubMed Central

    Kendall-Gallagher, Deborah; Aiken, Linda H.; Sloane, Douglas M.; Cimiotti, Jeannie P.

    2011-01-01

    Purpose To determine if hospital proportion of staff nurses with specialty certification is associated with risk-adjusted inpatient 30-day mortality and failure to rescue (deaths in surgical inpatients following a major complication). Design Secondary analysis of risk-adjusted adult general, orthopedic, and vascular surgical inpatients discharged during 2005–2006 (n = 1,283,241) from 652 nonfederal hospitals controlling for state, hospital, patient, and nursing characteristics by linking outcomes, administrative, and nurse survey data (n = 28,598). Method Nurse data, categorized by education and certification status, were aggregated to the hospital level. Logistic regression models were used to estimate effects of specialty certification and other nursing characteristics on mortality and failure to rescue. Findings Hospital proportion of baccalaureate and certified baccalaureate staff nurses were associated with mortality and failure to rescue; no effect of specialization was seen in the absence of baccalaureate education. A 10% increase in hospital proportion of baccalaureate and certified baccalaureate staff nurses, respectively, decreased the odds of adjusted inpatient 30-day mortality by 6% and 2%; results for failure to rescue were identical. Conclusions Nurse specialty certification is associated with better patient outcomes; effect on mortality and failure to rescue in general surgery patients is contingent upon baccalaureate education. Clinical Relevance Investment in a baccalaureate-educated workforce and specialty certification has the potential to improve the quality of care. PMID:21605323

  18. The International Permafrost Association: current initiatives for cryospheric research

    NASA Astrophysics Data System (ADS)

    Schollaen, Karina; Lewkowicz, Antoni G.; Christiansen, Hanne H.; Romanovsky, Vladimir E.; Lantuit, Hugues; Schrott, Lothar; Sergeev, Dimitry; Wei, Ma

    2015-04-01

    The International Permafrost Association (IPA), founded in 1983, has as its objectives to foster the dissemination of knowledge concerning permafrost and to promote cooperation among persons and national or international organizations engaged in scientific investigation and engineering work on permafrost. The IPA's primary responsibilities are convening International Permafrost Conferences, undertaking special projects such as preparing databases, maps, bibliographies, and glossaries, and coordinating international field programs and networks. Membership is through adhering national or multinational organizations or as individuals in countries where no Adhering Body exists. The IPA is governed by its Executive Committee and a Council consisting of representatives from 26 Adhering Bodies having interests in some aspect of theoretical, basic and applied frozen ground research, including permafrost, seasonal frost, artificial freezing and periglacial phenomena. This presentation details the IPA core products, achievements and activities as well as current projects in cryospheric research. One of the most important core products is the circumpolar permafrost map. The IPA also fosters and supports the activities of the Global Terrestrial Network on Permafrost (GTN-P) sponsored by the Global Terrestrial Observing System, GTOS, and the Global Climate Observing System, GCOS, whose long-term goal is to obtain a comprehensive view of the spatial structure, trends, and variability of changes in the active layer thickness and permafrost temperature. A further important initiative of the IPA are the biannually competitively-funded Action Groups which work towards the production of well-defined products over a period of two years. Current IPA Action Groups are working on highly topical and interdisciplinary issues, such as the development of a regional Palaeo-map of Permafrost in Eurasia, the integration of multidisciplinary knowledge about the use of thermokarst and permafrost

  19. Air Force Officer Specialty Structure. Reviewing the Fundamentals

    DTIC Science & Technology

    2009-01-01

    documents for commercial use. For information on reprint and linking permissions, please see RAND Permissions. Limited Electronic Distribution Rights This...JUSTICE EDUCATION ENERGY AND ENVIRONMENT HEALTH AND HEALTH CARE INTERNATIONAL AFFAIRS NATIONAL SECURITY POPULATION AND AGING PUBLIC SAFETY SCIENCE AND...of RAND Project AIR FORCE for a fiscal year (FY) 2007 study, “USAF Specialty Code Restructuring.” This report should interest Air Force human

  20. Treatment at the front end of the criminal justice continuum: the association between arrest and admission into specialty substance abuse treatment

    PubMed Central

    Kubiak, Sheryl Pimlott; Arfken, Cynthia L; Swartz, James A; Koch, Alison L

    2006-01-01

    important policy implications in reducing the number of subsequent arrests or preventing individuals moving further along the criminal justice continuum, as well as decreasing the fiscal and resource burdens associated with criminal justice processing and confinement. PMID:16879743

  1. Depression and Associated Factors in Internal Migrant Workers in China

    PubMed Central

    Qiu, Peiyuan; Caine, Eric; Yang, Yang; Chen, Quan; Li, Jin; Ma, Xiao

    2011-01-01

    Background Internal migrant workers are a large population in China. Current health related studies among this population mainly focused on infectious disease, maternal health and occupational diseases and injuries. However, very limited studies were paid attention to mental health of migrant workers though it is an important public health issue. Aims The current study aims to understand prevalence of depression symptoms and factors associated with depression among Chinese migrant workers using novel methods to develop a comprehensive sample. Methods Respondent-driven sampling (RDS) was employed to recruit the target population, who are required 1) not to hold a hukou indicative of living in central areas or near suburbs of Chengdu city; 2) to be 16 years or older; 3) not to be a student. The Center for Epidemiologic Depression Scale (CES-D) was used to measure depression symptoms of migrant workers. And then Structural Equation Model (SEM) was applied to explore factors associated with depression among Chinese migrant workers. Results Among 1,180 migrant workers, 23.7% of them had clinically relevant depression symptoms (CES-D score >= 16), and 12.8% were consistent with a clinical diagnosis of depression (CES-D score >= 21). Self-rated economic status, city adaptation status, and self-rated health had negative effects on depression. Social economic status (SES) affected depression, and was mediated by self-rated economic status and self-rated health. City adaptation status was affected by length of residence in the city, satisfaction with one’s job, and the social support that one could obtain while living in the city. Conclusions The findings indicated a higher prevalence of depression symptoms among migrant workers comparing to general population reported by previous studies, identified possible factors associated with depression symptoms, and also explored relationships between these factors. Our study provides a model to understand mental health of Chinese

  2. Factors associated with performance in an internal medicine clerkship

    PubMed Central

    McNeal, Tresa; Lezama, Maybelline; Chandler, Martha; Forrester, Lisa; Metting, Austin; Mirkes, Curtis; Van Cleave, Holly; Win, Sonny; Myers, John D.

    2017-01-01

    The purpose of this retrospective study was to examine the relationship between demographic and educational variables and student performance on an internal medicine (IM) clerkship in order to target areas for educational intervention and potential early remediation. This study examined data associated with third-year medical student performance (N = 505) during the IM clerkship at Baylor Scott & White, Temple/Texas A&M Health Science Center College of Medicine from 2005 to 2011. Multiple regression analysis (N = 341) showed that a model containing the following variables was significantly associated with scores on the National Board of Medical Examiners (NBME) subject exam, accounting for 46.5% of the variance: Objective Structured Clinical Exam (OSCE), Medical College Admissions Test (MCAT), US Medical Licensing Exam (USMLE) Step 1, second-year grade point average (GPA), and clinical evaluation. A model containing USMLE Step 1, clinical evaluation, and NBME was significantly associated with OSCE score, accounting for 30% of the variance. Additionally, a model containing age, MCAT score, undergraduate GPA, NBME subject exam score, and OSCE was significantly associated with clinical evaluation score, accounting for 22% of score variance. Age accounted for the most unique variance in clinical evaluation score. Gender and IM interest group were not significantly associated with any outcome variable. In conclusion, in contrast to previous studies in the field, we did not find a significant association between undergraduate GPA and NBME score. Our findings supply further evidence that the OSCE, typically believed to be a clinical performance exam, actually assesses a broader set of domains. Interest group membership did not confer any academic benefit to medical students in IM clerkships in our study. PMID:28127127

  3. Synthetic Biology for Specialty Chemicals.

    PubMed

    Markham, Kelly A; Alper, Hal S

    2015-01-01

    In this review, we address recent advances in the field of synthetic biology and describe how those tools have been applied to produce a wide variety of chemicals in microorganisms. Here we classify the expansion of the synthetic biology toolbox into three different categories based on their primary function in strain engineering-for design, for construction, and for optimization. Next, focusing on recent years, we look at how chemicals have been produced using these new synthetic biology tools. Advances in producing fuels are briefly described, followed by a more thorough treatment of commodity chemicals, specialty chemicals, pharmaceuticals, and nutraceuticals. Throughout this review, an emphasis is placed on how synthetic biology tools are applied to strain engineering. Finally, we discuss organism and host strain diversity and provide a future outlook in the field.

  4. Comparison of Support Services Offered by Residencies in Six Specialties, 1979-80 and 1988-89.

    ERIC Educational Resources Information Center

    Kahn, Norman B., Jr.; Addison, Richard B.

    1992-01-01

    A study investigated the availability of each of 19 medical school support services offered by 493 residencies in 6 specialties: family practice; internal medicine; obstetrics/gynecology; pediatrics; psychiatry; and surgery. Results show many specialties do not offer common, effective support services. It is suggested that programs move to…

  5. An Assessment of the Content of Medical Practice in the United States: Profiles of Physicians in Five Specialties.

    ERIC Educational Resources Information Center

    Girard, Roger A.; And Others

    1982-01-01

    The unique research methodology of a series of 24 specialty surveys of the professional activities of over 10,000 respondent physicians is described. Illustrative data are presented from five specialties (cardiology, family practice, general internal medicine, orthopedic surgery, and psychiatry), and the study's relevance and implications for…

  6. An Assessment of the Content of Medical Practice in the United States: Profiles of Physicians in Five Specialties.

    ERIC Educational Resources Information Center

    Girard, Roger A.; And Others

    1982-01-01

    The unique research methodology of a series of 24 specialty surveys of the professional activities of over 10,000 respondent physicians is described. Illustrative data are presented from five specialties (cardiology, family practice, general internal medicine, orthopedic surgery, and psychiatry), and the study's relevance and implications for…

  7. Comparison of Support Services Offered by Residencies in Six Specialties, 1979-80 and 1988-89.

    ERIC Educational Resources Information Center

    Kahn, Norman B., Jr.; Addison, Richard B.

    1992-01-01

    A study investigated the availability of each of 19 medical school support services offered by 493 residencies in 6 specialties: family practice; internal medicine; obstetrics/gynecology; pediatrics; psychiatry; and surgery. Results show many specialties do not offer common, effective support services. It is suggested that programs move to…

  8. 15 CFR 2011.203 - Issuance of specialty sugar certificates.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Issuance of specialty sugar... SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.203 Issuance of specialty sugar certificates. (a) Specialty sugars imported into the United States from specialty sugar source countries may be entered only...

  9. 15 CFR 2011.203 - Issuance of specialty sugar certificates.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 3 2014-01-01 2014-01-01 false Issuance of specialty sugar... SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.203 Issuance of specialty sugar certificates. (a) Specialty sugars imported into the United States from specialty sugar source countries may be entered only...

  10. 15 CFR 2011.203 - Issuance of specialty sugar certificates.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 15 Commerce and Foreign Trade 3 2013-01-01 2013-01-01 false Issuance of specialty sugar... SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.203 Issuance of specialty sugar certificates. (a) Specialty sugars imported into the United States from specialty sugar source countries may be entered only...

  11. 15 CFR 2011.203 - Issuance of specialty sugar certificates.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 3 2012-01-01 2012-01-01 false Issuance of specialty sugar... SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.203 Issuance of specialty sugar certificates. (a) Specialty sugars imported into the United States from specialty sugar source countries may be entered only...

  12. 15 CFR 2011.203 - Issuance of specialty sugar certificates.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Issuance of specialty sugar... SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.203 Issuance of specialty sugar certificates. (a) Specialty sugars imported into the United States from specialty sugar source countries may be entered only...

  13. Carrot yellow leaf virus Is Associated with Carrot Internal Necrosis

    PubMed Central

    Adams, Ian P.; Skelton, Anna; Macarthur, Roy; Hodges, Tobias; Hinds, Howard; Flint, Laura; Nath, Palash Deb; Boonham, Neil; Fox, Adrian

    2014-01-01

    Internal necrosis of carrot has been observed in UK carrots for at least 10 years, and has been anecdotally linked to virus infection. In the 2009 growing season some growers had up to 10% of yield with these symptoms. Traditional diagnostic methods are targeted towards specific pathogens. By using a metagenomic approach with high throughput sequencing technology, other, as yet unidentified causes of root necrosis were investigated. Additionally a statistical analysis has shown which viruses are most closely associated with disease symptoms. Carrot samples were collected from a crop exhibiting root necrosis (102 Affected: 99 Unaffected) and tested for the presence of the established carrot viruses: Carrot red leaf virus (CtRLV), Carrot mottle virus (CMoV), Carrot red leaf associated viral RNA (CtRLVaRNA) and Parsnip yellow fleck virus (PYFV). The presence of these viruses was not associated with symptomatic carrot roots either as single viruses or in combinations. A sub-sample of carrots of mixed symptom status was subjected to MiSeq sequencing. The results from these tests suggested Carrot yellow leaf virus (CYLV) was associated with symptomatic roots. Additionally a novel Torradovirus, a novel Closterovirus and two novel Betaflexiviradae related plant viruses were detected. A specific diagnostic test was designed for CYLV. Of the 102 affected carrots, 98% were positive for CYLV compared to 22% of the unaffected carrots. From these data we conclude that although we have yet to practically demonstrate a causal link, CYLV appears to be strongly associated with the presence of necrosis of carrots. PMID:25365290

  14. Sensing technologies for precision specialty crop production

    USDA-ARS?s Scientific Manuscript database

    With the advances in electronic and information technologies, various sensing systems have been developed for specialty crop production around the world. Accurate information concerning the spatial variability within fields is very important for precision farming of specialty crops. However, this va...

  15. Social Dominance Theory and Medical Specialty Choice

    ERIC Educational Resources Information Center

    Lepièce, Brice; Reynaert, Christine; van Meerbeeck, Philippe; Dory, Valérie

    2016-01-01

    Understanding how medical students select their specialty is a fundamental issue for public health and educational policy makers. One of the factors that students take into account is a specialty's prestige which hinges partly on its focus on technique rather than whole person. We examine the potential of a psychological framework, social…

  16. Social Dominance Theory and Medical Specialty Choice

    ERIC Educational Resources Information Center

    Lepièce, Brice; Reynaert, Christine; van Meerbeeck, Philippe; Dory, Valérie

    2016-01-01

    Understanding how medical students select their specialty is a fundamental issue for public health and educational policy makers. One of the factors that students take into account is a specialty's prestige which hinges partly on its focus on technique rather than whole person. We examine the potential of a psychological framework, social…

  17. The International Association of Student Surgical Societies: creation and dissemination

    PubMed Central

    Chandauka, Tinashe; Leusink, Astrid; Hsiao, Marvin; Kahn, Delawir; Azzie, Georges

    2016-01-01

    Summary While initiatives exist to address the worldwide need for surgeons, none involve a student-driven solution from low- and middle-income countries (LMICs). In response to falling surgical residency enrolment in South Africa, the students at the University of Cape Town (UCT) founded the UCT Surgical Society and were subsequently instrumental in creating the International Association of Student Surgical Societies (IASSS). The IASSS currently includes 25 societies in 15 countries. Its primary objectives are building sustainable networks for mutually beneficial exchanges, supporting student-driven projects, understanding issues impacting student interest in surgery, promoting global fellowship, creating an elective database and providing assistance to student surgical societies. The IASSS is a unique student-led initiative trying to improve surgical care in LMICs. PMID:27669399

  18. Excitatory Cerebellar Nucleocortical Circuit Provides Internal Amplification during Associative Conditioning

    PubMed Central

    Gao, Zhenyu; Proietti-Onori, Martina; Lin, Zhanmin; ten Brinke, Michiel M.; Boele, Henk-Jan; Potters, Jan-Willem; Ruigrok, Tom J.H.; Hoebeek, Freek E.; De Zeeuw, Chris I.

    2016-01-01

    Summary Closed-loop circuitries between cortical and subcortical regions can facilitate precision of output patterns, but the role of such networks in the cerebellum remains to be elucidated. Here, we characterize the role of internal feedback from the cerebellar nuclei to the cerebellar cortex in classical eyeblink conditioning. We find that excitatory output neurons in the interposed nucleus provide efference-copy signals via mossy fibers to the cerebellar cortical zones that belong to the same module, triggering monosynaptic responses in granule and Golgi cells and indirectly inhibiting Purkinje cells. Upon conditioning, the local density of nucleocortical mossy fiber terminals significantly increases. Optogenetic activation and inhibition of nucleocortical fibers in conditioned animals increases and decreases the amplitude of learned eyeblink responses, respectively. Our data show that the excitatory nucleocortical closed-loop circuitry of the cerebellum relays a corollary discharge of premotor signals and suggests an amplifying role of this circuitry in controlling associative motor learning. PMID:26844836

  19. Clinical fellowships in surgical training: analysis of a national pan-specialty workforce survey.

    PubMed

    Fitzgerald, J E F; Milburn, J A; Khera, G; Davies, R S M; Hornby, S T; Giddings, C E B

    2013-05-01

    Fellowship posts are increasingly common and offer targeted opportunities for training and personal development. Despite international demand, there is little objective information quantifying this effect or the motivations behind undertaking such a post. The present study investigated surgical trainees' fellowship aims and intentions. An electronic, 38-item, self-administered questionnaire survey was distributed in the United Kingdom via national and regional surgical mailing lists and websites via the Association of Surgeons in Training, Royal Surgical Colleges, and Specialty Associations. In all, 1,581 fully completed surveys were received, and 1,365 were included in the analysis. These represented trainees in core or higher training programs or research from all specialties and training regions: 66 % were male; the mean age was 32 years; 77.6 % intended to or had already completed a fellowship. Plastic surgery (95.2 %) and cardiothoracic (88.6 %) trainees were most likely to undertake a fellowship, with pediatrics (51.2 %), and urology (54.3 %) the least likely. Fellowship uptake increased with seniority (p < 0.01) and was positively correlated (p = 0.016, r = 0.767) with increasing belief that fellowships are necessary to the attainment of clinical competence, agreed by 73.1 %. Fellowship aims were ranked in descending order of importance as attaining competence, increasing confidence, and attaining subspecialist skills. Over three-quarters of trainees have or will undertake a clinical fellowship, varying with gender, specialty, and seniority. Competence, confidence, and subspecialty skills development are the main aims. The findings will influence workforce planning, and perceptions that current training does not deliver sufficient levels of competence and confidence merit further investigation.

  20. Personality as a prognostic factor for specialty choice: a prospective study of 4 medical school classes.

    PubMed

    Markert, Ronald J; Rodenhauser, Paul; El-Baghdadi, Mariam M; Juskaite, Kornelija; Hillel, Alexander T; Maron, Bradley A

    2008-02-27

    To augment the availability of medical care for a population that is older and more ethnically diverse, the number of US medical schools is increasing and existing medical schools are enlarging their class sizes. Predictors of specialty choice, especially primary care careers, are helpful to medical school officials and faculty involved in medical school recruitment and counseling and to students planning their career paths. The objective was to examine the association between personality characteristics and specialty choice. The Neuroticism-Extraversion-Openness Personality Inventory Revised (NEO PI-R) was administered to 4 Tulane University School of Medicine (New Orleans, Louisiana) classes (2003-2006). The NEO PI-R is a measure of 5 personality characteristics (neuroticism, extraversion, openness, agreeableness, and conscientiousness), with each domain having 6 underlying facets. The specialty choice of graduates was obtained from the National Residency Matching Program. Starting in 1999, 595 students matriculated and by June 2006, 542 (91%) had matched to residency programs in 22 specialties. There were differences among specialties for neuroticism (P = .006), openness (P < .001), and agreeableness (P = .003), but not for extraversion (P = .173) or conscientiousness (P = .103). Various pairwise differences between specialty categories were found. Eleven specialty categories were compared using the NEO PI-R. Numerous specialty variations were identified for neuroticism, openness, and agreeableness. The findings may be useful to medical school officials and faculty who recruit and counsel students and to students themselves as they reflect on their personality characteristics on their path to making career choices.

  1. Specialty pharmaceuticals care management in an integrated health care delivery system with electronic health records.

    PubMed

    Monroe, C Douglas; Chin, Karen Y

    2013-05-01

    The specialty pharmaceuticals market is expanding more rapidly than the traditional pharmaceuticals market. Specialty pharmacy operations have evolved to deliver selected medications and associated clinical services. The growing role of specialty drugs requires new approaches to managing the use of these drugs. The focus, expectations, and emphasis in specialty drug management in an integrated health care delivery system such as Kaiser Permanente (KP) can vary as compared with more conventional health care systems. The KP Specialty Pharmacy (KP-SP) serves KP members across the United States. This descriptive account addresses the impetus for specialty drug management within KP, the use of tools such as an electronic health record (EHR) system and process management software, the KP-SP approach for specialty pharmacy services, and the emphasis on quality measurement of services provided. Kaiser Permanente's integrated system enables KP-SP pharmacists to coordinate the provision of specialty drugs while monitoring laboratory values, physician visits, and most other relevant elements of the patient's therapy. Process management software facilitates the counseling of patients, promotion of adherence, and interventions to resolve clinical, logistic, or pharmacy benefit issues. The integrated EHR affords KP-SP pharmacists advantages for care management that should become available to more health care systems with broadened adoption of EHRs. The KP-SP experience may help to establish models for clinical pharmacy services as health care systems and information systems become more integrated.

  2. A Brief History of INA and ICOH SCNP: International Neurotoxicology Association and International Congress on Occupational Health Scientific Committee on Neurotoxicology and Psychophysiology

    EPA Science Inventory

    Two international scientific societies dedicated to research in neurotoxicology and neurobehavioral toxicology are the International Neurotoxicology Association (INA) and the International Congress on Occupational Health International Symposium on Neurobehavioral Methods and Effe...

  3. A Brief History of INA and ICOH SCNP: International Neurotoxicology Association and International Congress on Occupational Health Scientific Committee on Neurotoxicology and Psychophysiology

    EPA Science Inventory

    Two international scientific societies dedicated to research in neurotoxicology and neurobehavioral toxicology are the International Neurotoxicology Association (INA) and the International Congress on Occupational Health International Symposium on Neurobehavioral Methods and Effe...

  4. Role of reputation in top pediatric specialties rankings.

    PubMed

    Bush, Ruth A; Quigley, Edward J; Fox, Lyman; Garcia-Bassets, Ivan

    2011-12-01

    Although the role of reputation in determining the relative standings in the U.S. News & World Report (USNWR) annual rankings of the top 50 hospitals has received analytical attention, the role of reputation in the best children's hospitals pediatric specialty rankings has not been quantified. Our goal was to quantify the role of reputation in determining the relative standings of the top-ranked pediatric specialties and their associated hospitals in the 2008-2010 editions of the USNWR best children's hospital rankings. A cross-sectional study of USNWR data collected from the top 30 hospitals in each of 6 (and later 10) specialties was performed. The main outcome measures were rankings based on total USNWR scores and subjective reputation scores. On average, rankings based on reputation scores alone correlated with USNWR overall rankings; correlation coefficients ranged from 0.80 to 0.98 (Spearman Correlation; mean P < .001). This relationship was consistent over all 3 survey years. The relative standings of the top 30 pediatric hospitals in each of 10 specialties are largely explained by the compelling correlation between subjective reputation scores and ranking scores.

  5. Niche players in health policy: medical specialty societies in Congress 1969-2002.

    PubMed

    Rabinowitz, Aaron; Laugesen, Miriam

    2010-10-01

    Scholars and commentators alike have long used 'organized medicine' as shorthand for the American Medical Association (AMA). However, organized medicine has increasingly shown signs of fragmentation into specialty societies over the last two decades. While the AMA remains the largest association of physicians, and wields a great deal of influence in political circles, its use as a proxy for organized medicine may warrant reevaluation due to the changing political organization of medicine. We developed a unique database of specialty medical society appearances before all Congressional committees by combining records from Lexis-Nexis Congressional and the Policy Agendas database. Descriptive statistics were used to evaluate the participation of specialty societies by committee and by hearing type. The Herfindahl-Hirschman Index (HHI) was used to measure whether specialty societies develop niche roles with specific committees, and the Chi-Square Goodness of Fit test was used to study the distribution of specialty society testimonies in health hearings more formally. We found that although the AMA participates in Congressional hearings at a higher rate than any other individual medical specialty society, it accounts for a decreasing percentage of all specialty society appearances over time. In addition, specialty societies have developed niche and monopoly roles in health policymaking as well as relationships with particular congressional committees over time. We conclude that the increasing participation of specialty medical societies in the policymaking process is important because medical societies do not testify solely to promote the economic self-interest of their members. Specialization in medicine has segmented lobbying roles, such that specialty societies have a different focus than the AMA. Thus, 'organized medicine' and the AMA are no longer synonymous.

  6. Research involvement, specialty choice, and emigration preferences of final year medical students in croatia.

    PubMed

    Kolcić, Ivana; Polasek, Ozren; Mihalj, Hrvoje; Gombac, Elena; Kraljević, Vinka; Kraljević, Ivana; Krakar, Goran

    2005-02-01

    To explore involvement in scientific research, choice of specialty, and readiness to emigrate among graduating medical students in Croatia. A total of 312 out of 408 (76%) final year medical students of all Croatian Medical Schools (Zagreb, Rijeka, Osijek, and Split) graduating in 2004 answered a questionnaire designed for this study, including questions on scientific involvement, desired specialty, and emigration preferences. During undergraduate study, 71 (23%) students have been involved in scientific projects. However, only 27 of them (38%) succeeded in publishing their results. Students identified poor project management as the most common reason for publication failure. Specialty choice varied among the four medical schools in Croatia but internal medicine, pediatrics, and surgery were usually highly preferred in all schools. If they failed to get the desired specialty, 104 (33%) students would consider emigration. There is a clear need for improvement in the management of students' research projects in Croatia, enabling enthusiastic medical students to publish the results of their work and retain their interest in science. The analysis of change of the desired specialties throughout the undergraduate study suggests an increased interest in the "controllable lifestyle" specialties. Failure to get the desired specialty would result in emigration for many students.

  7. HPV-associated lung cancers: an international pooled analysis

    PubMed Central

    Ragin, Camille; Obikoya-Malomo, Monisola

    2014-01-01

    Human papillomavirus (HPV) is the etiologic risk factor for cervical cancer. Some studies have suggested an association with a subset of lung tumors, but the etiologic link has not been firmly established. We performed an international pooled analysis of cross-sectional studies (27 datasets, n = 3249 patients) to evaluate HPV DNA prevalence in lung cancer and to investigate viral presence according to clinical and demographic characteristics. HPV16/18 were the most commonly detected, but with substantial variation in viral prevalence between geographic regions. The highest prevalence of HPV16/18 was observed in South and Central America, followed by Asia, North America and Europe (adjusted prevalence rates = 22, 5, 4 and 3%, respectively). Higher HPV16 prevalence was noted in each geographic region compared with HPV18, except in North America. HPV16/18-positive lung cancer was less likely observed among White race (adjusted odds ratio [OR] = 0.33, 95% confidence interval [CI] = 0.12–0.90), whereas no associations were observed with gender, smoking history, age, histology or stage. Comparisons between tumor and normal lung tissue show that HPV was more likely to be present in lung cancer rather than normal lung tissues (OR = 3.86, 95% CI = 2.87–5.19). Among a subset of patients with HPV16-positive tumors, integration was primarily among female patients (93%, 13/14), while the physical status in male cases (N = 14) was inconsistent. Our findings confirm that HPV DNA is present in a small fraction of lung tumors, with large geographic variations. Further comprehensive analysis is needed to assess whether this association reflects a causal relationship. PMID:24523449

  8. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth.

    PubMed

    Diangelis, Anthony J; Andreasen, Jens O; Ebeleseder, Kurt A; Kenny, David J; Trope, Martin; Sigurdsson, Asgeir; Andersson, Lars; Bourguignon, Cecilia; Flores, Marie Therese; Hicks, Morris Lamar; Lenzi, Antonio R; Malmgren, Barbro; Moule, Alex J; Pohl, Yango; Tsukiboshi, Mitsuhiro

    2012-02-01

    Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning and followup are important for improving a favorable outcome. Guidelines should assist dentists and patients in decision making and for providing the best care effectively and efficiently. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion of the IADT board members. The guidelines represent the best current evidence based on literature search and professional opinion. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines for management of fractures and luxations of permanent teeth will be presented. © 2012 John Wiley & Sons A/S.

  9. Medical insurance claims associated with international business travel.

    PubMed Central

    Liese, B; Mundt, K A; Dell, L D; Nagy, L; Demure, B

    1997-01-01

    OBJECTIVES: Preliminary investigations of whether 10,884 staff and consultants of the World Bank experience disease due to work related travel. Medical insurance claims filed by 4738 travellers during 1993 were compared with claims of non-travellers. METHODS: Specific diagnoses obtained from claims were analysed overall (one or more v no missions) and by frequency of international mission (1, 2-3, or > or = 4). Standardised rate of claims ratios (SSRs) for each diagnostic category were obtained by dividing the age adjusted rate of claims for travellers by the age adjusted rate of claims for non-travellers, and were calculated for men and women travellers separately. RESULTS: Overall, rates of insurance claims were 80% higher for men and 18% higher for women travellers than their non-travelling counterparts. Several associations with frequency of travel were found. SRRs for infectious disease were 1.28, 1.54, and 1.97 among men who had completed one, two or three, and four or more missions, and 1.16, 1.28, and 1.61, respectively, among women. The greatest excess related to travel was found for psychological disorders. For men SRRs were 2.11, 3.13, and 3.06 and for women, SRRs were 1.47, 1.96, and 2.59. CONCLUSIONS: International business travel may pose health risks beyond exposure to infectious diseases. Because travellers file medical claims at a greater rate than non-travellers, and for many categories of disease, the rate of claims increases with frequency of travel. The reasons for higher rates of claims among travellers are not well understood. Additional research on psychosocial factors, health practices, time zones crossed, and temporal relation between travel and onset of disease is planned. PMID:9282127

  10. Lifestyle factors and primary care specialty selection: comparing 2012-2013 graduating and matriculating medical students' thoughts on specialty lifestyle.

    PubMed

    Clinite, Kimberly L; DeZee, Kent J; Durning, Steven J; Kogan, Jennifer R; Blevins, Terri; Chou, Calvin L; Diemer, Gretchen; Dunne, Dana W; Fagan, Mark J; Hartung, Paul J; Kazantsev, Stephanie M; Mechaber, Hilit F; Paauw, Douglas S; Wong, Jeffrey G; Reddy, Shalini T

    2014-11-01

    To compare how first-year (MS1) and fourth-year students (MS4) ascribe importance to lifestyle domains and specialty characteristics in specialty selection, and compare students' ratings with their primary care (PC) interest. In March 2013, MS4s from 11 U.S. MD-granting medical schools were surveyed. Using a five-point Likert-type scale (1 = not important at all; 5 = extremely important), respondents rated the importance of 5 lifestyle domains and 21 specialty selection characteristics. One-way analysis of variance was used to assess differences by PC interest among MS4s. Using logistic regression, ratings from MS4s were compared with prior analyses of ratings by MS1s who matriculated to the same 11 schools in 2012. The response rate was 57% (965/1,701). MS4s, as compared with MS1s, rated as more important to good lifestyle: time off (4.3 versus 4.0), schedule control (4.2 versus 3.9), and financial compensation (3.4 versus 3.2). More MS4s than MS1s selected "time-off" (262/906 [30%] versus 136/969 [14%]) and "control of work schedule" (169/906 [19%] versus 146/969 [15%]) as the most important lifestyle domains. In both classes, PC interest was associated with higher ratings of working with the underserved and lower ratings of prestige and salary. In the 2012-2013 academic year, matriculating students and graduating students had similar perceptions of lifestyle and specialty characteristics associated with PC interest. Graduating students placed more importance on schedule control and time off than matriculating students. Specialties should consider addressing a perceived lack of schedule control or inadequate time off to attract students.

  11. Medical residents' circadian preferences across specialties.

    PubMed

    Chin-Quee, Anthony L; Yaremchuk, Kathleen

    2017-10-01

    Circadian preference refers to the tendency of individuals to be more alert and effective in the morning (larks) or the evening (owls). Given the rigors of medical residency training and perceived lifestyle differences among specialties, circadian preference may play a role in choice of medical specialty and subsequent job satisfaction during training. This study aimed to determine the circadian preferences of residents across specialties and correlations with specialty choice and job satisfaction. Single-institution, cross-sectional survey. The Horne-Ostberg Morningness-Eveningness questionnaire, the standard to identify circadian preference, was modified to include demographic and job satisfaction variables and administered to residents at our tertiary care hospital in 2014. Independent t tests were used to correlate circadian preference and specialty choice, and Spearman's correlations were used to correlate circadian preference and job satisfaction. A total of 160 residents from postgraduate years 1 through 7 and 10 specialties responded. The mean chronotype scores from all specialties met the category of "neither" morning nor evening type. A significant difference occurred between emergency medicine residents and residents from anesthesiology (P = 0.0007), surgery (P < 0.0001), and medicine (P = 0.0005). Residents in the surgical specialties trended toward the morning chronotype, whereas emergency medicine trended toward evening chronotype. There was no significant correlation between chronotype and job satisfaction. Although preliminary because of the low response rate, this study points to the potential of considering circadian preference in choice of specialty training and for designing resident on-call schedules. NA. Laryngoscope, 127:2236-2238, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Scaling up routine HIV testing at specialty clinics: assessing the effectiveness of an academic detailing approach.

    PubMed

    Lubelchek, Ronald J; Hotton, Anna L; Taussig, Daniel; Amarathithada, David; Gonzalez, Marisol

    2013-11-01

    Scaling up routine HIV testing represents a key component of the National HIV/AIDS Strategy. Barriers to routine HIV testing have limited widespread adoption. Although many patients visit specialty care providers, few efforts to increase routine HIV testing in specialty care settings have been made. We report on use of a survey of barriers to routine testing coupled with academic detailing-type educational sessions to increase routine testing at specialty clinics in Chicago's main safety-net health system. We devised a survey to assess specialty provider knowledge, attitudes, and barriers to routine HIV testing. We administered this at 3 specialty clinics. Each clinic's survey responses informed content for academic detailing-type presentations to each clinic's medical providers. We provide descriptive statistics summarizing survey responses. We report changes in the HIV testing rates and use logistic regression to examine associations between time period and odds of testing at each clinic. Specialty clinic providers demonstrated varying knowledge regarding routine HIV testing guidelines-with trauma providers having the least knowledge. Concerns regarding arranging follow-up for patients with positive results was the most cited barrier to testing. Two of the 3 specialty clinics experienced significant increases in routine HIV testing, whereas the third specialty service, which uses more rotating residents, had downtrending routine testing rates. The increase in routine HIV testing in 2 of 3 specialty services suggests that academic detailing-type interventions can improve routine testing uptake in public safety-net specialty care settings and may represent a useful component to incorporate into system-wide scale-up efforts.

  13. Scaling up routine HIV testing at specialty clinics: Assessing the effectiveness of an academic detailing approach

    PubMed Central

    Hotton, Anna L.; Taussig, Daniel; Amarathithada, David; Gonzalez, Marisol

    2013-01-01

    Introduction Scaling up routine HIV testing represents a key component of the National HIV/AIDS Strategy. Barriers to routine HIV testing have limited widespread adoption. While many patients visit specialty care providers, few efforts to increase routine HIV testing in specialty care settings have been made. We report on use of a survey of barriers to routine testing, coupled with academic detailing-type educational sessions to increase routine testing at specialty clinics in Chicago’s main safety-net health system. Methods We devised a survey to assess specialty provider knowledge, attitudes and barriers to routine HIV testing. We administered this at three specialty clinics. Each clinic’s survey responses informed content for academic detailing-type presentations to each clinic’s medical providers. We provide descriptive statistics summarizing survey responses. We report changes in the HIV testing rates and use logistic regression to examine associations between time period and odds of testing at each clinic. Results Specialty clinic providers demonstrated varying knowledge regarding routine HIV testing guidelines – with trauma providers having the least knowledge. Concerns regarding arranging follow-up for patients with positive results was the most cited barrier to testing. Two of the three specialty clinics experienced significant increases in routine HIV testing, while the third specialty service, which utilizes more rotating residents, had down-trending routine testing rates. Discussion The increase in routine HIV testing in two of three specialty services suggests that academic detailing-type interventions can improve routine testing uptake in public safety-net specialty care settings and may represent a useful component to incorporate into system-wide scale-up efforts. PMID:24126444

  14. Computer Associates International, CA-ACF2/VM Release 3.1

    DTIC Science & Technology

    1987-09-09

    Associates CA-ACF2/VM Bibliography International Business Machines Corporation, IBM Virtual Machine/Directory Maintenance Program Logic Manual...publication number LY20-0889 International Business Machines International Business Machines Corporation, IBM System/370 Principles of Operation...publication number GA22-7000 International Business Machines Corporation, IBM Virtual Machine/Directory Maintenance Installation and System Administrator’s

  15. Global health training among U.S. residency specialties: a systematic literature review.

    PubMed

    Hau, Duncan K; Smart, Luke R; DiPace, Jennifer I; Peck, Robert N

    2017-01-01

    Interest in global health training during residency is increasing. Global health knowledge is also becoming essential for health-care delivery today. Many U.S. residency programs have been incorporating global health training opportunities for their residents. We performed a systematic literature review to evaluate global health training opportunities and challenges among U.S. residency specialties. We searched PubMed from its earliest dates until October 2015. Articles included were survey results of U.S. program directors on global health training opportunities, and web-based searches of U.S. residency program websites on global health training opportunities. Data extracted included percentage of residency programs offering global health training within a specialty and challenges encountered. Studies were found for twelve U.S. residency specialties. Of the survey based studies, the specialties with the highest percentage of their residency programs offering global health training were preventive medicine (83%), emergency medicine (74%), and surgery (71%); and the lowest were orthopaedic surgery (26%), obstetrics and gynecology (28%), and plastic surgery (41%). Of the web-based studies, the specialties with the highest percentage of their residency programs offering global health training were emergency medicine (41%), pediatrics (33%), and family medicine (22%); and the lowest were psychiatry (9%), obstetrics and gynecology (17%), and surgery (18%). The most common challenges were lack of funding, lack of international partnerships, lack of supervision, and scheduling. Among U.S. residency specialties, there are wide disparities for global health training. In general, there are few opportunities in psychiatry and surgical residency specialties, and greater opportunities among medical residency specialties. Further emphasis should be made to scale-up opportunities for psychiatry and surgical residency specialties.

  16. Global health training among U.S. residency specialties: a systematic literature review

    PubMed Central

    Hau, Duncan K.; Smart, Luke R.; DiPace, Jennifer I.; Peck, Robert N.

    2017-01-01

    ABSTRACT Background: Interest in global health training during residency is increasing. Global health knowledge is also becoming essential for health-care delivery today. Many U.S. residency programs have been incorporating global health training opportunities for their residents. We performed a systematic literature review to evaluate global health training opportunities and challenges among U.S. residency specialties. Methods: We searched PubMed from its earliest dates until October 2015. Articles included were survey results of U.S. program directors on global health training opportunities, and web-based searches of U.S. residency program websites on global health training opportunities. Data extracted included percentage of residency programs offering global health training within a specialty and challenges encountered. Results: Studies were found for twelve U.S. residency specialties. Of the survey based studies, the specialties with the highest percentage of their residency programs offering global health training were preventive medicine (83%), emergency medicine (74%), and surgery (71%); and the lowest were orthopaedic surgery (26%), obstetrics and gynecology (28%), and plastic surgery (41%). Of the web-based studies, the specialties with the highest percentage of their residency programs offering global health training were emergency medicine (41%), pediatrics (33%), and family medicine (22%); and the lowest were psychiatry (9%), obstetrics and gynecology (17%), and surgery (18%). The most common challenges were lack of funding, lack of international partnerships, lack of supervision, and scheduling. Conclusion: Among U.S. residency specialties, there are wide disparities for global health training. In general, there are few opportunities in psychiatry and surgical residency specialties, and greater opportunities among medical residency specialties. Further emphasis should be made to scale-up opportunities for psychiatry and surgical residency specialties

  17. The use of specialty training to retain doctors in Malawi: A discrete choice experiment.

    PubMed

    Mandeville, Kate L; Ulaya, Godwin; Lagarde, Mylène; Muula, Adamson S; Dzowela, Titha; Hanson, Kara

    2016-11-01

    Emigration has contributed to a shortage of doctors in many sub-Saharan African countries. Specialty training is highly valued by doctors and a potential tool for retention. Yet not all types of training may be valued equally. In the first study to examine preferences for postgraduate training in depth, we carried out a discrete choice experiment as part of a cross-sectional survey of all Malawian doctors within seven years of graduation and not yet in specialty training. Over August 2012 to March 2013, 148 doctors took part out of 153 eligible in Malawi. Despite evidence that specialty training is highly sought after, Malawian junior doctors would not accept all types of training. Doctors preferred timely training outside of Malawi in core specialties (internal medicine, general surgery, paediatrics, obstetrics & gynaecology). Specialty preferences are particularly strong, with most junior doctors requiring nearly double their monthly salary to accept training all in Malawi and over six-fold to accept training in ophthalmology (representing a bundle of unpopular but priority specialties). In contrast, the location of work before training did not significantly influence most doctors' choices when guaranteed specialty training. Using a latent class model, we identified four subgroups of junior doctors with distinct preferences. Policy simulations showed that these preferences could be leveraged by policymakers to improve retention in exchange for guaranteed specialty training, however incentivising the uptake of training in priority specialties will only be effective in those with more flexible preferences. These results indicate that indiscriminate expansion of postgraduate training to slow emigration of doctors from sub-Saharan African countries may not be effective unless doctors' preferences are taken into account.

  18. Variation by Specialty in the Treatment of Urinary Tract Infection in Women

    PubMed Central

    Wigton, Robert S; Longenecker, J Craig; Bryan, Teresa J; Parenti, Connie; Flach, Stephen D; Tape, Thomas G

    1999-01-01

    To determine practicing physicians' strategies for diagnosing and managing uncomplicated urinary tract infection, we surveyed physicians in general internal medicine, family practice, obstetrics and gynecology, and emergency medicine in four states. Responses differed significantly by respondents' specialty. For example, nitrofurantoin was the antibiotic of first choice for 46% of obstetricians, while over 80% in the other specialties chose trimethoprim-sulfamethoxazole. Most surveyed said they do not usually order urine culture, but the percentage who do varied by specialty. Most use a colony count of 105colony-forming units or more for diagnosis although evidence favors a lower threshold, and 70% continue antibiotic therapy even if the culture result is negative. This survey found considerable variation by specialty and also among individual physicians regarding diagnosis and treatment of urinary tract infection and also suggests that some of the new information from the literature has not been translated to clinical practice. PMID:10491234

  19. Geotechnologies for the Characterization of Specialty Coffee Environments of Mantiqueira de Minas in Brazil

    NASA Astrophysics Data System (ADS)

    Alves, H. M. R.; Vieira, T. G. C.; Volpato, M. M. L.; Lacerda, M. P. C.; Borém, F. M.

    2016-06-01

    Land-use/land-cover change (LUCC) is a major cause of environmental transformation. Distant drivers, often associated with emerging markets for specific products, are now being considered one of the main factors of LUCC and are gaining attention in land change science. Consumers show an increasing interest in local and quality food, certified for its origin and its environmental production standards. A kind of agricultural product certification, Geographic Indication, identifies a product as originating from a specific region where a given quality, reputation or characteristic is attributed to its geographical origin. Sustainable land use is potentially an indirect effect of Geographic Indication, as it requires better land management in order to preserve the natural resources associated with the unique characteristics of the certified product. Located in the southern region of the state of Minas Gerais in Brazil is the region of Mantiqueira de Minas, considered one of the most important regions for the production of specialty coffees in Brazil. In 2011, the region's tradition and reputation were recognized with a Geographic Indication, the second given for coffee regions in the country. To explore the full potential of this area for producing coffees with higher quality and meet the growing demand of this new international market, which aggregates value at specialty coffees, it became fundamental to understand the coffee environments of the region, the "terroirs" where these coffees are obtained. Geotechnology can give a significant contribution in filling this gap. This work is part of a research project that made a detailed characterization of the region's coffee agroecosystems. Geotechnologies were employed to map the areas occupied by coffee plantations by using RapidEye satellite images and SPRING and ArcGIS software. All the segments of the environment were characterized and mapped in detail and the relations with coffee quality were evaluated. The results

  20. Sports Counseling: A New Counseling Specialty Area.

    ERIC Educational Resources Information Center

    Miller, Gary M.; Wooten, H. Ray, Jr.

    1995-01-01

    Provides background information about sports counseling for student-athletes. Presents a proposal for a Council for Accreditation of Counseling and Related Educational Programs specialty training area for sports counseling. (Author)

  1. Specialty hospitals: can general hospitals compete?

    PubMed

    Dummit, Laura A

    2005-07-13

    The rapid increase in specialty cardiac, surgical, and orthopedic hospitals has captured the attention of general hospitals and policymakers. Although the number of specialty hospitals remains small in absolute terms, their entry into certain health care markets has fueled arguments about the rules of "fair" competition among health care providers. To allow the smoke to clear, Congress effectively stalled the growth in new specialty hospitals by temporarily prohibiting physicians from referring Medicare or Medicaid patients to specialty hospitals in which they had an ownership interest. During this 18-month moratorium, which expired June 8, 2005, two mandated studies of specialty hospitals provided information to help assess their potential effect on health care delivery. This issue brief discusses the research on specialty hospitals, including their payments under Medicare's hospital inpatient payment system, the quality and cost of care they deliver, their effect on general hospitals and on overall health care delivery, and the regulatory and legal environment in which they have proliferated. It concludes with open issues concerning physician self-referral and the role of general hospitals in providing a range of health care services.

  2. Medical Specialty Decision Model: Utilizing Social Cognitive Career Theory

    ERIC Educational Resources Information Center

    Gibson, Denise D.; Borges, Nicole J.

    2004-01-01

    Objectives: The purpose of this study was to develop a working model to explain medical specialty decision-making. Using Social Cognitive Career Theory, we examined personality, medical specialty preferences, job satisfaction, and expectations about specialty choice to create a conceptual framework to guide specialty choice decision-making.…

  3. Genetic and Environmental Influences on the Association between Pubertal Maturation and Internalizing Symptoms

    ERIC Educational Resources Information Center

    Marceau, Kristine; Neiderhiser, Jenae M.; Lichtenstein, Paul; Reiss, David

    2012-01-01

    The literature consistently shows an association between pubertal maturation and internalizing problems in girls. The association for boys is less clear. The present study examines genetic and environmental influences on the association between pubertal maturation and internalizing problems for boys and girls in two primarily Caucasian adolescent…

  4. Genetic and Environmental Influences on the Association between Pubertal Maturation and Internalizing Symptoms

    ERIC Educational Resources Information Center

    Marceau, Kristine; Neiderhiser, Jenae M.; Lichtenstein, Paul; Reiss, David

    2012-01-01

    The literature consistently shows an association between pubertal maturation and internalizing problems in girls. The association for boys is less clear. The present study examines genetic and environmental influences on the association between pubertal maturation and internalizing problems for boys and girls in two primarily Caucasian adolescent…

  5. Twitter in urology and other surgical specialties at global conferences.

    PubMed

    Chung, Amanda; Woo, Henry

    2016-04-01

    Over recent years, Twitter has demonstrated an expanding role in scientific discussion, surgical news and conferences. This study evaluates the role of Twitter in urological conferences, with comparison to other surgical specialties. A retrospective analysis of Twitter metrics during the two largest recent English-speaking conferences for each surgical specialty was performed. Using www.symplur.com, all 'tweets' under the official conference hashtag from 0000 hour the first day to 24.00 hour the final day were assessed. The number of impressions, 'tweeters' and rates of 'tweeting' were analysed. Nine of 18 conferences examined had official hashtags registered with Symplur Healthcare Hashtags. Plastic and urological surgery had both major conferences registered. Only one of two conferences for each cardiothoracic, general, orthopaedic, otolaryngology and paediatric was registered. Both major neurosurgical and vascular conferences were unregistered. Urological conferences were associated with significantly more Twitter activity than non-urological surgical conferences in all parameters, with greater than triple the number of impressions, tweets and 'tweeters'. Urological surgical conferences were associated with 337% more tweets and 164% more impressions per conference day, than non-urological surgical conferences. Twitter has been used to supplement surgical conferences. In this regard, the urological community leads the way compared to the remainder of surgical specialty communities. © 2015 Royal Australasian College of Surgeons.

  6. Specialty location decisions in the reformed NHS: a case study.

    PubMed

    Hindle, T; Roberts, E; Worthington, D

    1998-08-01

    A soft systems approach, largely based on soft systems methodology, was used to steer a study (completed in 1996) of the National Health Service contracting process. It led to action research projects on a number of related issues. One such area that emerged very strongly concerns service rationalization and service planning, and in particular the location of 'small' specialties. A Trust-based study involving patient flow modelling demonstrates the form these problems can take within the internal market and highlights the challenge they make to the contracting process or the new primary care group based commissioning process if they are to be resolved in a rational manner.

  7. Broad support evident for the emerging specialty of orofacial pain.

    PubMed

    Talley, R L; Fricton, J R; Okeson, J P

    2000-01-01

    The emerging field of Orofacial Pain is being considered by the American Dental Association for full status as a new dental specialty. Many recent advances in the neuroscience of orofacial pain have lead to treatments by orofacial pain dentists that provide significant relief for patients with chronic orofacial pain disorders. However, access to this care has been limited leaving many patients to continue to suffer. Subsequently, recent efforts to improve this by developing the field into a specialty have shown broad support among dentists and increased awareness of the benefits this field can provide for dentists and their patients. A recent survey of 805 individuals in the general population who reported having a persistent pain disorder revealed that more than four out of 10 people have yet to find adequate relief, saying their pain is out of control-despite having the pain for more than 5 years and switching doctors at least once. "This survey suggests that there are millions of people living with severe uncontrolled pain," says Russell Portenoy, MD, President of the American Pain Society. "This is a great tragedy. Although not everyone can be helped, it is very likely that most of these patients could benefit if provided with state-of-the-art therapies and improved access to pain specialists when needed." (1). Development of the field of Orofacial Pain into a dental specialty has been motivated primarily by this issue; patients with complex chronic orofacial pain disorders have not been historically treated well by any discipline of health care. Recent studies of chronic orofacial pain patients have found that these patients have a high number of previous clinicians and have endured many years with pain prior to seeing an orofacial pain dentist (2) (Fig. 1). Complex pain patients and the clinicians who see them are often confused about whom they should consult for relief of the painful disorder. Treatment for these patients within the existing structure of

  8. Relationship between pharmacy residency examination rank and specialty choice for French pharmacy residency-admitted students

    PubMed Central

    Fardel, Olivier

    2016-01-01

    Objective: To analyze the link between the rank at the national pharmacy residency examination and the choice of pharmacy specialty for hospital residency-admitted French pharmacy students. Methods: Examination ranks as well as the pharmacy residency specialty to which residency candidates are finally admitted were collected for all students (n=1948) having successfully passed the national French pharmacy residency examination over the period 2013-2016. Students were categorized by their pharmacy specialty for residency, i.e., “Medical Biology” (n=591), “Hospital Pharmacy” (n=1175) and “Pharmaceutical Innovation and Research” (n=182), and medians of examination ranks as well as limit ranks (the rank of the last admitted postulant) by specialty were compared. Results: Examination ranks for pharmacy residency-admitted students were found to significantly differ according to the nature of the specialty in which students were finally admitted. “Medical Biology” has the lowest examination ranks (and appears thus as the most selective specialty), followed by “Hospital Pharmacy” and ended by “Pharmaceutical Innovation and Research”, that has the highest examination ranks (and appears thus as the least selective specialty). Limit examination ranks were additionally shown to discriminate university hospitals in which residents were assigned. Conclusion: Specialty choice for hospital residency-admitted French pharmacy candidates is closely associated with their rank at the national pharmacy residency examination, which can be assumed as reflecting their academic level. By this way, an implicit hierarchy of French pharmacy residency specialties according to the academic level of postulants can likely be drawn. PMID:28503227

  9. 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

  10. Factors related to doctors' choice of rural pathway in general practice specialty training.

    PubMed

    Sureshkumar, Premala; Roberts, Chris; Clark, Tyler; Jones, Michael; Hale, Robert; Grant, Marcia

    2017-06-01

    To investigate the factors eligible applicants consider in electing for a rural pathway into specialty training. Cohort study. Australia. Applicants to the Australian General Practice Training program. Applicants' initial preference of either a general or rural pathway to undertake specialty training. Of the 2,221 applicants, 45% were Australian Medical Graduates (AMGs), 27% Foreign Graduates of Accredited Medical Schools (FGAMS) and 29% International Medical Graduates (IMGs). Through government regulation, two thirds (70%) were eligible to train on both general and rural pathways and a third (30%) were required to train rurally. For applicants eligible for general pathway (n = 1552), those with rural background [Odds Ratio (OR) = 3.7, 95% CI 2.7-5.2] and rural clinical school experience (OR = 2.0, 95% CI 1.5-2.8) were more likely to choose the rural pathway. In addition, FGAMS who were eligible for the general pathway were less likely to choose a rural pathway when compared with IMGs (OR = 0.33, 95%CI 0.1 = 0.7). In applicants who changed their training pathway from their initial to revised preference, lower Multiple-Mini-Interview (OR = 0.54, 95% CI 0.43-0.66) and Situational Judgement Test z-scores (OR = 0.68, 95% CI 0.56-0.83) were associated with a higher probability of changing from a general to rural pathway preference. For those eligible for a general or rural pathway, rural background and rural clinical school experience are associated with the decision to elect for rural training. Targeted support for international and foreign graduates of Australia/New Zealand schools may influence them to train rurally. © 2016 National Rural Health Alliance Inc.

  11. The specialty choice of medical students in China: a stated preference experiment.

    PubMed

    Liang, Dong; Tang, Cheng-Xiang

    2016-04-12

    Primary Care Providers (PCPs), such as internists and general practitioners, have been deemed a way of delivering cost-effective care in an equitable way because PCPs are responsible for providing accessible basic medical care for the general population. This study aims to examine medical students' preferences for PCP-based specialty choices in the context of an ageing population in China. We implemented a Best-Worst Scaling (BWS) experiment, a recently developed preference elicitation method based on random utility theory. Three hundred and fifty graduating medical students from three medical colleges were randomly recruited to evaluate 11 common medical specialties in China. A counting approach, a conditional logit model, and K-means clustering have been used to analyse the relative importance of items and preference heterogeneity among medical students. One hundred and ninety of 350 students completed valid questionnaires. General surgery was identified as the most preferred specialty among the overall sample, yet internal medicine shares the same importance as surgery. Both geriatric medicine and psychiatric medicine were found to be the least selected specialties. Finally, the K-means clustering further suggested there was preference heterogeneity across our sample. Two aims were fulfilled in this study. First, through our experimental approach the results provide a better understanding of the career desires of medical students in China. Second, the results of this study indicate that despite the fact a non-PCP-based specialty is the most popular among the sampled students; a PCP-based specialty is still an important alternative choice.

  12. Shaping an Australian nursing and midwifery specialty framework for workforce regulation: criteria development.

    PubMed

    King, Susan Jane; Ogle, Kaye Robyn; Bethune, Elizabeth

    2010-01-01

    One of the biggest obstacles identified in achieving Millennium Development Goals (MDGs) was the lack of available qualified health personal to meet the health needs of the global population. With nurses being the main workforce component in health systems, the human resource challenge for most countries is to address the reported shortage of nurses. Skill mix is one suggestion. In Australia, workforce projections indicated a shortage of 40,000 nurses by 2010. Toward the reform of the Australian health workforce, one project aimed to develop a nationally consistent framework for nursing and midwifery specialization based on knowledge and skills to generate the first national database iteration for designated specialties. A literature review looked at the way nursing specialty practices were defined in the United Kingdom, the United States of America and Canada. Three international and three national sources of criteria for specialty nursing practice were mapped against each other. The result was six criteria synthesized to define nursing practice groups as Australian nursing specialties. Each criterion was operationalized with criteria indicators to meet Australian expectations. The nurses in Australia commented on the criteria before they were finalized. An audit of national workforce databases identified nursing practice groups. The criteria were applied to identify nursing specialties and practice strands that would form a national nursing framework. This paper reports on the criteria developed to assess specialty practice at a national level in Australia.

  13. Connecting intentional learning and cardiac specialty practice: The experiences of bachelor of science in nursing students.

    PubMed

    Rush, Kathy L; Wilson, Ryan; Costigan, Jeannine; Bannerman, Maggie; Donnelly, Sarah

    2016-09-01

    Internationally pre-registration education programs have ranged from entirely specialist to entirely generalist with varying degrees of specialty preparation in between. Students in generalist programs with specialty practice options may benefit from novel pedagogical approaches, such as intentional learning, to ease the transition from generalist to specialist practice. The purpose of this qualitative descriptive study was to understand undergraduate students' experiences of intentional learning in a 4-week consolidated cardiac specialty practicum. Eight students (7 females, 1 male) participated in a combination of weekly Blackboard discussions and an end-of-practicum focus group and completed a competency self-rating. Students had marred expectations about the integration of intentional learning in their specialty practice experience. They reflected advantages and disadvantages of both intentional and total patient care learning models but worked with their instructor to find the right balance that maximized learning. Students identified features that maximized intentional learning including open-ended questions, using learning versus workspaces, receiving feedback, and integrating peer interaction. Despite advancing their confidence and competence in specialty practice students remained anxious about their ability to assume the role of the graduate nurse in a years' time. Preparing a generalist nurse for the workforce needs to be balanced with meeting students' needs and increasing professional demands for specialty experiences in undergraduate nurse education programs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Despite high costs, specialty drugs may offer value for money comparable to that of traditional drugs.

    PubMed

    Chambers, James D; Thorat, Teja; Pyo, Junhee; Chenoweth, Matthew; Neumann, Peter J

    2014-10-01

    Specialty drugs are often many times more expensive than traditional drugs, which raises questions of affordability and value. We compared the value of specialty and traditional drugs approved by the Food and Drug Administration (FDA) in the period 1999-2011. To do this, we identified published estimates of additional health gains (measured in quality-adjusted life-years, or QALYs) and increased costs of drug and health care resource use that were associated with fifty-eight specialty drugs and forty-four traditional drugs, compared to preexisting care. We found that specialty drugs offered greater QALY gains (0.183 versus 0.002 QALYs) but were associated with greater additional costs ($12,238 versus $784), compared to traditional drugs. The two types of drugs had comparable cost-effectiveness. However, the distributions across the two types differed, with 26 percent of specialty drugs--but only 9 percent of traditional drugs--associated with incremental cost-effectiveness ratios of greater than $150,000 per QALY. Our study suggests that although specialty drugs often have higher costs than traditional drugs, they also tend to confer greater benefits and hence may still offer reasonable value for money.

  15. Association between personality traits and future choice of specialisation among Swedish doctors: a cross-sectional study.

    PubMed

    Bexelius, Tomas S; Olsson, Caroline; Järnbert-Pettersson, Hans; Parmskog, Malin; Ponzer, Sari; Dahlin, Marie

    2016-08-01

    Medical students' choice of their future specialty is influenced by several factors, including working conditions and type of patient relations. The aim of this study was to investigate the association between the choice of specialty and personality traits. This is a cross-sectional questionnaire-based study of 399 alumni from Karolinska Institutet Medical School who were assumed to undergo specialty training at the time of the survey in 2013. The Big Five Inventory was used to assess the personality traits extraversion, agreeableness, conscientiousness, neuroticism and openness to experience. Medical specialties were categorised as primary care, psychiatry, internal medicine and surgical and hospital service specialties. Adjustments were made for demographic factors and the method of selection for medical school admission. The response rate was 72% (n=289, of which 262 were in training to become specialists). Among these, surgeons scored lower in agreeableness than physicians in primary care, internal medicine and hospital services. Psychiatrists and hospital service physicians showed lower conscientiousness compared with surgeons. We found distinctive differences in personality traits between medical specialties even after adjusting for other potential explanatory variables. Since there are differences between specialties, for example, surgeons and psychiatrists, this supports previous findings that personality may affect medical students' specialty choice also in a Swedish setting. 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/

  16. How are the different specialties represented in the major journals in general medicine?

    PubMed Central

    2011-01-01

    Background General practitioners and medical specialists mainly rely on one "general medical" journal to keep their medical knowledge up to date. Nevertheless, it is not known if these journals display the same overview of the medical knowledge in different specialties. The aims of this study were to measure the relative weight of the different specialties in the major journals of general medicine, to evaluate the trends in these weights over a ten-year period and to compare the journals. Methods The 14,091 articles published in The Lancet, the NEJM, the JAMA and the BMJ in 1997, 2002 and 2007 were analyzed. The relative weight of the medical specialities was determined by categorization of all the articles, using a categorization algorithm which inferred the medical specialties relevant to each article MEDLINE file from the MeSH terms used by the indexers of the US National Library of Medicine to describe each article. Results The 14,091 articles included in our study were indexed by 22,155 major MeSH terms, which were categorized into 81 different medical specialties. Cardiology and Neurology were in the first 3 specialties in the 4 journals. Five and 15 specialties were systematically ranked in the first 10 and first 20 in the four journals respectively. Among the first 30 specialties, 23 were common to the four journals. For each speciality, the trends over a 10-year period were different from one journal to another, with no consistency and no obvious explanatory factor. Conclusions Overall, the representation of many specialties in the four journals in general and internal medicine included in this study may differ, probably due to different editorial policies. Reading only one of these journals may provide a reliable but only partial overview. PMID:21255439

  17. Stability of and Factors Related to Medical Student Specialty Choice of Psychiatry.

    PubMed

    Goldenberg, Matthew N; Williams, D Keith; Spollen, John J

    2017-09-01

    Targeted efforts are needed to increase the number of medical students choosing psychiatry, but little is known about when students decide on their specialty or what factors influence their choice. The authors examined the timing and stability of student career choice of psychiatry compared with other specialties and determined what pre- and intra-medical school factors were associated with choosing a career in psychiatry. Using survey data from students who graduated from U.S. allopathic medical schools in 2013 and 2014 (N=29,713), the authors computed rates of psychiatry specialty choice at the beginning and end of medical school and assessed the stability of that choice. A multivariate-adjusted logistic regression and recursive partitioning were used to determine the association of 29 factors with psychiatry specialty choice. Choice of psychiatry increased from 1.6% at the start of medical school to 4.1% at graduation. The stability of psychiatry specialty choice from matriculation to graduation, at just over 50%, was greater than for any other specialty. However, almost 80% of future psychiatrists did not indicate an inclination toward the specialty at matriculation. A rating of "excellent" for the psychiatry clerkship (odds ratio=2.66), a major in psychology in college (odds ratio=2.58), and valuing work-life balance (odds ratio=2.25) were the factors most strongly associated with psychiatry career choice. Students who enter medical school planning to become psychiatrists are likely to do so, but the vast majority of students who choose psychiatry do so during medical school. Increasing the percentage of medical students with undergraduate psychology majors and providing an exemplary psychiatry clerkship are modifiable factors that may increase the rate of psychiatry specialty choice.

  18. Eruptive disseminated porokeratosis associated with internal malignancies: a case report.

    PubMed

    Schena, Donatella; Papagrigoraki, Anastasia; Frigo, Anna; Girolomoni, Giampiero

    2010-03-01

    Porokeratosis is a chronic skin disorder characterized by the presence of patches with elevated, thick, keratotic borders histologically featuring cornoid lamella. While porokeratosis usually is clinically defined by a slow onset, an eruptive variant has been reported. We report a 77-year-old woman affected by pancreatic carcinoma with-eruptive disseminated porokeratosis (EDP). We reviewed published cases of EDP developing suddenly or within a few months and found a total of 16 patients, 6 with internal malignancies of the liver or gastrointestinal tract. These findings suggest that patients with EDP should be investigated for the presence of internal malignancies.

  19. Personality and specialty interest in medical students.

    PubMed

    Hojat, Mohammadreza; Zuckerman, Marvin

    2008-01-01

    Research on the relationship between personality and specialty interest is important because of its implications in student career counseling and in forecasting future specialty distribution. This study was designed to test the following hypotheses: 1. Students interested in 'surgical' specialties would obtain higher scores on a measure of 'impulsive sensation seeking' and lower scores on a measure of 'neuroticism-anxiety'. 2. Students interested in 'hospital-based' specialties would score lower on a measure of 'sociability' whereas those interested in 'primary care' would score higher on this measure. In addition to these two hypotheses, gender differences on personality were also examined. Study participants were 1,076 students who matriculated at Jefferson Medical College between 2002 to 2006. A short version of the Zuckerman-Kuhlman personality questionnaire (ZKPQ) measuring five personality factors of 'impulsive sensation Seeking', 'neuroticism-anxiety', 'aggression-hostility', 'sociability', and 'activity' was completed by research participants at the beginning of medical school. Students were also asked to note their specialty interests. Multivariate statistical analyses confirmed the first and partially confirmed the second research hypotheses. Results also showed that men scored higher on 'impulsive sensation seeking,' and women outscored men in the 'neuroticism-Anxiety' and 'activity' scales. Findings suggest that information about the personalities of medical students can help to predict their career interests. Implications for career counseling are discussed.

  20. The International Association for the Exchange of Students for Technical Experience. 34th Annual Report 1981.

    ERIC Educational Resources Information Center

    International Association for the Exchange of Students for Technical Experience/United States, Columbia, MD.

    The 1981 annual report of the International Association for the Exchange of Students for Technical Experience (IAESTE) is presented. IAESTE seeks to provide students at institutions of higher education with technical experience abroad relative to their studies and to promote international understanding among all students. An international report…

  1. The International Association for the Exchange of Students for Technical Experience. 32nd Annual Report 1979.

    ERIC Educational Resources Information Center

    International Association for the Exchange of Students for Technical Experience/United States, Columbia, MD.

    After a general outline of the organization of the International Association for the Exchange of Students for Technical Experience and a brief introduction to its functions and activities, this annual report contains the international report. This includes: the report of the General Secretary; a list of international visits and visitors; publicity…

  2. School Psychology: How Universal Are Ethical Principles Approved by International Associations?

    ERIC Educational Resources Information Center

    Pettifor, Jean L.

    2004-01-01

    Globalization is a dominant issue in all aspects of business and professional activities in the 21st Century. The International School Psychology Association and the International Test Commission have adopted ethics and competency guidelines to raise the standards of practice for their members. Other international organizations are doing likewise.…

  3. School Psychology: How Universal Are Ethical Principles Approved by International Associations?

    ERIC Educational Resources Information Center

    Pettifor, Jean L.

    2004-01-01

    Globalization is a dominant issue in all aspects of business and professional activities in the 21st Century. The International School Psychology Association and the International Test Commission have adopted ethics and competency guidelines to raise the standards of practice for their members. Other international organizations are doing likewise.…

  4. The American Library Association and International Relations: Accomplishments, Current Activities, Observations, Strategies, and Plan of Action.

    ERIC Educational Resources Information Center

    Doyle, Robert P.

    This report on the international relations activities of the American Library Association (ALA) briefly reviews ALA's policies and accomplishments in the international arena; describes ALA's current international activities and interests; outlines principles and values, which when correlated with current developments and past experience, provide…

  5. The International Association for the Exchange of Students for Technical Experience. 34th Annual Report 1981.

    ERIC Educational Resources Information Center

    International Association for the Exchange of Students for Technical Experience/United States, Columbia, MD.

    The 1981 annual report of the International Association for the Exchange of Students for Technical Experience (IAESTE) is presented. IAESTE seeks to provide students at institutions of higher education with technical experience abroad relative to their studies and to promote international understanding among all students. An international report…

  6. The International Association for the Exchange of Students for Technical Experience. 32nd Annual Report 1979.

    ERIC Educational Resources Information Center

    International Association for the Exchange of Students for Technical Experience/United States, Columbia, MD.

    After a general outline of the organization of the International Association for the Exchange of Students for Technical Experience and a brief introduction to its functions and activities, this annual report contains the international report. This includes: the report of the General Secretary; a list of international visits and visitors; publicity…

  7. The Association between Internalizing Symptomology and Risky Behaviors

    ERIC Educational Resources Information Center

    Perle, Jonathan G.; Levine, Alison B.; Odland, Anthony P.; Ketterer, Jessica L.; Cannon, Megan A.; Marker, Craig D.

    2013-01-01

    Internalizing symptoms (withdrawn/depressed and anxious/depressed), measured by the Child Behavior Checklist (CBCL), were examined as related to the development of externalizing problems, a pathway to risky behavior. A cross-section of children ages 6 to 15 was drawn from the National Institute of Child Health and Human Development's (NICHD) Study…

  8. 14TH Annual International Performance Management Association Conference

    DTIC Science & Technology

    2007-11-02

    Being more responsive to all internal & external customers 6 Evolution of Business Planning & Execution Systems Functional View Mainframe Value Chain...integrating EVM to core business Planning , Budgeting, and Acquisition Under GPRA David Muzio Office of Federal Procurement Policy 202-395-6805 Largest

  9. Medication communication during handover interactions in specialty practice settings.

    PubMed

    Braaf, Sandra; Rixon, Sascha; Williams, Allison; Liew, Danny; Manias, Elizabeth

    2015-10-01

    To investigate what and how medication information is communicated during handover interactions in specialty hospital settings. Effective communication about patients' medications between health professionals and nurses at handover is vital for the delivery of safe continuity of care. An exploratory qualitative design and observational study. Participant observation was undertaken at a metropolitan Australian public hospital in four specialty settings: cardiothoracic care, intensive care, emergency care and oncology care. A medication communication model was applied to the data and thematic analysis was performed. Over 130 hours of observational data were collected. In total, 185 (predominately nursing) handovers were observed across the four specialty settings involving 37 nurse participants. Health professionals communicated partial details of patients' medication regimens, by focusing on auditing the medication administration record, and through the handover approach employed. Gaps in medication information at handover were evident as shown by lack of communication about detailed and specific medication content. Incoming nurses rarely posed questions about medications at handover. Handover interactions contained restricted and incomplete medication information. Improving the transparency, completeness and accuracy of medication communication is vital for optimising patient safety and quality of care in specialty practice settings. For nurses to make informed and rapid decisions regarding appropriate patient care, information about all types of prescribed medications is essential, which is communicated in an explicit and clear way. Jargon and assumptions related to medication details should be minimised to reduce the risk of misunderstandings. Disclosure of structured medication information supports nurses to perform accurate patient assessments, make knowledgeable decisions about the appropriateness of medications and their doses, and anticipate possible

  10. Junior doctors' preferences for specialty choice.

    PubMed

    Sivey, Peter; Scott, Anthony; Witt, Julia; Joyce, Catherine; Humphreys, John

    2012-12-01

    A number of studies suggest that there is an over-supply of specialists and an under-supply of general practitioners in many developed countries. Previous econometric studies of specialty choice from the US suggest that although income plays a role, other non-pecuniary factors may be important. This paper presents a novel application of a choice experiment to identify the effects of expected future earnings and other attributes on specialty choice. We find the implied marginal wage estimated from our discrete choice model is close to the actual wages of senior specialists, but much higher than those of senior GPs. In a policy simulation we find that increasing GPs' earnings by $50,000, or increasing opportunities for procedural or academic work can increase the number of junior doctors choosing general practice by between 8 and 13 percentage points. The simulation implies an earnings elasticity of specialty choice of 0.95.

  11. Evaluation of a Hepatitis C Patient Management Program at a University Specialty Pharmacy.

    PubMed

    Zaepfel, Michelle; Cristofaro, Lisa; Trawinski, Allison; McCarthy, Katharine; Rightmier, Elizabeth; Khadem, Tina

    2017-04-01

    The University of Rochester (UR) Specialty Pharmacy hepatitis C patient management program offers a unique advantage of being integrated within the same health system as the University of Rochester Medical Center (URMC) Gastroenterology and Hepatology division. The primary purpose of this study was to assess treatment success through the incidence of achieving a sustained virological response (SVR) in patients served by the UR Specialty Pharmacy versus other nonintegrated pharmacies. This was a single-center retrospective cohort study in adult patients of URMC Gastroenterology and Hepatology prescribed hepatitis C treatment between January 1, 2014, and July 15, 2015. The incidence of SVR, adherence, delay in therapy initiation, early treatment discontinuation, rate of attainment of viral load measurement post-therapy completion, and predictors associated with treatment outcome were assessed. A total of 414 patients were prescribed hepatitis C virus treatment during the study period; 137 did not initiate therapy. The rate of SVR was 93% among patients at the UR Specialty Pharmacy and 89% at nonintegrated pharmacies ( P = 0.357). Adherence to therapy was 100% and 97% at the UR Specialty Pharmacy and nonintegrated pharmacies, respectively ( P = 0.046). The UR Specialty Pharmacy was associated with a 93% SVR rate and significantly greater adherence compared with nonintegrated pharmacies. Larger studies are needed to determine if a significant difference in SVR exists between integrated and nonintegrated pharmacies. This study provides a framework for other institutions to justify developing integrated hepatitis C specialty pharmacy services and evaluate their success.

  12. Gender Distribution Among American Board of Medical Specialties Boards of Directors.

    PubMed

    Walker, Laura E; Sadosty, Annie T; Colletti, James E; Goyal, Deepi G; Sunga, Kharmene L; Hayes, Sharonne N

    2016-11-01

    Since 1995, women have comprised more than 40% of all medical school graduates. However, representation at leadership levels in medicine remains considerably lower. Gender representation among the American Board of Medical Specialties (ABMS) boards of directors (BODs) has not previously been evaluated. Our objective was to determine the relative representation of women on ABMS BODs and compare it with the in-training and in-practice gender composition of the respective specialties. The composition of the ABMS BODs was obtained from websites in March 2016 for all Member Boards. Association of American Medical Colleges and American Medical Association data were utilized to identify current and future trends in gender composition. Although represented by a common board, neurology and psychiatry were evaluated separately because of their very different practices and gender demographic characteristics. A total of 25 specialties were evaluated. Of the 25 specialties analyzed, 12 BODs have proportional gender representation compared with their constituency. Seven specialties have a larger proportion of women serving on their boards compared with physicians in practice, and 6 specialties have a greater proportion of men populating their BODs. Based on the most recent trainee data (2013), women have increasing workforce representation in almost all specialties. Although women in both training and practice are approaching equal representation, there is variability in gender ratios across specialties. Directorship within ABMS BODs has a more equitable gender distribution than other areas of leadership in medicine. Further investigation is needed to determine the reasons behind this difference and to identify opportunities to engage women in leadership in medicine. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  13. The Expansion of Higher Education. Papers of the International Association of Universities. No. 6.

    ERIC Educational Resources Information Center

    International Association of Universities, Paris (France).

    Papers are presented from a conference of the International Association of Universities concerning the expansion of higher education. The contents are as follows: Foreword by J. Baugniet, International Association of Universities; "The Expansion of Higher Education in Brazil," by Rev. A. Alonso, Pontifical Catholic University of Rio de…

  14. The Expansion of Higher Education. Papers of the International Association of Universities. No. 6.

    ERIC Educational Resources Information Center

    International Association of Universities, Paris (France).

    Papers are presented from a conference of the International Association of Universities concerning the expansion of higher education. The contents are as follows: Foreword by J. Baugniet, International Association of Universities; "The Expansion of Higher Education in Brazil," by Rev. A. Alonso, Pontifical Catholic University of Rio de…

  15. Specialty group differences over tonsillectomy: pediatricians versus otolaryngologists.

    PubMed

    Chow, S

    1998-01-01

    How physicians in different specialties explain their positions on tonsillectomy is explored using data based on in-depth interviews with 53 physicians. Justifications for and against particular indications, assessments of efficacy, and explanations of tonsillar function and pathology are presented. Clear specialty-specific differences exist, especially between pediatricians and otolaryngologists. Opposing specialty views rest upon radically different versions of cost/benefit assessment, whereas evaluations of efficacy are based primarily on conceptual reasoning and anecdotal accounts. Physicians' opinion of clinical trial results are specialty-dependent and are used to sustain specialty viewpoints. The implications of such specialty group differences for public policy are discussed.

  16. Construction and Practice of the New Business Specialty Talent Cultivation Mode

    ERIC Educational Resources Information Center

    Xiao, Xiaokong

    2009-01-01

    The vocational education of business should actively adapt the demands of the domestic and foreign business development to cultivate high-quality applicable talents with international knowledge. The traditional business specialty teaching and the talent cultivation mode have not followed the domestic and foreign market demands, and are difficult…

  17. DETERMINANTS OF SPECIALTY CHOICE OF RESIDENT DOCTORS; CASE STUDY--AMONG RESIDENT DOCTORS IN NIGERIA.

    PubMed

    Osuoji, Roland I; Adebanji, Atinuke; Abdulsalam, Moruf A; Oludara, Mobolaji A; Abolarinwa, Abimbola A

    2015-01-01

    This study examined medical specialty selection by Nigerian resident doctors using a marketing research approach to determine the selection criteria and the role of perceptions, expected remuneration, and job placement prospects of various specialties in the selection process. Data were from the Community of residents from April 2014 to July 2014. The cohort included 200 residents, but only 171 had complete information. Data were obtained from a cross section of resident doctors in the Lagos State University Teaching Hospital and at the 2014 Ordinary General Meeting of the National Association of Resident Doctors(NARD) where representatives from over 50 Teaching hospitals in Nigeria attended. Using a client behaviour model as a framework, a tripartite questionnaire was designed and administered to residents to deduce information on their knowledge about and interests in various specialties, their opinions of sixteen specialties, and the criteria they used in specialty selection. A total of 171 (85.5%) questionnaires were returned. ln many instances, consistency between selection criteria and perceptions of a specialty were accompanied by interest in pursuing the specialty. Job security, job availability on completion of programme, duration of training and qualifying examinations were highly correlated with p value < 0.05. Results of the Principal Component Analysis show two components (with Eigen values greater than one) explaining 65.3% of the total variance. The first component had placement and training and practice related variables loaded on it while the second component was loaded with job security and financial remuneration related variables. Using marketing research concepts for medical specialty selection (Weissmanet al 2012) stipulates that choice of speciality is influenced by criteria and perception. This study shows that job security expected financial remuneration, and examination requirements for qualification are major determinants of the choice of

  18. Personality as a Prognostic Factor for Specialty Choice: A Prospective Study of 4 Medical School Classes

    PubMed Central

    Markert, Ronald J.; Rodenhauser, Paul; El-Baghdadi, Mariam M.; Juskaite, Kornelija; Hillel, Alexander T.; Maron, Bradley A.

    2008-01-01

    Background To augment the availability of medical care for a population that is older and more ethnically diverse, the number of US medical schools is increasing and existing medical schools are enlarging their class sizes. Predictors of specialty choice, especially primary care careers, are helpful to medical school officials and faculty involved in medical school recruitment and counseling and to students planning their career paths. Objective The objective was to examine the association between personality characteristics and specialty choice. Methods The Neuroticism-Extraversion-Openness Personality Inventory Revised (NEO PI-R) was administered to 4 Tulane University School of Medicine (New Orleans, Louisiana) classes (2003–2006). The NEO PI-R is a measure of 5 personality characteristics (neuroticism, extraversion, openness, agreeableness, and conscientiousness), with each domain having 6 underlying facets. The specialty choice of graduates was obtained from the National Residency Matching Program. Results Starting in 1999, 595 students matriculated and by June 2006, 542 (91%) had matched to residency programs in 22 specialties. There were differences among specialties for neuroticism (P = .006), openness (P < .001), and agreeableness (P = .003), but not for extraversion (P = .173) or conscientiousness (P = .103). Various pairwise differences between specialty categories were found. Discussion Eleven specialty categories were compared using the NEO PI-R. Numerous specialty variations were identified for neuroticism, openness, and agreeableness. The findings may be useful to medical school officials and faculty who recruit and counsel students and to students themselves as they reflect on their personality characteristics on their path to making career choices. PMID:18382718

  19. Sign-out snapshot: cross-sectional evaluation of written sign-outs among specialties

    PubMed Central

    Schoenfeld, Amy R.; Al-Damluji, Mohammed Salim; Horwitz, Leora I.

    2013-01-01

    Background Sign-out is the process (written, verbal, or both) by which one clinical team transmits information about patients to another team. Poor quality sign-outs are associated with adverse events and delayed treatment. How different specialties approach written sign-outs is unknown. Objective To compare written sign-out practices across specialties and to determine consistency of content, format, and timeliness. Methods The authors evaluated all non-Intensive Care Unit written sign-outs from five inpatient specialties on January 18, 2012, at Yale-New Haven Hospital, focusing on content elements, format style, and whether the sign-outs had been updated within 24 hours. In our institution, all specialties used a single standardized sign-out template, which was built into the electronic medical record. Results The final cohort included 457 sign-outs: 313 medicine, 64 general surgery, 36 pediatrics, 30 obstetrics, and 14 gynecology. Though nearly all sign-outs (96%) had been updated within 24 hours, they frequently lacked key information. Hospital course prevalence ranged from 57% (gynecology) to 100% (pediatrics) (p<0.001). Clinical condition prevalence ranged from 34% (surgery) to 72% (pediatrics) (p=0.005). Conclusion Specialties have varied sign-out practices, and thus structured templates alone do not guarantee inclusion of critical content. Sign-outs across specialties often lacked complex clinical information such clinical condition, anticipatory guidance, and overnight tasks. PMID:23996093

  20. Impact of HESI Specialty Exams: the ninth HESI Exit Exam validity study.

    PubMed

    Zweighaft, Elizabeth L

    2013-01-01

    Using an ex post facto, nonexperimental design, this, the ninth validity study of Elsevier's HESI Exit Exam (E(2)), reexamined the predictive accuracy of the E(2). The value of administering HESI Specialty Exams within the nursing curriculum in terms of E(2) scores was also investigated. The sample was composed of nursing students (N = 3,790) from 63 randomly selected schools-26 baccalaureate, 31 associate degree, and 6 diploma programs-throughout the United States who took the E(2) between September 2008 and August 2009. As in the previous 8 studies, the E(2) was found to be highly accurate (96.61%) in predicting success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Findings also indicated that students who took one or more HESI Specialty Exams during their nursing curriculum had a significantly higher mean E(2) score (P ≤ .0001) than students who did not take HESI Specialty Exams during their nursing curriculum. Of the 8 HESI Specialty Exams investigated, scores on the Critical Care, Pediatrics, and Medical-Surgical specialty exams were most predictive of NCLEX-RN success. Schools of nursing that used HESI Specialty Exams as course final exams had a significantly higher mean E(2) score (P < .01) than schools that used the exams for remediation and practice. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Myers-Briggs type and medical specialty choice: a new look at an old question.

    PubMed

    Stilwell, N A; Wallick, M M; Thal, S E; Burleson, J A

    2000-01-01

    Career development of health professionals is one of many uses of Myers-Briggs Type Indicator (MBTI), with many studies reported from the 1950s. Since 1977, no large-scale effort to collect data on the medical school population has been reported. To determine (a) changes in MBTI profiles of medical students over time, (b) differences between the profiles of men and women and the effects of the increased number of women in medical school, (c) possible associations between type and career choices, and (d) possible type differences of graduates selecting primary care and specialties. Twelve U.S. schools with data on 3,987 students contributed to a database of their graduates' MBTI type and specialty choice at Match. Compared with data from the 1950s, the type distribution of physicians has remained fairly stable, save for a trend toward more judging types. Women in medicine today are more representative of the general population on the feeling dimension than earlier, when medicine was more male-dominated. Women are more likely than men to choose primary care specialties, as are those with preference for introversion and feeling. Feeling types choose Family Medicine significantly more often than thinking types; male, extraverted, and thinking types choose surgical specialties. Of those selecting nonprimary care, male, extraverted, and thinking types choose surgical specialties significantly more than women, introverted, and feeling types. Type remains useful for understanding how some aspects of personality relate to medical specialty choice.

  2. Medical student debt and major life choices other than specialty

    PubMed Central

    Rohlfing, James; Navarro, Ryan; Maniya, Omar Z.; Hughes, Byron D.; Rogalsky, Derek K.

    2014-01-01

    Background Median indebtedness at graduation is now more than $170,000 for graduates of US Medical Schools. Debate still exists as to whether higher debt levels influence students to choose high paying non-primary care specialties. Notably, no previous research on the topic has taken into account cost of attendance when constructing a debt model, nor has any research examined the non-career major life decisions that medical students face. Methods Medical students were surveyed using an anonymous electronic instrument developed for this study. The survey was delivered through a link included in a study email and students were recruited from school wide listservs and through snowball sampling (students were encouraged to share a link to the survey with other medical students). No incentives were offered for survey completion. Results Responses were recorded from 102 US Allopathic medical schools (n=3,032), with 22 institutions (11 public, 11 private) meeting inclusion criteria of 10% student body response proportion (n=1,846). Students with higher debt relative to their peers at their home institution reported higher frequencies of feeling callous towards others, were more likely to choose a specialty with a higher average annual income, were less likely to plan to practice in underserved locations, and were less likely to choose primary care specialties. Students with higher aggregate amounts of medical student loan debt were more likely to report high levels of stress from their educational debt, to delay getting married and to report disagreement that they would choose to become a physician again, if given the opportunity to revisit that choice. Increases in both aggregate and relative debt were associated with delaying having children, delaying buying a house, concerns about managing and paying back educational debt, and worrying that educational debt will influence one's specialty choice. Conclusions Medical student debt and particularly debt relative to peers

  3. Medical student debt and major life choices other than specialty.

    PubMed

    Rohlfing, James; Navarro, Ryan; Maniya, Omar Z; Hughes, Byron D; Rogalsky, Derek K

    2014-01-01

    Median indebtedness at graduation is now more than $170,000 for graduates of US Medical Schools. Debate still exists as to whether higher debt levels influence students to choose high paying non-primary care specialties. Notably, no previous research on the topic has taken into account cost of attendance when constructing a debt model, nor has any research examined the non-career major life decisions that medical students face. Medical students were surveyed using an anonymous electronic instrument developed for this study. The survey was delivered through a link included in a study email and students were recruited from school wide listservs and through snowball sampling (students were encouraged to share a link to the survey with other medical students). No incentives were offered for survey completion. Responses were recorded from 102 US Allopathic medical schools (n=3,032), with 22 institutions (11 public, 11 private) meeting inclusion criteria of 10% student body response proportion (n=1,846). Students with higher debt relative to their peers at their home institution reported higher frequencies of feeling callous towards others, were more likely to choose a specialty with a higher average annual income, were less likely to plan to practice in underserved locations, and were less likely to choose primary care specialties. Students with higher aggregate amounts of medical student loan debt were more likely to report high levels of stress from their educational debt, to delay getting married and to report disagreement that they would choose to become a physician again, if given the opportunity to revisit that choice. Increases in both aggregate and relative debt were associated with delaying having children, delaying buying a house, concerns about managing and paying back educational debt, and worrying that educational debt will influence one's specialty choice. Medical student debt and particularly debt relative to peers at the same institution appears to

  4. Nursing Interventions Core to Specialty Practice.

    ERIC Educational Resources Information Center

    McCloskey, Joanne Comi; Donahue, William; Bulechek, Gloria M.

    1998-01-01

    The identification of nursing interventions that are core to each clinical specialty will be useful in the development of nursing information systems, staff education programs and evaluations, referral networks, certification and licensing examinations, curricula, and research and theory construction. (Author/JOW)

  5. The 0351 Military Occupational Specialty Realignment

    DTIC Science & Technology

    2006-02-07

    conferences the need to restructure some of the skills and weapon systems within the Assaultman and the Anti-Tank Guided Missileman military occupational...specialty: The 0352 Missileman . Taking the Javelin from the Assaultman allowed for the expansion of the Assaultman’s breaching, mobility

  6. Facial Specialty. Teacher Edition. Cosmetology Series.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This publication is one of a series of curriculum guides designed to direct and support instruction in vocational cosmetology programs in the State of Oklahoma. It contains seven units for the facial specialty: identifying enemies of the skin, using aromatherapy on the skin, giving facials without the aid of machines, giving facials with the aid…

  7. Holland's Theory Applied to Medical Specialty Choice

    ERIC Educational Resources Information Center

    Borges, Nicole J.; Savickas, Mark L.; Jones, Bonnie J.

    2004-01-01

    The present study tested the hypothesis that medical specialties classified as technique oriented or patient oriented would be distinguished by RIASEC code, with technique-oriented specialists resembling Investigative-Realistic types and patient-oriented specialists resembling Investigative-Social types. Using longitudinal data obtained from 447…

  8. Facial Specialty. Teacher Edition. Cosmetology Series.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This publication is one of a series of curriculum guides designed to direct and support instruction in vocational cosmetology programs in the State of Oklahoma. It contains seven units for the facial specialty: identifying enemies of the skin, using aromatherapy on the skin, giving facials without the aid of machines, giving facials with the aid…

  9. Holland's Theory Applied to Medical Specialty Choice

    ERIC Educational Resources Information Center

    Borges, Nicole J.; Savickas, Mark L.; Jones, Bonnie J.

    2004-01-01

    The present study tested the hypothesis that medical specialties classified as technique oriented or patient oriented would be distinguished by RIASEC code, with technique-oriented specialists resembling Investigative-Realistic types and patient-oriented specialists resembling Investigative-Social types. Using longitudinal data obtained from 447…

  10. Personality Factors and Occupational Specialty Choice.

    ERIC Educational Resources Information Center

    Borges, Nicole J.; Jones, Bonnie J.

    This study is a continuation of an earlier investigation of personality and medical specialty choice. The earlier study determined that personality differences existed among family practitioners, anesthesiologists, and general surgeons. Based on this initial research, an attempt was made to answer the question of how the personality factors of…

  11. Perceptions of Israeli student nurses regarding clinical specialties and factors that influence these perceptions.

    PubMed

    DeKeyser Ganz, Freda; Kahana, Shulamit

    2006-10-01

    This paper reports a study to determine the perceptions of baccalaureate nursing students towards clinical specialties and what factors influenced these perceptions. Previous studies have shown that nursing students enter their professional education with preconceived perceptions about the different clinical specialties in nursing. Some investigators have found that factors such as clinical experience influence these perceptions, but others have not. Cultural and social influences, especially among non-western cultures, have rarely been investigated. Israeli baccalaureate nursing students were surveyed in their first, third and fourth years of study during the years 1998-2004. They were asked to rank their preferences for clinical areas related to social need, social prestige, level of interest in the clinical area, job choice and what factors influenced their decisions related to job choice. Mean ranks and associations between class and calendar year cohorts were calculated. Critical care was consistently ranked as the highest preference in all perception checklists, followed by emergency, maternity and paediatric nursing. Psychiatric, community and gerontological nursing were consistently found at the bottom of the list. High levels of association were found among students from different class cohorts and calendar years. Life experiences were ranked as the factor that most influenced career choice. Nursing students in Israel tend to perceive clinical areas in ways similar to other students around the world. These perceptions are strongly influenced by personal experiences and other personal contacts, most often not nursing instructors. Major changes in the local society seem for the most part to have little impact on these perceptions. Therefore there is a need for international nurse educators and recruiters to develop new, creative strategies to encourage nursing students to pursue careers in areas presently considered less popular.

  12. Infections associated with eating seed sprouts: an international concern.

    PubMed Central

    Taormina, P. J.; Beuchat, L. R.; Slutsker, L.

    1999-01-01

    Recent outbreaks of Salmonella and Escherichia coli O157:H7 infections associated with raw seed sprouts have occurred in several countries. Subjective evaluations indicate that pathogens can exceed 107 per gram of sprouts produced from inoculated seeds during sprout production without adversely affecting appearance. Treating seeds and sprouts with chlorinated water or other disinfectants fails to eliminate the pathogens. A comprehensive approach based on good manufacturing practices and principles of hazard analysis and critical control points can reduce the risk of sprout-associated disease. Until effective measures to prevent sprout-associated illness are identified, persons who wish to reduce their risk of foodborne illness from raw sprouts are advised not to eat them; in particular, persons at high risk for severe complications of infections with Salmonella or E. coli O157:H7, such as the elderly, children, and those with compromised immune systems, should not eat raw sprouts. PMID:10511518

  13. Internalized stigma among psychiatric outpatients: Associations with quality of life, functioning, hope and self-esteem.

    PubMed

    Picco, Louisa; Pang, Shirlene; Lau, Ying Wen; Jeyagurunathan, Anitha; Satghare, Pratika; Abdin, Edimansyah; Vaingankar, Janhavi Ajit; Lim, Susan; Poh, Chee Lien; Chong, Siow Ann; Subramaniam, Mythily

    2016-12-30

    This study aimed to: (i) determine the prevalence, socio-demographic and clinical correlates of internalized stigma and (ii) explore the association between internalized stigma and quality of life, general functioning, hope and self-esteem, among a multi-ethnic Asian population of patients with mental disorders. This cross-sectional, survey recruited adult patients (n=280) who were seeking treatment at outpatient and affiliated clinics of the only tertiary psychiatric hospital in Singapore. Internalized stigma was measured using the Internalized Stigma of Mental Illness scale. 43.6% experienced moderate to high internalized stigma. After making adjustments in multiple logistic regression analysis, results revealed there were no significant socio-demographic or clinical correlates relating to internalized stigma. Individual logistic regression models found a negative relationship between quality of life, self-esteem, general functioning and internalized stigma whereby lower scores were associated with higher internalized stigma. In the final regression model, which included all psychosocial variables together, self-esteem was the only variable significantly and negatively associated with internalized stigma. The results of this study contribute to our understanding of the role internalized stigma plays in patients with mental illness, and the impact it can have on psychosocial aspects of their lives.

  14. Damaged Self-Esteem is Associated with Internalizing Problems

    PubMed Central

    Creemers, Daan H. M.; Scholte, Ron H. J.; Engels, Rutger C. M. E.; Prinstein, Mitchell J.; Wiers, Reinout W.

    2013-01-01

    Implicit and explicit self-esteem are assumed to be important factors in understanding the onset and maintenance of psychological problems. The current study aims to examine the association between implicit and explicit self-esteem and their interaction with depressive symptoms, suicidal ideation, and loneliness. Specifically, the relationship between the size and the direction of the discrepancy between implicit and explicit self-esteem with depressive symptoms, suicidal ideation, and loneliness were examined. Participants were 95 young female adults (M = 21.2 years, SD = 1.88) enrolled in higher education. We administered the IAT to assess implicit self-esteem, and the Rosenberg self-esteem scale to measure explicit self-esteem while psychological problems were assessed through self-reports. Results showed that discrepancies between implicit and explicit self-esteem were positively associated with depressive symptoms, suicidal ideation, and loneliness. In addition, the direction of the discrepancy was specifically relevant: damaged self-esteem (i.e., high implicit self-esteem and low explicit self-esteem) was consistently associated with increased levels of depressive symptoms, suicidal ideation, and loneliness. In contrast, defensive or fragile self-esteem (i.e., low implicit and high explicit self-esteem) was solely associated with loneliness. These findings provide further support that specifically damaged self-esteem is an important vulnerability marker for depressive symptoms, suicidal ideation, and loneliness. PMID:23565101

  15. A qualitative study on physicians' perceptions of specialty characteristics.

    PubMed

    Park, Kwi Hwa; Jun, Soo-Koung; Park, Ie Byung

    2016-09-01

    There has been limited research on physicians' perceptions of the specialty characteristics that are needed to sustain a successful career in medical specialties in Korea. Medical Specialty Preference Inventory in the United States or SCI59 (specialty choice inventory) in the United Kingdom are implemented to help medical students plan their careers. The purpose of this study was to explore the characteristics of the major specialties in Korea. Twelve physicians from different specialties participated in an exploratory study consisting of qualitative interviews about the personal ability and emotional characteristics and job attributes of each specialty. The collected data were analysed with content analysis methods. Twelve codes were extracted for ability & skill attributes, 23 codes for emotion & attitude attributes, and 12 codes for job attributes. Each specialty shows a different profile in terms of its characteristic attributes. The findings have implications for the design of career planning programs for medical students.

  16. 76 FR 42112 - Specialty Crop Committee Stakeholder Listening Sessions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-18

    ...; ] DEPARTMENT OF AGRICULTURE Office of the Secretary Specialty Crop Committee Stakeholder Listening Sessions AGENCY: Research, Education, and Economics, USDA. ACTION: Notice of stakeholder listening sessions... Department of Agriculture announces two stakeholder listening sessions of the Specialty Crop Committee,...

  17. A qualitative study on physicians' perceptions of specialty characteristics

    PubMed Central

    2016-01-01

    Purpose: There has been limited research on physicians’ perceptions of the specialty characteristics that are needed to sustain a successful career in medical specialties in Korea. Medical Specialty Preference Inventory in the United States or SCI59 (specialty choice inventory) in the United Kingdom are implemented to help medical students plan their careers. The purpose of this study was to explore the characteristics of the major specialties in Korea. Methods: Twelve physicians from different specialties participated in an exploratory study consisting of qualitative interviews about the personal ability and emotional characteristics and job attributes of each specialty. The collected data were analysed with content analysis methods. Results: Twelve codes were extracted for ability & skill attributes, 23 codes for emotion & attitude attributes, and 12 codes for job attributes. Each specialty shows a different profile in terms of its characteristic attributes. Conclusion: The findings have implications for the design of career planning programs for medical students. PMID:27363502

  18. [Renovation of medical specialty education system in Japan (current status and future perspectives)].

    PubMed

    Muraoka, Akira

    2013-01-01

    In order to further improve competences of specialized physicians and to correct uneven distribution of young physicians in Japan, Ministry of Health, Labour and Welfare has compiled a report on April 22, proposing major renovation of training system for specialized medical doctors. In the proposed system, there will be 19 fundamental training areas for specialties, including general internal medicine, just after the completion of two-years of mandatory postgraduate clinical training defined by law. Japanese Board of Medical Specialties (tentative name), which is similar to ACGME in US, will be established as an independent organization in the late 2013 and play a pivotal role in renewal of the system. The new organization will possess two major functions, one is to assess and accredit training programs for medical specialties, and the other is to manage board examination systems for medical specialties. Specialty training based on the new system will commence in April 2017 at the earliest. In such circumstances, Japanese Society of Neurology will be requested not only to clarify competency profiles of capable neurologists but also to present effective training programs to produce such competent neurologists.

  19. Medical students' choices of specialty in The Gambia: the need for career counseling.

    PubMed

    Bittaye, Mustapha; Odukogbe, Akin-Tunde Ademola; Nyan, Ousman; Jallow, Bintou; Omigbodun, Akinyinka O

    2012-08-08

    Understanding preferences for specialties by medical students and the factors driving choices assists policy makers in ensuring optimal spread of personnel across disciplines. This cross-sectional survey using self-administered structured questionnaires was conducted on consenting students of the first medical school in The Gambia, established in 1999. Data collection was in June/July 2011. Questions were on sociodemographic characteristics of students, their parents, factors related to career preferences and opinions about counseling services. Data were analysed using JMP 8.0 software. Respondents were 52.4% of 202 eligible students. Mean age was 24.1 ± 5.0 years. Females constituted 54.7%. Muslims were 72.7% while Gambians formed 77.0%. Commonest specialties chosen by females were Obstetrics/Gynaecology, Paediatrics and Surgery in that order, while males preferred Internal Medicine, Surgery and Obstetrics/Gynaecology. Commonest factors influencing choices by females were 'focus on urgent care' (65.5%) and 'intellectual content of specialty' (56.9%). For males, these were 'intellectual content of specialty' (60.4%) and 'focus on urgent care' / 'individual's competence' (50.0% each). More females (30.0%) than males (23.0%) had ever received career counseling, but all students desired it. Significant gender differences exist in specialty choices and factors influencing these choices amongst these students. All want career counseling.

  20. Specialty preferences and motivating factors: A national survey on medical students from five uae medical schools.

    PubMed

    Abdulrahman, Mahera; Makki, Maryam; Shaaban, Sami; Al Shamsi, Maryam; Venkatramana, Manda; Sulaiman, Nabil; Sami, Manal M; Abdelmannan, Dima K; Salih, AbdulJabbar M A; AlShaer, Laila

    2016-01-01

    Workforce planning is critical for being able to deliver appropriate health service and thus is relevant to medical education. It is, therefore, important to understand medical students' future specialty choices and the factors that influence them. This study was conducted to identify, explore, and analyze the factors influencing specialty preferences among medical students of the United Arab Emirates (UAE). A multiyear, multicenter survey of medical student career choice was conducted with all five UAE medical schools. The questionnaire consisted of five sections. Chi-squared tests, regression analysis, and stepwise logistic regression were performed. The overall response rate was 46% (956/2079). Factors that students reported to be extremely important when considering their future career preferences were intellectual satisfaction (87%), work-life balance (71%), having the required talent (70%), and having a stable and secure future (69%). The majority of students (60%) preferred internal medicine, surgery, emergency medicine, or family Medicine. The most common reason given for choosing a particular specialty was personal interest (21%), followed by flexibility of working hours (17%). The data show that a variety of factors inspires medical students in the UAE in their choice of a future medical specialty. These factors can be used by health policymakers, university mentors, and directors of residency training programs to motivate students to choose specialties that are scarce in the UAE and therefore better serve the health-care system and the national community.

  1. Gastroenterology - Evolution of specialty choice in recent years.

    PubMed

    Curbelo, José; Galván-Román, José-María; Sánchez-Lasheras, Fernando; Romeo, Jose María; Fernández-Somoano, Ana; Villacampa, Tomás; Baladrón, Jaime

    2017-09-01

    Gastroenterology is one of the medical specialties offered to residency training candidates each year. This project analyzes the data associated with the choice of a Gastroenterology residency program in recent years. Data related to specialty selection were obtained from official reports with regard to the allocation of residency places by the Spanish Ministry of Health, Social Services and Equality. Information was collected from various teaching centers via their training guides, the Spanish National Catalogue of Hospitals and the National Transplant Organization. The median consecutive number involved in the choice of Gastroenterology training has decreased year after year, and this specialty is now positioned among the five most commonly selected residency programs in 2015. The median number of hospitals with a higher number of beds, adult liver transplantation activities and dedicated GI bleeding units is significantly lower. This is also true when centers are analyzed according to the presence of specific Gastroenterology on-call shifts for residents or their association with medical schools. Data from the past five years highlight Madrid, Aragón and the Basque Country as the autonomous communities where Gastroenterology is the most popular. Centers selected by candidates with the lowest median consecutive numbers from 2011-2015 included the university hospitals Ramón y Cajal, Santiago de Compostela and Gregorio Marañón. Gastroenterology has gradually escalated in the ranking of residency choices and is now one of the five most popular options. Potential residents prefer larger centers with complex-care patients and more research activity.

  2. A longitudinal analysis of nursing specialty certification by Magnet® status and patient unit type.

    PubMed

    Boyle, Diane K; Gajewski, Byron J; Miller, Peggy A

    2012-12-01

    The objective of this study was to examine nursing specialty certification trends by Magnet® status and unit type. Research exploring organizational and unit attributes associated with higher specialty certification rates is timely given the beginning evidence that certification is associated with lower patient adverse events. The sample included 6047 units in 1249 National Database of Nursing Quality Indicators hospitals. Hierarchical linear modeling was used to predict growth in percentage of specialty-certified RNs within each unit type and Magnet status. Data (Bayesian Information Criteria = 224 583.30) demonstrated significant growth in specialty certification rates over time (P < .0001). Magnet-designated organizations had significantly different starting certification rates (P = .0002) and rates of change (P = .0002). Unit types also had significantly different starting certification rates (P < .0001) and different rates of change (P < .0001). Magnet recognition is associated with increases in specialty certification rates. Certification rates have risen faster in unit types such as pediatric critical care than in unit types such as adult step-down and adult surgical.

  3. 15 CFR 2011.204 - Entry of specialty sugars.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Entry of specialty sugars. 2011.204... UNITED STATES TRADE REPRESENTATIVE ALLOCATION OF TARIFF-RATE QUOTA ON IMPORTED SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.204 Entry of specialty sugars. An importer or the importer's agent must...

  4. 15 CFR 2011.204 - Entry of specialty sugars.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Entry of specialty sugars. 2011.204... UNITED STATES TRADE REPRESENTATIVE ALLOCATION OF TARIFF-RATE QUOTA ON IMPORTED SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.204 Entry of specialty sugars. An importer or the importer's agent must...

  5. 15 CFR 2011.204 - Entry of specialty sugars.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 15 Commerce and Foreign Trade 3 2013-01-01 2013-01-01 false Entry of specialty sugars. 2011.204... UNITED STATES TRADE REPRESENTATIVE ALLOCATION OF TARIFF-RATE QUOTA ON IMPORTED SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.204 Entry of specialty sugars. An importer or the importer's agent must...

  6. 15 CFR 2011.204 - Entry of specialty sugars.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 3 2014-01-01 2014-01-01 false Entry of specialty sugars. 2011.204... UNITED STATES TRADE REPRESENTATIVE ALLOCATION OF TARIFF-RATE QUOTA ON IMPORTED SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.204 Entry of specialty sugars. An importer or the importer's agent must...

  7. 15 CFR 2011.204 - Entry of specialty sugars.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 3 2012-01-01 2012-01-01 false Entry of specialty sugars. 2011.204... UNITED STATES TRADE REPRESENTATIVE ALLOCATION OF TARIFF-RATE QUOTA ON IMPORTED SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.204 Entry of specialty sugars. An importer or the importer's agent must...

  8. Career Specialty Choice: A Combined Research-Intervention Project

    ERIC Educational Resources Information Center

    Leong, F.T.L.; Hardin, E.E.; Gaylor, M.

    2005-01-01

    This research describes and evaluates a workshop aimed at promoting career specialty choice and examines relationships between measured career specialty interests, work values, and personality type. Three consecutive classes of second-year medical students (N=161) participated in a two-session specialty choice workshop. All participants in the…

  9. Faculty's Degrees, Experience and Research Vary with Specialty.

    ERIC Educational Resources Information Center

    Fedler, Fred; Counts, Tim; Carey, Arlen; Santana, Maria Cristina

    1998-01-01

    Examines issues of professional experience, degrees, research, and productivity for journalism and mass communication faculty members, separating and comparing different specialties. Finds that requirements regarding academic degrees and research vary from specialty to specialty and that 53% of those teaching in advertising, radio/television, and…

  10. Predictive Validity of the Medical Specialty Preference Inventory

    ERIC Educational Resources Information Center

    Glavin, Kevin W.; Richard, George V.; Porfeli, Erik J.

    2009-01-01

    Medical schools can assist students by providing them with quality career counseling to help them choose a medical specialty. Many schools use interest inventories to help identify students' specialty interests. This study examined the predictive validity of one such inventory, the Medical Specialty Preference Inventory (MSPI). In a longitudinal…

  11. Outcomes of Global Education: External and Internal Change Associated with Study Abroad

    ERIC Educational Resources Information Center

    Miller-Perrin, Cindy; Thompson, Don

    2014-01-01

    This chapter provides an overview of external and internal changes associated with collegiate study abroad experiences. A brief review of the research literature is included along with recent research that sheds light on potential mechanisms associated with study abroad-related change. Recommendations for enhancing outcomes associated with study…

  12. The International Reading Association Responds to a Highly Charged Policy Environment.

    ERIC Educational Resources Information Center

    Roller, Cathy

    2000-01-01

    Argues that the International Reading Association (IRA) has an important and key role to play in the current volatile United States government policy environment. Looks at perceptions of literacy failure. Discusses the Association's involvement with the Reading Excellence Act, and outlines what the Association must continue to do to assure that…

  13. Outcomes of Global Education: External and Internal Change Associated with Study Abroad

    ERIC Educational Resources Information Center

    Miller-Perrin, Cindy; Thompson, Don

    2014-01-01

    This chapter provides an overview of external and internal changes associated with collegiate study abroad experiences. A brief review of the research literature is included along with recent research that sheds light on potential mechanisms associated with study abroad-related change. Recommendations for enhancing outcomes associated with study…

  14. Address given at the Opening Meeting of the XIXth Congress of the International Publishers Association.

    ERIC Educational Resources Information Center

    Maheu, Rene

    The relationship between Unesco's task "to promote the free flow of ideas by word and image" and the International Publishers Association's goal of the promotion, through international cooperation, of the right to culture is brought out in this speech. The cooperative efforts of the two organizations in efforts to protect creative…

  15. Effects Associated with Leadership Program Participation in International Students Compared to Domestic Students

    ERIC Educational Resources Information Center

    Collier, Daniel A.; Rosch, David M.

    2016-01-01

    International student enrollment in the U.S. higher education system has recently experienced profound growth. This research examines leadership-oriented differences between international and domestic students and focuses on their growth in capacity associated with participation in co-curricular leadership programs. Similarly-sized gains emerged…

  16. Disentangling the Associations between Autistic-Like and Internalizing Traits: A Community Based Twin Study

    ERIC Educational Resources Information Center

    Hallett, Victoria; Ronald, Angelica; Rijsdijk, Fruhling; Happe, Francesca

    2012-01-01

    Internalizing difficulties are prevalent in children with autism spectrum disorders (ASD), yet little is known about the underlying cause of this comorbidity. It is also unclear which types of autistic-like and internalizing difficulties are most strongly associated. The current study investigated the phenotypic and etiological associations…

  17. Effects Associated with Leadership Program Participation in International Students Compared to Domestic Students

    ERIC Educational Resources Information Center

    Collier, Daniel A.; Rosch, David M.

    2016-01-01

    International student enrollment in the U.S. higher education system has recently experienced profound growth. This research examines leadership-oriented differences between international and domestic students and focuses on their growth in capacity associated with participation in co-curricular leadership programs. Similarly-sized gains emerged…

  18. Greetings from The International Association of Environmental Mutagenesis and Genomics Societies.

    PubMed

    Nohmi, Takehiko

    2015-01-01

    The International Association of Environmental Mutagenesis and Genomics Societies (IAEMGS) is an organization that promotes basic and applied research on environmental mutagenesis and genomics. In this article, as President of IAEMGS, I stress the important role of Genes and Environment to spread the voice of Asia to the international scientific community. Open access will support the journal in achieving this mission.

  19. Disentangling the Associations between Autistic-Like and Internalizing Traits: A Community Based Twin Study

    ERIC Educational Resources Information Center

    Hallett, Victoria; Ronald, Angelica; Rijsdijk, Fruhling; Happe, Francesca

    2012-01-01

    Internalizing difficulties are prevalent in children with autism spectrum disorders (ASD), yet little is known about the underlying cause of this comorbidity. It is also unclear which types of autistic-like and internalizing difficulties are most strongly associated. The current study investigated the phenotypic and etiological associations…

  20. Problem-specific racial/ethnic disparities in pathways from maltreatment exposure to specialty mental health service use for youth in child welfare.

    PubMed

    Martinez, Jonathan I; Gudiño, Omar G; Lau, Anna S

    2013-05-01

    The authors examined racial/ethnic differences in pathways from maltreatment exposure to specialty mental health service use for youth in contact with the Child Welfare system. Participants included 1,600 non-Hispanic White, African American, and Latino youth (age 4-14) who were the subjects of investigations for alleged maltreatment and participated in the National Survey of Child and Adolescent Well-Being. Maltreatment exposure, internalizing, and externalizing problems were assessed at baseline and subsequent specialty mental health service use was assessed 1 year later. Maltreatment exposure predicted both internalizing and externalizing problems across all racial/ethnic groups, but non-Hispanic White youth were the only group for whom maltreatment exposure was linked with subsequent service use via both internalizing and externalizing problem severity. Only externalizing problems predicted subsequent service use for African American youth and this association was significantly stronger relative to non-Hispanic White youth. Neither problem type predicted service use for Latinos. Future research is needed to understand how individual-, family-, and system-level factors contribute to racial/ethnic differences in pathways linking maltreatment exposure to services via internalizing/externalizing problems.

  1. Genetic and Environmental Influences on the Association between Pubertal Maturation and Internalizing Symptoms

    PubMed Central

    Marceau, Kristine; Neiderhiser, Jenae M.; Lichtenstein, Paul; Reiss, David

    2015-01-01

    The literature consistently shows an association between pubertal maturation and internalizing problems in girls. The association for boys is less clear. The present study examines genetic and environmental influences on the association between pubertal maturation and internalizing problems for boys and girls in two primarily Caucasian adolescent twin/sibling studies: The Swedish Twin study of CHild and Adolescent Development (706 same-sex twin pairs aged 13-14, M=13.7 years, 50% female), and the Nonshared Environment in Adolescent Development sample (US-based, 687 same-sex twin/sibling pairs aged 10-18, M=13.6 years, 47% female). For girls, more advanced pubertal maturation was associated modestly with more internalizing problems, and that association was entirely explained by shared environmental influences. For boys, the association between pubertal maturation and internalizing problems was weak and inconsistent. Results for girls were remarkably consistent across samples. Findings suggest that nongenetic mechanisms mediate the association between pubertal maturation and internalizing problems. Findings have implications for intervention such that environmental influences shared by twins/siblings may provide the best targets for intervention strategies designed to minimize the potential negative effects of pubertal maturation on internalizing symptoms in girls. PMID:22476728

  2. ELECTROCHEMICAL DESIGN ASSOCIATES (FORMERLY GEOKINETICS INTERNATIONAL, INC.) LEAD RECOVERY TECHNOLOGY EVALUATION ITER

    EPA Science Inventory

    This report presents performance and economic data from U.S. Environmental Protection Agency (EPA) Superfund Innovative Technology Evaluation (SITE) Program evaluation of Electrochemical Design Associates (EDA), formerly known as Geokinetics International Inc., Lead Recovery Tech...

  3. Transcriptomic events associated with internal browning of apple during postharvest storage

    USDA-ARS?s Scientific Manuscript database

    Although apple (Malus x domestica) is of economic importance, little information is available about the transriptomic profiling of postharvest disorders, particularly internal browning. This study aimed to explore changes in the apple transcriptome associated with development of flesh browning durin...

  4. ELECTROCHEMICAL DESIGN ASSOCIATES (FORMERLY GEOKINETICS INTERNATIONAL, INC.) LEAD RECOVERY TECHNOLOGY EVALUATION ITER

    EPA Science Inventory

    This report presents performance and economic data from U.S. Environmental Protection Agency (EPA) Superfund Innovative Technology Evaluation (SITE) Program evaluation of Electrochemical Design Associates (EDA), formerly known as Geokinetics International Inc., Lead Recovery Tech...

  5. Low vagal tone magnifies the association between psychosocial stress exposure and internalizing psychopathology in adolescents.

    PubMed

    McLaughlin, Katie A; Rith-Najarian, Leslie; Dirks, Melanie A; Sheridan, Margaret A

    2015-01-01

    Vagal tone is a measure of cardiovascular function that facilitates adaptive responses to environmental challenge. Low vagal tone is associated with poor emotional and attentional regulation in children and has been conceptualized as a marker of sensitivity to stress. We investigated whether the associations of a wide range of psychosocial stressors with internalizing and externalizing psychopathology were magnified in adolescents with low vagal tone. Resting heart period data were collected from a diverse community sample of adolescents (ages 13-17; N = 168). Adolescents completed measures assessing internalizing and externalizing psychopathology and exposure to stressors occurring in family, peer, and community contexts. Respiratory sinus arrhythmia (RSA) was calculated from the interbeat interval time series. We estimated interactions between RSA and stress exposure in predicting internalizing and externalizing symptoms and evaluated whether interactions differed by gender. Exposure to psychosocial stressors was associated strongly with psychopathology. RSA was unrelated to internalizing or externalizing problems. Significant interactions were observed between RSA and child abuse, community violence, peer victimization, and traumatic events in predicting internalizing but not externalizing symptoms. Stressors were positively associated with internalizing symptoms in adolescents with low RSA but not in those with high RSA. Similar patterns were observed for anxiety and depression. These interactions were more consistently observed for male than female individuals. Low vagal tone is associated with internalizing psychopathology in adolescents exposed to high levels of stressors. Measurement of vagal tone in clinical settings might provide useful information about sensitivity to stress in child and adolescent clients.

  6. Low Vagal Tone Magnifies the Association Between Psychosocial Stress Exposure and Internalizing Psychopathology in Adolescents

    PubMed Central

    McLaughlin, Katie A.; Rith-Najarian, Leslie; Dirks, Melanie A.; Sheridan, Margaret A.

    2014-01-01

    Vagal tone is a measure of cardiovascular function that facilitates adaptive responses to environmental challenge. Low vagal tone is associated with poor emotional and attentional regulation in children and has been conceptualized as a marker of sensitivity to stress. We investigated whether the associations of a wide range of psychosocial stressors with internalizing and externalizing psychopathology were magnified in adolescents with low vagal tone. Resting heart period data were collected from a diverse community sample of adolescents (ages 13–17; N =168). Adolescents completed measures assessing internalizing and externalizing psychopathology and exposure to stressors occurring in family, peer, and community contexts. Respiratory sinus arrhythmia (RSA) was calculated from the interbeat interval time series. We estimated interactions between RSA and stress exposure in predicting internalizing and externalizing symptoms and evaluated whether interactions differed by gender. Exposure to psychosocial stressors was associated strongly with psychopathology. RSA was unrelated to internalizing or externalizing problems. Significant interactions were observed between RSA and child abuse, community violence, peer victimization, and traumatic events in predicting internalizing but not externalizing symptoms. Stressors were positively associated with internalizing symptoms in adolescents with low RSA but not in those with high RSA. Similar patterns were observed for anxiety and depression. These interactions were more consistently observed for male than female individuals. Low vagal tone is associated with internalizing psychopathology in adolescents exposed to high levels of stressors. Measurement of vagal tone in clinical settings might provide useful information about sensitivity to stress in child and adolescent clients. PMID:24156380

  7. Issues associated with establishing control zones for international space operations

    NASA Technical Reports Server (NTRS)

    Nader, Blair A.; Krishen, Kumar

    1991-01-01

    Cooperative missions in Earth orbit can be facilitated by developing a strategy to regulate the manner in which vehicles interact in orbit. One means of implementing such a strategy is to utilize a control zones technique that assigns different types of orbital operations to specific regions of space surrounding a vehicle. Considered here are issues associated with developing a control zones technique to regulate the interactions of spacecraft in proximity to a manned vehicle. Technical and planning issues, flight hardware and software issues, mission management parameter, and other constraints are discussed. Also covered are manned and unmanned vehicle operations, and manual versus automated flight control. A review of the strategies utilized by the Apollo Soyuz Test Project and the Space Station Freedom Program is also presented.

  8. Does physician specialty affect persistence to pharmacotherapy among patients with overactive bladder syndrome?

    PubMed

    Tran, Alexis M; Sand, Peter K; Seitz, Miriam J; Gafni-Kane, Adam; Zhou, Ying; Botros, Sylvia M

    2017-03-01

    We compared persistence on overactive bladder (OAB) pharmacotherapy in patients treated in the Female Pelvic Medicine and Reconstructive Surgery (FPMRS) department compared with patients treated in the Internal Medicine (IM) and General Urology (GU) departments within an integrated health-care system. We hypothesized that persistence would be higher among FPMRS patients. This was a retrospective cohort study. Patients with at least one prescription for OAB between January 2003 and July 2014 were identified. Demographic, prescription and treatment specialty data and data on the use of third-line therapies were collected. The primary outcome was persistence, defined as days on continuous pharmacotherapy. Discontinuation was defined as a treatment gap of ≥45 days. Discontinuation-free probabilities were calculated using the Kaplan-Meier method and compared among the specialties. Predictors of persistence were estimated using logistic regression with adjustment for covariates. Pearson correlation coefficients were calculated to identify risk associations. A total of 252 subjects were identified. At 12 weeks, 6 months and 1 year, FPMRS patients had the highest persistence rates of 93 %, 87 % and 79 % in contrast to 72 %, 68 % and 50 % in GU patients, and 83 %, 71 % and 63 % in IM patients (p = 0.006, p = 0.007, p = 0.001, respectively). The median persistence in FPMRS patients was 738 days, in GU patients 313 days and in IM patients 486 days (p = 0.006). Of the FPMRS patients, 61 % switched to at least a second medication, as compared to 27 % of IM patients and 14 % of GU patients (p < 0.0001). Persistence on OAB pharmacotherapy was higher among FPMRS patients than among GU and IM patients in this community setting. These results suggest that persistence is higher under subspecialist supervision.

  9. Electrochemical degradation of specialty chemical industry effluent.

    PubMed

    Basha, C Ahmed; Soloman, P A; Velan, M; Miranda, Lima Rose; Balasubramanian, N; Siva, R

    2010-04-15

    Conventional wastewater treatment techniques are inefficient to manage large quantities of refractory organics discharged by specialty chemical industries. It is aimed in the present investigation to compare overall performance of the basic electrochemical reactor configurations such as batch, batch recirculation and continuous recycle reactors, in removing the organic part of wastewater from a medium-scale, specialty chemical industry. The effects of current density, supporting electrolyte concentration, electrolysis duration and fluid flow rate on the pollutant removal and energy consumption performances were critically evaluated. Continuous recycle reactor is found to be the better configuration, because of its flexibility of operation. Circulation flow rate and withdrawal flow rate enable control on transfer coefficients and treatment duration respectively. The ability of artificial neural network (ANN) in predicting the performance of the batch electrochemical treatment has also been demonstrated. 2009 Elsevier B.V. All rights reserved.

  10. Comparing Public Safety Outcomes for Traditional Probation vs Specialty Mental Health Probation.

    PubMed

    Skeem, Jennifer L; Manchak, Sarah; Montoya, Lina

    2017-09-01

    Probation is a cornerstone of efforts to reduce mass incarceration. Although it is understudied, specialty probation could improve outcomes for the overrepresented group of people with mental illness. To test whether specialty probation yields better public safety outcomes than traditional probation. A longitudinal observational study with group matching on age, sex, race/ethnicity, probation time, and offense at 2 urban agencies that exemplify specialty and traditional probation. Enrollment began October 19, 2005; follow-up data were complete January 26, 2013. Participants were 359 diverse probationers with serious mental health problems and functional impairment. Probationers and officers were assessed 3 times (for probationers, 6-month retention, 315 of 359 [88%]; 12-month retention 304 of 359 [85%]) and follow-up records were obtained. Machine learning algorithms were combined with a targeted maximum likelihood estimation, a double robust estimator that accounts for associations between confounders and both treatment assignment and outcomes. Statistical analysis was conducted from January 1, 2016 to May 5, 2017. Specialty probationers were assigned to small, homogeneous caseloads supervised by experts. Prior data indicate that specialty officers had better relationships with probationers, participated more in probationers' treatment, and relied more on positive compliance strategies than traditional officers. Violence during 1 year, determined by probationer report, officer report, and records, and rearrest during a period of 2 to 5 years, according to Federal Bureau of Investigation records. Participants were 183 specialty (73.8% of 248 eligible) and 176 traditional (56.6% of 311 eligible) probationers (205 men and 154 women; mean [SD] age, 36.9 [10.6]). Although specialty probation had no significant effect on violence (odds ratio, 0.97; 95% CI, 0.69-1.36), the odds of rearrest were 2.68 times higher for traditional probationers than for specialty

  11. Theoretical Model of Professional Competence Development in Dual-Specialty Students (On the Example of the "History, Religious Studies" Specialty)

    ERIC Educational Resources Information Center

    Karimova, A. E.; Amanova, A. S.; Sadykova, A. M.; Kuzembaev, N. E.; Makisheva, A. T.; Kurmangazina, G. Zh.; Sakenov, Janat

    2016-01-01

    The article explores the significant problem of developing a theoretical model of professional competence development in dual-specialty students (on the example of the "History, Religious studies" specialty). In order to validate the specifics of the professional competence development in dual-specialty students (on the example of the…

  12. Accounting for the associations between child maltreatment and internalizing problems: The role of alexithymia.

    PubMed

    Brown, Shaquanna; Fite, Paula J; Stone, Katie; Bortolato, Marco

    2016-02-01

    Internalizing difficulties are one of the most widely documented consequences of child maltreatment. However, there is a need for studies delineating the factors that account for this association. Despite research showing that alexithymia is associated with both child maltreatment and internalizing problems, the role of alexithymia in the link between child maltreatment and internalizing problems has not received much attention in the literature. The current study evaluated whether a history of child maltreatment was associated with symptoms of depression, anxiety, and loneliness in emerging adulthood, and whether alexithymia partially accounted for these associations. Participants included 339 emerging adults ranging between 18 and 25 years of age (M=19.00, SD=1.26, 51.3% male). Exposure to child maltreatment (i.e., physical abuse, physical neglect, sexual abuse, emotional abuse, and emotional neglect) was positively associated with depression, anxiety, and loneliness symptoms. Tests of indirect effects suggested that associations between emotional neglect and symptoms of depression, anxiety, and loneliness were partially explained by alexithymia. However, alexithymia did not account for any other associations between the remaining four maltreatment types and internalizing problems. Findings highlight the need for further evaluation of the factors that might account for associations between child maltreatment and internalizing difficulties. Future directions and implications for interventions are reviewed.

  13. Epidemiology and Management of Infectious Diseases in International Adoptees

    PubMed Central

    Murray, Thomas S.; Groth, M. Elizabeth; Weitzman, Carol; Cappello, Michael

    2005-01-01

    International adoptees represent a group of children with unique health care needs. Data from published studies, along with the recent experience of the Yale International Adoption Clinic, suggest that the risk of serious infections in adoptees is low, although infections associated with institutionalization still occur commonly. Interpretation of these data must be undertaken with caution, however, since many, if not most, international adoptees are not evaluated in specialty clinics. Thus, prospective studies designed to minimize selection and referral bias are needed in order to accurately define the risk of infectious and noninfectious diseases in all international adoptees. PMID:16020687

  14. Epidemiology and management of infectious diseases in international adoptees.

    PubMed

    Murray, Thomas S; Groth, M Elizabeth; Weitzman, Carol; Cappello, Michael

    2005-07-01

    International adoptees represent a group of children with unique health care needs. Data from published studies, along with the recent experience of the Yale International Adoption Clinic, suggest that the risk of serious infections in adoptees is low, although infections associated with institutionalization still occur commonly. Interpretation of these data must be undertaken with caution, however, since many, if not most, international adoptees are not evaluated in specialty clinics. Thus, prospective studies designed to minimize selection and referral bias are needed in order to accurately define the risk of infectious and noninfectious diseases in all international adoptees.

  15. International.

    ERIC Educational Resources Information Center

    Hoover, Linn

    1979-01-01

    The International Geological Correlation Project has attained scientific maturity and broad support and participation by geologists world wide. Its purpose is to provide a mechanism for international cooperation and information exchange about geological problems that transcend national boundaries. (Author/BB)

  16. Electric hybrid module based specialty car design

    SciTech Connect

    Bohan, K.R.

    1995-12-31

    The vast majority of automobiles made in the United states today are manufactured by one of three major auto manufacturers. It is intrinsic in their nature to act conservatively. The big three`s large production runs represents a huge amount of capitalization. The amount of capital being invested is the real driving factor behind the conservative nature of these companies. In the computer industries we have seen a significant number of small start up companies as the driving force behind technological change. If a large company does not do it, a small venture capital company will certainly fill the vacuum. Unfortunately, the existing auto industry does not have a strong startup company presence. Even into the 1920`s, the specialty car or custom coach work manufactures represented a lively part of the auto economy. It was not until the coming of the great depression that the small specialty car manufacture was virtually eliminated. Today we see the beginnings of a comeback of the specialty car manufacturer in the kit car industry of today.

  17. [A new specialty is born: Vascular medicine].

    PubMed

    Laroche, J-P

    2016-05-01

    On the 4th of December 2015, the French authorities officially recognized the birth of a specialty in vascular medicine entitled CO-DES cardiology-vascular/vascular Medicine. France is the 7th country to obtain this specialty after Switzerland, Germany, Austria, Czech Republic, Slovakia and Slovenia, six countries in the EEC. It has taken years to achieve a long but exciting experience: we went from hopes to disappointments, sometimes with the blues, but lobbying helping… with sustained confidence. This article tells the story of 30 years of struggle to achieve this vascular medicine specialty. Gaston Bachelard wrote: "Nothing is obvious, nothing is given, all is built." For the construction of vascular medicine, we had to overcome many obstacles, nothing was given to us, everything was conquered. Beware "The specialist is one who knows more and more things about an increasingly restricted field, up to 'knowing everything about nothing"' recalled Ralph Barton Ferry, philosopher; so there is room for modesty and humility but also convictions. The physical examination will remain the basis of our exercise. But let us recall the contributions of all those vascular physicians who practiced in the past, together with those currently active, who built day after day, year after year, a vascular medicine of quality. It is because of the trust of our colleagues and our patients that we can occupy the place that is ours today. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. Positive affect: phenotypic and etiologic associations with prosocial behaviors and internalizing problems in toddlers

    PubMed Central

    Wang, Manjie; Saudino, Kimberly J.

    2015-01-01

    Despite evidence for the associations of positive affect to prosocial behaviors and internalizing problems, relatively little is known about the underlying etiology. The sample comprised over 300 twin pairs at age 3. Positive affect, prosocial behaviors, and internalizing problems were assessed using the Toddler Behavior Assessment Questionnaire (Goldsmith, 1996), the Revised Rutter Parent Scale for Preschool Children (Hogg et al., 1997), and the Child Behavior Checklist for ages 1.5–5 (Achenbach, 1991), respectively. Positive affect correlated positively with prosocial behaviors, and negatively with internalizing problems. Prosocial behaviors were negatively associated with internalizing problems. The relations of positive affect to prosocial behaviors and internalizing problems were due to environmental effects (shared and non-shared). In contrast, the link between prosocial behaviors and internalizing problems was entirely explained by genetic effects. The current study has moved beyond prior emphasis on negative affect and elucidated the less understood etiology underlying the associations between positive affect, prosocial behaviors, and internalizing problems. This study could guide the development of programs for promoting prosocial behaviors and alleviating internalizing problems in children. PMID:25914668

  19. Positive affect: phenotypic and etiologic associations with prosocial behaviors and internalizing problems in toddlers.

    PubMed

    Wang, Manjie; Saudino, Kimberly J

    2015-01-01

    Despite evidence for the associations of positive affect to prosocial behaviors and internalizing problems, relatively little is known about the underlying etiology. The sample comprised over 300 twin pairs at age 3. Positive affect, prosocial behaviors, and internalizing problems were assessed using the Toddler Behavior Assessment Questionnaire (Goldsmith, 1996), the Revised Rutter Parent Scale for Preschool Children (Hogg et al., 1997), and the Child Behavior Checklist for ages 1.5-5 (Achenbach, 1991), respectively. Positive affect correlated positively with prosocial behaviors, and negatively with internalizing problems. Prosocial behaviors were negatively associated with internalizing problems. The relations of positive affect to prosocial behaviors and internalizing problems were due to environmental effects (shared and non-shared). In contrast, the link between prosocial behaviors and internalizing problems was entirely explained by genetic effects. The current study has moved beyond prior emphasis on negative affect and elucidated the less understood etiology underlying the associations between positive affect, prosocial behaviors, and internalizing problems. This study could guide the development of programs for promoting prosocial behaviors and alleviating internalizing problems in children.

  20. Osteopathic medicine and the practice of dermatology: history and current status. An overview of the American Osteopathic College of Dermatology, an affiliate specialty college of the American Osteopathic Association.

    PubMed

    Austin, Erik; Way, Bill V; Lustig, Chava; Green, Jason; Manlio, Christopher; Broomer, Amy; Persichetti, Greg; Akhtar, Asfa; Elias, Merrick; Favreau, Tracy; Skopit, Stanley

    2005-12-01

    As the unified training body for osteopathic physicians specializing in dermatology, the American Osteopathic College of Dermatology (AOCD) sponsors 18 dermatology residency programs that integrate academic training (focusing on the core of basic medical sciences) with clinical instruction (emphasizing specialized diagnostic and laboratory techniques and the high-level performance of all dermatologic and surgical procedures) to engender the ability to provide superior, specialized dermatologic care. The board of directors of the American Academy of Dermatology (AAD) recommended passage of a bylaws amendment establishing a category of osteopathic fellow for those osteopathic physicians who are certified by the American Osteopathic Board of Dermatology; however, the AAD membership failed to adopt the amendment by the required two-thirds majority. Constitutional bylaws of both societies stress the importance of the goal of unification and representation of the specialty of dermatology. Continued rapprochement appears to be in the best interest of the AAD and AOCD and may well enhance our efforts to deal with the challenges that face dermatology and medical practice in the 21st century.

  1. Factors Associated With External and Internal Lymphedema in Patients With Head-and-Neck Cancer

    SciTech Connect

    Deng Jie; Ridner, Sheila H.; Dietrich, Mary S.; Wells, Nancy; Wallston, Kenneth A.; Sinard, Robert J.; Cmelak, Anthony J.; Murphy, Barbara A.

    2012-11-01

    Purpose: The purpose of this study was to examine factors associated with the presence of secondary external and internal lymphedema in patients with head-and-neck cancer (HNC). Methods and Materials: The sample included 81 patients {>=}3 months after HNC treatment. Physical and endoscopic examinations were conducted to determine if participants had external, internal, and/or combined head-and-neck lymphedema. Logistic regression analysis was used to examine the factors associated with the presence of lymphedema. Results: The following factors were statistically significantly associated with presence of lymphedema: (1) location of tumor associated with presence of external (P=.009) and combined lymphedema (P=.032); (2) time since end of HNC treatment associated with presence of external (P=.004) and combined lymphedema (P=.005); (3) total dosage of radiation therapy (P=.010) and days of radiation (P=.017) associated with the presence of combined lymphedema; (4) radiation status of surgical bed was associated with the presence of internal lymphedema, including surgery with postoperative radiation (P=.030) and (salvage) surgery in the irradiated field (P=.008); and (5) number of treatment modalities associated with external (P=.002), internal (P=.039), and combined lymphedema (P=.004). No demographic, health behavior-related, or comorbidity factors were associated with the presence of lymphedema in the sample. Conclusions: Select tumor and treatment parameters are associated with increased occurrence of lymphedema in patients with HNC. Larger and longitudinal studies are needed to identify adjusted effects and causative risk factors contributing to the development of lymphedema in patients with HNC.

  2. Parental internalizing problems in a community sample: association with child psychosocial problems.

    PubMed

    Spijkers, Willem; Jansen, Daniëlle E M C; Reijneveld, Sijmen A

    2014-02-01

    Offspring of depressed, anxious and stressed parents are at increased risk of developing mental disorders. However, most studies investigating this association concentrate on clinical symptoms. The objective of this study is to examine the association between parental internalizing problems (symptoms of depression, anxiety and stress) and child psychosocial problems in a community sample, crude and adjusted for potential confounders (such as child gender, parental educational level, ethnicity) and whether parental concerns affect this association. Preceding a routine health examination, cross-sectional data were obtained from a representative sample of 9453 parents of children aged 9-11 years (response 65%). Measures of parental internalizing problems (Depression Anxiety Stress Scale), child psychosocial problems (Strengths and Difficulties Questionnaire-Total Difficulties Score), background characteristics and parental concerns were completed by the parents. Parental internalizing problems were associated with child psychosocial problems in crude analysis and after adjustment for child, parent and family characteristics [β = 0.12, 95% confidence interval (CI) = 0.10-0.14]. Parental concerns about their child's emotional and behavioural problems were also strongly associated with child psychosocial problems. After adjustment for these parental concerns, the association of parental stress with child psychosocial problems remained, while the association of parental depression and anxiety symptoms with child psychosocial problems lost statistical significance. As in clinical samples, parental internalizing problems in a community sample are associated with child psychosocial problems. Parental concerns on the child seem to affect this association. Further research is needed on the mechanisms affecting this association.

  3. Association between internalizing disorders and day-to-day activities of low energetic expenditure.

    PubMed

    Gosmann, Natan Pereira; Salum, Giovanni Abrahão; Schuch, Felipe; Silveira, Patrícia Pelufo; Bosa, Vera Lucia; Goldani, Marcelo Zubaran; Manfro, Gisele Gus

    2015-02-01

    The objective of this study is to compare energetic expenditure in day-to-day activities among subjects with internalizing disorders (depression and anxiety), externalizing disorders (attention deficit/hyperactivity disorder and oppositional defiant disorder) and healthy children and adolescents without any psychiatric diagnosis. One hundred and five (n = 105) students from a community sample were evaluated throughout a structured psychiatric interview and categorized into three groups: internalizing (n = 54), externalizing (n = 12) and typically developing controls (TDC, n = 39). Energetic expenditure was evaluated using 3-day physical activity record. Subjects with internalizing disorders performed activities with lower energetic expenditure as compared to those with externalizing disorders and TDC. Participants with externalizing disorders had more energetic expenditure variability. Our study suggests that internalizing disorders are associated with activities of low energetic expenditure in day-to-day activities, extending previous findings with physical exercise. These findings may further contribute to the understanding of the associated morbidity previously described in patients with internalizing disorders.

  4. Referral of discharged emergency department patients to primary and specialty care follow-up.

    PubMed

    Ginde, Adit A; Talley, Brad E; Trent, Stacy A; Raja, Ali S; Sullivan, Ashley F; Camargo, Carlos A

    2012-08-01

    Emergency department (ED) patients often need urgent primary or specialty care follow-up, but access is particularly difficult for those without insurance. To characterize follow-up options for uninsured ED patients and to evaluate differences based on ED characteristics. We mailed a survey to all ED Directors in Colorado, Georgia, Massachusetts, and Oregon (n = 351 EDs). Typical referrals for urgent primary and specialty care follow-up for uninsured patients were classified as: a) private physician or clinic affiliated with the same hospital; b) external public clinic or university hospital; or c) no referral system/policy. Of the 298 (85%) responding EDs, 215 (72%) reported primary care referral to private physicians or clinics at the same hospital and 231 (78%) for specialty care. Twenty (7%) and 27 (9%) EDs had no referral system for primary and specialty care, respectively. Factors associated with typical referral to primary care follow-up at the same hospital were: lower visit volume (85% for EDs with < 1 patient per hour vs. 67% for EDs with ≥ 3 patients per hour); rural area (79% for rural vs. 68% for urban areas), and critical access hospital status (81% critical access vs. 69% non-critical access). Conversely, higher visit volume (87% vs. 58%), urban (81% vs. 72%), and non-critical access hospitals (83% vs. 53%) were more likely to refer for specialty care follow-up at the same hospital. Referral of uninsured ED patients to local follow-up was high for primary and specialty care. Smaller, rural EDs referred within their own hospital more often for primary care but less often for specialty care. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Quota in specialty and super-specialty courses: What does the judiciary say?

    PubMed

    Kapoor, Mukul Chandra; Anand, Shubhendu

    2017-01-01

    Reservations in super-specialty courses have been controversial for decades. A number of practising doctors, medical students and others in society have wanted to do away with reservations in specialty and super-specialty courses, while there are others in favour of persisting with reservations. Article 15 (4) of the Constitution of India states that nothing shall prevent the State from making any special provision for the advancement of any socially and educationally backward classes of citizens or for the Scheduled Castes/Tribes. However, Article 14 of the Indian Constitution should also be considered. The judiciary, particularly, the Supreme Court of India, in its judgments has strived to strike a balance between the two constitutional provisions. The Supreme Court, on various occasions, has observed that reservations in super-specialty courses should be done away with, as such reservations would be detrimental to the advancement of medical science and research and will also not serve national interest. We present the observations of the Supreme Court of India through its various judgments, with a focus on the recent case of Dr Sandeep versus Union of India, where the honourable court stated that the government should do away with reservations in super-specialty courses.

  6. Proceedings of the International Association for Development of the Information Society (IADIS) International Conference on Mobile Learning (Lisbon, Portugal, March 14-16, 2013)

    ERIC Educational Resources Information Center

    Sánchez, Inmaculada Arnedillo, Ed.; Isaías, Pedro, Ed.

    2013-01-01

    These proceedings contain the papers of the International Conference on Mobile Learning 2013, which was organised by the International Association for Development of the Information Society, in Lisbon, Portugal, March 14-16, 2013. The Mobile Learning 2013 International Conference seeks to provide a forum for the presentation and discussion of…

  7. Parent Discipline Practices in an International Sample: Associations with Child Behaviors and Moderation by Perceived Normativeness

    ERIC Educational Resources Information Center

    Gershoff, Elizabeth T.; Grogan-Kaylor, Andrew; Lansford, Jennifer E.; Chang, Lei; Zelli, Arnaldo; Deater-Deckard, Kirby; Dodge, Kenneth A.

    2010-01-01

    This study examined the associations of 11 discipline techniques with children's aggressive and anxious behaviors in an international sample of mothers and children from 6 countries and determined whether any significant associations were moderated by mothers' and children's perceived normativeness of the techniques. Participants included 292…

  8. Through the Lens of Theory: Perspectives on an International Library Association.

    ERIC Educational Resources Information Center

    Knuth, Rebecca

    1996-01-01

    Discusses a study of the International Association of School Librarianship (IASL) with the goal of offering an alternative model for studying associations that combines a theoretical framework with a case study design. Theories of organization, convergence, and global integrity ethics are discussed, and a survey of IASL membership is appended.…

  9. Nursing home research: the first International Association of Gerontology and Geriatrics (IAGG) research conference.

    PubMed

    Rolland, Yves; Resnick, Barbara; Katz, Paul R; Little, Milta O; Ouslander, Joseph G; Bonner, Alice; Geary, Carol R; Schumacher, Karen L; Thompson, Sarah; Martin, Finbarr C; Wilbers, Joachim; Zúñiga, Franziska; Ausserhofer, D; Schwendimann, R; Schüssler, S; Dassen, Theo; Lohrmann, Christa; Levy, Cari; Whitfield, Emily; de Souto Barreto, Philipe; Etherton-Beer, Christopher; Dilles, Tinne; Azermai, Majda; Bourgeois, Jolyce; Orrell, Martin; Grossberg, George T; Kergoat, Hélène; Thomas, David R; Visschedijk, Jan; Taylor, Stephanie J C; Handajani, Yvonne S; Widjaja, Nelly T; Turana, Yuda; Rantz, Marilyn J; Skubic, Marjorie; Morley, John E

    2014-05-01

    The International Association of Gerontology and Geriatrics held its first conference on nursing home research in St Louis, MO, in November 2013. This article provides a summary of the presentations. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

  10. Comparison of Women in Department Leadership in Obstetrics and Gynecology With Other Specialties

    PubMed Central

    Hofler, Lisa G.; Hacker, Michele R.; Dodge, Laura E.; Schutzberg, Rose; Ricciotti, Hope A.

    2016-01-01

    Objective To compare the representation of women in Obstetrics and Gynecology department-based leadership to other clinical specialties, while accounting for proportions of women in historical residency cohorts. Methods This was a cross-sectional observational study. The gender of department-based leaders (chair, vice chair, division director) and residency program directors was determined from websites of 950 academic departments of Anesthesiology, Diagnostic Radiology, General Surgery, Internal Medicine, Neurology, Obstetrics and Gynecology, Pathology, Pediatrics, and Psychiatry. Each specialty's representation ratio—proportion of leadership roles held by women in 2013 divided by proportion of residents in 1990 who were women—and 95% confidence interval (CI) were calculated. A ratio of one indicates proportionate representation. Results Women were significantly under-represented among chairs for all specialties (ratios ≤0.60, P≤0.02) and division directors for all specialties except Anesthesiology (ratio: 1.13, 95% CI: 0.87–1.46) and Diagnostic Radiology (ratio: 0.97, 95% CI: 0.81–1.16). The representation ratio for vice chair was below 1.0 for all specialties except Anesthesiology; this finding reached statistical significance only for Pathology, Pediatrics, and Psychiatry. Women were significantly over-represented as residency program directors in General Surgery, Anesthesiology, Obstetrics and Gynecology, and Pediatrics (ratios >1.19, P≤0.046). Obstetrics and Gynecology and Pediatrics had the highest proportions of residents in 1990 and department leaders in 2013 who were women. Conclusion Despite having the largest proportion of leaders who were women, representation ratios demonstrate Obstetrics and Gynecology is behind other specialties in progression of women to departmental leadership. Women's over-representation as residency program directors raises concern because education-based academic tracks may not lead to major leadership roles. PMID

  11. Comparison of Women in Department Leadership in Obstetrics and Gynecology With Those in Other Specialties.

    PubMed

    Hofler, Lisa G; Hacker, Michele R; Dodge, Laura E; Schutzberg, Rose; Ricciotti, Hope A

    2016-03-01

    To compare the representation of women in obstetrics and gynecology department-based leadership to other clinical specialties while accounting for proportions of women in historical residency cohorts. This was a cross-sectional observational study. The gender of department-based leaders (chair, vice chair, division director) and residency program directors was determined from websites of 950 academic departments of anesthesiology, diagnostic radiology, general surgery, internal medicine, neurology, obstetrics and gynecology, pathology, pediatrics, and psychiatry. Each specialty's representation ratio-proportion of leadership roles held by women in 2013 divided by proportion of residents in 1990 who were women-and 95% confidence interval (CI) were calculated. A ratio of 1 indicates proportionate representation. Women were significantly underrepresented among chairs for all specialties (ratios 0.60 or less, P≤.02) and division directors for all specialties except anesthesiology (ratio 1.13, 95% CI 0.87-1.46) and diagnostic radiology (ratio 0.97, 95% CI 0.81-1.16). The representation ratio for vice chair was below 1.0 for all specialties except anesthesiology; this finding reached statistical significance only for pathology, pediatrics, and psychiatry. Women were significantly overrepresented as residency program directors in general surgery, anesthesiology, obstetrics and gynecology, and pediatrics (ratios greater than 1.19, P≤.046). Obstetrics and gynecology and pediatrics had the highest proportions of residents in 1990 and department leaders in 2013 who were women. Despite having the largest proportion of leaders who were women, representation ratios demonstrate obstetrics and gynecology is behind other specialties in progression of women to departmental leadership. Women's overrepresentation as residency program directors raises concern because education-based academic tracks may not lead to major leadership roles.

  12. Racial disparities across provider specialties in opioid prescriptions dispensed to medicaid beneficiaries with chronic noncancer pain.

    PubMed

    Ringwalt, Chris; Roberts, Andrew W; Gugelmann, Hallam; Skinner, Asheley Cockrell

    2015-04-01

    Chronic pain affects both psychological and physical functioning, and is responsible for more than $60 billion in lost productivity annually in the United States. Although previous studies have demonstrated racial disparities in opioid treatment, there is little evidence regarding disparities in treatment of chronic noncancer pain (CNCP) and the role played by physician specialty in these disparities. A retrospective cohort study. We analyzed North Carolina Medicaid claims data, from July 1, 2009 to May 31, 2010, to examine disparities by different provider specialties in beneficiaries' dispensed prescriptions for opioids. The population included white and black North Carolina Medicaid beneficiaries with CNCP (N = 75,458). We used bivariate statistics and logistic regression analysis to examine race-based discrepancies in opioid prescribing by physician specialty. Compared with white beneficiaries with CNCP (N = 49,197), black beneficiaries (N = 26,261) were less likely (odds ratio [OR] 0.91 [confidence interval {CI}: 0.88-0.94]) to fill an opioid prescription. Our hypothesis was partially supported: we found that race-based differences in beneficiaries' dispensed opioid prescriptions were more prominent in certain specialties. In particular, these differences were most salient among patients of specialists in obstetrics and gynecology (OR 0.78 [CI: 0.67-0.89]) and internal medicine (OR 0.86 [CI: 0.79-0.92]), as well as general practitioners/family medicine physicians (OR 0.91 [CI: 0.85-0.97]). Our findings suggest that, in our study population, black beneficiaries with CNCP are less likely than whites to fill prescriptions for opioid analgesics as a function of their provider's specialty. Although race-based differences in patients filling opioid prescriptions have been noted in previous studies, this is the first study that clearly demonstrates these disparities by provider specialty. Wiley Periodicals, Inc.

  13. Treatment of veterans with PTSD at a VA medical center: primary care versus mental health specialty care.

    PubMed

    Vojvoda, Dolores; Stefanovics, Elina; Rosenheck, Robert A

    2014-10-01

    Recent military conflicts have generated significantly more demand for treatment of posttraumatic stress disorder (PTSD) as well as concerns about the adverse effects of stigma associated with specialty mental health care. This study examined the extent to which veterans diagnosed as having PTSD received treatment exclusively in primary care settings. Administrative data from the U.S. Department of Veterans Affairs (VA) Connecticut Healthcare System for fiscal year 2010 were used to compare the proportions and characteristics of veterans with PTSD (N=4,144) who were treated exclusively in a primary care setting or a mental health specialty clinic. Most (87%) veterans were treated in specialty mental health clinics, and 13% were treated exclusively in primary care. In contrast, 24% of veterans with any mental health diagnosis received treatment exclusively in primary care. Comorbid psychiatric diagnoses were much more prevalent among those treated in mental health specialty clinics than in primary care (86% versus 14%), and psychotropic medications were far more likely to be filled in mental health specialty clinics than in primary care (80% versus 36%). The percentage of veterans with service-connected disabilities did not differ between the two treatment settings. Despite the VA's successful expansion of mental health services in primary care, the vast majority of patients with PTSD received treatment in mental health specialty clinics. Stigma does not seem to keep veterans with PTSD from receiving care in specialty mental health settings in spite of the availability of services in primary care.

  14. Is there a need for a common framework of dental specialties in Europe?

    PubMed

    Sanz, M; Widström, E; Eaton, K A

    2008-08-01

    This paper aims to promote discussion about dental specialties and post-graduate dental education in the European Union (EU). Previously, dental educators have concentrated their efforts of seeking Pan-EU convergence in undergraduate dental education. However, the impact of the enlargement of the EU, the new European Commission (EC) Directive of professional training and the Bologna Process all impact on post-graduate (specialist) just as much as on undergraduate dental education. The provisions of the new EC directive mean that, unlike new medical specialties, new Pan-EU dental specialties cannot be created purely because they exist in two-fifths of EU Member States. At present, some EU Member States recognise eight or more dental specialties, whereas others recognise none. It is suggested that changing needs and demands of patients, which reflect a general improvement in oral health, increased wealth and an aging population will place increasing demands on dentistry to provide more complex care and treatment and that the current undergraduate curriculum cannot be expanded to provide suitable training to meet these needs and demands. There is thus a need to expand dental specialist training in all EU Member States, to agree common standards for specialist education and to officially recognise a wider range of Pan-EU dental specialties. The paper concludes that in order to achieve these goals, there is a need of a better collaboration between competent authorities, including governments, universities, dental associations and the various Pan-European Scientific Specialist Organizations.

  15. Footprint and imprint: an ecologic time-trend analysis of cardiovascular publications in general and specialty journals.

    PubMed

    Baldridge, Abigail S; Huffman, Mark D; Bloomfield, Gerald S; Prabhakaran, Dorairaj

    2014-06-01

    Studies have demonstrated strong associations between publication source and citations, as well as investigatory analysis of collaboration effects, in general and medical literature, but are limited to specific journals or short duration of time. This study sought to analyze time trends in cardiovascular research publications in leading general and specialty journals and to determine the association between collaboration and citation index. Cardiovascular publications were retrieved from Web of Knowledge by a cardiovascular bibliometric filter, and annual publication volumes in 8 general and specialty journals were compared. Univariable linear regression models were used to determine global and journal-specific trends for overall publication, cardiovascular publication, proportion of cardiovascular publication, collaboration, and citations. Cardiovascular publications increased (1999 to 2008) by 36% and number of sources by 74%. Volume increased in European Heart Journal (beta: 18.4, 95% confidence interval [CI]: 10.6 to 26.3) and decreased in Circulation (beta: -42.9, 95% CI: -79.3 to -6.5), Annals of Internal Medicine (beta: -1.9, 95% CI: -3.5 to -0.3), and Lancet (beta: -11.2, 95% CI: -14.7 to -7.8). Number of contributing countries increased in 3 journals: BMJ (beta: 0.8, 95% CI: 0.2 to 1.5), European Heart Journal (beta: -1.2, 95% CI: 0.8 to 1.7), and New England Journal of Medicine (beta: 1.6, 95% CI: 0.6 to 2.7). Fraction of collaborative publications increased (beta: 1.1 to 2.9) in all but Annals of Internal Medicine. Collaboration was associated with a higher median actual citation index (p < 0.0001). We found increasing trends in collaboration and citation in both general and specialty journals. Contribution by country in selected journals was disproportionate and under-represents total cardiovascular research in low- and middle-income countries. Copyright © 2014 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

  16. [International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Hebrew edition].

    PubMed

    Diangelis, A J; Andreasen, J O; Ebeleseder, K A; Kenny, D J; Trope, M; Sigurdsson, A; Andersson, L; Bourguignon, C; Flores, M T; Hicks, M L; Lenzi, A R; Malmgren, B; Moule, A J; Pohl, Y; Tsukiboshi, M

    2014-04-01

    Traumatic dental injuries (TDIs) of permanent teeth occur frequently in children and young adults. Crown fractures and luxations are the most commonly occurring of all dental injuries. Proper diagnosis, treatment planning and follow up are important for improving a favorable outcome. Guidelines should assist dentists and patients in decision making and for providing the best care effectively and efficiently. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion of the IADT board members. The guidelines represent the best current evidence based on literature search and professional opinion. The primary goal of these guidelines is to delineate an approach for the immediate or urgent care of TDIs. In this first article, the IADT Guidelines for management of fractures and luxations of permanent teeth will be presented. The Hebrew Edition is part of the IADT global effort to provide accessibility to these guidelines worldwide.

  17. Mediators of the Associations Between Externalizing Behaviors and Internalizing Symptoms in Late Childhood and Early Adolescence

    PubMed Central

    Fleming, Charles B.; McCarty, Carolyn A.; Catalano, Richard F.

    2014-01-01

    This study tests the predictive associations between externalizing behaviors and internalizing symptoms and examines the mediating roles of social competence, parent-child conflicts, and academic achievement. Using youth-, parent-, and teacher-reported longitudinal data on a sample of 523 boys and 460 girls from late childhood to early adolescence, we found evidence for pathways between externalizing behaviors and internalizing symptoms in both directions. Parent-child conflict, but not social competence and academic achievement, was found to be a significant mediator such that externalizing behaviors predicted parent-child conflicts, which in turn, predicted internalizing symptoms. Internalizing symptoms showed more continuity during early adolescence for girls than boys. For boys, academic achievement was unexpectedly, positively predictive of internalizing symptoms. The results highlight the importance of facilitating positive parental and caregiver involvement during adolescence in alleviating the risk of co-occurring psychopathology. PMID:25554717

  18. Mediators of the Associations Between Externalizing Behaviors and Internalizing Symptoms in Late Childhood and Early Adolescence.

    PubMed

    Yong, Minglee; Fleming, Charles B; McCarty, Carolyn A; Catalano, Richard F

    2014-10-01

    This study tests the predictive associations between externalizing behaviors and internalizing symptoms and examines the mediating roles of social competence, parent-child conflicts, and academic achievement. Using youth-, parent-, and teacher-reported longitudinal data on a sample of 523 boys and 460 girls from late childhood to early adolescence, we found evidence for pathways between externalizing behaviors and internalizing symptoms in both directions. Parent-child conflict, but not social competence and academic achievement, was found to be a significant mediator such that externalizing behaviors predicted parent-child conflicts, which in turn, predicted internalizing symptoms. Internalizing symptoms showed more continuity during early adolescence for girls than boys. For boys, academic achievement was unexpectedly, positively predictive of internalizing symptoms. The results highlight the importance of facilitating positive parental and caregiver involvement during adolescence in alleviating the risk of co-occurring psychopathology.

  19. Organizational readiness in specialty mental health care.

    PubMed

    Hamilton, Alison B; Cohen, Amy N; Young, Alexander S

    2010-01-01

    Implementing quality improvement efforts in clinics is challenging. Assessment of organizational "readiness" for change can set the stage for implementation by providing information regarding existing strengths and deficiencies, thereby increasing the chance of a successful improvement effort. This paper discusses organizational assessment in specialty mental health, in preparation for improving care for individuals with schizophrenia. To assess organizational readiness for change in specialty mental health in order to facilitate locally tailored implementation strategies. EQUIP-2 is a site-level controlled trial at nine VA medical centers (four intervention, five control). Providers at all sites completed an organizational readiness for change (ORC) measure, and key stakeholders at the intervention sites completed a semi-structured interview at baseline. At the four intervention sites, 16 administrators and 43 clinical staff completed the ORC, and 38 key stakeholders were interviewed. The readiness domains of training needs, communication, and change were the domains with lower mean scores (i.e., potential deficiencies) ranging from a low of 23.8 to a high of 36.2 on a scale of 10-50, while staff attributes of growth and adaptability had higher mean scores (i.e., potential strengths) ranging from a low of 35.4 to a high of 41.1. Semi-structured interviews revealed that staff perceptions and experiences of change and decision-making are affected by larger structural factors such as change mandates from VA headquarters. Motivation for change, organizational climate, staff perceptions and beliefs, and prior experience with change efforts contribute to readiness for change in specialty mental health. Sites with less readiness for change may require more flexibility in the implementation of a quality improvement intervention. We suggest that uptake of evidence-based practices can be enhanced by tailoring implementation efforts to the strengths and deficiencies of the

  20. History of specialty residency funding in Canada.

    PubMed Central

    Ruedy, J

    1993-01-01

    Specialty residency training in Canada has evolved from its origin in teaching hospitals through an era dominated by universities to the present when public accountability is emerging as a dominant influence. The predominant educational strategies, including experimental learning, role modelling, continuum of training, independent thinking, self-directed learning and research experiences, have been influenced by the diversity of roles expected of the resident, including that of an employee, a student, a teacher and, more recently, a part of the policy instrument of governments in controlling physician resources. PMID:8477380

  1. Microbiological Spoilage of Acidified Specialty Products

    NASA Astrophysics Data System (ADS)

    Sperber, William H.

    Acidified specialty products or condiments are among the most microbiologically stable and safe food products. Often formulated, packaged, and distributed without heat treatments, they are microbiologically stable indefinitely at ambient temperatures in unopened containers. The packaged, acidified products are often intended for multiple uses, exposing them at the points of consumption to numerous opportunities for contamination with microorganisms. Nonetheless, they remain resistant to microbiological spoilage for many months, often under refrigerated conditions that are used to retard chemical reactions, flavor changes, and yeast growth.

  2. Association between Social Integration and Health among Internal Migrants in ZhongShan, China

    PubMed Central

    Lin, Yanwei; Zhang, Qi; Chen, Wen; Shi, Jingrong; Han, Siqi; Song, Xiaolei; Xu, Yong; Ling, Li

    2016-01-01

    Internal migrants are the individuals who migrate between regions in one country. The number of internal migrants were estimated at 245 million in China in 2013. Results were inconsistent in the literature about the relationship between their health statuses and social integration. The main difference exists on how to measure the social integration and whether health statuses of internal migrants improve with years of residence. To complement the existing literature, this study measured social integration more comprehensively and estimated the internal migrants’ health statuses with varying years of residence, and explored the associations between the migrants’ social integration and health. We used the data from 2014 Internal Migrant Dynamic Monitoring Survey of Health and Family Planning in ZhongShan, China. Health status was measured from four aspects: self-reported health, subjective well-being, perception of stress, mental health. We measured social integration through four dimensions: economy, social communication, acculturation, and self-identity. The analyses used multiple linear regressions to examine the associations between self-reported health, subjective well-being, and perception of stress, mental health and social integration. The analytical sample included 1,999 households of the internal migrants and 1,997 local registered households, who were permanent residents in ZhongShan. Among the internal migrants, Adults in the labor force, who were aged 25 to 44 years old, accounted for 91.2% of the internal migrant population, while 74.6% of the registered population were in that age group. Median residential time among migrants was 2.8 (1.3–6.2) years, and 20.2% of them were migrating in the same Guangdong province. Except for mental health, other health statuses among migrants had significant differences compared with local registered population, e.g. self-reported health was better, but subjective well-being was worse. However, these health

  3. Association between Social Integration and Health among Internal Migrants in ZhongShan, China.

    PubMed

    Lin, Yanwei; Zhang, Qi; Chen, Wen; Shi, Jingrong; Han, Siqi; Song, Xiaolei; Xu, Yong; Ling, Li

    2016-01-01

    Internal migrants are the individuals who migrate between regions in one country. The number of internal migrants were estimated at 245 million in China in 2013. Results were inconsistent in the literature about the relationship between their health statuses and social integration. The main difference exists on how to measure the social integration and whether health statuses of internal migrants improve with years of residence. To complement the existing literature, this study measured social integration more comprehensively and estimated the internal migrants' health statuses with varying years of residence, and explored the associations between the migrants' social integration and health. We used the data from 2014 Internal Migrant Dynamic Monitoring Survey of Health and Family Planning in ZhongShan, China. Health status was measured from four aspects: self-reported health, subjective well-being, perception of stress, mental health. We measured social integration through four dimensions: economy, social communication, acculturation, and self-identity. The analyses used multiple linear regressions to examine the associations between self-reported health, subjective well-being, and perception of stress, mental health and social integration. The analytical sample included 1,999 households of the internal migrants and 1,997 local registered households, who were permanent residents in ZhongShan. Among the internal migrants, Adults in the labor force, who were aged 25 to 44 years old, accounted for 91.2% of the internal migrant population, while 74.6% of the registered population were in that age group. Median residential time among migrants was 2.8 (1.3-6.2) years, and 20.2% of them were migrating in the same Guangdong province. Except for mental health, other health statuses among migrants had significant differences compared with local registered population, e.g. self-reported health was better, but subjective well-being was worse. However, these health

  4. Brain mechanisms associated with internally directed attention and self-generated thought

    PubMed Central

    Benedek, Mathias; Jauk, Emanuel; Beaty, Roger E.; Fink, Andreas; Koschutnig, Karl; Neubauer, Aljoscha C.

    2016-01-01

    Internal cognition like imagination and prospection require sustained internally directed attention and involve self-generated thought. This fMRI study aimed to disentangle the brain mechanisms associated with attention-specific and task-specific processes during internally directed cognition. The direction of attention was manipulated by either keeping a relevant stimulus visible throughout the task, or by masking it, so that the task had to be performed “in the mind’s eye”. The level of self-directed thought was additionally varied between a convergent and a divergent thinking task. Internally directed attention was associated with increased activation in the right anterior inferior parietal lobe (aIPL), bilateral lingual gyrus and the cuneus, as well as with extended deactivations of superior parietal and occipital regions representing parts of the dorsal attention network. The right aIPL further showed increased connectivity with occipital regions suggesting an active top-down mechanism for shielding ongoing internal processes from potentially distracting sensory stimulation in terms of perceptual decoupling. Activation of the default network was not related to internally directed attention per se, but rather to a higher level of self-generated thought. The findings hence shed further light on the roles of inferior and superior parietal cortex for internally directed cognition. PMID:26960259

  5. Correlates of physician burnout across regions and specialties: a meta-analysis

    PubMed Central

    2013-01-01

    Background Health care organizations globally realize the need to address physician burnout due to its close linkages with quality of care, retention and migration. The many functions of health human resources include identifying and managing burnout risk factors for health professionals, while also promoting effective coping. Our study of physician burnout aims to show: (1) which correlates are most strongly associated with emotional exhaustion (EE) and depersonalization (DP), and (2) whether the associations vary across regions and specialties. Methods Meta-analysis allowed us to examine a diverse range of correlates. Our search yielded 65 samples of physicians from various regions and specialties. Results EE was negatively associated with autonomy, positive work attitudes, and quality and safety culture. It was positively associated with workload, constraining organizational structure, incivility/conflicts/violence, low quality and safety standards, negative work attitudes, work-life conflict, and contributors to poor mental health. We found a similar but weaker pattern of associations for DP. Physicians in the Americas experienced lower EE levels than physicians in Europe when quality and safety culture and career development opportunities were both strong, and when they used problem-focused coping. The former experienced higher EE levels when work-life conflict was strong and they used ineffective coping. Physicians in Europe experienced lower EE levels than physicians in the Americas with positive work attitudes. We found a similar but weaker pattern of associations for DP. Outpatient specialties experienced higher EE levels than inpatient specialties when organization structures were constraining and contributors to poor mental health were present. The former experienced lower EE levels when autonomy was present. Inpatient specialties experienced lower EE levels than outpatient specialties with positive work attitudes. As above, we found a similar but weaker

  6. Correlates of physician burnout across regions and specialties: a meta-analysis.

    PubMed

    Lee, Raymond T; Seo, Bosu; Hladkyj, Steven; Lovell, Brenda L; Schwartzmann, Laura

    2013-09-28

    Health care organizations globally realize the need to address physician burnout due to its close linkages with quality of care, retention and migration. The many functions of health human resources include identifying and managing burnout risk factors for health professionals, while also promoting effective coping. Our study of physician burnout aims to show: (1) which correlates are most strongly associated with emotional exhaustion (EE) and depersonalization (DP), and (2) whether the associations vary across regions and specialties. Meta-analysis allowed us to examine a diverse range of correlates. Our search yielded 65 samples of physicians from various regions and specialties. EE was negatively associated with autonomy, positive work attitudes, and quality and safety culture. It was positively associated with workload, constraining organizational structure, incivility/conflicts/violence, low quality and safety standards, negative work attitudes, work-life conflict, and contributors to poor mental health. We found a similar but weaker pattern of associations for DP.Physicians in the Americas experienced lower EE levels than physicians in Europe when quality and safety culture and career development opportunities were both strong, and when they used problem-focused coping. The former experienced higher EE levels when work-life conflict was strong and they used ineffective coping. Physicians in Europe experienced lower EE levels than physicians in the Americas with positive work attitudes. We found a similar but weaker pattern of associations for DP.Outpatient specialties experienced higher EE levels than inpatient specialties when organization structures were constraining and contributors to poor mental health were present. The former experienced lower EE levels when autonomy was present. Inpatient specialties experienced lower EE levels than outpatient specialties with positive work attitudes. As above, we found a similar but weaker pattern of associations for

  7. Health and well-being factors associated with international business travel.

    PubMed

    Burkholder, Justin D; Joines, Ron; Cunningham-Hill, Mark; Xu, Baowei

    2010-01-01

    International travel by US business travelers is continuing to increase with the globalization of the economy. The objective of this study was to determine if the frequency and duration of international business travel is associated with differences in travelers' health and well-being. This study expands our limited knowledge of the impact of long-haul travel on healthy lifestyle choices and traveler's perceptions of their health and well-being. 12,942 unique health risk appraisal (HRA) records of US employees of a multinational corporation were analyzed according to self-reported (objective and subjective) travel history and lifestyle habits. Comparing 2,962 international travelers and 9,980 non-travelers, international business travel was significantly associated with a lower body mass index, lower blood pressure, excess alcohol consumption, sleep deprivation, and diminished confidence to keep up with the pace of work. This study demonstrated both positive and negative associations on the health risks and well-being of a large sample of US-based international business travelers from an US multinational company. This study identifies targeted areas for pretrip screening and counseling to proactively address potential negative effects of travel and may assist in the design of corporate travel health and employee assistance programs. © 2010 International Society of Travel Medicine.

  8. Integrated clinical and specialty pharmacy practice model for management of patients with multiple sclerosis.

    PubMed

    Hanson, Rebekah L; Habibi, Mitra; Khamo, Nehrin; Abdou, Sherif; Stubbings, JoAnn

    2014-03-15

    An integrated clinical and specialty pharmacy practice model for the management of patients with multiple sclerosis (MS) is described. Specialty medications, such as disease-modifying therapies (DMTs) used to treat MS, are costly and typically require special administration, handling, and storage. DMTs are associated with high rates of nonadherence and may have associated safety risks. The University of Illinois Hospital and Health Sciences System developed an MS pharmacy practice model that sought to address the many challenges of coordinating care with multiple entities outside the health system. Several key features of the integrated model include a dedicated clinical pharmacist on the MS specialty team, an integrated specialty pharmacy service, direct access to the electronic medical record, and face-to-face interaction with patients. Through the active involvement of the neurology clinical pharmacist and an onsite specialty pharmacy service, targeted assessments and medication and disease education are provided to the patient before DMT initiation and maintained throughout therapy. In addition, the regular point of contact and refill coordination encourages improved compliance, appropriate medication use, ongoing safety monitoring, and improved communication with the provider for quicker interventions. This fosters increased accessibility, convenience, and patient confidence. Improving patient outcomes--the priority goal of this service model--will be assessed in future planned studies. Through this new practice model, providers are empowered to incorporate specialty medication management into transitions in care, admission and discharge quality indicators, readmissions, and other core measures. An integrated pharmacy practice model that includes an interdisciplinary team of physicians, nurses, and pharmacists improved patient compliance with MS therapies.

  9. Real Returns to Career Decisions: The Physician's Specialty and Location Choices.

    ERIC Educational Resources Information Center

    Langwell, Kathryn M.

    1980-01-01

    Studies the physician's choice of a practice location as a factor influencing lifetime earnings. Also, computations of net present values associates with the decision to specialize, rather than enter general or family practice, suggest that returns to specialty choice are highly dependent upon the choice of a practice location. (CT)

  10. Comparison of public health and preventive medicine physician specialty training in six countries: Identifying challenges and opportunities.

    PubMed

    Peik, Samuel M; Mohan, Keerthi M; Baba, Toshiaki; Donadel, Morgane; Labruto, Andrea; Loh, Lawrence C

    2016-11-01

    Public health and preventive medicine (PHPM) has been recognized internationally as a physician specialty, but national parallels and differences exist between training contexts. This paper reviews PHPM training and employment in Canada, France, Italy, Japan, the United Kingdom, and the USA. Information gathered from relevant accreditation bodies and literature searches was used to create descriptive profiles of national training demographics and structure and a narrative outlining trends and challenges facing the specialty. Notable similarities and differences exist between national contexts. Key themes were differences in training strategies and practice scope, specialty stakeholders, certification structure, and funding. Recognition challenges faced the specialty across all six countries. Other challenges included unclear competencies and training strategies and a need for PHPM specialists to highlight their role in combating population health threats. Additional differences existed between comparator countries on the structure of training, funding sources for training programs, availability of training posts, and linkages with other physician specialties. Highlighting these themes is a first step to fostering training collaborations between PHPM specialist physicians to augment transnational action on global public health challenges and also supports PHPM physician educators with innovative solutions from abroad that might address domestic specialty challenges.

  11. Parental discipline behaviours and beliefs about their child: associations with child internalizing and mediation relationships.

    PubMed

    Laskey, B J; Cartwright-Hatton, S

    2009-09-01

    Internalizing disorders of childhood are a common and disabling problem, with sufferers at increased risk of subsequent psychiatric morbidity. Several studies have found associations between parenting styles and children's internalizing, although few have considered the role of parental discipline. Parental discipline style may exert an effect on children's internalizing symptoms. Anxiety and depression are reliably found to run in families and parental anxiety has been shown to effect parenting behaviour. This study set out to examine the links between parental anxiety, parental discipline style and child internalizing symptoms. Eighty-eight parents of children aged 4-10 years were recruited through primary schools. All parents completed questionnaires including measures relating to: adult anxiety (State-Trait Anxiety Inventory - Trait version, Penn State Worry Questionnaire), parental depression (Beck Depression Inventory - Fastscreen), parental discipline (The Parenting Scale), parenting-related attributions (Parenting Attitudes, Beliefs and Cognitions Scale) and child psychological morbidity (Child Behaviour Checklist 4-18 version). Significant correlations were found between both parental anxiety and child internalizing symptoms with ineffective discipline and negative beliefs about parenting. Particularly strong correlations were found between parental anxiety and child internalizing symptoms with harsh discipline. Parents of anxious/withdrawn children were more likely to hold negative beliefs about their child. The link between parental anxiety and child internalizing symptoms was mediated by harsh discipline. The link between parental anxiety and harsh discipline was mediated by parental beliefs about the child. Discipline style may be an important factor in the relationship between parent anxiety and child internalizing symptoms.

  12. How Do Medical Specialty Training Educators and Trainees Perceive Medical Specialty Selection Examination (TUS)

    ERIC Educational Resources Information Center

    Ozen Kutanis, Rana; Tunc, Tulin; Tunc, Murat

    2011-01-01

    In this study, it was aimed to explore whether a single-step examination is adequate for ranking the medical graduates for specialty training in medicine which is practically similar to doctoral training (PhD) in other disciplines. For this purpose, a semi- structured interview-based qualitative research was carried out at a university medical…

  13. The Association of Parental Depressive Symptoms with Child Internalizing Problems: The Role of Parental Guilt Induction

    PubMed Central

    Rakow, Aaron; Forehand, Rex; Haker, Kelly; McKee, Laura G.; Champion, Jennifer E.; Potts, Jennifer; Hardcastle, Emily; Roberts, Lorinda; Compas, Bruce E.

    2010-01-01

    This study builds on prior research by Rakow et al. (2009) by examining the role of parental guilt induction in the association between parent depressive symptoms and child internalizing problems in a sample of parents with a history of major depressive disorder. One hundred and two families with 129 children (66 males; Mage = 11.42 years) were studied. The association of parental depressive symptoms with child internalizing problems was accounted for by parental guilt induction, which was assessed by behavioral observations and child report. Implications of the findings for parenting programs are discussed and future research directions are considered. PMID:21355654

  14. [Post-graduate education of pharmacist specialties].

    PubMed

    Shibayama, Yoshihiko

    2012-01-01

    In our unprecedented ageing society, high quality pharmacy practices are recommended; the activities of pharmacists who have received novel education are therefore expected. Although advanced education before graduation is important, postgraduate education is also required because the knowledge and skill required by pharmacists are increasing and are progressing everyday. The period of pharmacist education has been six years, and the new educational system produces next generation pharmacists. Postgraduate education should be established with the education contents corresponding to the new education system. The career path has an important role in postgraduate education, which consists of fundamental to advanced training through the various stages according to pharmacist experience. Clinical academic societies and some pharmacists' organizations provide accreditation systems for pharmacist specialties. This system will play an important role as a route in the career path. It is necessary to accredit pharmacist specialties to establish postgraduate education and research in cooperation with pharmaceutical institutions. It is thought that the responsibility of universities of pharmaceutical science will become more important to improve pharmacist ability and pharmacy practice. Universities of pharmaceutical science should collaborate with pharmaceutical institutions to establish postgraduate education and research into clinical pharmacy practice.

  15. Specialty glass raw materials: Status and developments

    SciTech Connect

    Bauer, R.J.; Gray, S.L.

    1996-12-31

    The authors highlight several key raw materials used in the specialty glass industry. The focus here is to update changes and shifts underway in the worldwide availability and processes that will impact both costs and efficient use of these products. The glass types that use these materials generally are those other than container, float, and fiber glass. Those high-volume consumers of glass raw materials are discussed in a companion paper in this volume. In the specialty glass field, the batch materials involve minerals, and the chemicals derived from them, which are less readily available domestically. These are much more critically defined by specifications of assay, contamination, and particle size, resulting in their being more expensive. They are seldom commodity products. The scope of materials for this fragmented industry includes those for leads, borosilicates, aluminosilicates, opals, sealing and frit glasses, optical glass, ophthalmic glass, cathode ray tubes (CRTs) for TV and display, and glass-ceramics as major segments. They use lead oxides, nearly all the alkalies and alkaline earth portions of the periodic table, as well as rare earths, transition element oxides, phosphates, boron minerals and chemicals, zircon, zinc, most of the halogens, and many of the anions. They often require very special particle size specifications. The requirements for these batch materials are often based on chemistry, the absence of contaminants that impact melting, very wide ranges of the electromagnetic spectrum, glass homogeneity, and freedom from solid and gaseous inclusions down to ppm levels in both size and number.

  16. [Music therapy in different dental specialties].

    PubMed

    Mehr, Katarzyna; Wyganowska-Swiatkowska, Marzena; Kowalkowska, Iwona; Kurhańska-Flisykowska, Anna; Piotrowski, Paweł

    2012-01-01

    Music is generally recognized as the best and, in parallel, the simplest medium of communication. The music therapy, applied in various spheres linked to a therapeutic process, is particularly valued in rehabilitation, medicine, humanities and social sciences. Present study aimed at determination of usefulness of selected techniques of music therapy in different dental specialties. The studies were conducted on 81 generally healthy patients aging 18 to 62 years. Various planned dental procedures were performed first time or were appraised by the patients as unpleasant ones. On the basis of pilot studies, a stable scheme of the visits was established. At the beginning of the studies, music therapy according to Kierył was conducted. Subsequently, basing on description of Schwabe, a form of regulatory individual music therapy was conducted. Depending on psychoemotional condition of the patient, music programming was based on ISO and LEVEL principles, taking into account musical preferences of the patient and his/her age. After every visit the patients filled questionnaires and appropriate results, together with results of studies performed by the dentist, were subjected to statistical analysis. 1. Results of the studies encourage application of musicotherapeutic techniques in different dental specialties. 2. Dental visit can be made attractive and patient's visits in dental office can be facilitated with no significant financial input or organizational.

  17. Collaboration between paediatric surgery and other medical specialties in Nigeria.

    PubMed

    Okoro, Philemon E; Ameh, Emmanuel A

    2012-01-01

    The quality of service and success of patient care and research in most fields of medicine depend on effective collaboration between different specialties. Paediatric surgery is a relatively young specialty in Nigeria and such collaborations are desirable. This survey assesses the nature and extent of collaboration between paediatric surgery and other specialties in Nigeria. This is a questionnaire survey carried out in November 2008 among paediatric surgeons and their trainees practising in Nigeria. Questionnaires were distributed and retrieved either by hand or e-mailing. The responses were then collated and analysed using the SPSS 17.0. Forty-seven respondents were included in the survey. Forty-five (95.7%) respondents thought that there was inadequate collaboration and that there was a need for an increased collaboration between paediatric surgery and other specialties. Anaesthesia, paediatrics and radiology are among the specialties where collaborations were most required but not adequately received. Collaboration had been required from these specialties in areas of patient care, training and research. Reasons for inadequate collaboration included the paucity of avenues for inter-specialty communication and exchange of ideas 33 (70.3%), lack of awareness of the need for collaboration 32 (68.1%), tendency to apportion blames for bad outcome 13 (27.7%), and mutual suspicion 8 (17%). There is presently inadequate collaboration between paediatric surgery and other specialties in Nigeria. There is a need for more inter-specialty support, communication, and exchange of ideas in order to achieve desirable outcomes.

  18. Associations between subspecialty fellowship interest and knowledge of internal medicine: a hypothesis-generating study of internal medicine residents.

    PubMed

    Ofoma, Uchenna R; Lehman, Erik E; Haidet, Paul; Yacht, Andrew C

    2011-01-31

    Little is known about whether and how medical knowledge relates to interest in subspecialty fellowship training. The purpose of this study was to examine the relationships between residents' interest in subspecialty fellowship training and their knowledge of internal medicine (IM). A questionnaire was emailed to 48 categorical postgraduate-year (PGY) two and three residents at a New York university-affiliated IM residency program in 2007 using the Survey Monkey online survey instrument. Overall and content area-specific percentile scores from the IM in-training examination (IM-ITE) for the same year was used to determine objective knowledge. Forty-five of 48 residents (response rate was 93.8%) completed the survey. Twenty-two (49%) were PG2 residents and 23(51%) were PGY3 residents. Sixty percent of respondents were male. Six (13%) residents were graduates of U.S. medical schools. Eight (18%) reported formal clinical training prior to starting internal medicine residency in the U.S. Of this latter group, 6 (75%) had training in IM and 6 (75) % reported a training length of 3 years or less. Thirty-seven of 45 (82%) residents had a subspecialty fellowship interest. Residents with a fellowship interest had a greater mean overall objective knowledge percentile score (56.44 vs. 31.67; p = 0.04) as well as greater mean percentile scores in all content areas of IM. The adjusted mean difference was statistically significant (p < 0.02) across three content areas. More than half of surveyed residents indicated interest in pursuing a subspecialty fellowship. Fellowship interest appears positively associated with general medical knowledge in this study population. Further work is needed to explore motivation and study patterns among internal medicine residents.

  19. Socio-Demographic Moderators of Environment-Physical Activity Associations: Results From the International Prevalence Study.

    PubMed

    Perez, Lilian G; Conway, Terry L; Bauman, Adrian; Kerr, Jacqueline; Elder, John P; Arredondo, Elva M; Sallis, Jim F

    2017-08-03

    Associations between the built environment and physical activity (PA) may vary by socio-demographic factors. However, such evidence from international studies is limited. This study tested moderating effects of socio-demographic factors on associations between perceived environment and self-report total PA among adults from the International Prevalence Study. Between 2002-2003, adults from nine countries (N=10,258) completed surveys assessing total PA (IPAQ-short), perceived environment, and socio-demographics (age, gender, and education). Total PA was dichotomized as meeting/not meeting a) high PA levels and b) minimum PA guidelines (PAG). Logistic models tested environment by socio-demographic interactions (24 total). Education and gender moderated the association between safety from crime and meeting high PA levels (interaction p<0.05), with inverse associations found only among the high-education group and men. Education and gender also moderated associations of safety from crime and the presence of transit stops with meeting minimum PAG (interaction p<0.05), with positive associations found for safety from crime only among women and presence of transit stops only among men and the high-education group. The limited number of moderating effects found provides support for population-wide environment-PA associations. International efforts to improve built environments are needed to promote health-enhancing PA, and maintain environmental sustainability.

  20. Longitudinal associations between adolescent perceived degree and style of parental prohibition and internalization and defiance.

    PubMed

    Vansteenkiste, Maarten; Soenens, Bart; Van Petegem, Stijn; Duriez, Bart

    2014-01-01

    This study examined associations between perceived degree and style of parental prohibition and adolescents' internalization of and oppositional defiance against parental rules in the friendship and moral domain. Relations were investigated in 2 longitudinal adolescent samples (total N = 532). Results indicated that perceived style but not degree of prohibition related to overtime changes in internalization and oppositional defiance. Specifically, in line with self-determination theory, autonomy-supportive and controlling styles of prohibiting were found to relate differentially to quality of internalization and oppositional defiance. Cross-lagged analyses indicated that several of these associations were reciprocal. The discussion focuses on the critical role of perceived parental style for communicating prohibitions. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  1. Longitudinal Risk and Protective Factors Associated with Internalizing and Externalizing Symptoms Among Male and Female Adolescents.

    PubMed

    Cotter, Katie L; Wu, Qi; Smokowski, Paul R

    2016-06-01

    Using ecological theory and the peer socialization model, the current study identified risk and protective factors associated with internalizing and externalizing symptoms across ecological domains. It was hypothesized that the constellation of risk and protective factors within the peer microsystem would vary by gender: future optimism and negative peer influence were expected to be significant risk/protective factors for males, whereas peer victimization was expected to be significant risk factors among females. Using four waves of data, three-level hierarchical linear models were estimated for males and females. Results revealed that negative peer influence was a particularly salient risk factor for both internalizing and externalizing behaviors among males, although future optimism did not emerge as a significant protective factor. In addition, as hypothesized, peer victimization indicators were significant risk factors for females. Parent-child conflict was also significantly and positively associated with both internalizing and externalizing symptoms for males and females. Implications are discussed.

  2. "I remember thinking …": Neural activity associated with subsequent memory for stimulus-evoked internal mentations.

    PubMed

    Gilead, Michael; Liberman, Nira; Maril, Anat

    2014-01-01

    Conscious thought involves an interpretive inner monologue pertaining to our waking experiences. Previous studies focused on the mechanisms that allow us to remember externally presented stimuli, but the neurobiological basis of the ability to remember one's internal mentations remains unknown. In order to investigate this question, we presented participants with sentences and scanned their neural activity using functional magnetic resonance imaging (fMRI) as they incidentally produced spontaneous internal mentations. After the scan, we presented the sentences again and asked participants to describe the specific thoughts they had during the initial presentation of each sentence. We categorized experimental trials for each participant according to whether they resulted in subsequently reported internal mentations or not. The results show that activation within classic language processing areas was associated with participants' ability to recollect their thoughts. Activation within mostly right lateralized and medial "default-mode network" regions was associated with not reporting such thoughts.

  3. The association of students requiring remediation in the internal medicine clerkship with poor performance during internship.

    PubMed

    Hemann, Brian A; Durning, Steven J; Kelly, William F; Dong, Ting; Pangaro, Louis N; Hemmer, Paul A

    2015-04-01

    To determine whether the Uniformed Services University (USU) system of workplace performance assessment for students in the internal medicine clerkship at the USU continues to be a sensitive predictor of subsequent poor performance during internship, when compared with assessments in other USU third year clerkships. Utilizing Program Director survey results from 2007 through 2011 and U.S. Medical Licensing Examination (USMLE) Step 3 examination results as the outcomes of interest, we compared performance during internship for students who had less than passing performance in the internal medicine clerkship and required remediation, against students whose performance in the internal medicine clerkship was successful. We further analyzed internship ratings for students who received less than passing grades during the same time period on other third year clerkships such as general surgery, pediatrics, obstetrics and gynecology, family medicine, and psychiatry to evaluate whether poor performance on other individual clerkships were associated with future poor performance at the internship level. Results for this recent cohort of graduates were compared with previously published findings. The overall survey response rate for this 5 year cohort was 81% (689/853). Students who received a less than passing grade in the internal medicine clerkship and required further remediation were 4.5 times more likely to be given poor ratings in the domain of medical expertise and 18.7 times more likely to demonstrate poor professionalism during internship. Further, students requiring internal medicine remediation were 8.5 times more likely to fail USMLE Step 3. No other individual clerkship showed any statistically significant associations with performance at the intern level. On the other hand, 40% of students who successfully remediated and did graduate were not identified during internship as having poor performance. Unsuccessful clinical performance which requires remediation in

  4. ANNOUNCEMENT OF THE INTERNATIONAL ASSOCIATION OF APPLIED LINGUISTICS (L'AILA). (TITLE SUPPLIED).

    ERIC Educational Resources Information Center

    STREVENS, PETER

    SPONSORED BY THE COUNCIL OF EUROPE, THE INSTITUTE OF APPLIED LINGUISTICS OF STOCKHOLM UNIVERSITY, AND AN INTERNATIONAL CONGRESS OF SPECIALISTS MEETING AT THE UNIVERSITY OF NANCY, L'ASSOCIATION INTERNATIONALE DE LINGUISTIQUE APPLIQUEE (L'AILA) WAS ESTABLISHED IN 1964. ITS PRINCIPAL AIMS ARE (1) COORDINATING RESEARCH, INFORMATION, AND ACADEMIC…

  5. Association of Parental ADHD and Depression with Externalizing and Internalizing Dimensions of Child Psychopathology

    ERIC Educational Resources Information Center

    Humphreys, Kathryn L.; Mehta, Natasha; Lee, Steve S.

    2012-01-01

    Objective: To study the independent association of parental depression and ADHD on three dimensions of child psychopathology among 178 children aged 5 to 10 years. Method: Self-reported measures of parental depression and ADHD as well as rating scales and structure diagnostic interviews of child internalizing, ADHD, and externalizing problems were…

  6. UNESCO and the Associated Schools Project: Symbolic Affirmation of World Community, International Understanding, and Human Rights

    ERIC Educational Resources Information Center

    Suarez, David F.; Ramirez, Francisco O.; Koo, Jeong-Woo

    2009-01-01

    The UNESCO Associated Schools Project emphasizes world community, human rights, and international understanding. This article investigates the emergence and global diffusion of the project from 1953 to 2001, estimating the influence of national, regional, and world characteristics on the likelihood of a country adopting a UNESCO school. It also…

  7. Mediators of the Associations between Externalizing Behaviors and Internalizing Symptoms in Late Childhood and Early Adolescence

    ERIC Educational Resources Information Center

    Yong, Minglee; Fleming, Charles B.; McCarty, Carolyn A.; Catalano, Richard F.

    2014-01-01

    This study tests the predictive associations between externalizing behaviors and internalizing symptoms and examines the mediating roles of social competence, parent-child conflicts, and academic achievement. Using youth-, parent-, and teacher-reported longitudinal data on a sample of 523 boys and 460 girls from late childhood to early…

  8. Differing Types of Higher Education. Papers of the International Association of Universities. No. 14.

    ERIC Educational Resources Information Center

    International Association of Universities, Paris (France).

    Papers are presented from the fourth seminar of the International Association of Universities (IAU) held in Alexandria, Egypt. Inaugural addresses are presented by M.L. Dowidar, former president of the University of Alexandria, A.R. El Heneidey, President of the University of Alexandria, H.E. Abd El Tawab Hodeib, Governor of Alexandria, and Roger…

  9. Quinolone-resistant Salmonella enterica serotype Enteritidis infections associated with international travel.

    PubMed

    O'Donnell, Allison T; Vieira, Antonio R; Huang, Jennifer Y; Whichard, Jean; Cole, Dana; Karp, Beth E

    2014-11-01

    We found a strong association between nalidixic acid-resistant Salmonella enterica serotype Enteritidis infections in the United States and recent international travel by linking Salmonella Enteritidis data from the National Antimicrobial Resistance Monitoring System and the Foodborne Diseases Active Surveillance Network.

  10. Mediators of the Associations between Externalizing Behaviors and Internalizing Symptoms in Late Childhood and Early Adolescence

    ERIC Educational Resources Information Center

    Yong, Minglee; Fleming, Charles B.; McCarty, Carolyn A.; Catalano, Richard F.

    2014-01-01

    This study tests the predictive associations between externalizing behaviors and internalizing symptoms and examines the mediating roles of social competence, parent-child conflicts, and academic achievement. Using youth-, parent-, and teacher-reported longitudinal data on a sample of 523 boys and 460 girls from late childhood to early…

  11. The Association for Behavior Analysis International Position Statement on Restraint and Seclusion

    ERIC Educational Resources Information Center

    Vollmer, Timothy R.; Hagopian, Louis P.; Bailey, Jon S.; Dorsey, Michael F.; Hanley, Gregory P.; Lennox, David; Riordan, Mary M.; Spreat, Scott

    2011-01-01

    A task force authorized by the Executive Council of the Association for Behavior Analysis International (ABAI) generated the statement below concerning the techniques called "restraint" and "seclusion." Members of the task force independently reviewed the scientific literature concerning restraint and seclusion and agreed unanimously to the…

  12. Experiencing Adventure Education Internationally: What in the World Is the Wilderness Education Association Doing?

    ERIC Educational Resources Information Center

    Wilson, Jackson

    2008-01-01

    The Wilderness Education Association (WEA) is increasingly offering more international courses (Williams, 2007). Recent examples of such courses have included courses operating in Taiwan, Japan, New Zealand, Romania, and East Africa. This article compares the ethnographic data resulting from a recent 14 day Wilderness Stewardship Course in Taiwan…

  13. Longitudinal Associations between Adolescent Perceived Degree and Style of Parental Prohibition and Internalization and Defiance

    ERIC Educational Resources Information Center

    Vansteenkiste, Maarten; Soenens, Bart; Van Petegem, Stijn; Duriez, Bart

    2014-01-01

    This study examined associations between perceived degree and style of parental prohibition and adolescents' internalization of and oppositional defiance against parental rules in the friendship and moral domain. Relations were investigated in 2 longitudinal adolescent samples (total N = 532). Results indicated that perceived style but not…

  14. The International Federation of Library Associations. A Selected List of References.

    ERIC Educational Resources Information Center

    Cambio, Edward P., Comp.

    Prepared in anticipation of the 40th session of the General Council of the International Federation of Library Associations (IFLA), this bibliography cites materials issued by or under the auspices of the federation and its council, sections, and committees, as well as selected works about IFLA and its various subdivisions. The citations are…

  15. An NSTA Position Statement: International Science Education and the National Science Teachers Association

    ERIC Educational Resources Information Center

    National Science Teachers Association (NJ1), 2009

    2009-01-01

    The National Science Teachers Association (NSTA) encourages and promotes international science education because it has the ability to improve the teaching and learning of science, as well as to "empower people, improve their quality of life, and increase their capacity to participate in the decision-making processes leading to social, cultural,…

  16. Evaluation of the Unesco Associated Schools Project in Education for International Co-operation and Peace.

    ERIC Educational Resources Information Center

    Churchill, Stacy; Omari, Issa

    In accordance with a mandate from Unesco's 1978 General Conference, an evaluation methodology and instruments were devised to assess the Unesco Associated School's success in encouraging international peace and human rights. The background of this assessment project and a report of evaluation activities are presented in this document. The…

  17. Improving Public Education through Comprehensive School Reform: An Issue Brief from the International Reading Association.

    ERIC Educational Resources Information Center

    International Reading Association, Newark, DE.

    The Comprehensive School Reform (CSR) program is a new initiative that could affect International Reading Association members in the United States--but will benefit only those who take advantage of it. The purpose of the CSR initiative is to provide financial incentives for schools to develop comprehensive school reforms. Funding is available to…

  18. Play: Essential for All Children. A Position Paper of the Association for Childhood Education International.

    ERIC Educational Resources Information Center

    Isenberg, Joan Packer; Quisenberry, Nancy

    2002-01-01

    Presents position of the Association for Childhood Education International (ACEI) regarding children and play. Discusses ACEI's fundamental beliefs about the importance of play, citing supporting research and theory. Presents guiding principles and practices for play experiences, focusing on adults' crucial role in structuring and planning the…

  19. Longitudinal Associations between Adolescent Perceived Degree and Style of Parental Prohibition and Internalization and Defiance

    ERIC Educational Resources Information Center

    Vansteenkiste, Maarten; Soenens, Bart; Van Petegem, Stijn; Duriez, Bart

    2014-01-01

    This study examined associations between perceived degree and style of parental prohibition and adolescents' internalization of and oppositional defiance against parental rules in the friendship and moral domain. Relations were investigated in 2 longitudinal adolescent samples (total N = 532). Results indicated that perceived style but not…

  20. Integrating Literacy and Technology in the Curriculum. A Position Statement of the International Reading Association.

    ERIC Educational Resources Information Center

    International Reading Association, Newark, DE.

    Literacy educators have a responsibility to effectively integrate information and communication technologies (ICT) into the literacy curriculum to prepare students for the literacy future they deserve. The International Reading Association (IRA) believes that much can be done to support students in developing the new literacies that will be…

  1. The Association for Behavior Analysis International Position Statement on Restraint and Seclusion

    ERIC Educational Resources Information Center

    Vollmer, Timothy R.; Hagopian, Louis P.; Bailey, Jon S.; Dorsey, Michael F.; Hanley, Gregory P.; Lennox, David; Riordan, Mary M.; Spreat, Scott

    2011-01-01

    A task force authorized by the Executive Council of the Association for Behavior Analysis International (ABAI) generated the statement below concerning the techniques called "restraint" and "seclusion." Members of the task force independently reviewed the scientific literature concerning restraint and seclusion and agreed unanimously to the…

  2. United States Energy Association Final Report International Partnership for the Hydrogen Economy Ministerial Conference

    SciTech Connect

    William L. Polen

    2006-04-05

    This report summarizes the activities of the United States Energy Association as it conducted the initial Ministerial Meeting of the International Partnership for the Hydrogen Economy in Washington, DC on November 18-21, 2003. The report summarizes the results of the meeting and subsequent support to the Office of Energy Efficiency and Renewable Energy in its role as IPHE Secretariat.

  3. Experiencing Adventure Education Internationally: What in the World Is the Wilderness Education Association Doing?

    ERIC Educational Resources Information Center

    Wilson, Jackson

    2008-01-01

    The Wilderness Education Association (WEA) is increasingly offering more international courses (Williams, 2007). Recent examples of such courses have included courses operating in Taiwan, Japan, New Zealand, Romania, and East Africa. This article compares the ethnographic data resulting from a recent 14 day Wilderness Stewardship Course in Taiwan…

  4. UNESCO and the Associated Schools Project: Symbolic Affirmation of World Community, International Understanding, and Human Rights

    ERIC Educational Resources Information Center

    Suarez, David F.; Ramirez, Francisco O.; Koo, Jeong-Woo

    2009-01-01

    The UNESCO Associated Schools Project emphasizes world community, human rights, and international understanding. This article investigates the emergence and global diffusion of the project from 1953 to 2001, estimating the influence of national, regional, and world characteristics on the likelihood of a country adopting a UNESCO school. It also…

  5. Differing Types of Higher Education. Papers of the International Association of Universities. No. 14.

    ERIC Educational Resources Information Center

    International Association of Universities, Paris (France).

    Papers are presented from the fourth seminar of the International Association of Universities (IAU) held in Alexandria, Egypt. Inaugural addresses are presented by M.L. Dowidar, former president of the University of Alexandria, A.R. El Heneidey, President of the University of Alexandria, H.E. Abd El Tawab Hodeib, Governor of Alexandria, and Roger…

  6. A Report on the Peace Education Commission Program, International Peace Research Association Conference 2010, Sydney, Australia

    ERIC Educational Resources Information Center

    Toh, Swee-Hin

    2010-01-01

    From July 6th to 10th, 2010, International Peace Research Association (IPRA) held its biennial conference at the University of Sydney in Australia. Hosted by the University's Centre for Peace & Conflict Studies and coordinated by Jake Lynch and a team of dedicated staff and volunteers, the conference featured seven plenary panels and many…

  7. The International Federation of Library Associations. A Selected List of References.

    ERIC Educational Resources Information Center

    Cambio, Edward P., Comp.

    Prepared in anticipation of the 40th session of the General Council of the International Federation of Library Associations (IFLA), this bibliography cites materials issued by or under the auspices of the federation and its council, sections, and committees, as well as selected works about IFLA and its various subdivisions. The citations are…

  8. Association of Parental ADHD and Depression with Externalizing and Internalizing Dimensions of Child Psychopathology

    ERIC Educational Resources Information Center

    Humphreys, Kathryn L.; Mehta, Natasha; Lee, Steve S.

    2012-01-01

    Objective: To study the independent association of parental depression and ADHD on three dimensions of child psychopathology among 178 children aged 5 to 10 years. Method: Self-reported measures of parental depression and ADHD as well as rating scales and structure diagnostic interviews of child internalizing, ADHD, and externalizing problems were…

  9. The International University Courses on Permafrost (IUCP): an IPY Education Initiative From the International Permafrost Association (IPA)

    NASA Astrophysics Data System (ADS)

    Prick, A.; Christiansen, H. H.

    2006-12-01

    Worldwide, only very few dedicated permafrost courses exist at university level today. This significantly limits the development of new permafrost researchers. Therefore, the International Permafrost Association (IPA) has developed an overview of International University Courses on Permafrost (IUCP), as part of its participation in the IPY. This polar-related educational program covers cross-cutting activities of the four core IPY-IPA endorsed cluster projects that constitute the IPY Permafrost Programme: Permafrost Observatory Project: A Contribution to the Thermal State of Permafrost (TSP; Project 50); Antarctic and sub-Antarctic Permafrost, Periglacial and Soil Environments (ANTPAS; Project 33); Arctic Circumpolar Coastal Observatory Network (ACCO-Net; Project 90); Carbon Pools in Permafrost Regions (CAPP; Project 373). The IUCP collects information about existing and new IPY permafrost courses worldwide, to encourage a broad international student participation in the existing courses. All courses dealing with permafrost and periglacial geomorphology within the science and engineering disciplines and organized in 2007 to 2009 in both hemispheres qualify for IUCP. Some courses are exclusively field-based and take place in various polar regions, offering students a unique opportunity to gather field experience. Other courses are theoretical and classroom-based or include only limited time in the field. All course levels are taken into account, from undergraduate to doctorate level; the IPA also encourages young professional participation in the IUCP. IPA- IPY education coordinators in each country are providing relevant information. IUCP course information is presented on the IPA webpage. The use of web resource and search tools allow easy access to course contents. The IUCP course numbers by countries as by August 2006 is: Argentina (1), Belgium (1), Canada (29), China (11), Denmark (1), France (2), Japan (7), Mongolia (1), Netherlands (4), New Zealand (1

  10. Development of specialty chemicals from dimethyl ether

    SciTech Connect

    Tartamella, T.L.; Lee, S.

    1996-12-31

    Dimethyl ether (DME) may be efficiently produced from coal-bases syngas in a high pressure, mechanically agitated slurry reactor. DME synthesis occurs in the liquid phase using a dual catalyst. By operating in a dual catalyst mode, DME may be converted from in-situ produced methanol resulting in higher methyl productivities and syngas conversions over methanol conversion alone. The feasibility of utilizing DME as a building block for more valuable specialty chemicals has been examined. A wide variety of petrochemicals may be produced from DME including light olefins, gasoline range hydrocarbons, oxygenates, and glycol precursors. These chemicals represent an important part of petroleum industries inventory of fine chemicals. Carbonylation, hydrocarbonylation, and oxidative dimerization are but a few of the reactions in which DME may undergo conversion. DME provides an additional route for the production of industrially important petrochemicals.

  11. [Problems in cardiology specialty training in Turkey].

    PubMed

    Altun, Armağan

    2012-04-01

    Cardiology Specialty Training in our country should be made in accordance with the law numbered 1219 on the Practice of Medicine and Related Arts, and according to the Medical and Dental Specialist Training Regulation which is published according to the 9th article of this law. The duration of Cardiology Specialist Training has been defined as 4 years in our country. The European Society of Cardiology (ESC), European Union of Medical Specialists (UEMS), and the European Cardiology Section Foundation (ECSF) define the duration of Cardiology Specialist Training as 6 years. Therefore, insufficient Cardiology residency training occurs in our country due to the shortened length of time. In this report, the problems of the Cardiology Specialist Training in Turkey will be addressed under different headings.

  12. Sunset Specialty Turf: Growing the heap

    SciTech Connect

    Heumann, J.M.

    1998-07-01

    Almost a quarter of the municipal solid waste (MSW) generated in the US is compostable. As composting as an industry is growing in the US, entrepreneurs are going where the markets are to expand their facilities and, hopefully, their revenues by making turf and groundcovers from recovered materials. In fact, over the past 20 years, the composting business has grown from a nascent backyard project to a full-fledged industry in the US. According to the US EPA`s recent waste characterization report, food and yard waste generated in the US in 1996 came to almost 53 million tons, or almost a quarter of the total 209 million tons of MSW generated in the US. Of the 28 million tons of yard waste generated in the US in 1996 alone, 38.6% was recycled. Yard trimmings made up about 13.4% of all the materials discarded as MSW. With its warm climate and abundance of foliage that create yard waste year round, the South is a region where composting facilities are thriving. And a Midwestern composting company is looking to reap the benefits of the current growing market for compostable materials in the Southeast while providing an environmentally beneficial end product. Sunset Turf Nursery, Inc. is a company that manufacturers turf products from compost materials. The company already runs a 51-acre facility in St. Louis, where it composts municipal materials and, using its patented process, grows turf grass to make a specialty groundcover which can be used for landscaping applications. Sunset officials plan to expand the company`s composting and turf manufacturing operations to more than 350 acres over the next three years, starting with the St. Louis facility. The company, specifically its division Sunset Specialty Turf, currently has a research and development testing site in Jacksonville, Florida, which it would like to use additional funding to expand to a full fledged manufacturing site similar to the St. Louis site.

  13. Mixing and sediment resuspension associated with internal bores in a shallow bay

    NASA Astrophysics Data System (ADS)

    Masunaga, Eiji; Homma, Hikaru; Yamazaki, Hidekatsu; Fringer, Oliver B.; Nagai, Takeyoshi; Kitade, Yujiro; Okayasu, Akio

    2015-11-01

    Observations of the run-up of internal bores in a shallow bay were made with a tow-yo instrument and mooring arrays with high spatial and temporal resolution. Shoreward propagating internal bores have been studied with laboratory experiments and numerical models, but few observational studies have shown the detailed structure of the run-up of internal bores induced by internal tides. Our observations showed that internal bores propagate along the slope, accompanied by strong turbulent mixing and strong sediment resuspension in a shallow bay. The isothermal displacement due to the bores reached 20 m vertically in a water depth of 40 m. Turbidity measurements showed suspended particles transported from the sloping bottom and offshore above the thermocline, forming an intermediate nepheloid layer (INL). At the head of the bore (dense water), a vortex accompanied by strong vertical motion induced strong vertical sediment resuspension and a steep isothermal displacement. The rate of turbulent kinetic energy dissipation reached 10-6 W kg-1 at the head of the wave. A nonhydrostatic numerical simulation in a two-dimensional domain reproduced fine features associated with the run-up of an internal bore and the vortex motion at its head.

  14. Validating genetic risk associations for ovarian cancer through the international Ovarian Cancer Association Consortium

    PubMed Central

    Pearce, C L; Near, A M; Van Den Berg, D J; Ramus, S J; Gentry-Maharaj, A; Menon, U; Gayther, S A; Anderson, A R; Edlund, C K; Wu, A H; Chen, X; Beesley, J; Webb, P M; Holt, S K; Chen, C; Doherty, J A; Rossing, M A; Whittemore, A S; McGuire, V; DiCioccio, R A; Goodman, M T; Lurie, G; Carney, M E; Wilkens, L R; Ness, R B; Moysich, K B; Edwards, R; Jennison, E; Kjaer, S K; Hogdall, E; Hogdall, C K; Goode, E L; Sellers, T A; Vierkant, R A; Cunningham, J C; Schildkraut, J M; Berchuck, A; Moorman, P G; Iversen, E S; Cramer, D W; Terry, K L; Vitonis, A F; Titus-Ernstoff, L; Song, H; Pharoah, P D P; Spurdle, A B; Anton-Culver, H; Ziogas, A; Brewster, W; Galitovskiy, V; Chenevix-Trench, G

    2009-01-01

    The search for genetic variants associated with ovarian cancer risk has focused on pathways including sex steroid hormones, DNA repair, and cell cycle control. The Ovarian Cancer Association Consortium (OCAC) identified 10 single-nucleotide polymorphisms (SNPs) in genes in these pathways, which had been genotyped by Consortium members and a pooled analysis of these data was conducted. Three of the 10 SNPs showed evidence of an association with ovarian cancer at P⩽0.10 in a log-additive model: rs2740574 in CYP3A4 (P=0.011), rs1805386 in LIG4 (P=0.007), and rs3218536 in XRCC2 (P=0.095). Additional genotyping in other OCAC studies was undertaken and only the variant in CYP3A4, rs2740574, continued to show an association in the replication data among homozygous carriers: ORhomozygous(hom)=2.50 (95% CI 0.54-11.57, P=0.24) with 1406 cases and 2827 controls. Overall, in the combined data the odds ratio was 2.81 among carriers of two copies of the minor allele (95% CI 1.20–6.56, P=0.017, phet across studies=0.42) with 1969 cases and 3491 controls. There was no association among heterozygous carriers. CYP3A4 encodes a key enzyme in oestrogen metabolism and our finding between rs2740574 and risk of ovarian cancer suggests that this pathway may be involved in ovarian carcinogenesis. Additional follow-up is warranted. PMID:19127255

  15. Validating genetic risk associations for ovarian cancer through the international Ovarian Cancer Association Consortium.

    PubMed

    Pearce, C L; Near, A M; Van Den Berg, D J; Ramus, S J; Gentry-Maharaj, A; Menon, U; Gayther, S A; Anderson, A R; Edlund, C K; Wu, A H; Chen, X; Beesley, J; Webb, P M; Holt, S K; Chen, C; Doherty, J A; Rossing, M A; Whittemore, A S; McGuire, V; DiCioccio, R A; Goodman, M T; Lurie, G; Carney, M E; Wilkens, L R; Ness, R B; Moysich, K B; Edwards, R; Jennison, E; Kjaer, S K; Hogdall, E; Hogdall, C K; Goode, E L; Sellers, T A; Vierkant, R A; Cunningham, J M; Cunningham, J C; Schildkraut, J M; Berchuck, A; Moorman, P G; Iversen, E S; Cramer, D W; Terry, K L; Vitonis, A F; Titus-Ernstoff, L; Song, H; Pharoah, P D P; Spurdle, A B; Anton-Culver, H; Ziogas, A; Brewster, W; Galitovskiy, V; Chenevix-Trench, G

    2009-01-27

    The search for genetic variants associated with ovarian cancer risk has focused on pathways including sex steroid hormones, DNA repair, and cell cycle control. The Ovarian Cancer Association Consortium (OCAC) identified 10 single-nucleotide polymorphisms (SNPs) in genes in these pathways, which had been genotyped by Consortium members and a pooled analysis of these data was conducted. Three of the 10 SNPs showed evidence of an association with ovarian cancer at P< or =0.10 in a log-additive model: rs2740574 in CYP3A4 (P=0.011), rs1805386 in LIG4 (P=0.007), and rs3218536 in XRCC2 (P=0.095). Additional genotyping in other OCAC studies was undertaken and only the variant in CYP3A4, rs2740574, continued to show an association in the replication data among homozygous carriers: OR(homozygous(hom))=2.50 (95% CI 0.54-11.57, P=0.24) with 1406 cases and 2827 controls. Overall, in the combined data the odds ratio was 2.81 among carriers of two copies of the minor allele (95% CI 1.20-6.56, P=0.017, p(het) across studies=0.42) with 1969 cases and 3491 controls. There was no association among heterozygous carriers. CYP3A4 encodes a key enzyme in oestrogen metabolism and our finding between rs2740574 and risk of ovarian cancer suggests that this pathway may be involved in ovarian carcinogenesis. Additional follow-up is warranted.

  16. Diffusion of robotic-assisted laparoscopic technology across specialties: a national study from 2008 to 2013.

    PubMed

    Juo, Yen-Yi; Mantha, Aditya; Abiri, Ahmad; Lin, Anne; Dutson, Erik

    2017-08-25

    Robotic-assisted procedures were frequently found to have similar outcomes and indications to their laparoscopic counterparts, yet significant variation existed in the acceptance of robotic-assisted technology between surgical specialties and procedures. We performed a retrospective cohort study investigating factors associated with the adoption of robotic assistance across the United States from 2008 to 2013. Using the Nationwide Inpatient Sample database, patient- and hospital-level variables were examined for differential distribution between robotic-assisted and conventional laparoscopic procedures. Multilevel logistic regression models were constructed to identify independent factors associated with robotic adoption. Furthermore, cases were stratified by procedure and specialty before being ranked according to proportion of robotic-assistance adoption. Correlation was examined between robotic-assistance adoption and relative outcome in comparison with conventional laparoscopic procedures. The national robotic case volume doubled over the five-year period while a gradual decline in laparoscopic case volume was observed, resulting in an increase in the proportion of procedures performed with robotic assistance from 6.8 to 17%. Patients receiving robotic procedures were more likely to be younger, males, white, privately insured, more affluent, and with less comorbidities. These differences have been decreasing over the study period. The three specialties with the highest proportion of robotic-assisted laparoscopic procedures were urology (34.1%), gynecology (11.0%), and endocrine surgery (9.4%). However, no significant association existed between the frequency of robotic-assistance usage and relative outcome statistics such as mortality, charge, or length of stay. The variation in robotic-assistance adoption between specialties and procedures could not be attributable to clinical outcomes alone. Cultural readiness toward adopting new technology within specialty

  17. International Student Access to U.S. Higher Education since World War II: How NAFSA (Association of International Educators) Has Influenced Federal Policy

    ERIC Educational Resources Information Center

    Miyokawa, Norifumi

    2009-01-01

    This dissertation is a study of the policy process behind the legislation and regulation governing international student access to U.S. higher education since the immediate aftermath of World War II. The particular research focus of this dissertation is on NAFSA: Association of International Educators (originally established as the National…

  18. Proceedings of the International Association for Development of the Information Society (IADIS) International Conference on Mobile Learning (12th, Vilamoura, Algarve, Portugal, April 9-11, 2016)

    ERIC Educational Resources Information Center

    Sánchez, Inmaculada Arnedillo, Ed.; Isaías, Pedro, Ed.

    2016-01-01

    These proceedings contain the papers of the 12th International Conference on Mobile Learning 2016, which was organized by the International Association for Development of the Information Society, in Vilamoura, Algarve, Portugal, April 9-11, 2016. The Mobile Learning 2016 Conference seeks to provide a forum for the presentation and discussion of…

  19. IFLA General Conference, 1985. International Association of Law Libraries (IALL) Round-Table on Access to Information in International Legal Research. Papers.

    ERIC Educational Resources Information Center

    International Federation of Library Associations, The Hague (Netherlands).

    Papers on international access to information pertaining to legal research, which were presented at the 1985 conference of the International Federation of Library Associations (IFLA) include: (1) "Materials of European Intergovernmental Organizations and Their Accessibility through Available Research Tools" (Irene Berkey, Northwestern…

  20. Proceedings of the International Association for Development of the Information Society (IADIS) International Conference on e-Learning (Prague, Czech Republic, July 23-26, 2013)

    ERIC Educational Resources Information Center

    Nunes, Miguel Baptista, Ed.; McPherson, Maggie, Ed.

    2013-01-01

    These proceedings contain the papers of the International Conference e-Learning 2013, which was organised by the International Association for Development of the Information Society and is part of the Multi Conference on Computer Science and Information Systems (Prague, Czech Republic, July 23-26, 2013). The e-Learning 2013 conference aims to…

  1. Proceedings of the International Association for Development of the Information Society (IADIS) International Conference on Mobile Learning (11th, Madeira, Portugal, March 14-16, 2015)

    ERIC Educational Resources Information Center

    Sánchez, Inmaculada Arnedillo, Ed.; Isaías, Pedro, Ed.

    2015-01-01

    These proceedings contain the papers and posters of the 11th International Conference on Mobile Learning 2015, which was organised by the International Association for Development of the Information Society, in Madeira, Portugal, March 14-16, 2015. The Mobile Learning 2015 Conference seeks to provide a forum for the presentation and discussion of…

  2. Proceedings of the International Association for Development of the Information Society (IADIS) International Conference on e-Learning (Madeira, Portugal, July 1-4, 2016)

    ERIC Educational Resources Information Center

    Nunes, Miguel Baptista, Ed.; McPherson, Maggie, Ed.

    2016-01-01

    These proceedings contain the papers of the International Conference e-Learning 2016, which was organised by the International Association for Development of the Information Society, 1-3 July, 2016. This conference is part of the Multi Conference on Computer Science and Information Systems 2016, 1-4 July. The e-Learning (EL) 2016 conference aims…

  3. IFLA General Conference, 1985. International Association of Law Libraries (IALL) Round-Table on Access to Information in International Legal Research. Papers.

    ERIC Educational Resources Information Center

    International Federation of Library Associations, The Hague (Netherlands).

    Papers on international access to information pertaining to legal research, which were presented at the 1985 conference of the International Federation of Library Associations (IFLA) include: (1) "Materials of European Intergovernmental Organizations and Their Accessibility through Available Research Tools" (Irene Berkey, Northwestern…

  4. 76 FR 69288 - Cable Statutory License: Specialty Station List

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-08

    ... Copyright Office Cable Statutory License: Specialty Station List AGENCY: Copyright Office, Library of... Office (``Office'') seeks to update its list of specialty stations related to the use of the cable.... Telephone: (202) 707-8380. Telefax: (202) 707-8366. SUPPLEMENTARY INFORMATION: Under the cable statutory...

  5. 76 FR 72982 - Cable Statutory License: Specialty Station List; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-28

    ... From the Federal Register Online via the Government Publishing Office LIBRARY OF CONGRESS Copyright Office Cable Statutory License: Specialty Station List; Correction AGENCY: Copyright Office... use of the cable compulsory license. In response to the publication of an initial list of specialty...

  6. 75 FR 42431 - Onyx Specialty Papers, Inc; Notice Soliciting Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-21

    ... Energy Regulatory Commission Onyx Specialty Papers, Inc; Notice Soliciting Applications July 14, 2010. On April 29, 2009, Onyx Specialty Papers, Inc. (Onyx), licensee for the Willow Mill Project No. 2985, filed... Housatonic River. The turbine generating unit is located in the basement of MeadWestvaco's paper mill. There...

  7. How price responsive is the demand for specialty care?

    PubMed

    Maciejewski, Matthew L; Liu, Chuan-Fen; Kavee, Andrew L; Olsen, Maren K

    2012-08-01

    Outpatient visit co-payments have increased in recent years. We estimate the patient response to a price change for specialty care, based on a co-payment increase from $15 to $50 per visit for veterans with hypertension. A retrospective cohort of veterans required to pay co-payments was compared with veterans exempt from co-payments whose nonequivalence was reduced via propensity score matching. Specialty care expenditures in 2000-2003 were estimated via a two-part mixed model to account for the correlation of the use and level outcomes over time, and results from this correlated two-part model were compared with an uncorrelated two-part model and a correlated random intercept two-part mixed model. A $35 specialty visit co-payment increase had no impact on the likelihood of seeking specialty care but induced lower specialty expenditures over time among users who were required to pay co-payments. The log ratio of price responsiveness (semi-elasticity) for specialty care increased from -0.25 to -0.31 after the co-payment increase. Estimates were similar across the three models. A significant increase in specialty visit co-payments reduced specialty expenditures among patients obtaining medications at the Veterans Affairs medical centers. Longitudinal expenditure analysis may be improved using recent advances in two-part model methods. Published 2011. This article is a US Government work and is in the public domain in the USA.

  8. Item Calibrations for Licensure Tests with Multiple Specialty Components.

    ERIC Educational Resources Information Center

    Huang, Chi-Yu; Lohss, William E.; Lin, Chuan-Ju; Shin, David

    This study was conducted to compare the usefulness of three item response theory (IRT) calibration packages (BILOG, BILOG-MG, and PIC) for examinations that include common and specialty components. Because small sample sizes and different mean abilities between specialty components are the most frequent problems that licensure/certification…

  9. Counselor Personality Needs as a Determinant of Functional Specialty Preference

    ERIC Educational Resources Information Center

    Randolph, Daniel Lee

    1973-01-01

    This study investigated whether personality needs discriminate between counselor trainees who prefer the administrator specialty and those who prefer the practitioner functional specialty. The results suggest that the Personality Research Form (PRF) may have value as a tool in the selection of counselors. (Author)

  10. Analysis of Enrollment Scale of Chinese Specialty Education

    ERIC Educational Resources Information Center

    Hao, Jinmei; Li, Suke

    2017-01-01

    With the adjustment of industrial structure of China in recent years, the market urgently needs different levels of professionals. Specialty education is an important part of higher education in China, has its unique advantages. Through the analysis of the history data of specialty education in our country, the result shows that the specialty…

  11. The Orientation and Development of the Public Affair Management Specialty

    ERIC Educational Resources Information Center

    Li, Chenghui; Fu, Yongxian; Chen, Rongxiang; Hu, Xueqi

    2010-01-01

    Though the specialty of the public affair management has been developed for ten years, but it is still facing the actuality that the orientation and development are difficult. Only by confirming the cultivation target and the development orientation, the development of the specialty could find the development approach and method. According to the…

  12. Outreach Programmes for Education and Training: Contributions from the International Cartographic Association

    NASA Astrophysics Data System (ADS)

    Cartwright, W. E.; Fairbairn, D.

    2012-07-01

    Organisations like the International Cartographic Association champion programmes that develop and deliver education and training to cartographers and geospatial scientists, globally. This can be in the form of traditional university and training college programmes, short courses for professional and technical members of mapping agencies and as outreach initiatives to transfer knowledge about the discipline and its contemporary practices. Through its international community, the ICA undertakes the transfer of knowledge about cartography and GI Science by publishing books and special editions of journals and running workshops. Colleagues from the ICA community conduct these workshops on a volunteer basis, generally with the support of the national member organisation of ICA or the national mapping body. For example, the ICA promotes the generation of extensive publications, generally through its Commissions and Working Groups. The publications include books, journals and the ICA Newsletter. Outreach activities are especially pertinent to up skill colleagues from developing countries. Specialist programmes can be offered for professional and 'everyday' map users (from adults to children). The ICA can assist with its current programmes, designed to embrace professional and non-professional cartographers alike. This paper will address how education and outreach programmes can be supported by international associations, by offering programmes independently, or in partnership with sister associations and national and regional organisations and societies. As well, the paper will address the need to deliver education and outreach programmes not to just the professional international community, but also to map users and citizen map publishers.

  13. Factors associated with higher levels of depressive symptoms among international university students in the Philippines.

    PubMed

    Lee, Romeo B; Maria, Madelene Sta; Estanislao, Susana; Rodriguez, Cristina

    2013-11-01

    Over the years, the number of international university students has been increasing in the Philippines. Depression tends to be common among this demographic sector, because of the varying challenges and expectations associated with studying abroad. Depression can be prevented if its symptoms, particularly those at higher levels, are identified and addressed early and effectively. This survey examined the social and demographic factors that are significantly associated with higher levels of depressive symptoms. One hundred twenty-six international university students were interviewed using the University Students Depression Inventory. Of the 13 factors analyzed, 3 were found with statistically significant associations with more intense levels of depressive symptoms. These factors were: level of satisfaction with one's financial condition, level of closeness with parents, and level of closeness with peers. In identifying international students with greater risk for depression, characteristics related to their financial condition and primary group relationships can be considered. There is a need to carry out more studies to confirm this initial evidence. The findings can help guide further discourse, research and program to benefit international students with higher levels of depressive symptoms.

  14. Children's perceptions of dissimilarity in parenting styles are associated with internalizing and externalizing behavior.

    PubMed

    Berkien, Myra; Louwerse, Anneke; Verhulst, Frank; van der Ende, Jan

    2012-02-01

    The purpose of this study was to examine the relationship between children's perception of dissimilarity in parenting styles, and internalizing and externalizing problems in children. Children from the general population (n = 658) reported on the level of emotional warmth, rejection, and overprotection of both parents by filling out the child version of the Egna Minnen Beträffande Uppfostran (EMBU-C) and mothers completed the child behavior checklist (CBCL). Intraclass correlations were computed as measures of dissimilarity between parenting styles of mothers and fathers. Children's perceived dissimilarity in parental emotional warmth is associated with internalizing and externalizing problems (β = 0.092, p < 0.05; β = 0.091, p < 0.05). Perceived dissimilarity between parents' overprotection is associated with externalizing problems (β = 0.097, p < 0.05). Perceived dissimilarity between parenting styles is associated with externalizing and internalizing problems, over and above the effects of the level of the parenting styles. The results highlight the negative consequences of perceived dissimilarity between parents. To conclude, children have more internalizing and externalizing problems when they perceive their parents as more dissimilar in parenting styles.

  15. The International Xenotransplantation Association consensus statement on conditions for undertaking clinical trials of xenocorneal transplantation.

    PubMed

    Kim, Mee Kum; Choi, Hyuk Jin; Kwon, Ivo; Pierson, Richard N; Cooper, David K C; Soulillou, Jean-Paul; O'Connell, Philip J; Vabres, Bertrand; Maeda, Naoyuki; Hara, Hidetaka; Scobie, Linda; Gianello, Pierre; Takeuchi, Yasuhiro; Yamada, Kazuhiko; Hwang, Eung-Soo; Kim, Sang Joon; Park, Chung-Gyu

    2014-01-01

    To develop an international consensus regarding the appropriate conditions for undertaking clinical trials in xenocorneal transplantation, here we review specific ethical, logistical, scientific, and regulatory issues regarding xenocorneal transplantation, and propose guidelines for conduct of clinical xenocorneal transplantation trials. These proposed guidelines are modeled on the published consensus statement of the International Xenotransplantation Association regarding recommended guidelines for conduct of clinical islet xenotransplantation. It is expected that this initial consensus statement will be revised over time in response to scientific advances in the field, and changes in the regulatory framework based on accumulating clinical experience.

  16. Life-course fertility patterns associated with childhood externalizing and internalizing behaviors.

    PubMed

    Jokela, Markus

    2014-12-01

    Childhood behavioral problems have been associated with earlier childbearing, but their life-course reproductive consequences are unknown. The present study examined whether and how behavioral problems assessed in childhood predict fertility patterns over the life course in women and men. Participants were 9,472 individuals from the British National Child Development Study (4,739 men and 4,733 women). Childhood externalizing and internalizing behaviors were rated by teachers at ages 7 and 11. Information on fertility history was derived from interviews at ages 33, 42, and 46, including date of pregnancy, whether the pregnancy was planned or non-planned, and pregnancy outcome (live birth, miscarriages/stillbirth, induced abortion). Transition to parenthood and fertility rate were assessed using survival analysis and age-stratified regression models. In both sexes, higher externalizing behavior was associated with higher rate of pregnancies, especially non-planned pregnancies in adolescence and early adulthood, but this association attenuated or even reversed later in adulthood. Internalizing behavior was associated with lower pregnancy rates, especially planned pregnancies and later in adulthood, and particularly in men. In women, higher internalizing behavior was also associated with earlier transition to parenthood. Externalizing behavior in women predicted higher risk of miscarriages and induced abortions, while internalizing behavior predicted lower risk for these outcomes. These findings suggest that childhood behavioral problems have long-term associations with fertility behavior over the life course, including earlier transition to parenthood, lower probability of normative family formation later in adulthood, and higher risk of adverse pregnancy outcomes.

  17. Specialty pharmacies and other restricted drug distribution systems: financial and safety considerations for patients and health-system pharmacists.

    PubMed

    Kirschenbaum, Bonnie E

    2009-12-15

    To discuss the role of restricted drug distribution systems in the implementation of risk evaluation and mitigation strategies (REMS), health-system pharmacists' concerns associated with the use of specialty pharmacies and other restricted drug distribution systems, reimbursement policies for high-cost specialty drugs, supply chain models for traditional and specialty drugs, and emerging trends in the management of and reimbursement for specialty pharmaceuticals. Restricted drug distribution systems established by pharmaceutical manufacturers, specialty pharmacies, or other specialty suppliers may be a component of REMS, which are required by the Food and Drug Administration for the management of known or potential serious risks from certain drugs. Concerns of health-system pharmacists using specialty suppliers include access to pharmaceuticals, operational challenges, product integrity, financial implications, continuity of care, and patient safety. An ambulatory care patient taking a specialty drug product from home to a hospital outpatient clinic or inpatient setting for administration, a practice known as "brown bagging," raises concerns about product integrity and institutional liability. An institution's finances, tolerance for liability, and ability to skillfully manage the processes involved often determine its choice between an approach that prohibits brown bagging but is costly and one that permits the practice under certain conditions and is less costly. The recent shift from a traditional supply chain model to a specialty pharmacy supply chain model for high-cost pharmaceuticals has the potential to increase pharmaceutical costs for health systems. A dialogue is needed between health-system pharmacists and group purchasing organizations to address the latter's role in mitigating the financial implications of this change and to help clarify the safety issues. Some health plans have shifted part of the cost of expensive drugs to patients by establishing a

  18. Emergency medicine in Argentina: a stepwise process to specialty recognition.

    PubMed

    Godoy Monzón, Daniel; Peralta, Hugo; Iserson, Kenneth V

    2010-04-01

    As emergency medicine (EM) has developed as a medical specialty throughout the world, each country has followed its own path to official recognition. Despite a successful EM model in the United States, some countries, especially those that require government approval of new medical specialties, have often found it difficult to attain recognition. As of early 2009, Argentina had yet to recognize EM as an official specialty, although some regional governments have acknowledged the specialty's status. The Argentine Society of EM has taken a number of steps and proposed educational paths to EM specialization to convince Argentina's political decision-makers that Emergency Medicine is a fundamental step toward a modern medical system. Such national recognition would further an already thriving EM community and improve the quality of patient care in Argentina. To assist colleagues around the world who are pursuing or will pursue this goal, this article outlines Argentina's complex and ongoing path to specialty recognition. Copyright 2010 Elsevier Inc. All rights reserved.

  19. Factors associated with onset of delirium among internal medicine inpatients in Spain.

    PubMed

    Díez-Manglano, Jesús; Palazón-Fraile, Claudia; Diez-Massó, Fabiola; Martínez-Álvarez, Rosa; Del Corral-Beamonte, Esther; Carreño-Borrego, Pilar; Pueyo-Tejedor, Pilar; Gomes-Martín, Javier

    2013-01-01

    Delirium increases mortality and length of stay among hospital inpatients. Little is known about the incidence of delirium among inpatients receiving care in internal medicine nursing units in Spain. The aim of this study was to estimate frequency of delirium onset among internal medicine inpatients and identify factors associated with delirium onset using nursing records and administrative databases. Retrospective cohort study of 744 patients hospitalized in an internal medicine department in October 2010 and January, May, and October 2011. Data concerning occurrence of delirium, age, gender, living in a nursing residence, Barthel Index of activities of daily living, Norton scale for pressure ulcer risk, intravenous fluid therapy, urinary catheterization, presence of pressure ulcers, major diagnostic category at discharge, length of stay, and mean weight in the diagnosis-related group were gathered for each patient. Backward stepwise logistic regression was used to identify factors associated with onset of delirium. Ninety-seven (13%) patients experienced delirium. Factors associated with delirium were age (OR = 1.03, 95% CI [1.01, 1.06]), Barthel Index (OR = 0.99. 95% CI [0.98, 0.99]), and urinary catheterization (OR = 2.00, 95% CI [1.19, 3.68]). Increased age and presence of a urinary catheter were associated with increased onset of delirium, whereas higher levels of independence in activities of daily living were protective.

  20. A cross-sectional study of aggression levels in physicians and orthopaedic surgeons: impact on specialty selection and training?

    PubMed Central

    Barlow, T; Wight, A; Barlow, D

    2012-01-01

    Objectives To determine if current validated psychometric evaluations could determine a difference in basic behavioural characteristics between surgical and medical specialties. Design Cross-sectional study. Setting Two district general hospitals and one University teaching hospital in England, UK. Participants Internal medicine (16) and trauma and orthopaedic (20) consultants. Main outcome measures Aggression levels as assessed by the Buss and Warren questionnaire. The self-administered questionnaire assesses aggression in terms of physical, verbal, anger, hostility, indirect hostility and an overall assessment of aggression. Results All participants had aggression scores below the population average. We found a significant difference (P < 0.01) in total level of aggression, with orthopaedic consultants scoring a mean of 61.1 (standard deviation [SD] 9.2) and physicians 51.3 (SD 9.5). When analysis of the five different subtypes of aggression was carried out, orthopaedic surgeons scored significantly higher in terms of verbal aggression (P = 0.005), hostility (P = 0.002) and indirect hostility (P = 0.03). Conclusion This study joins a growing evidence base for aspects of behaviour indicative of a given specialty. Aggression is a relatively stable behavioural characteristic from adolescence, and as such this is the first study of its type to suggest that the differences in behavioural characteristics seen between specialties are inherent, rather than learned. It is unclear if the differences observed represent an attraction of that specialty to the personality type or is required for success within the given specialty. Whether this can be used in terms of selection into higher specialty training, or influence training within specialties, requires further work. PMID:23476726

  1. Peer nominations as related to academic attainment, empathy, personality, and specialty interest.

    PubMed

    Pohl, Charles A; Hojat, Mohammadreza; Arnold, Louise

    2011-06-01

    To test the hypotheses that peer nomination is associated with measures of (1) academic performance, (2) empathy, (3) personality, and (4) specialty interest. In 2007-2008, 255 third-year medical students at Jefferson Medical College were asked to nominate classmates they considered the best in six areas of clinical and humanistic excellence. The authors compared students who received nominations with those who did not, analyzing differences in academic performance, personality factors (empathy as measured by the Jefferson Scale of Empathy and personality qualities as measured by the Zuckerman-Kuhlman Personality Questionnaire), and specialty interests. A comparison of the 155 students who received at least one peer nomination with the 100 students who received none found no significant difference in scores on objective examinations; nominated students, however, were rated significantly higher in clinical competence by faculty in six core third-year clerkships. Nominated students were also significantly more empathic and "active." In addition, a larger proportion of nominated students choose "people-oriented" (rather than "technology- or procedure-oriented") specialties. These results confirmed the hypotheses that peer nomination can predict clinical competence, empathy and other positive personal qualities, and interest in people-oriented specialties. Thus, in the assessment of medical students, peer nomination holds promise as a valid indicator of positive dimensions of professionalism.

  2. Ability of prospective assessment of personality profiles to predict the practice specialty of medical students

    PubMed Central

    Maron, Bradley A.; Fein, Steven; Hillel, Alexander T.; El Baghdadi, Mariam M.; Rodenhauser, Paul

    2007-01-01

    Medical practice encompasses a diverse spectrum of specialties. Factors that impact selection of clinical disciplines by young physicians may have recently evolved associated with changes in medical school demographics. We assessed whether physicians gravitate to certain practice specialties due to preexisting personality traits. The Neuroticism-Extraversion-Openness Personality Inventory Revised Test was administered prospectively to 130 first-year students the week before they began medical school. Scores for five traits (neuroticism, extraversion, openness, agreeableness, conscientiousness) were compared with the selection among nine medical residencies at the conclusion of medical school. Personality scores for medical students selecting psychiatry residencies showed greater degrees of neuroticism (P < 0.01) and openness (P < 0.03). Students electing family practice also deviated from other specialties, showing a lower degree of neuroticism (P < 0.03). Unexpectedly, personality traits in prospective surgical residents did not differ from those of students choosing nonsurgical residencies. Personality profiles present before medical school appear to predict the selection of some residencies and clinical specialties but not others. PMID:17256038

  3. Patterns of preoperative consultation and surgical specialty in an integrated healthcare system.

    PubMed

    Thilen, Stephan R; Bryson, Christopher L; Reid, Robert J; Wijeysundera, Duminda N; Weaver, Edward M; Treggiari, Miriam M

    2013-05-01

    Many patients scheduled for elective surgery are referred for a preoperative medical consultation. Only limited data are available on factors associated with preoperative consultations. The authors hypothesized that surgical specialty contributes to variation in referrals for preoperative consultations. This is a cohort study using data from Group Health Cooperative, an integrated healthcare system. The authors included 13,673 patients undergoing a variety of common procedures-primarily low-risk surgeries-representing six surgical specialties, in 2005-2006. The authors identified consultations by family physicians, general internists, pulmonologists, or cardiologists in the 42 days preceding surgery. Multivariable logistic regression was used to estimate the association between surgical specialty and consultation, adjusting for potential confounders including the revised cardiac risk index, age, gender, Deyo comorbidity index, number of prescription medications, and 11 medication classes. The authors found that 3,063 (22%) of all patients had preoperative consultations, with significant variation by surgical specialty. Patients having ophthalmologic, orthopedic, or urologic surgery were more likely to have consultations compared with those having general surgery-adjusted odds ratios (95% CI) of 3.8 (3.3-4.2), 1.5 (1.3-1.7), and 2.3 (1.8-2.8), respectively. Preoperative consultations were more common in patients with lower revised cardiac risk scores. There is substantial practice variation among surgical specialties with regard to the use of preoperative consultations in this integrated healthcare system. Given the large number of consultations provided for patients with low cardiac risk and for patients presenting for low-risk surgeries, their indications, the financial burden, and cost-effectiveness of consultations deserve further study.

  4. Women in Urology Residency, 1978-2013: A Critical Look at Gender Representation in Our Specialty.

    PubMed

    Halpern, Joshua A; Lee, Una J; Wolff, Erika M; Mittal, Sameer; Shoag, Jonathan E; Lightner, Deborah J; Kim, Soo; Hu, Jim C; Chughtai, Bilal; Lee, Richard K

    2016-06-01

    To evaluate changes over time in female representation among urology residents compared to those within other specialties. Urology match data were obtained from the American Urological Association from 1996 to 2015. Trends in match rates of male and female urology applicants were assessed. Data for gender representation among residencies were extracted from reports in the Journal of the American Medical Association from 1978 to 2013. We compared the annual percentage of women among urology residents vs residents of other specialties over time. Mean number of male vs female urology applicants per year was 285.0 ± 27.1 vs 76.5 ± 21.8 (P < .001). There was no statistically significant difference in the mean successful match rate of male vs female applicants (68.2% vs 66.6%, P = .36). From 1978 to 2013, the proportion of female residents across all specialties rose from 15.4% to 46.1%, whereas female residents in urology rose from 0.9% to 23.8%. Between 2009 and 2013, obstetrics and gynecology and orthopedics had the highest and lowest average proportion of women, respectively (80.7% and 13.5%). The largest growth occurred in urology among all other specialties (P < .001), with an 11-fold increase seen during the study period. Male and female applicants to urology residency have similar match rates. Although urology demonstrated the greatest fold-increase in proportion of women among all specialties during the study period, women have remained a minority among urology residents. Gender representation within urology is a reflection of many factors and demonstrates a need for further improvement. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Prescribing of psychostimulant medications for attention deficit hyperactivity disorder in children: differences between clinical specialties.

    PubMed

    Preen, David B; Calver, Janine; Sanfilippo, Frank M; Bulsara, Max; Holman, C D'Arcy J

    2008-03-17

    To examine differences in psychostimulant prescribing between paediatricians and child/adolescent psychiatrists for treating children with attention deficit hyperactivity disorder (ADHD) in Western Australia. Using whole-population prescribing data, logistic and linear regressions were used to model the number of children (aged 2-17 years) treated with psychostimulants between August 2003 and December 2004 for ADHD and medication dose prescribed by clinical specialty, controlling for age, sex, body weight, and other medication use. Mean number of patients treated by specialty; associations between prescriber specialty and patient characteristics; associations between stimulant dose and patient characteristics and prescriber specialty. 54 paediatricians and 23 child/adolescent psychiatrists prescribed stimulant medications for children with ADHD. The mean number of patients treated (per prescriber) was 159.8 (range, 1-1977) for paediatricians and 34.3 (range, 1-166) for psychiatrists. Boys were 32% more likely to be treated with stimulants by paediatricians (P = 0.002). Psychiatrists were 2.9 times (95% CI, 2.4-3.3; P < 0.001) more likely than paediatricians to treat patients with multiple psychotropic medications. When controlled for all other factors, psychiatrists prescribed higher stimulant doses (4.5 mg/day greater; 95% CI, 2.0-7.0 mg/day; P < 0.001) than paediatricians. Treatment of children with stimulant medicines for ADHD differed between clinical specialties. Paediatricians treated more patients per prescriber, a greater proportion of boys, and a younger age demographic, but relied less on combined psychotropic pharmacotherapy and prescribed lower stimulant doses than psychiatrists.

  6. Dental student perceptions of oral and maxillofacial surgery as a specialty.

    PubMed

    Jarosz, Krystian F; Ziccardi, Vincent B; Aziz, Shahid R; Sue-Jiang, Shuying

    2013-05-01

    The specialty of oral and maxillofacial surgery (OMS) encompasses the diagnosis and surgical management of a variety of pathologic, functional, and esthetic conditions of the oral and maxillofacial region. Despite the specialty's prominent role in the field of dentistry, a lack of complete understanding still remains among dental and medical health professionals as to the exact scope and expertise of the oral and maxillofacial surgeon. The present study aimed to analyze a population of dental students' perceptions of OMS as a specialty with respect to treatment rendered, referral patterns, and a general opinion of the specialty as a whole. A survey consisting of 10 multiple-choice questions was compiled and distributed to dental students through an on-line polling service (SurveyMonkey). A total of 5 dental student classes at a single dental school were polled using school-based electronic mail, including the graduating seniors. All answers were kept confidential, and no individual students were identified. The students were not able to retake the survey once completed. The final tallies of the survey results were compiled and submitted for statistical analysis. Statistically significant associations between the year of dental education and student perceptions of OMS were determined. As dental students progress through their undergraduate studies, their perceptions change with regard to the referral of dental implants. Periodontists were found to have statistically significantly greater rates of referral than oral and maxillofacial surgeons from dental students in the fourth year and recent graduates compared with younger dental students from the first, second, and third years for placement of dental implants. Statistically insignificant in terms of a changing dental student perception was the finding that third molar removal was within the domain of the oral and maxillofacial surgeon, as well as the management of cleft lip and palate deformities and mandibular

  7. Classroom-level adversity: Associations with children's internalizing and externalizing behaviors across elementary school.

    PubMed

    Abry, Tashia; Bryce, Crystal I; Swanson, Jodi; Bradley, Robert H; Fabes, Richard A; Corwyn, Robert F

    2017-03-01

    Concerns regarding the social-behavioral maladjustment of U.S. youth have spurred efforts among educators and policymakers to identify and remedy educational contexts that exacerbate children's anxiety, depression, aggression, and misconduct. However, investigations of the influence of collective classroom student characteristics on individuals' social-behavioral functioning are few. The present study examined concurrent and longitudinal relations between adversity factors facing the collective classroom student group and levels of children's internalizing and externalizing behaviors across the elementary school years, and whether the pattern of relations differed for girls and boys. First-, third-, and fifth-grade teachers reported on the extent to which adversity-related factors (e.g., home/family life, academic readiness, social readiness, English proficiency, tardiness/absenteeism, student mobility, health) presented a challenge in their classrooms (i.e., classroom-level adversity [CLA]). Mothers reported on their child's internalizing and externalizing behavior at each grade. Autoregressive, lagged panel models controlled for prior levels of internalizing and externalizing behavior, mothers' education, family income-to-needs, and class size. For all children at each grade, CLA was concurrently and positively associated with externalizing behavior. For first-grade girls, but not boys, CLA was also concurrently and positively associated with internalizing behavior. Indirect effects suggested CLA influenced later internalizing and externalizing behavior through its influence on maladjustment in a given year. Discussion highlights possible methods of intervention to reduce CLA or the negative consequences associated with being in a higher-adversity classroom. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. Restriction in hip internal rotation is associated with an increased risk of ACL injury.

    PubMed

    Bedi, Asheesh; Warren, Russell F; Wojtys, Edward M; Oh, You Keun; Ashton-Miller, James A; Oltean, Hanna; Kelly, Bryan T

    2016-06-01

    Evidence suggests that femoroacetabular impingement (FAI) in athletes may increase the risk of anterior cruciate ligament (ACL) injury. This study correlates ACL injury with hip range of motion in a consecutive series of elite, contact athletes and tests the hypothesis that a restriction in the available hip axial rotation in a dynamic in silico model of a simulated pivot landing would increase ACL strain and the risk of ACL rupture. Three hundred and twenty-four football athletes attending the 2012 NFL National Invitational Camp were examined. Hip range of internal rotation was measured and correlated with a history of ACL injury and surgical repair. An in silico biomechanical model was used to study the effect of FAI on the peak relative ACL strain developed during a simulated pivot landing. The in vivo results demonstrated that a reduction in internal rotation of the left hip was associated with a statistically significant increased odds of ACL injury in the ipsilateral or contralateral knee (OR 0.95, p = 0.0001 and p < 0.0001, respectively). A post-estimation calculation of odds ratio for ACL injury based on deficiency in hip internal rotation demonstrated that a 30-degree reduction in left hip internal rotation was associated with 4.06 and 5.29 times greater odds of ACL injury in the ipsilateral and contralateral limbs, respectively. The in silico model demonstrated that FAI systematically increased the peak ACL strain predicted during the pivot landing. FAI may be associated with ACL injury because of the increased resistance to femoral internal axial rotation during a dynamic maneuver such as a pivot landing. This insight may lead to better interventions to prevent ACL injury and improved understanding of ACL reconstruction failure. Cohort study, Level IV.

  9. The association between overweight and internalizing and externalizing behavior in early childhood.

    PubMed

    Camfferman, Roxanna; Jansen, Pauline W; Rippe, Ralph C A; Mesman, Judi; Derks, Ivonne P M; Tiemeier, Henning; Jaddoe, Vincent; van der Veek, Shelley M C

    2016-11-01

    The aim of this study was to examine bidirectional associations between overweight and behavior problems during early childhood taking into account the adiposity rebound, which is the turning point in the nonlinear development of Body Mass Index in early childhood. Longitudinal data from 6624 Dutch children in the Generation R Study were used to analyze the association between measured overweight and scores on the internalizing and externalizing scale of the Child Behavior Checklist between one-and-a-half, three and six years. The adiposity rebound was determined for each child by estimating the lowest point in their growth curve. Cross-lagged modeling was used to test (bi)directional associations. Both body mass and behavior problems were modest to highly stable from age one-and-a-half to six years. Externalizing and internalizing behavior were both associated with later overweight, although effect sizes were small (βs ranged between 0.06 and 0.07, ps < 0.05). No significant associations in the other direction were found. Controlling for adiposity rebound did not change the pattern of associations. There was a moderating effect of gender, and ethnicity, and timing of adiposity rebound. Behavior problems in early childhood may put children at risk for overweight at a later age. This implies that young children with behavior problems may benefit from careful monitoring of eating behavior and weight development. Future studies should take the adiposity rebound into account. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Association of acculturative stress, Islamic practices, and internalizing symptoms among Arab American adolescents.

    PubMed

    Goforth, Anisa N; Pham, Andy V; Chun, Heejung; Castro-Olivo, Sara M; Yosai, Erin R

    2016-06-01

    Although the numbers of Arab American immigrant youth in schools is increasing, there is little understanding of their mental health and the sociocultural factors that might influence it. This study examined the relationship between 2 sociocultural factors (i.e., acculturative stress and religious practices) and internalizing symptoms in first- and second-generation Muslim Arab American adolescents. Adolescents (n = 88) ages 11 to 18 completed measures related to acculturative stress, religious practices, internalizing symptoms, and general demographic information. Results of multiple regression analyses found that acculturative stress significantly predicted internalizing symptoms. Gender was found to moderate this association. No differences in the reported acculturative stress and internalizing symptoms were found between youth of different generational status (i.e., first- vs. second-generation). Finally, adolescents' organizational religious practices, but not their private religious practices, were found to be associated with lower acculturative stress. Implications are discussed related to how school psychologists can provide culturally responsive services to this population. (PsycINFO Database Record

  11. Content validity of a clinical problem solving test for use in recruitment to the acute specialties.

    PubMed

    Crossingham, Gemma; Gale, Thomas; Roberts, Martin; Carr, Alison; Langton, Jeremy; Anderson, Ian

    2011-02-01

    Clinical problem solving tests (CPSTs) have been shown to be reliable and valid for recruitment to general practice (GP) training programmes. This article presents the results from a Department of Health-funded pilot into the use of a CPST designed for recruitment to the acute specialties (AS). The pilot paper consisted of 99 items from the validated GP question bank and 40 new items aimed specifically at topics of relevance to AS training. The CPST successfully differentiated between applicants. The overall test and the GP section showed high internal reliability, whereas the AS pilot section performed less well. A detailed item analysis revealed that the AS pilot items were, on average, more difficult and of poorer quality than the GP items. Important issues that need to be addressed in the early development phase of a test used for high stakes selection to specialty training programmes are discussed.

  12. Internal friction and Moessbauer study of C{endash}Cr associates in MANET steel

    SciTech Connect

    Gondi, P.; Gupta, R.; Montanari, R.; Principi, G.; Tata, M.E.

    1997-02-01

    Internal friction and Moessbauer techniques have been used to investigate the structure of C{endash}Cr associates and the arrangement of Fe atoms near them in the Cr martensitic steel MANET subjected to different thermal treatments. After slow rate cooling from the austenitic field, the Moessbauer spectra exhibit, besides the complex magnetic pattern of martensite, a low intensity single attributed to the presence of a Cr-rich b.c.c. phase. In correspondence, the internal friction curves show, among others, a Snoek-type peak due to an elastic processes involving C{endash}Cr associates with 6 Cr atoms. To explain the experimental results a simple structure model is suggested. {copyright} {ital 1997 Materials Research Society.}

  13. International outbreak investigation of Salmonella Heidelberg associated with in-flight catering.

    PubMed

    Rebolledo, J; Garvey, P; Ryan, A; O'Donnell, J; Cormican, M; Jackson, S; Cloak, F; Cullen, L; Swaan, C M; Schimmer, B; Appels, R W; Nygard, K; Finley, R; Sreenivasan, N; Lenglet, A; Gossner, C; McKeown, P

    2014-04-01

    Rapid and wide dispersal of passengers after flights makes investigation of flight-related outbreaks challenging. An outbreak of Salmonella Heidelberg was identified in a group of Irish travellers returning from Tanzania. Additional international cases sharing the same flight were identified. Our aim was to determine the source and potential vehicles of infection. Case-finding utilized information exchange using experts' communication networks and national surveillance systems. Demographic, clinical and food history information was collected. Twenty-five additional cases were identified from Ireland, The Netherlands, Norway, USA and Canada. We conducted a case-control study which indicated a significant association between illness and consumption of milk tart (OR 10.2) and an egg dish (OR 6) served on-board the flight. No food consumed before the flight was associated with illness. Cases from countries other than Ireland provided supplementary information that facilitated the identification of likely vehicles of infection. Timely, committed international collaboration is vital in such investigations.

  14. Healthcare Spending and Performance of Specialty Hospitals: Nationwide Evidence from Colorectal-Anal Specialty Hospitals in South Korea

    PubMed Central

    Kim, Sun Jung; Lee, Sang Gyu; Kim, Tae Hyun

    2015-01-01

    Purpose Aim of this study is to investigate the characteristics and performance of colorectal-anal specialty vs. general hospitals for South Korean inpatients with colorectal-anal diseases, and assesses the short-term designation effect of the government's specialty hospital. Materials and Methods Nationwide all colorectal-anal disease inpatient claims (n=292158) for 2010-2012 were used to investigate length of stay and inpatient charges for surgical and medical procedures in specialty vs. general hospitals. The patients' claim data were matched to hospital data, and multi-level linear mixed models to account for clustering of patients within hospitals were performed. Results Inpatient charges at colorectal-anal specialty hospitals were 27% greater per case and 92% greater per day than those at small general hospitals, but the average length of stay was 49% shorter. Colorectal-anal specialty hospitals had shorter length of stay and a higher inpatient charges per day for both surgical and medical procedures, but per case charges were not significantly different. A "specialty" designation effect also found that the colorectal-anal specialty hospitals may have consciously attempted to reduce their length of stay and inpatient charges. Both hospital and patient level factors had significant roles in determining length of stay and inpatient charges. Conclusion Colorectal-anal specialty hospitals have shorter length of stay and higher inpatient charges per day than small general hospitals. A "specialty" designation by government influence performance and healthcare spending of hospitals as well. In order to maintain prosperous specialty hospital system, investigation into additional factors that affect performance, such as quality of care and patient satisfaction should be carried out. PMID:26446659

  15. Chicago Astronomical Society/International Dark-Sky Association Outreach For IYA And Beyond

    NASA Astrophysics Data System (ADS)

    Fischer, Audrey

    2008-09-01

    As a joint effort between the Chicago Astronomical Society, the oldest astronomical society in the Western Hemisphere, and the International Dark-Sky Association, dark sky education and outreach is planned for the Chicago area for IYA. Through our annual festival, Astrofest, in September, and the (new in 2008) Stell-O-Rama overnighter for Boy and Girl Scouts, as well as through other channels, we seek to educate the public about astronomy and light pollution issues.

  16. Thoracic bite wounds and associated internal injury in 11 dogs and 1 cat.

    PubMed

    McKiernan, B C; Adams, W M; Huse, D C

    1984-04-15

    In 11 dogs and 1 cat with thoracic bite wounds and associated internal injury, the most common radiographic findings were subcutaneous emphysema, pulmonary infiltrates (contusion), pneumothorax, and rib separation. Treatment consisted of simple wound cleansing/repair, extensive thoracic surgery, or pleural drainage. Three of the 12 animals died or were euthanatized as a result of their bite wounds, 1 from a nonthoracic injury and 2 as a result of pleural and/or parenchymal disease.

  17. The International Relations Committee of the Association of Anaesthetists of Great Britain and Ireland.

    PubMed

    Aitken, H; O'Sullivan, E

    2007-12-01

    The International Relations Committee of the Association of Anaesthetists of Great Britain and Ireland was established over 30 years ago to assist anaesthetists working in developing countries. The committee has attempted to make an impact through distribution of educational materials, supporting training courses and investing in a number of small equipment projects. In 2005, the Overseas Anaesthesia Fund was set up to allow members to donate directly to support our work.

  18. Advancing nursing home practice: the International Association of Geriatrics and Gerontology Recommendations.

    PubMed

    Tolson, Debbie; Morley, John E; Rolland, Yves; Vellas, Bruno

    2011-01-01

    Recognition of the urgent need to improve the provision of long-term care, as well as the known variations in standards of nursing home care around the world, prompted the International Association of Geriatrics and Gerontology (IAGG), in association with the World Health Organization (WHO), to form a task force. This task force was charged with the identification of the key concerns, research priorities, and actions that would enhance the care provided to older people in nursing homes. Nurses are equipped with the knowledge to take a leadership role in the IAGG/WHO initiative, and the task force eagerly seeks their input.

  19. An analysis of the inpatient charge and length of stay for patients with joint diseases in Korea: specialty versus small general hospitals.

    PubMed

    Kim, Sun Jung; Park, Eun-Cheol; Jang, Sung In; Lee, Minjee; Kim, Tae Hyun

    2013-11-01

    In 2011, the Korean government designated hospitals with certain structural characteristics as specialty hospitals. This study compared the inpatient charges and length of stay of patients with joint diseases treated at these specialty hospitals with those of patients treated at small general hospitals. In addition, the study investigated whether the designation of certain hospitals as specialty hospitals had an effect on inpatient charges and length of stay. Multi-level models were used to perform regression analyses on inpatient claims data (N=268,809) for 2010-2012 because of the hierarchical structure of the data. The inpatient charge at specialty hospitals was 19% greater than that at small general hospitals, but the length of stay was 21% shorter. After adjusting for patient and hospital level confounders, specialty hospitals had a higher inpatient charge (34.6%) and a reduced length of stay (31.7%). However, the effect of specialty hospital designation on inpatient charge (2.7% higher) and length of stay (2.3% longer) was relatively smaller. Among the patient characteristics, female gender, age, and severity of illness were positively associated with inpatient charge and length of stay. In terms of location, hospitals in metropolitan area had higher inpatient charges (5.5%), but much shorter length of stay (-14%). Several structural factors, such as occupancy rate, bed size, number of outpatients and nurses were positively associated with both inpatient charges and length of stay. However, number of specialists was positively associated with inpatient charges, but negatively associated with length of stay. In sum, this study found that specialty hospitals treating joint diseases tend to incur higher charges but produce shorter length of stay, compared to their counterparts. Specialty hospitals' overcharging behaviors, although shorter length of stay, suggest that policy makers could introduce bundled payments for the joint procedures. To promote a successful

  20. PREFACE: First International Congress of the International Association of Inverse Problems (IPIA): Applied Inverse Problems 2007: Theoretical and Computational Aspects

    NASA Astrophysics Data System (ADS)

    Uhlmann, Gunther

    2008-07-01

    This volume represents the proceedings of the fourth Applied Inverse Problems (AIP) international conference and the first congress of the Inverse Problems International Association (IPIA) which was held in Vancouver, Canada, June 25 29, 2007. The organizing committee was formed by Uri Ascher, University of British Columbia, Richard Froese, University of British Columbia, Gary Margrave, University of Calgary, and Gunther Uhlmann, University of Washington, chair. The conference was part of the activities of the Pacific Institute of Mathematical Sciences (PIMS) Collaborative Research Group on inverse problems (http://www.pims.math.ca/scientific/collaborative-research-groups/past-crgs). This event was also supported by grants from NSF and MITACS. Inverse Problems (IP) are problems where causes for a desired or an observed effect are to be determined. They lie at the heart of scientific inquiry and technological development. The enormous increase in computing power and the development of powerful algorithms have made it possible to apply the techniques of IP to real-world problems of growing complexity. Applications include a number of medical as well as other imaging techniques, location of oil and mineral deposits in the earth's substructure, creation of astrophysical images from telescope data, finding cracks and interfaces within materials, shape optimization, model identification in growth processes and, more recently, modelling in the life sciences. The series of Applied Inverse Problems (AIP) Conferences aims to provide a primary international forum for academic and industrial researchers working on all aspects of inverse problems, such as mathematical modelling, functional analytic methods, computational approaches, numerical algorithms etc. The steering committee of the AIP conferences consists of Heinz Engl (Johannes Kepler Universität, Austria), Joyce McLaughlin (RPI, USA), William Rundell (Texas A&M, USA), Erkki Somersalo (Helsinki University of Technology

  1. Best practices in specialty pharmacy management.

    PubMed

    Patterson, Courtney J

    2013-01-01

    Specialty pharmacy is a growing area of research, utilization, and cost. Because of the unique nature of the diseases treated by specialty pharmaceuticals, such as cancer and rheumatoid arthritis, novel management approaches are needed. Advocate Physician Partners (APP) is an entity within the Advocate Health Care Health System in the Chicago and the central Illinois area. It coordinates the care management and managed care contracting between the Advocate Health Care System and more than 4,000 physicians on the medical staffs of Advocate hospitals. APP has experienced a per-member-per-month (PMPM) increase of less than  3% in oncology intravenous medications spend in 2012. This spend refers to the intravenous medications covered under the medical benefits for APP's health maintenance organization (HMO) population. The spend has consistently been less than national projections, and we believe this is tied to the adoption of several key best practices. Prior to instituting the best practices, the yearly percentage increases for oncology spending were 5.52% (2007 to 2008), 9.39% (2008 to 2009), and 5.29% (2009 to 2010). After instituting best practices during the first quarter of 2011, the increases in PMPM were 3.11% (2010 to 2011) and 2.11% (2011 to 2012), which were below previous years. To describe the best practices of specialty pharmacy management adopted by APP, specifically (a) establishing a content expert and governing bodies, (b) ensuring compliance with policies, and (c) providing educational resources. APP has several key result areas (KRAs). One KRA was compliance with appropriate utilization of intravenous oncology protocols for its HMO population. The protocols for each medication outline the appropriate indication and patient population. These protocols were developed and reviewed by the APP Pharmacy and Technology (PT) committee. The PT-approved indications reflect FDA indications and indications found in national guidelines. The APP KRA target

  2. Specialty competencies for residents in aerospace medicine.

    PubMed

    Yasuhara, T T; Dodge, R E; Jennings, R T; Valdez, M R

    1999-06-01

    The American College of Preventive Medicine (ACPM), with sponsorship from the Health Resources Administration (HRSA), has published core competencies that are common to all preventive medicine residencies-aerospace medicine (ASM), occupational medicine (OM), and general preventive medicine/public health (GPM/PH). Further development of specialty area competencies for ASM residents was addressed by a working group comprised of representatives from each of the four ASM residency programs. Representatives from the U.S. Air Force School of Aerospace Medicine, Wright State University, University of Texas Medical Branch-Galveston, and the Naval Operational Medicine Institute convened to develop a set of broad competency statements for ASM residents that would encompass the breadth of ASM residency training as it is currently provided in the U.S. A listing of six ASM resident competencies, with supporting skill sets, are presented. In combination with the ACPM core competencies, the ASM resident competencies represent a refocusing of educational objectives on skills attainment. The ASM resident competencies identify the capabilities of graduating ASM residents as distinct from OM and GPM/PH residents. At the same time, they are broad enough to permit specific areas of emphasis (e.g., military, civil, or space) to be pursued within the various ASM residencies. This represents the first successful attempt to draft a consolidated statement of educational objectives that has universal acceptance and applicability across all U.S. aerospace medicine residencies.

  3. [Specialty care in the transformation process].

    PubMed

    Rodríguez Suárez, Romeo S; Mansilla Olivares, Armando; Díaz Jiménez, María Juana

    2012-01-01

    The scientific research goals developed and applied beyond their own frontiers, by the National Institutes of Health and High Specialty Hospitals, are presented regarding the specialized medical care of excellence on the field of global health, in benefice of the Mexican population. Maternal mortality as well as malnutrition, and the lack of micronutrients in the pregnant mother and child, put them in disadvantage to face future physical and mental diseases. Low weight at birth, prematurity, and overweight during childhood are factors that can trigger the the development of the metabolic syndrome, with all its consequences on physical and mental health. These challenges are faced with a preventive vision by means of pilot programs like "Towards a new generation of Mexicans" and "Chronic kidney disease stratification in high risk patients", besides the development of new strategies for the prevention and treatment of other chronic diseases such as cancer, hypertension, and diabetes among others by decreasing the number of overweight and obesity people in the Mexican population.

  4. Allocation of time in three academic specialties.

    PubMed

    Sanders, A B; Spaite, D W; Smith, R; Criss, E

    1988-01-01

    A survey was done to: 1) characterize the allocation and distribution of time by tenure track emergency physicians, and 2) compare the time distribution of emergency physicians to two other academic disciplines. All emergency medicine residency programs were surveyed by telephone to determine if faculty were eligible for tenure and if tenure was available, how many hours per week were spent on clinical duties, research, and administrative tasks. Similar information was compiled from cardiology and orthopedic surgery faculty at the same universities. Data from the survey revealed that a tenure track assistant professor spends 23 hours (46%) working clinical shifts in the emergency department; 11 hours (20%) doing research and 18 hours (34%) in administrative tasks. In contrast, cardiologists spend significantly more time in clinical duties (32 hours) and research (18 hours). However, cardiologists spend significantly less time in administrative duties (10 hours). Data for orthopedic surgeons show a similar pattern. Distributions within each academic discipline were also analyzed and a significant difference in research time was found between four tenure track emergency medicine programs and the other eighteen. Data from this survey may help academic emergency physicians evaluate how they are allocating their time in comparison to other busy clinical specialties.

  5. Disentangling psychobiological mechanisms underlying internalizing and externalizing behaviors in youth: longitudinal and concurrent associations with cortisol.

    PubMed

    Ruttle, Paula L; Shirtcliff, Elizabeth A; Serbin, Lisa A; Fisher, Dahlia Ben-Dat; Stack, Dale M; Schwartzman, Alex E

    2011-01-01

    Research examining cortisol dysregulation is seemingly contradictory with studies showing that both internalizing and externalizing behaviors are related to high and low cortisol. One extant theory to explain divergent findings in the stress literature is that both hypo- and hyper-arousal of the hypothalamic-pituitary-adrenal (HPA) axis may be present depending on time since onset of the stressor. This theory may extend to the onset of internalizing and externalizing behaviors. Data from 96 youth participating in a longitudinal project were used to examine this possibility. Composite measures of internalizing and externalizing behaviors at both childhood and early adolescence were formed using mother and teacher reports. Multiple salivary cortisol samples were also collected over two consecutive days during early adolescence. Problematic behaviors were associated with cortisol and the direction of the association was dependent on amount of time passed since onset of the behaviors. When examined concurrently in adolescence, youth with more internalizing behaviors had higher morning cortisol; however, when examined longitudinally, youth with more internalizing behaviors in childhood had lower morning cortisol levels as adolescents. Youth with more externalizing behaviors in childhood had flattened diurnal cortisol rhythms as adolescents, and this finding persisted when examined in adolescence. Cortisol dysregulation was greatest in children with the most severe behavior problems. Findings support the theoretical model of blunting of the HPA axis over time. While the HPA axis may show hyper-arousal when youth first display behaviors, long-term exposure may lead to a hypo-arousal of the HPA axis which culminates in a dysregulated diurnal rhythm.

  6. Primary care, the ROAD less traveled: what first-year medical students want in a specialty.

    PubMed

    Clinite, Kimberly L; Reddy, Shalini T; Kazantsev, Stephanie M; Kogan, Jennifer R; Durning, Steven J; Blevins, Terri; Chou, Calvin L; Diemer, Gretchen; Dunne, Dana W; Fagan, Mark J; Hartung, Paul J; Mechaber, Hilit F; Paauw, Douglas S; Wong, Jeffrey G; DeZee, Kent J

    2013-10-01

    Medical students are increasingly choosing non-primary-care specialties. Students consider lifestyle in selecting their specialty, but how entering medical students perceive lifestyle is unknown. This study investigates how first-year students value or rate lifestyle domains and specialty-selection characteristics and whether their ratings vary by interest in primary care (PC). During the 2012-2013 academic year, the authors conducted a cross-sectional survey of first-year medical students from 11 MD-granting medical schools. Using a five-point Likert-type scale (1 = not important at all; 5 = extremely important), respondents rated the importance of 5 domains of good lifestyle and 21 characteristics related to specialty selection. The authors classified students into five groups by PC interest and assessed differences by PC interest using one-way analysis of variance. Of 1,704 participants, 1,020 responded (60%). The option "type of work I am doing" was the highest-rated lifestyle domain (mean 4.8, standard deviation [SD] 0.6). "Being satisfied with the job" was the highest-rated specialty-selection characteristic (mean 4.7, SD 0.5). "Availability of practice locations in rural areas" was rated lowest (mean 2.0, SD 1.1). As PC interest decreased, the importance of "opportunities to work with underserved populations" also decreased, but importance of "average salary earned" increased (effect sizes of 0.98 and 0.94, respectively). First-year students valued enjoying work. The importance of financial compensation was inversely associated with interest in PC. Examining the determinants of enjoyable work may inform interventions to help students attain professional fulfillment in PC.

  7. Global medical education partnerships to expand specialty expertise: a case report on building neurology clinical and research capacity.

    PubMed

    Kaddumukasa, Mark; Katabira, Elly; Salata, Robert A; Costa, Marco A; Ddumba, Edward; Furlan, Anthony; Kakooza-Mwesige, Angelina; Kamya, Moses R; Kayima, James; Longenecker, Chris T; Mayanja-Kizza, Harriet; Mondo, Charles; Moore, Shirley; Pundik, Svetlana; Sewankambo, Nelson; Simon, Daniel I; Smyth, Kathleen A; Sajatovic, Martha

    2014-12-30

    Neurological disorders are a common cause of morbidity and mortality in sub-Saharan African, but resources for their management are scarce. Collaborations between training institutions in developed and resource-limited countries can be a successful model for supporting specialty medical education and increasing clinical and research capacity. This report describes a US National Institutes of Health (NIH) funded Medical Education Partnership Initiative (MEPI) to enhance expertise in neurology, developed between Makerere University College of Health Sciences in Kampala, Uganda, and Case Western Reserve University School of Medicine in Cleveland, OH, USA. This collaborative model is based on a successful medical education and research model that has been developed over the past two decades. The Ugandan and US teams have accumulated knowledge and 'lessons learned' that facilitate specialty expertise in neurological conditions, which are widespread and associated with substantial disability in resource-limited countries. Strengths of the model include a focus on community health care settings and a strong research component. Key elements include strong local leadership; use of remote technology, templates to standardize performance; shared exchanges; mechanisms to optimize sustainability and of dissemination activities that expand impact of the original initiative. Efficient collaborations are further enhanced by external and institutional support, and can be sequentially refined. Models such as the Makerere University College of Health Sciences - Case Western Reserve University partnership may help other groups initiate collaborative education programmes and establish successful partnerships that may provide the opportunity to expand to other chronic diseases. A benefit of collaboration is that learning is two-directional, and interaction with other international medical education collaborators is likely to be of benefit to the larger global health community.

  8. Children with epilepsy in Africa: recommendations from the International Child Neurology Association/African Child Neurology Association Workshop.

    PubMed

    Wilmshurst, Jo M; Cross, J Helen; Newton, Charles; Kakooza, Angelina M; Wammanda, Robinson D; Mallewa, Macpherson; Samia, Pauline; Venter, Andre; Hirtz, Deborah; Chugani, Harry

    2013-05-01

    This article presents key findings from the International Child Neurology Association/African Child Neurology Association Workshop. The viability of international guidelines for the management of children with epilepsy should be reviewed within each African country, and adapted to comply with the regional capacity. Such recommendations can be used to lobby for resources. More training centers should be developed in Africa, so that specialists can be trained within Africa, in skills relevant to the continent, in collaboration with "out of Africa" visiting-specialists to develop the concept of "train the trainers." At least 1 child neurology specialist per 100,000 of the population is required. Specific to Africa are the challenges from stigma, prejudice, and misconceptions. "Epilepsy teams," inclusive of the traditional healers, would enable management of increased numbers of children, and challenge policy such that it is the right of the child with epilepsy to have reliable access to appropriate antiepileptic drugs, support, and health care equity between the rural and urban settings.

  9. Pressure ulcers in patients hospitalized in Internal Medicine: associated factors and mortality.

    PubMed

    Díez-Manglano, J; Fernández-Jiménez, C; Lambán-Aranda, M P; Landa-Santesteban, M C; Isasi de Isasmendi-Pérez, S; Moreno-García, P; Bejarano-Tello, E; Barranco-Usón, J; Munilla-López, E; Del Corral-Beamonte, E

    2016-12-01

    To determine the prevalence of pressure ulcers in patients hospitalized in internal medicine and the clinical factors and risk of death associated with its presence. Prospective cohort study with patients hospitalized in internal medicine. We recorded the age, sex, presence of pressure ulcers, degree of ulceration, Barthel index, Norton scale, major diagnostic category, length of hospital stay and weight of the diagnosis-related groups. We compared the clinical characteristics of the patients with or without ulcers and analysed the mortality after 3 years based on the presence of ulcers. The study included 699 patients, 100 of whom (14.3%) had pressure ulcers (27 with grade I, 17 with grade II, 21 with grade III, 25 with grade IV and 10 with unknown grade). The Barthel index (OR 0.985; 95% CI 0.972-0.998; p=.022) and Norton scale (OR 0.873; 95% CI 0.780-0.997; p=.018) are independently associated with ulcers. Twenty-three percent of the patients with ulcers died during hospitalization, 68% died within a year, and 83% died within 3 years. The presence of pressure ulcers was independently associated with mortality (HR, 1.531; 95% CI 1.140-2.056; p=.005). Pressure ulcers are common in patients hospitalized in internal medicine, and their presence is associated with higher short, medium and long-term mortality. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  10. RECALMIN: The association between management of Spanish National Health Service Internal Medical Units and health outcomes.

    PubMed

    Zapatero-Gaviria, Antonio; Javier Elola-Somoza, Francisco; Casariego-Vales, Emilio; Fernandez-Perez, Cristina; Gomez-Huelgas, Ricardo; Bernal, José Luis; Barba-Martín, Raquel

    2017-08-01

    To investigate the association between management of Internal Medical Units (IMUs) with outcomes (mortality and length of stay) within the Spanish National Health Service. Data on management were obtained from a descriptive transversal study performed among IMUs of the acute hospitals. Outcome indicators were taken from an administrative database of all hospital discharges from the IMUs. Spanish National Health Service. One hundred and twenty-four acute general hospitals with available data of management and outcomes (401 424 discharges). IMU risk standardized mortality rates were calculated using a multilevel model adjusted by Charlson Index. Risk standardized myocardial infarction and heart failure mortality rates were calculated using specific multilevel models. Length of stay was adjusted by complexity. Greater hospital complexity was associated with longer average length of stays (r: 0.42; P < 0.001). Crude in-hospital mortality rates were higher at larger hospitals, but no significant differences were found when mortality was risk adjusted. There was an association between nurse workload with mortality rate for selected conditions (r: 0.25; P = 0.009). Safety committee and multidisciplinary ward rounds were also associated with outcomes. We have not found any association between complexity and intra-hospital mortality. There is an association between some management indicators with intra-hospital mortality and the length of stay. Better disease-specific outcomes adjustments and a larger number of IMUs in the sample may provide more insights about the association between management of IMUs with healthcare outcomes.

  11. Impact of cost sharing on specialty drug utilization and outcomes: a review of the evidence and future directions.

    PubMed

    Doshi, Jalpa A; Li, Pengxiang; Ladage, Vrushabh P; Pettit, Amy R; Taylor, Erin A

    2016-03-01

    Specialty drugs often represent major medical advances for patients with few other effective options available, but high costs have attracted the attention of both payers and policy makers. We reviewed the evidence regarding the impact of cost sharing on utilization of specialty drugs indicated for rheumatoid arthritis (RA), multiple sclerosis (MS), and cancer, and on the use of nondrug medical services, health outcomes, and spending. Systematic review of Medline-indexed studies identified via an OVID search for articles published in English from 1995 to 2014, using combinations of terms for cost sharing and specialty drugs, and/or our 3 conditions of interest. We identified additional studies from reference lists. We identified 19 articles focusing on specialty drugs indicated for MS (n = 9), cancer (n = 8), and RA (n = 8). Studies examined prescription abandonment (n = 3), initiation or any utilization (n = 8), adherence (n = 9), persistence/discontinuation (n = 7), number of claims (n = 1), and drug spending (n = 1). Findings varied by disease, but generally indicated stronger effects for noninitiation or abandonment of a prescription at the pharmacy and somewhat smaller effects for refill behavior and drug spending once patients initiated therapy. Studies have not examined specialty tier cost sharing seen under Medicare Part D or health insurance exchanges, nor effects on medical utilization, spending, or health outcomes. Evidence to date generally indicates reductions in specialty drug utilization associated with higher cost sharing; effects have varied by type of disease and specialty drug use outcome. We draw upon our findings and the gaps in evidence to summarize future directions for research and policy.

  12. Clinical work intensity among physician specialties: how might we assess it? What do we find?

    PubMed

    Horner, Ronnie D; Szaflarski, Jerzy P; Jacobson, C Jeffrey; Elder, Nancy; Bolon, Shannon; Matthews, Gerald; Ying, Jun; Meganathan, Karthikeyan; Raphaelson, Marc

    2011-01-01

    The level of work intensity associated with patient encounters has implications for quality of care, patient safety, practice management, and reimbursement. The utility of available instruments for clinical work intensity assessment is unknown. We assessed, in the clinical setting, the performance of existing measures of work intensity that are valid for nonclinical contexts. A cross-sectional, multimeasure design involving work intensity assessments for the last patient encounter and for an entire half-day clinic session. A convenience sample of 14 providers from the following 4 specialties: family medicine, general internal medicine, neurology, and surgery. Perceived clinical work intensity was measured by the following 3 instruments: National Aeronautic and Space Administration-Task Load Index, Subjective Workload Assessment Technique, and Multiple Resources Questionnaire; stress was measured by the Dundee Stress State Questionnaire. Convergent validity was assessed by correlation among the instruments. For the last patient encounter, there was a moderate to high correlation between the work intensity instruments' scores (Pearson's r ranged from 0.41 to 0.73) and low to moderate correlation with the distress subscale of the Dundee Stress State Questionnaire (Pearson's r ranged from -0.11 to 0.46), reflecting their stress dimension. Provider personality was associated with reported levels of work intensity and stress. Similar results were obtained when the entire clinic session was the unit of reference. Existing measures of work intensity and stress appear to be valid for use in the clinical setting to generate evidence on perceived intensity and stress experienced by providers in the performance of medical services.

  13. Parent Discipline Practices in an International Sample: Associations With Child Behaviors and Moderation by Perceived Normativeness

    PubMed Central

    Gershoff, Elizabeth T.; Grogan-Kaylor, Andrew; Lansford, Jennifer E.; Chang, Lei; Zelli, Arnaldo; Deater-Deckard, Kirby; Dodge, Kenneth A.

    2010-01-01

    This study examined the associations of 11 discipline techniques with children's aggressive and anxious behaviors in an international sample of mothers and children from 6 countries and determined whether any significant associations were moderated by mothers’ and children's perceived normativeness of the techniques. Participants included 292 mothers and their 8- to 12-year-old children living in China, India, Italy, Kenya, Philippines, and Thailand. Parallel multilevel and fixed effects models revealed that mothers’ use of corporal punishment, expressing disappointment, and yelling were significantly related to more child aggression symptoms, whereas giving a time out, using corporal punishment, expressing disappointment, and shaming were significantly related to greater child anxiety symptoms. Some moderation of these associations was found for children's perceptions of normativeness. PMID:20438455

  14. A Program for Risk Assessment Associated with IGSCC of BWR Vessel Internals

    SciTech Connect

    A. G. Ware; D. K. Morton; J. D. Page; M. E. Nitzel; S. A. Eide; T. -Y. Chang

    1999-08-01

    A program is being carried out for the US Nuclear Regulatory Commission (NRC) by the Idaho National Engineering and Environmental Laboratory (INEEL), to conduct an independent risk assessment of the consequences of failures initiated by intergranular stress corrosion cracking (IGSCC) of the reactor vessel internals of boiling water reactor (BWR) plants. The overall project objective is to assess the potential consequences and risks associated with the failure of IGSCC-susceptible BWR vessel internals, both singly and in combination with the failures of others, with specific consideration given to potential cascading and common mode effects on system performance. This paper presents a description of the overall program that is underway to modify an existing probabilistic risk assessment (PRA) of the BWR/4 plant to include IGSCC-initiated failures, subsequently to complete a quantitative PRA.

  15. Cutaneous dermatomyositis: an updated review of treatment options and internal associations.

    PubMed

    Femia, Alisa N; Vleugels, Ruth Ann; Callen, Jeffrey P

    2013-08-01

    Dermatomyositis is a specific type of inflammatory myopathy with characteristic cutaneous findings. Patients may have skin disease without clinically apparent muscle disease, but this disorder is best thought of as a systemic process. Therefore, all patients with dermatomyositis skin lesions need appropriate evaluation for muscle disease, esophageal dysfunction, cardiopulmonary disease, and potential internal malignancy. There are many therapies that have been used for patients with dermatomyositis, but most are based upon case series or expert opinion rather than meta-analyses or randomized, placebo-controlled trials. Even those therapies that have been subjected to randomized, blinded, placebo-controlled trials include a mixture of patients with idiopathic inflammatory myopathy and do not utilize a validated assessment tool for measuring cutaneous disease responses. In this review, we discuss the therapies available as well as the internal associations with dermatomyositis.

  16. [A case of accessory middle cerebral artery associated with internal carotid artery aneurysm (author's transl)].

    PubMed

    Munekata, K; Omori, H; Kanazawa, Y; Miyazaki, S; Fukushima, H; Kamata, K

    1979-12-01

    A case of accessory middle cerebral artery associated with internal carotid artery aneurysm was reported. A 50-year-old female was admitted to our hospital with complaints of headache, nausea, vomiting and conciousness disturbance. Lumbar puncture showed bloody CSF. Right carotid angiogram revealed saccular aneurysm of the internal carotid-posterior communicating artery and accessory middle cerebral artery originating from the horizontal portion of the right anterior cerebral artery. No other vascular lesion was observed on other angiograms. Operation was performed 2 days after admission. The neck of the aneurysm was clipped. Postoperative aseptic meningitis was cured by frequent lumbar punctures, and her course was uneventful. The etiological hypothesis of these cerebral vascular anomalies was briefly discussed.

  17. Forty years of the international association for study of lung cancer pathology committee.

    PubMed

    Tsao, Ming-Sound; Travis, William D; Brambilla, Elisabeth; Nicholson, Andrew G; Noguchi, Masayuki; Hirsch, Fred R

    2014-12-01

    Lung cancer classification during the last four decades has undergone major changes and evolution, mostly lead by pathologists who were actively involved in the International Association for the Study of Lung Cancer (IASLC) Pathology Committee. The Committee members have led the development and writing of the second (1981), third (1999 and 2004), and fourth (2015) editions of the World Health Organization classifications on lung tumors. Committee members were responsible for defining and refining the classifications of small-cell carcinoma and adenocarcinoma subtypes that are relevant to their clinical behavior. Particularly notable was development of the 2011 IASLC/American Thoracic Society/European Respiratory Society international, multidisciplinary lung adenocarcinoma classification. The multidisciplinary approach that represents the IASLC culture in research, education, and practice in clinical management of lung cancer patients have paved the way for integrating pathology practice into the new era of personalized cancer care.

  18. Clarifying Co-Rumination: Associations with Internalizing Symptoms and Romantic Involvement among Adolescent Girls

    PubMed Central

    Starr, Lisa R.; Davila, Joanne

    2009-01-01

    Co-rumination, or excessive discussion of problems within friendships, has been associated with internalizing symptoms and is especially prevalent among adolescent girls. Eighty-three early adolescent girls participated in a prospective study further examining this construct. Co-rumination was positively correlated with depressive symptoms and positive aspects of friendship, but did not predict longitudinal changes in depressive symptoms. Co-rumination was negatively related to social anxiety when controlling for depressive symptoms. Co-rumination correlated positively with romantic experiences, and the two interacted to predict longitudinal changes in depressive symptoms, implying that co-rumination may only be depressogenic under certain circumstances. Theoretical ramifications for the construct of co-rumination and interpersonal aspects of adolescent internalizing symptoms are discussed. PMID:18241914

  19. Physician specialty practices. Strategic survival for rural hospitals.

    PubMed

    Deprez, Ronald

    2004-01-01

    Rural hospital financial performance can be boosted by implementing a model for providing greater access to specialty care. Each of these models has its own unique financial implications and advantages for rural hospitals.

  20. Eastman Specialties Corporation – Chestertown MD - MDD001890060

    EPA Pesticide Factsheets

    The U.S. EPA is announcing its proposed decision of Corrective Action Complete with Controls under the RCRA, for the Eastman Specialties Corporation Facility EPA ID: MDD001890060, located in Chestertown MD.

  1. Development and implementation of the specialty certificate examinations.

    PubMed

    Mucklow, John

    2011-06-01

    Following successful pilots in 2006, knowledge-based assessments for those engaged in specialty training have been developed and implemented in 11 medical specialties, by the Federation of Royal Colleges of Physicians in partnership with the specialist societies. Over 400 physicians have been involved in a project that has required recruitment and training of up to 25 question writers in each discipline, and the constitution of examining boards and standard setting advisory groups in each specialty. The assessments (now known as the specialty certificate examinations) are delivered by computer-based testing in centres throughout the UK and overseas. This paper analyses the outcome of 14 examination diets, sat by 948 candidates, of whom 72% were occupying UK numbered training posts. A total of 786 candidates sat the examination in the UK, 162 in overseas centres. Pass rates among UK trainees have generally exceeded 80%, with reliability coefficients well in excess of 0.8.

  2. Theme: Staying Current--Small Animals and Specialty Crops.

    ERIC Educational Resources Information Center

    Knight, James A.; And Others

    1986-01-01

    Six theme articles examine ways that vocational agriculture teachers can keep current, including related hobbies, resource persons, beekeeping as a supervised occupational experience, specialty crops such as fruits and nuts, an inservice poultry project, and trade and industry organizations. (SK)

  3. The Relationship between Congruent Specialty Choice within Occupations and Satisfaction.

    ERIC Educational Resources Information Center

    Meir, Elchanan I.; Yaari, Yael

    1988-01-01

    Examined hypothesis that relationship between congruent specialty choice within occupations and satisfaction exceeds relationship between congruent occupational choice and satisfaction. Responses from 324 engineers, physicians, nurses, teachers, policemen, biologists, lawyers, and psychologists to appropriate within-occupation interest inventories…

  4. Theme: Staying Current--Small Animals and Specialty Crops.

    ERIC Educational Resources Information Center

    Knight, James A.; And Others

    1986-01-01

    Six theme articles examine ways that vocational agriculture teachers can keep current, including related hobbies, resource persons, beekeeping as a supervised occupational experience, specialty crops such as fruits and nuts, an inservice poultry project, and trade and industry organizations. (SK)

  5. Personality and Medical Specialty Choice: Technique Orientation versus People Orientation.

    ERIC Educational Resources Information Center

    Borges, Nicole J.; Osmon, William R.

    2001-01-01

    Results of the 16 Personality Factor Questionnaire completed by 161 physicians indicated that role consciousness, abstractedness, and tough mindedness differentiated medical specialties (surgeons, anesthesiologists, family practitioners). Results correlated with the use of differences between person orientation and technique orientation to…

  6. Evaluation of Internal Validity Using Modern Test Theory: Application to Word Association

    PubMed Central

    Shono, Yusuke; Ames, Susan L.; Stacy, Alan W.

    2015-01-01

    Word association tests (WATs) have been widely used to examine associative/semantic memory structures and shown to be relevant to behavior and its underpinnings. Despite successful applications of WATs in diverse research areas, few studies have examined psychometric properties of these tests or other open-ended cognitive tests of common use. Modern test theory models, such as item response theory (IRT) models, are well suited to evaluate interpretations of this class of test. In this evaluation, unidimensional IRT models were fitted to the data on the WAT designed to capture associative memory relevant to an important applied issue: casual sex in a sample of 1138 adult drug offenders. Using association instructions, participants were instructed to generate the first behavior or action that came to mind in response to cues (e.g., “hotel/motel”) that might elicit casual sex-related responses. Results indicate a multitude of evidence for the internal validity of WAT score interpretations. All WAT items measured a single latent trait of casual sex-related associative memory, strongly related to the latent trait, and were invariant across gender, ethnicity, age groups, and sex partner profiles. The WAT was highly informative at average-to-high levels of the latent trait and also associated with risky sex behavior, demonstrating the usefulness of this class of test. The study illustrates the utility of the assessments in this at-risk population as well as the benefits of application of the modern test theory models in the evaluation of internal validity of open-ended cognitive test score interpretation. PMID:26053001

  7. Evaluation of internal validity using modern test theory: Application to word association.

    PubMed

    Shono, Yusuke; Ames, Susan L; Stacy, Alan W

    2016-02-01

    Word association tests (WATs) have been widely used to examine associative/semantic memory structures and shown to be relevant to behavior and its underpinnings. Despite successful applications of WATs in diverse research areas, few studies have examined psychometric properties of these tests or other open-ended cognitive tests of common use. Modern test theory models, such as item response theory (IRT) models, are well suited to evaluate interpretations of this class of test. In this evaluation, unidimensional IRT models were fitted to the data on the WAT designed to capture associative memory relevant to an important applied issue: casual sex in a sample of 1,138 adult drug offenders. Using association instructions, participants were instructed to generate the first behavior or action that came to mind in response to cues (e.g., "hotel/motel") that might elicit casual sex-related responses. Results indicate a multitude of evidence for the internal validity of WAT score interpretations. All WAT items measured a single latent trait of casual sex-related associative memory, strongly related to the latent trait, and were invariant across gender, ethnicity, age groups, and sex partner profiles. The WAT was highly informative at average-to-high levels of the latent trait and also associated with risky sex behavior, demonstrating the usefulness of this class of test. The study illustrates the utility of the assessments in this at-risk population as well as the benefits of application of the modern test theory models in the evaluation of internal validity of open-ended cognitive test score interpretation. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. Association of Eating Disorder Symptoms with Internalizing and Externalizing Dimensions of Psychopathology among Men and Women

    PubMed Central

    Mitchell, Karen S.; Wolf, Erika J.; Reardon, Annemarie F.; Miller, Mark W.

    2014-01-01

    Objective A large body of factor analytic research supports the idea that common mental disorders are organized along correlated latent dimensions termed internalizing and externalizing. Eating disorders (EDs) have been associated with both internalizing (mood and anxiety disorders) and externalizing (substance use, antisocial personality disorder) forms of psychopathology. Previous studies found that EDs are best classified as internalizing disorders. However, no previous factor analytic studies of EDs and the internalizing/externalizing dimensions have evaluated if the EDs align with these spectra similarly for men and women. We examined the location of anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) symptoms within this model of psychopathology among a sample of veterans, a population traditionally understudied in EDs. Method Data were from two studies of veterans and their intimate partners (N = 453 men and 307 women). Participants were administered the Structured Clinical Interview for DSM-IV without skip-outs. Lifetime symptom severity scores were used in confirmatory factor analytic models. Results A model with AN, BN, and BED symptoms loading onto the distress sub-factor of the internalizing domain fit the data best in the full sample and the male and female subsamples. This model was statistically equivalent for men and women. Discussion All three EDs loaded onto distress, indicating that these conditions overlap with psychopathology characterized by negative affect. Investigating latent dimensions of psychopathology is one approach to identifying common factors that partially account for patterns of comorbidity among psychiatric disorders which may aid in translating research findings into clinical practice. PMID:24849585

  9. Specialty empowerment: a new trend in managed care.

    PubMed

    Beard, P L

    1998-03-01

    The rise of the open-access managed care model has brought the concept of specialist empowerment to the forefront. Specialists are being asked to assume the gatekeeper role for specialty services throughout individual provider networks. A growing number of specialty practices are structuring to assume this role and manage the accompanying risk and capitation dollars. Many specialist practices are using this new structure to gain a competitive edge in the market.

  10. Gastroenterology, a historical specialty with a great future.

    PubMed

    Crespo, Javier; Jorquera Plaza, Francisco

    2017-09-01

    The specialty of gastroenterology (SGI) deals with the conditions involving the gut (esophagus, stomach, bowels, anorectal region), liver, bile ducts, pancreas, and peritoneum, specifically with their etiology, epidemiology, pathophysiology, semiology, diagnosis, prognosis, prevention, and treatment. As shown by Dr. Curbelo et al. in the present issue of The Spanish Journal of Digestive Diseases (Revista Española de Enfermedades Digestivas), our SGI has progressively grown as a specialty training option, and is now one of the five most commonly requested residency programs.

  11. Specialty Engineering Supplement to IEEE-15288.1

    DTIC Science & Technology

    2015-05-15

    MISSILE SYSTEMS CENTER TAILORING SPECIALTY ENGINEERING SUPPLEMENT TO IEEE -15288.1 APPROVED FOR PUBLIC RELEASE; DISTRIBUTION...IS UNLIMITED 1 Tailoring of IEEE 15288.1: Specialty Engineering Supplement. 1. Intent of this Tailoring Document This tailoring document is...historically deemed valuable to mission assurance/success of high-reliability space systems. This tailoring document supplements IEEE 15288.1-2015 Annex E

  12. Medical students’ choices of specialty in The Gambia: the need for career counseling

    PubMed Central

    2012-01-01

    Background Understanding preferences for specialties by medical students and the factors driving choices assists policy makers in ensuring optimal spread of personnel across disciplines. Methods This cross-sectional survey using self-administered structured questionnaires was conducted on consenting students of the first medical school in The Gambia, established in 1999. Data collection was in June/July 2011. Questions were on sociodemographic characteristics of students, their parents, factors related to career preferences and opinions about counseling services. Data were analysed using JMP 8.0 software. Results Respondents were 52.4% of 202 eligible students. Mean age was 24.1 ± 5.0 years. Females constituted 54.7%. Muslims were 72.7% while Gambians formed 77.0%. Commonest specialties chosen by females were Obstetrics/Gynaecology, Paediatrics and Surgery in that order, while males preferred Internal Medicine, Surgery and Obstetrics/Gynaecology. Commonest factors influencing choices by females were ‘focus on urgent care’ (65.5%) and ‘intellectual content of specialty’ (56.9%). For males, these were ‘intellectual content of specialty’ (60.4%) and ‘focus on urgent care’ / ‘individual’s competence’ (50.0% each). More females (30.0%) than males (23.0%) had ever received career counseling, but all students desired it. Conclusions Significant gender differences exist in specialty choices and factors influencing these choices amongst these students. All want career counseling. PMID:22873698

  13. The relationship between direct-care RN specialty certification and surgical patient outcomes.

    PubMed

    Boyle, Diane K; Cramer, Emily; Potter, Catima; Gatua, Mary W; Stobinski, James X

    2014-11-01

    Specialty certification enhances patient safety in health care by validating that practice is consistent with standards of excellence. The purpose of this research was to explore the relationship between direct-care, specialty-certified nurses employed in perioperative units, surgical intensive care units (SICUs), and surgical units and nursing-sensitive patient outcomes in SICUs and surgical units. Lower rates of central-line-associated bloodstream infections in SICUs were significantly associated with higher rates of CPAN (certified postanesthesia nurse) (β = -0.09, P = .05) and CNOR/CRNFA (certified nurse operating room/certified RN first assistant) (β = -0.17, P = .00) certifications in perioperative units. Unexpectedly, higher rates of CNOR/CRNFA certification in perioperative units were associated with higher rates of hospital-acquired pressure ulcers (β = 0.08, P = .03) and unit-acquired pressure ulcers (β = 0.13, P = .00), possibly because of a higher risk of pressure ulcers in the patient population. Additional research is needed to clarify this relationship. Our findings lend credence to perioperative, SICU, and surgical nurses participating in lifelong learning and continuous professional development, including achievement of specialty certification. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  14. Spatial Patterns of Sea Level Variability Associated with Natural Internal Climate Modes

    NASA Astrophysics Data System (ADS)

    Han, Weiqing; Meehl, Gerald A.; Stammer, Detlef; Hu, Aixue; Hamlington, Benjamin; Kenigson, Jessica; Palanisamy, Hindumathi; Thompson, Philip

    2016-10-01

    Sea level rise (SLR) can exert significant stress on highly populated coastal societies and low-lying island countries around the world. Because of this, there is huge societal demand for improved decadal predictions and future projections of SLR, particularly on a local scale along coastlines. Regionally, sea level variations can deviate considerably from the global mean due to various geophysical processes. These include changes of ocean circulations, which partially can be attributed to natural, internal modes of variability in the complex Earth's climate system. Anthropogenic influence may also contribute to regional sea level variations. Separating the effects of natural climate modes and anthropogenic forcing, however, remains a challenge and requires identification of the imprint of specific climate modes in observed sea level change patterns. In this paper, we review our current state of knowledge about spatial patterns of sea level variability associated with natural climate modes on interannual-to-multidecadal timescales, with particular focus on decadal-to-multidecadal variability. Relevant climate modes and our current state of understanding their associated sea level patterns and driving mechanisms are elaborated separately for the Pacific, the Indian, the Atlantic, and the Arctic and Southern Oceans. We also discuss the issues, challenges and future outlooks for understanding the regional sea level patterns associated with climate modes. Effects of these internal modes have to be taken into account in order to achieve more reliable near-term predictions and future projections of regional SLR.

  15. Psychosocial Factors Associated with Bulimia Nervosa during Pregnancy: An Internal Validation Study

    PubMed Central

    Watson, Hunna J.; Von Holle, Ann; Knoph, Cecilie; Hamer, Robert M.; Torgersen, Leila; Reichborn-Kjennerud, Ted; Stoltenberg, Camilla; Magnus, Per; Bulik, Cynthia M.

    2014-01-01

    Objective The aim of this paper was to internally validate previously reported relations (1) between psychosocial factors and bulimia nervosa (BN) outcomes during pregnancy. Method This study is based on the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Participants were women enrolled during pregnancy (N = 69,030). Internal validity was evaluated by way of bootstrapped parameter estimates using the overall sample and a split sample calibration approach. Results Bootstrap bias estimates were below the problematic threshold, and extend earlier findings(1) by providing support for the validity of the models at the population level of all pregnant women in Norway. Bootstrap risk ratios indicated that prevalence, incidence, and remission of BN during pregnancy were significantly associated with psychosocial factors. The split sample procedure showed that the models developed on the training sample did not predict risks in the validation sample. Discussion This study characterizes associations between psychosocial exposures and BN outcomes among pregnant women in Norway. Women with lifetime and current self-reported psychosocial adversities were at a much higher risk for BN during pregnancy. Psychosocial factors were associated with BN remission during pregnancy, inviting the prospect of enhancing therapeutic interventions. We consider the findings in the context of reproducibility in science. PMID:25346291

  16. Associations between family religious practices, internalizing/externalizing behaviors, and body mass index in obese youth.

    PubMed

    Limbers, Christine A; Young, Danielle; Bryant, William; Stephen, Matthew

    2015-01-01

    The objective of the present study was to assess the associations among family religious practices, internalizing/externalizing behaviors, and body mass index in a sample of severely obese youth referred to an outpatient pediatric endocrinology clinic. The sample consisted of 43 obese youth (body mass index > 95th percentile) aged 6-16 years (mean age = 12.67 years). Approximately 93% of families endorsed their religious faith as Christian or Catholic. Parents of youth were administered a demographic questionnaire, religiosity questionnaire, and the Child Behavior Checklist. Three multiple linear regression models were examined with body mass index percentile, Child Behavior Checklist Internalizing Scale, and Child Behavior Checklist Externalizing Scale as outcome variables. A parent endorsing greater importance of religious faith in shaping family life was associated with lower child body mass index percentile (p < 0.05) in the present sample. Greater family attendance at religious services was associated with higher child body mass index percentile (p < 0.05). Our data suggest that church-based interventions may be one viable option for the delivery of lifestyle interventions in families of youth with severe obesity. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  17. Spatial Patterns of Sea Level Variability Associated with Natural Internal Climate Modes

    NASA Astrophysics Data System (ADS)

    Han, Weiqing; Meehl, Gerald A.; Stammer, Detlef; Hu, Aixue; Hamlington, Benjamin; Kenigson, Jessica; Palanisamy, Hindumathi; Thompson, Philip

    2017-01-01

    Sea level rise (SLR) can exert significant stress on highly populated coastal societies and low-lying island countries around the world. Because of this, there is huge societal demand for improved decadal predictions and future projections of SLR, particularly on a local scale along coastlines. Regionally, sea level variations can deviate considerably from the global mean due to various geophysical processes. These include changes of ocean circulations, which partially can be attributed to natural, internal modes of variability in the complex Earth's climate system. Anthropogenic influence may also contribute to regional sea level variations. Separating the effects of natural climate modes and anthropogenic forcing, however, remains a challenge and requires identification of the imprint of specific climate modes in observed sea level change patterns. In this paper, we review our current state of knowledge about spatial patterns of sea level variability associated with natural climate modes on interannual-to-multidecadal timescales, with particular focus on decadal-to-multidecadal variability. Relevant climate modes and our current state of understanding their associated sea level patterns and driving mechanisms are elaborated separately for the Pacific, the Indian, the Atlantic, and the Arctic and Southern Oceans. We also discuss the issues, challenges and future outlooks for understanding the regional sea level patterns associated with climate modes. Effects of these internal modes have to be taken into account in order to achieve more reliable near-term predictions and future projections of regional SLR.

  18. Personal values related to primary care specialty aspirations.

    PubMed

    Schubot, D B; Cayley, W; Eliason, B C

    1996-01-01

    Two recent studies showed that personal values influence specialty choice. However, both studies assessed the perceived influence of values instead of measuring values directly. The present study measured and compared the values of aspirants to primary care versus other specialties. In 1993, first-year medical students, entering residents, and graduating residents at a private Midwestern medical school completed a questionnaire on their specialty aspirations and completed the Schwartz Values Survey, which measures the importance of 10 types of values: achievement, benevolence, conformity, hedonism, power, security, self-direction, stimulation, tradition, and universalism. A three-factor MANOVA (specialty aspiration, gender, level of training) was performed on the importance ratings. The three MANOVA main effects were significant. Primary care aspirants rated power and self-direction values lower and benevolence values higher than did aspirants to other specialties. Women gave higher ratings to universalism and benevolence and lower ratings to power, tradition, and conformity values than did men. Medical students rated security values lower than did the two resident groups. This study demonstrates the relationship of personal values and specialty choice and provides empirical support for admissions policies that incorporate personal values into the admissions process.

  19. Specialty pharmacy cost management strategies of private health care payers.

    PubMed

    Stern, Debbie; Reissman, Debi

    2006-01-01

    The rate of increase in spending on specialty pharmaceuticals is outpacing by far the rate of increase in spending for other drugs. To explore the strategies payers are using in response to challenges related to coverage, cost, clinical management, and access of specialty pharmaceuticals and to describe the potential implications for key stakeholders, including patients, physicians, and health care purchasers. Sources of information were identified in the course of providing consulting services in the subject area of specialty pharmaceuticals to health plans, pharmacy benefit managers, employers, and pharmaceutical manufacturers. Specialty pharmaceuticals represent the fastest growing segment of drug spending due to new product approvals, high unit costs, and increasing use. Health care payers are faced with significant challenges related to coverage, cost, clinical management, and access. A variety of short- and long-term strategies have been employed to address these challenges. Current management techniques for specialty pharmaceuticals often represent a stop-gap approach for controlling rising drug costs. Optimum cost and care management methods will evolve as further research identifies the true clinical and economic value of various specialty pharmaceuticals.

  20. Challenges in referral communication between VHA primary care and specialty care.

    PubMed

    Zuchowski, Jessica L; Rose, Danielle E; Hamilton, Alison B; Stockdale, Susan E; Meredith, Lisa S; Yano, Elizabeth M; Rubenstein, Lisa V; Cordasco, Kristina M

    2015-03-01

    Poor communication between primary care providers (PCPs) and specialists is a significant problem and a detriment to effective care coordination. Inconsistency in the quality of primary-specialty communication persists even in environments with integrated delivery systems and electronic medical records (EMRs), such as the Veterans Health Administration (VHA). The purpose of this study was to measure ease of communication and to characterize communication challenges perceived by PCPs and primary care personnel in the VHA, with a particular focus on challenges associated with referral communication. The study utilized a convergent mixed-methods design: online cross-sectional survey measuring PCP-reported ease of communication with specialists, and semi-structured interviews characterizing primary-specialty communication challenges. 191 VHA PCPs from one regional network were surveyed (54% response rate), and 41 VHA PCPs and primary care staff were interviewed. PCP-reported ease of communication mean score (survey) and recurring themes in participant descriptions of primary-specialty referral communication (interviews) were analyzed. Among PCPs, ease-of-communication ratings were highest for women's health and mental health (mean score of 2.3 on a scale of 1-3 in both), and lowest for cardiothoracic surgery and neurology (mean scores of 1.3 and 1.6, respectively). Primary care personnel experienced challenges communicating with specialists via the EMR system, including difficulty in communicating special requests for appointments within a certain time frame and frequent rejection of referral requests due to rigid informational requirements. When faced with these challenges, PCPs reported using strategies such as telephone and e-mail contact with specialists with whom they had established relationships, as well as the use of an EMR-based referral innovation called "eConsults" as an alternative to a traditional referral. Primary-specialty communication is a continuing

  1. The Impact of a Rural Training Track on Medical Students Specialty Choice.

    PubMed

    Jensen, Brooke; Anderson, Susan M; Simanton, Edward

    2017-06-01

    Compare the expectations and outcomes of students involved in rural medical training versus those of urban trainees. Survey items relating to primary care interest were added to program evaluation surveys already being sent at the beginning and end of the primary clinical year. Students from the graduating class of 2016 and the class of 2017 responded to the surveys (N=115). Responses from students trained in rural sites were compared with students trained in medium or large communities. For the purposes of the survey, primary care was not specifically defined and was open to participants' interpretation. Primary care is commonly thought of as the medical care from the doctor who sees a patient first and provides treatment or decides the other specialist care that the patient may need. Primary care specialties can include family medicine, internal medicine, pediatrics and obstetrics and gynecology. Most students enter their primary clinical year undecided about specialty choice and preferred practice location. At the end of the primary clinical year, most students have decided on a specialty and most report wanting to practice in communities similar to where they trained during that year. Before the primary clinical year student attitudes toward primary care are not significantly different based on selected training site. However at the end of the primary clinical year, students who had been trained in small communities were significantly more likely to choose primary care compared with students trained in medium to large communities. For students who begin the primary clinical year undecided regarding specialty choice, and practice location, the community size of the training site plays a large role in the decisions they will make. A majority of students trained in small communities chose to go into primary care and practice in small communities.

  2. What Factors Are Associated With Femoral Component Internal Rotation in TKA Using the Gap Balancing Technique?

    PubMed

    Lee, Seung-Yup; Lim, Hong-Chul; Jang, Ki-Mo; Bae, Ji-Hoon

    2017-08-01

    When using the gap-balancing technique for TKA, excessive medial release and varus proximal tibial resection can be associated with internal rotation of the femoral component. Previous studies have evaluated the causes of femoral component rotational alignment with a separate factor analysis using unadjusted statistical methods, which might result in treatment effects being attributed to confounding variables. (1) What pre- and intraoperative factors are associated with internal rotation of the femoral component in TKA using the gap balancing technique? (2) To what degree does femoral component rotation as defined by the navigation system differ from rotation as measured by postoperative CT? Three hundred seventy-seven knees that underwent computer-assisted primary TKA attributable to degenerative osteoarthritis with varus or mild valgus alignment in which medial soft tissue release was performed, and those with preoperative radiographs including preoperative CT between October 2007 and June 2014 were included in the study. To achieve a balanced mediolateral gap, the structures released during each medial release step were as follows: Step 1, deep medial collateral ligament (MCL); Step 2, superficial MCL (proximal, above the pes anserine tendon) and semimembranosus tendon; and Step 3, the superficial MCL (distal, below the pes anserine tendon). Knees with internal rotation of the femoral component, which was directed by navigation, to achieve a rectangular mediolateral flexion gap were considered cases, and knees without internally rotated femoral components were considered controls. Univariable analysis of the variables (age, sex, BMI, operated side, preoperative hip-knee-ankle angle, preoperative medial proximal tibial angle, preoperative rotation degree of the clinical transepicondylar axis [TEA] relative to the posterior condylar axis [PCA], coronal angle of resected tibia, resection of the posterior cruciate ligament, type of prosthesis, and extent of medial

  3. INVASIVESNET towards an International Association for Open Knowledge on Invasive Alien Species

    USGS Publications Warehouse

    Lucy, Frances E; Roy, Helen; Simpson, Annie; Carlton, James T.; Hanson, John Mark; Magellan, Kit; Campbell, Marnie L.; Costello, Mark J.; Pagad, Shyama; Hewitt, Chad L; McDonald, Justin; Cassey, Phillip; Thomaz, Sidinei M; Katsanevakis, Stelios; Zenetos, Argyro; Tricarico, Elena; Boggero, Angela; Groom, Quentin J; Adriaens, Tim; Vanderhoeven, Sonia; Torchin, Mark E.; Hufbauer, Ruth A.; Fuller, Pam; Carman, Mary R; Conn, David Bruce; Vitule, Jean R. S.; Canning-Clode, João; Galil, Bella S; Ojaveer, Henn; Bailey, Sarah A; Therriault, Thomas W; Claudi, Renata; Gazda, Anna; Dick, Jaimie T A; Caffrey, Joe; Witt, Arne; Kenis, Marc; Lehtiniemi, Maiju; Helmisaari, Harry; Panov, Vadim E

    2016-01-01

    To date, the sustainability of many strategic national and international initiatives on IAS have unfortunately been hampered by time-limited grants or funding cycles. Recognising that IAS initiatives need to be globally coordinated and ongoing, we aim to develop a sustainable knowledge sharing association to connect the outputs of IAS research and to inform the consequential management and societal challenges arising from IAS introductions. INVASIVESNET will provide a dynamic and enduring network of networks to ensure the continuity of connections among the IAS community of practice, science and management.

  4. Congenital Horner Syndrome with Heterochromia Iridis Associated with Ipsilateral Internal Carotid Artery Hypoplasia

    PubMed Central

    Coulier, Julie; Rommel, Denis; Boschi, Antonella

    2015-01-01

    Background Horner syndrome (HS), also known as Claude-Bernard-Horner syndrome or oculosympathetic palsy, comprises ipsilateral ptosis, miosis, and facial anhidrosis. Case Report We report herein the case of a 67-year-old man who presented with congenital HS associated with ipsilateral hypoplasia of the internal carotid artery (ICA), as revealed by heterochromia iridis and confirmed by computed tomography (CT). Conclusions CT evaluation of the skull base is essential to establish this diagnosis and distinguish aplasia from agenesis/hypoplasia (by the absence or hypoplasia of the carotid canal) or from acquired ICA obstruction as demonstrated by angiographic CT. PMID:25749818

  5. Specialty Preferences of Physicians and Medical Students

    ERIC Educational Resources Information Center

    Gough, Harrison G.

    1975-01-01

    Family and internal medicine were rated high by the groups studied. Neurological and colon-rectal surgery were rated low. Males gave higher ratings to surgical specialities, whereas females express stronger preferences for obstetrics and gynecology. (Author/KE)

  6. Specialty Preferences of Physicians and Medical Students

    ERIC Educational Resources Information Center

    Gough, Harrison G.

    1975-01-01

    Family and internal medicine were rated high by the groups studied. Neurological and colon-rectal surgery were rated low. Males gave higher ratings to surgical specialities, whereas females express stronger preferences for obstetrics and gynecology. (Author/KE)

  7. Racial disparities across provider specialties in opioid prescriptions dispensed to Medicaid beneficiaries with chronic non-cancer pain

    PubMed Central

    Ringwalt, Chris; Roberts, Andrew W.; Gugelmann, Hallam; Skinner, Asheley Cockrell

    2016-01-01

    Objective Chronic pain affects both psychological and physical functioning, and is responsible for more than $60 billion in lost productivity annually in the United States. Although previous studies have demonstrated racial disparities in opioid treatment, there is little evidence regarding disparities in treatment of chronic non-cancer pain (CNCP) and the role of physician specialty. Design A retrospective cohort study. Setting We analyzed North Carolina Medicaid claims data, from July 1, 2009 to May 31, 2010, to examine disparities by different provider specialties in beneficiaries dispensed prescriptions for opioids. Subjects The population included White and Black North Carolina Medicaid beneficiaries with CNCP (n=75,458). Methods We used bivariate statistics and logistic regression analysis to examine race-based discrepancies in opioid prescribing by physician specialty. Results Compared to White beneficiaries with CNCP (n=49,197), Black beneficiaries (n=26,261) were less likely [OR 0.91 (CI: 0.88–0.94)] to fill an opioid prescription. Our hypothesis was partially supported: we found that race-based differences in beneficiaries dispensed opioid prescriptions were more prominent in certain specialties. In particular, these differences were most salient among patients of specialists in obstetrics and gynecology [OR 0.78 (CI: 0.67–0.89)] and internal medicine [OR 0.86 (CI: 0.79–0.92)], as well as general practitioners/family medicine physicians [OR 0.91 (CI: 0.85–0.97)]. Conclusions Our findings suggest that, in our study population, Black beneficiaries with CNCP are less likely than Whites to fill prescriptions for opioid analgesics as a function of their provider’s specialty. Although race-based differences in patients filling opioid prescriptions have been noted in previous studies, this is the first study that clearly demonstrates these disparities by provider specialty. PMID:25287703

  8. Do Legal Issues Deserve Space in Specialty Medical Journals ?

    PubMed

    Nagpal, Neeraj

    2016-02-01

    Physicians and Internists in India have tended to brush under the carpet legal issues affecting their profession. Of concern to all Physicians is the judgment in a recent case where the NCDRC has stated that if MD Medicine Physicians write Physician & Cardiologist on their letterhead it is Quackery. What is MD Medicine degree holder in India qualified and trained to treat ? These are issues which need debate and that can only be initiated once we recognize that there is a problem. Either an MD Medicine is a cardiologist or he is not. If he is then it is the bounded duty of the Association of Physicians of India to challenge this judgment in a higher court of law and seek clear guidelines from MCI as well as Supreme Court on the issue. Editors of Specialty journals have a responsibility of selecting the best articles from those which are submitted to them to be published. Ultimately space in these journals is limited and hence the responsibility to select is enormous and simultaneously reason for rejection of an academic paper also has to be substantial. The question is "do issues which are not core to the specialty concerned deserve space in these?" Physicians and Internists in India have tended to brush under the carpet legal issues effecting their profession. Surgical specialties specially obstetricians and their associations have to some extent recognized the problem and taken steps to address the issue specially as regard PCPNDT Act.1 Physicians are more complacent and regard the Consumer Protection Act (CPA) 19862 and problems associated with it to primarily concern the surgical specialties. What is forgotten is that the maximum penalty of 6.08 crore plus interest of 5.5 cr has been awarded in case involving a patient treated primarily by a physician and on whom no surgical procedure was performed.3 It has also to be realized that there is no limit on the amount of compensation which can be asked for under CPA.2 Compensations have been awarded by National

  9. Specialty drug coupons lower out-of-pocket costs and may improve adherence at the risk of increasing premiums.

    PubMed

    Starner, Catherine I; Alexander, G Caleb; Bowen, Kevin; Qiu, Yang; Wickersham, Peter J; Gleason, Patrick P

    2014-10-01

    Expenditures for specialty drugs account for more than 25 percent of total US drug spending and have been increasing at more than 13 percent annually. We examined insurers' role in maintaining the affordability and accessibility of specialty drugs while maximizing their value. We conducted two analyses: one using an administrative claims database with information on more than ten million commercially insured patients and another using the same database combined with the drug prescription records from a specialty pharmacy. First, we examined the prevalence of specialty drug coupons and the degree to which these reduced patients' out-of-pocket costs, focusing on 264,801 prescriptions. Second, we quantified the association between the magnitude of out-of-pocket costs for specialty drugs and patients' abandonment of their new or restarted therapy, focusing on a group of nearly 16,000 patients. We found that drug coupons accounted for $21.2 million of patients' $35.3 million annual out-of-pocket costs. In the vast majority of cases, coupons reduced monthly cost sharing to less than $250, a point at which patients were far less likely to abandon therapy with biologic anti-inflammatory drugs or with drugs for multiple sclerosis. However, by reducing cost sharing, coupons may also circumvent efforts to encourage patients to use the most cost-effective drugs. Project HOPE—The People-to-People Health Foundation, Inc.

  10. [Prevalence and factors associated with clinical counselling on drug use among internal specialists residents of Andalusia (Spain)].

    PubMed

    Juárez-Jiménez, María de la Villa; Pérez-Milena, Alejandro; Valverde-Bolívar, Francisco Javier; Rosa-Garrido, Carmen

    2015-12-01

    To determine the frequency of offering clinical counseling against the consumption of alcohol, tobacco and illegal drugs by internal specialist residents (EIR) of Andalusia, and the factors related to such advice. Multicenter cross-sectional study by self-administered questionnaire sent by mail. EIR of Andalusia. The questionnaire collected the frequency of counseling against the use of alcohol, tobacco and illegal drugs (dependent variable). age/gender, specialty, drug consumption and Fagerström test. Out of a total of 4245 participants, 66% responded, 29% did not respond, and 5% poorly completed questionnaires. The mean age was 29.1(±SD 5.1) years, 69% female, 89% Spanish nationality, 84% in medical training (73% hospital, 27% family medicine). The frequency of counseling against tobacco (85%) and alcohol (82%) is higher than illegal drugs (56%, p<.001, χ(2) test). Counseling against alcohol consumption is related to family medicine (OR=2.8; 95% CI [1.4-4.6]) and nursing (OR=2.5 [1.7-4.4]), and the age of first alcohol consumption (OR=1.07 [1.03-1.1]). Counseling against smoking is related to family medicine (OR=12.9;[7.6-21.9]) and nursing (OR=8.4;[4.3-16.5]), personal consumption of tobacco (OR=1.5 [1.2-2.0]), and wine (OR=1.1 [1.04-1.3]), and age of first alcohol consumption (OR=1.06 [1.01-1.1]). Counseling against illegal drugs is related to the age of first alcohol consumption (OR=1.09 [1.05-1.1]) and smoking (OR=.58 [.4-.7]). There is a high frequency of counseling against consumption of tobacco and alcohol by EIR, although remarkably smaller for illegal drugs. The influencing factors are both formative elements of their own specialty such as personal consumption of alcohol and tobacco, which should be considered for improvement of this preventive activity. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  11. Mapping turbulent diffusivity associated with oceanic internal lee waves offshore Costa Rica

    NASA Astrophysics Data System (ADS)

    Fortin, Will F. J.; Holbrook, W. Steven; Schmitt, Raymond W.

    2016-04-01

    Breaking internal waves play a primary role in maintaining the meridional overturning circulation. Oceanic lee waves are known to be a significant contributor to diapycnal mixing associated with internal wave dissipation, but direct measurement is difficult with standard oceanographic sampling methods due to the limited spatial extent of standing lee waves. Here, we present an analysis of oceanic internal lee waves observed offshore eastern Costa Rica using seismic imaging and estimate the turbulent diffusivity via a new seismic slope spectrum method that extracts diffusivities directly from seismic images, using tracked reflections only to scale diffusivity values. The result provides estimates of turbulent diffusivities throughout the water column at scales of a few hundred meters laterally and 10 m vertically. Synthetic tests demonstrate the method's ability to resolve turbulent structures and reproduce accurate diffusivities. A turbulence map of our seismic section in the western Caribbean shows elevated turbulent diffusivities near rough seafloor topography as well as in the mid-water column where observed lee wave propagation terminates. Mid-water column hotspots of turbulent diffusivity show levels 5 times higher than surrounding waters and 50 times greater than typical open-ocean diffusivities. This site has steady currents that make it an exceptionally accessible laboratory for the study of lee-wave generation, propagation, and decay.

  12. Lung cancer and DNA repair genes: multilevel association analysis from the International Lung Cancer Consortium

    PubMed Central

    Kazma, Rémi; Babron, Marie-Claude; Gaborieau, Valérie; Génin, Emmanuelle; Brennan, Paul; Hung, Rayjean J.; McLaughlin, John R.; Krokan, Hans E.; Elvestad, Maiken B.; Skorpen, Frank; Anderssen, Endre; Vooder, Tõnu; Välk, Kristjan; Metspalu, Andres; Field, John K.; Lathrop, Mark; Sarasin, Alain; Benhamou, Simone

    2012-01-01

    Lung cancer (LC) is the leading cause of cancer-related death worldwide and tobacco smoking is the major associated risk factor. DNA repair is an important process, maintaining genome integrity and polymorphisms in DNA repair genes may contribute to susceptibility to LC. To explore the role of DNA repair genes in LC, we conducted a multilevel association study with 1655 single nucleotide polymorphisms (SNPs) in 211 DNA repair genes using 6911 individuals pooled from four genome-wide case–control studies. Single SNP association corroborates previous reports of association with rs3131379, located on the gene MSH5 (P = 3.57 × 10-5) and returns a similar risk estimate. The effect of this SNP is modulated by histological subtype. On the log-additive scale, the odds ratio per allele is 1.04 (0.84–1.30) for adenocarcinomas, 1.52 (1.28–1.80) for squamous cell carcinomas and 1.31 (1.09–1.57) for other histologies (heterogeneity test: P = 9.1 × 10−3). Gene-based association analysis identifies three repair genes associated with LC (P < 0.01): UBE2N, structural maintenance of chromosomes 1L2 and POLB. Two additional genes (RAD52 and POLN) are borderline significant. Pathway-based association analysis identifies five repair pathways associated with LC (P < 0.01): chromatin structure, DNA polymerases, homologous recombination, genes involved in human diseases with sensitivity to DNA-damaging agents and Rad6 pathway and ubiquitination. This first international pooled analysis of a large dataset unravels the role of specific DNA repair pathways in LC and highlights the importance of accounting for gene and pathway effects when studying LC. PMID:22382497

  13. 15 CFR 2011.205 - Application for a specialty sugar certificate.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 15 Commerce and Foreign Trade 3 2012-01-01 2012-01-01 false Application for a specialty sugar... SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.205 Application for a specialty sugar certificate. Applicants for certificates for the import of specialty sugars must apply in writing to the Certifying...

  14. 15 CFR 2011.205 - Application for a specialty sugar certificate.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 15 Commerce and Foreign Trade 3 2013-01-01 2013-01-01 false Application for a specialty sugar... SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.205 Application for a specialty sugar certificate. Applicants for certificates for the import of specialty sugars must apply in writing to the Certifying...

  15. 15 CFR 2011.205 - Application for a specialty sugar certificate.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Application for a specialty sugar... SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.205 Application for a specialty sugar certificate. Applicants for certificates for the import of specialty sugars must apply in writing to the Certifying...

  16. 15 CFR 2011.205 - Application for a specialty sugar certificate.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Application for a specialty sugar... SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.205 Application for a specialty sugar certificate. Applicants for certificates for the import of specialty sugars must apply in writing to the Certifying...

  17. 15 CFR 2011.205 - Application for a specialty sugar certificate.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 3 2014-01-01 2014-01-01 false Application for a specialty sugar... SUGARS, SYRUPS AND MOLASSES Specialty Sugar § 2011.205 Application for a specialty sugar certificate. Applicants for certificates for the import of specialty sugars must apply in writing to the Certifying...

  18. 77 FR 6531 - Notice of Funds Availability (NOFA) Inviting Applications for the Specialty Crop Block Grant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-08

    ...) 2012, to solely enhance the competitiveness of specialty crops. SCBGP-FB funds are authorized by the... INFORMATION: SCBGP-FB is authorized under Section 101 of the Specialty Crops Competitiveness Act of 2004 (7 U... the competitiveness of U.S. specialty crops. Specialty crops are defined as fruits and...

  19. 78 FR 27178 - Notice of Funds Availability (NOFA) Inviting Applications for the Specialty Crop Block Grant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-09

    ... competitiveness of specialty crops. SCBGP-FB funds are authorized by Section 701 of the American Taxpayer Relief...: SCBGP-FB is authorized under Section 101 of the Specialty Crops Competitiveness Act of 2004 (7 U.S.C... competitiveness of U.S. specialty crops. Specialty crops are defined as fruits and vegetables, dried fruit,...

  20. 16 CFR 300.18 - Use of name of specialty fiber.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Use of name of specialty fiber. 300.18... specialty fiber. (a) In setting forth the required fiber content of a product containing any of the specialty fibers named in Section 2(b) of the Act, the name of the specialty fiber present may be used...