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

PubMed

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

2015-10-27

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

Chronically ill Canadians' experiences of being unattached to a family doctor: a qualitative study of marginalized patients in British Columbia.

PubMed

Crooks, Valorie A; Agarwal, Gina; Harrison, Angela

2012-07-16

Unattached patients do not have a regular primary care provider. Initiatives are being developed to increase attachment rates across Canada. Most existing attention paid to patient unattachment has focused on quantifying the problem and health system costs. Our purpose is to qualitatively identify the implications of chronically ill patients' experiences of unattachment for health policy and planning to provide policy-relevant insights for Canadian attachment initiatives. Three focus groups were conducted with marginalized chronically ill individuals residing in a mid-sized city in British Columbia who are unattached to a family doctor. We use the term marginalized as a descriptor to acknowledge that by virtue of their low socio-economic status and lack of attachment the participants are marginalized in Canada's health care system Focus groups were structured as an open conversation organized around a series of probing questions. They were digitally recorded and transcribed verbatim. Thematic analysis was employed. Twenty-six individuals participated in the focus groups. The most common chronic illnesses reported were active drug addiction or recovery (and their associated symptoms), depression, arthritis, and hepatitis C. Participants identified life transitions as being the root cause for not having a family doctor. There was a strong sense that unsuccessful attempts to get a family doctor reflected that they were undesirable patients. Participants wanted to experience having a trusting relationship with a regular family doctor as they believed it would encourage greater honesty and transparency. One of the main health concerns regarding lack of access to a regular family doctor is that participants lacked access to preventative care. Participants were also concerned about having a discontinuous medical record due to unattachment. Participants perceived that there are many benefits to be had by having attachment to a regular family doctor and that experiencing

Medical encounters and exchange in early Canadian missions.

PubMed

Parsons, Chris

2008-01-01

The exchange of medical and pharmaceutical knowledge was an important facet of the encounter between native and newcomer in early Canada. Throughout New France Récollet and Jesuit missionaries were given privileged access both to indigenous peoples and indigenous plants. Curiously, however, when it came to describing medical treatments, it was people, rather than medicinal plants, that were targets of what might be called "the descriptive enterprise." Attempting to divide suspect shamanic remedies from those deemed natural, missionary observers carefully documented the context of medical treatments rather than simply the specific remedy applied for treatment. Using records left by early Canadian missionaries this paper will look at the peculiar character of medical exchange in the missions of seventeenth and eighteenth-century New France to look at the interpersonal encounters that formed a constitutive element of colonial botany and framed the way in which indigenous knowledge was represented to metropolitan audiences.

[Development of modern medical doctors in Japan from late Edo to early Meiji].

PubMed

Kim, OckJoo; Takuya, Miyagawa

2011-12-31

Western medicine began to be introduced to Japan since late 16th century. Japanese encounter with Western medicine centered on Dejima in Nagasaki in the seventeenth and eighteenth century and the initial process of introduction was gradual and slow. In the mid-nineteenth century, facing threats from Western countries, Tokugawa bakufu asked Dutch naval surgeon, J. L. C. Pompe van Meerdervoort to teach western medicine at the Kaigun Denshujo naval academy in Nagasaki. The government also supported the western medical school in Edo. This paper deals with how modern western medical doctors were developed in Japan from late Edo to early Meiji. The publication of the New Text on Anatomy in 1774 translated by Sugita Genpaku and his colleagues stimulated Japanese doctors and scholars to study western medicine, called Rangaku. During the Edo period, western medicine spread into major cities and countryside in Japan through Rangaku doctors. In 1838, for example, Dr. Ogata Koan established the Rangaku school named Tekijuku and educated many people with western medicine. When smallpox vaccination was introduced in Japan in 1849, Rangaku doctors played an important role in practiving the vaccination in cities and in countryside. After the Edo bakufu and the feudal lords of han(han) actively pursued to introduce western medicine to their hans by sending their Samurai to Edo or Nagasaki or abroad and by establishing medical schools and hospitals until their abolition in 1871. In late Edo and early Meiii military doctors were the main focus of training to meet the urgent need of military doctors in the battle fields of civil wars. The new Meiji government initiated a series of top-down reformations concerning army recruitment, national school system, public health and medical system. In 1874, the government introduced a law on medicine to adopt western medicine only and to launch a national licence system for medical doctors. Issuing supplementary regulations in the following

Helping Doctoral Students Teach: Transitioning to Early Career Academia through Cognitive Apprenticeship

ERIC Educational Resources Information Center

Greer, Dominique A.; Cathcart, Abby; Neale, Larry

2016-01-01

Doctoral training is strongly focused on honing research skills at the expense of developing teaching competency. As a result, emerging academics are unprepared for the pedagogical requirements of their early-career academic roles. Employing an action research approach, this study investigates the effectiveness of a competency-based teaching…

Canadian Early-Childhood Educators' Perceptions of Children's Gendered Shy, Aggressive, and Prosocial Behaviors

ERIC Educational Resources Information Center

Woods, Heather; Bosacki, Sandra; Coplan, Robert J.

2016-01-01

Early childhood educators' (ECE) perceptions of gender roles may contribute to the development of children's own gender-role identities. This qualitative study examined 40 Canadian female ECEs' perceptions of gender and children's shy, aggressive, and prosocial behaviors. Content analysis of extensive interviews revealed three themes: (1) shyness…

Early Mentoring of Medical Students and Junior Doctors on a Path to Academic Cardiothoracic Surgery.

PubMed

Fricke, Tyson A; Lee, Melissa G Y; Brink, Johann; d'Udekem, Yves; Brizard, Christian P; Konstantinov, Igor E

2018-01-01

In 2005 the Department of Cardiothoracic Surgery at The Royal Children's Hospital started an early academic mentoring program for medical students and junior doctors with the aim of fostering an interest in academic surgery. Between 2005 and 2015, 37 medical students and junior doctors participated in research in the Department of Cardiothoracic Surgery at The Royal Children's Hospital. Each was given an initial project on which to obtain ethics approval, perform a literature review, data collection, statistical analysis, and prepare a manuscript for publication. A search of the names of these former students and doctors was conducted on PubMed to identify publications. A total of 113 journal articles were published in peer-reviewed journals with an average impact factor of 4.1 (range, 1.1 to 19.9). Thirty (30 of 37, 81%) published at least one article. A mean of 4.3 journal articles was published per student or junior doctor (range, 0 to 29). Eleven (11 of 37, 30%) received scholarships for their research. Nine (9 of 37, 24%) have completed or are enrolled in higher research degrees with a cardiothoracic surgery focus. Of these 9, 2 have completed doctoral degrees while in cardiothoracic surgery training. Five will complete their cardiothoracic surgery training with a doctoral degree and the other 2 are pursuing training in cardiology. A successful early academic mentoring program in a busy cardiothoracic surgery unit is feasible. Mentoring of motivated individuals in academic surgery benefits not only their medical career, but also helps maintain high academic output of the unit. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

The Struggle to Make Sense of Doctoral Study

ERIC Educational Resources Information Center

Acker, Sandra; Haque, Eve

2015-01-01

Semi-structured, qualitative interviews conducted with an ethno-culturally diverse group of 27 doctoral students in one Canadian university department produced narratives that often featured stories of stress and struggle. Two interrelated themes emerging from the data are highlighted here: surviving financially and dealing with divisions and…

Senior doctor triage (SDT), a qualitative study of clinicians' views on senior doctors' involvement in triage and early assessment of emergency patients.

PubMed

Abdulwahid, Maysam Ali; Turner, Janette; Mason, Suzanne M

2018-07-01

Despite the focus during the last decade on introducing interventions such as senior doctor initial assessment or senior doctor triage (SDT) to reduce emergency department (ED) crowding, there has been little attempt to identify the views of emergency healthcare professionals on such interventions. The aim of this study was to gain an understanding of SDT from the perspective of emergency hospital staff. A secondary aim of this study was to develop a definition of SDT based on the interview findings and the available literature on this process. Qualitative semi-structured telephone interviews were conducted with participants of different backgrounds including senior doctors, nurses, paramedics and ED managers. Textual data were analysed using a template analysis approach. 27 participants from 13 EDs across England were interviewed. SDT was viewed as a safety mechanism and a measure to control patient flow. The most prominent positive aspect was the ability to initiate early investigations and treatment. Various shortcomings of SDT were described such as the lack of standardisation of the process and its cost implications. Participants identified a number of barriers to this process including insufficient resources and exit block, and called for solutions focused on these issues. A proposed definition of an 'ideal' SDT was developed where it is described as a systematic brief assessment of patients arriving at the ED by a senior doctor-led team, which takes place in a dedicated unit. The aim of this assessment is to facilitate early investigation and management of patients, early patient disposition and guide junior staff to deliver safe and high-quality clinical care. This is the first national study to explore the opinions of various emergency and managerial staff on the SDT model. It revealed variable interpretations of this model and what it can and cannot offer. This has led to a standard definition of the SDT process, which can be useful for clinicians and

The ethics and economics of consuming Canadian drugs.

PubMed

Seaman, Rachel M H

2005-01-01

Many U.S. citizens are unable to afford prescription medication in their own country, so they purchase them from Canadian pharmacies. This paper examines the ethics of importing drugs from Canada, including economic implications and how physicians should respond to this dilemma. The four basic principles of ethics are balanced by examining financial incentives, current Canadian and U.S. law, safety issues, the burden of research and development, the impact on Canadian physicians, and issues of liability. The paper concludes that the principle of autonomy permits individuals to cross the border and purchase drugs for personal use; however, nonmaleficence prohibits the purchase of these drugs through third parties. In addition, the U.S. government has special obligations to justice and beneficence and may not ethically sponsor the importation of Canadian drugs. Finally, the paper shows that U.S. doctors must not recommend importation on the basis of beneficence and autonomy.

Imaging for metastatic disease in patients with newly diagnosed breast cancer: are doctor's perceptions in keeping with the guidelines?

PubMed

Simos, Demetrios; Hutton, Brian; Graham, Ian D; Arnaout, Angel; Caudrelier, Jean-Michel; Clemons, Mark

2015-02-01

Despite multiple guidelines advocating against routine radiological evaluation for metastases in women with early stage breast cancer, imaging is still frequently overused. The objective of this study was to assess doctor's views on imaging guidelines, and an attempt to establish why personal and local clinical practice patterns regarding imaging may differ from current guidelines. Canadian doctors who treat breast cancer were invited by email to complete an online survey developed by members of the research team. Responses were received from 173 physicians (26% response rate). Most (82%) indicated awareness of at least one published imaging guideline. Sixty per cent indicated that they had read the recommendations of the 2012 American Society of Clinical Oncology 'Top 5' list for choosing wisely in oncology imaging and, of those, 81% agreed with it. However, most indicated that this recommendation has not influenced them to order less imaging. Over 95% of doctors identified suspicious history, physical examination findings and inflammatory breast cancer as important factors for performing imaging. The majority did not feel that patient demand, fear of litigation or ease of access to imaging influenced their ordering for imaging. The majority of breast cancer doctors are aware of and generally agree that guidelines pertaining to staging imaging for early breast cancer are reflective of evidence. Despite this, adherence is variable and factors such as local practice patterns and disease biology may play a role. Alternative strategies, beyond simply publishing recommendations, are therefore required if there is to be a sustained change in doctor behaviour. © 2014 John Wiley & Sons, Ltd.

Fields of Plenty, Fields of Lean: The Early Labour Market Outcomes of Canadian University Graduates by Discipline.

ERIC Educational Resources Information Center

Finnie, Ross

2001-01-01

Analyzed early career outcomes of recent Canadian college graduates by discipline. Found that many outcomes conform to expectations: the professions and other applied disciplines generally experienced lower unemployment rates, closer skill and qualification matches, and higher earnings; however, fine arts and humanities graduates are more…

Canadian patient played key role in uncovering secrets about early-onset Alzheimer's disease.

PubMed Central

Lyttle, J

1996-01-01

Last June, the University of Toronto announced that Canadian scientists and a team of international researchers had discovered the gene responsible for most cases of early-onset Alzheimer's disease. One of the key players in that discovery had died just 3 months earlier. Frances Hodge, who participated in a battery of tests for the 20 years she lived with the disease, helped lead researchers to gene S182--and an ember of hope for future generations. Images p906-a PMID:8634971

Anastrozole is cost-effective vs tamoxifen as initial adjuvant therapy in early breast cancer: Canadian perspectives on the ATAC completed-treatment analysis.

PubMed

Rocchi, A; Verma, S

2006-09-01

To conduct an economic analysis comparing tamoxifen and anastrozole (Arimidex) in the adjuvant treatment of hormone receptor-positive (HR+), post-menopausal early breast cancer patients. An economic model examined typical patients (64 years of age, HR+, 64% node negative) from the Arimidex, tamoxifen alone, or in combination (ATAC) trial over a lifetime horizon. Rates of events were derived from ATAC trial results. Post-trial event rates were drawn from the literature for tamoxifen; event rates for anastrozole were modified by the relative risks observed in the ATAC trial. Resource utilization was drawn from Statistics Canada's Population Health Model for breast cancer, supplemented by an expert panel. A public health care system perspective, 2004 Canadian prices and a 5% discount rate were employed. Anastrozole-taking patients incurred additional hormonal treatment costs compared to tamoxifen-taking patients (incremental lifetime cost, 6,974 Canadian dollars per patient), partially offset by reduced downstream recurrences of breast cancer (1,143 Canadian dollars lifetime savings per patient) for a net incremental cost of 5,796 Canadian dollars per patient on anastrozole. The anastrozole-treated patients were projected to experience a 5.6% absolute risk reduction of first breast cancer recurrence and a 2.8% absolute risk reduction in breast cancer death. This corresponded to 30,000 Canadian dollars per life year gained and 28,000 Canadian dollars per quality-adjusted life year gained (95% confidence interval, 17,428 to 54,605 Canadian dollars). The results were affected by the duration and extent of anastrozole benefit under sensitivity analysis but remained cost-effective. Compared to tamoxifen, anastrozole therapy is effective and cost-effective as initial adjuvant therapy in post-menopausal, HR+ early breast cancer patients.

The Effects of Doctoral Teaching Development on Early-Career STEM Scholars' College Teaching Self-Efficacy

ERIC Educational Resources Information Center

Connolly, Mark R.; Lee, You-Geon; Savoy, Julia N.

2018-01-01

To help prepare future faculty in science, technology, engineering, and mathematics (STEM) to teach undergraduates, more research universities are offering teaching development (TD) programs to doctoral students who aspire to academic careers. Using social cognitive career theory, we examine the effects of TD programs on early-career STEM…

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

PubMed Central

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

1995-01-01

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

Tinkering through Transition: On "Doctoring" as an Early-Career Academic in Physical Education and Sport Pedagogy

ERIC Educational Resources Information Center

Williams, Benjamin; Christensen, Erin; Occhino, Joseph

2017-01-01

This article addresses the notion of "making it" as an early-career academic in physical education and sport pedagogy. In it, we draw on the tradition of material semiotics to reflect on our shared journeys from doctoral student to beginning scholar and beyond. By attuning ourselves to the relationality, materiality and precariousness of…

Early Detection of Neonatal Cholestasis: Inadequate Assessment of Stool Color by Parents and Primary Healthcare Doctors.

PubMed

Witt, Mauri; Lindeboom, Jeanet; Wijnja, Corry; Kesler, Anneke; Keyzer-Dekker, Claudia M G; Verkade, Henkjan J; Hulscher, Jan B F

2016-02-01

Early diagnosis and surgery (< 60 days of age) improve outcomes in children with biliary atresia. Only 56% of patients undergo timely surgery in the Netherlands. Lack of acquaintance with symptoms such as discolored stools might underlie this delay. We analyzed whether Dutch parents, youth healthcare doctors, or general practitioners recognized discolored stools and evaluated the effect of the Infant Stool Color Card (ISCC) on recognizing discolored stools. We asked 100 parents, 33 youth healthcare doctors, and 50 general practitioners to classify photographs of stools as "normal" or "abnormal." Subsequently, we asked whether parents would seek medical help and doctors would refer the patient for medical investigation. Finally, parents scored stools using the ISCC. Two-third of both parents and youth healthcare doctors recognized all discolored stools. Only half of them would seek medical help for all discolored stools resp. refer patient for medical investigation. Only one-third of the general practitioners recognized all discolored stools and would refer for medical investigation for all discolored stools. Using the ISCC, the percentage of parents recognizing all discolored stool increased from 66 to 87% (p < 0.01). Neither parents nor youth healthcare doctors nor general practitioners reliably recognize discolored stool. The ISCC is an effective screening method for discolored stool. Our data indicate that the ISCC should be accompanied by unequivocal advices regarding referral for medical investigation upon detection of discolored stools. Georg Thieme Verlag KG Stuttgart · New York.

Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years).

PubMed

Tremblay, Mark S; Leblanc, Allana G; Carson, Valerie; Choquette, Louise; Connor Gorber, Sarah; Dillman, Carrie; Duggan, Mary; Gordon, Mary Jane; Hicks, Audrey; Janssen, Ian; Kho, Michelle E; Latimer-Cheung, Amy E; Leblanc, Claire; Murumets, Kelly; Okely, Anthony D; Reilly, John J; Stearns, Jodie A; Timmons, Brian W; Spence, John C

2012-04-01

The Canadian Society for Exercise Physiology (CSEP), with assistance from multiple partners, stakeholders, and researchers, developed the first Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years). These national guidelines are in response to a call from health and health care professionals, child care providers, and fitness practitioners for guidance on sedentary behaviour in the early years. The guideline development process followed the Appraisal of Guidelines for Research Evaluation (AGREE) II framework. The recommendations are informed by evidence from a systematic review that examined the relationships between sedentary behaviour (predominantly screen time) and health indicators (healthy body weight, bone and skeletal health, motor skill development, psychosocial health, cognitive development, and cardio-metabolic disease risk factors) for three age groups (infants aged <1 year; toddlers aged 1-2 years; preschoolers aged 3-4 years). Evidence from the review was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The new guidelines include a preamble to provide context, followed by the specific recommendations. The final guidelines benefitted from extensive on-line consultations with input from >900 domestic and international stakeholders, end-users, and key informants. The final guidelines state: for healthy growth and development, caregivers should minimize the time infants (aged <1 year), toddlers (aged 1-2 years), and preschoolers (aged 3-4 years) spend being sedentary during waking hours. This includes prolonged sitting or being restrained (e.g., stroller, high chair) for more than 1 h at a time. For those under 2 years, screen time (e.g., TV, computer, electronic games) is not recommended. For children 2-4 years, screen time should be limited to under 1 h per day; less is better.

Health services utilization of people having and not having a regular doctor in Canada.

PubMed

Thanh, Nguyen Xuan; Rapoport, John

2017-04-01

Canada having a universal health insurance plan that provides hospital and physician benefits offers a natural experiment of whether continuity of care actually provides lower or higher utilization of services. The question we are evaluating is whether Canadians, who have a regular physician, use more health resources than those who do not have one? Using two statistical methods, including propensity score matching and zero-inflated negative binomial regression, we analyzed data from the 2010 and 2007/2008 Canadian Community Health Surveys separately to document differences between people self-reportedly having and not having a regular doctor in the utilization of general practitioner, specialist, and hospital services. The results showed, consistently for all two statistical methods and two datasets used, that people reportedly having a regular doctor used more healthcare services than a matched group of people who was self-reportedly not having a regular doctor. For specialist and hospital utilization, the statistically significant differences were in the likelihood if the service was used but not in the number of specialist visits or hospital nights among users. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Doctoral Studies: What Has Radical Adult Education Got to Do with It?

ERIC Educational Resources Information Center

Choudry, Aziz; Rochat, Désirée

2015-01-01

Working and writing together as supervisor and graduate student in a Canadian university, the authors bring their community/activist/adult education learning backgrounds into dialogue--and tension--with doctoral studies by reflecting on their personal learning paths and thinking about what this means for teaching and learning in academic contexts.…

Exploring the Nexus between Research and Doctoral Education

ERIC Educational Resources Information Center

Pearson, Margot; Evans, Terry; Macauley, Peter

2012-01-01

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

Access to health-care in Canadian immigrants: a longitudinal study of the National Population Health Survey.

PubMed

Setia, Maninder Singh; Quesnel-Vallee, Amelie; Abrahamowicz, Michal; Tousignant, Pierre; Lynch, John

2011-01-01

Immigrants often lose their health advantage as they start adapting to the ways of the new society. Having access to care when it is needed is one way that individuals can maintain their health. We assessed the healthcare access in Canadian immigrants and the socioeconomic factors associated with access over a 12-year period. We compared two measures of healthcare access (having a regular doctor and reporting an unmet healthcare need in the past 12 months) among immigrants and Canadian-born men and women, aged more than 18 years. We applied a logistic random effects model to evaluate these outcomes separately, in 3081 males and 4187 females from the National Population Health Survey (1994-2006). Adjusting for all covariates, immigrant men and women (white and non-white) had similar odds of having a regular doctor than the Canadian-born individuals (white immigrants: males OR: 1.32, 95% C.I.: 0.89-1.94, females OR: 1.14, 95% C.I.: 0.78-1.66; non-white immigrants: males OR: 1.28, 95% C.I.: 0.73-2.23, females OR: 1.23, 95% C.I.: 0.64-2.36). Interestingly, non-white immigrant women had significantly fewer unmet health needs (OR: 0.32, 95% C.I.: 0.17-0.59). Among immigrants, time since immigration was associated with having access to a regular doctor (OR per year: 1.02, 95% C.I.: 1.00-1.04). Visible minority female immigrants were least likely to report an unmet healthcare need. In general, there is little evidence that immigrants have worse access to health-care than the Canadian-born population. © 2010 Blackwell Publishing Ltd.

Becoming an Academic: The Role of Doctoral Capital in the Field of Education

ERIC Educational Resources Information Center

Walker, Jude; Yoon, EeSeul

2017-01-01

This paper draws on Bourdieu's concepts of "field," "capital" and "habitus" to examine the learning and enculturation of alumni of a Canadian PhD programme in the discipline of Education. We introduce the concept of "doctoral capital" to help explain how and why some PhD graduates go on to secure faculty…

Facies patterns and conodont biogeography in Arctic Alaska and the Canadian Arctic Islands: Evidence against juxtaposition of these areas during early Paleozoic time

USGS Publications Warehouse

Dumoulin, Julie A.; Harris, A.G.; Bradley, D.C.; De Freitas, T. A.

2000-01-01

Differences in lithofacies and biofacies suggest that lower Paleozoic rocks now exposed in Arctic Alaska and the Canadian Arctic Islands did not form as part of a single depositional system. Lithologic contrasts are noted in shallow- and deep-water strata and are especially marked in Ordovician and Silurian rocks. A widespread intraplatform basin of Early and Middle Ordovician age in northern Alaska has no counterpart in the Canadian Arctic, and the regional drowning and backstepping of the Silurian shelf margin in Canada has no known parallel in northern Alaska. Lower Paleozoic basinal facies in northern Alaska are chiefly siliciclastic, whereas resedimented carbonates are volumetrically important in Canada. Micro- and macrofossil assemblages from northern Alaska contain elements typical of both Siberian and Laurentian biotic provinces; coeval Canadian Arctic assemblages contain Laurentian forms but lack Siberian species. Siberian affinities in northern Alaskan biotas persist from at least Middle Cambrian through Mississippian time and appear to decrease in intensity from present-day west to east. Our lithologic and biogeographic data are most compatible with the hypothesis that northern Alaska-Chukotka formed a discrete tectonic block situated between Siberia and Laurentia in early Paleozoic time. If Arctic Alaska was juxtaposed with the Canadian Arctic prior to opening of the Canada basin, biotic constraints suggest that such juxtaposition took place no earlier than late Paleozoic time.

Examining the social determinants of children's developmental health: protocol for building a pan-Canadian population-based monitoring system for early childhood development

PubMed Central

Guhn, Martin; Janus, Magdalena; Enns, Jennifer; Brownell, Marni; Forer, Barry; Duku, Eric; Muhajarine, Nazeem; Raos, Rob

2016-01-01

Introduction Early childhood is a key period to establish policies and practices that optimise children's health and development, but Canada lacks nationally representative data on social indicators of children's well-being. To address this gap, the Early Development Instrument (EDI), a teacher-administered questionnaire completed for kindergarten-age children, has been implemented across most Canadian provinces over the past 10 years. The purpose of this protocol is to describe the Canadian Neighbourhoods and Early Child Development (CanNECD) Study, the aims of which are to create a pan-Canadian EDI database to monitor trends over time in children's developmental health and to advance research examining the social determinants of health. Methods and analysis Canada-wide EDI records from 2004 to 2014 (representing over 700 000 children) will be linked to Canada Census and Income Taxfiler data. Variables of socioeconomic status derived from these databases will be used to predict neighbourhood-level EDI vulnerability rates by conducting a series of regression analyses and latent variable models at provincial/territorial and national levels. Where data are available, we will measure the neighbourhood-level change in developmental vulnerability rates over time and model the socioeconomic factors associated with those trends. Ethics and dissemination Ethics approval for this study was granted by the Behavioural Research Ethics Board at the University of British Columbia. Study findings will be disseminated to key partners, including provincial and federal ministries, schools and school districts, collaborative community groups and the early childhood development research community. The database created as part of this longitudinal population-level monitoring system will allow researchers to associate practices, programmes and policies at school and community levels with trends in developmental health outcomes. The CanNECD Study will guide future early childhood

Identification of a novel truncating PALB2 mutation and analysis of its contribution to early-onset breast cancer in French-Canadian women.

PubMed

Foulkes, William D; Ghadirian, Parviz; Akbari, Mohammed Reza; Hamel, Nancy; Giroux, Sylvie; Sabbaghian, Nelly; Darnel, Andrew; Royer, Robert; Poll, Aletta; Fafard, Eve; Robidoux, André; Martin, Ginette; Bismar, Tarek A; Tischkowitz, Marc; Rousseau, Francois; Narod, Steven A

2007-01-01

PALB2 has recently been identified as a breast cancer susceptibility gene. PALB2 mutations are rare causes of hereditary breast cancer but may be important in countries such as Finland where a founder mutation is present. We sought to estimate the contribution of PALB2 mutations to the burden of breast cancer in French Canadians from Quebec. We screened all coding exons of PALB2 in a sample of 50 French-Canadian women diagnosed with either early-onset breast cancer or familial breast cancer at a single Montreal hospital. The genetic variants identified in this sample were then studied in 356 additional women with breast cancer diagnosed before age 50 and in 6,448 newborn controls. We identified a single protein-truncating mutation in PALB2 (c.2323 C>T, resulting in Q775X) in 1 of the 50 high-risk women. This variant was present in 2 of 356 breast cancer cases and in none of 6,440 newborn French-Canadian controls (P = 0.003). We also identified two novel new non-synonymous single nucleotide polymorphisms in exon 4 of PALB2 (c.5038 A>G [I76V] and c.5156 G>T [G115V]). G115V was found in 1 of 356 cases and in 15 of 6,442 controls (P = 0.6). The I76V variant was not identified in either the extended case series or the controls. We have identified a novel truncating mutation in PALB2. The mutation was found in approximately 0.5% of unselected French-Canadian women with early-onset breast cancer and appears to have a single origin. Although mutations are infrequent, PALB2 can be added to the list of breast cancer susceptibility genes for which founder mutations have been identified in the French-Canadian population.

Identification of a novel truncating PALB2 mutation and analysis of its contribution to early-onset breast cancer in French-Canadian women

PubMed Central

Foulkes, William D; Ghadirian, Parviz; Akbari, Mohammed Reza; Hamel, Nancy; Giroux, Sylvie; Sabbaghian, Nelly; Darnel, Andrew; Royer, Robert; Poll, Aletta; Fafard, Eve; Robidoux, André; Martin, Ginette; Bismar, Tarek A; Tischkowitz, Marc; Rousseau, Francois; Narod, Steven A

2007-01-01

Background PALB2 has recently been identified as a breast cancer susceptibility gene. PALB2 mutations are rare causes of hereditary breast cancer but may be important in countries such as Finland where a founder mutation is present. We sought to estimate the contribution of PALB2 mutations to the burden of breast cancer in French Canadians from Quebec. Methods We screened all coding exons of PALB2 in a sample of 50 French-Canadian women diagnosed with either early-onset breast cancer or familial breast cancer at a single Montreal hospital. The genetic variants identified in this sample were then studied in 356 additional women with breast cancer diagnosed before age 50 and in 6,448 newborn controls. Results We identified a single protein-truncating mutation in PALB2 (c.2323 C>T, resulting in Q775X) in 1 of the 50 high-risk women. This variant was present in 2 of 356 breast cancer cases and in none of 6,440 newborn French-Canadian controls (P = 0.003). We also identified two novel new non-synonymous single nucleotide polymorphisms in exon 4 of PALB2 (c.5038 A>G [I76V] and c.5156 G>T [G115V]). G115V was found in 1 of 356 cases and in 15 of 6,442 controls (P = 0.6). The I76V variant was not identified in either the extended case series or the controls. Conclusion We have identified a novel truncating mutation in PALB2. The mutation was found in approximately 0.5% of unselected French-Canadian women with early-onset breast cancer and appears to have a single origin. Although mutations are infrequent, PALB2 can be added to the list of breast cancer susceptibility genes for which founder mutations have been identified in the French-Canadian population. PMID:18053174

"Disqus" Website-Based Commenting as an e-Research Method: Engaging Doctoral and Early-Career Academic Learners in Educational Research

ERIC Educational Resources Information Center

Kilburn, Daniel; Earley, Jonathan

2015-01-01

This article presents an adaptation of established qualitative research methods for online focus groups by using the "Disqus" website-based commenting platform as a medium for discussion among doctoral and early-career academic learners. Facilities allowing Internet users to comment on the content of web pages are increasingly popular on…

Ryerson University's Internationally Trained Medical Doctors Bridging Program: Preliminary Results from a Pilot Program

ERIC Educational Resources Information Center

Bhuiyan, Shafi U.

2018-01-01

Although Canada is home to a large number of internationally educated health professionals, their skills and experiences are grossly underutilized in the Canadian healthcare landscape. Barriers to medical practice are pervasive, and as a result, the majority of internationally trained medical doctors (ITMDs) work in "survival" jobs…

Encouraging entrepreneurship in university labs: Research activities, research outputs, and early doctorate careers

PubMed Central

2017-01-01

This paper investigates how the encouragement of entrepreneurship within university research labs relates with research activities, research outputs, and early doctorate careers. Utilizing a panel survey of 6,840 science & engineering doctoral students at 39 R1 research universities, this study shows that entrepreneurship is widely encouraged across university research labs, ranging from 54% in biomedical engineering to 18% in particle physics, while only a small share of labs openly discourage entrepreneurship, from approximately 3% in engineering to approximately 12% in the life sciences. Within fields, there is no difference between labs that encourage entrepreneurship and those that do not with respect to basic research activity and the number of publications. At the same time, labs that encourage entrepreneurship are significantly more likely to report invention disclosures, particularly in engineering where such labs are 41% more likely to disclose inventions. With respect to career pathways, PhDs students in labs that encourage entrepreneurship do not differ from other PhDs in their interest in academic careers, but they are 87% more likely to be interested in careers in entrepreneurship and 44% more likely to work in a startup after graduation. These results persist even when accounting for individuals’ pre-PhD interest in entrepreneurship and the encouragement of other non-academic industry careers. PMID:28178270

Encouraging entrepreneurship in university labs: Research activities, research outputs, and early doctorate careers.

PubMed

Roach, Michael

2017-01-01

This paper investigates how the encouragement of entrepreneurship within university research labs relates with research activities, research outputs, and early doctorate careers. Utilizing a panel survey of 6,840 science & engineering doctoral students at 39 R1 research universities, this study shows that entrepreneurship is widely encouraged across university research labs, ranging from 54% in biomedical engineering to 18% in particle physics, while only a small share of labs openly discourage entrepreneurship, from approximately 3% in engineering to approximately 12% in the life sciences. Within fields, there is no difference between labs that encourage entrepreneurship and those that do not with respect to basic research activity and the number of publications. At the same time, labs that encourage entrepreneurship are significantly more likely to report invention disclosures, particularly in engineering where such labs are 41% more likely to disclose inventions. With respect to career pathways, PhDs students in labs that encourage entrepreneurship do not differ from other PhDs in their interest in academic careers, but they are 87% more likely to be interested in careers in entrepreneurship and 44% more likely to work in a startup after graduation. These results persist even when accounting for individuals' pre-PhD interest in entrepreneurship and the encouragement of other non-academic industry careers.

(un) Disciplining the nurse writer: doctoral nursing students' perspective on writing capacity.

PubMed

Ryan, Maureen M; Walker, Madeline; Scaia, Margaret; Smith, Vivian

2014-12-01

In this article, we offer a perspective into how Canadian doctoral nursing students' writing capacity is mentored and, as a result, we argue is disciplined. We do this by sharing our own disciplinary and interdisciplinary experiences of writing with, for and about nurses. We locate our experiences within a broader discourse that suggests doctoral (nursing) students be prepared as stewards of the (nursing) discipline. We draw attention to tensions and effects of writing within (nursing) disciplinary boundaries. We argue that traditional approaches to developing nurses' writing capacity in doctoral programs both shepherds and excludes emerging scholarly voices, and we present some examples to illustrate this dual role. We ask our nurse colleagues to consider for whom nurses write, offering an argument that nurses' writing must ultimately improve patient care and thus would benefit from multiple voices in writing. © 2013 John Wiley & Sons Ltd.

Management of Early- and Late-Stage Rheumatoid Arthritis: Are Physiotherapy Students' Intended Behaviours Consistent with Canadian Best Practice Guidelines?

PubMed Central

Lineker, Sydney C.; Hallett, Christina; Tumber, Jake; Fernando, Nalin; Hul, Magdalena

2012-01-01

ABSTRACT Purpose: This study examined whether physiotherapy students in a problem-based learning (PBL) curriculum intend to implement best practices for management of clients with rheumatoid arthritis (RA). Method: Physiotherapy students (n=49) completed a subsection of the ACREU Primary Care Survey to evaluate the concordance between intended behaviours and Canadian best practices for early- and late-stage RA, before and after completing the relevant PBL content. Changes in scores were assessed using McNemar's test for dependent proportions. Results: Most students indicated that they would recommend treatments or referrals for physiotherapy/exercise, education, and occupational therapy or joint protection pre- and post-PBL (>83% and >95%, respectively). Post-PBL, more students recommended referral to a rheumatologist and disease-modifying anti-rheumatic drugs (DMARDs) for both early and late RA; however, the increase was significant only for early RA (p=0.013 and 0.031 for referral to rheumatologist and DMARDs, respectively). More students recommended psychosocial support at both stages of RA post-PBL (early RA: p<0.001; late RA: p=0.031). Although more students recommended DMARDs post-PBL, only 8 students in total made this recommendation (16%), and fewer students considered use of non-steroidal anti-inflammatory drugs. Most students (94%) did not recommend referral to a surgeon for early or late RA. Conclusion: Intended behaviour of physiotherapy students was more consistent with Canadian best practice guidelines for managing clients with early- and late-stage RA following the PBL curriculum. Further study is required to determine whether the students were less aware of best practices related to pharmacologic interventions and timely referral to appropriate specialists, or whether they considered these issues to be outside their scope of practice. PMID:23729962

Surveys of Ph.D. Thesis: Review of Doctoral Research in Language Assessment in Canada (2006-2011)

ERIC Educational Resources Information Center

Cheng, Liying; Fox, Janna

2013-01-01

This paper reviews a selected sample of 24 doctoral dissertations in language assessment (broadly defined), completed between 2006 and 2011 in Canadian universities. These dissertations fall into five thematic categories: 1) reliability, validity and factors affecting test performance; 2) washback (impact) and ethics; 3) raters, rating and rating…

The Canadian effort to prevent and control hypertension: can other countries adopt Canadian strategies?

PubMed

Campbell, Norm R C; Sheldon, Tobe

2010-07-01

To indicate the key elements of current Canadian programs to treat and control hypertension. In the early 1990s Canada had a hypertension treatment and control rate of 13%. A Canadian strategy to prevent and control hypertension was developed and a coalition of national organizations and volunteers formed to develop increasingly extensive programs. The Canadian effort was largely based on annually updated hypertension management recommendations, an integrated and extensive hypertension knowledge translation program and an increasingly comprehensive outcomes assessment program. After the start of the annual process in 1999, there were very large increases in diagnosis and hypertension treatment coupled with dropping rates of cardiovascular disease. More recent initiatives include an extensive education program for the public and people with hypertension, a program to reduce dietary salt and a funded leadership position. The treatment and control rate increased to 66% when last assessed (2007-2009). The study describes important aspects of the Canadian hypertension management programs to aid those wishing to develop similar programs. Many of the programs could be fully or partially implemented by other countries.

Left out in the Academic Field: Doctoral Graduates Deal with a Decade of Disappearing Jobs

ERIC Educational Resources Information Center

Acker, Sandra; Haque, Eve

2017-01-01

In 2001-2002, the authors of this article interviewed 31 ethno-culturally diverse doctoral students about their experiences in a sociology of education program at a Canadian university. Approximately 10 years later, in a second qualitative study, we had the chance to conduct semi-structured interviews with 13 of the former students to find out…

Some doctors of medicine who published optometry books and played significant roles in early twentieth century optometric education.

PubMed

Goss, David A

2011-01-01

This paper provides brief profiles of four doctors of medicine who wrote books for optometrists and who were faculty members in, and/or directors of, optometry schools in the early twentieth century. Those studied were Thomas G. Atkinson (1870-1946), Marshall B. Ketchum (1856-1937), Joseph I. Pascal (1890-1955), and Clarence W. Talbot (1883-1958). The content of the books they wrote is also discussed.

Examining the social determinants of children's developmental health: protocol for building a pan-Canadian population-based monitoring system for early childhood development.

PubMed

Guhn, Martin; Janus, Magdalena; Enns, Jennifer; Brownell, Marni; Forer, Barry; Duku, Eric; Muhajarine, Nazeem; Raos, Rob

2016-04-29

Early childhood is a key period to establish policies and practices that optimise children's health and development, but Canada lacks nationally representative data on social indicators of children's well-being. To address this gap, the Early Development Instrument (EDI), a teacher-administered questionnaire completed for kindergarten-age children, has been implemented across most Canadian provinces over the past 10 years. The purpose of this protocol is to describe the Canadian Neighbourhoods and Early Child Development (CanNECD) Study, the aims of which are to create a pan-Canadian EDI database to monitor trends over time in children's developmental health and to advance research examining the social determinants of health. Canada-wide EDI records from 2004 to 2014 (representing over 700,000 children) will be linked to Canada Census and Income Taxfiler data. Variables of socioeconomic status derived from these databases will be used to predict neighbourhood-level EDI vulnerability rates by conducting a series of regression analyses and latent variable models at provincial/territorial and national levels. Where data are available, we will measure the neighbourhood-level change in developmental vulnerability rates over time and model the socioeconomic factors associated with those trends. Ethics approval for this study was granted by the Behavioural Research Ethics Board at the University of British Columbia. Study findings will be disseminated to key partners, including provincial and federal ministries, schools and school districts, collaborative community groups and the early childhood development research community. The database created as part of this longitudinal population-level monitoring system will allow researchers to associate practices, programmes and policies at school and community levels with trends in developmental health outcomes. The CanNECD Study will guide future early childhood development action and policies, using the database as a tool

The Effects of Doctoral Teaching Development on Early-Career STEM Scholars' College Teaching Self-efficacy.

PubMed

Connolly, Mark R; Lee, You-Geon; Savoy, Julia N

2018-01-01

To help prepare future faculty in science, technology, engineering, and mathematics (STEM) to teach undergraduates, more research universities are offering teaching development (TD) programs to doctoral students who aspire to academic careers. Using social cognitive career theory, we examine the effects of TD programs on early-career STEM scholars' sense of self-efficacy as postsecondary teachers. In 2011, a survey questionnaire was administered to 2156 people who in 2009 were doctoral students in STEM departments at three U.S. research universities; 1445 responded (67%). Regression analysis revealed positive relationships between TD participation and participants' college teaching self-efficacy and positive interaction effects for women. These findings may be used to improve the quality and quantity of TD offerings and help them gain wider acceptance. © 2018 M. R. Connolly et al. CBE—Life Sciences Education © 2018 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Psychosocial Interventions in Reducing Cannabis Use in Early Phase Psychosis: A Canadian Survey of Treatments Offered.

PubMed

Aydin, Cristina; Tibbo, Philip G; Ursuliak, Zenovia

2016-06-01

Cannabis use in people with early phase psychosis (EPP) can have a significant impact on long-term outcomes. The purpose of this investigation was to describe current cannabis use treatment practices in English-speaking early intervention services (EISs) in Canada and determine if their services are informed by available evidence. Thirty-five Canadian English-speaking EISs for psychosis were approached to complete a survey through email, facsimile, or online in order to collect information regarding their current cannabis use treatment practices. Data were acquired from 27 of the 35 (78%) programs approached. Only 12% of EISs offered formal services that targeted cannabis use, whereas the majority (63%) of EISs offered informal services for all substance use, not specifically cannabis. In programs with informal services, individual patient psychoeducation (86%) was slightly more common than individual motivational interviewing (MI) (76%) followed by group patient psychoeducation (52%) and information handouts (52%). Thirty-seven percent of EISs offered formal services for substance use, and compared to programs with informal services, more MI, cognitive-behavioural therapy, and family services were offered, with individual treatment modalities more common than groups. No EISs used contingency management, even though it has some preliminary evidence in chronic populations. Evidence-based service implementation barriers included appropriate training and administrative support. While most English-speaking Canadian EIS programs offer individual MI and psychoeducation, which is in line with the available literature, there is room for improvement in cannabis treatment services based on current evidence for both people with EPP and their families. © The Author(s) 2016.

A qualitative examination of the perceptions of parents on the Canadian Sedentary Behaviour Guidelines for the early years.

PubMed

Carson, Valerie; Clark, Marianne; Berry, Tanya; Holt, Nicholas L; Latimer-Cheung, Amy E

2014-05-17

Minimizing sedentary behavior, in particular screen-based sedentary behavior, during the early years is important for healthy growth and development. Consequently, new Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0-4 years) were recently released. Researchers are unclear what messages should supplement the guidelines when disseminating them to parents and when using the guidelines in behaviour-change interventions to increase adoption. The objective of this study was to qualitatively examine parents' perceptions of the new Canadian Sedentary Behaviour Guidelines for the Early Years. Parents with a child ≤4 years who attended a child care centre were purposefully recruited from child care centres. A total of 7 semi-structured focus groups with 2 to 5 parents were conducted from August to November, 2013 by a trained and experienced moderator. Participants were asked a series of open-ended questions pertaining to the Sedentary Behaviour Guidelines information sheet. Initial themes were identified followed by further review and analysis. For the most part parents thought the guidelines were clear and did not disagree with the recommendations per se. However, some confusion arose around the value of some sedentary activities, such as reading and coloring, for social and cognitive development. Many parents described feeling guilty after reading the guidelines and perceived several barriers in meeting the daily recommendations. Common barriers included the need to balance multiple demands of family life, the prevalence and accessibility of screen technology, and the weather and built environment where families live. Parents expressed the importance of communicating the guidelines early enough for good habits to be established and the need for realistic strategies and ideas to help them meet the recommendations. Overall the findings indicate that gain-framed messages around the role of screen-based and non-screen-based sedentary behavior for children

Students' Research Self-Efficacy during Online Doctoral Research Courses

ERIC Educational Resources Information Center

Baltes, Beate; Hoffman-Kipp, Peter; Lynn, Laura; Weltzer-Ward, Lisa

2010-01-01

This study will explore student skill development and research self-efficacy as related to online doctoral students' first core research course experience. Findings from this study will be used to inform instructors in effective ways to support doctoral students during their early research experiences. This support will ensure that online graduate…

Medical doctors in healthcare leadership: theoretical and practical challenges.

PubMed

Denis, Jean-Louis; van Gestel, Nicolette

2016-05-24

While healthcare systems vary in their structure and available resources, it is widely recognized that medical doctors play a key role in their adaptation and performance. In this article, we examine recent government and organizational policies in two different health systems that aim to develop clinical leadership among the medical profession. Clinical leadership refers to the engagement and guiding role of physicians in health system improvement. Three dimensions are defined to conduct our analysis of engaging medical doctors in healthcare leadership: the position and status of medical doctors within the system; the broader institutional context of governmental and organizational policies to engage medical doctors in clinical leadership roles; and the main factors that may facilitate or limit achievements. Our aim in this study is exploratory. We selected two contrasting cases according to their level of institutional pluralism: one national health insurance system, Canada, and one etatist social insurance system, the Netherlands. We documented the institutional dynamics of medical doctors' engagement and leadership through secondary sources, such as government websites, key policy reports, and scholarly literature on health policies in both countries. Initiatives across Canadian provinces signal that the medical profession and governments search for alternatives to involve doctors in health system improvement beyond the limitations imposed by their fundamental social contract and formal labour relations. These initiatives suggest an emerging trend toward more joint collaboration between governments and medical associations. In the Dutch system, organizational and legal attempts for integration over the past decades do not yet fit well with the ideas and interests of medical doctors. The engagement of medical doctors requires additional initiatives that are closer to their professional values and interests and that depart from an overly focus on top down

Rhetorical Analysis of the Doctoral Abstracts on English Language Teaching in Turkey

ERIC Educational Resources Information Center

Özmen, Kemal Sinan

2016-01-01

Doctoral dissertation has an important role to embark on an academic career confidently. The case is much more challenging for the early career doctorate who strives to contribute to the wider academic community. Using Swale's IMRD model, this study analyzed the rhetorical organization of English abstracts of 147 doctoral dissertations written…

Attitude and knowledge of physicians about cancer pain management: young doctors of South Korea in their early career.

PubMed

Kim, Myung-Hyun; Park, Hyeonggeun; Park, Eun Chul; Park, Keeho

2011-06-01

This study is aimed at evaluating the attitude and knowledge about the optimal use of opioids and finding out the barriers to cancer pain management especially for young doctors in South Korea. A survey through questionnaire form was conducted on 1204 physicians. Physicians were grouped by their medical specialties and personal characteristics. Specialties were grouped into internal medicine and family medicine doctors, surgeons, anesthesiologists, pediatricians, other board holders and general physicians. Personal characteristics were grouped by their past experiences and current surroundings. Though many doctors thought that they were fairly well educated for pain management strategy, a large population of physicians showed a negative attitude and inadequate knowledge status about cancer pain management. The degree of attitude and knowledge status was different as their specialties and personal experiences. The factors that affected doctors' attitude and knowledge were: (i) medical specialty, (ii) past history of using practical pain assessment tool, (iii) self-perception of knowledge status about pain management, (iv) experience of prescribing opioids, (v) experience of education for cancer pain management. Although many physicians had a passive attitude in prescribing opioid analgesics, they are willingly open to use opioids for cancer pain management in the future. The most important perceived barriers to optimal cancer pain management were the fear for risk of tolerance, drug addiction, side effects of opioid analgesics and knowledge deficit about opioid analgesics. From this study, we found that further education and practical training will be needed for adequate cancer pain management for young physicians in their early career.

Sexual-risk behaviour and HIV testing among Canadian snowbirds who winter in Florida.

PubMed

Mairs, Katie; Bullock, Sandra L

2013-06-01

Rates of HIV (human immunodeficiency virus) and sexual-risk behaviour for those aged 50 and over in the United States are highest and increasing in Florida, where many Canadian "snowbirds" winter. This pilot study examined the sexual-risk behaviour and predictors of HIV testing in a convenience sample of Canadian snowbirds who winter in Florida (n = 265). Multivariate logistic regression analyses revealed that the odds of testing were increased for the unmarried, those aged 50-64, those who had talked to a doctor about sexual-risk behaviour since age 50, and those who agreed that sex was important in their lives. Dating males were more likely to test than non-dating males. Dating females were not more likely to test than non-dating females; and males who dated were 13.6 times more likely to test than females who dated. Further research will improve understanding of Canadian snowbirds' sexual interactions and HIV-testing behaviour.

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

PubMed

Bertens, R M; Huisman, F G

2016-01-01

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

Examining Doctoral Examination and the Question of the Viva

ERIC Educational Resources Information Center

Lovat, Terence; Holbrook, Allyson; Bourke, Sid; Fairbairn, Hedy; Kiley, Margaret; Paltridge, Brian; Starfield, Sue

2015-01-01

The paper draws on a series of Australian Research Council (ARC) projects aimed at understanding better the process of doctoral examination. The early phase focussed on the Australian doctorate, which functions without a Viva, while the later phase was concerned with comparing the earlier findings with analysis of the United Kingdom (UK) and New…

Bioecological Theory, Early Child Development and the Validation of the Population-Level Early Development Instrument

ERIC Educational Resources Information Center

Guhn, Martin; Goelman, Hillel

2011-01-01

The Early Development Instrument (EDI; Janus and Offord in "Canadian Journal of Behavioural Science" 39:1-22, 2007) project is a Canadian population-level, longitudinal research project, in which teacher ratings of Kindergarten children's early development and wellbeing are linked to health and academic achievement variables at the…

Sorry doctor, I can't afford the root canal, I have a job: Canadian dental care policy and the working poor.

PubMed

Quiñonez, Carlos; Figueiredo, Rafael

2010-01-01

In Canada, most dental care is privately financed through employment-based insurance, with only a small amount of care supported by governments for groups deemed in social need. Recently, this low level of public financing has been linked to problems in accessing dental care, and one group that has received major attention are the working poor (WP), or those who maintain regular employment but remain in relative poverty. The WP highlight a significant gap in Canadian dental care policy, as they are generally not eligible for either public or private insurance. This is a mixed methods study, comprised of an historical review of Canadian dental care policy and a telephone interview survey of WP Canadian adults. By its very definitions, Canadian dental care policy recognizes the WP as persons with employment, yet incorrectly assumes that they will have ready access to employment-based insurance. In addition, through historically developed biases, it also fails to recognize them as persons in social need. Our telephone survey suggests that this policy approach has important impacts in that oral health and dental care outcomes are significantly mitigated by the presence of dental insurance. Canadian dental care policy should be reassessed in terms of how it determines need in order to close a gap that holds negative consequences for many Canadian families.

[HOLOCAUST DOCTORS SURVIVORS IN ISRAEL 1945-1952: FROM EARLY POSITIONS TO PROFESSIONAL INTEGRATION].

PubMed

Herzog, Rachel

2017-04-01

The encounter between Holocaust doctor survivors and the Israeli society was part of the whole encounter between Holocaust survivors and the Israeli society. The present thesis aimed at evaluating the integration process of Holocaust doctor survivors in the Israeli health care system from 1945 until the end of 1952. Between these years about 1350 doctors arrived in Israel, the vast majority of them Holocaust survivors. Their rapid entrance to work provided the healthcare system with professional manpower, contributing their share during a tough period of the nation's history. The doctors themselves gained the opportunity for rapid professional recovery and social integration, all at the same time. The individual contributions of each of these doctors constitute a significant collective contribution. It is an inspiring story of personal and universal human victory. There are similarities between the absorption of all Holocaust survivals in Israel with regard to the motives of immigration and the feelings towards the absorption places and organizations. But Holocaust doctor survivors didn't stay too long and moved out rather quickly. The beginning was difficult. They were absorbed in each of the healthcare fronts, but especially in new clinics established in immigrant-concentrated areas, in hospitals dedicated to lung diseases and in psychiatric hospitals. They started at low professional levels, but as soon as 1952, they could be found in management positions. This was indicative of their professional advancement and the willingness of the medical establishment to absorb and promote.

Online Doctorates for Administrators

ERIC Educational Resources Information Center

Beem, Kate

2010-01-01

Ron Dickson knew he needed a terminal degree. In the early 2000s, he was toiling away as an assistant superintendent in a suburban Phoenix school district, but he had higher aspirations--a superintendency. Yet with a family and a demanding job, he wasn't sure how he could swing a doctoral degree. He diligently checked out the traditional Ed.D. and…

A qualitative examination of the perceptions of parents on the Canadian Sedentary Behaviour Guidelines for the early years

PubMed Central

2014-01-01

Background Minimizing sedentary behavior, in particular screen-based sedentary behavior, during the early years is important for healthy growth and development. Consequently, new Canadian Sedentary Behaviour Guidelines for the Early Years (aged 0–4 years) were recently released. Researchers are unclear what messages should supplement the guidelines when disseminating them to parents and when using the guidelines in behaviour-change interventions to increase adoption. The objective of this study was to qualitatively examine parents’ perceptions of the new Canadian Sedentary Behaviour Guidelines for the Early Years. Methods Parents with a child ≤4 years who attended a child care centre were purposefully recruited from child care centres. A total of 7 semi-structured focus groups with 2 to 5 parents were conducted from August to November, 2013 by a trained and experienced moderator. Participants were asked a series of open-ended questions pertaining to the Sedentary Behaviour Guidelines information sheet. Initial themes were identified followed by further review and analysis. Results For the most part parents thought the guidelines were clear and did not disagree with the recommendations per se. However, some confusion arose around the value of some sedentary activities, such as reading and coloring, for social and cognitive development. Many parents described feeling guilty after reading the guidelines and perceived several barriers in meeting the daily recommendations. Common barriers included the need to balance multiple demands of family life, the prevalence and accessibility of screen technology, and the weather and built environment where families live. Parents expressed the importance of communicating the guidelines early enough for good habits to be established and the need for realistic strategies and ideas to help them meet the recommendations. Conclusions Overall the findings indicate that gain-framed messages around the role of screen-based and non

Measuring vaccine acceptance among Canadian parents: A survey of the Canadian Immunization Research Network.

PubMed

Dubé, Eve; Gagnon, Dominique; Ouakki, Manale; Bettinger, Julie A; Witteman, Holly O; MacDonald, Shannon; Fisher, William; Saini, Vineet; Greyson, Devon

2018-01-25

Parental decision making about childhood vaccinations is complex and multidimensional. There is a perception that the number of parents having concerns regarding childhood vaccinations has been increasing in Canada. The aim of this study was to explore vaccine hesitancy among Canadian parents and to examine factors associated with a parent's intention to vaccinate his/her child. Informed by the Theory of Planned Behaviour (TPB) this study assesses potential associations between parents' knowledge, attitudes and beliefs toward vaccination and their intention to vaccinate their child in the future. A national sample of Canadian parents of children aged 24-59 months (N = 2013) was surveyed using an online survey methodology. Half of the surveyed parents strongly intended to have their child vaccinated in the future. Parents' information needs and searches as well as parents' trust in different institutions were associated with intention to vaccinate. Parents who reported having frequently looked for vaccine information, who considered that it was their role as parents to question vaccines, or who had previously experienced difficulty accessing vaccination services were less likely to strongly intend to vaccinate their child in the future. Parents who had a high level of trust in doctors and public health were most likely to strongly intend to vaccinate their child. Results of the multivariate analysis showed that positive attitudes (aOR = 8.0; 95% CI: 6.0, 10.4), higher perceived social support (aOR = 3.0; 95% CI: 2.3, 3.93), and higher perceived behavioural control (aOR = 1.8; 95% CI: 1.4, 2.43) were associated with parents' intention to vaccinate their child. Findings of this study suggest that trust-building interventions that promote pro-vaccine social norms and that address negative attitudes toward vaccination could enhance vaccine acceptance among Canadian parents. Copyright © 2017 Elsevier Ltd. All rights reserved.

Female physicist doctoral experiences

NASA Astrophysics Data System (ADS)

Dabney, Katherine P.; Tai, Robert H.

2013-06-01

The underrepresentation of women in physics doctorate programs and in tenured academic positions indicates a need to evaluate what may influence their career choice and persistence. This qualitative paper examines eleven females in physics doctoral programs and professional science positions in order to provide a more thorough understanding of why and how women make career choices based on aspects both inside and outside of school and their subsequent interaction. Results indicate that female physicists experience conflict in achieving balance within their graduate school experiences and personal lives and that this then influences their view of their future careers and possible career choices. Female physicists report both early and long-term support outside of school by family, and later departmental support, as being essential to their persistence within the field. A greater focus on informal and out-of-school science activities for females, especially those that involve family members, early in life may help influence their entrance into a physics career later in life. Departmental support, through advisers, mentors, peers, and women’s support groups, with a focus on work-life balance can help females to complete graduate school and persist into an academic career.

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

PubMed

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

2007-08-28

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

The Canadian war on drugs: structural violence and unequal treatment of Black Canadians.

PubMed

Khenti, Akwatu

2014-03-01

This paper examines the impact of Canada's war on drugs on segments of the Black community, specifically with respect to the impact of structural violence, over-policing, and high incarceration rates. It offers evidence of the systemic nature of these dynamics by examining the early context of the war, growing stigma against Blacks, globalizing influences, and the punitive focus of funding and policy. The paper also explores how Black men have been identified as the main enemy and how drug control efforts have served to diminish the health, well-being, and self-image of Black men via discriminatory and inequitable treatment before the law. The current high rates of imprisonment of Black men are an indicator of systematic deprivation of significant social capital, which will perpetuate socioeconomic harm and cycles of violence. This commentary calls for an immediate dissolution of policies regulating the war on drugs as the first step in remedying the injustices experienced by Black Canadians. Due to the lack of Canadian data in this important area, the paper also emphasizes the critical need for more research to shed more light on the Canadian-specific complexities. Copyright © 2013 Elsevier B.V. All rights reserved.

Suicide In Doctors And Wives Of Doctors

PubMed Central

Sakinofsky, Isaac

1980-01-01

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

Suicide in doctors and wives of doctors.

PubMed

Sakinofsky, I

1980-06-01

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

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

PubMed

Himmelstein, Mary S; Sanchez, Diana T

2016-03-01

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

Skin deep: Coverage of skin cancer and recreational tanning in Canadian women's magazines (2000-2012).

PubMed

McWhirter, Jennifer E; Hoffman-Goetz, Laurie

2015-06-18

Skin cancer is a significant public health problem among Canadians. Knowledge and attitudes about health are informed by mass media. The aim of our study was to describe the volume and nature of coverage of skin cancer and recreational tanning in Canadian women's magazines. Directed content analysis on article text and images in six popular Canadian women's magazines (Chatelaine, Canadian Living, Homemakers, Flare, FASHION, ELLE Canada) from 2000-2012 with attention to risk factors, ultraviolet radiation (UV) exposure and protection behaviours, and early detection. Six popular American women's magazines were used for a between-country comparison. There were 154 articles (221 images) about skin cancer and tanning published over 13 years. Volume of coverage did not increase in a linear fashion over time. The most common risk factor reported on was UV exposure (39%), with other risk factors less frequently identified. Although 72% of articles promoted sunscreen use, little content encouraged other protection behaviours. Only 15% of articles and 1% of images discouraged indoor tanning, while 41% of articles and 53% of images promoted the tanned look as attractive. Few articles (<11%) reported on early detection. Relative to American magazines, Canadian magazines had a greater proportion of content that encouraged sunscreen use and promoted the tanned look and a lesser proportion of content on risk factors and early detection. Skin cancer and tanning messages in Canadian women's magazines had a narrow focus and provided limited information on risk factors or screening. Conflicting messages about prevention (text vs. images) may contribute to harmful UV behaviours among Canadian women.

Self-reported attitudes, skills and use of evidence-based practice among Canadian doctors of chiropractic: a national survey

PubMed Central

Bussières, André E.; Terhorst, Lauren; Leach, Matthew; Stuber, Kent; Evans, Roni; Schneider, Michael J.

2015-01-01

Objectives: To identify Canadian chiropractors’ attitudes, skills and use of evidence based practice (EBP), as well as their level of awareness of previously published chiropractic clinical practice guidelines (CPGs). Methods: 7,200 members of the Canadian Chiropractic Association were invited by e-mail to complete an online version of the Evidence Based practice Attitude & utilisation SurvEy (EBASE); a valid and reliable measure of participant attitudes, skills and use of EBP. Results: Questionnaires were completed by 554 respondents. Most respondents (>75%) held positive attitudes toward EBP. Over half indicated a high level of self-reported skills in EBP, and over 90% expressed an interest in improving these skills. A majority of respondents (65%) reported over half of their practice was based on evidence from clinical research, and only half (52%) agreed that chiropractic CPGs significantly impacted on their practice. Conclusions: While most Canadian chiropractors held positive attitudes towards EBP, believed EBP was useful, and were interested in improving their skills in EBP, many did not use research evidence or CPGs to guide clinical decision making. Our findings should be interpreted cautiously due to the low response rate. PMID:26816412

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

PubMed

Bracke, N; Moens, L

2010-01-01

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

A peer-led teaching initiative for foundation doctors.

PubMed

Ramsden, Sophie; Abidogun, Abiola; Stringer, Emma; Mahgoub, Sara; Kastrissianakis, Artemis; Baker, Paul

2015-08-01

Peer teaching has been used informally throughout the history of medical education. Formal studies within the medical student and allied health care professional communities have found it to be a popular, and highly effective, method of teaching. Newly qualified doctors are currently an underused resource in terms of teaching one another. A committee, made up of newly qualified doctors and postgraduate education staff, was established. Using only a few resources, this committee organised regular, peer-led tutorials and used educational needs assessment tools, such as questionnaires, to make improvements to early postgraduate training. A realistic and well-received intervention to improve the teaching of newly qualified doctors, which is feasible in the modern, busy health care setting. Other institutions may find this method and its resources valuable. Newly qualified doctors are currently an underused resource in terms of teaching one another. © 2015 John Wiley & Sons Ltd.

Characteristics of first-year students in Canadian medical schools

PubMed Central

Dhalla, Irfan A.; Kwong, Jeff C.; Streiner, David L.; Baddour, Ralph E.; Waddell, Andrea E.; Johnson, Ian L.

2002-01-01

Background The demographic and socioeconomic profile of medical school classes has implications for where people choose to practise and whether they choose to treat certain disadvantaged groups. We aimed to describe the demographic and socioeconomic characteristics of first-year Canadian medical students and compare them with those of the Canadian population to determine whether there are groups that are over- or underrepresented. Furthermore, we wished to test the hypothesis that medical students often come from privileged socioeconomic backgrounds. Methods As part of a larger Internet survey of all students at Canadian medical schools outside Quebec, conducted in January and February 2001, first-year students were asked to give their age, sex, self-described ethnic background using Statistics Canada census descriptions and educational background. Postal code at the time of high school graduation served as a proxy for socioeconomic status. Respondents were also asked for estimates of parental income and education. Responses were compared when possible with Canadian age-group-matched data from the 1996 census. Results Responses were obtained from 981 (80.2%) of 1223 first-year medical students. There were similar numbers of male and female students (51.1% female), with 65% aged 20 to 24 years. Although there were more people from visible minorities in medical school than in the Canadian population (32.4% v. 20.0%) (p < 0.001), certain minority groups (black and Aboriginal) were underrepresented, and others (Chinese, South Asian) were overrepresented. Medical students were less likely than the Canadian population to come from rural areas (10.8% v. 22.4%) (p < 0.001) and were more likely to have higher socioeconomic status, as measured by parents' education (39.0% of fathers and 19.4% of mothers had a master's or doctoral degree, as compared with 6.6% and 3.0% respectively of the Canadian population aged 45 to 64), parents' occupation (69.3% of fathers and 48.7% of

[Becoming medical doctors in colonial Korea: focusing on the faculty of medical colleges in early north Korea].

PubMed

Kim, Geun Bae

2014-12-01

This paper traces how Koreans of north area became medical doctors in colonial Korea. Most of the past research have focused only on the well-known medical doctors, or even when they discussed a great number of doctors, many research tended to only pay attention to the explicit final results of those doctors. This research, on the other hand, includes ordinary medical doctors as well as the renowed ones, and adjusts the focus to the lifetime period of their growth and activities. As a result, the misunderstanding and obscurity about the Korean medical doctors of north area during this period have been cleared. The new characteristics of the Korean medical doctors of this period have been found, along with their embodiment of historical significance. At the time, Koreans had to get through a number of qualifications in order to become doctors. First is the unique background of origin in which the family held interest in the modern education and was capable of supporting it financially. Second is the long-term status of education that the education from elementary to high school was completed without interruption. Third is the academic qualification that among various institutions of higher education, medical science was chosen as a major. Fourth is the condition of career in which as the career as a doctor had consistently continued. Thus, in oder to become a modern medical doctor, Koreans had to properly complete these multiple steps of process. The group of Korean medical doctors in north area, which was formed after getting through these series of process, possessed a number of characteristics. Firstly, as the upper-middle classes constituted the majority of medical doctors in Korea, the societal status of doctors rose and the foundation for the career as a doctor to be persisted as the family occupation settled. Secondly, the research career and academic degree became the principal method to escape from the discrimination and hierarchy existed between doctors. A

Aspirations to become an anaesthetist: longitudinal study of historical trends and trajectories of UK-qualified doctors' early career choices and of factors that have influenced their choices.

PubMed

Emmanouil, Beatrice; Goldacre, Michael J; Lambert, Trevor W

2017-07-25

It is important to inform medical educators and workforce planners in Anaesthesia about early career choices for the specialty, factors that influence them and to elucidate how recent choices of men and women doctors relate to the overall historical trends in the specialty's popularity. We analysed longitudinal data on career choice, based on self-completed questionnaires, from national year-of-qualification cohorts of UK-trained doctors from 1974 to 2012 surveyed one, three and 5 years post-qualification. Career destination data 10 years post-qualification were used for qualifiers between 1993 and 2002, to investigate the association between early choice and later destinations. In years 1, 3 and 5 post-qualification, respectively, 59.9% (37,385), 64.6% (31,473), and 67.2% (24,971) of contactable doctors responded. There was an overall increase, from the early to the later cohorts, in the percentage of medical graduates who wished to enter anaesthesia: for instance year 1 choices rose from 4.6 to 9.4%, comparing the 1974 and 2012 cohorts. Men were more likely than women to express an early preference for a career in anaesthesia: for example, at year 3 after qualification anaesthesia was the choice of 10.1% of men and 7.9% of women. There was a striking increase in the certainty with which women chose anaesthesia as their future career specialty in recent compared to earlier cohorts, not reflected in any trends observed in men choosing anaesthesia. Sixty percent of doctors who were anaesthetists, 10 years after qualifying, had specified anaesthesia as their preferred specialty when surveyed in year 1, 80% in year 3, and 92% in year 5. Doctors working as anaesthetists were less likely than those working in other hospital specialties to have specified, as strong influences on specialty choice, 'experience of the subject' as students, 'inclinations before medical school', and 'what I really want to do'. Men anaesthetists were more influenced in their specialty

Growing number of female physicians changing the face of Canadian medicine.

PubMed Central

Birenbaum, R

1995-01-01

The growing number of female physicians is changing the way medicine is practised. One recent Canadian study found that "significant differences in practice characteristics and service mix and pattern between men and women." Another change involves differences in the way men and women communicate. One lawyer noted that most medical lawsuits involve a breakdown in communication between doctor and patient, and very few female physicians have been the target of malpractice suits--even in high-risk specialties such as obstetrics and anesthesiology. Images p1165-a PMID:7553527

Patient-doctor agreement on recall of clinical trial discussion across cultures.

PubMed

Bernhard, J; Aldridge, J; Butow, P N; Zoller, P; Brown, R; Smith, A; Juraskova, I

2013-02-01

The purpose was to investigate patient-doctor agreement on clinical trial discussion cross-culturally. In the International Breast Cancer Study Group Trial 33-03 on shared decision-making for early breast cancer in Australian/New Zealand (ANZ) and Swiss/German/Austrian (SGA) centers, doctor and patient characteristics plus doctor stress and burnout were assessed. Within 2 weeks post-consultation about treatment options, the doctor and patient reported independently, whether a trial was discussed. Odds ratios of agreement for covariables were estimated by generalized estimating equations for each language cohort, with doctor as a random effect. In ANZ, 21 doctors and 339 patients were eligible; in SGA, 41 doctors and 427 patients. In cases where the doctor indicated 'no trial discussed', 82% of both ANZ and SGA patients agreed; if the doctor indicated 'trial discussed', 50% of ANZ and 38% of SGA patients agreed, respectively. Factors associated with higher agreement were: low tumor grade and fewer patients recruited into clinical trials in SGA; public institution, patient born in ANZ (versus other), higher doctor depersonalization and personal accomplishment in ANZ. There is discordance between oncologists and their patients regarding clinical trial discussion, particularly when the doctor indicates that a trial was discussed. Factors contributing to this agreement vary by culture.

Ross E. Baker, DC: A Canadian chiropractic survivor

PubMed Central

Brown, Douglas M.

2014-01-01

This paper is an historical biography of a fortunate man. It begins with a glimpse of Ross E. Baker’s origins in south-western Ontario, watches him going to school and working in Hamilton before joining the Canadian Army and shipping off to Europe to fight in the Second World War. At War’s end, the article picks up Dr. Baker as he comes home, starts a family, becomes a chiropractor and sustains a viable practice. Now in the twilight of life, the good doctor is last seen content with his retirement, spending days at his cottage property, reviewing his memoirs and reflecting on the tumult, terror and eventual triumph of the D-Day landing at Normandy. PMID:24587499

Ross E. Baker, DC: A Canadian chiropractic survivor.

PubMed

Brown, Douglas M

2014-03-01

This paper is an historical biography of a fortunate man. It begins with a glimpse of Ross E. Baker's origins in south-western Ontario, watches him going to school and working in Hamilton before joining the Canadian Army and shipping off to Europe to fight in the Second World War. At War's end, the article picks up Dr. Baker as he comes home, starts a family, becomes a chiropractor and sustains a viable practice. Now in the twilight of life, the good doctor is last seen content with his retirement, spending days at his cottage property, reviewing his memoirs and reflecting on the tumult, terror and eventual triumph of the D-Day landing at Normandy.

Crucible of fire: the Boer War and the birth of the Canadian Army Medical Corps.

PubMed Central

McCulloch, I

1995-01-01

Although Canada's military physicians didn't come to prominence until WW I and WW II, the Canadian Army Medical Corps (CAMC), the forerunner of the Royal Canadian Army Medical Corps and the current Canadian Forces Medical Service, actually had its origins in the Boer War. During that turn-of-the-century conflict, field hospitals accompanied Canadian troops to South Africa. Ian McCulloch discusses that early type of medical service and the steps that led to the creation of the CAMC. Images p1495-a p1496-a PMID:7585380

A comparison of vowel formant frequencies in the babbling of infants exposed to Canadian English and Canadian French

NASA Astrophysics Data System (ADS)

Mattock, Karen; Rvachew, Susan; Polka, Linda; Turner, Sara

2005-04-01

It is well established that normally developing infants typically enter the canonical babbling stage of production between 6 and 8 months of age. However, whether the linguistic environment affects babbling, either in terms of the phonetic inventory of vowels produced by infants [Oller & Eiler (1982)] or the acoustics of vowel formants [Boysson-Bardies et al. (1989)] is controversial. The spontaneous speech of 42 Canadian English- and Canadian French-learning infants aged 8 to 11, 12 to 15 and 16 to 18 months of age was recorded and digitized to yield a total of 1253 vowels that were spectrally analyzed and statistically compared for differences in first and second formant frequencies. Language-specific influences on vowel acoustics were hypothesized. Preliminary results reveal changes in formant frequencies as a function of age and language background. There is evidence of decreases over age in the F1 values of French but not English infants vowels, and decreases over age in the F2 values of English but not French infants vowels. The notion of an age-related shift in infants attention to language-specific acoustic features and the implications of this for early vocal development as well as for the production of Canadian English and Canadian French vowels will be discussed.

Further Education Pathways of Canadian University Graduates

ERIC Educational Resources Information Center

Adamuti-Trache, Maria

2008-01-01

Through secondary analysis of the National Graduate Survey data, this study examines determinants of choice of further education pathways by Canadian university graduates in early 2000s. This paper extends the Cross' participation model by introducing a typology of path choices that are related to socio-demographic, post-secondary and situational…

What do junior doctors want in start-of-term orientation?

PubMed

Mulroy, Seonaid; Rogers, Ian R; Janakiramanan, Neela; Rodrigues, Michelle

2007-04-02

A comprehensive but succinct orientation is vital for junior doctors as they rotate through jobs during the early postgraduate years. The orientation process will become increasingly relevant in Australia with the change of work patterns to shorter hours and rotating shift rosters. Although orientation is often thought to be suboptimal, there is limited research published on this important process. Feedback from junior doctors suggests that formalised orientation programs at the start of term are highly valued. Junior doctors themselves should be involved in the development and delivery of the orientation program. Junior doctors appreciate the participation of senior staff in the orientation program, but much of it can be overseen by registrars, nursing staff and allied health staff. Use of a standardised proforma with peer-to-peer delivery can facilitate a smooth orientation.

Early diagnosis of hantavirus infection by family doctors can reduce inappropriate antibiotic use and hospitalization.

PubMed

Brorstad, Alette; Oscarsson, Kristina Bergstedt; Ahlm, Clas

2010-09-01

Hantavirus infections are emerging infections that cause either Hantavirus pulmonary syndrome or haemorrhagic fever with renal syndrome (HFRS). A recent Swedish outbreak of nephropathia epidemica, a European HFRS, was analysed to study the patient flow and clinical picture and to investigate the value of an early diagnosis in general practice. Design. In a retrospective design, medical records of verified cases of Hantavirus infection were studied. The study was conducted in the county of Norrbotten, Sweden. Data from Hantavirus patients diagnosed between 2006 and 2008 were analysed. Demographic data, level of care, treatment, clinical symptoms, and laboratory findings were obtained. In total, 456 cases were included (58% males and 42% females). The majority of patients first saw their general practitioner and were exclusively treated in general practice (83% and 56%, respectively). When diagnosed correctly at the first visit, antibiotics and hospitalization were significantly lowered compared with delayed diagnosis (14% vs. 53% and 30% vs. 54%, respectively; p < 0.0001). The clinical picture was diverse. Early thrombocytopenia was found in 65% of the patients, and haemorrhagic manifestations were documented in a few cases. Signs of renal involvement--haematuria, proteinuria, and raised levels of serum creatinine--were found in a majority of patients. Raised awareness in general practice regarding emerging infections and better diagnostic tools are desirable. This study of a Hantavirus outbreak shows that general practitioners are frontline doctors during outbreaks and through early and correct diagnosis they can reduce antibiotic treatment and hospitalization.

Professional paradox: identity formation in qualified doctors pursuing further training.

PubMed

Chan, Mercedes; Pratt, Dan; Poole, Gary; Sidhu, Ravi

2018-03-01

Many newly qualified specialists and subspecialists pursue additional training. Although their motivations are many, the pursuit of further training as an alternative to unemployment is an emerging trend. Paradoxically, doctors continue as trainees with a consultant's credentials, and without the guarantee of eventual employment. This study explores seven doctors' experiences, the effects of further training on their professional identity formation (PIF), and how these effects are reconciled on a personal and professional level. This phenomenological study involved interviews with seven qualified Canadian specialists (three were female) who pursued additional training in response to a lack of available positions in their respective specialties. Template analysis generated theoretical constructs of influences on their PIF, and characteristics of their lived experiences. Four themes shaped PIF: setting and context; language and communication; responsibilities and privileges; and participants' visions of their future selves. Professional identity formation (PIF) continued to develop in further training, but was inconsistently affirmed by participants' communities of practice. Four major themes characterised training experiences: prescription; managing multiple masters; limiting access to others and community ties; and constantly questioning the value of extra training. Qualified doctors traverse professional paradoxes as they seek further education with no guarantee of employment and provide consultant-level care as 'trainees'. An identity dissonance emerges that may continue until a clear identity is prescribed for them. Although disruptive to these doctors' PIF and personal and professional lives, the long-term effects of additional training are unknown. Its utility and influence on securing employment and future job satisfaction are areas for further research. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Effects of individual immigrant attitudes and host culture attitudes on doctor-immigrant patient relationships and communication in Canada.

PubMed

Whittal, Amanda; Rosenberg, Ellen

2015-10-29

In many countries doctors are seeing an increasing amount of immigrant patients. The communication and relationship between such groups often needs to be improved, with the crucial factor potentially being the basic attitudes (acculturation orientations) of the doctors and patients. This study therefore explores how acculturation orientations of Canadian doctors and immigrant patients impact the doctor-patient relationship. N = 10 participants (five doctors, five patients) participated in acculturation orientation surveys, video recordings of a regular clinic visit, and semi structured interviews with each person. Acculturation orientations were calculated using the Euclidean distance method, video recordings were analyzed according to the Verona Coding System, and thematic analysis was used to analyze the interviews. Interviews were used to explain and interpret the behaviours observed in the video recordings. The combined acculturation orientations of each the doctor and immigrant patient played a role in the doctor-patient relationship, although different combinations than expected produced working relationships. Video recordings and interviews revealed that these particular immigrant patients were open to adapting to their new society, and that the doctors were generally accepting of the immigrants' previous culture. This produced a common level of understanding from which the relationship could work effectively. A good relationship and level of communication between doctors and immigrant patients may have its foundation in acculturation orientations, which may affect the quality of care, health behaviours and quality of life of the immigrant. The implications of these findings are more significant when considering effective interventions to improve the quality of doctor-patient relationships, which should have a solid foundational framework. Our research suggests that interventions based on understanding the influence of acculturation orientations could

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

PubMed

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

2009-04-18

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

The "Canadian" in Canadian Children's Literature.

ERIC Educational Resources Information Center

Bainbridge, Joyce; Wolodko, Brenda

2001-01-01

Notes that a rich body of Canadian children's literature exists that reflects the country's literary and socio-cultural values, beliefs, themes and images, including those of geography, history, language and identity. Discusses how Canadians tend to identify themselves first by region or province and then by nation. (SG)

[Carl Gillmeister: the first Doctor of veterinary medicine in Mecklenburg--and in Germany (1834)].

PubMed

Kuhlmann, W; Schäffer, J

2004-02-01

German schools and faculties of veterinary medicine did not receive the sovereign right to award the degree "Doctor medicinae veterinarae" until the early twentieth century. Until then, in the nineteenth century there were two possibilities for veterinarians to earn a doctoral degree, usually referred to as the title of "Doctor": 1. On the basis of an exceptionally excellent dissertation and after very stringent examination a candidate could be awarded the degree "Dr. med." by the faculty of a medical school, or, if the candidate had studied at a philosophical faculty, the degree "Dr. phil." 2. A doctoral degree specifically in veterinary medicine could be earned only at a medical faculty. The Medical Faculty of the University of Giessen awarded the degree "Doctor in arte veterinaria" for the first time in 1832. In this study we prove that Giessen was not the first German university to award a doctorate in veterinary medicine, a priority which has never been questioned in the literature. As early as 1829, veterinarians could earn the degree "Doctor artis veterinariae" at the Medical Faculty of the University of Rostock, where three such awards are documented between 1829 and 1831. The designation "medicina" was also intially avoided in Rostock. Therefore, of particular significance is the discovery of a fourth such document from the Rostock University Archives, the doctoral diploma of Carl Jacob Friedrich Gillmeister, who at the age of 22 was awarded the degree "Doctor medicinae veterinariae" in Rostock after a successful defense. This is the earliest, but also the last archival record of the German doctoral degree in veterinary medicine in the modern sense, because after Gillmeister no veterinarian could earn a doctoral degree in Rostock further more. Gillmeisters vita sheds light on the times and the difficulties of the veterinary profession in the poor agricultural area of Mecklenburg.

Canadian University, Inc., and the Role of Canadian Criticism

ERIC Educational Resources Information Center

Milz, Sabine

2005-01-01

In this article, the author seeks to address the present function of Canadian criticism by undertaking a meditation on the contemporary Canadian university and stating his own position as a critic of Canadian literature in this institutional framework. The author asks: What are the connections between neoliberalism and cultural nationalism in…

Media Analysis of Early Dissemination of Canadian Child Maltreatment Surveillance Data

ERIC Educational Resources Information Center

Tonmyr, Lil; Jack, Susan

2010-01-01

A media strategy was developed to disseminate Canadian child maltreatment surveillance data. Print media were systematically searched and 29 articles reporting on the data were retrieved. Using content analysis, the articles were analyzed to assess informational accuracy and to understand how the media framed the issue of maltreatment. This…

Predicting doctor performance outcomes of curriculum interventions: problem-based learning and continuing competence.

PubMed

Norman, Geoffrey R; Wenghofer, Elizabeth; Klass, Daniel

2008-08-01

Problem-based learning (PBL) is an educational strategy designed to enhance self-assessment, self-directed learning and lifelong learning. The present study examines a peer review programme to determine whether the impact of PBL on continuing competence can be detected in practice. This study aimed to establish whether McMaster graduates who graduated between 1972 and 1991 were any less likely to be identified as having issues of competence by a systematic peer review programme than graduates of other Ontario medical schools. We identified a total of 1166 doctors who had graduated after 1972 and had completed a mandated peer review programme. Of these, 108 had graduated from McMaster and 857 from other Canadian schools. School of graduation was cross-tabulated against peer rating. A secondary analysis examined predictors of ratings using multiple regression. We found that 4% of McMaster graduates and 5% of other graduates were deemed to demonstrate cause for concern or serious concern, and that 24% of McMaster doctors and 28% of other doctors were rated as excellent. These differences were not significant. Multiple regression indicated that certification by family medicine or a specialty, female gender and younger age were all predictors of practice outcomes, but school of graduation was not. There is no evidence from this study that PBL graduates are better able to maintain competence than graduates of conventional schools. The study highlights potential problems in attempting to link undergraduate educational interventions to doctor performance outcomes.

Curbing Early-Career Teacher Attrition: A Pan-Canadian Document Analysis of Teacher Induction and Mentorship Programs

ERIC Educational Resources Information Center

Kutsyuruba, Benjamin; Tregunna, Leigha

2014-01-01

Over the past two decades, the phenomenon of teachers abandoning the profession has been noted internationally, and has increasingly caught the attention of policy makers and educational leaders. Despite this awareness, no pan-Canadian statistics or comprehensive reviews are available. This paper reports on the exploratory, pan-Canadian document…

Doctors on Values and Advocacy: A Qualitative and Evaluative Study.

PubMed

Gallagher, Siun; Little, Miles

2017-12-01

Doctors are increasingly enjoined by their professional organisations to involve themselves in supraclinical advocacy, which embraces activities focused on changing practice and the system in order to address the social determinants of health. The moral basis for doctors' decisions on whether or not to do so has been the subject of little empirical research. This opportunistic qualitative study of the values of medical graduates associated with the Sydney Medical School explores the processes that contribute to doctors' decisions about taking up the advocate role. Our findings show that personal ideals were more important than professional commitments in shaping doctors' decisions on engagement in advocacy. Experiences in early life and during training, including exposure to power and powerlessness, significantly influenced their role choices. Doctors included supraclinical advocacy in their mature practices if it satisfied their desire to achieve excellence. These findings suggest that common approaches to promoting and facilitating advocacy as an individual professional obligation are not fully congruent with the experiences and values of doctors that are significant in creating the advocate. It would seem important to understand better the moral commitments inherent in advocacy to inform future developments in codes of medical ethics and medical education programs.

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

PubMed

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

2014-01-01

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

Development of a Weight Loss Mobile App Linked With an Accelerometer for Use in the Clinic: Usability, Acceptability, and Early Testing of its Impact on the Patient-Doctor Relationship.

PubMed

Choo, Seryung; Kim, Ju Young; Jung, Se Young; Kim, Sarah; Kim, Jeong Eun; Han, Jong Soo; Kim, Sohye; Kim, Jeong Hyun; Kim, Jeehye; Kim, Yongseok; Kim, Dongouk; Steinhubl, Steve

2016-03-31

Although complications of obesity are well acknowledged and managed by clinicians, management of obesity itself is often difficult, which leads to its underdiagnosis and undertreatment in hospital settings. However, tools that could improve the management of obesity, including self-monitoring, engagement with a social network, and open channels of communication between the patient and doctor, are limited in a clinic-based setting. The objective of our study was to evaluate the usability and acceptability of a newly developed mobile app linked with an accelerometer and its early effects on patient-doctor relationships. From September 2013 to February 2014, we developed a mobile app linked with an accelerometer as a supportive tool for a clinic-based weight loss program. The app used information from electronic health records and delivered tailored educational material. Personal goal setting, as well as monitoring of weight changes and physical activity combined with feedback, are key features of the app. We also incorporated an interactive message board for patients and doctors. During the period of March 2014 to May 2014, we tested our mobile app for 1 month in participants in a hospital clinic setting. We assessed the app's usability and acceptability, as well as the patient-doctor relationship, via questionnaires and analysis of app usage data. We recruited 30 individuals (18 male and 12 female) for the study. The median number of log-ins per day was 1.21, with the most frequently requested item being setting goals, followed by track physical activities and view personal health status. Scales of the depth of the patient-doctor relationship decreased from 27.6 (SD 4.8) to 25.1 (SD 4.5) by a Wilcoxon signed rank test (P=.02). A mobile phone app linked with an accelerometer for a clinic-based weight loss program is useful and acceptable for weight management but exhibited less favorable early effects on patient-doctor relationships.

Development of a Weight Loss Mobile App Linked With an Accelerometer for Use in the Clinic: Usability, Acceptability, and Early Testing of its Impact on the Patient-Doctor Relationship

PubMed Central

Choo, Seryung; Jung, Se Young; Kim, Sarah; Kim, Jeong Eun; Han, Jong Soo; Kim, Sohye; Kim, Jeong Hyun; Kim, Jeehye; Kim, Yongseok; Kim, Dongouk; Steinhubl, Steve

2016-01-01

Background Although complications of obesity are well acknowledged and managed by clinicians, management of obesity itself is often difficult, which leads to its underdiagnosis and undertreatment in hospital settings. However, tools that could improve the management of obesity, including self-monitoring, engagement with a social network, and open channels of communication between the patient and doctor, are limited in a clinic-based setting. Objective The objective of our study was to evaluate the usability and acceptability of a newly developed mobile app linked with an accelerometer and its early effects on patient-doctor relationships. Methods From September 2013 to February 2014, we developed a mobile app linked with an accelerometer as a supportive tool for a clinic-based weight loss program. The app used information from electronic health records and delivered tailored educational material. Personal goal setting, as well as monitoring of weight changes and physical activity combined with feedback, are key features of the app. We also incorporated an interactive message board for patients and doctors. During the period of March 2014 to May 2014, we tested our mobile app for 1 month in participants in a hospital clinic setting. We assessed the app’s usability and acceptability, as well as the patient-doctor relationship, via questionnaires and analysis of app usage data. Results We recruited 30 individuals (18 male and 12 female) for the study. The median number of log-ins per day was 1.21, with the most frequently requested item being setting goals, followed by track physical activities and view personal health status. Scales of the depth of the patient-doctor relationship decreased from 27.6 (SD 4.8) to 25.1 (SD 4.5) by a Wilcoxon signed rank test (P=.02). Conclusions A mobile phone app linked with an accelerometer for a clinic-based weight loss program is useful and acceptable for weight management but exhibited less favorable early effects on patient-doctor

Renal function preservation in type 2 diabetes mellitus patients with early nephropathy: a comparative prospective cohort study between primary health care doctors and a nephrologist.

PubMed

Martínez-Ramírez, Héctor R; Jalomo-Martínez, Basilio; Cortés-Sanabria, Laura; Rojas-Campos, Enrique; Barragán, Graciela; Alfaro, Gilberto; Cueto-Manzano, Alfonso M

2006-01-01

Early referral of patients with end-stage renal disease to a nephrologist is associated with lower morbidity and mortality after initiating dialysis therapy; earlier referral may have better results. The aim of the study is to prospectively determine the impact of earlier referral to a nephrologist on renal damage progression of patients with type 2 diabetes mellitus (DM2) with early nephropathy. Fifty-two patients (27 patients, early nephropathy [EN]; 25 patients, overt nephropathy [ON]) from a primary health care unit were referred to a nephrologist (study cohort); 65 patients (34 patients, EN; 31 patients, ON) from another health care unit remained treated by only family doctors (control cohort). Both cohorts were followed up for 1 year. Delta (final-baseline) in serum creatinine levels was maintained better by the nephrologist in the EN (study, 0.02 mg/dL versus control, 0.13 mg/dL [2 versus 11 micromol/L]; P = 0.02) than ON group (study, 0.15 mg/dL versus control, 0.25 mg/dL [13 versus 22 micromol/L]). In concordance, glomerular filtration rate was maintained better by the nephrologist in EN (study, 3.2 mL/min/1.73 m2 versus control, -13.3 mL/min/1.73 m2 [0.05 versus -0.22 mL/s/1.73 m2]; P = 0.01) than ON patients (study, -9.8 mL/min/1.73 m2 versus control, -10.9 mL/min/1.73 m2 [-0.16 versus -0.18 mL/s/1.73 m2]). Albuminuria increased more in patients treated by family doctors in the EN (study, 30 mg/d versus control, 116 mg/d; P < 0.05) and ON groups (study, 160 mg/d versus control, 623 mg/d). The nephrologist controlled systolic blood pressure better in both the EN (study, -3 mm Hg versus control, 2 mm Hg; P < 0.05) and ON groups (study, -19 mm Hg versus control, 5 mm Hg; P < 0.05); diastolic blood pressure had a similar pattern. The nephrologist significantly increased (P < 0.05) the use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and statins and discontinued nonsteroidal anti-inflammatory drugs more than family doctors

Canadian advanced life support capacities and future directions

NASA Astrophysics Data System (ADS)

Bamsey, M.; Graham, T.; Stasiak, M.; Berinstain, A.; Scott, A.; Vuk, T. Rondeau; Dixon, M.

2009-07-01

Canada began research on space-relevant biological life support systems in the early 1990s. Since that time Canadian capabilities have grown tremendously, placing Canada among the emerging leaders in biological life support systems. The rapid growth of Canadian expertise has been the result of several factors including a large and technically sophisticated greenhouse sector which successfully operates under challenging climatic conditions, well planned technology transfer strategies between the academic and industrial sectors, and a strong emphasis on international research collaborations. Recent activities such as Canada's contribution of the Higher Plant Compartment of the European Space Agency's MELiSSA Pilot Plant and the remote operation of the Arthur Clarke Mars Greenhouse in the Canadian High Arctic continue to demonstrate Canadian capabilities with direct applicability to advanced life support systems. There is also a significant latent potential within Canadian institutions and organizations with respect to directly applicable advanced life support technologies. These directly applicable research interests include such areas as horticultural management strategies (for candidate crops), growth media, food processing, water management, atmosphere management, energy management, waste management, imaging, environment sensors, thermal control, lighting systems, robotics, command and data handling, communications systems, structures, in-situ resource utilization, space analogues and mission operations. With this background and in collaboration with the Canadian aerospace industry sector, a roadmap for future life support contributions is presented here. This roadmap targets an objective of at least 50% food closure by 2050 (providing greater closure in oxygen, water recycling and carbon dioxide uptake). The Canadian advanced life support community has chosen to focus on lunar surface infrastructure and not low Earth orbit or transit systems (i.e. microgravity

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

PubMed

Strauman, Elena C; Goodier, Bethany C

2011-03-01

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

Canadian crop calendars in support of the early warning project

NASA Technical Reports Server (NTRS)

Trenchard, M. H.; Hodges, T. (Principal Investigator)

1980-01-01

The Canadian crop calendars for LACIE are presented. Long term monthly averages of daily maximum and daily minimum temperatures for subregions of provinces were used to simulate normal daily maximum and minimum temperatures. The Robertson (1968) spring wheat and Williams (1974) spring barley phenology models were run using the simulated daily temperatures and daylengths for appropriate latitudes. Simulated daily temperatures and phenology model outputs for spring wheat and spring barley are given.

Choose your doctorate.

PubMed

Jolley, Jeremy

2007-02-01

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

Early mobilization of critically ill adults: a survey of knowledge, perceptions and practices of Canadian physicians and physiotherapists

PubMed Central

Koo, Karen K.Y.; Choong, Karen; Cook, Deborah J.; Herridge, Margaret; Newman, Anastasia; Lo, Vincent; Guyatt, Gordon; Priestap, Fran; Campbell, Eileen; Burns, Karen E.A.; Lamontagne, FranÇois; Meade, Maureen O.

2016-01-01

Background: The promotion of early mobilization following critical illness is tempered by national reports of patient and institutional barriers to this approach. We carried out a survey to assess current knowledge, perceptions and practices of Canadian physicians and physiotherapists with respect to acquired weakness and early mobilization in adults in the intensive care unit (ICU). Methods: We conducted a cross-sectional, self-administered postal survey among critical care physicians and physiotherapists in all 46 academic ICUs in Canada in 2011-2012. To identify all physicians and physiotherapists working in the ICUs, we contacted division heads and senior physiotherapists by telephone or email. We designed, tested and administered a questionnaire with the following domains: knowledge of ICU-acquired weakness and early mobilization; personal views of, perceived barriers to and adequacy of technical skills for early mobilization; assessments for initiation of early mobilization and permissible activity levels by patient physiologic characteristics, diagnoses and therapies; staffing issues; and sedation practices. Results: The overall response rate was 71.3% (311/436); it was 64.2% (194/302) among physicians and 87.3% (117/134) among physiotherapists. A total of 214 respondents (68.8%) underestimated the incidence of ICU-acquired weakness in the general medical-surgical ICU population, and 186 (59.8%) stated they had insufficient knowledge or skills to mobilize patients receiving mechanical ventilation. Excessive sedation, medical instability, limited staffing, safety concerns, insufficient guidelines and insufficient equipment were common perceived barriers to early mobilization. Interpretation: Physicians and physiotherapists in the ICU underestimated the incidence of ICU-acquired weakness and felt inadequately trained to mobilize patients receiving mechanical ventilation. We identified multiple modifiable barriers to early mobilization at the institutional

Public Health Adaptation to Climate Change in Canadian Jurisdictions

PubMed Central

Austin, Stephanie E.; Ford, James D.; Berrang-Ford, Lea; Araos, Malcolm; Parker, Stephen; Fleury, Manon D.

2015-01-01

Climate change poses numerous risks to the health of Canadians. Extreme weather events, poor air quality, and food insecurity in northern regions are likely to increase along with the increasing incidence and range of infectious diseases. In this study we identify and characterize Canadian federal, provincial, territorial and municipal adaptation to these health risks based on publically available information. Federal health adaptation initiatives emphasize capacity building and gathering information to address general health, infectious disease and heat-related risks. Provincial and territorial adaptation is varied. Quebec is a leader in climate change adaptation, having a notably higher number of adaptation initiatives reported, addressing almost all risks posed by climate change in the province, and having implemented various adaptation types. Meanwhile, all other Canadian provinces and territories are in the early stages of health adaptation. Based on publically available information, reported adaptation also varies greatly by municipality. The six sampled Canadian regional health authorities (or equivalent) are not reporting any adaptation initiatives. We also find little relationship between the number of initiatives reported in the six sampled municipalities and their provinces, suggesting that municipalities are adapting (or not adapting) autonomously. PMID:25588156

Public health adaptation to climate change in Canadian jurisdictions.

PubMed

Austin, Stephanie E; Ford, James D; Berrang-Ford, Lea; Araos, Malcolm; Parker, Stephen; Fleury, Manon D

2015-01-12

Climate change poses numerous risks to the health of Canadians. Extreme weather events, poor air quality, and food insecurity in northern regions are likely to increase along with the increasing incidence and range of infectious diseases. In this study we identify and characterize Canadian federal, provincial, territorial and municipal adaptation to these health risks based on publically available information. Federal health adaptation initiatives emphasize capacity building and gathering information to address general health, infectious disease and heat-related risks. Provincial and territorial adaptation is varied. Quebec is a leader in climate change adaptation, having a notably higher number of adaptation initiatives reported, addressing almost all risks posed by climate change in the province, and having implemented various adaptation types. Meanwhile, all other Canadian provinces and territories are in the early stages of health adaptation. Based on publically available information, reported adaptation also varies greatly by municipality. The six sampled Canadian regional health authorities (or equivalent) are not reporting any adaptation initiatives. We also find little relationship between the number of initiatives reported in the six sampled municipalities and their provinces, suggesting that municipalities are adapting (or not adapting) autonomously.

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

PubMed Central

Ross, Daniella; Petrie, Claire; Tully, Vicki

2016-01-01

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

Failing to retain a new generation of doctors: qualitative insights from a high-income country.

PubMed

Humphries, Niamh; Crowe, Sophie; Brugha, Ruairí

2018-02-27

The failure of high-income countries, such as Ireland, to achieve a self-sufficient medical workforce has global implications, particularly for low-income, source countries. In the past decade, Ireland has doubled the number of doctors it trains annually, but because of its failure to retain doctors, it remains heavily reliant on internationally trained doctors to staff its health system. To halve its dependence on internationally trained doctors by 2030, in line with World Health Organisation (WHO) recommendations, Ireland must become more adept at retaining doctors. This paper presents findings from in-depth interviews conducted with 50 early career doctors between May and July 2015. The paper explores the generational component of Ireland's failure to retain doctors and makes recommendations for retention policy and practice. Interviews revealed that a new generation of doctors differ from previous generations in several distinct ways. Their early experiences of training and practice have been in an over-stretched, under-staffed health system and this shapes their decision to remain in Ireland, or to leave. Perhaps as a result of the distinct challenges they have faced in an austerity-constrained health system and their awareness of the working conditions available globally, they challenge the traditional view of medicine as a vocation that should be prioritised before family and other commitments. A new generation of doctors have career options that are also strongly shaped by globalisation and by the opportunities presented by emigration. Understanding the medical workforce from a generational perspective requires that the health system address the issues of concern to a new generation of doctors, in terms of working conditions and training structures and also in terms of their desire for a more acceptable balance between work and life. This will be an important step towards future-proofing the medical workforce and is essential to achieving medical workforce

Doctor Shopping

PubMed Central

Sansone, Lori A.

2012-01-01

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

Perceived Stress and Canadian Early Childcare Educators

ERIC Educational Resources Information Center

Wagner, Shannon L.; Forer, Barry; Cepeda, Ivan L.; Goelman, Hillel; Maggi, Stefania; D'Angiulli, Amedeo; Wessel, Julie; Hertzman, Clyde; Grunau, Ruth E.

2013-01-01

Background: Occupational stress for early childcare educators is an area of apparent understudy in the literature. The present study attempted to address this gap and provide some updated data regarding the experiences of this occupational group. Methods: Early childhood workers across a variety of early childhood education settings (N = 69)…

Supervising the Professional Doctoral Student: Less Process and Progress, More Peripheral Participation and Personal Identity

ERIC Educational Resources Information Center

Mawson, Kate; Abbott, Ian

2017-01-01

This article presents a discussion around issues of identity for part-time professional doctoral students. The current supervision arrangements of a professional doctoral programme were considered, using an exploratory study, to explore the idea that supervision for competent confident professionals should, in the early stages, focus on identity…

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

PubMed

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

2011-04-01

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

Disorganized junior doctors fail the MRCP (UK).

PubMed

Stanley, Adrian G; Khan, Khalid M; Hussain, Walayat; Tweed, Michael

2006-02-01

Career progression during undergraduate and early postgraduate years is currently determined by successfully passing examinations. Both academic factors (secondary school examination results, learning style and training opportunities) and non-academic factors (maturity, ethnic origin, gender and motivation) have been identified as predicting examination outcome. Few studies have examined organization skills. Disorganized medical students are more likely to perform poorly in end-of-year examinations but this observation has not been examined in junior doctors. This study asked whether organization skills relate to examination outcome amongst junior doctors taking the clinical Part II examination for the Membership of the Royal College of Physicians (Practical Assessment of Clinical Examination Skills). The study was conducted prospectively at four consecutive clinical courses that provided clinical teaching and practice to prepare trainees for the examination. Arrival time at registration for the course was the chosen surrogate for organization skills. Trainees were advised that they should arrive promptly at 8.00 a.m. for registration and it was explained that the course would start at 8.30 a.m. Recorded arrival times were compared with the pass lists published by the Royal College of Physicians. The mean arrival time was 8.17 a.m. A total of 81 doctors (53.3%) passed the examination with a mean arrival time of 8.14 a.m. However, 71 doctors failed the exam and arrived, on average, six minutes later than doctors who passed (p?=?0.006). Better-prepared junior doctors were more likely to pass the final examination. Arriving on time represents a composite of several skills involved in the planning of appropriate travel arrangements and is therefore a valid marker of organization skills and preparation. This novel study has shown that good time-keeping skills are positively associated with examination outcome.

Working mothers and early childhood outcomes: lessons from the Canadian National Longitudinal Study on Children and Youth.

PubMed

Sherlock, R L; Synnes, A R; Koehoorn, M

2008-04-01

More mothers are choosing to return to work during the first 2 years of their child's life with an uncertain impact on early developmental outcomes. To determine the association between duration of maternity leave and motor and social development of toddlers. Population-based, retrospective cohort study. The Canadian National Longitudinal Survey on Children and Youth (NLSCY) Cycle 3 provides data on the characteristics and life experience of Canadian children. For sampled households, the person most knowledgeable about the child completed a survey on demographics, parent characteristics and family environment. The analysis was limited to 6664 families with children up to 2 years. Logistic regression was used to assess the association between duration of maternity leave and impaired performance (<-1 SD below the mean) on the Motor and Social Development (MSD) scale adjusted for multiple covariates including maternal age, gender, breastfeeding and socioeconomic status. One month of maternity leave increased the odds of impaired performance on the MSD by 3% (OR 1.03, 95% CI 1.02, 1.04). This was also seen with categorized maternity leave duration. Being male (OR 1.53, 95% CI 1.35, 1.74) and having a younger mother (OR 1.48, 95% CI 0.98, 2.23) increased the risk of impaired performance on the MSD while being of higher SES reduced the risk (OR 0.96, 95% CI 0.93, 1.00). There is an association between duration of maternity leave and impaired performance in motor and social development in children up to 2 years.

Doctoral Women: Managing Emotions, Managing Doctoral Studies

ERIC Educational Resources Information Center

Aitchison, Claire; Mowbray, Susan

2013-01-01

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

The Canadian experience in frontier environmental protection

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

Jones, G.H.

1991-03-01

Early Canadian frontier exploration (from 1955 onshore and from 1966 for offshore drilling) caused insignificant public concern. The 1967-1968 Torrey Canyon Tanker and Santa Barbara disasters roused public opinion and governments. In Canada, 1969-1970 Arctic gas blowouts, a tanker disaster, and damage to the 'Manhattan' exacerbated concerns and resulted in new environmental regulatory constraints. From 1970, the Arctic Petroleum Operations Association learned to operate safely with environmental responsibility. It studied physical environment for design criteria, and the biological and human environment to ameliorate impact. APOA's research projects covered sea-ice, permafrost, sea-bottom, oil-spills, bird and mammal migration, fish habitat, food chains,more » oceanography, meteorology, hunters'/trappers' harvests, etc. In 1971 Eastcoast Petroleum Operators' Association and Alaska Oil and Gas Association followed APOA's cooperative research model. EPOA stressed icebergs and fisheries. Certain research was handled by the Canadian Offshore Oil Spill Research Association. By the mid-1980s these associations had undertaken $70,000,000 of environmental oriented research, with equivalent additional work by member companies on specific needs and similar sums by Federal agencies often working with industry on complementary research. The frontier associations then merged with the Canadian Petroleum Association, already active environmentally in western Canada. Working with government and informing environmental interest groups, the public, natives, and local groups, most Canadian frontier petroleum operations proceeded with minimal delay and environmental disturbance.« less

Early Triassic development of a foreland basin in the Canadian high Arctic: Implications for a Pangean Rim of Fire

NASA Astrophysics Data System (ADS)

Hadlari, Thomas; Dewing, Keith; Matthews, William A.; Alonso-Torres, Daniel; Midwinter, Derrick

2018-06-01

Following the amalgamation of Laurasia and Gondwana to form Pangea, some Triassic tectonic models show an encircling arc system called the "Pangean Rim of Fire". Here we show that the stratigraphy and Early Triassic detrital zircon provenance of the Sverdrup Basin in the Canadian Arctic is most consistent with deposition in a retro-arc foreland basin. Late Permian and Early Triassic volcanism was accompanied by relatively high rates of subsidence leading to a starved basin with volcanic input from a magmatic arc to the northwest. The mostly starved basin persisted through the Middle and Late Triassic with nearly continuous input of volcanic ash recorded as bentonites on the northwestern edge of the basin. In the latest Triassic it is interpreted that decreasing subsidence and a significant influx of sand-grade sediment when the arc was exhumed led to filling of the basin at the end of an orogenic cycle. Combined with other hints of Early Triassic arc activity along the western margin of Laurentia we propose that the Pangean Rim of Fire configuration spanned the entire Triassic. This proposed configuration represents the ring of external subduction zones that some models suggest are necessary for the breakup of supercontinents such as Pangea.

A Longitudinal Examination of Risky Sexual Behaviors among Canadian and Italian Adolescents: Considering Individual, Parental, and Friend Characteristics

ERIC Educational Resources Information Center

Boislard P., Marie-Aude; Poulin, Francois; Kiesner, Jeff; Dishion, Thomas J.

2009-01-01

In this study, two longitudinal models of early adolescent risky sexual behaviors (RSB) were compared using a pooled sample of 267 Canadian and Italian adolescents (55% females; 53% Canadians) assessed yearly from grade 8 to 10. We focused on parenting practices (monitoring, control, limit setting), adolescent problem behaviors (antisocial…

Culturally Relevant Pedagogies: Possibilities and Challenges for African Canadian Children

ERIC Educational Resources Information Center

Henry, Annette

2017-01-01

Background/Context: Ladson-Billings's concept of Culturally Relevant Pedagogy for African American children has been widely reinterpreted in various contexts for racialized students. In this reflective essay, I consider its challenges in Canadian contexts. Focus: I use my early ethnographic work to illustrate important aspects of culturally…

How do workplaces, working practices and colleagues affect UK doctors' career decisions? A qualitative study of junior doctors' career decision making in the UK.

PubMed

Spooner, Sharon; Pearson, Emma; Gibson, Jonathan; Checkland, Kath

2017-10-25

This study draws on an in-depth investigation of factors that influenced the career decisions of junior doctors. Junior doctors in the UK can choose to enter specialty training (ST) programmes within 2 years of becoming doctors. Their specialty choices contribute to shaping the balance of the future medical workforce, with views on general practice (GP) careers of particular interest because of current recruitment difficulties. This paper examines how experiences of medical work and perceptions about specialty training shape junior doctors' career decisions. Twenty doctors in the second year of a Foundation Training Programme in England were recruited. Purposive sampling was used to achieve a diverse sample from respondents to an online survey. Narrative interviewing techniques encouraged doctors to reflect on how experiences during medical school and in medical workplaces had influenced their preferences and perceptions of different specialties. They also spoke about personal aspirations, work priorities and their wider future.Junior doctors' decisions were informed by knowledge about the requirements of ST programmes and direct observation of the pressures under which ST doctors worked. When they encountered negative attitudes towards a specialty they had intended to choose, some became defensive while others kept silent. Achievement of an acceptable work-life balance was a central objective that could override other preferences.Events linked with specific specialties influenced doctors' attitudes towards them. For example, findings confirmed that while early, positive experiences of GP work could increase its attractiveness, negative experiences in GP settings had the opposite effect. Junior doctors' preferences and perceptions about medical work are influenced by multiple intrinsic and extrinsic factors and experiences. This paper highlights the importance of understanding how perceptions are formed and preferences are developed, as a basis for generating

Doctors in Balzac's work.

PubMed

Moulin, Thierry

2013-01-01

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

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

PubMed

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

2005-12-01

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

Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep.

PubMed

Tremblay, Mark S; Chaput, Jean-Philippe; Adamo, Kristi B; Aubert, Salomé; Barnes, Joel D; Choquette, Louise; Duggan, Mary; Faulkner, Guy; Goldfield, Gary S; Gray, Casey E; Gruber, Reut; Janson, Katherine; Janssen, Ian; Janssen, Xanne; Jaramillo Garcia, Alejandra; Kuzik, Nicholas; LeBlanc, Claire; MacLean, Joanna; Okely, Anthony D; Poitras, Veronica J; Rayner, Mary-Ellen; Reilly, John J; Sampson, Margaret; Spence, John C; Timmons, Brian W; Carson, Valerie

2017-11-20

The Canadian Society for Exercise Physiology convened representatives of national organizations, research experts, methodologists, stakeholders, and end-users who followed rigorous and transparent guideline development procedures to create the Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years): An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These novel guidelines for children of the early years embrace the natural and intuitive integration of movement behaviours across the whole day (24-h period). The development process was guided by the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Four systematic reviews (physical activity, sedentary behaviour, sleep, combined behaviours) examining the relationships within and among movement behaviours and several health indicators were completed and interpreted by a Guideline Development Panel. The systematic reviews that were conducted to inform the development of the guidelines, and the framework that was applied to develop the recommendations, followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. Complementary compositional analyses were performed using data from the Canadian Health Measures Survey to examine the relationships between movement behaviours and indicators of adiposity. A review of the evidence on the cost effectiveness and resource use associated with the implementation of the proposed guidelines was also undertaken. A stakeholder survey (n = 546), 10 key informant interviews, and 14 focus groups (n = 92 participants) were completed to gather feedback on draft guidelines and their dissemination. The guidelines provide evidence-informed recommendations as to the combinations of light-, moderate- and vigorous-intensity physical activity, sedentary behaviours, and sleep that infants (<1 year), toddlers (1-2 years) and preschoolers (3-4 years) should achieve for a healthy day (24�

Designing medical internships to improve recruitment and retention of doctors in rural areas.

PubMed

Gaski, Margrete; Abelsen, Birgit

2017-01-01

The medical internship as a way of exposing young doctors to training in a rural context is regarded as a useful tool to recruit and retain doctors in rural areas. Norwegian health authorities tested an arrangement of early sign-up for medical internships in the Finnmark County in Norway. To report on the effects of the early sign-up for medical internship. This study compares the choice of workplace after internship among physicians who signed up early with those candidates assigned to the raffle model of internship in the study area, and in a comparison area experiencing similar recruitment and retention problems. The proportion of interns who signed up early that still worked as physicians in the study area by April 2014 (29%) was twice as high as among the regular interns (15%) and interns in the comparison area (14%). Among the 59 interns who signed up early still working in the study area in April 2014, 33% had grown up in this area. However, the greatest benefits were for the most densely populated municipalities in the study area. The early sign-up model had a net contribution of proving additional physicians in the study area.

[Behavioral risk factors of chronic non-communicable diseases in medical doctors].

PubMed

Исаева, Анна С; Резник, Лариса А; Вовченко, Марина Н; Буряковская, Алена А; Довганюк, Инна Э

medical doctors. Absence of continuous sleep and early awakenings dominated between diagnosed sleep disorders. Fifty three percent of women and 47 percent of men had early awakenings. Conclusions: the main part of medical doctors in present study had low physical activity, sleep disorders and unhealthy nutrition behavior. So, special programs designed for medical professionals are needed to correct risk of chronic non-communicable disease related to behavioral factors.

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

PubMed

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

2010-03-01

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

Canadian 24-hour movement guidelines for the early years (0-4 years): exploring the perceptions of stakeholders and end users regarding their acceptability, barriers to uptake, and dissemination.

PubMed

Riazi, Negin; Ramanathan, Subha; O'Neill, Meghan; Tremblay, Mark S; Faulkner, Guy

2017-11-20

It is important to engage stakeholders and end users in the development of guidelines for knowledge translation purposes. The aim of this study was to examine stakeholders' (experts in pediatric and family medicine, physical activity knowledge translation, and research) and end users' (parents and early childhood educators) perceptions of the Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years). Stakeholders (n = 10) engaged in telephone interviews and end users (n = 92) participated in focus groups (n = 14) to discuss perceived clarity and need for the guidelines, potential barriers to implementation, identification of credible messengers, and methods for dissemination of the guidelines. A thematic analysis was conducted. The proposed guidelines were very well received by both stakeholders and end users. A clear need for such guidelines was identified, and most believed the guidelines were achievable. Stakeholders and end users identified several potential barriers to uptake, including low awareness of current guidelines; 'daily challenges' such as allure of screen time, lack of time, and competing priorities; and challenges in the context of shifting social norms. A range of methods and messengers of dissemination were identified. Medical and child care settings were the most frequently cited places for dissemination, and physicians and early childhood educators were the most common suggestions for messengers. There was consistent support for the Canadian 24-Hour Movement Guidelines for the Early Years (0-4 years) from both stakeholders and end users. Moving forward, it is important to dedicate appropriate support and funding toward dissemination efforts in order to reach end users, particularly parents and early childhood educators.

A Cross-Cultural Investigation of the Efficacy Beliefs of South Asian Immigrant and Anglo Canadian Nonimmigrant Early Adolescents

ERIC Educational Resources Information Center

Klassen, Robert M.

2004-01-01

The author explored the mathematics efficacy beliefs of 270 South Asian (Indo Canadian) immigrant and Anglo Canadian nonimmigrant Grade 7 students. Self-efficacy beliefs strongly predicted mathematics performance for both cultural groups, but there were differences between the 2 groups in the sources of self-efficacy, the predictiveness of the…

Re-Imagining Doctoral Education: Professional Doctorates and beyond

ERIC Educational Resources Information Center

Lee, Alison; Brennan, Marie; Green, Bill

2009-01-01

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

Science Traverses in the Canadian High Arctic

NASA Technical Reports Server (NTRS)

Williamson, Marie-Claude

2012-01-01

The presentation is divided into three parts. Part I is an overview of early expeditions to the High Arctic, and their political consequences at the time. The focus then shifts to the Geological Survey of Canada s mapping program in the North (Operation Franklin), and to the Polar Continental Shelf Project (PCSP), a unique organization that resides within the Government of Canada s Department of Natural Resources, and supports mapping projects and science investigations. PCSP is highlighted throughout the presentation so a description of mandate, budgets, and support infrastructure is warranted. In Part II, the presenter describes the planning required in advance of scientific deployments carried out in the Canadian High Arctic from the perspective of government and university investigators. Field operations and challenges encountered while leading arctic field teams in fly camps are also described in this part of the presentation, with particular emphasis on the 2008 field season. Part III is a summary of preliminary results obtained from a Polar Survey questionnaire sent out to members of the Arctic research community in anticipation of the workshop. The last part of the talk is an update on the analog program at the Canadian Space Agency, specifically, the Canadian Analog Research Network (CARN) and current activities related to Analog missions, 2009-2010.

Perceived Caring of Instructors among Online Doctoral Nursing Students

ERIC Educational Resources Information Center

Walters, Gwendolyn M.

2013-01-01

The concept of caring has been integral to the practice of nursing and nursing education since the early teachings of Florence Nightingale. Significant changes in both the practice and the need for educating increasing numbers of advanced-degree nurses have resulted in an increase in online doctoral-level nursing programs. This internet-based…

Socialization, Indifference, and Convenience: Exploring the Uptake of Influenza Vaccine Among Medical Students and Early Career Doctors.

PubMed

Edge, Rhiannon; Goodwin, Dawn; Isba, Rachel; Keegan, Thomas

2017-11-01

The Chief Medical Officer recommends that all health care workers receive an influenza vaccination annually. High vaccination coverage is believed to be the best protection against the spread of influenza within a hospital, although uptake by health care workers remains low. We conducted semistructured interviews with seven medical students and nine early career doctors, to explore the factors informing their influenza vaccination decision making. Data collection and analysis took place iteratively, until theoretical saturation was achieved, and a thematic analysis was performed. Socialization was important although its effects were attenuated by participants' previous experiences and a lack of clarity around the risks and benefits of vaccination. Many participants did not have strong intentions regarding vaccination. There was considerable disparity between an individual's opinion of the vaccine, their intentions, and their vaccination status. The indifference demonstrated here suggests few are strongly opposed to the vaccination-there is potential to increase vaccination coverage.

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

PubMed

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

2017-01-01

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

Burnout among public doctors in Hong Kong: cross-sectional survey.

PubMed

Siu, Christina F Y; Yuen, S K; Cheung, Andy

2012-06-01

The stressful life of doctors makes them prone to burnout. We evaluated the prevalence of burnout among Hong Kong public hospital doctors and correlated burnout with job characteristics, working hours, stressors, and stress-relieving strategies. Cross-sectional survey. Hong Kong. One thousand doctors were randomly sampled from the Hong Kong Public Doctors' Association registry. Self-administered, anonymous questionnaires with postage-paid envelopes were mailed twice in early 2009. The Maslach Burnout Inventory-Human Services Survey was used for burnout assessment. According to this scale, burnout is defined as emotional exhaustion, depersonalisation, and a reduced sense of personal accomplishment. Correlation analysis, as well as univariate and multivariate analyses, were performed to assess factors associated with high degrees of burnout. RESULTS. A total of 226 questionnaires were analysed, of which 31.4% of the respondents satisfied the criteria for high burnout. They were younger and needed to work shifts, and their median year of practice was 8.5. High-burnout doctors worked similar hours per week to non-high-burnout doctors (mean ± standard deviation, 56.2 ± 12.7 vs 54.7 ± 10.9; P=0.413) and reported suicidal thoughts more often (9.9% vs 2.6%; P=0.033). Moreover, 52.2% of high-burnout doctors were dissatisfied or very dissatisfied with their jobs. 'Excessive stress due to global workload' and 'feeling that their own work was not valued by others' were the most significant stressors associated with high emotional exhaustion and depersonalisation, while 'feeling that their own work was not valued by others' and 'poor job security' correlated with low personal accomplishment. A high proportion of public doctors who responded to our survey endured high burnout. Trainees with some experience were at heightened risk. Stressors identified in this study should be addressed, so as to improve job satisfaction.

Not What I Expected: Early Career Prospects of Doctoral Graduates in Academia

ERIC Educational Resources Information Center

Etmanski, Brittany; Walters, David; Zarifa, David

2017-01-01

Various studies acknowledge the uncertainty many doctoral graduates face when beginning their search for full-time employment within the academic sector. Recent graduates face a job market where the likelihood of obtaining full-time permanent positions in academia is perceived to be declining, and the mobility of graduates within the sector is…

Ageing doctors.

PubMed

Lillis, Steven; Milligan, Eleanor

2017-03-01

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

Doctors and pharmaceutical industry.

PubMed

Beran, Roy G

2009-09-01

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

Contemplate Doctoral Study

ERIC Educational Resources Information Center

Flowers, Jim; Lazaros, Edward

2009-01-01

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

Early sex work initiation independently elevates odds of HIV infection and police arrest among adult sex workers in a Canadian setting.

PubMed

Goldenberg, Shira M; Chettiar, Jill; Simo, Annick; Silverman, Jay G; Strathdee, Steffanie A; Montaner, Julio S G; Shannon, Kate

2014-01-01

To explore factors associated with early sex work initiation and model the independent effect of early initiation on HIV infection and prostitution arrests among adult sex workers (SWs). Baseline data (2010-2011) were drawn from a cohort of SWs who exchanged sex for money within the last month and were recruited through time location sampling in Vancouver, Canada. Analyses were restricted to adults ≥18 years old. SWs completed a questionnaire and HIV/sexually transmitted infection testing. Using multivariate logistic regression, we identified associations with early sex work initiation (<18 years old) and constructed confounder models examining the independent effect of early initiation on HIV and prostitution arrests among adult SWs. Of 508 SWs, 193 (38.0%) reported early sex work initiation, with 78.53% primarily street-involved SWs and 21.46% off-street SWs. HIV prevalence was 11.22%, which was 19.69% among early initiates. Early initiates were more likely to be Canadian born [adjusted odds ratio (AOR): 6.8, 95% confidence interval (CI): 2.42 to 19.02], inject drugs (AOR: 1.6, 95% CI: 1.0 to 2.5), and to have worked for a manager (AOR: 2.22, 95% CI: 1.3 to 3.6) or been coerced into sex work (AOR: 2.3, 95% CI: 1.14 to 4.44). Early initiation retained an independent effect on increased risk of HIV infection (AOR: 2.5, 95% CI: 1.3 to 3.2) and prostitution arrests (AOR: 2.0, 95% CI: 1.3 to 3.2). Adolescent sex work initiation is concentrated among marginalized, drug, and street-involved SWs. Early initiation holds an independent increased effect on HIV infection and criminalization of adult SWs. Findings suggest the need for evidence-based approaches to reduce harm among adult and youth SWs.

Early sex work initiation independently elevates odds of HIV infection and police arrest among adult sex workers in a Canadian setting

PubMed Central

GOLDENBERG, Shira M.; CHETTIAR, Jill; SIMO, Annick; SILVERMAN, Jay G.; STRATHDEE, Steffanie A.; MONTANER, Julio; SHANNON, Kate

2014-01-01

Objectives To explore factors associated with early sex work initiation, and model the independent effect of early initiation on HIV infection and prostitution arrests among adult sex workers (SWs). Design Baseline data (2010–2011) were drawn from a cohort of SWs who exchanged sex for money within the last month and were recruited through time-location sampling in Vancouver, Canada. Analyses were restricted to adults ≥18 years old. Methods SWs completed a questionnaire and HIV/STI testing. Using multivariate logistic regression, we identified associations with early sex work initiation (<18 years old) and constructed confounder models examining the independent effect of early initiation on HIV and prostitution arrests among adult SWs. Results Of 508 SWs, 193 (38.0%) reported early sex work initiation, with 78.53% primarily street-involved SWs and 21.46% off-street SWs. HIV prevalence was 11.22%, which was 19.69% among early initiates. Early initiates were more likely to be Canadian-born (Adjusted Odds Ratio (AOR): 6.8, 95% Confidence Interval (CI): 2.42–19.02), inject drugs (AOR: 1.6, 95%CI: 1.0–2.5), and to have worked for a manager (AOR: 2.22, 95%CI: 1.3–3.6) or been coerced into sex work (AOR: 2.3, 95%CI: 1.14–4.44). Early initiation retained an independent effect on increased risk of HIV infection (AOR: 2.5, 95% CI: 1.3–3.2) and prostitution arrests (AOR: 2.0, 95%CI: 1.3–3.2). Conclusions Adolescent sex work initiation is concentrated among marginalized, drug and street-involved SWs. Early initiation holds an independent increased effect on HIV infection and criminalization of adult SWs. Findings suggest the need for evidence-based approaches to reduce harm among adult and youth SWs. PMID:23982660

Wanted--doctors who care.

PubMed

Lovdal, L T; Pearson, R

1989-03-01

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

Can new doctors be prepared for practice? A review.

PubMed

Alexander, Cameron; Cameron, Alexander; Millar, James; Szmidt, Natasha; Hanlon, Katie; Cleland, Jennifer

2014-06-01

The transition from medical student to junior doctor is an important period of change. Research shows junior doctors often experience high levels of stress, and consequently burnout. Understanding how to prepare for the transition may allow individuals who are likely to struggle to be identified and assisted. The aim of this paper is to systematically review the literature on preparedness for practice in newly qualified junior doctors. This was a systematic review of literature concerning the transition from student to junior doctor, published in the last 10 years, and that measured or explored one or more factors affecting preparedness. Nine papers were included in this review. These varied in design and methodological quality. Most used survey methodology (n = 7). Six found knowledge and skills, particularly deficiencies in prescribing and practical procedures, relevant in terms of preparedness. Five looked at personal traits, with high levels of neuroticism and low confidence deemed to be important. Medical school and workplace factors, including early clinical experience and shadowing, positively affected preparedness. A lack of senior support proved detrimental. The influence of demographics was inconclusive. The studies reviewed indicate that both personal and organisational factors are pertinent to managing the transition from student to junior doctor. Further prospective studies, both qualitative and quantitative, drawing on theories of change, are required to identify what precise factors would make a difference to this transition. © 2014 John Wiley & Sons Ltd.

Doctor-patient relationship

PubMed Central

Chamsi-Pasha, Hassan; Albar, Mohammed A.

2016-01-01

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

The regional distribution of doctors in Mexico, 1930-1990: a policy assessment.

PubMed

Nigenda, G

1997-02-01

The results of the doctor distributional policy in Mexico is evaluated. Despite the government's efforts to achieve a better distribution of doctors throughout the country between 1930 and 1990, important disparities still exist among geographic areas. Diverse factors ranging from the underdevelopment of some areas, to the resistance of doctors to leave the urban areas, are related to this unequal distribution. Early programmes aimed at redressing the original distribution in the 1930's had limited effects. In subsequent years, additional programmes were implemented. However, a lack of coordination and the short time span of many programmes produced only minor changes to the distributional pattern. Although in recent years the distribution has improved, southern states still suffer an acute scarcity while northern states have a relative abundance. Finally, the paper discusses how economic, political and social variables, as well as the structure of the health system, have shaped the current distribution of Mexican doctors.

Doctors and the test ban: 25 years on.

PubMed

Haines, A; Hartog, M

1988-08-06

Events leading up to the signing of the partial test ban treaty in 1963 are traced from the first public concern about nuclear testing in 1954 when a hydrogen bomb was detonated in the Pacific, through Albert Schweitzer's 1957 appeal for a ban on nuclear tests; agreements between the United States, the Soviet Union, and the United Kingdom to start formal negotiations; growth in medical and scientific concern in the early 1960s; to the impetus provided by the Cuban missile crisis of October 1962. Arguments for and against a comprehensive test ban treaty are discussed. Current activity by doctors and health professionals grows out of the successful campaign waged by doctors and scientists against atmospheric testing and is held to constitute a uniquely important exercise in primary prevention.

Future career plans of a cohort of senior doctors working in the National Health Service.

PubMed

Taylor, Kathryn; Lambert, Trevor; Goldacre, Michael

2008-04-01

To report on the future career plans of senior doctors working in the NHS. Postal questionnaires. All doctors who qualified in 1977 from all UK medical schools. Future plans and whether participants had any unmet needs for advice on how to put their future plans into effect. 25% definitely intended to continue with their current employment on the same basis until they retired; 75% hoped for change. A reduction in working hours was the most commonly desired change; but a substantial percentage also wanted changes in job content. 50% of respondents intended definitely (17%) or probably (33%) to work in the NHS to their normal retirement age; and 37% definitely (20%) or probably (17%) intended to retire early. 48% had made plans, in addition to the standard pension, to facilitate early retirement. The main factors given for considering early retirement were family reasons and wanting more time for leisure, a desire to maintain good health, excessive pressure of work, and disillusionment with NHS changes. A reduction in workload would be the greatest inducement to stay. 31% of respondents reported that they had unmet needs for advice about their future plans. Of these, about half were needs for advice about planning for retirement. Many senior NHS doctors would like to reduce their working hours. Less than a quarter definitely intend to work in the NHS to normal retirement age. Even for senior doctors, advice on career development is needed.

An ethnographic investigation of junior doctors' capacities to practice interprofessionally in three teaching hospitals.

PubMed

Milne, Jacqueline; Greenfield, David; Braithwaite, Jeffrey

2015-01-01

Collaborative practice among early career staff is at the bedrock of interprofessional care. This study investigated factors influencing the enactment of interprofessional practice by using the day-to-day role of six junior doctors in three teaching hospitals as a gateway to understand the various professions' interactive behaviours. The contextual framework used for the study was Strauss' theory of negotiated order. Ethnographic techniques were applied to observe the actions and interactions of participants on typical working days in their hospital environments. Field notes were created and thematic analysis was applied to the data. Three themes explored were culture, communication, and collaboration. Issues identified highlight the bounded organisational and professional cultures within which junior doctors work, and systemic problems in interprofessional interaction and communication in the wards of hospitals. There are indications that early career doctors are interprofessional isolates. The constraints of short training terms and pressure from multi-faceted demands on junior doctors can interfere with the establishment of meaningful relationships with nurses and other health professionals. The realisation of sustained interprofessional practice is, therefore, practically and structurally difficult. Enabling factors supporting the sharing of expertise are outweighed by barriers associated with professional and hospital organisational cultures, poor interprofessional communication, and the pressure of competing individual task demands in the course of daily practice.

A family of doctors over 250 years: innovation and controversy.

PubMed

Watkins, Peter J

2011-05-01

A family of Watkins doctors originating in the Northamptonshire town of Towcester included 13 doctors in seven generations during 250 years. In each generation there were between one and four doctors. Three doctors involved themselves actively in innovative yet controversial practises, described in their own writings and publications. Timothy Watkins' (1755-1834) own handwritten lecture notes describe the problems affecting an 18th-century man-midwife, while his accounts book provides insights into his lifestyle. The concept of the waterborne spread of cholera during the 1854 epidemic in Towcester is described by Robert Webb Watkins (1822-1901) during the same year as the observations made by John Snow (1813-58). John Webb Watkins (1833-1903) in his MD thesis (1856) describes his use of chloroform in labour in Towcester during the early 1850s, followed by self-experimentation with chloroform administered to him between 40 and 50 times by Sir James Young Simpson (1811-70) in Edinburgh. Descriptions of the two 19th-century general practitioners offer insights into the exemplary extent of their civic involvement in all walks of local community life, and of their family ties.

Designing medical internships to improve recruitment and retention of doctors in rural areas

PubMed Central

Gaski, Margrete; Abelsen, Birgit

2017-01-01

ABSTRACT Background: The medical internship as a way of exposing young doctors to training in a rural context is regarded as a useful tool to recruit and retain doctors in rural areas. Norwegian health authorities tested an arrangement of early sign-up for medical internships in the Finnmark County in Norway. Objective: To report on the effects of the early sign-up for medical internship. Design: This study compares the choice of workplace after internship among physicians who signed up early with those candidates assigned to the raffle model of internship in the study area, and in a comparison area experiencing similar recruitment and retention problems. Results: The proportion of interns who signed up early that still worked as physicians in the study area by April 2014 (29%) was twice as high as among the regular interns (15%) and interns in the comparison area (14%). Among the 59 interns who signed up early still working in the study area in April 2014, 33% had grown up in this area. However, the greatest benefits were for the most densely populated municipalities in the study area. Conclusions: The early sign-up model had a net contribution of proving additional physicians in the study area. PMID:28417680

Identifying poor performance among doctors in NHS organizations.

PubMed

Locke, Rachel; Scallan, Samantha; Leach, Camilla; Rickenbach, Mark

2013-10-01

To account for the means by which poor performance among career doctors is identified by National Health Service organizations, whether the tools are considered effective and how these processes may be strengthened in the light of revalidation and the requirement for doctors to demonstrate their fitness to practice. This study sought to look beyond the 'doctor as individual'; as well as considering the typical approaches to managing the practice of an individual, the systems within which the doctor is working were reviewed, as these are also relevant to standards of performance. A qualitative review was undertaken consisting of a literature review of current practice, a policy review of current documentation from 15 trusts in one deanery locality, and 14 semi-structured interviews with respondents with an overview of processes in use. The framework for the analysis of the data considered tools at three levels: individual, team and organizational. Tools are, in the main, reactive--with an individual focus. They rely on colleagues and others to speak out, so their effectiveness is hindered by a reluctance to do so. Tools can lack an evidence base for their use, and there is limited linking of data across contexts and tools. There is more work to be done in evaluating current tools and developing stronger processes. Linkage between data sources needs to be improved and proactive tools at the organizational level need further development to help with the early identification of performance issues. This would also assist in balancing a wider systems approach with a current over emphasis on individual doctors. © 2012 John Wiley & Sons Ltd.

Socialization, Indifference, and Convenience: Exploring the Uptake of Influenza Vaccine Among Medical Students and Early Career Doctors

PubMed Central

Edge, Rhiannon; Goodwin, Dawn; Isba, Rachel; Keegan, Thomas

2017-01-01

The Chief Medical Officer recommends that all health care workers receive an influenza vaccination annually. High vaccination coverage is believed to be the best protection against the spread of influenza within a hospital, although uptake by health care workers remains low. We conducted semistructured interviews with seven medical students and nine early career doctors, to explore the factors informing their influenza vaccination decision making. Data collection and analysis took place iteratively, until theoretical saturation was achieved, and a thematic analysis was performed. Socialization was important although its effects were attenuated by participants’ previous experiences and a lack of clarity around the risks and benefits of vaccination. Many participants did not have strong intentions regarding vaccination. There was considerable disparity between an individual’s opinion of the vaccine, their intentions, and their vaccination status. The indifference demonstrated here suggests few are strongly opposed to the vaccination—there is potential to increase vaccination coverage. PMID:28737075

Ethical erosion in newly qualified doctors: perceptions of empathy decline.

PubMed

Stratta, Emily C; Riding, David M; Baker, Paul

2016-09-06

This study sought to understand whether UK Foundation doctors perceived the phenomena of ethical erosion and empathy decline during their initial period of clinical practice, and if so, why this occurred. This qualitative study used semi-structured interviews with nine doctors in their first year of clinical practice at Royal Bolton Hospital, UK. Participants were invited to discuss the definition of empathy, how individuals acquire and maintain empathic ability, perceptions of ethical erosion in the self and others, and how clinical experiences have influenced their empathic ability. The interviews were transcribed, and analysed to identify emergent themes. Each participant reported a conscious acknowledgement of empathy decline in their own and their colleagues' early clinical experiences as doctors. Stressful working environments, the prioritisation of patients' physical rather than psychological well-being, and the attitudes of senior colleagues were all suggested as possible causes. Some doctors believed that specialties with reduced patient contact had a culture which precluded empathy, and influenced their own practice. In addition, some described how their value judgements of patients had affected their ability to empathise. However, all doctors perceived that empathy skills were desirable in senior clinicians, and some believed that educational interventions may be useful in arresting ethical erosion. Newly qualified doctors are aware of ethical erosion in themselves and their colleagues as they begin clinical practice. This has serious implications for patient care. Improving working conditions may reverse this trend. Empathy skills training within undergraduate and postgraduate curricula may be a useful intervention.

Learning needs in clinical biochemistry for doctors in foundation years.

PubMed

Khromova, Victoria; Gray, Trevor A

2008-01-01

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

[Priest-doctors in Russia].

PubMed

Berlan, Hélène; Triaire, Dominique

2012-01-01

Jean Pierre Frank offers in the early nineteenth century a revolution in medical Russian Empire. Indeed, Russia is in an emergency situation where the lack of practitioners is obvious. The imperial project is inspired by past practices in some European countries. Frank fits these transfers and implements a unique model where the priest-doctor stands out as the solution to overcome the lack of medicalization of the Empire. Even if the attempt was a failure, it remains that the proposals were part of Frank in both an ancient tradition that priests and physicians providing care for souls and bodies, but also showed that called his wishes the advent of "public health" in this country disinherited.

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

ERIC Educational Resources Information Center

Baylor Coll. of Medicine, Houston, TX.

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

Childhood emotional support and borderline personality features in a sample of Canadian psychiatric outpatients.

PubMed

Kealy, David; Sierra-Hernandez, Carlos A; Ogrodniczuk, John S

2016-08-01

Despite links between early relational experiences and psychopathology, data regarding childhood emotional neglect among Canadian mental health services users are scarce. To explore the absence of emotional support experiences reported by Canadian psychiatric outpatients, and to examine the relationship between childhood emotional support and borderline personality disorder (BPD) features. A survey regarding childhood emotional support was completed by consecutively admitted adult outpatients, along with self-report assessments of symptom distress and BPD features. A substantial proportion of outpatients reported absent emotional support experiences. After controlling for the effects of age and symptom distress, childhood emotional support was found to be significantly negatively associated with BPD features. The findings add further support to the need for clinical attention to the early relational experiences of mental health service users. © The Author(s) 2016.

The medical complaints and disciplinary process in New Zealand: doctors' suggestions for change.

PubMed

Cunningham, Wayne

2004-07-23

To document New Zealand doctors' opinions about the complaints and disciplinary process, and to develop a proposal for change. A cross-sectional survey of New Zealand doctors randomly selected to include vocationally registered general practitioners, vocationally registered hospital-based specialists, and general registrants. Qualitative (thematic) analysis of written responses was used to categorise doctors' ideas about the complaints system, and to develop a proposal for change 453 doctors responded to the survey. Respondents were aware of the complexity of medicine, the fallibility of doctors, and of tension between societal expectations of care and their ability to meet those expectations. They perceived a societal culture of blame, and indicated that complaints should provide an opportunity for learning (for both complainants and doctors to be heard), and for a satisfactory outcome to be achieved for both doctors and complainants. They indicated that complaints should be resolved rapidly, that frivolous and vexatious complaints should be identified early in the process, and that the role of the media should be minimised. They indicated that the complaints process should be transparent, with complaints tribunals using appropriate advisors and standards of judgment. The proposal for change was a single point of entry for all complaints. New Zealand doctors are aware of the nature of the practice of medicine, and the sociopolitical context of the delivery of care. They support the notion of a Complaints Tribunal providing a single point of entry for all complaints, and which uses a process that is transparently appropriate for both doctors and complainants.

Employment experiences of vocationally trained doctors.

PubMed Central

Osler, K

1991-01-01

OBJECTIVES--To investigate the expectations and employment experiences of male and female doctors who completed vocational training in East Anglia during 1981-7 and to examine the factors which had influenced those who had changed direction early in their careers. DESIGN--Survey conducted by confidential postal questionnaire. SETTING--Britain. SUBJECTS--281 doctors, 233 (83%) of whom responded. MAIN OUTCOME MEASURES--Ideal choice of work on completion of vocational training; present employment; factors which had restricted present choice of work; factors associated with reported satisfaction with job. RESULTS--77/83 (93%) men and 130/150 (87%) women had hoped to work in general practice (p = 0.75). A smaller proportion of women (71%; 106) than men (89%; 74) were in general practice posts (p less than 0.01); only 6% (nine) of women were on maternity leave or caring for children without paid employment. More women than men were working in medical jobs other than general practice (18% (27) women v 4% (three) men; p less than 0.01). 44/91 (49%) women with children had achieved their employment goals compared with 47/59 (80%) women without children and 55/71 (78%) men with children. 87% (72/83) of men and 65% (98/150) of women had achieved the status of principal (p less than 0.01). 162/193 (84%) doctors who had worked in general practice reported satisfaction with their jobs. Dissatisfaction was linked with doing a job different from that hoped for and with perceiving that the share of practice income did not accurately reflect their share of the practice workload. CONCLUSIONS--Steps need to be taken to retain women in general practice, including a statutory part time pay allowance and incentives for practices to allow flexible working hours for doctors with young children. PMID:1932939

Employment experiences of vocationally trained doctors.

PubMed

Osler, K

1991-09-28

To investigate the expectations and employment experiences of male and female doctors who completed vocational training in East Anglia during 1981-7 and to examine the factors which had influenced those who had changed direction early in their careers. Survey conducted by confidential postal questionnaire. Britain. 281 doctors, 233 (83%) of whom responded. Ideal choice of work on completion of vocational training; present employment; factors which had restricted present choice of work; factors associated with reported satisfaction with job. 77/83 (93%) men and 130/150 (87%) women had hoped to work in general practice (p = 0.75). A smaller proportion of women (71%; 106) than men (89%; 74) were in general practice posts (p less than 0.01); only 6% (nine) of women were on maternity leave or caring for children without paid employment. More women than men were working in medical jobs other than general practice (18% (27) women v 4% (three) men; p less than 0.01). 44/91 (49%) women with children had achieved their employment goals compared with 47/59 (80%) women without children and 55/71 (78%) men with children. 87% (72/83) of men and 65% (98/150) of women had achieved the status of principal (p less than 0.01). 162/193 (84%) doctors who had worked in general practice reported satisfaction with their jobs. Dissatisfaction was linked with doing a job different from that hoped for and with perceiving that the share of practice income did not accurately reflect their share of the practice workload. Steps need to be taken to retain women in general practice, including a statutory part time pay allowance and incentives for practices to allow flexible working hours for doctors with young children.

Cognitive aspects of sexual functioning: differences between East Asian-Canadian and Euro-Canadian women.

PubMed

Morton, Heather; Gorzalka, Boris B

2013-11-01

The purpose of this study was to investigate the sexual beliefs of female undergraduates, as well as the thoughts they experience during sexual experiences. The study aimed to determine potential differences in these variables between East Asian-Canadians and Euro-Canadians, as well as the influence of acculturation on these variables. In addition, the relationships between sexual beliefs, automatic thoughts, and specific aspects of sexual functioning were examined. Euro-Canadian (n = 77) and East Asian-Canadian (n = 123) undergraduate women completed the Sexual Dysfunctional Beliefs Questionnaire, the Sexual Modes Questionnaire, the Female Sexual Function Index, and the Vancouver Index of Acculturation. East Asian women endorsed almost all sexual beliefs assessed in this study more than did Euro-Canadian women, and endorsement of these beliefs was associated with acculturation. In addition, East Asian-Canadian and Euro-Canadian women differed in the frequency of experiencing negative automatic thoughts. Results also revealed associations between difficulties in sexual functioning, and both sexual beliefs and automatic thoughts. Together, these results provide preliminary support for the hypothesis that differences in cognitive aspects of sexuality may underlie the differences in sexual functioning previously observed between these two groups.

Student assistantships: bridging the gap between student and doctor

PubMed Central

Crossley, James GM; Vivekananda-Schmidt, Pirashanthie

2015-01-01

In 2009, the General Medical Council UK (GMC) published its updated guidance on medical education for the UK medical schools – Tomorrow’s Doctors 2009. The Council recommended that the UK medical schools introduce, for the first time, a clinical placement in which a senior medical student, “assisting a junior doctor and under supervision, undertakes most of the duties of an F1 doctor”. In the UK, an F1 doctor is a postgraduation year 1 (PGY1) doctor. This new kind of placement was called a student assistantship. The recommendation was considered necessary because conventional UK clinical placements rarely provided medical students with opportunities to take responsibility for patients – even under supervision. This is in spite of good evidence that higher levels of learning, and the acquisition of essential clinical and nontechnical skills, depend on students participating in health care delivery and gradually assuming responsibility under supervision. This review discusses the gap between student and doctor, and the impact of the student assistantship policy. Early evaluation indicates substantial variation in the clarity of purpose, setting, length, and scope of existing assistantships. In particular, few models are explicit on the most critical issue: exactly how the student participates in care and how supervision is deployed to optimize learning and patient safety. Surveys indicate that these issues are central to students’ perceptions of the assistantship. They know when they have experienced real responsibility and when they have not. This lack of clarity and variation has limited the impact of student assistantships. We also consider other important approaches to bridging the gap between student and doctor. These include supporting the development of the student as a whole person, commissioning and developing the right supervision, student-aligned curricula, and challenging the risk assumptions of health care providers. PMID:26109879

A Literature Review of Early Intervention.

ERIC Educational Resources Information Center

Panitch, Melanie

This review of the literature on early childhood intervention with special needs children provides a Canadian perspective on theory, models, program development, effects, and training. After an introductory chapter, the second chapter identifies theoretical influences on early childhood intervention, including the work of Piaget, Bronfenbrenner,…

Skin-Color Preferences and Body Satisfaction among South Asian-Canadian and European-Canadian Female University Students.

ERIC Educational Resources Information Center

Sahay, Sarita; Piran, Niva

1997-01-01

Examines skin-color preferences and body satisfaction among South Asian-Canadian and European-Canadian female university students. Hypothesizes that South Asian-Canadians would display a greater wish to be lighter in skin color than would European-Canadians and that the discrepancy would be greater the darker their skin color. Reports that the…

Reproductive health practices among Indian, Indo-Canadian, Canadian East Asian, and Euro-Canadian women: the role of acculturation.

PubMed

Brotto, Lori A; Chou, Annie Y; Singh, Tara; Woo, Jane S T

2008-03-01

Lower rates of cervical cancer screening in Indian women have been consistently reported, and this has been attributed to cultural barriers. In Canada, the fastest-growing and largest immigrant groups are South Asian and East Asian. Since traditional values are largely retained in Indo-Canadian immigrants and their children, identifying reproductive health behaviours among these ethnic minority groups is important. Our goal was to compare reproductive health knowledge and behaviours of Indian women living in India and in Canada, East Asian women in Canada, and Euro-Canadian women. We also explored the level of acculturation in the two immigrant groups in order to understand the extent to which affiliation with Western culture may improve reproductive health knowledge. We recruited 663 women of reproductive age from India and from a Canadian university for assessment. These women completed the Health Beliefs Questionnaire, which measures reproductive health behaviours and knowledge, and the Vancouver Index of Acculturation, which measures the level of mainstream and heritage acculturation. Euro-Canadian women were most likely to have ever had a Papanicolaou (Pap) test and to perform breast self-examination (BSE). There was no difference between the two Indian groups in the proportion who had ever had a Pap test, but Indo-Canadian women were more likely to have performed BSE. All women showed knowledge of reproductive health, but the three Canadian groups consistently had more accurate knowledge than the Indian group. Among the two immigrant groups, the level of acculturation was associated with reproductive health knowledge. Canadian women show reproductive health behaviours and knowledge that is superior to Indian women. Moving to a western culture did not influence Indian women's Pap testing behaviour; however, the fact that the reproductive health knowledge of Indian women who moved to Canada was better than that of women in India suggests that there may be a

An industry perspective on Canadian patients' involvement in Medical Tourism: implications for public health

PubMed Central

2011-01-01

Background The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Methods Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Results Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. Conclusions No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients seeking care abroad

An industry perspective on Canadian patients' involvement in medical tourism: implications for public health.

PubMed

Johnston, Rory; Crooks, Valorie A; Adams, Krystyna; Snyder, Jeremy; Kingsbury, Paul

2011-05-31

The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as spread of infectious diseases, associated with this industry. This article addresses this knowledge gap by analyzing interviews conducted with Canadian medical tourism facilitators in order to understand Canadian patients' involvement in medical tourism and the implications of this involvement for public health. Semi-structured phone interviews were conducted with 12 medical facilitators from 10 companies in 2010. An exhaustive recruitment strategy was used to identify interviewees. Questions focused on business dimensions, information exchange, medical tourists' decision-making, and facilitators' roles in medical tourism. Thematic analysis was undertaken following data collection. Facilitators helped their Canadian clients travel to 11 different countries. Estimates of the number of clients sent abroad annually varied due to demand factors. Facilitators commonly worked with medical tourists aged between 40 and 60 from a variety of socio-economic backgrounds who faced a number of potential barriers including affordability, fear of the unfamiliar, and lack of confidence. Medical tourists who chose not to use facilitators' services were thought to be interested in saving money or have cultural/familial connections to the destination country. Canadian doctors were commonly identified as barriers to securing clients. No effective Canadian public health response to medical tourism can treat medical tourists as a unified group with similar motivations for engaging in medical tourism and choosing similar mechanisms for doing so. This situation may be echoed in other countries with patients seeking care abroad. Therefore, a call for a comprehensive public

[Why don't doctors use early insulinization therapy in patients with diabetes mellitus type 2?: A qualitative approach in a Mexican city].

PubMed

Lagunes-Córdoba, Roberto; Galindo-Guevara, Isaac; Reyes, Atalia Castillo; Romero-Aparicio, Citlalli; Rosas-Santiago, Francisco Javier

2017-01-01

Early insulinization therapy is regarded as an efficient aid to improve long term control and quality of life in patients with diabetes mellitus type 2 (DM2). Nevertheless, both patients and medical staff confront barriers in using this therapeutic tool. This study employs a qualitative approach to explore the barriers to early insulinization among medical staff from the public sector in the city of Xalapa, Veracruz, México. Between 2015 and 2016, in-depth interviews were conducted with general and specialist physicians offering primary health care to patients with DM2. The transcribed interviews were analyzed to extract and organize categories and subcategories of barriers among medical staff. These barriers were then grouped into three categories and exemplified with interview excerpts: barriers coming from the medical staff itself, barriers emerging from the doctor-patient interaction, and institutional barriers. Uses for the classification obtained are discussed, as are some of the solutions proposed by study participants.

The Impact of Single-Payer Health Care on Physician Income in Canada, 1850–2005

PubMed Central

2011-01-01

This study traces the average net income of Canadian physicians over 150 years to determine the impact of medicare. It also compares medical income in Canada to that in the United States. Sources include academic studies, government reports, Census data, taxation statistics, and surveys. The results show that Canadian doctors enjoyed a windfall in earnings during the early years of medicare and that, after a period of adjustment, medicare enhanced physician income. Except during the windfall boom, Canadian physicians have earned less than their American counterparts. Until at least 2005, however, the medical profession was the top-earning trade in Canada relative to all other professions. PMID:21566029

Becoming a caregiver: attachment theory and poorly performing doctors.

PubMed

Adshead, Gwen

2010-02-01

In this paper, I review a theoretical paradigm (attachment theory) which facilitates an understanding of how human care-giving and care-eliciting behaviours develop and are maintained over the lifespan. I argue that this paradigm has particular utility in: (i) the training of doctors; (ii) understanding why some doctors and medical students experience high levels of stress, and (iii) developing interventions to help those who struggle to manage high levels of work-related stress. I carried out a review of key texts and previously published studies of attachment styles in caregivers. Large-scale epidemiological studies, using valid and reliable measures, show that insecure attachment styles are found in a proportion of normal populations of both males and females. Insecure attachment is associated with impaired stress management and subtle deficits in care-giving sensitivity. It is reasonable to assume that a proportion of students entering medical training and doctors with performance problems may have insecure attachment styles which influence how they approach their training experience and how they manage occupational stress. Attachment theory is a useful paradigm for thinking about training as a professional caregiver. Insecure early attachment experiences may be a risk factor for poor stress management in some medical students and doctors who are exposed to increasing demands as carers. These findings lead to suggestions for possible research and support interventions.

Doctoral Scientists in Oceanography.

ERIC Educational Resources Information Center

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

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

Developing Online Doctoral Programmes

ERIC Educational Resources Information Center

Chipere, Ngoni

2015-01-01

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

Foreign science and engineering doctoral attainment at American universities

NASA Astrophysics Data System (ADS)

Hamilton, Robert V.

This dissertation analyzes the nearly 100,000 foreign students who attained science and engineering (S&E) doctorates in the five fields of physical sciences, life sciences, engineering, mathematics and computer sciences, and social and behavioral sciences at American universities from 1994 to 2005. Two models are presented. In the first model controlling for population, multivariate regression results testing for whether foreign students from higher or lower income nations (181 nations) tended to attain S&E doctorates showed that certain S&E fields tended to be represented by students from higher income nations early in the time period (e.g. 1994 to 1999) but the national income variable explaining foreign S&E doctoral attainment was not statistically significant in four of the fields after the year 2000. Four nations, China, India, South Korea and Taiwan stand out due to their large S&E doctoral student presence at American universities, but virtually all growth in foreign doctoral attainment in four of the S&E fields from 1994 to 2005 came from Chinese students, and this growth was most pronounced after the year 2001. In short, whereas the foreign student populations from South Korea and Taiwan were the outliers in 1994 and as such skewed testing results, they had largely been displaced in 2005 by the increased presence of Chinese students. From the US public policy perspective, to the extent that growth in foreign S&E doctoral attainment is an issue to include its related costs and benefits, the appropriate policy focus should shift more specifically towards the growth in Chinese S&E doctoral attainment. Further, with the exception of China and India, foreign doctoral students from the lowest income nations of the world in all five S&E fields were greatly under represented on American campuses from 1994 to 2005. Testing results from the second model complement the findings in the first model. Whereas the first model tested for the effects of national income on

The McDonaldization of appraisal? Doctors' views of the early impacts of medical revalidation in the United Kingdom.

PubMed

Archer, Julian; Nunn, Suzanne; Regan de Bere, Sam

2017-09-01

Medical regulation is rapidly changing with claims that systems such as revalidation/relicensing will reassure the public. Yet the impact of such initiatives is unknown. Using the principles of efficiency, calculability, predictability and control through technology, identified by Ritzer, and exampled by the McDonalds business model, we analyzed interviews with doctors between May 2012-Dec 2013 which focused on doctor experiences of appraisal and revalidation in SW England. The research found significant changes in appraisals since the launch of revalidation in December 2012. Appraisal has been standardized with a list of supporting information that must be collected by doctors. The success of implementation is measured in the numbers of appraisals completed but less is known about the quality of the appraisal itself. Such efficiencies have been supported by IT systems that themselves might be at risk of driving the process. There are potential advantages to McDonaldization including appraisals available to all, not just for doctors working in the NHS, and a potentially more appetizing recipe for their completion. As yet a state of McAppraisal has not been reached; with a complete transfer of trust in the doctor to trust in the appraisal process within revalidation. However policymakers will need to continue to ensure that regulatory initiatives, such as revalidation, are not just a process for their own sake. Copyright © 2017 Elsevier B.V. All rights reserved.

Interprofessional collaboration within Canadian integrative healthcare clinics: Key components.

PubMed

Gaboury, Isabelle; Bujold, Mathieu; Boon, Heather; Moher, David

2009-09-01

Research shows that interprofessional collaboration has become an important factor in the implementation of effective healthcare models. To date, the literature has not focused on the collaboration between medical doctors and complementary and alternative medicine (CAM) healthcare practitioners, an example of interdisciplinary collaboration called integrative healthcare (IHC). Drawing on in-depth, semi-standardized interviews conducted with 21 practitioners working in Canadian IHC clinics, this paper explored and interpreted how IHC is experienced by those working in Canadian IHC clinics. The interview questions and analysis were guided by the Input, Process, Output conceptual framework drawn from the organizational management theory (McGrath, J. E. (1964). Social psychology: A brief introduction. New York: Holt, Rinehart and Winston.) to study collaboration within teams. We found that constructs contributing to collaboration included practitioners' attitudes and educational background, as well as external factors such as the healthcare system and financial pressures. Major processes affecting collaboration included communication, patient referral and power relationships. These determinants of collaboration were found to result in learning opportunities for practitioners, modified burden of work and ultimately, higher affective commitment toward the clinic. These constructs serve as a guide for further investigation of interprofessional collaboration within an IHC clinic. This exploration of interprofessional collaboration in IHC identified a broad array of key factors associated with interprofessional collaboration. These factors are critical to better understand the functioning of IHC clinics, and provide guidance for creation or maintenance of successful clinics.

Cross-situational consistency of trait expressions and injunctive norms among Asian Canadian and European Canadian undergraduates.

PubMed

Locke, Kenneth D; Sadler, Pamela; McDonald, Kelly

2018-06-14

In the current paper, we sought to clarify when and why Asian Americans/Canadians and European Americans/Canadians differ in self-consistency (the consistency of personality traits across situations). European Canadian (n = 220) and second-generation Asian Canadian (n = 166) undergraduates (Mage = 19 years) described the traits they expressed and the traits others wanted them to express (i.e., injunctive norms, or injunctions) in four different social situations (i.e., with parents, with friends, with siblings, and with professors). Self-consistency was greater among European Canadians than Asian Canadians, but only when comparing behavior with parents versus with peers (i.e., friends and siblings). The same pattern was found for injunctive consistency (cross-situational consistency of trait injunctions). Injunctions strongly predicted the behavior of both Asian and European Canadians, but because the injunctions from parents versus peers diverged more for Asian Canadians, so did their behaviors. Controlling for the effect of inconsistent injunctions across situations eliminated the ethnic difference in self-consistency. Finally, Asian Canadians who perceived their immigrant parents as embracing a Canadian identity were as cross-situationally consistent as European Canadians because they tended to behave-and believe their parents approved of their behaving-with parents similarly to how they behaved with peers (e.g., more carefree and outspoken). Contrary to previous theorizing, cultural influences on broad cognitive or motivational dispositions (e.g., dialecticism, collectivism) alone cannot explain the observed pattern of ethnic differences in consistency. To understand when bicultural individuals are less consistent across situations also requires an understanding of the specific situations across which they tend to encounter divergent social norms. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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

ERIC Educational Resources Information Center

Bireda, Asamenew Demessie

2015-01-01

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

Canadian digitization: radical beginning and pragmatic follow-on

NASA Astrophysics Data System (ADS)

Grant, Terrill K.

2000-08-01

The Canadian Army, like most Western armies, spent a lot of time soul-searching about the application of technology to its Command and Control processes during the height of the Cold War in the 70's and 80's. In the late 1980's, these efforts were formalized in a program called the Tactical Command, Control and Communications System (TCCCS). As envisioned, the project would replace in one revolutionary Big Bang all of the tactical communications employed in the Canadian field forces. It would also add significant capabilities such as a long range satellite communications system, a universal tactical e-mail system, and a command and control system for the commander and his staff from division to unit HQ. In 1989, the project was scaled back due to budgetary constraints by removing the divisional trunk communications system and the command and control system. At this point a contract was let to Computing Devices Canada for the core communications functionality. During the next 6 years, the Canadian Army expanded on this digitization effort by amending the contract to add in a trunk system and a situational awareness system. As well, in 1996, Computing Devices received a contract to develop and integrate a C2 system with the communications system thereby restoring the final two Cs of TCCCS. This paper discusses the architecture and implementation of the TCCCS as the revolutionary enabler of the Canadian Army's digitization effort for the early 2000 era. The choice of a hybrid approach of using commercial standards supplemented by appropriate NATO communications standards allowed for an easy addition of the trunk system. As well, conformance to the emerging NATO Communications architecture for Land Tactical Communications in the Post 2000 era will enhance interoperability with Canada's allies. The paper also discusses the pragmatic approach taken by the Canadian Army in inserting C2 functionally into TCCCS, and presents the ultimate architecture and functionality. This

[Job satisfaction among Norwegian doctors].

PubMed

Nylenna, Magne; Aasland, Olaf Gjerløw

2010-05-20

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

Essentials of tuberculosis control for the practising physician. Tuberculosis Committee, Canadian Thoracic Society.

PubMed Central

1994-01-01

OBJECTIVE: To recommend guidelines for the management of tuberculosis (TB), particularly in high-risk groups including poor and homeless people, aboriginal Canadians, immigrants from countries where TB is highly prevalent and people with HIV infection. OPTIONS: Diagnosis, pharmacotherapy, vaccination and chemoprophylaxis. OUTCOMES: Prevention of infection and diagnosis and cure of TB. EVIDENCE: The evidence was gathered in late 1992 from previous guidelines, recommendations by specialist societies and new studies. VALUES: Evidence was categorized into four levels: I, randomized clinical trials of therapeutic interventions or prospective studies of diagnostic strategies; II, case-control studies; III, retrospective descriptive studies; and IV, consensus of the committee members and published statements. The Tuberculosis Committee of the Canadian Thoracic Society comprises experts in TB from across Canada. BENEFITS, HARM AND COSTS: The benefits of early diagnosis and prompt initiation of therapy are well documented. The cost effectiveness of antituberculous therapy in developing countries is well documented. In developed countries chemoprophylaxis has been shown to be cost effective, and directly observed chemotherapy has recently been hypothesized to have economic benefits. RECOMMENDATIONS: In the appropriate clinical setting, particularly when patients are known to be at high risk of TB, clinicians should consider TB, reserve body secretions for mycobacteriologic tests and conduct other investigations such as chest radiography. Furthermore, if TB is strongly suspected or confirmed by appropriate investigation the early initiation of multi-drug therapy, including at least three first-line drugs, is strongly recommended. If drug resistance is suspected a regimen of four to five drugs, including at least two drugs with which the patient has not been treated, should be started. If the strain is found to be resistant to any of the drugs in the regimen appropriate

Foundation doctors and dyslexia: a qualitative study of their experiences and coping strategies.

PubMed

Newlands, Freda; Shrewsbury, Duncan; Robson, Jean

2015-03-01

Dyslexia is the most common form of specific learning difficulty affecting approximately 6% of the general UK population and believed to affect approximately 2% of UK medical students. The impact of dyslexia on early practice has not been studied. To develop an understanding of the challenges faced by doctors with dyslexia in the first year of practice and their support requirements. Semistructured telephone interviews were conducted with seven foundation year 1 doctors with dyslexia from Scottish hospitals between March 2013 and August 2013. Foundation doctors indicated that due to their dyslexia, they experience difficulty with all forms of communication, time management and anxiety. There were concerns about disclosure of their dyslexia to colleagues and supervisors. Coping strategies used frequently were safety-netting and planning; technology solutions did offer some assistance. Although technological interventions have the potential to offer benefits to foundation doctors with dyslexia, increased openness about a diagnosis of dyslexia with discussion between doctor and supervisors about the challenges and anxieties is likely to provide the most benefit. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

ERIC Educational Resources Information Center

Deshpande, Anant

2016-01-01

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

Should junior doctors strike?

PubMed

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

2016-03-01

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

Multiculturalism: Being Canadian.

ERIC Educational Resources Information Center

Department of the Secretary of State, Ottawa (Ontario). Multiculturalism Directorate.

This booklet introduces Canada's Multiculturalism Act which provides for a new government-wide commitment to the principles and policy objectives of multiculturalism. As an essential component of the Canadian identity, multiculturalism has been fundamental to nation building and has allowed Canadians to enjoy the benefits of life in a culturally…

Degree Progress of Women Doctoral Students: Factors that Constrain, Facilitate, and Differentiate

ERIC Educational Resources Information Center

Maher, Michelle A.; Ford, Martin E.; Thompson, Candace M.

2004-01-01

Using survey and qualitative data, this study identified emergent themes that remain consistent across or differentiate among reports of women earning their doctoral degree relatively quickly ("early-finishers") and those taking considerably longer ("late-finishers"). Emergent themes included commitment to timely degree completion, faculty…

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

ERIC Educational Resources Information Center

Miclea, Mircea

2008-01-01

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

Professional Legitimation for Education in Canadian Universities: "The Canadian Journal of Education", 1976-1997

ERIC Educational Resources Information Center

Fisher, Donald

2017-01-01

In this commentary, Donald Fisher reports on the history of the "The Canadian Journal of Education" as part of this 40th anniversary issue. Fisher states that the history of the Canadian Society for the Study of Education (CSSE) has been profoundly influenced by changes in the role of the Canadian State. The 1960s and 1970s were a time…

Canadian content at GU-ASCO 2014: Highlights of research involving Canadian researchers.

PubMed

Kapoor, Anil

2014-03-01

The 2014 Genitourinary Cancers Symposium (GU-ASCO 2014) provided an opportunity for researchers from around the world to present their research in a variety of fields, including prostate, renal cell, penile, urethral and testicular cancers. Over the symposium's 3 days, Canadian researchers were well-represented, with a number of oral abstract podium presentations and many more research posters. The following section provides brief summaries of some of the most interesting work involving Canadians presented at GU-ASCO 2014 and a listing of all the studies that included contributions from Canadian researchers.

A marketing clinical doctorate programs.

PubMed

Montoya, Isaac D; Kimball, Olive M

2007-01-01

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

Succeeding with Your Doctorate

ERIC Educational Resources Information Center

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

2005-01-01

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

Misalignments of purpose and power in an early Canadian interprofessional education initiative.

PubMed

Whyte, Sarah; Paradis, Elise; Cartmill, Carrie; Kuper, Ayelet; Boon, Heather; Hart, Corinne; Razack, Saleem; Pipher, Mandy; Whitehead, Cynthia R

2017-12-01

Interprofessional education (IPE) has been widely incorporated into health professional curricula and accreditation standards despite an arguably thin base of evidence regarding its clinical effects, theoretical underpinnings, and social implications. To better understand how and why IPE first took root, but failed to grow, this study examines one of the earliest documented IPE initiatives, which took place at the University of British Columbia between 1960 and 1975. We examined a subset of 110 texts (academic literature, grey literature, and unpublished records) from a larger study that uses Critical Discourse Analysis to trace the emergence of IPE in Canada. We asked how IPE was promoted and received, by whom, for what purposes, and to what effects. Our analysis demonstrates that IPE was promoted as a response to local challenges for the Faculty of Medicine as well as national challenges for Canada's emerging public healthcare system. These dual exigencies enabled the IPE initiative, but they shaped it in somewhat divergent ways: the former gave rise to its core component (a health sciences centre) and the latter its ultimate purpose (increasing the role of non-medical professions in primary care). Reception of the initiative was complicated by a further tension: nurses and allied health professionals were sometimes represented as independent experts with unique knowledge and skills, and sometimes as assistants or substitutes for medical doctors. We relate the successes and frustrations of this early initiative to particular (mis)alignments of purpose and relationships of power, some of which continue to enable and constrain IPE today.

The Canadian Astronomy Data Centre

NASA Astrophysics Data System (ADS)

Ball, Nicholas M.; Schade, D.; Astronomy Data Centre, Canadian

2011-01-01

The Canadian Astronomy Data Centre (CADC) is the world's largest astronomical data center, holding over 0.5 Petabytes of information, and serving nearly 3000 astronomers worldwide. Its current data collections include BLAST, CFHT, CGPS, FUSE, Gemini, HST, JCMT, MACHO, MOST, and numerous other archives and services. It provides extensive data archiving, curation, and processing expertise, via projects such as MegaPipe, and enables substantial day-to-day collaboration between resident astronomers and computer specialists. It is a stable, powerful, persistent, and properly supported environment for the storage and processing of large volumes of data, a condition that is now absolutely vital for their science potential to be exploited by the community. Through initiatives such as the Common Archive Observation Model (CAOM), the Canadian Virtual Observatory (CVO), and the Canadian Advanced Network for Astronomical Research (CANFAR), the CADC is at the global forefront of advancing astronomical research through improved data services. The CAOM aims to provide homogeneous data access, and hence viable interoperability between a potentially unlimited number of different data collections, at many wavelengths. It is active in the definition of numerous emerging standards within the International Virtual Observatory, and several datasets are already available. The CANFAR project is an initiative to make cloud computing for storage and data-intensive processing available to the community. It does this via a Virtual Machine environment that is equivalent to managing a local desktop. Several groups are already processing science data. CADC is also at the forefront of advanced astronomical data analysis, driven by the science requirements of astronomers both locally and further afield. The emergence of 'Astroinformatics' promises to provide not only utility items like object classifications, but to directly enable new science by accessing previously undiscovered or intractable

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

PubMed

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

2014-03-04

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

Talking to Your Child's Doctor

MedlinePlus

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

Medical students' professional identity development in an early nursing attachment.

PubMed

Helmich, Esther; Derksen, Els; Prevoo, Mathieu; Laan, Roland; Bolhuis, Sanneke; Koopmans, Raymond

2010-07-01

The importance of early clinical experience for medical training is well documented. However, to our knowledge there are no studies that assess the influence of very early nursing attachments on the professional development and identity construction of medical students. Working as an assistant nurse while training to be a doctor may offer valuable learning experiences, but may also present the student with difficulties with respect to identity and identification issues. The aim of the present study was to describe first-year medical students' perceptions of nurses, doctors and their own future roles as doctors before and after a nursing attachment. A questionnaire containing open questions concerning students' perceptions of nurses, doctors and their own future roles as doctors was administered to all Year 1 medical students (n=347) before and directly after a 4-week nursing attachment in hospitals and nursing homes. We carried out two confirmatory focus group interviews. We analysed the data using qualitative and quantitative content analyses. The questionnaire was completed by 316 students (response rate 91%). Before starting the attachment students regarded nurses as empathic, communicative and responsible. After the attachment students reported nurses had more competencies and responsibilities than they had expected. Students' views of doctors were ambivalent. Before and after the attachment, doctors were seen as interested and reliable, but also as arrogant, detached and insensible. However, students maintained positive views of their own future roles as doctors. Students' perceptions were influenced by age, gender and place of attachment. An early nursing attachment engenders more respect for the nursing profession. The ambivalent view of doctors needs to be explored further in relation to students' professional development. It would seem relevant to attune supervision to the age and gender differences revealed in this study.

[Dual-doctor marriages].

PubMed

Gjerberg, Elisabeth

2003-08-28

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

Canadian development and commercialization of a North American mobile satellite service

NASA Technical Reports Server (NTRS)

Athanassiadis, Demetre

1990-01-01

Canada recognized early the value of mobile satellite communications, originally through the planning of a military system and subsequently through the development of the Canadian Mobile Satellite (MSAT) systems. Acting on behalf of the government, the Department of Communications (DOC) defined and carried out a complete plan for the implementation of Mobile Satellite Services (MSS). Based on an extensive dialogue between government, industry, and users and encompassing all technical, economic regulatory, and institutional aspects, this plan resulted in the completion by 1986 of a comprehensive business plan and a decision for commercial MSS delivery. The Canadian lead for a commercial system was quickly followed by others, and in particular the U.S., giving rise to the concept of North American MSS.

Future human health research directions for the Canadian Northern Contaminants Program.

PubMed

Donaldson, Shawn G; Curren, Meredith S; Adlard, Bryan; Provost, Jonathan; Leech, Tara; Tikhonov, Constantine; Feeley, Mark; Tomlinson, Scott; Shearer, Russel

2013-01-01

Studies conducted in the mid-1980s and early 1990s demonstrated that persistent organic pollutants (POPs) and metals were reaching the Arctic ecosystem at unexpectedly high levels, many of which had no Arctic or Canadian sources. Epidemiological and toxicological studies in Canada and in other countries have found that these contaminants may pose a risk to human health. The objective of this paper is to provide the foundation for the discussion on future northern human health research under the Northern Contaminants Program (NCP) in Canada. This short discussion of human health priorities will help guide a path forward for future northern human health research in Canada to address on-going and new health concerns related to contaminants exposure in the Canadian Arctic.

Future human health research directions for the Canadian Northern Contaminants Program

PubMed Central

Donaldson, Shawn G.; Curren, Meredith S.; Adlard, Bryan; Provost, Jonathan; Leech, Tara; Tikhonov, Constantine; Feeley, Mark; Tomlinson, Scott; Shearer, Russel

2013-01-01

Studies conducted in the mid-1980s and early 1990s demonstrated that persistent organic pollutants (POPs) and metals were reaching the Arctic ecosystem at unexpectedly high levels, many of which had no Arctic or Canadian sources. Epidemiological and toxicological studies in Canada and in other countries have found that these contaminants may pose a risk to human health. The objective of this paper is to provide the foundation for the discussion on future northern human health research under the Northern Contaminants Program (NCP) in Canada. This short discussion of human health priorities will help guide a path forward for future northern human health research in Canada to address on-going and new health concerns related to contaminants exposure in the Canadian Arctic. PMID:24282784

A reanalysis of cancer mortality in Canadian nuclear workers (1956-1994) based on revised exposure and cohort data.

PubMed

Zablotska, L B; Lane, R S D; Thompson, P A

2014-01-07

A 15-country study of nuclear workers reported significantly increased radiation-related risks of all cancers excluding leukaemia, with Canadian data a major factor behind the pooled results. We analysed mortality (1956-1994) in the updated Canadian cohort and provided revised risk estimates. Employment records were searched to verify and revise exposure data and to restore missing socioeconomic status. Excess relative risks per sievert (ERR/Sv) of recorded radiation dose and 95% confidence intervals (CIs) were estimated using Poisson regression. A significant heterogeneity of the dose-response for solid cancer was identified (P=0.02), with 3088 early (1956-1964) Atomic Energy of Canada Limited (AECL) workers having a significant increase (ERR/Sv=7.87, 95% CI: 1.88, 19.5), and no evidence of radiation risk for 42,228 workers employed by three nuclear power plant companies and post-1964 AECL (ERR/Sv=-1.20, 95% CI: <-1.47, 2.39). Radiation risks of leukaemia were negative in early AECL workers and non-significantly increased in other workers. In analyses with separate terms for tritium and gamma doses, there was no evidence of increased risk from tritium exposure. All workers had mortality lower than the general population. Significantly increased risks for early AECL workers are most likely due to incomplete transfer of AECL dose records to the National Dose Registry. Analyses of the remainder of the Canadian nuclear workers (93.2%) provided no evidence of increased risk, but the risk estimate was compatible with estimates that form the basis of radiation protection standards. Study findings suggest that the revised Canadian cohort, with the exclusion of early AECL workers, would likely have an important effect on the 15-country pooled risk estimate of radiation-related risks of all cancer excluding leukaemia by substantially reducing the size of the point estimate and its significance.

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

ERIC Educational Resources Information Center

Virtanen, V.; Taina, J.; Pyhältö, K.

2017-01-01

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

Doctor-patient relationship. Islamic perspective.

PubMed

Chamsi-Pasha, Hassan; Albar, Mohammed A

2016-02-01

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

Canadian Space Agency Space Station Freedom utilization plans

NASA Technical Reports Server (NTRS)

Faulkner, James; Wilkinson, Ron

1992-01-01

Under the terms of the NASA/CSA Memorandum of Understanding, Canada will contribute the Mobile Servicing System and be entitled to use 3 percent of all Space Station utilization resources and user accommodations over the 30 year life of the Station. Equally importantly Canada, like NASA, can begin to exploit these benefits as soon as the Man-Tended Capability (MTC) phase begins, in early 1997. Canada has been preparing its scientific community to fully utilize the Space Station for the past five years; most specifically by encouraging, and providing funding, in the area of Materials Science and Applications, and in the area of Space Life Sciences. The goal has been to develop potential applications and an experienced and proficient Canadian community able to effectively utilize microgravity environment facilities such as Space Station Freedom. In addition, CSA is currently supporting four facilities; a Laser Test System, a Large Motion Isolation Mount, a Canadian Float Zone Furnace, and a Canadian Protein Crystallization Apparatus. In late April of this year CSA sent out a Solicitation of Interest (SOI) to potential Canadian user from universities, industry, and government. The intent of the SOI was to determine who was interested, and the type of payloads which the community at large intended to propose. The SOI will be followed by the release of an Announcement of Opportunity (AO) following governmental approval of the Long Term Space plan later this year, or early next year. Responses to the AO will be evaluated and prioritized in a fair and impartial payload selection process, within the guidelines set by our international partners and the Canadian Government. Payload selection is relatively simple compared to the development and qualification process. An end-to-end user support program is therefore also being defined. Much of this support will be provided at the new headquarters currently being built in St. Hubert, Quebec. It is recognized that utilizing the

Canadian Space Agency Space Station Freedom utilization plans

NASA Astrophysics Data System (ADS)

Faulkner, James; Wilkinson, Ron

Under the terms of the NASA/CSA Memorandum of Understanding, Canada will contribute the Mobile Servicing System and be entitled to use 3 percent of all Space Station utilization resources and user accommodations over the 30 year life of the Station. Equally importantly Canada, like NASA, can begin to exploit these benefits as soon as the Man-Tended Capability (MTC) phase begins, in early 1997. Canada has been preparing its scientific community to fully utilize the Space Station for the past five years; most specifically by encouraging, and providing funding, in the area of Materials Science and Applications, and in the area of Space Life Sciences. The goal has been to develop potential applications and an experienced and proficient Canadian community able to effectively utilize microgravity environment facilities such as Space Station Freedom. In addition, CSA is currently supporting four facilities; a Laser Test System, a Large Motion Isolation Mount, a Canadian Float Zone Furnace, and a Canadian Protein Crystallization Apparatus. In late April of this year CSA sent out a Solicitation of Interest (SOI) to potential Canadian user from universities, industry, and government. The intent of the SOI was to determine who was interested, and the type of payloads which the community at large intended to propose. The SOI will be followed by the release of an Announcement of Opportunity (AO) following governmental approval of the Long Term Space plan later this year, or early next year. Responses to the AO will be evaluated and prioritized in a fair and impartial payload selection process, within the guidelines set by our international partners and the Canadian Government. Payload selection is relatively simple compared to the development and qualification process. An end-to-end user support program is therefore also being defined. Much of this support will be provided at the new headquarters currently being built in St. Hubert, Quebec. It is recognized that utilizing the

Cross-Cultural Comparison of a French Canadian and U.S. Developmental Screening Test

ERIC Educational Resources Information Center

Dionne, Carmen; Squires, Jane; Leclerc, Danielle; Peloquin, Josianne; McKinnon, Suzie

2006-01-01

The psychometric properties of the Ages & Stages Questionnaires (ASQ) (Bricker & Squires, 1999) used in a French-Canadian preschool population were compared with psychometric data derived from U.S. normative studies. The ASQ was translated into French (Bonin, Robaey, Vandaele, Bastin, & Lacroix, 2000) and used in four early childhood…

Intolerance and Violence Against Doctors.

PubMed

Singh, Meharban

2017-10-01

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

Capacity development in health systems and policy research: a survey of the Canadian context.

PubMed

Grudniewicz, Agnes; Hedden, Lindsay; Kromm, Seija; Lavergne, Ruth; Menear, Matthew; Sivananthan, Saskia

2014-02-07

Over the past decade, substantial global investment has been made to support health systems and policy research (HSPR), with considerable resources allocated to training. In Canada, signs point to a larger and more highly skilled HSPR workforce, but little is known about whether growth in HSPR human resource capacity is aligned with investments in other research infrastructure, or what happens to HSPR graduates following training. We collected data from the Canadian Institutes of Health Research, Canada's national health research funding agency, and the Canadian Association for Health Services and Policy Research on recent graduates in the HSPR workforce. We also surveyed 45 Canadian HSPR training programs to determine what information they collect on the career experiences of graduates. No university programs are currently engaged in systematic follow-up. Collaborative training programs funded by the national health research funding agency report performing short-term mandated tracking activities, but whether and how data are used is unclear. No programs collected information about whether graduates were using skills obtained in training, though information collected by the national funding agency suggests a minority (<30%) of doctoral-level trainees moving on to academic careers. Significant investments have been made to increase HSPR capacity in Canada and around the world but no systematic attempts to evaluate the impact of these investments have been made. As a research community, we have the expertise and responsibility to evaluate our health research human resources and should strive to build a stronger knowledge base to inform future investment in HSPR research capacity.

Introducing Research Initiatives into Healthcare: What Do Doctors Think?

PubMed Central

Wyld, Lucy; Smith, Sian; Hawkins, Nicholas J.; Long, Janet

2014-01-01

Background: Current national and international policies emphasize the need to develop research initiatives within our health care system. Institutional biobanking represents a modern, large-scale research initiative that is reliant upon the support of several aspects of the health care organization. This research project aims to explore doctors' views on the concept of institutional biobanking and to gain insight into the factors which impact the development of research initiatives within healthcare systems. Methods: Qualitative research study using semi-structured interviews. The research was conducted across two public teaching hospitals in Sydney, Australia where institutional biobanking was being introduced. Twenty-five participants were interviewed, of whom 21 were medical practitioners at the specialist trainee level or above in a specialty directly related to biobanking; four were key stakeholders responsible for the design and implementation of the biobanking initiative. Results: All participants strongly supported the concept of institutional biobanking. Participants highlighted the discordance between the doctors who work to establish the biobank (the contributors) and the researchers who use it (the consumers). Participants identified several barriers that limit the success of research initiatives in the hospital setting including: the ‘resistance to change’ culture; the difficulties in engaging health professionals in research initiatives; and the lack of incentives offered to doctors for their contribution. Doctors positively valued the opportunity to advise the implementation team, and felt that the initiative could benefit from their knowledge and expertise. Conclusion: Successful integration of research initiatives into hospitals requires early collaboration between the implementing team and the health care professionals to produce a plan that is sensitive to the needs of the health professionals and tailored to the hospital setting. Research

200 junior doctors sacked in Zambia.

PubMed

Ahmad, K

2000-07-29

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

The good doctor: the carer's perspective.

PubMed

Levine, Carol

2004-01-01

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

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

PubMed

Kanwar, R S

2010-01-01

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

Management of Mass Casualties Using Doctor Helicopters and Doctor Cars.

PubMed

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

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

Authoring the identity of learner before doctor in the figured world of medical school.

PubMed

Stubbing, Evangeline; Helmich, Esther; Cleland, Jennifer

2018-02-01

Students enter the 'figured world' of medical school with preconceptions of what it means to be a doctor. The meeting of these early preconceptions and their newly developing identities can create emotional tensions. The aim of this study was to advance our understanding of how such tensions were experienced and managed. Using figured worlds as a theoretical framework we explored students' interactions of preconceptions with their newly developing professional identities in their first year at medical school. Advancing our understanding of this phenomena provided new insights into the complex process of identity formation. This was a qualitative study underpinned by a constructivist epistemology. We ran biannual focus groups with 23 first year students in one UK medical school. Data were recorded, transcribed and then template analysis used to undertake an inductive, iterative process of analysis until it was considered the template provided a detailed representation of the data. Significant preconceptions associated with the identity of a doctor were 'to help' and 'to be a leader'. These early preconceptions were in conflict with realities of the figured world of medical school creating the emotional tensions of 'being unable to help' and 'lacking power', with implications for interactions with patients. By the end of year one students' negotiated tensions and 'self-authored' their identity as a learner as opposed to an imagined 'as if' identity of a doctor. We revealed how preconceptions associated with becoming a doctor can conflict with a newly developing professional identity highlighting the importance of supporting students to embrace the formation of a 'learner' identity, a necessary part of the process of becoming a doctor.

Early Childhood Development in Abbotsford, British Columbia. Understanding the Early Years

ERIC Educational Resources Information Center

Human Resources Development Canada, 2003

2003-01-01

Understanding the Early Years (UEY) is a national research initiative. It provides communities with information to enable them to make informed decisions about the best policies and most appropriate programs for Canadian families with young children. This report is based on one of seven communities studied in 2001-2002. Children's outcomes were…

Early Childhood Development in Niagara Falls, Ontario. Understanding the Early Years

ERIC Educational Resources Information Center

Wilms, Douglas J.

2003-01-01

Understanding the Early Years (UEY) is a national research initiative. It provides communities with information to enable them to make informed decisions about the best policies and most appropriate programs for Canadian families with young children. This report is based on one of seven communities studied in 2001-2002. Children's outcomes were…

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

ERIC Educational Resources Information Center

Mulvey, James

2003-01-01

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

Understanding Canadian Agriculture. "Understanding Economics" Series No. 5.

ERIC Educational Resources Information Center

Loyns, R. M. A.

This document for secondary school Canadian students analyzes the role of agriculture in the national economy and in Canadian trade, describes characteristics of Canadian farms, and discusses governmental inlfuences on Canadian agriculture. The document stresses that agriculture is a large source of national wealth; about 30% of Canadian farm…

[Physician from Constance doctor of medicine Georg Vogelin (1508-1542), an early follower of Copernicus].

PubMed

Burmeister, K H

1999-01-01

Georg Vogelin was born in Constance as the son of the town clerk. He studied the artes liberales and medicine at Wittenberg (since 1523) and Montpellier (since 1527). From 1531 onwards he practiced as a medical doctor in Constance. In 1542 Vogelin died of the plague in Constance. Vogelin was very close friends with the medical doctor Achilles Pirmin Gasser (1505-1577) and Georg Joachim Rheticus (1514-1574), a well known pupil of Copernicus. He was amongst the first supporters of the teachings of Copernicus. Gasser, who published the second edition of Rheticus' "Narratio prima" (Basle 1541), dedicated this edition to Georg Vogelin. In this book Vogelin published a poem in Latin. In the poem he described the teachings of Copernicus ("Terraque iam currit, credita stare prius") and recommended the academic community to approve Copernicus' theory.

Constructing Anthropologists: Culture Learning and Culture Making in U.S. Doctoral Education

ERIC Educational Resources Information Center

Bathurst, Laura

2012-01-01

In the tradition of anthropological reflexivity, this article examines how the structure of early doctoral training contributes to the construction of particular kinds of anthropologists. Based on research conducted in an anthropology department in the U.S.A. during the late 1990s, the experience of the transition from undergraduate to doctoral…

Canadian Military Nurse Deaths in the First World War.

PubMed

Dodd, Dianne

2017-01-01

This paper examines the lives of sixty-one Canadian Nursing Sisters who served during the First World War, and whose deaths were attributed, more or less equally, to three categories: general illness, Spanish Influenza, and killed in action. The response by Canadian Army Medical Corps (CAMC) physicians to the loss of these early female officers who were, in fact, Canada's first female war casualties, suggests a gendered construction of illness at work in the CAMC. While nurses tried to prove themselves good soldiers, military physicians were quick to attribute their illnesses and deaths to horrific war conditions deemed unsuitable for women. This gendered response is particularly evident in how CAMC physicians invoked a causal role for neurasthenia or shell shock for the nurses' poor health. The health profile of these women also suggests that some of these deaths might have occurred had these women stayed in Canada, and it encourages future comparative research into death rates among physicians and orderlies.

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

PubMed

Hao, Haijing

2015-06-01

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

Mercury in the Canadian Arctic terrestrial environment: an update.

PubMed

Gamberg, Mary; Chételat, John; Poulain, Alexandre J; Zdanowicz, Christian; Zheng, Jiancheng

2015-03-15

Contaminants in the Canadian Arctic have been studied over the last twenty years under the guidance of the Northern Contaminants Program. This paper provides the current state of knowledge on mercury (Hg) in the Canadian Arctic terrestrial environment. Snow, ice, and soils on land are key reservoirs for atmospheric deposition and can become sources of Hg through the melting of terrestrial ice and snow and via soil erosion. In the Canadian Arctic, new data have been collected for snow and ice that provide more information on the net accumulation and storage of Hg in the cryosphere. Concentrations of total Hg (THg) in terrestrial snow are highly variable but on average, relatively low (<5 ng L(-1)), and methylmercury (MeHg) levels in terrestrial snow are also generally low (<0.1 ng L(-1)). On average, THg concentrations in snow on Canadian Arctic glaciers are much lower than those reported on terrestrial lowlands or sea ice. Hg in snow may be affected by photochemical exchanges with the atmosphere mediated by marine aerosols and halogens, and by post-depositional redistribution within the snow pack. Regional accumulation rates of THg in Canadian Arctic glaciers varied little during the past century but show evidence of an increasing north-to-south gradient. Temporal trends of THg in glacier cores indicate an abrupt increase in the early 1990 s, possibly due to volcanic emissions, followed by more stable, but relatively elevated levels. Little information is available on Hg concentrations and processes in Arctic soils. Terrestrial Arctic wildlife typically have low levels of THg (<5 μg g(-1) dry weight) in their tissues, although caribou (Rangifer tarandus) can have higher Hg because they consume large amounts of lichen. THg concentrations in the Yukon's Porcupine caribou herd vary among years but there has been no significant increase or decrease over the last two decades. Copyright © 2014 Elsevier B.V. All rights reserved.

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

ERIC Educational Resources Information Center

Barnes, Benita J.

2010-01-01

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

Surgical activity of first-year Canadian neurosurgical residents.

PubMed

Fallah, Aria; Ebrahim, Shanil; Haji, Faizal; Gillis, Christopher; Girgis, Fady; Howe, Kathryn; Ibrahim, George M; Radic, Julia; Shahideh, Mehdi; Wallace, M Christopher

2010-11-01

Surgical activity is probably the most important component of surgical training. During the first year of surgical residency, there is an early opportunity for the development of surgical skills, before disparities between the skill sets of residents increase in future years. It is likely that surgical skill is related to operative volumes. There are no published guidelines that quantify the number of surgical cases required to achieve surgical competency. The aim of this study was to describe the current trends in surgical activity in a recent cohort of first-year Canadian neurosurgical trainees. This study utilized retrospective database review and survey methodology to describe the current state of surgical training for first-year neurosurgical trainees. A committee of five residents designed this survey in an effort to capture factors that may influence the operative activity of trainees. Nine out of a cohort of 20 first-year Canadian neurosurgical trainees that began training in July of 2008 participated in the study. The median number of cases completed by a resident during the initial three month neurosurgical rotation was 66, within which the trainee was identified as the primary surgeon in 12 cases. Intracranial hemorrhage and cerebrospinal fluid diversion procedures were the most common operations to have the trainee as primary surgeon. Based on this pilot study, it appears that the operative activity of Canadian first-year residents is at least equivalent to the residents of other studied training systems with respect to volume and diversity of surgical activity.

Reduction in Serum Uric Acid May Be Related to Methotrexate Efficacy in Early Rheumatoid Arthritis: Data from the Canadian Early Arthritis Cohort (CATCH)

PubMed Central

Lee, Jason J.; Bykerk, Vivian P.; Dresser, George K.; Boire, Gilles; Haraoui, Boulos; Hitchon, Carol; Thorne, Carter; Tin, Diane; Jamal, Shahin; Keystone, Edward C.; Pope, Janet E.

2016-01-01

OBJECTIVES The mechanism of action of methotrexate in rheumatoid arthritis (RA) is complex. It may increase adenosine levels by blocking its conversion to uric acid (UA). This study was done to determine if methotrexate lowers UA in early RA (ERA). METHODS Data were obtained from Canadian Early Arthritis Cohort, an incident ERA cohort. All ERA patients with serial UA measurements were included, comparing those with methotrexate use vs. no methotrexate exposure (controls). Analyses were exploratory. Patients with concomitant gout or taking UA-lowering therapies were excluded. RESULTS In total, 49 of the 2,524 ERA patients were identified with data available for both pre-methotrexate UA levels and post-methotrexate UA levels (300 µmol/L and 273 µmol/L, respectively; P = 0.035). The control group not taking methotrexate had a mean baseline UA level of 280 µmol/L and a follow-up level of 282 µmol/L (P = 0.448); mean change in UA with methotrexate was −26.8 µmol/L vs. 2.3 µmol/L in the no methotrexate group (P = 0.042). Methotrexate users with a decrease in UA had a disease activity score of 2.37 for 28 joints when compared with the controls (3.26) at 18 months (P = 0.042). Methotrexate users with decreased UA had a lower swollen joint count (SJC) of 0.9 at 18 months, whereas methotrexate users without lowering of UA had an SJC of 4.5 (P = 0.035). Other analyses were not significant. CONCLUSIONS Methotrexate response is associated with lowering of serum UA in ERA compared to nonusers. This may be due to changes in adenosine levels. Methotrexate response is associated with lower UA and fewer swollen joints compared to nonresponders. PMID:27081318

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

ERIC Educational Resources Information Center

Wildy, Helen; Peden, Sanna; Chan, Karyn

2015-01-01

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

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

PubMed Central

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

2005-01-01

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

[Advancement of the medical doctorate].

PubMed

Baum, C; Förster, R; Schmidt, R E

2009-08-01

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

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

PubMed Central

2015-01-01

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

The doctor's dilemma.

PubMed

Irvine, D H; Donaldson, L J

1995-10-01

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

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

PubMed

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

2014-12-01

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

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

PubMed

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

2016-07-01

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

[Doctor's attendance in police custody].

PubMed

Chariot, Patrick

2012-06-01

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

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

ERIC Educational Resources Information Center

Danby, Susan; Lee, Alison

2012-01-01

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

Early Childhood Development in Hampton/Sussex, New Brunswick. Understanding the Early Years

ERIC Educational Resources Information Center

Willms, J. Douglas

2003-01-01

Understanding the Early Years (UEY) is a national research initiative. It provides communities with information to enable them to make informed decisions about the best policies and most appropriate programs for Canadian families with young children. This report is based on one of seven communities studied in 2001-2002. Children's outcomes were…

Trends and variability in summer sea ice cover in the Canadian Arctic based on the Canadian Ice Service Digital Archive, 1960-2008 and 1968-2008

NASA Astrophysics Data System (ADS)

Tivy, Adrienne; Howell, Stephen E. L.; Alt, Bea; McCourt, Steve; Chagnon, Richard; Crocker, Greg; Carrieres, Tom; Yackel, John J.

2011-03-01

The Canadian Ice Service Digital Archive (CISDA) is a compilation of weekly ice charts covering Canadian waters from the early 1960s to present. The main sources of uncertainty in the database are reviewed and the data are validated for use in climate studies before trends and variability in summer averaged sea ice cover are investigated. These data revealed that between 1968 and 2008, summer sea ice cover has decreased by 11.3% ± 2.6% decade-1 in Hudson Bay, 2.9% ± 1.2% decade-1 in the Canadian Arctic Archipelago (CAA), 8.9% ± 3.1% decade-1 in Baffin Bay, and 5.2% ± 2.4% decade-1 in the Beaufort Sea with no significant reductions in multiyear ice. Reductions in sea ice cover are linked to increases in early summer surface air temperature (SAT); significant increases in SAT were observed in every season and they are consistently greater than the pan-Arctic change by up to ˜0.2°C decade-1. Within the CAA and Baffin Bay, the El Niño-Southern Oscillation index correlates well with multiyear ice coverage (positive) and first-year ice coverage (negative) suggesting that El Niño episodes precede summers with more multiyear ice and less first-year ice. Extending the trend calculations back to 1960 along the major shipping routes revealed significant decreases in summer sea ice coverage ranging between 11% and 15% decade-1 along the route through Hudson Bay and 6% and 10% decade-1 along the southern route of the Northwest Passage, the latter is linked to increases in SAT. Between 1960 and 2008, no significant trends were found along the northern western Parry Channel route of the Northwest Passage.

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

ERIC Educational Resources Information Center

Gopaul, Bryan

2015-01-01

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

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

ERIC Educational Resources Information Center

Godskesen, Mirjam; Kobayashi, Sofie

2016-01-01

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

Heartburn - what to ask your doctor

MedlinePlus

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

Doctor coach: a deliberate practice approach to teaching and learning clinical skills.

PubMed

Gifford, Kimberly A; Fall, Leslie H

2014-02-01

The rapidly evolving medical education landscape requires restructuring the approach to teaching and learning across the continuum of medical education. The deliberate practice strategies used to coach learners in disciplines beyond medicine can also be used to train medical learners. However, these deliberate practice strategies are not explicitly taught in most medical schools or residencies. The authors designed the Doctor Coach framework and competencies in 2007-2008 to serve as the foundation for new faculty development and resident-as-teacher programs. In addition to teaching deliberate practice strategies, the programs model a deliberate practice approach that promotes the continuous integration of newly developed coaching competencies by participants into their daily teaching practice. Early evaluation demonstrated the feasibility and efficacy of implementing the Doctor Coach framework across the continuum of medical education. Additionally, the Doctor Coach framework has been disseminated through national workshops, which have resulted in additional institutions applying the framework and competencies to develop their own coaching programs. Design of a multisource evaluation tool based on the coaching competencies will enable more rigorous study of the Doctor Coach framework and training programs and provide a richer feedback mechanism for participants. The framework will also facilitate the faculty development needed to implement the milestones and entrustable professional activities in medical education.

Examining Child Welfare Decisions and Services for Asian-Canadian Versus White-Canadian Children and Families in the Child Welfare System.

PubMed

Lee, Barbara; Fuller-Thomson, Esme; Fallon, Barbara; Black, Tara; Trocmé, Nico

2017-05-01

Using administrative child welfare data from the Ontario Child Abuse and Neglect Data System (OCANDS), this study compared the profiles of Asian-Canadian and White-Canadian children and families that experienced a case closure after an investigation instead of being transferred to ongoing child protection services (CPS). Child protection investigations involving Asian-Canadian and White-Canadian children and families that were transferred to ongoing CPS presented a different profile of case characteristics and caregiver and child clinical needs. Asian-Canadian children and families received ongoing CPS for over a month longer than White-Canadian children and families and were less likely (odds ratio [ OR] = 0.39) to be reinvestigated for any form of maltreatment-related concerns within 1 year after case closure. It appears that child protection investigations involving Asian-Canadian children and families are less likely to be closed prematurely than White-Canadian children and families, and the child protection system may be meeting the needs of Asian-Canadian communities. Alternatively, it is possible there is unaccounted biases that may be reflective of systemic problem of discriminative practices in the child protection system. Further research is needed to explore this phenomenon.

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

PubMed

Cunningham, Wayne; Crump, Raewyn; Tomlin, Andrew

2003-10-10

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

Child Care Options for Canadian Families.

ERIC Educational Resources Information Center

Vanier Inst. of the Family, Ottawa (Ontario).

Contemporary Canadian families need a system of child care that is more appropriate to modern conditions than the present system is. Because many Canadian parents do not have extended families to turn to, they are increasingly paying for child care. More than half prefer a form of care other than the one they use. Canadian policy and programs…

Porphyry deposits of the Canadian Cordillera

USGS Publications Warehouse

McMillan, W.J.; Thompson, J.F.H.; Hart, C.J.R.; Johnston, S.T.

1996-01-01

Porphyry deposits are intrusion-related, large tonnage low grade mineral deposits with metal assemblages that may include all or some of copper, molybdenum, gold and silver. The genesis of these deposits is related to the emplacement of intermediate to felsic, hypabyssal, generally porphyritic intrusions that are commonly formed at convergent plate margins. Porphyry deposits of the Canadian Cordillera occur in association with two distinctive intrusive suites: calc-alkalic and alkalic. In the Canadian Cordillera, these deposits formed during two separate time periods: Late Triassic to Middle Jurassic (early Mesozoic), and Late Cretaceous to Eocene (Mesozoic-Cenozoic). Deposits of the early Mesozoic period occur in at least three different arc terranes (Wrangellia, Stikinia and Quesnellia) with a single deposit occurring in the oceanic assemblage of the Cache Creek terrane. These terranes were located outboard from continental North America during formation of most of their contained early Mesozoic porphyry deposits. Some of the deposits of this early period may have been emplaced during terrane collisions. Metal assemblages in deposits of the calc-alkalic suite include Mo-Cu (Brenda), Cu-Mo (Highland Valley, Gibraltar), Cu-Mo-Au-Ag (Island Copper, Schaft Creek) and Cu-Au (Kemess, Kerr).The alkalic suite deposits are characterized by a Cu-Au assemblage (Copper Mountain, Afton-Ajax, Mt. Milligan, Mount Polley, Galore Creek). Although silver is recovered from calc-alkalic and alkalic porphyry copper mining operations, silver data are seldom included in the published reserve figures. Those available are in the range of 1-2 grams per tonne (g??t-1). Alkalic suite deposits are restricted to the early Mesozoic and display distinctive petrology, alteration and mineralization that suggest a similar tectonic setting for both Quesnellia and Stikinia in Early Jurassic time. The younger deposits, late Mesozoic to Cenozoic in age, formed in an intracontinental setting, after the

The Canadian National Retirement Risk Index: employing statistics Canada's LifePaths to measure the financial security of future Canadian seniors.

PubMed

MacDonald, Bonnie-Jeanne; Moore, Kevin D; Chen, He; Brown, Robert L

2011-01-01

This article measures a Canadian National Retirement Risk Index (NRRI). Originally developed by the Center for Retirement Research at Boston College, the NRRI is a forward-looking measure that evaluates the proportion of working-aged individuals who are at risk of not maintaining their standard of living in retirement. The Canadian retirement income system has been very effective in reducing elderly poverty, but our results suggest that it has been much less successful in maintaining the living standards of Canadians after retirement. Since the earlier years of the new millennium, we find that approximately one-third of retiring Canadians have been unable to maintain their working-age consumption after retirement—a trend that is projected to worsen significantly for future Canadian retirees. The release of the Canadian NRRI is timely given the widespread concern that the current Canadian retirement income system is inadequate. Many proposals have recently emerged to extend and/or enhance Canadian public pensions, and the NRRI is a tool to test their merit. The methodology underlying the Canadian NRRI is uniquely sophisticated and comprehensive on account of our employment of Statistics Canada’s LifePaths, a state-of-the-art stochastic microsimulation model of the Canadian population. For instance, the Canadian NRRI is novel in that it models all of the relevant sources of consumption before and after retirement, while accounting for important features that are typically neglected in retirement adequacy studies such as family size, the variation of consumption over a person’s lifetime, and the heterogeneity among the life courses of individuals.

What Matters for Excellence in PhD Programs? Latent Constructs of Doctoral Program Quality Used by Early Career Social Scientists

ERIC Educational Resources Information Center

Morrison, Emory; Rudd, Elizabeth; Zumeta, William; Nerad, Maresi

2011-01-01

This paper unpacks how social science doctorate-holders come to evaluate overall excellence in their PhD training programs based on their domain-specific assessments of aspects of their programs. Latent class analysis reveals that social scientists 6-10 years beyond their PhD evaluate the quality of their doctoral program with one of two…

Perceived vs actual knowledge and risk of heart disease in women: findings from a Canadian survey on heart health awareness, attitudes, and lifestyle.

PubMed

McDonnell, Lisa A; Pipe, Andrew L; Westcott, Courtney; Perron, Sue; Younger-Lewis, Deborah; Elias, Nadine; Nooyen, Jessica; Reid, Robert D

2014-07-01

Heart disease is a leading cause of morbidity and mortality in men and women. Our understanding of heart disease stems chiefly from clinical trials on men, but key features of the disease differ in women. This article reports findings from the first Canadian national survey of women that focuses on knowledge, perceptions, and lifestyle related to heart health. A cross-country survey using an adaptation of an instrument used in the United States was undertaken in spring of 2013. Based on online (208) and telephone (1446) responses from a randomly selected sample of women aged 25 or older, a total sample of 1654 weighted percentage estimates were produced. The overall response rate was 12.5%. Just under half of women were able to name smoking as a risk factor of heart disease, and less than one quarter named hypertension or high cholesterol. Fewer than half of women knew the major symptoms of heart disease. Most women prefer to receive information on heart health from their doctor, but only slightly more than half report that their doctor includes discussion of prevention and lifestyle during clinical consultations. Most women lack knowledge of heart disease symptoms and risk factors, and significant proportions are unaware of their own risk status. The findings underscore the opportunity for patient education and intervention regarding risk and prevention of heart disease. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2018-07-01

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

Committing Canadian sociology: developing a Canadian sociology and a sociology of Canada.

PubMed

Matthews, Ralph

2014-05-01

This paper is a slightly revised version of the author's "Outstanding Career Award Lecture" presented at the Annual Meeting of the Canadian Sociological Association in Victoria, British Columbia on June 6, 2013. The paper distinguishes between Canadian Sociology and the Sociology of Canada. The former involves the explanatory stance that one takes to understanding Canada. The latter addresses the significant social dimensions that underlie Canadian social organization, culture, and behavior. I make a case for a Canadian Sociology that focuses on the unique features of Canadian society rather than adopting a comparative perspective. I also argue that there is a continuing need within the Sociology of Canada to address the issues of staples development. However, I argue that "new" staples analysis must have a directional change from that of the past, in that social processes now largely determine the pattern of staples development. Moreover, new staples analysis must include issues that were never part of earlier staples analysis, such as issues of environmental impacts and of staples depletion under conditions, such as climate change. The paper concludes by analyzing four factors that provide the dominant social contexts for analyzing modern staples development: (1) the rise of neoliberal government, (2) the implementation of globalization and its social consequences, (3) the assumption of aboriginal rights and entitlement, and (4) the rise of environmentalism. These factors were generally not considered in earlier staples approaches. They are critical to understanding the role of staples development and its impact on Canada in the present time.

Junior doctors and clinical audit.

PubMed

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

1997-01-01

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

[Murder of the doctor].

PubMed

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

2015-01-01

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

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Health practices of Canadian physicians.

PubMed

Frank, Erica; Segura, Carolina

2009-08-01

To study the health and health practices of Canadian physicians, which can often influence patient health. Mailed survey. Canada. A random sample of 8100 Canadian physicians; 7934 were found to be eligible and 3213 responded (40.5% response rate). Factors that influence health, such as consumption of fruits and vegetables, amount of exercise and alcohol consumption, smoking status, body mass idex, and participation in preventive health screening measures, as well as work-life balance and emotional stability. Canadian physicians are healthy. More than 90% reported being in good to excellent health, and only 5% reported that poor physical or mental health made it difficult to handle their workload more than half the time in the previous month (although a quarter had reduced work activity because of long-term health conditions). Eight percent were obese, 3% currently smoked cigarettes, and 1% typically consumed 5 drinks or more on days when they drank alcohol. Physicians averaged 4.7 hours of exercise per week and ate fruits and vegetables 4.8 times a day. Their personal screening practices were largely compliant with Canadian Task Force on Preventive Health Care recommendations. They averaged 38 hours per week on patient care and 11 hours on other professional activities. Fifty-seven percent agreed that they had a good work-life balance, and 11% disagreed with the statement "If I can, I work when I am ill." Compared with self-reports from the general Canadian population, Canadian physicians, like American physicians, seem to be healthy and to have generally healthy behaviour. There is, however, room for improvement in physicians' personal and professional well-being, and improving their personal health practices could be an efficient and beneficent way to improve the health of all Canadians.

An exploratory, descriptive study of consumer opinions and behaviors regarding health products sales at 4 chiropractic practices in a large, western Canadian urban center.

PubMed

Page, Stacey A; Mbadiwe, Chinyere; McMorland, D Gordon; Grod, Jaroslaw P

2015-01-01

This study describes the opinions and behaviors of chiropractic patients in a large, western Canadian urban center regarding the sale of health products by doctors of chiropractic. A brief, descriptive survey consisting of both fixed-choice and open-ended questions was distributed by clinic reception staff at 4 chiropractic offices in Calgary, Alberta, Canada. Each practice sold a range of health products, including those relating to musculoskeletal care and nutrition, and served between 275 and 320 clients per week. After a 10-week recruitment interval between January and March 2013, a convenience sample of 103 chiropractic patients was obtained. Most patients supported the sale of health products by doctors of chiropractic (n = 101; 98.1%), and most had made health product purchases from a doctor of chiropractic at some point (n = 73; 70.9%). Products relating to muscular care, exercise/rehabilitation products, and pillows were purchased most often (>40%). Consumers were most supportive of doctors of chiropractic selling products they perceived to be directly related to musculoskeletal care. Some participants believed that there should be limits placed on the range of products sold including the products had to be consistent with the practitioner's area of expertise and had to have some demonstrated level of effectiveness. Primary reasons for health product purchase included the doctor's recommendations, convenience, and perception that the product would improve well-being (>50%). This study found that chiropractic patients were supportive of health product sales by doctors of chiropractic, assuming certain conditions were met. Consumers believed that product sales should be undertaken with integrity and should be consistent with the doctor's area of expertise. Consumer beliefs appeared to impact their purchasing behaviors. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Early Childhood Development in the Montreal Study Area (Quebec). Understanding the Early Years

ERIC Educational Resources Information Center

Human Resources Development Canada, 2003

2003-01-01

Understanding the Early Years (UEY) is a national research initiative. It provides communities with information to enable them to make informed decisions about the best policies and most appropriate programs for Canadian families with young children. This report is based on one of seven communities studied in 2001-2002. Children's outcomes were…

Psychiatric Prescribers' Experiences With Doctor Shoppers.

PubMed

Worley, Julie; Johnson, Mary; Karnik, Niranjan

2015-01-01

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

The wealth of distinguished doctors: retrospective survey.

PubMed

McManus, I C

2005-12-24

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

The Global Public Health Intelligence Network and early warning outbreak detection: a Canadian contribution to global public health.

PubMed

Mykhalovskiy, Eric; Weir, Lorna

2006-01-01

The recent SARS epidemic has renewed widespread concerns about the global transmission of infectious diseases. In this commentary, we explore novel approaches to global infectious disease surveillance through a focus on an important Canadian contribution to the area--the Global Public Health Intelligence Network (GPHIN). GPHIN is a cutting-edge initiative that draws on the capacity of the Internet and newly available 24/7 global news coverage of health events to create a unique form of early warning outbreak detection. This commentary outlines the operation and development of GPHIN and compares it to ProMED-mail, another Internet-based approach to global health surveillance. We argue that GPHIN has created an important shift in the relationship of public health and news information. By exiting the pyramid of official reporting, GPHIN has created a new monitoring technique that has disrupted national boundaries of outbreak notification, while creating new possibilities for global outbreak response. By incorporating news within the emerging apparatus of global infectious disease surveillance, GPHIN has effectively responded to the global media's challenge to official country reporting of outbreak and enhanced the effectiveness and credibility of international public health.

Variability and Change in the Canadian Cryosphere: A Canadian Science Contribution to International Polar Year

NASA Astrophysics Data System (ADS)

Walker, A. E.; Derksen, C.

2008-12-01

The cryosphere (snow, permafrost and seasonally frozen ground, ice caps and glaciers, sea-, river-, and lake ice) represents a significant feature of the Canadian landscape that impacts climate, hydrology, the economy and the daily lives of all Canadians, especially those living in northern communities. Over the past few decades significant changes have been observed in cryospheric elements (e.g. decreases in snow cover, glacier extent, sea ice cover) that have been attributed to a warming climate. This poster presentation will highlight initial scientific results from the approved Canadian International Polar Year project "Variability and Change in the Canadian Cryosphere" that is being led by Environment Canada and involves 33 co- investigators from government, academia and the private sector and links with international collaborators. This project builds on Canadian strengths in remote sensing, climate analysis and modeling with the overall objective to observe and understand the current state of the cryosphere in Canada and determine how fast it is changing and why. Research activities are focused on: (1) developing new satellite-based capabilities to provide information on the current state of the Canadian cryosphere during the IPY period; (2) placing current cryospheric conditions in the context of the historical record to document the magnitude of changes over the 50 years since the last International Polar Year (IGY 1957-1958); (3) characterizing and explaining the observed variability and changes in the context of the coupled climate cryosphere system; and (4) improving the representation of the cryosphere in Canadian land surface and climate models to provide current and future climate simulations of the cryosphere for climate impact studies. The project also includes several outreach activities to engage northern communities in cryospheric monitoring and incorporate traditional knowledge with remotely-sensed information to generate new maps on local

Alberta Learning: Early Development Instrument Pilot Project Evaluation.

ERIC Educational Resources Information Center

Meaney, Wanda; Harris-Lorenze, Elayne

The Early Development Instrument (EDI) was designed by McMaster University to measure the outcomes of childrens early years as they influence their readiness to learn at school. The EDI was piloted in several Canadian cities in recent years through two national initiatives. Building on these initiatives, Alberta Learning piloted the EDI as a…

Tanning equipment use: 2014 Canadian Community Health Survey.

PubMed

Qutob, Sami Q; O'Brien, Michelle; Feder, Katya; McNamee, James; Guay, Mireille; Than, John

2017-01-18

Tanning equipment use is related to the early onset of cancer, with the risk increasing as the duration and repetition of exposure increase. In 2009, the International Agency for Research on Cancer classified tanning equipment use as carcinogenic to humans, and according to the World Health Organization, the risk of skin melanoma increases significantly when use begins before age 35. The rapid response component of the 2014 Canadian Community Health Survey collected data on the use of tanning equipment in the previous 12 months, including reasons for use, frequency/duration of use, precautions taken, and adverse reactions or injuries. This analysis examines the prevalence of self-reported indoor tanning in a nationally representative sample of Canadians aged 12 or older in the 10 provinces. In 2014, 4.5% of Canadians (an estimated 1.35 million) reported that they had used tanning equipment in the past year; 70.3% of them were female, and just over half of female users were aged 18 to 34. The prevalence of indoor tanning was highest among people with some postsecondary education and among those in higher income households (trend p-value ⟨ 0.0001). Most users reported fewer than 10 sessions in the past year. The most common reason (62.0%) was to develop a "protective" base tan. Females made up the majority of tanning equipment users, particularly at ages 18 to 34. Efforts to increase awareness of the risks may be beneficial, given the high percentage of users who believed that indoor tanning offers some level of skin protection from future sun exposure.

A Canadian perspective on documentary film: Drug Addict.

PubMed

Boyd, Susan

2013-11-01

In 1948 the first National Film Board (NFB) documentary in Canada about illegal drugs, trafficking, and addiction was produced. The documentary is titled Drug Addict, and was directed by Robert Anderson. This paper provides a socio-historical context for the documentary Drug Addict. Viewing the film through the lens of Canadian history gives readers a better context to understand the claims and representations in the film about law enforcement, people who use illegal drugs and treatment. To examine Drug Addict, a socio-historical analysis and case study were conducted. This project's qualitative methodological framework is consistent with its critical theoretical perspective, drawing from Stuart Hall's perspectives on visual and textual representation and cultural criminology. Drug Addict is a significant documentary because it provides insight into early foundational law enforcement discourses and practices about illegal drugs, addiction, and treatment, including obstacles to drug substitution and maintenance programs. It also highlights the emergence of psychiatry as a new knowledge producer in the area of drug treatment. The film also transmits ideas about the criminal nature of addicts and the need for punitive criminal justice control. Drug Addict captures some past and contemporary tensions related to Canadian drug policy. The film also provides another lens to understand some of the foundational frameworks of Canadian drug policy such as the dominance of criminal justice, and its practices of knowledge production, the resistance espoused by institutions to diverse models of treatment such as drug maintenance programs, and the power of visual representation. Copyright © 2013 Elsevier B.V. All rights reserved.

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

ERIC Educational Resources Information Center

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

2018-01-01

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

Doctors writing outside the square.

PubMed

Hurley, Thomas H

2011-01-17

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

Exposure to Polybrominated Diphenyl Ethers (PBDEs) and Hypothyroidism in Canadian Women.

PubMed

Oulhote, Youssef; Chevrier, Jonathan; Bouchard, Maryse F

2016-02-01

Polybrominated diphenyl ethers (PBDEs) are used as flame retardants in a wide range of products, resulting in widespread human exposure. Epidemiological studies in some populations reported exposure to PBDEs and thyroid hormone levels but little epidemiological data are available among women from the general population. The objective of the study was to examine the association of PBDEs with hypothyroidism. This was a cross-sectional analysis of the 2007-2009 Canadian Health Measures Survey. A total of 745 women representative of Canadian women aged 30-79 years participated in the study. Main Outcome and Methods: We estimated the prevalence ratios (PRs) for hypothyroidism in relation to plasma concentrations of BDE-47, -99, -100, and -153 and their sum (ΣPBDEs). Women were identified as cases if they reported a doctor-diagnosed thyroid condition and underwent thyroid hormone replacement therapy (n = 90). Higher plasma levels of brominated diphenyl ether (BDE)-47 and -100 and ΣPBDEs were associated with an increased prevalence of hypothyroidism. The PR for a 10-fold increase in ΣPBDEs was 1.7 (95% confidence interval [CI] 1.0, 3.0). Associations were consistently higher among women aged 30-50 years than among those 51-79 years for ΣPBDEs and the other PBDE congeners, although the interaction was significant only for BDE-100. For instance, in the younger age group, women with detectable levels of BDE-100 had a PR of 3.8 (95% CI 1.2, 12.3) compared with women with undetectable levels; the corresponding PR in the older age group was 1.2 (95% CI 0.6, 2.3). No association was observed for BDE-99 and -153. Plasma PBDE levels were associated with an increased prevalence of hypothyroidism in Canadian women aged 30-50 years. Although the cross-sectional design of the study limits inferences of causality, these findings have important implications, given the key role of thyroid hormones in several biological mechanisms during reproductive age.

Retheorizing Doctoral Supervision as Professional Work

ERIC Educational Resources Information Center

Halse, Christine; Malfroy, Janne

2010-01-01

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

Female Physicist Doctoral Experiences

ERIC Educational Resources Information Center

Dabney, Katherine P.; Tai, Robert H.

2013-01-01

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

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

ERIC Educational Resources Information Center

National Science Foundation, 2009

2009-01-01

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

[Life conditions of Togolese doctors].

PubMed

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

2010-09-01

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

A reanalysis of cancer mortality in Canadian nuclear workers (1956–1994) based on revised exposure and cohort data

PubMed Central

Zablotska, L B; Lane, R S D; Thompson, P A

2014-01-01

Background: A 15-country study of nuclear workers reported significantly increased radiation-related risks of all cancers excluding leukaemia, with Canadian data a major factor behind the pooled results. We analysed mortality (1956–1994) in the updated Canadian cohort and provided revised risk estimates. Methods: Employment records were searched to verify and revise exposure data and to restore missing socioeconomic status. Excess relative risks per sievert (ERR/Sv) of recorded radiation dose and 95% confidence intervals (CIs) were estimated using Poisson regression. Results: A significant heterogeneity of the dose–response for solid cancer was identified (P=0.02), with 3088 early (1956–1964) Atomic Energy of Canada Limited (AECL) workers having a significant increase (ERR/Sv=7.87, 95% CI: 1.88, 19.5), and no evidence of radiation risk for 42 228 workers employed by three nuclear power plant companies and post-1964 AECL (ERR/Sv=−1.20, 95% CI: <−1.47, 2.39). Radiation risks of leukaemia were negative in early AECL workers and non-significantly increased in other workers. In analyses with separate terms for tritium and gamma doses, there was no evidence of increased risk from tritium exposure. All workers had mortality lower than the general population. Conclusion: Significantly increased risks for early AECL workers are most likely due to incomplete transfer of AECL dose records to the National Dose Registry. Analyses of the remainder of the Canadian nuclear workers (93.2%) provided no evidence of increased risk, but the risk estimate was compatible with estimates that form the basis of radiation protection standards. Study findings suggest that the revised Canadian cohort, with the exclusion of early AECL workers, would likely have an important effect on the 15-country pooled risk estimate of radiation-related risks of all cancer excluding leukaemia by substantially reducing the size of the point estimate and its significance. PMID:24231946

The U.S./Canadian GEO Bilateral Drought Indices and Definitions Study: Implications for the Canadian Drought Monitor and a Global Drought Early Warning System

NASA Astrophysics Data System (ADS)

Hadwen, T.; Heim, R. R.; Howard, A.

2011-12-01

Drought is a difficult phenomenon to define; the way in which it is monitored, measured, assessed and even the very definition of drought vary from location to location based on the regional climate and the potential impacts. Drought is not an absolute condition but an evolving state brought on by relatively dry weather, growing more severe over time. There are many factors that define a drought and many more that define its impacts. Many definitions and indices are based solely on meteorological characteristics. Although this approach has merit, it is often necessary to go further to define those meteorological conditions in a way that is relevant to the land and water use in a region. A Drought Indices and Definitions Study was initiated in 2010 as part of a GEO Bilateral effort to examine drought across the U.S. and Canada. The Study's deliverables will include a survey of the drought indices used to monitor drought, and a bibliography of research addressing the nature of drought, across the diverse climates of the continent. With an increasing pressure to utilize drought monitoring as a primary indicator of need for disaster assistance, the reliability of drought indices must be validated and utilized in appropriate in various regions. In 2009, following over five years of participation in the North American Drought Monitor (NA-DM), the National Agroclimate Information Service of Agriculture and Agri-Food Canada initiated a project to develop a Canadian Drought Monitor (Can-DM), based on primary principles used in the NA-DM and the US Drought Monitor (US-DM). The process of developing an operational monitoring tool and using drought indices in a vast and environmentally diverse country has been challenging. in Canada, many of the commonly used indices are not appropriate in certain regions or data densities do not allow for proper use. This paper will discuss the experiences that the Can-DM team has had dealing with these challenges, how these experiences

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

ERIC Educational Resources Information Center

Nelson Russom, Lynn A.

2017-01-01

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

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

PubMed Central

Petersson, Göran; Hamberg, Katarina

2003-01-01

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

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

PubMed

Umefjord, Göran; Petersson, Göran; Hamberg, Katarina

2003-10-22

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

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

PubMed

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

2017-04-01

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

Changing Doctoral Degrees: An International Perspective.

ERIC Educational Resources Information Center

Noble, Keith Allan

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

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

ERIC Educational Resources Information Center

Aittola, Helena

2017-01-01

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

Discourse Types in Canadian Basal Reading Programs.

ERIC Educational Resources Information Center

Murphy, Sharon

This study examined the authorship and discourse types of Canadian basal anthologies to determine whether the lingering centrality of the basal anthology in Canadian programs controls students and teachers by controlling language and reading. Each selection within five Canadian basal series (Gage Expressways II, Ginn Journeys, Holt Impressions,…

The Ideological Orientations of Canadian University Professors

ERIC Educational Resources Information Center

Nakhaie, M. Reza; Brym, Robert J.

2011-01-01

This paper analyzes the ideological orientations of Canadian university professors based on a unique 2000 study of a representative sample of Canadian academics (n=3,318). After summarizing methodological problems with extant research on this subject, and tentatively comparing the political views of Canadian and American academics, the paper…

International immigration, internal migration, and homicide in Canadian provinces.

PubMed

Andresen, Martin A

2013-05-01

The relationship between immigration and crime is politically charged and often fueled by the presence (or lack) of xenophobia. Many theoretical and empirical assessments of this relationship indicate that immigration does indeed lead to increased crime, but more recent (and very early) research investigating homicide calls this finding into question. The current analysis investigates the relationship between immigration and homicide using multiple measures of migration and Canadian provinces as the unit of analysis. It is found that the link between immigration and homicide is complex and dependent on the measure of migration used. Generally speaking, the results presented here are consistent with the more recent and very early research. Immigration, in and of itself, does not increase homicide. Rather it is the increase in the most criminogenic subpopulation that matters, that is young males.

The wealth of distinguished doctors: retrospective survey

PubMed Central

McManus, I C

2005-01-01

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

EHR adoption among doctors who treat the elderly.

PubMed

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

2010-12-01

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

Science and Engineering Doctorate Awards: 1998.

ERIC Educational Resources Information Center

Hill, Susan T.

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

Science and Engineering Doctorate Awards: 1999.

ERIC Educational Resources Information Center

Hill, Susan T.

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

Invisible Roles of Doctoral Program Specialists

ERIC Educational Resources Information Center

Bachman, Eva Burns; Grady, Marilyn L.

2016-01-01

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

Advising Doctoral Students in Education Programs

ERIC Educational Resources Information Center

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

2016-01-01

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

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

PubMed Central

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

2008-01-01

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

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

PubMed

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

2014-02-13

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

Representations of Language Education in Canadian Newspapers

ERIC Educational Resources Information Center

Vessey, Rachelle

2017-01-01

This article examines the salience and content of representations of language education in a corpus of English- and French-Canadian newspapers. Findings suggest that English-Canadian newspapers foreground official-language education issues, in which public schools are represented as the primary means by which Canadians can gain equal access to…

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

PubMed

Wegwarth, Odette; Gaissmaier, Wolfgang; Gigerenzer, Gerd

2009-08-01

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

Physical rehabilitation following polytrauma. The Canadian Forces Physical Rehabilitation Program 2008-2011.

PubMed

Besemann, Markus

2011-12-01

As a consequence of Canada's involvement in the war in Afghanistan, many members of the Canadian Forces have experienced debilitating injuries. Despite the Canadian Forces Health Services (CFHS) having outstanding relationships with many civilian care providers for the rehabilitation of injured soldiers, it became apparent early on that the high-level goals and aspirations of these returning soldiers were sometimes beyond the capability of these centres to facilitate. From this reality grew the need to develop a Physical Rehabilitation Program within the CFHS. This article describes the lessons learned since the creation of the program and outlines the future vision in terms of unique challenges and opportunities. The primary purpose of this article is to describe a hybrid model of civilian-military rehabilitation for injured soldiers and discuss the benefits and challenges of such a model of care.

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

PubMed

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

2016-07-07

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

Trends in Canadian School Finance.

ERIC Educational Resources Information Center

Atherton, Peter J.

The great similarity between the Canadian and American structures of school finance conceals some fundamental, constitutional, and structural differences that shape the trends in Canadian school finance. First, provincial governments exercise a high degree of centralized control over education and its finance. Second, provincial governments have…

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

ERIC Educational Resources Information Center

Philpott, Carey

2015-01-01

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

The Trouble with Doctoral Aspiration Now

ERIC Educational Resources Information Center

Burford, James

2018-01-01

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

[Social issues in the doctor's clinic].

PubMed

Vos, H

2017-01-01

Doctors are confronted with issues that arise in society. These social issues can affect patients' health. Solving these problems requires more than just prescribing a pill, as illustrated by the cases of three patients. The first patient is a 42-year-old male with cardiac symptoms, chronic lower back pain and an excessive use of tranquillizers. The welfare worker intervened and his demand for health care and use of tranquillizers diminished. The second patient is a 53-year-old female with symptoms of chronic back pain, migraine and depression. A labour dispute concerning her health eventually led to a referral to a project named 'social hospital', but actual assistance never took place due to the patient's alleged lack of time to participate. The third case concerns an 86-year-old female with postherpetic neuralgia who also suffered from loneliness. The patient's named welfare worker tried to get in touch with her, but the patient kept her at a distance. These three cases illustrate that it is very important to get to know the social network in a community in order to refer patients with social issues to the right person or place. Furthermore, prevention and early intervention strategies should be applied where possible. Doctors and local governments must act together in order to succeed in solving patient ill health as a result of social issues.

Novel LRPPRC Mutation in a Boy With Mild Leigh Syndrome, French-Canadian Type Outside of Québec.

PubMed

Han, Velda Xinying; Tan, Teresa S; Wang, Furene S; Tay, Stacey Kiat-Hong

2017-01-01

Leigh syndrome, French-Canadian type is unique to patients from a genetic isolate in the Saguenay-Lac-Saint-Jean region of Québec. It has also been recently described in 10 patients with LRPPRC mutation outside of Québec. It is an autosomal recessive genetic disorder with fatal metabolic crisis and severe neurological morbidity in infancy caused by LRPPRC mutation. The authors report a boy with a novel LRPPRC compound heterozygous missense mutations c.3130C>T, c.3430C>T, and c.4078G>A found on whole-exome sequencing which correlated with isolated cytochrome c-oxidase deficiency found in skeletal muscle. LRPPRC mutation is a rare cause of cytochrome c-oxidase-deficient form of Leigh syndrome outside of Québec. Our patient broadens the spectrum of phenotypes of Leigh syndrome, French-Canadian type. LRPPRC mutation should be considered in children with early childhood neurodegenerative disorder, even in the absence of metabolic crisis. Early evaluation with whole-exome sequencing is useful for early diagnosis and for genetic counseling.

Career Interests of Canadian Psychiatry Residents: What Makes Residents Choose a Research Career?

PubMed Central

Laliberté, Vincent; Rapoport, Mark J.; Andrew, Melissa; Davidson, Marla

2016-01-01

Objectives: Training future clinician-researchers remains a challenge faced by Canadian psychiatry departments. Our objectives were to determine the prevalence of residents interested in pursuing research and other career options as part of their practice, and to identify the factors associated with interest in research. Method: Data from a national online survey of 207 Canadian psychiatry residents from a total of 853 (24.3% response rate) were examined. The main outcome was interest in research as part of residents’ future psychiatrist practice. Bivariate and multivariate analyses were performed to identify demographic and vocational variables associated with research interest. Results: Interest in research decreases by 76% between the first and fifth year of psychiatry residency (OR 0.76 per year, 95% CI 0.60 to 0.97). Training in a department with a residency research track did not correlate with increased research interest (χ2 = 0.007, df = 1, P = 0.93). Conclusions: Exposing and engaging psychiatry residents in research as early as possible in residency training appears key to promoting future research interest. Psychiatry residency programs and research tracks could consider emphasizing research training initiatives and protected research time early in residency. PMID:27253699

Career Interests of Canadian Psychiatry Residents: What Makes Residents Choose a Research Career?

PubMed

Laliberté, Vincent; Rapoport, Mark J; Andrew, Melissa; Davidson, Marla; Rej, Soham

2016-02-01

Training future clinician-researchers remains a challenge faced by Canadian psychiatry departments. Our objectives were to determine the prevalence of residents interested in pursuing research and other career options as part of their practice, and to identify the factors associated with interest in research. Data from a national online survey of 207 Canadian psychiatry residents from a total of 853 (24.3% response rate) were examined. The main outcome was interest in research as part of residents' future psychiatrist practice. Bivariate and multivariate analyses were performed to identify demographic and vocational variables associated with research interest. Interest in research decreases by 76% between the first and fifth year of psychiatry residency (OR 0.76 per year, 95% CI 0.60 to 0.97). Training in a department with a residency research track did not correlate with increased research interest (χ2 = 0.007, df = 1, P = 0.93). Exposing and engaging psychiatry residents in research as early as possible in residency training appears key to promoting future research interest. Psychiatry residency programs and research tracks could consider emphasizing research training initiatives and protected research time early in residency. © The Author(s) 2015.

The impact of doctor-patient communication on patients' perceptions of their risk of breast cancer recurrence.

PubMed

Janz, Nancy K; Li, Yun; Zikmund-Fisher, Brian J; Jagsi, Reshma; Kurian, Allison W; An, Lawrence C; McLeod, M Chandler; Lee, Kamaria L; Katz, Steven J; Hawley, Sarah T

2017-02-01

Doctor-patient communication is the primary way for women diagnosed with breast cancer to learn about their risk of distant recurrence. Yet little is known about how doctors approach these discussions. A weighted random sample of newly diagnosed early-stage breast cancer patients identified through SEER registries of Los Angeles and Georgia (2013-2015) was sent surveys about ~2 months after surgery (Phase 2, N = 3930, RR 68%). We assessed patient perceptions of doctor communication of risk of recurrence (i.e., amount, approach, inquiry about worry). Clinically determined 10-year risk of distant recurrence was established for low and intermediate invasive cancer patients. Women's perceived risk of distant recurrence (0-100%) was categorized into subgroups: overestimation, reasonably accurate, and zero risk. Understanding of risk and patient factors (e.g. health literacy, numeracy, and anxiety/worry) on physician communication outcomes was evaluated in multivariable regression models (analytic sample for substudy = 1295). About 33% of women reported that doctors discussed risk of recurrence as "quite a bit" or "a lot," while 14% said "not at all." Over half of women reported that doctors used words and numbers to describe risk, while 24% used only words. Overestimators (OR .50, CI 0.31-0.81) or those who perceived zero risk (OR .46, CI 0.29-0.72) more often said that their doctor did not discuss risk. Patients with low numeracy reported less discussion. Over 60% reported that their doctor almost never inquired about worry. Effective doctor-patient communication is critical to patient understanding of risk of recurrence. Efforts to enhance physicians' ability to engage in individualized communication around risk are needed.

The Impact of Doctor-Patient Communication on Patients’ Perceptions of their Risk of Breast Cancer Recurrence

PubMed Central

Janz, Nancy K.; Li, Yun; Zikmund-Fisher, Brian J.; Jagsi, Reshma; Kurian, Allison W.; An, Lawrence C.; McLeod, M. Chandler; Lee, Kamaria L.; Katz, Steven J.; Hawley, Sarah T.

2017-01-01

Purpose Doctor-patient communication is the primary way women diagnosed with breast cancer learn about their risk of distant recurrence. Yet little is known about how doctors approach these discussions. Methods A weighted random sample of newly diagnosed early stage breast cancer patients identified through SEER registries of Los Angeles and Georgia (2013–2015) were sent surveys ~about 2 months after surgery (Phase 2, N=3930, RR 68%). We assessed patient perceptions of doctor communication of risk of recurrence (i.e., amount, approach, inquiry about worry). Clinically-determined 10-year risk of distant recurrence was established for low and intermediate invasive cancer patients. Women’s perceived risk of distant recurrence (0–100%) was categorized into subgroups: overestimation, reasonably accurate, zero risk. Understanding of risk and patient factors (e.g., health literacy, numeracy and anxiety/worry) on physician communication outcomes was evaluated in multivariable regression models (analytic sample for substudy = 1295). Results About 33% of women reported doctors discussed risk of recurrence “quite a bit” or “a lot” while 14% said “not at all.” Over half of women reported doctors used words and numbers to describe risk, while 24% used only words. Overestimators (OR =.50, CI 0.31, 0.81) or those who perceived zero risk (OR =.46, CI 0.29,0.72) more often said their doctor did not discuss risk. Patients with low numeracy reported less discussion. Over 60% reported their doctor almost never inquired about worry. Conclusions Effective doctor-patient communication is critical to patient understanding of risk of recurrence. Efforts to enhance physicians’ ability to engage in individualized communication around risk are needed. PMID:27943007

Wasting the doctor's time? A video-elicitation interview study with patients in primary care.

PubMed

Llanwarne, Nadia; Newbould, Jennifer; Burt, Jenni; Campbell, John L; Roland, Martin

2017-03-01

Reaching a decision about whether and when to visit the doctor can be a difficult process for the patient. An early visit may cause the doctor to wonder why the patient chose to consult when the disease was self-limiting and symptoms would have settled without medical input. A late visit may cause the doctor to express dismay that the patient waited so long before consulting. In the UK primary care context of constrained resources and government calls for cautious healthcare spending, there is all the more pressure on both doctor and patient to meet only when necessary. A tendency on the part of health professionals to judge patients' decisions to consult as appropriate or not is already described. What is less well explored is the patient's experience of such judgment. Drawing on data from 52 video-elicitation interviews conducted in the English primary care setting, the present paper examines how patients seek to legitimise their decision to consult, and their struggles in doing so. The concern over wasting the doctor's time is expressed repeatedly through patients' narratives. Referring to the sociological literature, the history of 'trivia' in defining the role of general practice is discussed, and current public discourses seeking to assist the patient in developing appropriate consulting behaviour are considered and problematised. Whilst the patient is expected to have sufficient insight to inform timely consulting behaviour, it becomes clear that any attempt on the part of doctor or patient to define legitimate help-seeking is in fact elusive. Despite this, a significant moral dimension to what is deemed appropriate consulting by doctors and patients remains. The notion of candidacy is suggested as a suitable framework and way forward for encompassing these struggles to negotiate eligibility for medical time. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Routine immunization of adults by pharmacists: Attitudes and beliefs of the Canadian public and health care providers

PubMed Central

MacDougall, D.; Halperin, B. A.; Isenor, J.; MacKinnon-Cameron, D.; Li, L.; McNeil, S. A.; Langley, J. M.; Halperin, S. A.

2016-01-01

Abstract Vaccine coverage among adults for recommended vaccines is generally low. In Canada and the US, pharmacists are increasingly becoming involved in the administration of vaccines to adults. This study measured the knowledge, attitudes, beliefs, and behaviors of Canadian adults and health care providers regarding pharmacists as immunizers. Geographically representative samples of Canadian adults (n = 4023) and health care providers (n = 1167) were surveyed, and 8 focus groups each were conducted nationwide with adults and health care providers. Provision of vaccines by pharmacists was supported by 64.6% of the public, 82.3% of pharmacists, 57.4% of nurses, and 38.9% of physicians; 45.7% of physicians opposed pharmacist-delivered vaccination. Pharmacists were considered a trusted source of vaccination information by 75.0% of the public, exceeding public health officials (68.3%) and exceeded only by doctors and nurses (89.2%). Public concerns about vaccination in pharmacies centered on safety (management of adverse events), record keeping (ensuring their family physician was informed), and cost (should be no more expensive than vaccination at public health or physicians' offices). Concerns about the logistics of vaccination delivery were expressed more frequently in regions where pharmacists were not yet immunizing than in jurisdictions with existing pharmacist vaccination programs. These results suggest that the expansion of pharmacists' scope of practice to include delivery of adult vaccinations is generally accepted by Canadian health care providers and the public. Acceptance of this expanded scope of pharmacist practice may contribute to improvements in vaccine coverage rates by improving vaccine accessibility. PMID:26810485

Doctors' views about their work, education and training three years after graduation in the UK: questionnaire survey.

PubMed

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

2015-12-01

Doctors who graduated in the UK after 2005 have followed a restructured postgraduate training programme (Modernising Medical Careers) and have experienced the introduction of the European Working Time Regulation and e-portfolios. In this paper, we report the views of doctors who graduated in 2008 three years after graduation and compare these views with those expressed in year 1. Questionnaires about career intentions, destinations and views sent in 2011 to all medical graduates of 2008. 3228 UK medical graduates. Comments on work, education and training. Response was 49% (3228/6538); 885 doctors wrote comments. Of these, 21.8% were unhappy with the standard of their training; 8.4% were positive. Doctors made positive comments about levels of supervision, support, morale and job satisfaction. Many doctors commented on poor arrangements for rotas, cover and leave, which had an adverse effect on work-life balance, relationships, morale and health. Some doctors felt pressured into choosing their future specialty too early, with inadequate career advice. Themes raised in year 3 that were seldom raised in year 1 included arrangements for flexible working and maternity leave, obtaining posts in desired locations and having to pay for courses, exams and conferences. Many doctors felt training was available, but that European Working Time Regulation, rotas and cover arrangements made it difficult to attend. Three years after graduation, doctors raised similar concerns to those they had raised two years earlier, but the pressures of career decision making, family life and job seeking were new issues.

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

PubMed

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

2012-12-01

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

Political Socialization Research and Canadian Studies

ERIC Educational Resources Information Center

Tomkins, George S.

1977-01-01

Presents a review of the burgeoning field of Canadian political socialization research as it applies to children and youth, and considers some implications of recent findings for the Canadian studies curriculum. (Editor)

Work of female rural doctors.

PubMed

Wainer, Jo

2004-04-01

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

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

PubMed Central

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

2014-01-01

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

Directory of Canadian Universities, 1977.

ERIC Educational Resources Information Center

Statistics Canada, Ottawa (Ontario). Education, Science, and Culture Div.

Information about the colleges and universities of Canada is presented in this twentieth edition of the Directory of Canadian Universities for 1977. The history and development of the Canadian system of higher education is discussed in an introductory article that focuses on changes in the structure, governance, students, curriculum, and…

Australian and Canadian mental health Acts compared.

PubMed

Gray, John Ellery; McSherry, Bernadette Maree; O'Reilly, Richard L; Weller, Penelope June

2010-12-01

The main objective of this paper is to compare the mental health Acts of the eight Australian jurisdictions and the 13 Canadian jurisdictions on three major issues: involuntary admission criteria, treatment authorization/consent and compulsory treatment in the community, in the light of international trends towards patients' rights. The legislation was examined against the background of rights instruments such as the Canadian Charter of Rights and Freedoms and the United Nations Convention on the Rights of Persons with Disabilities. It was found that some Canadian involuntary admission criteria require the likelihood of bodily harm whereas all Australian Acts have broad harm and deterioration criteria. Unlike all Australian jurisdictions, some Canadian jurisdictions allow for the refusal of treatment that may be required for discharge. In addition, Canadian community treatment orders are much more restrictive than in Australia because they require a person to have considerable previous hospitalization despite meeting the committal criteria. Australian jurisdictions can use community treatment orders as a least restrictive alternative to inpatient status without prior hospitalization. The paper concludes that there are significant philosophical differences regarding the purpose of involuntary admission between Australian and some Canadian jurisdictions where treatment refusal is possible. Australian mental health Acts have a relatively stronger 'treatment' focus than some Canadian Acts. The apparently stronger 'rights' focus of some Canadian laws (such as the permission of treatment refusal) can paradoxically result in a denial of liberty rights. The way in which the relevant legislation is shaped in both countries will increasingly be affected by international trends towards the rights of individuals with disabilities.

Ethics expertise for health technology assessment: a Canadian national survey.

PubMed

Bond, Kenneth; Oremus, Mark; Duthie, Katherine M; Griener, Glenn G

2014-04-01

The aim of this study was to identify individuals with expertise in ethics analysis in Canada, who might contribute to health technology assessment (HTA); to gauge these individuals' familiarity with, and experience participating in, the production of HTA. A contact list was developed using the Canadian Bioethics Society membership list and faculty listings of Canadian universities, bioethics centers, and health agencies. An eighteen-question email survey was distributed to potential respondents to collect data on demographic information, education and work experience in applied ethics, and involvement in HTA. The survey response rate was 52.8 percent (350/663). Respondents worked primarily in academic institutions (50.4 percent) or hospitals (15.4 percent). Many respondents (83.1 percent) had education, formal training, or work-related experience in practical ethics related to health care, with many having a doctorate (34.5 percent) or master's degree (19.0 percent). One quarter (24.5 percent; n = 87) of respondents indicated they had been involved in an analysis of ethical issues for HTA. Almost two-thirds (65.4 percent; n = 165) of those who had not previously participated in ethics analysis believed they might usefully contribute to an analysis of ethical issues in HTA. Experts who have conducted ethics analysis in HTA had more than twice the odds of having education and training in ethics and a PhD than those who might contribute to ethics analysis. Many people have contributed to ethics analysis in HTA in Canada, and more are willing to do so. Given the absence of a reliable credential for ethics expertise, HTA producers should exercise caution when enlisting ethics experts.

Reminiscence functions and the health of Israeli Holocaust survivors as compared to other older Israelis and older Canadians.

PubMed

O'Rourke, Norm; Bachner, Yaacov G; Cappeliez, Philippe; Chaudhury, Habib; Carmel, Sara

2015-01-01

Existing research with English-speaking samples indicates that various ways in which older adults recall their past affect both their physical and mental health. Self-positive reminiscence functions (i.e. identity, problem-solving, death preparation) correlate and predict mental health in later life whereas self-negative functions (i.e. bitterness revival, boredom reduction, intimacy maintenance) correlate and predict the physical health of older adults. For this study, we recruited 295 Israeli Holocaust survivors to ascertain if early life trauma affects these associations between reminiscence and health. In order to distinguish cross-national differences from survivor-specific effects, we also recruited two comparative samples of other older Israelis (not Holocaust survivors; n = 205) and a second comparative sample of 335 older Canadians. Three separate structural equation models were computed to replicate this tripartite reminiscence and health model. Coefficients for self-negative functions significantly differed between survivors and both Canadians and other older Israelis, and between Canadians and both Israeli samples. However, no differences were found between prosocial and self-positive functions. Moreover, the higher order structure of reminiscence and health appears largely indistinguishable across these three groups. Early life trauma does not appear to fundamentally affect associations between reminiscence and health. These findings underscore the resilience of Holocaust survivors.

"Canadianizing" an American Communication Textbook.

ERIC Educational Resources Information Center

Maclennan, Jennifer M.

2000-01-01

Presents a study on the process involved in the "Canadianization" of U.S. textbooks for the domestic market. Explores whether disciplinary values have been shaped by the United States in the field of communication. Focuses on the experience of developing the Canadian edition of the book "Public Speaking: Strategies for Success"…

Doctors with dyslexia: strategies and support.

PubMed

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

2017-10-01

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

Kidney stones - what to ask your doctor

MedlinePlus

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

Epilepsy - what to ask your doctor - adult

MedlinePlus

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

Early Childhood Development in the Dixie Bloor Community of Mississauga, Ontario. Understanding the Early Years.

ERIC Educational Resources Information Center

Human Resources Development Canada, 2003

2003-01-01

Understanding the Early Years (UEY) is a national research initiative. It provides communities with information to enable them to make informed decisions about the best policies and most appropriate programs for Canadian families with young children. This report is based on one of seven communities studied in 2001-2002. Children's outcomes were…

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

PubMed

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

2012-12-01

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

The Canadian Dermatology Workforce Survey: implications for the future of Canadian dermatology--who will be your skin expert?

PubMed

Maguiness, Sheilagh; Searles, Gordon E; From, Lynn; Swiggum, Susan

2004-01-01

To survey Canadian dermatologists for specialty-specific physician resource information including demographics, workload and future career plans. In 2001, the Canadian Dermatology Association (CDA) surveyed 555 dermatologists in Canada to gain specialty-specific physician resource information. Three hundred and seventy-one dermatologists (69%) provided information about themselves, their workloads and their future career goals. The average Canadian dermatologist is 52 years old and 35% of practicing dermatologists are over the age of 55. Eighty-nine percent of dermatologists practice in an urban setting, 19% include practice in a rural setting while less than 0.5% practice in remote areas. Canadian dermatologists spend 61% of their clinical time providing services in Medical Dermatology. Within 5 years, 50% of dermatologists reported that they plan to reduce their practices or retire. The Canadian Dermatology Workforce Survey provides a snapshot of the current practice of dermatology in Canada. It also serves to highlight the critical shortage of dermatologists, which will continue to worsen without immediate, innovative planning for the future.

Effective doctor-patient communication: an updated examination.

PubMed

Matusitz, Jonathan; Spear, Jennifer

2014-01-01

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

The 2 × 2 model of perfectionism: a comparison across Asian Canadians and European Canadians.

PubMed

Franche, Véronique; Gaudreau, Patrick; Miranda, Dave

2012-10-01

The 2 × 2 model of perfectionism posits that the 4 within-person combinations of self-oriented and socially prescribed perfectionism (i.e., pure SOP, mixed perfectionism, pure SPP, and nonperfectionism) can be distinctively associated with psychological adjustment. This study examined whether the relationship between the 4 subtypes of perfectionism proposed in the 2 × 2 model (Gaudreau & Thompson, 2010) and academic outcomes (i.e., academic satisfaction and grade-point average [GPA]) differed across 2 sociocultural groups: Asian Canadians and European Canadians. A sample of 697 undergraduate students (23% Asian Canadians) completed self-report measures of dispositional perfectionism, academic satisfaction, and GPA. Results replicated most of the 2 × 2 model's hypotheses on ratings of GPA, thus supporting that nonperfectionism was associated with lower GPA than pure SOP (Hypothesis 1a) but with higher GPA than pure SPP (Hypothesis 2). Results also showed that mixed perfectionism was related to higher GPA than pure SPP (Hypothesis 3) but to similar levels as pure SOP, thus disproving Hypothesis 4. Furthermore, results provided evidence for cross-cultural differences in academic satisfaction. While all 4 hypotheses were supported among European Canadians, only Hypotheses 1a and 3 were supported among Asian Canadians. Future lines of research are discussed in light of the importance of acknowledging the role of culture when studying the influence of dispositional perfectionism on academic outcomes. (c) 2012 APA, all rights reserved.

Understanding doctors' ethical challenges as role virtue conflicts.

PubMed

McDougall, Rosalind

2013-01-01

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

Canadian Families (Les Familles Canadiennes).

ERIC Educational Resources Information Center

Vanier Inst. of the Family, Ottawa (Ontario).

Structural changes that have taken place in Canadian families in recent decades are described in this booklet. Topical sections are as follows: (1) What Counts in Canadian Families (importance of (importance of family); (2) The Family--Variations on a Theme origins, family structure, seniors aged 60 and over, how lives are spent, religion); (3)…

Rationale, design, and methods for Canadian alliance for healthy hearts and minds cohort study (CAHHM) - a Pan Canadian cohort study.

PubMed

Anand, Sonia S; Tu, Jack V; Awadalla, Philip; Black, Sandra; Boileau, Catherine; Busseuil, David; Desai, Dipika; Després, Jean-Pierre; de Souza, Russell J; Dummer, Trevor; Jacquemont, Sébastien; Knoppers, Bartha; Larose, Eric; Lear, Scott A; Marcotte, Francois; Moody, Alan R; Parker, Louise; Poirier, Paul; Robson, Paula J; Smith, Eric E; Spinelli, John J; Tardif, Jean-Claude; Teo, Koon K; Tusevljak, Natasa; Friedrich, Matthias G

2016-07-27

The Canadian Alliance for Healthy Hearts and Minds (CAHHM) is a pan-Canadian, prospective, multi-ethnic cohort study being conducted in Canada. The overarching objective of the CAHHM is to understand the association of socio-environmental and contextual factors (such as societal structure, activity, nutrition, social and tobacco environments, and access to health services) with cardiovascular risk factors, subclinical vascular disease, and cardiovascular and other chronic disease outcomes. Participants between 35 and 69 years of age are being recruited from existing cohorts and a new First Nations Cohort to undergo a detailed assessment of health behaviours (including diet and physical activity), cognitive function, assessment of their local home and workplace environments, and their health services access and utilization. Physical measures including weight, height, waist/hip circumference, body fat percentage, and blood pressure are collected. In addition, eligible participants undergo magnetic resonance imaging (MRI) of the brain, heart, carotid artery and abdomen to detect early subclinical vascular disease and ectopic fat deposition. CAHHM is a prospective cohort study designed to investigate the impact of community level factors, individual health behaviours, and access to health services, on cognitive function, subclinical vascular disease, fat distribution, and the development of chronic diseases among adults living in Canada.

Western University (No. 10 Canadian Stationary Hospital and No. 14 Canadian General Hospital): a study of medical volunteerism in the First World War.

PubMed

Istl, Alexandra C; McAlister, Vivian C

2016-12-01

The Canadian government depended on chaotic civilian volunteerism to staff a huge medical commitment during the First World War. Offers from Canadian universities to raise, staff and equip hospitals for deployment, initially rejected, were incrementally accepted as casualties mounted. When its offer was accepted in 1916, Western University Hospital quickly adopted military decorum and equipped itself using Canadian Red Cross Commission guidelines. Staff of the No. 10 Canadian Stationary Hospital and the No. 14 Canadian General Hospital retained excellent morale throughout the war despite heavy medical demand, poor conditions, aerial bombardment and external medical politics. The overwhelming majority of volunteers were Canadian-born and educated. The story of the hospital's commanding officer, Edwin Seaborn, is examined to understand the background upon which the urge to volunteer in the First World War was based. Although many Western volunteers came from British stock, they promoted Canadian independence. A classical education and a broad range of interests outside of medicine, including biology, history and native Canadian culture, were features that Seaborn shared with other leaders in Canadian medicine, such as William Osler, who also volunteered quickly in the First World War.

Canadian guidelines for acute bacterial rhinosinusitis

PubMed Central

Kaplan, Alan

2014-01-01

Objective To provide a clinical summary of the Canadian clinical practice guidelines for acute bacterial rhinosinusitis (ABRS) that includes relevant considerations for family physicians. Quality of evidence Guideline authors performed a systematic literature search and drafted recommendations. Recommendations received both strength of evidence and strength of recommendation ratings. Input from external content experts was sought, as was endorsement from Canadian medical societies (Association of Medical Microbiology and Infectious Disease Canada, Canadian Society of Allergy and Clinical Immunology, Canadian Society of Otolaryngology—Head and Neck Surgery, Canadian Association of Emergency Physicians, and the Family Physicians Airways Group of Canada). Main message Diagnosis of ABRS is based on the presence of specific symptoms and their duration; imaging or culture are not needed in uncomplicated cases. Treatment is dependent on symptom severity, with intranasal corticosteroids (INCSs) recommended as monotherapy for mild and moderate cases, although the benefit might be modest. Use of INCSs plus antibiotics is reserved for patients who fail to respond to INCSs after 72 hours, and for initial treatment of patients with severe symptoms. Antibiotic selection must account for the suspected pathogen, the risk of resistance, comorbid conditions, and local antimicrobial resistance trends. Adjunct therapies such as nasal saline irrigation are recommended. Failure to respond to treatment, recurrent episodes, and signs of complications should prompt referral to an otolaryngologist. The guidelines address situations unique to the Canadian health care environment, including actions to take during prolonged wait periods for specialist referral or imaging. Conclusion The Canadian guidelines provide up-to-date recommendations for diagnosis and treatment of ABRS that reflect an evolving understanding of the disease. In addition, the guidelines offer useful tools to help

Women who doctor shop for prescription drugs.

PubMed

Worley, Julie; Thomas, Sandra P

2014-04-01

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

Some Thoughts on Doctoral Preparation in Mathematics Education

ERIC Educational Resources Information Center

Reys, Robert

2016-01-01

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

Satisfaction among Current Doctoral Students in Special Education

ERIC Educational Resources Information Center

Wasburn-Moses, Leah

2008-01-01

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

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

ERIC Educational Resources Information Center

Gopaul, Bryan

2011-01-01

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

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

ERIC Educational Resources Information Center

Karnow, Gerald F.

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

SAS doctors career progression survey 2013.

PubMed

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

2016-03-01

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

Supervising Doctoral Students: Variation in Purpose and Pedagogy

ERIC Educational Resources Information Center

Åkerlind, Gerlese; McAlpine, Lynn

2017-01-01

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

Canadian Cardiovascular Society/Canadian Society of Cardiac Surgeons/Canadian Society for Vascular Surgery Joint Position Statement on Open and Endovascular Surgery for Thoracic Aortic Disease.

PubMed

Appoo, Jehangir J; Bozinovski, John; Chu, Michael W A; El-Hamamsy, Ismail; Forbes, Thomas L; Moon, Michael; Ouzounian, Maral; Peterson, Mark D; Tittley, Jacques; Boodhwani, Munir

2016-06-01

In 2014, the Canadian Cardiovascular Society (CCS) published a position statement on the management of thoracic aortic disease addressing size thresholds for surgery, imaging modalities, medical therapy, and genetics. It did not address issues related to surgical intervention. This joint Position Statement on behalf of the CCS, Canadian Society of Cardiac Surgeons, and the Canadian Society for Vascular Surgery provides recommendations about thoracic aortic disease interventions, including: aortic valve repair, perfusion strategies for arch repair, extended arch hybrid reconstruction for acute type A dissection, endovascular management of arch and descending aortic aneurysms, and type B dissection. The position statement is constructed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, and has been approved by the primary panel, an international secondary panel, and the CCS Guidelines Committee. Advent of endovascular technology has improved aortic surgery safety and extended the indications of minimally invasive thoracic aortic surgery. The combination of safer open surgery with endovascular treatment has improved patient outcomes in this rapidly evolving subspecialty field of cardiovascular surgery. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Proportion of preschool-aged children meeting the Canadian 24-Hour Movement Guidelines and associations with adiposity: results from the Canadian Health Measures Survey.

PubMed

Chaput, Jean-Philippe; Colley, Rachel C; Aubert, Salomé; Carson, Valerie; Janssen, Ian; Roberts, Karen C; Tremblay, Mark S

2017-11-20

New Canadian 24-Hour Movement Guidelines for the Early Years have been released in 2017. According to the guidelines, within a 24-h period, preschoolers should accumulate at least 180 min of physical activity (of which at least 60 min is moderate-to-vigorous physical activity), engage in no more than 1 h of screen time, and obtain between 10 and 13 h of sleep. This study examined the proportions of preschool-aged (3 to 4 years) Canadian children who met these new guidelines and different recommendations within the guidelines, and the associations with adiposity indicators. Participants were 803 children (mean age: 3.5 years) from cycles 2-4 of the Canadian Health Measures Survey (CHMS), a nationally representative cross-sectional sample of Canadians. Physical activity was accelerometer-derived, and screen time and sleep duration were parent-reported. Participants were classified as meeting the overall 24-Hour Movement Guidelines if they met all three specific time recommendations for physical activity, screen time, and sleep. The adiposity indicators in this study were body mass index (BMI) z-scores and BMI status (World Health Organization Growth Standards). A total of 12.7% of preschool-aged children met the overall 24-Hour Movement Guidelines, and 3.3% met none of the three recommendations. A high proportion of children met the sleep duration (83.9%) and physical activity (61.8%) recommendations, while 24.4% met the screen time recommendation. No associations were found between meeting individual or combined recommendations and adiposity. Very few preschool-aged children in Canada (~13%) met all three recommendations contained within the 24-Hour Movement Guidelines. None of the combinations of recommendations were associated with adiposity in this sample. Future work should focus on identifying innovative ways to reduce screen time in this population, and should examine the associations of guideline adherence with health indicators other than adiposity.

Doctors as Stewards of medicare, or not: CAMSI, MRG, CDM, DRHC and the thin alphabet soup of physician support.

PubMed

Duffin, Jacalyn

2018-07-01

Physicians are deeply involved in Canadian medicare because it is through medicare that they are paid. However, from its origins to the present physicians -as a profession - have not been strong supporters of medicare. Fearing loss of income and individual autonomy, they have frequently opposed it with criticisms, strikes, threatened job action and lawsuits. Some opponents are unaware that medicare was a boon to physician income, and many fail to connect medicare with responsibility for improving the health status of the country. This paper will trace physician involvement, support and opposition to medicare from its inception to the present, with special attention to small physician organizations that have supported medicare. It will close with a proposal for how doctors could display greater stewardship.

[Practical use of doctor's assistant].

PubMed

Honda, Jiro

2012-07-01

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

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

ERIC Educational Resources Information Center

Westerband, Yamissette Milagros

2016-01-01

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

Breast cancer survival in Canada and the USA: meta-analytic evidence of a Canadian advantage in low-income areas.

PubMed

Gorey, Kevin M

2009-12-01

This study tested the hypothesis that relatively poor Canadian women with breast cancer have a survival advantage over their counterparts in the USA. Seventy-eight independent retrospective cohort (incidence between 1984 and 2000, followed until 2006) outcomes were synthesized. Fixed effects meta-regression models compared women with breast cancer in low-income areas of Canada and the USA. Low-income Canadian women were advantaged on survival [rate ratio (RR) = 1.14; 95% confidence interval (CI) 1.13-1.15] and their advantage was even larger among women <65 years of age who are not yet eligible for Medicare coverage in the USA (RR = 1.21, 95% CI 1.18-1.24). Canadian advantages were also larger for node positive breast cancer, which may present with greater clinical and managerial discretion (RR = 1.40, 95% CI 1.30-1.50), and smaller when Hawaii, the state providing the most Canadian-like access, was the US comparator (RR = 1.12, 95% CI 1.01-1.20). More inclusive health care insurance coverage in Canada vs the USA, particularly among each country's relatively poor people, seems the most plausible explanation for such Canadian advantages. Provision of health care for all Americans would likely prevent countless early deaths, particularly among the relatively poor.

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

ERIC Educational Resources Information Center

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

2007-01-01

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

Are the General Medical Council's Tests of Competence fair to long standing doctors? A retrospective cohort study.

PubMed

Mehdizadeh, Leila; Sturrock, Alison; Dacre, Jane

2015-04-21

well on the test of competence than their more recently qualified peers under investigation. The performance of the comparator group tended to stay consistent irrespective of year qualified. Our results suggest that the test format does not disadvantage early qualified doctors. We discuss findings in relation to the GMC's fitness to practise procedures and suggest alternative explanations for the poorer performance of long standing doctors under investigation.

Transnational Education -- An Opportunity and a Canadian Role

ERIC Educational Resources Information Center

Dennis, Roger

2013-01-01

Transnational education is a huge growth industry and a potential source of considerable income for Canadian educational institutions. Canadian educational establishments seem to be missing out on this, and this seems short sighted. Canada has a very good reputation globally; this could be utilized when selling Canadian educational institutions in…

Cultural and musical activity among Norwegian doctors.

PubMed

Nylenna, Magne; Aasland, Olaf Gjerløw

2013-06-25

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

Doctorate Program Trains Industrial Chemists.

ERIC Educational Resources Information Center

Chemical and Engineering News, 1982

1982-01-01

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

Will Medical Technology Deskill Doctors?

ERIC Educational Resources Information Center

Lu, Jingyan

2016-01-01

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

47 CFR 90.121 - Canadian registration.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Canadian registration. 90.121 Section 90.121 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PRIVATE LAND MOBILE RADIO SERVICES Applications and Authorizations § 90.121 Canadian registration. Form 410 shall be...

Tips for Talking to Your Doctor

MedlinePlus

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

Choosing a doctor and hospital for your cancer treatment

MedlinePlus

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

Investing in learning and training refugee doctors.

PubMed

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

2010-06-01

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

Developing a psychiatrist–patient relationship when both people are doctors: a qualitative study

PubMed Central

Stanton, Josephine; Randal, Patte

2016-01-01

Objective To better understand the complexities of developing an effective psychiatrist–patient relationship when both people involved are doctors. Method In-depth, semistructured interviews were conducted with 11 doctors with experiences as patients of psychiatrists (DPs) and eight psychiatrists with experience of treating doctors (TPs). A thematic analysis was undertaken. Results The medical culture of unrealistically high standards with limited room for vulnerability and fallibility, vigilance for judgment and valuing clinical over personal knowledge affected both people in the relationship. DPs struggled with the contradictions involved in entering the patient role but tried hard to be good patients. They wanted guidance but found it hard to accept and seldom communicated dissatisfaction or disagreement to their TPs. They described widely varying responses to diagnosis and treatment within the biomedical model. TPs described enjoyment and satisfaction and extreme challenge in engaging with TPs. Despite focusing on providing ordinary care they described providing extra care in many ways. Conclusions This study brings forward important issues when a psychiatrist is building a therapeutic relationship with another doctor. These are also likely to arise with other people and contribute to making truly patient-centred ‘ordinary care’ a hard ideal to fulfil. They include: (1) doctors' sense of ourselves as invincible, (2) TPs' sense of personal connection to, and identity with, DPs, (3) having extensive medical knowledge and (4) striving to be good patients. We need to make these issues explicit and enable the DP (or other patients) to tell their story and speak about their experience of the consultation so that any potential rupture in the therapeutic relationship can be addressed early. PMID:27207623

A Canadian paradox: Tommy Douglas and eugenics.

PubMed

Shevell, Michael

2012-01-01

Tommy Douglas is an icon of Canadian 20th Century political history and is considered by many as the "Father" of Medicare, a key component of our national identity. Throughout his career, he was associated at both the provincial and federal levels with progressive causes concerning disadvantaged populations. In his sociology Master's thesis written in the early 1930's, Douglas endorsed eugenic oriented solutions such as segregation and sterilization to address what was perceived to be an endemic and biologically determined problem. At first glance, this endorsement of eugenics appears to be paradoxical, but careful analysis revealed that this paradox has multiple roots in religion, political belief, historical exposure and our own desire to view our collective history in a favourable light.

The Content Feedback Practices of Applied Linguistics Doctoral Supervisors in New Zealand and Australian Universities

ERIC Educational Resources Information Center

Bitchener, John

2016-01-01

The focus of this article is on the written feedback that supervisors say they often give their second language (L2) doctoral students. Little is known about the focus of this feedback and about what supervisors consider as priorities in the early draft writing of dissertation chapters. Given the potentially different priorities and foci of…

Headache - what to ask your doctor

MedlinePlus

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

Cholesterol - what to ask your doctor

MedlinePlus

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

Women, Men and the Doctorate.

ERIC Educational Resources Information Center

Centra, John A; Kuykendall, Nancy M.

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

Reframing Doctoral Examination as Teaching

ERIC Educational Resources Information Center

Kumar, Vijay; Stracke, Elke

2018-01-01

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

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

PubMed

Siu, Judy Yuen-Man

2014-02-06

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

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

ERIC Educational Resources Information Center

Perez, Joel

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

Early Recollections of First-Borns.

ERIC Educational Resources Information Center

Fakouri, M. Ebrahim; Hafner, James L.

1984-01-01

Compared the early recollections of 50 first-borns and 98 later-borns. The first-borns mentioned significantly more nonfamily members, illness/injury, hospital/doctor's office. Later-borns mentioned significantly more siblings than did first-borns. Findings were discussed in the context of Adler's personality theory. (JAC)

Participant selection for lung cancer screening by risk modelling (the Pan-Canadian Early Detection of Lung Cancer [PanCan] study): a single-arm, prospective study.

PubMed

Tammemagi, Martin C; Schmidt, Heidi; Martel, Simon; McWilliams, Annette; Goffin, John R; Johnston, Michael R; Nicholas, Garth; Tremblay, Alain; Bhatia, Rick; Liu, Geoffrey; Soghrati, Kam; Yasufuku, Kazuhiro; Hwang, David M; Laberge, Francis; Gingras, Michel; Pasian, Sergio; Couture, Christian; Mayo, John R; Nasute Fauerbach, Paola V; Atkar-Khattra, Sukhinder; Peacock, Stuart J; Cressman, Sonya; Ionescu, Diana; English, John C; Finley, Richard J; Yee, John; Puksa, Serge; Stewart, Lori; Tsai, Scott; Haider, Ehsan; Boylan, Colm; Cutz, Jean-Claude; Manos, Daria; Xu, Zhaolin; Goss, Glenwood D; Seely, Jean M; Amjadi, Kayvan; Sekhon, Harmanjatinder S; Burrowes, Paul; MacEachern, Paul; Urbanski, Stefan; Sin, Don D; Tan, Wan C; Leighl, Natasha B; Shepherd, Frances A; Evans, William K; Tsao, Ming-Sound; Lam, Stephen

2017-11-01

Results from retrospective studies indicate that selecting individuals for low-dose CT lung cancer screening on the basis of a highly predictive risk model is superior to using criteria similar to those used in the National Lung Screening Trial (NLST; age, pack-year, and smoking quit-time). We designed the Pan-Canadian Early Detection of Lung Cancer (PanCan) study to assess the efficacy of a risk prediction model to select candidates for lung cancer screening, with the aim of determining whether this approach could better detect patients with early, potentially curable, lung cancer. We did this single-arm, prospective study in eight centres across Canada. We recruited participants aged 50-75 years, who had smoked at some point in their life (ever-smokers), and who did not have a self-reported history of lung cancer. Participants had at least a 2% 6-year risk of lung cancer as estimated by the PanCan model, a precursor to the validated PLCOm2012 model. Risk variables in the model were age, smoking duration, pack-years, family history of lung cancer, education level, body-mass index, chest x-ray in the past 3 years, and history of chronic obstructive pulmonary disease. Individuals were screened with low-dose CT at baseline (T0), and at 1 (T1) and 4 (T4) years post-baseline. The primary outcome of the study was incidence of lung cancer. This study is registered with ClinicalTrials.gov, number NCT00751660. 7059 queries came into the study coordinating centre and were screened for PanCan risk. 15 were duplicates, so 7044 participants were considered for enrolment. Between Sept 24, 2008, and Dec 17, 2010, we recruited and enrolled 2537 eligible ever-smokers. After a median follow-up of 5·5 years (IQR 3·2-6·1), 172 lung cancers were diagnosed in 164 individuals (cumulative incidence 0·065 [95% CI 0·055-0·075], incidence rate 138·1 per 10 000 person-years [117·8-160·9]). There were ten interval lung cancers (6% of lung cancers and 6% of individuals with cancer

Ileostomy - what to ask your doctor

MedlinePlus

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

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

PubMed

Pagaiya, Nonglak; Kongkam, Lalitaya; Sriratana, Sanya

2015-03-01

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

Reshaping Doctoral Education: International Approaches and Pedagogies

ERIC Educational Resources Information Center

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

2011-01-01

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

Doctor and pharmacy shopping for controlled substances.

PubMed

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

2012-06-01

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

[Problems of Doctor Judym's peers].

PubMed

Kamiński, J

2000-01-01

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

Canadian and Siberian Boreal Fire Activity during ARCTAS Spring and Summer Phases

NASA Astrophysics Data System (ADS)

Stocks, B. J.; Fromm, M. D.; Soja, A. J.; Servranckx, R.; Lindsey, D.; Hyer, E.

2009-12-01

The summer phase of ARCTAS (Arctic Research of the Composition of the Troposphere from Aircraft and Satellites) was designed specifically around forest fire activity in the Canadian boreal forest, and located in areas of northern Canada where summer forest fires are ubiquitous. Lightning fires are most often allowed to burn naturally in these regions, and a number of large free-burning fires in northern Saskatchewan in late June/early July 2008 provided excellent targets during the summer phase of ARCTAS. Smoke generated by a large number of early spring fires in Kazakhstan and southern Siberia unexpectedly made a significant contribution to arctic haze during the Alaska-based spring phase of ARCTAS, Numerous smoke plumes were sampled during the spring phase of ARCTAS, creating interest in the origin and characteristics of the fires in the source regions of East Asia. This presentation is designed to connect aircraft and satellite smoke chemistry/transport measurements with ground-based measurements of fire activity during the spring and summer phases of ARCTAS. The Canadian Forest Fire Danger Rating System (CFFDRS) is used to determine forest fire danger conditions in regions of fire activity, and these measurements are in turn used to project fire behavior characteristics. Fuel consumption, spread rates, and frontal fire intensity are calculated using the CFFDRS. Energy release rates at ground level are related to convection/smoke column development and smoke injection heights.

Objectively Assessed Exercise Behavior in Chinese Patients with Early-Stage Cancer: A Predictor of Perceived Benefits, Communication with Doctors, Medical Coping Modes, Depression and Quality of Life.

PubMed

Liu, Zhunzhun; Zhang, Lanfeng; Shi, Songsong; Xia, Wenkai

2017-01-01

This study sought to identify factors associated with objectively assessed exercise behavior in Chinese patients with early-stage cancer. Three hundred and fifty one cancer patients were recruited from the Affiliated Jiangyin Hospital of Southeast University Medical College and the Nantong Tumor Hospital. One-way ANOVA, Pearson Chi-square tests and regression analysis were employed to identify the correlations between physical exercise and the measured factors. The results showed that occupation type (χ2 = 14.065; p = 0.029), monthly individual monthly income level (χ2 = 24.795; p = 0.003), BMI (χ2 = 15.709; p = 0.015) and diagnosis (χ2 = 42.442; p < 0.000) were significantly correlated with the subjects self-reported exercise with different frequency per week. Differences in the frequency of exercise were associated with different degrees of reported Benefit Finding (BF) (F = 24.651; p < 0.000), communication with doctors (F = 15.285; p < 0.000), medical coping modes (F = 45.912; p < 0.000), social support (F = 2.938; p = 0.030), depression (F = 6.017; p < 0.000), and quality of life (F = 12.288; p < 0.000). Multiple regression analysis showed that 1.6%-6.4% of the variance in five variables, excluding social support and optimism could be explained by exercise. Our results indicated that benefit finding, medical coping modes, communication with doctors, social support, depression and quality of life were significantly correlated with exercise. The variance in several psychosocial factors (benefit finding, medical coping modes, the communication with doctors, depression and quality of life) could be explained by exercise. Psychosocial factors should be addressed and examined over time when evaluating the effect of physical exercise that is prescribed as a clinically relevant treatment.

Doctors and baldness: a five thousand year old challenge.

PubMed

Campo, Daniele; D'Acunzo, Valeria

2016-02-01

The history of trichology follows a thread that continually intersects with that of the history of medicine in general. Even Hippocrates believed that the approach to baldness should be of a medical nature. This confrontation between doctors and hair loss, which has lasted for five thousand years, begins with the invocations of the head physicians in the Egyptian era and ends with the recent institution of postgraduate Master's degrees at Faculties of Medicine and Surgery. The biggest names in medicine concerned themselves with trichology beginning with Hippocrates, who dealt with the topic in his most famous work: the Aphorisms. Even the most celebrated doctors of the Roman era, such as Galen and Pliny the Elder, did not disdain considering hair loss, leaving important scientific contributions before passing on the baton to their distinguished colleagues of the Byzantine Empire. The narrative then flows through the most prestigious institutions of the Middle Ages, such as the Salerno School of Medicine and the Siena Accademia del Fisiocritici where, at the end of the 1600s, the distinguished anatomical describer Marcello Malpighi also taught trichology, and left his contribution to "Hair Science" with a fine description of the hair follicle in the pages of his Opera Posthuma. At the turn of the late Middle Ages and the early modern era, barbers formed the primordial nucleus of surgery and at the same time became the ones to concern themselves with hair loss. In the 1800s, several doctors published the first texts dealing with the anatomy and physiology of the hair and taking into account the principal forms of alopecia, but at the therapeutic level did not yet propose anything scientifically valid. Until a few decades ago trichology still lent itself to various commercial speculations. It was not until the twentieth century that the pathogenetic mechanisms of baldness were clarified in a scientific manner. With this knowledge, the pharmaceutical industry has been

Patient dissatisfaction and institutional betrayal in the Canadian medical system: A qualitative study.

PubMed

Tamaian, Andreea; Klest, Bridget; Mutschler, Christina

2017-01-01

Individuals who struggle with chronic medical conditions frequently use medical services and may depend on the medical system to ensure their overall well-being. As a result, they may be at a greater risk of feeling betrayed by the medical system when their needs are not being met. The current study aimed to qualitatively assess patients' negative experiences with the medical system that may lead to feelings of institutional betrayal. A total of 14 Canadian adults struggling with various chronic conditions completed an online open-ended questionnaire. Results indicated that institutional betrayal is composed of doctor-level betrayal (inadequate medical care and lack of psychological support) as well as system-level betrayal. The findings are discussed in the context of betrayal trauma theory; specifically, patients' appraisals of their negative health care experiences may play a vital role when one is considering the impact of institutional betrayal on an individual's overall well-being.

Introduction to the Canadian Cardiovascular Outcomes Research Team's (CCORT) Canadian Cardiovascular Atlas project.

PubMed

Tu, Jack V; Brien, Susan E; Kennedy, Courtney C; Pilote, Louise; Ghali, William A

2003-03-15

The Canadian Cardiovascular Outcomes Research Team's (CCORT) Canadian Cardiovascular Atlas project was developed to provide Canadians with a national report on the state of cardiovascular health and health services in Canada. Written by a group of Canada's leading experts in cardiovascular outcomes research, the CCORT cardiac Atlas will cover a wide variety of topics ranging from cardiac risk factors and cardiac mortality rates to the treatment of patients with acute myocardial infarction and congestive heart failure and the outcomes of invasive cardiac procedures across Canada. Data in the Atlas will be presented at a national, provincial and health region level. The Atlas will be published as a series of 20 articles and chapters in future issues of The Canadian Journal of Cardiology and on CCORT's web site (www.ccort.ca). The journal version of the Atlas chapters will be written for a clinical audience and will include editorials written by invited experts, whereas the web-based version of each chapter will be written for a more general audience and will include additional supplemental information (for example, interactive colour maps and tables) that cannot be included in the journal version. Material from the Journal and the web will eventually be compiled into a book that will be distributed across Canada. This article serves as an introduction to the Atlas project and describes the rationale for and objectives of the CCORT national cardiac Atlas project.

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

PubMed

Childress, Marcia Day

2017-03-01

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

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

PubMed

Jagsi, Reshma; Surender, Rebecca

2004-06-01

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

NASA and Canadian Snowbirds Aircrafts

NASA Image and Video Library

2018-05-09

Several types of aircraft are on the tarmac at the Shuttle Landing Facility (SLF) at NASA's Kennedy Space in Florida. From left, are two Canadian Forces Snowbird CF-18 jets, a NASA Huey helicopter, and two NASA T-38 trainer aircraft. The Canadian Forces Snowbirds performed aerial maneuvers over Kennedy and Cape Canaveral Air Force Station during a practice flight on May 9, 2018, between their scheduled air shows.

Computer and Internet usage by Canadian dentists.

PubMed

Flores-Mir, Carlos; Palmer, Neal G; Northcott, Herbert C; Huston, Carolyn; Major, Paul W

2006-03-01

To determine the frequency of computers in Canadian dental offices and to assess their use; to evaluate Internet access and use in Canadian dental offices; and to compare use of computers and the Internet by Canadian dentists, by the general public and by other dental groups. An anonymous, self-administered survey of Canadian dentists was conducted by mail. A potential mailing list of 14,052 active Canadian dentists was compiled from the 2003 records of provincial regulatory bodies. For each province, 7.8% of the general dentists were randomly selected with the help of computer software. The surveys were mailed to this stratified random sample of 1,096 dentists. The response rate was 28%. Of the 312 respondents, 4 (1%) were in full-time academic positions, 15 (5%) were not practising, and 9 (3%) provided incomplete data. Therefore, 284 survey responses were available for descriptive analysis. Two hundred and fifty-seven (90%) of the respondents had a computer in their primary practice. Computers were used mainly for administrative tasks (accounting, bookkeeping and scheduling) rather than clinical tasks. Internet access was common (185/250 or 74%), and high-speed Internet access (93/250 or 37%) was increasingly common, judging from the results of previous studies on computer use. The main reasons given for not having in-office Internet access were security or privacy concerns and no reported need for or interest in the service. Computer use was high in this sample of Canadian dentists, but a small proportion of dental offices remained without computers. Canadian dentists" use of the Internet was greater than that of American dentists, private enterprise and the North American public in general.

Progression-free survival in advanced ovarian cancer: a Canadian review and expert panel perspective

PubMed Central

Oza, A.M.; Castonguay, V.; Tsoref, D.; Diaz–Padilla, I.; Karakasis, K.; Mackay, H.; Welch, S.; Weberpals, J.; Hoskins, P.; Plante, M.; Provencher, D.; Tonkin, K.; Covens, A.; Ghatage, P.; Gregoire, J.; Hirte, H.; Miller, D.; Rosen, B.; Maroun, J.; Buyse, M.; Coens, C.; Brady, M.F.; Stuart, G.C.E.

2011-01-01

Ovarian cancer is leading cause of gynecologic cancer mortality in Canada. To date, overall survival (os) has been the most-used endpoint in oncology trials because of its relevance and objectivity. However, as a result of various factors, including the pattern of sequential salvage therapies, measurement of os and collection of os data are becoming particularly challenging. Phase ii and iii trials have therefore adopted progression-free survival (pfs) as a more convenient surrogate endpoint; however, the clinical significance of pfs remains unclear. This position paper presents discussion topics and findings from a pan-Canadian meeting of experts that set out to evaluate the relevance of pfs as a valid endpoint in ovarian cancer;reach a Canadian consensus on the relevance of pfs in ovarian cancer; andtry to address how pfs translates into clinical benefit in ovarian cancer. Overall, the findings and the group consensus posit that future studies should ensure that trials are designed to evaluate pfs, os, and other clinically relevant endpoints such as disease-related symptoms or quality of life;incorporate interim futility analyses intended to stop accrual early when the experimental regimen is not active;stop trials early to declare superiority only when compelling evidence suggests that a new treatment provides benefit for a pre-specified, clinically relevant endpoint such as os or symptom relief; anddiscourage early release of secondary endpoint results when such a release might increase the frequency of crossover to the experimental intervention. PMID:21969808

Special article: Horace Nelson MD, John Webster LDS--unrecognized Canadian anesthesia pioneers.

PubMed

Craig, Douglas; Chartrand, Daniel

2014-03-01

The timing of the earliest reported ether anesthetics in early 1847, in regions to become Canada in July 1867, was examined using information from on-line and library-based sources. Previous authors had identified the first reported ether anesthetic given by a visiting American dentist in January 1847 in Saint John, New Brunswick. Nevertheless, they had reported three different anesthetics as the second occurrence - which would denote the first anesthetic given by a resident of Canada. We confirmed that there were no reports of ether anesthetics being given in Canada before that reported on January 18, 1847 in Saint John. The information available for our review indicates that the second ether anesthetic, and the first by a Canadian, was given in Montreal by a dentist, Dr. John Horatio Webster, on February 20, 1847. The surgical assistant for that operation, Dr. Horace Nelson, later reported on animal and human experiments with ether, which he had led in Montreal starting in January 1847. Earlier authors, who may not have had access to the information now available, came to incorrect conclusions about the first ether anesthetic reported to have been given by a Canadian. Current information indicates that John Webster gave the first reported anesthetic in Montreal on February 20, 1847 following experiments with ether led by Horace Nelson. Both Webster and Nelson deserve recognition as Canadian anesthesia pioneers.

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

ERIC Educational Resources Information Center

Ramírez, Magdalena Jiménez

2016-01-01

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

Recent Books on Canadian Business History.

ERIC Educational Resources Information Center

Armstrong, Christopher

1979-01-01

Reviews Canadian business history books published since 1972 as well as reprints of useful older works. Topics dealt with are the fish, timber, and wheat industry, transportation, entrepreneurs and entrepreneurship, Canadian economy during World War I, the development of natural resources, and the lives of the rich and the powerful. (KC)

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

PubMed

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

2005-08-01

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

Ear tube surgery - what to ask your doctor

MedlinePlus

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

Comparative satisfaction of receiving medical abortion service from nurses and auxiliary nurse-midwives or doctors in Nepal: results of a randomized trial.

PubMed

Tamang, Anand; Shah, Iqbal H; Shrestha, Pragya; Warriner, I K; Wang, Duolao; Thapa, Kusum; My Huong, N T; Meirik, Olav

2017-12-16

Early first-trimester medical abortion (MA) service (≤ 63 days) has been provided by doctors and nurses under doctors' supervision since 2009 in Nepal. This paper assesses whether MA services provided by specifically trained and certified nurses and auxiliary nurse-midwives independently from doctors' supervision, is considered as satisfactory by women as those provided by doctors. The data come from a multi-center, randomized, controlled equivalence trial conducted between April 2009 and March 2010 in five district hospitals in Nepal. Women seeking MA were randomly assigned to doctors or nurses and auxiliary nurse-midwives(ANMs).Eligible women were administered 200 mg mifepristone orally followed by 800 μg misoprostol vaginally two days later by their assigned providers and followed up 10-14 days later. At the follow-up visit women's reported satisfaction with MA service they received was measured. Of 1295 women screened for eligibility, 535 were randomly assigned to a doctor and 542 to a nurse or ANM. Nineteen women were lost-to-follow up in the former group and 27 were lost-to-follow up or did not complete the acceptability interview in the latter group. This study is, therefore, based on516womenin the doctor's group and 515 women in the nurse or ANM group. All women in the nurse or ANM group reported being satisfied or highly satisfied by MA compared to 99% in the doctor's group. Satisfaction was similar regardless of the type of provider; 38% among nurse or ANM and 35% among the doctor group were "highly satisfied", and 62% and 64%, respectively, were "satisfied". Women's experiences such as 'less than expected amount or duration of bleeding following MA', 'shorter than expected duration of the abortion process', and 'able to manage symptoms', were found to be associated with women's higher satisfaction with MA. Counseling and information on the method, potential complications of MA and post-abortion contraception was nearly universal. No statistically

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

PubMed Central

2014-01-01

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

Early Validation Evidence of a Canadian Practitioner-Based Assessment of Physical Literacy in Physical Education: Passport for Life

ERIC Educational Resources Information Center

Lodewyk, Ken R.; Mandigo, James L.

2017-01-01

Physical and Health Education Canada has developed and implemented a formative, criterion-referenced, and practitioner-based national (Canadian) online educational assessment and support resource called Passport for Life (PFL). It was developed to support the awareness and advancement of physical literacy among PE students and teachers. PFL…

Professionalization as an Advocacy Strategy: A Content Analysis of Canadian Child Care Social Movement Organizations' 2008 Discursive Resources

ERIC Educational Resources Information Center

Langford, Rachel; Prentice, Susan; Albanese, Patrizia; Summers, Bernadette; Messina-Goertzen, Brianne; Richardson, Brooke

2013-01-01

Do early childhood education and care (ECEC) professionals make good advocates? Canadian advocates have fought for better child care policies since the mid-1940s. What has happened to this advocacy with the recent increased professionalization of the ECEC sector? How does increased professionalization limit, innovate or expand advocacy strategies?…

Multicentre prospective validation of use of the Canadian C-Spine Rule by triage nurses in the emergency department

PubMed Central

Stiell, Ian G.; Clement, Catherine M.; O’Connor, Annette; Davies, Barbara; Leclair, Christine; Sheehan, Pamela; Clavet, Tamara; Beland, Christine; MacKenzie, Taryn; Wells, George A.

2010-01-01

Objectives The Canadian C-Spine Rule for imaging of the cervical spine was developed for use by physicians. We believe that nurses in the emergency department could use this rule to clinically clear the cervical spine. We prospectively evaluated the accuracy, reliability and acceptability of the Canadian C-Spine Rule when used by nurses. Methods We conducted this three-year prospective cohort study in six Canadian emergency departments. The study involved adult trauma patients who were alert and whose condition was stable. We provided two hours of training to 191 triage nurses. The nurses then assessed patients using the Canadian C-Spine Rule, including determination of neck tenderness and range of motion, reapplied immobilization and completed a data form. Results Of the 3633 study patients, 42 (1.2%) had clinically important injuries of the cervical spine. The kappa value for interobserver assessments of 498 patients with the Canadian C-Spine Rule was 0.78. We calculated sensitivity of 100.0% (95% confidence interval [CI] 91.0%–100.0%) and specificity of 43.4% (95% CI 42.0%–45.0%) for the Canadian C-Spine Rule as interpreted by the investigators. The nurses classified patients with a sensitivity of 90.2% (95% CI 76.0%–95.0%) and a specificity of 43.9% (95% CI 42.0%–46.0%). Early in the study, nurses failed to identify four cases of injury, despite the presence of clear high-risk factors. None of these patients suffered sequelae, and after retraining there were no further missed cases. We estimated that for 40.7% of patients, the cervical spine could be cleared clinically by nurses. Nurses reported discomfort in applying the Canadian C-Spine Rule in only 4.8% of cases. Conclusion Use of the Canadian C-Spine Rule by nurses was accurate, reliable and clinically acceptable. Widespread implementation by nurses throughout Canada and elsewhere would diminish patient discomfort and improve patient flow in overcrowded emergency departments. PMID:20457772

Clandestine existences and secret research: eliminating official discrimination in the Canadian military and going public in academia.

PubMed

Poulin, Carmen; Gouliquer, Lynne

2012-01-01

The 1990s was a notable decade for lesbians and gays in the Canadian military. Two important changes were the 1992 elimination of the official policy permitting discrimination against homosexual service members, and the 1996 introduction of benefits to same-sex partners. These changes radically influenced the psychological day-to-day reality of lesbian and gay military members. Yet, given the military culture, lesbian and gay members only began to come out in significant numbers at the turn of the century. This article presents an overview of our experience with researching the history of lesbians and gays in the Canadian military during the late 1990s and early years of the new century. It reveals the early clandestine nature of our research, and recounts some of the trials, tribulations, resistance, and successes we encountered when dealing with ethics boards and funding sources. It also describes our relationship with the media and how the military actively took steps to stall our efforts. We draw parallels between our experiences as researchers, and those of the lesbian service-members we were interviewing.

[Tomorrow's family doctor].

PubMed

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

2012-05-16

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

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

PubMed

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

2015-03-25

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

Social Workers' Role in the Canadian Mental Health Care System

ERIC Educational Resources Information Center

Towns, Ashley M.; Schwartz, Karen

2012-01-01

Objective: Using Canadian survey data this research provides social workers in Canada with a better understanding of their role in the Canadian mental health care system. Methods: By analyzing data from the Canadian Community Health Survey, Cycle 1.2 Mental Health and Well-being, the role of social workers in the Canadian mental health system was…

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

ERIC Educational Resources Information Center

Sterie, Anca Cristina

2015-01-01

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

Developing a psychiatrist-patient relationship when both people are doctors: a qualitative study.

PubMed

Stanton, Josephine; Randal, Patte

2016-05-20

To better understand the complexities of developing an effective psychiatrist-patient relationship when both people involved are doctors. In-depth, semistructured interviews were conducted with 11 doctors with experiences as patients of psychiatrists (DPs) and eight psychiatrists with experience of treating doctors (TPs). A thematic analysis was undertaken. The medical culture of unrealistically high standards with limited room for vulnerability and fallibility, vigilance for judgment and valuing clinical over personal knowledge affected both people in the relationship. DPs struggled with the contradictions involved in entering the patient role but tried hard to be good patients. They wanted guidance but found it hard to accept and seldom communicated dissatisfaction or disagreement to their TPs. They described widely varying responses to diagnosis and treatment within the biomedical model. TPs described enjoyment and satisfaction and extreme challenge in engaging with TPs. Despite focusing on providing ordinary care they described providing extra care in many ways. This study brings forward important issues when a psychiatrist is building a therapeutic relationship with another doctor. These are also likely to arise with other people and contribute to making truly patient-centred 'ordinary care' a hard ideal to fulfil. They include: (1) doctors' sense of ourselves as invincible, (2) TPs' sense of personal connection to, and identity with, DPs, (3) having extensive medical knowledge and (4) striving to be good patients. We need to make these issues explicit and enable the DP (or other patients) to tell their story and speak about their experience of the consultation so that any potential rupture in the therapeutic relationship can be addressed early. 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/

The Canadian elder standard - pricing the cost of basic needs for the Canadian elderly.

PubMed

MacDonald, Bonnie-Jeanne; Andrews, Doug; Brown, Robert L

2010-03-01

We determined the after-tax income required to finance basic needs for Canadian elders living with different circumstances in terms of age, gender, city of residence, household size, homeowner or renter status, means of transportation, and health status. Using 2001 as our base year, we priced the typical expenses for food, shelter, medical, transportation, miscellaneous basic living items and home-based long-term care for elders living in five Canadian cities. This is the first Canadian study of basic living expenses tailored to elders instead of adults in general, prepared on an absolute rather than a relative basis. We also accounted for an individual's unique life circumstances and established the varying effect that they have on the cost of basic expenses, particularly for home care. We found that the maximum Guaranteed Income Supplement and Old Age Security benefit did not meet the cost of basic needs for an elder living in poor circumstances.

Talking to Your Doctor (For Teens)

MedlinePlus

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

[Practice and experience in early clinical education of dental students in preventive dentistry].

PubMed

Tao, Dan-ying; Shu, Chen-bin; Pan, Ying; Feng, Xi-ping

2013-02-01

To help dental students acquaint the medical environment, doctor-patient communication and relationship, early clinic education was arranged in our college of stomatology. The interesting topics were chosen to enhance the learning enthusiasm of the students in the teaching practice of preventive dentistry. Students were encouraged to practice the skill of doctor-patient communication. To obtain the satisfactory teaching effect and aim, it was important to pay attention to the aspects in the groups and clinical practice. Early clinic education in preventive dentistry help the students understand the specialty of preventive dentistry.

Canadian asthma consensus report, 1999

PubMed Central

Boulet, L P; Becker, A; Bérubé, D; Beveridge, R; Ernst, P

1999-01-01

OBJECTIVES: To provide physicians with current guidelines for the diagnosis and optimal management of asthma in children and adults, including pregnant women and the elderly, in office, emergency department, hospital and clinic settings. OPTIONS: The consensus group considered the roles of education, avoidance of provocative environmental and other factors, diverse pharmacotherapies, delivery devices and emergency and in-hospital management of asthma. OUTCOMES: Provision of the best control of asthma by confirmation of the diagnosis using objective measures, rapid achievement and maintenance of control and regular follow-up. EVIDENCE: The key diagnostic and therapeutic recommendations are based on the 1995 Canadian guidelines and a critical review of the literature by small groups before a full meeting of the consensus group. Recommendations are graded according to 5 levels of evidence. Differences of opinion were resolved by consensus following discussion. VALUES: Respirologists, immunoallergists, pediatricians and emergency and family physicians gave prime consideration to the achievement and maintenance of optimal control of asthma through avoidance of environmental inciters, education of patients and the lowest effective regime of pharmacotherapy to reduce morbidity and mortality. BENEFITS, HARMS AND COSTS: Adherence to the guidelines should be accompanied by significant reduction in patients' symptoms, reduced morbidity and mortality, fewer emergency and hospital admissions, fewer adverse side-effects from medications, better quality of life for patients and reduced costs. RECOMMENDATIONS: Recommendations are included in each section of the report. In summary, after a diagnosis of asthma is made based on clinical evaluation, including demonstration of variable airflow obstruction, and contributing factors are identified, a treatment plan is established to obtain and maintain optimal asthma control. The main components of treatment are patient education

The impact of senior doctor assessment at triage on emergency department performance measures: systematic review and meta-analysis of comparative studies.

PubMed

Abdulwahid, Maysam Ali; Booth, Andrew; Kuczawski, Maxine; Mason, Suzanne M

2016-07-01

To determine if placing a senior doctor at triage versus standard single nurse in a hospital emergency department (ED) improves ED performance by reviewing evidence from comparative design studies using several quality indicators. Systematic review. Cochrane Library, MEDLINE, EMBASE, CINAHL, Cochrane Effective Practice and Organisation of Care (EPOC), Web of Science, Clinical Trials Registry website. In addition, references from included studies and citation searches were used to identify relevant studies. Databases were searched for comparative studies examining the role of senior doctor triage (SDT), published from 1994 to 2014. Senior doctor was defined as a qualified medical doctor who completed high specialty training in emergency medicine. Articles with a primary aim to investigate the effect of SDT on ED quality indicators such as waiting time (WT), length of stay (LOS), left without being seen (LWBS) and left without treatment complete (LWTC) were included. Articles examining the adverse events and cost associated with SDT were also included. Only studies with a control group, either in a randomised controlled trial (RCT) or in an observational study with historical controls, were included. The systematic literature search was followed by assessment of relevance and risk of bias in each individual study fulfilling the inclusion criteria using the Effective Public Health Practice Project (EPHPP) bias tool. Data extraction was based on a form designed and piloted by the authors for dichotomous and continuous data. Narrative synthesis and meta-analysis of homogenous data were performed. Of 4506 articles identified, 25 relevant studies were retrieved; 12 were of the weak pre-post study design, 9 were of moderate quality and 4 were of strong quality. The majority of the studies revealed improvements in ED performance measures favouring SDT. Pooled results from two Canadian RCTs showed a significant reduction in LOS of medium acuity patients (weighted means

Access to new cardiovascular therapies in Canadian hospitals: a national survey of the formulary process.

PubMed

Shalansky, Stephen J; Virk, Roohina; Ackman, Margaret; Jackevicius, Cynthia; Kertland, Heather; Tsuyuki, Ross; Humphries, Karin

2003-02-01

Access to new therapies in hospitals depends upon both clinical trial evidence and local Pharmacy and Therapeutics (P&T) committee approval. The process of formulary evaluation by P&T committees is not well-understood. To describe the formulary decision-making process in Canadian hospitals for cardiovascular medications recently made available on the Canadian market. Postal survey of hospital pharmacy directors in all Canadian hospitals with more than 50 beds. Target drugs included abciximab, enoxaparin, dalteparin, clopidogrel, eptifibatide and tirofiban. Of 428 surveys mailed, responses were received from 164 P&T committees representing 350 hospitals for an effective response rate of 82%. While physicians make up the largest proportion of committee membership, pharmacists play an influential role. Information most commonly cited as influencing formulary decisions included published clinical trials (97%), regional guidelines (90%), pharmacoeconomic data (84%), decisions at peer hospitals (73%) and local opinion leaders (60%). However, this information was often not required on formulary applications. Approval timelines varied widely for target medications but there were no regional, hospital or P&T committee characteristics that were independent predictors of early formulary application or approval. There is wide variability in the time taken for Canadian institutions to adopt new cardiovascular therapies, which is not explained by regional, hospital or P&T committee characteristics. Standardization of the formulary application and evaluation processes, including sharing of information amongst institutions, would lead to broader understanding of the applicable issues, more objectivity and improved efficiency.

Burnout and Doctors: Prevalence, Prevention and Intervention

PubMed Central

Kumar, Shailesh

2016-01-01

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

Multicultural Early Childhood Education Bibliography and Resource List.

ERIC Educational Resources Information Center

Mock, Karen R., Comp.

Compiled for early childhood educators, this list of resources for multicultural education provides a total of 153 entries in the categories of readings for teachers, curriculum materials, nonprint media, children's books, resource bibliographies and catalogues, Canadian periodicals, and resource agencies. Brief annotations accompany most entries.…

Cancer screening behaviors among Canadian women living with physical disabilities.

PubMed

Cooper, Nicole S; Yoshida, Karen K

2007-05-01

To report the prevalence and factors associated with ever having had a Papanicolaou (Pap) test or pelvic examination among Canadian women with physical disabilities and the barriers to having the tests. Cross-sectional survey. General community. Convenience sample of 1095 women between the ages of 18 to 93 completed the survey. The most frequently reported health conditions were musculoskeletal (44%), neurologic (17%), and sensory (13%). Not applicable. Outcomes included prevalence of ever having a Pap test or pelvic examination and odds ratios of having the tests. Prevalence of ever having a Pap test was 90% and 91% for a pelvic examination. The most common barriers to the screening tests were "not being sexually active," "my doctor told me I do not need one," and "the exam table is too high/narrow." Although the prevalence of ever having a Pap test or pelvic examination was at or above 90%, women with physical disabilities need further education on the necessity and benefits of having regular cancer screening behaviors, especially among those who may not be sexually active. Further research is also required into why these women are informed that they do not require cancer screening tests.

'Multiple-test' approach to the laboratory diagnosis of tuberculosis -perception of medical doctors from Ujjain, India.

PubMed

Purohit, Manju Raj; Sharma, Megha; Rosales-Klintz, Senia; Lundborg, Cecilia Stålsby

2015-08-11

Delay in diagnosis is one of the most important factors for the control of tuberculosis (TB) in endemic countries like India. As laboratory diagnosis is the mainstay for identification of active disease, we aim to explore and understand the opinions of medical doctors about the laboratory diagnosis of TB in Ujjain, India. Sixteen qualified specialist medical doctors from Ujjain were purposefully selected for the study. Individual interviews with the doctors (13 men and 3 women), were conducted. As one interview could not be completed, data from 15 interviews were analyzed using manifest and latent content analysis. Based on perception of the doctors, the theme; 'challenges and need for the laboratory diagnosis of TB' emerged from the following subthemes: (i) Relationship between basic element of the TB diseases process such as 'Symptoms prior to diagnoses' and 'Clinical characteristics of TB', which were not specific enough to diagnose TB (ii) The prevailing conditions such as lack of explicit diagnostic tools, lead to the doctors using the 'multiple tests' or 'empiric treatment' approach (iii) The doctors proposed that there is a need for access to a rapid, single and simple diagnostic test, and a need for awareness and knowledge of the practitioners regarding specific TB investigations, and early referral to improve the situation at resource-limited settings. The medical specialists use a 'multiple test' or 'empiric treatment' approach to diagnose TB. According to the participants, there is a low dependence and uptake of the available laboratory TB investigations by medical practitioners. There is an urgent need to have a specific, simple and reliable test, and a protocol, to improve diagnosis of TB and to prevent development of resistant TB.

The Professional Doctorate in Nursing: A Position Paper

ERIC Educational Resources Information Center

Newman, Margaret A.

1975-01-01

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

Groundwater mixing dynamics at a Canadian Shield mine

NASA Astrophysics Data System (ADS)

Douglas, M.; Clark, I. D.; Raven, K.; Bottomley, D.

2000-08-01

Temporal and spatial variations in geochemistry and isotopes in mine inflows at the Con Mine, Yellowknife, are studied to access the impact of underground openings on deep groundwater flow in the Canadian Shield. Periodic sampling of inflow at 20 sites from 700 to 1615 m depth showed that salinities range from 1.4 to 290 g/l, with tritium detected at all depths. Three mixing end-members are identified: (1) Ca(Na)-Cl Shield brine; (2) glacial meltwater recharged at the margin of the retreating Laurentide ice sheet at ˜10 ka; and (3) modern meteoric water. Mixing fractions, calculated for inflows on five mine levels, illustrate the infiltration of modern water along specific fault planes. Tritium data for the modern component are corrected for mixing with brine and glacial waters and interpreted with an exponential-piston flow model. Results indicate that the mean transit time from surface to 1300 m depth is about 23 years in the early period after drift construction in 1979, but decreases to about 17 years in the past decade. The persistence of glacial meltwater in the subsurface to the present time, and the rapid circulation of modern meteoric water since the start of mining activities underline the importance of gradient, in addition to permeability, as a control on deep groundwater flow in the Canadian Shield.

Physical activity of Canadian children and youth: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey.

PubMed

Colley, Rachel C; Garriguet, Didier; Janssen, Ian; Craig, Cora L; Clarke, Janine; Tremblay, Mark S

2011-03-01

Physical activity is an important determinant of health and fitness. This study provides contemporary estimates of the physical activity levels of Canadians aged 6 to 19 years. Data are from the 2007 to 2009 Canadian Health Measures Survey. The physical activity of a nationally representative sample was measured using accelerometers. Data are presented as time spent in sedentary, light, moderate and vigorous intensity movement, and in steps accumulated per day. An estimated 9% of boys and 4% of girls accumulate 60 minutes of moderate-to-vigorous physical activity on at least 6 days a week. Regardless of age group, boys are more active than girls. Canadian children and youth spend 8.6 hours per day-62% of their waking hours-in sedentary pursuits. Daily step counts average 12,100 for boys and 10,300 for girls. Based on objective and robust measures, physical activity levels of Canadian children and youth are low.

2009 Canadian Radiation Oncology Resident Survey

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

Debenham, Brock, E-mail: debenham@ualberta.net; Banerjee, Robyn; Fairchild, Alysa

2012-03-15

Purpose: Statistics from the Canadian post-MD education registry show that numbers of Canadian radiation oncology (RO) trainees have risen from 62 in 1999 to approximately 150 per year between 2003 and 2009, contributing to the current perceived downturn in employment opportunities for radiation oncologists in Canada. When last surveyed in 2003, Canadian RO residents identified job availability as their main concern. Our objective was to survey current Canadian RO residents on their training and career plans. Methods and Materials: Trainees from the 13 Canadian residency programs using the national matching service were sought. Potential respondents were identified through individual programmore » directors or chief resident and were e-mailed a secure link to an online survey. Descriptive statistics were used to report responses. Results: The eligible response rate was 53% (83/156). Similar to the 2003 survey, respondents generally expressed high satisfaction with their programs and specialty. The most frequently expressed perceived weakness in their training differed from 2003, with 46.5% of current respondents feeling unprepared to enter the job market. 72% plan on pursuing a postresidency fellowship. Most respondents intend to practice in Canada. Fewer than 20% of respondents believe that there is a strong demand for radiation oncologists in Canada. Conclusions: Respondents to the current survey expressed significant satisfaction with their career choice and training program. However, differences exist compared with the 2003 survey, including the current perceived lack of demand for radiation oncologists in Canada.« less

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

ERIC Educational Resources Information Center

Beeler, Karl J.

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

State Level Review of Doctoral Programs in Texas.

ERIC Educational Resources Information Center

Whittington, Nil

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

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

PubMed

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

2015-02-01

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

Doctoral Education in Nursing: Future Directions

ERIC Educational Resources Information Center

Downs, Florence S.

1978-01-01

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

Universal values of Canadian astronauts

NASA Astrophysics Data System (ADS)

Brcic, Jelena; Della-Rossa, Irina

2012-11-01

Values are desirable, trans-situational goals, varying in importance, that guide behavior. Research has demonstrated that universal values may alter in importance as a result of major life events. The present study examines the effect of spaceflight and the demands of astronauts' job position as life circumstances that affect value priorities. We employed thematic content analysis for references to Schwartz's well-established value markers in narratives (media interviews, journals, and pre-flight interviews) of seven Canadian astronauts and compared the results to the values of National Aeronautics and Space Administration (NASA) and Russian Space Agency (RKA) astronauts. Space flight did alter the level of importance of Canadian astronauts' values. We found a U-shaped pattern for the values of Achievement and Tradition before, during, and after flight, and a linear decrease in the value of Stimulation. The most frequently mentioned values were Achievement, Universalism, Security, and Self-Direction. Achievement and Self Direction are also within the top 4 values of all other astronauts; however, Universalism was significantly higher among the Canadian astronauts. Within the value hierarchy of Canadian astronauts, Security was the third most frequently mentioned value, while it is in seventh place for all other astronauts. Interestingly, the most often mentioned value marker (sub-category) in this category was Patriotism. The findings have important implications in understanding multi-national crew relations during training, flight, and reintegration into society.

Silurian pinnacle reefs of the Canadian Arctic

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

De Freitas, T.A.; Dixon, O.A.; Mayr, U.

1993-04-01

Pinnacle reefs are commonly an attractive target for oil exploration because they are usually porous carbonate bodies entombed in impervious, deep-water shales that provide both the source and the seal for hydrocarbons. Silurian pinnacle reefs, the first described in the Canadian Arctic Archipelago, are exposed on Ellesmere and Devon Islands. Two main reef trends occur, one of early middle Llandovery to middle Ludlow age and a second of middle Ludlow to Late Silurian or Early Devonian age. Reefs of both phases contain lime mudstone cores: some are stromatactoid-rich and others consist predominantly of microbialite-rich lime mudstone or microbial boundstone. Faciesmore » sequences of both reef phases show evidence of upward-shallowing overall, but, in the older reefs, isochronous capping facies are dominated either by coral-mirian or by stromatoporoid boundstone and floatstone. This difference perhaps reflects variation in wave stress and apparent ability of a few corals,thickly encrusted by or associated with microbial boundstone and skeletal algae, to withstand greater wave energy than a stromatoporoid-coral-rich reef community. These reefs constitute one of the bright prospects of hydrocarbon exploration in rocks of the Franklinian succession. 43 refs., 9 figs.« less

Tearing the Fabric of Canada: The Broadcast Media and Canadian Identity.

ERIC Educational Resources Information Center

Weiss, Elaine F.

This paper explores the perceived threat of American cultural "imperialism" in Canada, the effect of constant exposure to American broadcasting on the Canadian national identity, the role broadcasting plays in shaping Canadian identity, and the efforts by the Canadian government to "Canadianize" its broadcasting. A brief…

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

PubMed Central

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

2016-01-01

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

Guide to Canadian Aerospace Related Industries,

DTIC Science & Technology

1983-01-01

Research and Development (US). Digital Radar - Contract with Fundacao Educacional Data Processing de Bauru, Brazil. Satellite/Radar - Contract with Canadian... especially suitable for cartography and thematic mapping. The principal applications to date have been to Vehicle Mobility mapping for the Canadian Forces...This latter capability is especially applied to the repair and rebuilding of sawmill and pulpmill machinery, and mining equipment. Ebco is

Genetic analysis of milk β-hydroxybutyrate and its association with fat-to-protein ratio, body condition score, clinical ketosis, and displaced abomasum in early first lactation of Canadian Holsteins.

PubMed

Koeck, A; Jamrozik, J; Schenkel, F S; Moore, R K; Lefebvre, D M; Kelton, D F; Miglior, F

2014-11-01

The aim of this study was to estimate genetic parameters for milk β-hydroxybutyrate (BHBA) in early first lactation of Canadian Holstein cows and to examine its genetic association with indicators of energy balance (fat-to-protein ratio and body condition score) and metabolic diseases (clinical ketosis and displaced abomasum). Data for milk BHBA recorded between 5 and 100 d in milk was obtained from Valacta (Sainte-Anne-de-Bellevue, Québec, Canada), the Canadian Dairy Herd Improvement organization responsible for Québec and Atlantic provinces. Test-day milk samples were analyzed by mid-infrared spectrometry using previously developed calibration equations for milk BHBA. Test-day records of fat-to-protein ratio were obtained from the routine milk recording scheme. Body condition score records were available from the routine type classification system. Data on clinical ketosis and displaced abomasum recorded by producers were available from the national dairy cattle health system in Canada. Data were analyzed using linear animal models. Heritability estimates for milk BHBA at different stages of early lactation were between 0.14 and 0.29. Genetic correlations between milk BHBA were higher between adjacent lactation intervals and decreased as intervals were further apart. Correlations between breeding values for milk BHBA and routinely evaluated traits revealed that selection for lower milk BHBA in early lactation would lead to an improvement of several health and fertility traits, including SCS, calving to first service, number of services, first service to conception, and days open. Also, lower milk BHBA was associated with a longer herd life, better conformation, and better feet and legs. A higher genetic merit for milk yield was associated with higher milk BHBA, and, therefore, a greater susceptibility to hyperketonemia. Milk BHBA at the first test-day was moderately genetically correlated with fat-to-protein ratio (0.49), body condition score (-0.35), and

Canadian global village reality: anthropometric surrogate cutoffs and metabolic abnormalities among Canadians of East Asian, South Asian, and European descent.

PubMed

He, Meizi; Li, E T S; Harris, Stewart; Huff, Murray W; Yau, Chun Y; Anderson, G Harvey

2010-05-01

To test the appropriateness of body mass index (BMI) and waist circumference (WC) cutoff points derived in largely white populations (ie, those of European descent) for detecting obesity-related metabolic abnormalities among East Asian and South Asian Canadians. Cross-sectional survey. Primary care and community settings in Ontario. Canadians of East Asian (n = 130), South Asian (n = 113), and European (n = 111) descent. Variables for metabolic syndromes, including BMI, WC, body fat percentage, blood pressure, lipid profile, and fasting blood glucose and insulin levels, were measured. Receiver operating characteristics curve analysis was used to generate BMI and WC cutoff points based on various criteria for metabolic syndromes. Adjusting for sex and age, East Asian Canadians had a significantly lower mean BMI (23.2 kg/m(2)) and mean WC (79.6 cm) than did those of South Asian (26.1 kg/m(2) and 90.3 cm) and European (26.5 kg/m(2) and 89.3 cm) descent (P < .05). The BMI cutoffs for an increased risk of metabolic abnormalities ranged from 23.1 to 24.4 kg/m(2) in East Asian Canadians; 26.6 to 26.8 kg/m(2) in South Asian Canadians; and 26.3 to 28.2 kg/m(2) in European Canadians. Waist circumference cutoffs for increased risk of metabolic abnormalities were relatively low in East Asian men (83.3 to 85.2 cm) and women (74.1 to 76.7 cm), compared with South Asian men (98.8 cm) and women (90.1 to 93.5 cm), as well as European men (91.6 to 95.2 cm) and women (82.8 to 88.3 cm). The BMI and WC cutoffs used for defining risk of metabolic abnormalities should be lowered for East Asian Canadians but not for South Asian Canadians. The World Health Organization ethnic-specific BMI and WC cutoffs should be used with caution, particularly with Asian migrants who have resided in Canada for a long period of time.

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

PubMed

Engeström, Yrjö

2013-01-01

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

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

MedlinePlus

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

Looking Back at Doctoral Education in South Africa

ERIC Educational Resources Information Center

Herman, Chaya

2017-01-01

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

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

MedlinePlus

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

Root Doctors as Providers of Primary Care

PubMed Central

Stitt, Van J.

1983-01-01

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

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

PubMed

Churchman, J J; Doherty, C

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

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

PubMed

Akinyemi, Oluwaseun; Atilola, Olayinka

2013-01-01

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

Comparison of maternity experiences of Canadian-born and recent and non-recent immigrant women: findings from the Canadian Maternity Experiences Survey.

PubMed

Kingston, Dawn; Heaman, Maureen; Chalmers, Beverley; Kaczorowski, Janusz; O'Brien, Beverley; Lee, Lily; Dzakpasu, Susie; O'Campo, Patricia

2011-11-01

To compare the maternity experiences of immigrant women (recent, ≤ 5 years in Canada; non-recent > 5 years) with those of Canadian-born women. This study was based on data from the Canadian Maternity Experiences Survey of the Public Health Agency of Canada. A stratified random sample of 6421 women was drawn from a sampling frame based on the 2006 Canadian Census of Population. Weighted proportions were calculated using survey sample weights. Multivariable logistic regression was used to estimate odds ratios comparing recent immigrant women with Canadian-born women and non-recent immigrant women with Canadian-born women, adjusting for education, income, parity, and maternal age. The sample comprised 7.5% recent immigrants, 16.3% non-recent immigrants, and 76.2% Canadian-born women. Immigrant women reported experiencing less physical abuse and stress, and they were less likely to smoke or consume alcohol during pregnancy, than Canadian women; however, they were more likely to report high levels of postpartum depression symptoms and were less likely to have access to social support, to take folic acid before and during pregnancy, to rate their own and their infant's health as optimal, and to place their infants on their backs for sleeping. Recent and non-recent immigrant women also had different experiences, suggesting that duration of residence in Canada plays a role in immigrant women's maternity experiences. These findings can assist clinicians and policy-makers to understand the disparities that exist between immigrant and non-immigrant women in order to address the needs of immigrant women more effectively.

Revisiting the Canadian English vowel space

NASA Astrophysics Data System (ADS)

Hagiwara, Robert

2005-04-01

In order to fill a need for experimental-acoustic baseline measurements of Canadian English vowels, a database is currently being constructed in Winnipeg, Manitoba. The database derives from multiple repetitions of fifteen English vowels (eleven standard monophthongs, syllabic /r/ and three standard diphthongs) in /hVd/ and /hVt/ contexts, as spoken by multiple speakers. Frequencies of the first four formants are taken from three timepoints in every vowel token (25, 50, and 75% of vowel duration). Preliminary results (from five men and five women) confirm some features characteristic of Canadian English, but call others into question. For instance the merger of low back vowels appears to be complete for these speakers, but the result is a lower-mid and probably rounded vowel rather than the low back unround vowel often described. With these data Canadian Raising can be quantified as an average 200 Hz or 1.5 Bark downward shift in the frequency of F1 before voiceless /t/. Analysis of the database will lead to a more accurate picture of the Canadian English vowel system, as well as provide a practical and up-to-date point of reference for further phonetic and sociophonetic comparisons.

Stress in doctors and dentists who teach.

PubMed

Rutter, Harry; Herzberg, Joe; Paice, Elisabeth

2002-06-01

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

Something to Chew On: Canadian Fiction for Young Adults.

ERIC Educational Resources Information Center

Pederson, Beverley

An annotated bibliography of fiction about Canada or written by Canadian authors is presented. The list is intended as a guide for Canadian young adult readers in search of a literature they can identify as their own. It can also be used by librarians and teachers who need assistance in selecting novels and short stories for young Canadians. Over…

European Industrial Doctorates: Marie Curie Actions

ERIC Educational Resources Information Center

European Commission, 2012

2012-01-01

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

Epilepsy - what to ask your doctor - child

MedlinePlus

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

The Plight of the Woman Doctoral Student

ERIC Educational Resources Information Center

Holmstrom, Engin Inel; Holmstrom, Robert W.

1974-01-01

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

Do neonatologists limit parental decision-making authority? A Canadian perspective.

PubMed

Albersheim, Susan G; Lavoie, Pascal M; Keidar, Yaron D

2010-12-01

According to the principles of family-centered care, fully informed parents and health care professionals are partners in the care of sick neonates. The aim of this study was to assess the attitudes of Canadian neonatologists towards the authority of parents to make life-and-death decisions for their babies. We interviewed 121 (74%) of the 164 practicing neonatologists in Canada (June 2004-March 2005), using scripted open-ended questions and common clinical scenarios. Data analysis employed interpretive description methodology. The main outcome measure was the intention of neonatologists to limit parental life-and-death decision-making authority, when they disagree with parental decisions. Neonatologists' self-rated respect for parental decision-making authority was 8/10. Most neonatologists thought that parents should be either primary decision-makers or part of the decision-making team. Fifty-six percent of neonatologists would limit parental decision-making authority if the parents' decision is not in the baby's "best interest". In response to common neonatal severe illness scenarios, up to 18% of neonatologists said they would limit parental decision-making, even if the chance of intact survival is very poor. For clinical scenarios with equally poor long-term outcomes, neonatologists were more likely to comply with parental wishes early in the life of a baby, particularly with documented brain injury. Canadian neonatologists espouse high regard for parental decision-making authority, but are prepared to limit parental authority if the parents' decision is not thought to be in the baby's best interest. Although neonatologists advise parents that treatment can be started at birth, and stopped later, this was only for early severe brain injury. Copyright © 2010 Elsevier Ltd. All rights reserved.

The Half-circled "C": Canadian Copyright Legislation.

ERIC Educational Resources Information Center

Hansen, Linda

1992-01-01

Reviews the legislative history of Canadian copyright law, especially with respect to government documents. Briefly describes the British origins of Canadian copyright, the British North America Act (1867), and the Copyright Act of 1921, all of which serve as background to the current law. (111 references) (LAE)

An analysis of the Canadian cognitive psychology job market (2006-2016).

PubMed

Pennycook, Gordon; Thompson, Valerie A

2018-06-01

How accomplished does one need to be to compete in the Canadian cognitive psychology job market? We looked at the publication record of everyone who was hired as an assistant professor in Canadian cognitive psychology divisions with PhD programs between 2006 and 2016 (N = 64). Individuals who were hired from 2006 to 2011 averaged 10 journal-article publications up to and including the year they were hired. However, this number increased by 57% to 18 publications between 2012 and 2016. Notably, this increase (a) occurred despite an increase in the number of positions since 2010, (b) was not restricted to top-ranked institutions, (c) did not come at the cost of decreasing quality in research (based on citations), and (d) was not driven by longer postdoctoral fellowships. To supply context, we obtained data on the publication records of 98 eminent and early-career award-winning cognitive psychologists when they obtained their first faculty positions. The correlation between year of hire and publication number in the full sample was strongly positive (r = .47) and driven primarily by a substantial increase in recent years, which suggests that the increasingly competitive job market is not specific to Canada. Finally, we found that behaviour (as opposed to neuroscience) researchers and those who obtained their PhDs from Canadian universities may be at particular risk in the job market. At a time when increasing numbers of PhDs are graduating from cognitive psychology programs, it has likely never been more difficult to obtain a faculty position. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Canadian media representations of mad cow disease.

PubMed

Boyd, Amanda D; Jardine, Cynthia G; Driedger, S Michelle

2009-01-01

A Canadian case of bovine spongiform encephalopathy (BSE) or "mad cow disease" was confirmed in May, 2003. An in-depth content analysis of newspaper articles was conducted to understand the portrayal of BSE and variant Creutzfeldt-Jakob disease (vCJD) in the Canadian media. Articles in the "first 10 days" following the initial discovery of a cow with BSE in Canada on May 20, 2003, were examined based on the premise that these initial stories provide the major frames that dominate news media reporting of the same issue over time and multiple occurrences. Subsequent confirmed Canadian cases were similarly analyzed to determine if coverage changed in these later media articles. The results include a prominence of economic articles, de-emphasis of health aspects, and anchoring the Canadian outbreak to that of Britain's crisis. The variation in media representations between those in Canada and those documented in Britain are explored in this study.

Omega-3 Index of Canadian adults.

PubMed

Langlois, Kellie; Ratnayake, Walisundera M N

2015-11-01

Cardioprotective properties have been associated with two fatty acids-eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The Omega-3 Index indicates the percentage of EPA+DHA in red blood cell fatty acids. Omega-3 Index levels of the Canadian population have not been directly measured. Data for respondents aged 20 to 79 from cycle 3 (2012/2013) of the Canadian Health Measures Survey were used to calculate means and the prevalence of Omega-3 Index coronary heart disease (CHD) risk cut-offs-high (4% or less), moderate (more than 4% to less than 8%), and low (8% or more)-by sociodemographic and lifestyle characteristics, including fish consumption and use of omega-3 supplements. Associations between the Omega-3 Index and CHD-related factors including biomarkers, risk factors, and previous CHD events, were examined in multivariate regression models. The mean Omega-3 Index level of Canadians aged 20 to 79 was 4.5%. Levels were higher for women, older adults, Asians and other non-white Canadians, omega-3 supplement users, and fish consumers; levels were lower for smokers and people who were obese. Fewer than 3% of adults had levels associated with low CHD risk; 43% had levels associated with high risk. No CHD-related factor was associated with the Omega-3 Index when control variables were taken into account. Omega-3 Index levels among Canadian adults were strongly related to age, race, supplement use, fish consumption, smoking status and obesity. Fewer than 3% of adults had Omega-3 Index levels associated with low risk for CHD.

The good doctor - strong and persevering.

PubMed

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

2016-10-01

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

Is there a risk profile for the vulnerable junior doctor?

PubMed

Byrne, D; Buttrey, S; Carberry, C; Lydon, S; O'Connor, P

2016-08-01

Mental ill health is prevalent among doctors, especially those in the early stages of postgraduate training. However, a paucity of research has examined factors predictive of psychological distress in this population. To report the findings from a multi-centre survey of mental health among junior doctors in Ireland, and assess the extent to which moderator variables (e.g., age, academic performance, nationality, etc.) alter the levels of psychological distress caused by internship. An online, anonymous, questionnaire was distributed to all interns in the Republic of Ireland in January 2012. A total of 270 interns responded to the survey (45.0 % response rate), with 48.5 % of the respondents having a score indicative of psychological distress. A regression model found that nationality, academic performance, intern training network, rating of work stressors, home stressors, and work-life balance were associated with differing levels of mental health as measured by the General Health Questionnaire-12. There is a need to consider moderator variables when examining mental health in healthcare populations to avoid drawing overly simplistic conclusions. Interns in Ireland reported particularly high levels of psychological distress compared to other studies of mental health among healthcare populations.

48 CFR 249.7000 - Terminated contracts with Canadian Commercial Corporation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Canadian Commercial Corporation. 249.7000 Section 249.7000 Federal Acquisition Regulations System DEFENSE... Termination Requirements 249.7000 Terminated contracts with Canadian Commercial Corporation. (a) Terminate contracts with the Canadian Commercial Corporation in accordance with— (1) The Letter of Agreement (LOA...

48 CFR 249.7000 - Terminated contracts with Canadian Commercial Corporation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Canadian Commercial Corporation. 249.7000 Section 249.7000 Federal Acquisition Regulations System DEFENSE... Termination Requirements 249.7000 Terminated contracts with Canadian Commercial Corporation. (a) Terminate contracts with the Canadian Commercial Corporation in accordance with— (1) The Letter of Agreement (LOA...

48 CFR 249.7000 - Terminated contracts with Canadian Commercial Corporation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Canadian Commercial Corporation. 249.7000 Section 249.7000 Federal Acquisition Regulations System DEFENSE... Termination Requirements 249.7000 Terminated contracts with Canadian Commercial Corporation. (a) Terminate contracts with the Canadian Commercial Corporation in accordance with— (1) The Letter of Agreement (LOA...

Curricular Ethics in Early Childhood Education Programming: A Challenge to the Ontario Kindergarten Program

ERIC Educational Resources Information Center

Heydon, Rachel M.; Wang, Ping

2006-01-01

Through a case study of a key Canadian early childhood education program, The Kindergarten Program (Ontario Ministry of Education and Training, 1998a), we explore the relationship between curricular paradigms and early childhood education (ECE) models, and the opportunities that each creates for enacting ethical teaching and learning…

Purposes, Diversities, and Futures in MFT Doctoral Education

ERIC Educational Resources Information Center

Woolley, Scott R.

2010-01-01

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

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

PubMed

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

2014-07-01

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

The Risky Business of Doctoral Management

ERIC Educational Resources Information Center

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

2006-01-01

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

Best Practices in Doctoral Retention: Mentoring

ERIC Educational Resources Information Center

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

2014-01-01

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

Febrile seizures - what to ask your doctor

MedlinePlus

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

Concussion - what to ask your doctor - child

MedlinePlus

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

Taking Medicines Safely: At Your Doctor's Office

MedlinePlus

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

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

PubMed

Figueroa, Gustavo

2014-10-01

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