Equivalence of Students' Scores on Timed and Untimed Anatomy Practical Examinations

ERIC Educational Resources Information Center

Zhang, Guiyun; Fenderson, Bruce A.; Schmidt, Richard R.; Veloski, J. Jon

2013-01-01

Untimed examinations are popular with students because there is a perception that first impressions may be incorrect, and that difficult questions require more time for reflection. In this report, we tested the hypothesis that timed anatomy practical examinations are inherently more difficult than untimed examinations. Students in the Doctor of…

The future of UK/Irish surgery: A European solution.

PubMed

Varzgalis, M; Kerin, M J; Sweeney, K J

2015-11-01

The United Kingdom (UK) and Republic of Ireland (ROI) hospital systems are dependent on junior doctors for their functionality however it is increasingly difficult to recruit UK/ROI trained doctors to fill these posts. Directive 2005/36/EC, which came into force in 2007, is the principal European legislation on the recognition of equivalence of professional qualifications across Europe. European trained doctors are therefore attractive candidates for junior doctor posts. However, although their training is recognised as equivalent by the Irish Medical Council (IMC) and General Medical Council (GMC) they are not being appointed to equivalent posts by the Health Service Executive (HSE) or National Health Service (NHS). With the influence of European Union (EU) centralisation, modification of UK/ROI consultant grade is imminent, possibly to pyramidal structure of the Continental European model with clearer lines of corporate responsibility. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

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…

Understanding the Experiences of Female Doctoral Students

ERIC Educational Resources Information Center

Brown, Lorraine; Watson, Pamela

2010-01-01

This article presents findings from a qualitative study of the impact of gender on the doctoral experience. Eight women who had recently completed or who had almost completed a PhD were interviewed about their experiences. Seven studied part time and one full time. It was found that being a mother had profound implications for doctoral-level…

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…

Facts about Hospital Worker Safety

MedlinePlus

... Transferred FTE full-time employee (or full-time equivalent) HIPAA Health Insurance Portability and Accountability Act MSD ... injury and illness rates per 100 full-time equivalent employees (FTEs)—also known as the Total Case ...

20 CFR 655.736 - What are H-1B-dependent employers and willful violators?

Code of Federal Regulations, 2014 CFR

2014-04-01

.... workers and H-1B nonimmigrants, and measured according to full-time equivalent employees) and the employer...)— (i)(A) The employer has 25 or fewer full-time equivalent employees who are employed in the U.S.; and... than 50 full-time equivalent employees who are employed in the U.S.; and (B) Employs more than 12 H-1B...

20 CFR 655.736 - What are H-1B-dependent employers and willful violators?

Code of Federal Regulations, 2011 CFR

2011-04-01

.... workers and H-1B nonimmigrants, and measured according to full-time equivalent employees) and the employer...)— (i)(A) The employer has 25 or fewer full-time equivalent employees who are employed in the U.S.; and... than 50 full-time equivalent employees who are employed in the U.S.; and (B) Employs more than 12 H-1B...

20 CFR 655.736 - What are H-1B-dependent employers and willful violators?

Code of Federal Regulations, 2013 CFR

2013-04-01

.... workers and H-1B nonimmigrants, and measured according to full-time equivalent employees) and the employer...)— (i)(A) The employer has 25 or fewer full-time equivalent employees who are employed in the U.S.; and... than 50 full-time equivalent employees who are employed in the U.S.; and (B) Employs more than 12 H-1B...

20 CFR 655.736 - What are H-1B-dependent employers and willful violators?

Code of Federal Regulations, 2012 CFR

2012-04-01

.... workers and H-1B nonimmigrants, and measured according to full-time equivalent employees) and the employer...)— (i)(A) The employer has 25 or fewer full-time equivalent employees who are employed in the U.S.; and... than 50 full-time equivalent employees who are employed in the U.S.; and (B) Employs more than 12 H-1B...

20 CFR 655.736 - What are H-1B-dependent employers and willful violators?

Code of Federal Regulations, 2010 CFR

2010-04-01

.... workers and H-1B nonimmigrants, and measured according to full-time equivalent employees) and the employer...)— (i)(A) The employer has 25 or fewer full-time equivalent employees who are employed in the U.S.; and... than 50 full-time equivalent employees who are employed in the U.S.; and (B) Employs more than 12 H-1B...

Impact of New Shift Models for Doctors Working at a German University Hospital for Gynaecology and Obstetrics Four Years After Implementation. Can They Meet the European Working Time Directive Without Increasing Costs?

PubMed

Maschmann, J; Holderried, M; Blumenstock, G; Bamberg, M; Rieger, M A; Wallwiener, D; Brucker, S

2013-07-01

Background: The impact of the European Working Time Directive and subsequent collective wage agreements for doctors from 2006 onwards were substantial. So far, no systematic evaluation of their application in Germany has been performed. We evaluated the impact four years after implementation of new shift models in a University Hospital for Gynaecology and Obstetrics (UHGO). Methods: A new shift model was created together with doctors of Tübingen UHOG in 2007 and implemented in 2008. Documentation of working hours has hence been done electronically. Adherence to the average weekly working time limit (AWTL) and the maximum of 10 h daily working time (10 h-dwt) was evaluated, as well as staffing costs in relation to case-weight points gathered within the German DRG (diagnosis related groups) System. Results: Staff increased from a mean of 44.7 full time equivalent (FTE) doctors in 2007 to 52.5 FTE in 2009, 50.8 in 2010, and 54.5 in 2011. There was no statistically significant difference of the monthly staff expenditures per case-weight between the years 2009 or 2010 vs. 2007. 2011, however, was significantly more expensive than 2007 (p = 0.02). The internal control group (five other departments of the university hospital) did not show an increase during the same period. AWTL were respected by 90, 96, and 98 % in 2009, 2010, and 2011, respectively. Of all shifts 10 h-dwt was exceeded by 7.4 % in 2009, 1.3 % in 2010, and 2.6 % in 2011, with significant differences between 2009 and both, 2010 and 2011 (p < 0.001), and between 2010 and 2011 (p = 0.02). Discussion: AWTL and 10 h-dwt could be continuously respected quite well after implementation of the new shift model without increasing the cost/earnings ratio for the first two years. However, in 2011 the ratio increased significantly (p = 0.02).

Impact of New Shift Models for Doctors Working at a German University Hospital for Gynaecology and Obstetrics Four Years After Implementation. Can They Meet the European Working Time Directive Without Increasing Costs?

PubMed Central

Maschmann, J.; Holderried, M.; Blumenstock, G.; Bamberg, M.; Rieger, M. A.; Wallwiener, D.; Brucker, S.

2013-01-01

Background: The impact of the European Working Time Directive and subsequent collective wage agreements for doctors from 2006 onwards were substantial. So far, no systematic evaluation of their application in Germany has been performed. We evaluated the impact four years after implementation of new shift models in a University Hospital for Gynaecology and Obstetrics (UHGO). Methods: A new shift model was created together with doctors of Tübingen UHOG in 2007 and implemented in 2008. Documentation of working hours has hence been done electronically. Adherence to the average weekly working time limit (AWTL) and the maximum of 10 h daily working time (10 h-dwt) was evaluated, as well as staffing costs in relation to case-weight points gathered within the German DRG (diagnosis related groups) System. Results: Staff increased from a mean of 44.7 full time equivalent (FTE) doctors in 2007 to 52.5 FTE in 2009, 50.8 in 2010, and 54.5 in 2011. There was no statistically significant difference of the monthly staff expenditures per case-weight between the years 2009 or 2010 vs. 2007. 2011, however, was significantly more expensive than 2007 (p = 0.02). The internal control group (five other departments of the university hospital) did not show an increase during the same period. AWTL were respected by 90, 96, and 98 % in 2009, 2010, and 2011, respectively. Of all shifts 10 h-dwt was exceeded by 7.4 % in 2009, 1.3 % in 2010, and 2.6 % in 2011, with significant differences between 2009 and both, 2010 and 2011 (p < 0.001), and between 2010 and 2011 (p = 0.02). Discussion: AWTL and 10 h-dwt could be continuously respected quite well after implementation of the new shift model without increasing the cost/earnings ratio for the first two years. However, in 2011 the ratio increased significantly (p = 0.02). PMID:24771928

Changes in Doctors' Working Hours: A Longitudinal Analysis.

PubMed

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

2015-10-01

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

42 CFR 66.102 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... level in a program leading to the award of a doctor of philosophy of science, or equivalent degree. For... individuals holding a doctor of philosophy, science, medicine, dentistry, osteopathy, optometry, podiatry...

42 CFR 66.102 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... level in a program leading to the award of a doctor of philosophy of science, or equivalent degree. For... individuals holding a doctor of philosophy, science, medicine, dentistry, osteopathy, optometry, podiatry...

42 CFR 66.102 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... level in a program leading to the award of a doctor of philosophy of science, or equivalent degree. For... individuals holding a doctor of philosophy, science, medicine, dentistry, osteopathy, optometry, podiatry...

A Comparison of Web-based and Small-Group Palliative and End-of-Life Care Curricula: A Quasi-Randomized Controlled Study at One Institution

PubMed Central

Day, Frank C.; Srinivasan, Malathi; Der-Martirosian, Claudia; Griffin, Erin; Hoffman, Jerome R.; Wilkes, Michael S.

2014-01-01

Purpose Few studies have compared the effect of web-based eLearning versus small-group learning on medical student outcomes. Palliative and end-of-life (PEOL) education is ideal for this comparison, given uneven access to PEOL experts and content nationally. Method In 2010, the authors enrolled all third-year medical students at the University of California, Davis School of Medicine into a quasi-randomized controlled trial of web-based interactive education (eDoctoring) compared to small-group education (Doctoring) on PEOL clinical content over two months. All students participated in three 3-hour PEOL sessions with similar content. Outcomes included a 24-item PEOL-specific self-efficacy scale with three domains (diagnosis/treatment [Cronbach’s alpha = 0.92, CI: 0.91–0.93], communication/prognosis [alpha = 0.95; CI: 0.93–0.96], and social impact/self-care [alpha = 0.91; CI: 0.88–0.92]); eight knowledge items; ten curricular advantage/disadvantages, and curricular satisfaction (both students and faculty). Results Students were randomly assigned to web-based eDoctoring (n = 48) or small-group Doctoring (n = 71) curricula. Self-efficacy and knowledge improved equivalently between groups: e.g., prognosis self-efficacy, 19%; knowledge, 10–42%. Student and faculty ratings of the web-based eDoctoring curriculum and the small group Doctoring curriculum were equivalent for most goals, and overall satisfaction was equivalent for each, with a trend towards decreased eDoctoring student satisfaction. Conclusions Findings showed equivalent gains in self-efficacy and knowledge between students participating in a web-based PEOL curriculum, in comparison to students learning similar content in a small-group format. Web-based curricula can standardize content presentation when local teaching expertise is limited, but may lead to decreased user satisfaction. PMID:25539518

[C.P. Thunberg and his voyage to Japan (4). Mercury water therapy for syphilis introduced into Japan by Thunberg].

PubMed

Takahashi, F

1994-01-01

During his 16-month stay in Japan from August 1775 to December 1776, Thunberg taught mercury water therapy to Japanese medical doctors and interpreters in order to help them treat syphilis, which was prevalent in Japan at that time. Kohgyu Yoshio, a Japanese-Dutch interpreter who was taught this therapy by Thunberg, recorded Thunberg's teaching in his "Kohmoh Hijiki." According to this book, the mercury water therapy that Thunberg introduced to Japan had been tested successfully by van Swieten, a Dutch doctor, about 20 years previously in Europe and used corrosive sublimate (mercuric chloride), the active ingredient, dissolved in distilled water with honey. The formula is described, in measurement units used in Europe at that time, in a letter addressed by van Swieten to a doctor in Rotterdam in 1755. The formula recorded in "Kohmoh Hijiki" in measurement units used in Japan at that time gives a content of the active ingredient equivalent to that mentioned in van Swieten's letter. This fact indicates that van Swieten's formula introduced by Thunberg was correctly accepted by Japanese doctors and interpreters, who had acquired basic medical knowledge since the publication of "Kaitai Shinsho" in 1774.

Paradigm Devolution: The Twilight of Traditional Doctoral Education

ERIC Educational Resources Information Center

Sonstrom, Wendy Jean

2009-01-01

In this reflection, the author proposes that doctoral education is currently undergoing paradigm devolution. Her perspective is that of a doctoral student, specifically a full-time graduate student working towards a Ph.D. in adult education. This fall semester marks her last of coursework, and she finds herself searching to make meaning of the…

Doctoral Enrolment and Graduation Patterns at Canadian Universities During the Seventies and Their Implications for the Eighties: A Statistical Documentation by Discipline.

ERIC Educational Resources Information Center

Belliveau, J.; And Others

Doctoral enrollment and graduation patterns at Canadian universities during the 1970s and projections for the 1980s are presented. Attention is directed to full-time and part-time doctoral enrollment by eight fields of study, and 26 disciplines are examined for the 10-year period of 1970-71 to 1979-80. Breakdowns by region and by selected…

42 CFR 60.50 - Which schools are eligible to be HEAL schools?

Code of Federal Regulations, 2011 CFR

2011-10-01

... of Chiropractic or equivalent degree Doctoral degree of Clinical Psychology Masters or doctoral... Education for Public Health. (I) Council on Chiropractic Education. (J) Accrediting Commission on Education...

42 CFR 60.50 - Which schools are eligible to be HEAL schools?

Code of Federal Regulations, 2013 CFR

2013-10-01

... of Chiropractic or equivalent degree Doctoral degree of Clinical Psychology Masters or doctoral... Education for Public Health. (I) Council on Chiropractic Education. (J) Accrediting Commission on Education...

42 CFR 60.50 - Which schools are eligible to be HEAL schools?

Code of Federal Regulations, 2014 CFR

2014-10-01

... of Chiropractic or equivalent degree Doctoral degree of Clinical Psychology Masters or doctoral... Education for Public Health. (I) Council on Chiropractic Education. (J) Accrediting Commission on Education...

42 CFR 60.50 - Which schools are eligible to be HEAL schools?

Code of Federal Regulations, 2012 CFR

2012-10-01

... of Chiropractic or equivalent degree Doctoral degree of Clinical Psychology Masters or doctoral... Education for Public Health. (I) Council on Chiropractic Education. (J) Accrediting Commission on Education...

42 CFR 57.1502 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... medicine, dentistry, osteopathy, pharmacy, optometry, podiatry, veterinary medicine, or public health which... equivalent degree, doctor of podiatry or an equivalent degree, bachelor of science in pharmacy or an...

42 CFR 57.1502 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... medicine, dentistry, osteopathy, pharmacy, optometry, podiatry, veterinary medicine, or public health which... equivalent degree, doctor of podiatry or an equivalent degree, bachelor of science in pharmacy or an...

42 CFR 57.1502 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... medicine, dentistry, osteopathy, pharmacy, optometry, podiatry, veterinary medicine, or public health which... equivalent degree, doctor of podiatry or an equivalent degree, bachelor of science in pharmacy or an...

42 CFR 57.1502 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... medicine, dentistry, osteopathy, pharmacy, optometry, podiatry, veterinary medicine, or public health which... equivalent degree, doctor of podiatry or an equivalent degree, bachelor of science in pharmacy or an...

Nonlinear Representation and Pulse Testing of Communication Subsystems.

DTIC Science & Technology

1982-05-01

The Post-Doctoral Program provides an opportunity for faculty at participating universities to spend up to one year full time on explora- tory...development and problem-solving efforts with the post-doctorals splitting their time between the customer location and their educational institutions. The...CHAPTER II z-DOMAIN CHARACTERIZATION OF THE QUJADRATIC VOLTERRA SYSTEM................3 2.1 Continuous- Time Analysis .................. 3 Rational

Women doctors in Norway: the challenging balance between career and family life.

PubMed

Gjerberg, Elisabeth

2003-10-01

In most Western countries, women doctors are still underrepresented in the higher positions in the medical hierarchy and in the most prestigious specialities. A crucial question is whether family responsibilities affect female and male career differently. The article examines how Norwegian physicians balance their work and family responsibilities and demonstrates differences in the way doctors combine work and family obligations, between women and compared with men. Among women doctors, the probability of becoming a specialist decreased with an increasing number of children. Moreover, postponing the birth of the first child increased the probability of completing hospital specialities. Although more women than men work part-time, this was the case only for a small proportion of women doctors. Transition from full-time to part-time work is primarily an accommodating strategy to family responsibilities, however strongly influenced by variations in the opportunity structure of different specialities. The findings further demonstrate that being married to another doctor had a positive impact on the career, especially for women doctors.

Junior hospital doctors' views on their training in the UK.

PubMed Central

Panayiotou, B. N.; Fotherby, M. D.

1996-01-01

To ascertain the views of senior house officers and registrars on the educational and training component of their posts, a questionnaire was sent to all full-time doctors working in training posts in general and/or geriatric medicine at three district general and three teaching hospitals. Completed questionnaires were received from 64 (61%) of 105 doctors who were contacted. Most had a careers counsellor or tutor, although less than two-thirds thought they had benefited from this arrangement. The majority of doctors attended at least two medical tutorials or meetings per week; most wanted to attend more but were unable to because of other work commitments. Supervision by more senior staff on the ward was deemed by most to be satisfactory, but less so in out-patient clinics. Overall, one-third of doctors thought that training was inadequate and three-quarters wanted a greater amount of formal education. The majority of junior doctors' time was spent on routine work and most considered :training' constituted less than 10% of their working time. Doctors in training require more sessions designated as educational, with protected time to attend these. PMID:8949591

DOD Civilian and Contractor Workforces: Additional Cost Savings Data and Efficiencies Plan are Needed

DTIC Science & Technology

2016-10-01

reductions reported in average strength bNumber of reductions reported in full-time equivalents Note: DOD costs savings provided for the prior FY are...comparing costs from FY 2012 to FY 2017, and not each year in between. Further, officials stated that DOD did not include full- time equivalents ...Application FTE Full-time Equivalent NDAA National Defense Authorization Act This is a work of the U.S. government and is not subject to copyright

Paying the Piper: The Costs and Consequences of Academic Advancement

ERIC Educational Resources Information Center

Casey, Ashley; Fletcher, Tim

2017-01-01

In many professions there are qualifications to gain and professional standards to achieve. Lawyers pass the bar and doctors pass their boards. In academic life the equivalent is a doctorate, closely followed by a profile of peer-reviewed publication. To hold a doctoral degree is the common requirement to become "academic" but does it…

An economic-research-based approach to calculate community health-staffing requirements in Xicheng District, Beijing.

PubMed

Yin, Delu; Yin, Tao; Yang, Huiming; Xin, Qianqian; Wang, Lihong; Li, Ninyan; Ding, Xiaoyan; Chen, Bowen

2016-12-07

A shortage of community health professionals has been a crucial issue hindering the development of CHS. Various methods have been established to calculate health workforce requirements. This study aimed to use an economic-research-based approach to calculate the number of community health professionals required to provide community health services in the Xicheng District of Beijing and then assess current staffing levels against this ideal. Using questionnaires, we collected relevant data from 14 community health centers in the Xicheng District, including resident population, number of different health services provided, and service volumes. Through 36 interviews with family doctors, nurses, and public health workers, and six focus groups, we were able to calculate the person-time (equivalent value) required for each community health service. Field observations were conducted to verify the duration. In the 14 community health centers in Xicheng District, 1752 health workers were found in our four categories, serving a population of 1.278 million. Total demand for the community health service outstripped supply for doctors, nurses, and public health workers, but not other professionals. The method suggested that to properly serve the study population an additional 64 family doctors, 40 nurses, and 753 public health workers would be required. Our calculations indicate that significant numbers of new health professionals are required to deliver community health services. We established time standards in minutes (equivalent value) for each community health service activity, which could be applied elsewhere in China by government planners and civil society advocates.

Professional attitudes toward incident reporting: can we measure and compare improvements in patient safety culture?

PubMed

Tricarico, Pierfrancesco; Castriotta, Luigi; Battistella, Claudio; Bellomo, Fabrizio; Cattani, Giovanni; Grillone, Lucrezia; Degan, Stefania; De Corti, Daniela; Brusaferro, Silvio

2017-04-01

To establish categories of professionals' attitudes toward incident reporting by analyzing the trends in incident reporting while accounting for general risk indicators. The incident reporting system was evaluated over 6 years. Reporting rates, stratified by year and profession, were estimated using the non-mandatory reported events/full-time equivalent (NM-IR/FTE) rate. Other indicators were collected using the hospital's official database. Staff attitudes toward self-reporting were analyzed. Univariate and multivariable analyses were performed. A 1000-bed Italian academic hospital. Staff of the hospital (over 3200 professionals). None. NM-IT/FTE rates, self-reported rates, patient complaints/praises, work accidents among professionals and 30-day readmissions. The overall reporting rate was 0.44 (95% confidence interval [CI]: 0.42-0.46) among doctors and 0.40 (95% CI: 0.39-0.41) among nurses. Between 2010 and 2015, only the doctors' reporting rate increased significantly (P = 0.04), from 0.29 (95% CI: 0.25-0.34) to 0.67 (95% CI: 0.60-0.73). Patient complaints decreased from 384 to 224 (P < 0.001) and work accidents decreased from 296 to 235 (P = 0.01), while other indicators remained constant. Multivariable logistic regression showed that self-reporting was more likely among nurses than doctors (odds ratio: 1.51; 95% CI: 1.31-1.73) and for severe events than near misses (odds ratio: 1.78; 95% CI: 1.11-2.87). Because the doctors' reporting rates increased during the study period, doctors may be more likely to report adverse events than nurses, although nurses reported more events. Incident reporting trends and other routinely collected risk indicators may be useful to improve our understanding and measurement of patient safety issues. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Music Therapy: A Career in Music Therapy

MedlinePlus

... combination with doctoral study in related areas. Degree Equivalent Training in Music Therapy P ersonal qualifications include ... the student completes only the coursework necessary for equivalent music therapy training without necessarily earning a second ...

[Present status of Japanese neurologists from the questionnaire survey - to support women doctor's career advancement].

PubMed

Fukaura, Hikoaki

2013-01-01

Childcare issue and family care issue are critical factors for women doctors to make a career as a neurologist in Japan. To know the actual business conditions of Japanese neurologists an online questioner survey was conducted. Answers were obtained from 737 members of Japanese Society of Neurology and 21 neurological medical facilities. Most of the answers were form members at three major metropolitan areas such as Tokyo, Osaka and Nagoya. Nobody from some prefectures was replied any answer. Almost sixty percent woman doctors had to change their working style from full time to part time at their child raising period and had difficulty with returning to full time job. Some neurologists have answered they used paid vacation to care their families and they felt they could not keep it for a longer period. At 70 percent of medical facilities sick child day care center were not operated. Opinions form members extremely varied from "In the first place woman doctors are unnecessary"to "With the help of the partner I have survived my child raising period".

Can Low-Cost Support Programmes with Coaching Accelerate Doctoral Completion in Health Science Faculty Academics?

ERIC Educational Resources Information Center

Geber, Hilary; Bentley, Alison

2012-01-01

Career development for full-time Health Sciences academics through to doctoral studies is a monumental task. Many academics have difficulty completing their studies in the minimum time as well as publishing after obtaining their degree. As this problem is particularly acute in the Health Sciences, the PhD Acceleration Programme in Health Sciences…

Accounting for psychotropic medication changes in prisons: patient and doctor perspectives.

PubMed

Hassan, Lamiece; Edge, Dawn; Senior, Jane; Shaw, Jenny

2015-07-01

Psychotropic medicines are widely used to treat mental illness; however, people entering prison commonly report that prescribed psychotropic medicines are changed or withdrawn, adding to their distress in difficult times. Drawing on three extracts from a larger qualitative dataset in which patients and doctors were interviewed about psychotropic medication use in English prisons, we combined discursive psychological and Foucauldian discourse analysis techniques to examine how individuals accounted for medication changes. Patients used four discursive strategies to organize descriptions of medication changes: they established entitlement to psychotropic medication, questioned the clinical judgment of prison doctors; highlighted communication problems; and attributed negative health outcomes to medication regime changes. In contrast, we examined an effective defense by a general practitioner, which showed how clinical needs were prioritized over previously held prescriptions when making prescribing decisions. Wider implications for continuity and equivalence of care between prisons and the wider community are discussed. © The Author(s) 2014.

Adapting to the Job Market: Graduate Programs in Speech Communication.

ERIC Educational Resources Information Center

Berg, David M.

The percentage of speech communication doctoral graduates employed full time and the percentage working in academic institutions have declined considerably since 1968. The glut of humanities doctorates appears to present three courses of action: increase undergraduate enrollments, decrease graduate enrollments, or increase nonacademic employment…

Fine-Tuning Neural Patient Question Retrieval Model with Generative Adversarial Networks.

PubMed

Tang, Guoyu; Ni, Yuan; Wang, Keqiang; Yong, Qin

2018-01-01

The online patient question and answering (Q&A) system attracts an increasing amount of users in China. Patient will post their questions and wait for doctors' response. To avoid the lag time involved with the waiting and to reduce the workload on the doctors, a better method is to automatically retrieve the semantically equivalent question from the archive. We present a Generative Adversarial Networks (GAN) based approach to automatically retrieve patient question. We apply supervised deep learning based approaches to determine the similarity between patient questions. Then a GAN framework is used to fine-tune the pre-trained deep learning models. The experiment results show that fine-tuning by GAN can improve the performance.

"The Prognosis, Doctor?"

ERIC Educational Resources Information Center

Everhart, Nancy

1998-01-01

Updates a 1994 report on school library staffing, highlighting states with the best and worst student/librarian ratios, states requiring full-time certified library media specialists, states with site-based management, states replacing librarians with technology specialists. Lists states requiring full-time specialists for elementary,…

Chief, Structural Biophysics Laboratory | Center for Cancer Research

Cancer.gov

The SBL Chief is expected to establish a strong research program in structural biology/biophysics in addition to providing leadership of the SBL and the structural biology community in the NCI Intramural Program.  Applicants should hold a Ph.D., M.D./Ph.D., or equivalent doctoral degree in a relevant discipline, and should possess outstanding communication skills and documented leadership experience.  Tenured faculty or industrial scientists of equivalent rank with a demonstrated commitment to structural biophysics should apply.  Salary will be commensurate with experience and accomplishments.  This position is not restricted to U.S. citizens. A full civil service package of benefits (including health insurance, life insurance, and retirement) is available. This position is subject to a background investigation.  The NIH is dedicated to building a diverse community in its training and employment programs.

“Patient-Time,” “Doctor-Time,” and “Institution-Time”: Perceptions and Definitions of Time Among Doctors Who Become Patients

PubMed Central

Klitzman, Robert

2010-01-01

Objective To examine views and experiences of conflicts concerning time in healthcare, from the perspective of physicians who have become patients. Methods We conducted two in-depth semi-structured two-hour interviews concerning experiences of being health care workers, and becoming a patient, with each of 50 doctors who had serious illnesses. Results These doctor-patients often came to realize as they had not before how patients experience time differently, and how “patient-time,” “doctor-time,” and “institution-time” exist and can conflict. Differences arose in both long and short term, regarding historical time (prior eras/decades in medicine), prognosis (months/years), scheduling delays (days/weeks), daily medical events and tasks (hours), and periods in waiting rooms (minutes/hours). Definitions of periods of time (e.g., “fast,” “slow,” “plenty,” and “soon”) also varied widely, and could clash. Professional socialization had heretofore impeded awareness of these differences. Physicians tried to address these conflicts in several ways (e.g., trying to provide test results promptly), though full resolution remained difficult. Conclusions Doctors who became patients often now realized how physicians and patients differ in subjective experiences of time. Medical education and research have not adequately considered these issues, which can affect patient satisfaction, doctor-patient relationships and communication, and care. Practice Implications Physicians need to be more sensitive to how their definitions, perceptions, and experiences concerning time can differ from those of patients. PMID:17125956

Assessing the Progress and the Underlying Nature of the Flows of Doctoral and Master Degree Candidates Using Absorbing Markov Chains

ERIC Educational Resources Information Center

Nicholls, Miles G.

2007-01-01

In this paper, absorbing markov chains are used to analyse the flows of higher degree by research candidates (doctoral and master) within an Australian faculty of business. The candidates are analysed according to whether they are full time or part time. The need for such analysis stemmed from what appeared to be a rather poor completion rate (as…

Do medical doctors respond to economic incentives?

PubMed

Andreassen, Leif; Di Tommaso, Maria Laura; Strøm, Steinar

2013-03-01

A longitudinal analysis of married physicians labor supply is carried out on Norwegian data from 1997 to 1999. The model utilized for estimation implies that physicians can choose among 10 different job packages which are a combination of part time/full time, hospital/primary care, private/public sector, and not working. Their current choice is influenced by past available options due to a habit persistence parameter in the utility function. In the estimation we take into account the budget constraint, including all features of the tax system. Our results imply that an overall wage increase or less progressive taxation moves married physicians toward full time job packages, in particular to full time jobs in the private sector. But the overall and aggregate labor supply elasticities in the population of employed doctors are rather low compared to previous estimates. Copyright © 2012 Elsevier B.V. All rights reserved.

34 CFR 607.4 - What are low educational and general expenditures?

Code of Federal Regulations, 2010 CFR

2010-07-01

... general expenditures per full-time equivalent undergraduate student in the base year must be less than the average educational and general expenditures per full-time equivalent undergraduate student of comparable... student for institutions with graduate students that do not differentiate between graduate and...

[Physicians' tasks in the Occupational Health Services].

PubMed

von Bülow, B A

1995-03-06

The aim of this study was to describe the kind of present and future tasks doctors employed in the Occupational Health Service (OHS) in Denmark carried out and to shed light on the reasons why only a moderate number of doctors are employed in the OHS. Additional aims were to map out the number of engaged part-time and full-time doctors in the OHS in Denmark compared with the number of other professionals engaged in the OHS. The study was based on questionnaires sent out to all 109 OHS units in Denmark and to all the doctors employed in the OHS. Ten persons in the OHS were strategically selected for an open interview. There were still only a very few doctors (9%) employed in the OHS in comparison to the other professionals employed in OHS, (nurses, various therapists and technicians) and the doctors were mostly engaged part-time; most of them for less than 10 hours a week. The moderate number of doctors was amongst other things explained by the relatively high cost of the doctors' salaries and the doctors having a reputation for being arrogant and dominating. The doctors were in general very experienced in occupational health matters and solved many problems which required a doctors education. A great deal of the problems they solved were in finding the causality between the workers' symptoms and the working-place conditions. The doctors suggested several future tasks for OHS, e.g. to evaluate its preventive results and to participate in a higher degree when planning working environments.

The European Working Time Directive: a practical review for surgical trainees.

PubMed

Fitzgerald, J E F; Caesar, B C

2012-01-01

The European Working Time Directive (EWTD) 2003/88/EC is a Union Directive laying down minimum health and safety requirements for the organisation of working time. Originally primarily intended as labour law, its progressive introduction up to full implementation for doctors-in-training in August 2009 has substantially reduced duty-hours and caused widespread concern in surgery. Detrimental effects on the continuity of patient care, reduced availability of medical staff with associated rota difficulties, and the reduction in time for training junior doctors have been widely cited. Craft-specialities such as surgery and those providing an acute service have faced particular challenges. This review offers a practical guide for surgical trainees, explaining the European regulations in the context of current terms and conditions of doctor's employment in the UK. Information is provided on protecting training, opting-out, seeking remuneration for this, and ensuring doctors and patients are protected with appropriate medical indemnity cover in place. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Factors associated with less-than-full-time working in medical practice: results of surveys of five cohorts of UK doctors, 10 years after graduation.

PubMed

Lachish, Shelly; Svirko, Elena; Goldacre, Michael J; Lambert, Trevor

2016-10-13

The greater participation of women in medicine in recent years, and recent trends showing that doctors of both sexes work fewer hours than in the past, present challenges for medical workforce planning. In this study, we provide a detailed analysis of the characteristics of doctors who choose to work less-than-full-time (LTFT). We aimed to determine the influence of these characteristics on the probability of working LTFT. We used data on working patterns obtained from long-term surveys of 10,866 UK-trained doctors. We analysed working patterns at 10 years post-graduation for doctors of five graduating cohorts, 1993, 1996, 1999, 2000 and 2002 (i.e. in the years 2003, 2006, 2009, 2010 and 2012, respectively). We used multivariable binary logistic regression models to examine the influence of a number of personal and professional characteristics on the likelihood of working LTFT in male and female doctors. Across all cohorts, 42 % of women and 7 % of men worked LTFT. For female doctors, having children significantly increased the likelihood of working LTFT, with greater effects observed for greater numbers of children and for female doctors in non-primary care specialties (non-GPs). While >40 % of female GPs with children worked LTFT, only 10 % of female surgeons with children did so. Conversely, the presence of children had no effect on male working patterns. Living with a partner increased the odds of LTFT working in women doctors, but decreased the odds of LTFT working in men (independently of children). Women without children were no more likely to work LTFT than were men (with or without children). For both women and men, the highest rates of LTFT working were observed among GPs (~10 and 6 times greater than non-GPs, respectively), and among those not in training or senior positions. Family circumstances (children and partner status) affect the working patterns of women and men differently, but both sexes respond similarly to the constraints of their clinical specialty and seniority. Thus, although women doctors comprise the bulk of LTFT workers, gender is just one of several determinants of doctors' working patterns, and wanting to work LTFT is evidently not solely an issue for working mothers.

Narcotic Use and Postoperative Doctor Shopping in the Orthopaedic Trauma Population.

PubMed

Morris, Brent J; Zumsteg, Justin W; Archer, Kristin R; Cash, Brian; Mir, Hassan R

2014-08-06

The negative consequences of narcotic use and diversion for nonmedical use are on the rise. A growing number of narcotic abusers obtain narcotic prescriptions from multiple providers ("doctor shopping"). This study sought to determine the effects of multiple postoperative narcotic providers on the number of narcotic prescriptions, duration of narcotics, and morphine equivalent dose per day in the orthopaedic trauma population. Our prospective cohort study used the state-controlled substance monitoring database to identify all narcotic prescriptions filled three months prior to admission and six months following discharge for enrolled patients. Patients were assigned into two groups: a single narcotic provider group with prescriptions only from the treating surgeon (or extenders) or a multiple narcotic provider group with prescriptions from both the treating surgeon and an additional provider or providers. Complete data were available for 130 of 151 eligible patients. Preoperative narcotic use, defined by three or more narcotic prescriptions within three months of admission, was noted in 8.5% of patients. Overall, 20.8% of patients sought multiple narcotic providers postoperatively. There were significant increases in postoperative narcotic prescriptions (p < 0.001) between the single narcotic provider group (two prescriptions) and the multiple narcotic provider group (seven prescriptions), in duration of postoperative narcotic use (p < 0.001) between the single narcotic provider group (twenty-eight days) and the multiple narcotic provider group (110 days), and in morphine equivalent dose per day (p = 0.002) between the single narcotic provider group (26 mg) and the multiple narcotic provider group (43 mg). Patients with a high school education or less were 3.2 times more likely to seek multiple providers (p = 0.02), and patients with a history of preoperative narcotic use were 4.5 times more likely to seek multiple providers (p < 0.001). There is a 20.8% prevalence of postoperative doctor shopping in the orthopaedic trauma population. Patients with multiple postoperative narcotic providers had a significant increase in postoperative narcotic prescriptions, duration of narcotics, and morphine equivalent dose per day. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Doctor Shopping Behavior and the Diversion of Prescription Opioids.

PubMed

Simeone, Ronald

2017-01-01

"Doctor shopping" as a means of prescription opioid diversion is examined. The number and percentage of prescriptions and morphine-equivalent milligrams diverted in this manner are estimated by state and molecule for the period 2008-2012. Eleven billion prescriptions with unique patient, doctor, and pharmacy identifiers were used to construct diversion "events" that involved between 1 and 6 unique doctors and between 1 and 6 unique pharmacies. Diversion thresholds were established based on the probability of each contingency. A geographically widespread decline occurred between 2008 and 2012. The number of prescriptions diverted fell from approximately 4.30 million (1.75% of all prescriptions) in 2008 to approximately 3.37 million (1.27% of all prescriptions) in 2012, and the number of morphine-equivalent milligrams fell from approximately 6.55 metric tons (2.95% of total metric tons) in 2008 to approximately 4.87 metric tons (2.19% of total metric tons) in 2012. Diversion control efforts have likely been effective. But given increases in opioid-related deaths, opioid-related drug treatment admissions, and the more specific resurgence of heroin-related events, it is clear that additional public health measures are required.

42 CFR 136.302 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... he or she lives on or near a reservation, is a member of a tribe, band or other organized group... degree of doctor of osteopathy, a degree of bachelor of science in pharmacy or an equivalent degree, a... degree of bachelor of arts, bachelor of science, bachelor of nursing, or to an equivalent degree, or to a...

42 CFR 136.302 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... he or she lives on or near a reservation, is a member of a tribe, band or other organized group... degree of doctor of osteopathy, a degree of bachelor of science in pharmacy or an equivalent degree, a... degree of bachelor of arts, bachelor of science, bachelor of nursing, or to an equivalent degree, or to a...

42 CFR 136.302 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... he or she lives on or near a reservation, is a member of a tribe, band or other organized group... degree of doctor of osteopathy, a degree of bachelor of science in pharmacy or an equivalent degree, a... degree of bachelor of arts, bachelor of science, bachelor of nursing, or to an equivalent degree, or to a...

42 CFR 136.302 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... he or she lives on or near a reservation, is a member of a tribe, band or other organized group... degree of doctor of osteopathy, a degree of bachelor of science in pharmacy or an equivalent degree, a... degree of bachelor of arts, bachelor of science, bachelor of nursing, or to an equivalent degree, or to a...

Hospital doctors' career structure and misuse of medical womanpower.

PubMed

Bewley, B R; Bewley, T H

1975-08-09

Biological and culturel differences between men and women lead to severe discrimination against women doctors who bear the burdens of pregnancy, child-rearing, and housework. These lead, from equality within medical school and at qualification, to increasing failure to obtain posts commensurate with their innate abilities. Women doctors who temporarily and partially drop out of full-time practice have been studied frequently, but men (who are equally expensive to train) have not, despite their disappearing from National Health Service practice through emigration, death, alcoholism, suicide, or removal from the Medical Register. In a working lifetime of forty years, a woman doctor with an average family is likely to do seven-eighths of the work of a doctor who has not had to carry the primary responsibility of bearing and rearing children. Doctors with dependants are handicapped, and a separate career structure might be set up for them. Supernumerary consultant posts are proposed.

The Construction of Professional Identity and Pathways of Participation of Full Time Faculty Members in University Restructuring in Mexico

ERIC Educational Resources Information Center

Montero Hernandez, Virginia

2010-01-01

Since the 1990s, the federal government required public state universities in Mexico to recruit full time faculty members with doctoral degrees and research productivity to increase the academic competitiveness of higher education. After two decades of the implementation of federal mandates, public state universities have not improved their…

Minorities in Higher Education: A Pipeline Problem?

ERIC Educational Resources Information Center

Sethna, Beheruz N.

2011-01-01

This paper uses national data from the American Council on Education (ACE) to study the progress of different ethnic groups through the academic pipeline--stages studied include the Bachelor's, Master's, doctoral, levels, and then progress to the Assistant, Associate, and (full) Professor stages, to full-time administrators and finally to the CEO…

Contribution of physician assistants/associates to secondary care: a systematic review.

PubMed

Halter, Mary; Wheeler, Carly; Pelone, Ferruccio; Gage, Heather; de Lusignan, Simon; Parle, Jim; Grant, Robert; Gabe, Jonathan; Nice, Laura; Drennan, Vari M

2018-06-19

To appraise and synthesise research on the impact of physician assistants/associates (PA) in secondary care, specifically acute internal medicine, care of the elderly, emergency medicine, trauma and orthopaedics, and mental health. Systematic review. Electronic databases (Medline, Embase, ASSIA, CINAHL, SCOPUS, PsycINFO, Social Policy and Practice, EconLit and Cochrane), reference lists and related articles. Peer-reviewed articles of any study design, published in English, 1995-2017. Blinded parallel processes were used to screen abstracts and full text, data extractions and quality assessments against published guidelines. A narrative synthesis was undertaken. Impact on: patients' experiences and outcomes, service organisation, working practices, other professional groups and costs. 5472 references were identified and 161 read in full; 16 were included-emergency medicine (7), trauma and orthopaedics (6), acute internal medicine (2), mental health (1) and care of the elderly (0). All studies were observational, with variable methodological quality. In emergency medicine and in trauma and orthopaedics, when PAs are added to teams, reduced waiting and process times, lower charges, equivalent readmission rate and good acceptability to staff and patients are reported. Analgesia prescribing, operative complications and mortality outcomes were variable. In internal medicine outcomes of care provided by PAs and doctors were equivalent. PAs have been deployed to increase the capacity of a team, enabling gains in waiting time, throughput, continuity and medical cover. When PAs were compared with medical staff, reassuringly there was little or no negative effect on health outcomes or cost. The difficulty of attributing cause and effect in complex systems where work is organised in teams is highlighted. Further rigorous evaluation is required to address the complexity of the PA role, reporting on more than one setting, and including comparison between PAs and roles for which they are substituting. CRD42016032895. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Qualitative research about euthanasia concept, between Spanish doctors].

PubMed

Cuervo Pinna, M Á; Rubio, M; Altisent Trota, R; Rocafort Gil, J; Gómez Sancho, M

2016-01-01

The decriminalisation of euthanasia and assisted medical suicide has generated a continuous debate. The terminological confusion is one of the main difficulties in obtaining medical practice consensus. The objective of this study was to determine whether the terms of Euthanasia and physician assisted suicide are used with the same meaning by doctors in Extremadura (Spain). A qualitative study was conducted using two focus groups in which doctors from different specialties who attended a large number of terminal patients participated. No other focus group was required due to saturation. The sessions were tape recorded and transcribed by two experts in qualitative methodology. Atlas.ti software was used for the analysis. We were advised by the "Health Care at the end of life" Group of the Organizacion Médica Colegial of Spain. Terminological confusion was verified in: 1) The mixture of etymological, functional and social concepts, 2) the term Passive Euthanasia, 3) the association between euthanasia and physician assisted suicide, 4) the confusion with the equivalent "wish to hasten death", and 5) the difficulty of differentiating sedation with Euthanasia. There was consensus on some aspects: a) Full voluntariness, b) the condition of terminal illness, and c) the condition of unbearable symptoms. Conceptual variability persists in relation to the concept of Euthanasia, and is particularly noticeable in the persistence of the concept of passive euthanasia. It would be desirable to achieve a common language to assign a precise meaning to these words to help doctors in their professional practice. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

Current trends in treatment of obesity in Karachi and possibilities of cost minimization.

PubMed

Hussain, Mirza Izhar; Naqvi, Baqir Shyum

2015-03-01

Our study finds out drug usage trends in over weight and obese patients without any compelling indications in Karachi, looks for deviations of current practices from evidence based antihypertensive therapeutic guidelines and identifies not only cost minimization opportunities but also communication strategies to improve patients' awareness and compliance to achieve therapeutic goal. In present study two sets were used. Randomized stratified independent surveys were conducted in hospital doctors and family physicians (general practitioners), using pretested questionnaires. Sample size was 100. Statistical analysis was conducted on Statistical Package for Social Science (SPSS). Opportunities of cost minimization were also analyzed. One the basis of doctors' feedback, preference is given to non-pharmacologic management of obesity. Mass media campaign and media usage were recommended to increase patients awareness and patients' education along with strengthening family support systems was recommended for better compliance of the patients to doctor's advice. Local therapeutic guidelines for weight reduction were not found. Feedbacks showed that global therapeutic guidelines were followed by the doctors practicing in the community and hospitals in Karachi. However, high price branded drugs were used instead of low priced generic therapeutic equivalents. Patient's education is required for better awareness and improving patients' compliance. The doctors found preferring brand leaders instead of low cost options. This trend increases cost of therapy by 0.59 to 4.17 times. Therefore, there are great opportunities for cost minimization by using evidence-based clinically effective and safe medicines.

Sex differences in medico-legal action against doctors: a systematic review and meta-analysis.

PubMed

Unwin, Emily; Woolf, Katherine; Wadlow, Clare; Potts, Henry W W; Dacre, Jane

2015-08-13

The relationship between male sex and poor performance in doctors remains unclear, with high profile studies showing conflicting results. Nevertheless, it is an important first step towards understanding the causes of poor performance in doctors. This article aims to establish the robustness of the association between male sex and poor performance in doctors, internationally and over time. The electronic databases MEDLINE, EMBASE, and PsycINFO were searched from inception to January 2015. Backward and forward citation searching was performed. Journals that yielded the majority of the eligible articles and journals in the medical education field were electronically searched, along with the conference and poster abstracts from two of the largest international medical education conferences. Studies reporting original data, written in English or French, examining the association between sex and medico-legal action against doctors were included. Two reviewers independently extracted study characteristics and outcome data from the full texts of the studies meeting the eligibility criteria. Study quality was assessed using the Newcastle-Ottawa scale. A random effect meta-analysis model was used to summarize and assess the effect of doctors' sex on medico-legal action. Extracted outcomes included disciplinary action by a medical regulatory board, malpractice experience, referral to a medical regulatory body, complaints received by a healthcare complaints body, criminal cases, and medico-legal matter with a medical defence organisation. Overall, 32 reports examining the association between doctors' sex and medico-legal action were included in the systematic review (n=4,054,551), of which 27 found that male doctors were more likely to have experienced medico-legal action. 19 reports were included in the meta-analysis (n=3,794,486, including 20,666 cases). Results showed male doctors had nearly two and a half times the odds of being subject to medico-legal action than female doctors. Heterogeneity was present in all meta-analyses. Male doctors are more likely to have had experienced medico-legal actions compared to female doctors. This finding is robust internationally, across outcomes of varying severity, and over time.

Effectiveness of a smartphone app on improving immunization of children in rural Sichuan Province, China: a cluster randomized controlled trial.

PubMed

Chen, Li; Du, Xiaozhen; Zhang, Lin; van Velthoven, Michelle Helena; Wu, Qiong; Yang, Ruikan; Cao, Ying; Wang, Wei; Xie, Lihui; Rao, Xiuqin; Zhang, Yanfeng; Koepsell, Jeanne Catherine

2016-08-31

The aim of this study was to assess the effectiveness of an EPI smartphone application (EPI app) on improving vaccination coverage in rural Sichuan Province, China. This matched-pair cluster randomized controlled study included 32 village doctors, matched in 16 pairs, and took place from 2013 to 2015. Village doctors in the intervention group used the EPI app and reminder text messages while village doctors in the control group used their usual procedures and text messages. The primary outcome was full vaccination coverage with all five vaccines (1 dose of BCG, 3 doses of hepatitis B, 3 doses of OPV, 3 doses of DPT and 1 dose of measles vaccine), and the secondary outcome was coverage with each dose of the five individual vaccines. We also conducted qualitative interviews with village doctors to understand perceptions on using the EPI app and how this changed their vaccination work. The full vaccination coverage increased statistically significant from baseline to end-line in both the intervention (67 % [95 % CI:58-75 %] to 84 % [95 % CI:76-90 %], P = 0.028) and control group (71 % [95 % CI:62-79 %] to 82 % [95 % CI:74-88 %], P = 0.014). The intervention group had higher increase in full vaccination coverage from baseline to end-line compared to the control group (17 % vs 10 %), but this was not statistically significant (P = 0.164). Village doctors found it more convenient to use the EPI app to manage child vaccination and also reported saving time by looking up information of caregivers and contacting caregivers for overdue vaccinations quicker. However, village doctors found it hard to manage children who migrated out of the counties. This study showed that an app and text messages can be used by village doctors to improve full vaccination coverage, though no significant increase in vaccination coverage was found when assessing the effect of the app on its own. Village doctors using EPI app reported having improved their working efficiency of managing childhood vaccination. Future studies should be conducted to evaluate the impact of more integrated approach of mHealth intervention on child immunization. Chinese Clinical Trials Registry (ChiCTR): ChiCTR-TRC- 13003960 , registered on December 6, 2013.

Primary medical care in Irish prisons.

PubMed

Barry, Joe M; Darker, Catherine D; Thomas, David E; Allwright, Shane P A; O'Dowd, Tom

2010-03-22

An industrial dispute between prison doctors and the Irish Prison Service (IPS) took place in 2004. Part of the resolution of that dispute was that an independent review of prison medical and support services be carried out by a University Department of Primary Care. The review took place in 2008 and we report here on the principal findings of that review. This study utilised a mixed methods approach. An independent expert medical evaluator (one of the authors, DT) inspected the medical facilities, equipment and relevant custodial areas in eleven of the fourteen prisons within the IPS. Semistructured interviews took place with personnel who had operational responsibility for delivery of prison medical care. Prison doctors completed a questionnaire to elicit issues such as allocation of clinician's time, nurse and administrative support and resources available. There was wide variation in the standard of medical facilities and infrastructure provided across the IPS. The range of medical equipment available was generally below that of the equivalent general practice scheme in the community. There is inequality within the system with regard to the ratio of doctor-contracted time relative to the size of the prison population. There is limited administrative support, with the majority of prisons not having a medical secretary. There are few psychiatric or counselling sessions available. People in prison have a wide range of medical care needs and there is evidence to suggest that these needs are being met inconsistently in Irish prisons.

7 CFR 3431.9 - Eligibility to apply.

Code of Federal Regulations, 2011 CFR

2011-01-01

... applicant must: (1) Have a degree of Doctor of Veterinary Medicine (DVM), or the equivalent, from a college...; and (4) Provide certifications and verifications in accordance with § 3431.16. (b) Non-eligibility...

A Paradigm Shift From Brick and Mortar: Full-Time Nursing Faculty Off Campus.

PubMed

Beck, Marlene; Bradley, Holly B; Cook, Linda L; Leasca, Joslin B; Lampley, Tammy; Gatti-Petito, JoAnne

The organizational structure for the Master of Science in Nursing's online program at Sacred Heart University offers a remarkably different innovative faculty model. Full-time, doctorally prepared faculty reside in several different states and teach online but are fully integrated and immersed in all aspects of the college of nursing. This untraditional model, which has proven to be successful over time using best practices for online education, is replicable and offers an innovative option for online learning.

Human resources in health research institutions in sub-Saharan African countries: results of a questionnaire-based survey.

PubMed

Kebede, Derege; Zielinski, Chris; Mbondji, Peter Ebongue; Sanou, Issa; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson

2014-05-01

To describe human capacity and staff movement in national health research institutions in 42 sub-Saharan African countries. A structured questionnaire was used to solicit information on governance and stewardship from health research institutions. Eight hundred and forty-seven health research institutions in 42 sub-Saharan African countries. Key informants from 847 health research institutions. The availability, mix and quality of human resources in health research institutions. On average, there were 122 females employed per respondent health research institution, compared with 159 males. For researchers, the equivalent figures were nine females to 17 males. The average annual gross salary of researchers varied between US$ 12,260 for staff with 5-10 years of experience and US$ 14,772 for the institution head. Of those researchers who had joined the institution in the previous 12 months, 55% were employed on a full-time basis. Of the researchers who left the institutions in the same period, 71% had a full-time contract. Among all those who left, those who left to a non-research sector and to another country accounted for two-thirds. The study revealed significant gaps in the area of human capacity development for research in Africa. The results showed a serious shortage of qualified staff engaged in health research, with a dearth of staff that held at least a master's degree or doctoral degree. Major efforts will be required to strengthen human resource capacity, including addressing the lack of motivation or time for research on the part of existing capable staff. © The Royal Society of Medicine.

What factors are affecting physician payment by acute care hospitals in rural Japan?

PubMed

Yamauchi, Kazushi; Funada, Takao; Shimizu, Hiroshi; Kawahara, Kazuo

2007-03-01

The regional discrepancies of physician supply have been a growing concern in Japan. To find out how hospitals are responding in terms of physician payment (by monthly salaries and additional benefits), we conducted a survey of acute care hospitals in Yamagata, Japan. We asked about the salary and additional benefits of full-time physicians and the structural and functional characteristics of health care service provision. From these data we set out to assemble a model that can explain effectively the variability of physician payment in acute care hospitals within the prefecture. We found that physician payment was associated with variables such as type of management, staff employed per bed, full time doctors employed per bed and average length of stay. Hospital location was found to have a significant effect on payment. Variables expressing workload, like number of in-patients per doctor and number of surgical operations per doctor were inversely related. Our results suggest that hospitals may have adapted to physician preferences of workplace in terms of physician payment. To further address the problems of unbalanced geographic distribution of physicians in rural areas, work-sharing and educational and technical support schemes may also help.

Doctoral Research Education in Canada: Full-Time and Part-Time Students' Access to Research Assistantships

ERIC Educational Resources Information Center

Niemczyk, Ewalina Kinga

2016-01-01

Graduate students' development as researchers is a key objective in higher education internationally. Research assistantships (RAships) nurture graduate students as novice researchers as they develop theoretical and methodological knowledge. However, few studies have investigated the ways institutional regulations, informal practices, and…

Full circuit calculation for electromagnetic pulse transmission in a high current facility

NASA Astrophysics Data System (ADS)

Zou, Wenkang; Guo, Fan; Chen, Lin; Song, Shengyi; Wang, Meng; Xie, Weiping; Deng, Jianjun

2014-11-01

We describe herein for the first time a full circuit model for electromagnetic pulse transmission in the Primary Test Stand (PTS)—the first TW class pulsed power driver in China. The PTS is designed to generate 8-10 MA current into a z -pinch load in nearly 90 ns rise time for inertial confinement fusion and other high energy density physics research. The PTS facility has four conical magnetic insulation transmission lines, in which electron current loss exists during the establishment of magnetic insulation. At the same time, equivalent resistance of switches and equivalent inductance of pinch changes with time. However, none of these models are included in a commercially developed circuit code so far. Therefore, in order to characterize the electromagnetic transmission process in the PTS, a full circuit model, in which switch resistance, magnetic insulation transmission line current loss and a time-dependent load can be taken into account, was developed. Circuit topology and an equivalent circuit model of the facility were introduced. Pulse transmission calculation of shot 0057 was demonstrated with the corresponding code FAST (full-circuit analysis and simulation tool) by setting controllable parameters the same as in the experiment. Preliminary full circuit simulation results for electromagnetic pulse transmission to the load are presented. Although divergences exist between calculated and experimentally obtained waveforms before the vacuum section, consistency with load current is satisfactory, especially at the rising edge.

76 FR 14032 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-15

... to the level of Medicare GME support received by other, non-children's hospitals. The legislation... equivalent residents in applicant children's hospitals' training programs to determine the amount of direct... data on the number of full-time equivalent residents a second time during the Federal fiscal year to...

Lack of patients? A hypothesis for understanding discrepancies between hospital resources and productivity.

PubMed

Bratlid, Dag

2006-04-02

Despite a substantial increase in hospital resources, increased hospital admissions and out-patient visits, long waiting lists have been a significant problem in Norwegian health care. A detailed analysis of the development in resource allocation and productivity at St. Olavs University Hospital in central Norway was therefore undertaken. Resource allocation and patient volume was analysed during the period 1995 to 2001. Data were analysed both for emergency and elective admissions as well as outpatient visits specified into new referrals and follow-up consultations. Full time employee equivalents for doctors and nurses increased by 36.6% and 25.9%, respectively, and all employees by 28.1%. However, admitted patients, outpatient consultations and surgical procedures only increased by 10%, 15% and 8.3%, respectively. Thus, the productivity for each hospital employee, defined as operations pr. surgeon, outpatient consultations pr. doctor etc. was significantly reduced. A striking finding was that although the number of outpatient consultations increased, the number of new referrals actually went down and the whole increase in activity at the outpatient clinics could be explained by a substantial increase in follow-up consultations. This trend was more evident in the surgical departments, where some departments actually showed a reduction in total outpatient consultations. In view of the slow increase in hospital activity in spite of a significant increase in resources, it can be speculated that patient volume might be a limiting factor for hospital activity. The health market (patient population) might not be big enough in relation to the investments in increased production capacity (equipment and manpower).

Lack of patients? – a hypothesis for understanding discrepancies between hospital resources and productivity

PubMed Central

Bratlid, Dag

2006-01-01

Background Despite a substantial increase in hospital resources, increased hospital admissions and out-patient visits, long waiting lists have been a significant problem in Norwegian health care. A detailed analysis of the development in resource allocation and productivity at St. Olavs University Hospital in central Norway was therefore undertaken. Methods Resource allocation and patient volume was analysed during the period 1995 to 2001. Data were analysed both for emergency and elective admissions as well as outpatient visits specified into new referrals and follow-up consultations. Results Full time employee equivalents for doctors and nurses increased by 36.6% and 25.9%, respectively, and all employees by 28.1%. However, admitted patients, outpatient consultations and surgical procedures only increased by 10%, 15% and 8.3%, respectively. Thus, the productivity for each hospital employee, defined as operations pr. surgeon, outpatient consultations pr. doctor etc. was significantly reduced. A striking finding was that although the number of outpatient consultations increased, the number of new referrals actually went down and the whole increase in activity at the outpatient clinics could be explained by a substantial increase in follow-up consultations. This trend was more evident in the surgical departments, where some departments actually showed a reduction in total outpatient consultations. Conclusion In view of the slow increase in hospital activity in spite of a significant increase in resources, it can be speculated that patient volume might be a limiting factor for hospital activity. The health market (patient population) might not be big enough in relation to the investments in increased production capacity (equipment and manpower). PMID:16579861

Estazolam

MedlinePlus

... by slowing activity in the brain to allow sleep. ... full night after you take the medication.Your sleep problems should improve within 7 to 10 days ... start taking estazolam. Call your doctor if your sleep problems do not improve during this time, if ...

26 CFR 1.401-10 - Definitions relating to plans covering self-employed individuals.

Code of Federal Regulations, 2013 CFR

2013-04-01

... reason of the provisions of section 7701(a)(20), relating to the treatment of certain full-time life... religious orders, doctors of medicine, and Christian Science practitioners are treated for purposes of...

42 CFR 60.50 - Which schools are eligible to be HEAL schools?

Code of Federal Regulations, 2010 CFR

2010-10-01

... Osteopathic Medicine Doctor of Dentistry or equivalent degree Bachelor or Master of Science in Pharmacy or...) Council on Podiatric Medical Education. (G) American Council on Pharmaceutical Education. (H) Council on...

75 FR 56546 - Agency Information Collection Activities: Proposed Collection: Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-16

... students enrolled full-time in a master's or doctoral nursing education program that will prepare them to... information; (c) ways to enhance the quality, utility, and clarity of the information to be collected; and (d...

Quality of faculty, students, curriculum and resources for nursing doctoral education in Korea: a focus group study.

PubMed

Kim, Mi Ja; Lee, Hyeonkyeong; Kim, Hyun Kyung; Ahn, Yang-Heui; Kim, Euisook; Yun, Soon-Nyoung; Lee, Kwang-Ja

2010-03-01

The rapidly increasing number of nursing doctoral programs has caused concern about the quality of nursing doctoral education, including in Korea. To describe the perceived quality of Korean nursing doctoral education in faculty, student, curriculum and resources. Focus group. Fourteen Korean nursing doctoral programs that are research focused and include coursework. Four groups of deans, faculty, students and graduates; students completed three semesters of doctoral program; and graduates completed doctoral programs within the most recent 3 years. Focus groups examined the strengths and weaknesses of faculty, students, curriculum, and resources. Faculty strengths were universities' recognition of faculty research/scholarship and the ability of faculty to attract extramural funding. Faculty weaknesses were aging faculty; high faculty workload; insufficient number of faculty; and teaching without expertise in nursing theories. Student strengths were diverse student backgrounds; multidisciplinary dissertation committee members, and opportunities to socialize with peers and graduates/faculty. Students' weaknesses were overproduction of PhDs with low academic quality; a lower number and quality of doctoral applicants; and lack of full-time students. Curriculum strengths were focusing on specific research areas; emphasis on research ethics; and multidisciplinary courses. Curriculum weaknesses were insufficient time for curriculum development; inadequate courses for core research competencies; and a lack of linkage between theory and practice. Resources strengths were inter-institutional courses with credit transfer. Weaknesses were diminished university financial support for graduate students and limited access to school facilities. Variations in participant groups (providers [deans and faculty] vs. receivers [students and graduates]) and geographical location (capital city vs. regional) were noted on all the four components. The quality characteristics of faculty, students, curriculum, and resources identified in this first systematic evaluation of the quality of nursing doctoral education can inform nursing schools, universities, and policy-makers about areas for improvement in Korea and possibly in the world. Geographical variations found in these four components of doctoral education warrant attention by policy-makers in Korea. Copyright 2009 Elsevier Ltd. All rights reserved.

Australian doctors' non-clinical activities: results from the Medicine in Australia: Balancing Employment and Life (MABEL) survey of doctors.

PubMed

Joyce, Catherine; Eyre, Harris; Wang, Wei Chun; Laurence, Caroline

2015-11-01

The aim of the present study was to investigate non-clinical work conducted by Australian doctors. This study was an exploratory descriptive study using data from Wave 5 of the Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal survey, collected in 2012 from Australian medical practitioners (2200 general practitioners (GPs), 3455 specialists, 1270 specialists in training and 1656 hospital non-specialists). The main outcome measure was the number of hours worked per week in non-clinical work. Regression analysis was used to determine associations between non-clinical activities (i.e. education-related, management and administration and other) and personal and professional characteristics, including age, gender, job and life satisfaction, total clinical working hours, sector of practice (public or private) and doctor type. Australian doctors spend an average of just under 7 h per week, or 16% of their working time, on non-clinical activities. Doctors who worked more hours on non-clinical activities overall, and in education-related and management and administration specifically, were male, younger, had lower life satisfaction and generally spent fewer hours on clinical work. Lower job satisfaction was associated with longer management and administration hours, but not with time spent in education-related activities. Specialists were more likely to work long non-clinical hours, whereas GPs were more likely to report none. Hospital non-specialists reported relatively high management and administration hours. Further work is required to better understand the full range of non-clinical activities doctors are involved in and how this may impact future workforce projections.

Titration of Limited Hold to Comparison in Conditional Discrimination Training and Stimulus Equivalence Testing

ERIC Educational Resources Information Center

Arntzen, Erik; Haugland, Silje

2012-01-01

Reaction time (RT), thought to be important for acquiring a full understanding of the establishment of equivalence classes, has been reported in a number of studies within the area of stimulus equivalence research. In this study, we trained 3 classes of potentially 3 members, with arbitrary stimuli in a one-to-many training structure in 5 adult…

Expression of proliferative and inflammatory markers in a full-thickness human skin equivalent following exposure to the model sulfur mustard vesicant, 2-chloroethyl ethyl sulfide

PubMed Central

Black, Adrienne T.; Hayden, Patrick J.; Casillas, Robert P.; Heck, Diane E.; Gerecke, Donald R.; Sinko, Patrick J.; Laskin, Debra L.; Laskin, Jeffrey D.

2010-01-01

Sulfur mustard is a potent vesicant that induces inflammation, edema and blistering following dermal exposure. To assess molecular mechanisms mediating these responses, we analyzed the effects of the model sulfur mustard vesicant, 2-chloroethyl ethyl sulfide, on EpiDerm-FT™, a commercially available full-thickness human skin equivalent. CEES (100–1000 μM) caused a concentration-dependent increase in pyknotic nuclei and vacuolization in basal keratinocytes; at high concentrations (300–1000 μM), CEES also disrupted keratin filament architecture in the stratum corneum. This was associated with time-dependent increases in expression of proliferating cell nuclear antigen, a marker of cell proliferation, and poly(ADP-ribose) polymerase (PARP) and phosphorylated histone H2AX, markers of DNA damage. Concentration- and time-dependent increases in mRNA and protein expression of eicosanoid biosynthetic enzymes including COX-2, 5-lipoxygenase, microsomal PGE2 synthases, leukotriene (LT) A4 hydrolase and LTC4 synthase were observed in CEES-treated skin equivalents, as well as in antioxidant enzymes, glutathione S-transferases A1–2 (GSTA1–2), GSTA3 and GSTA4. These data demonstrate that CEES induces rapid cellular damage, cytotoxicity and inflammation in full-thickness skin equivalents. These effects are similar to human responses to vesicants in vivo and suggest that the full thickness skin equivalent is a useful in vitro model to characterize the biological effects of mustards and to develop potential therapeutics. PMID:20840853

Expression of proliferative and inflammatory markers in a full-thickness human skin equivalent following exposure to the model sulfur mustard vesicant, 2-chloroethyl ethyl sulfide.

PubMed

Black, Adrienne T; Hayden, Patrick J; Casillas, Robert P; Heck, Diane E; Gerecke, Donald R; Sinko, Patrick J; Laskin, Debra L; Laskin, Jeffrey D

2010-12-01

Sulfur mustard is a potent vesicant that induces inflammation, edema and blistering following dermal exposure. To assess molecular mechanisms mediating these responses, we analyzed the effects of the model sulfur mustard vesicant, 2-chloroethyl ethyl sulfide, on EpiDerm-FT™, a commercially available full-thickness human skin equivalent. CEES (100-1000 μM) caused a concentration-dependent increase in pyknotic nuclei and vacuolization in basal keratinocytes; at high concentrations (300-1000 μM), CEES also disrupted keratin filament architecture in the stratum corneum. This was associated with time-dependent increases in expression of proliferating cell nuclear antigen, a marker of cell proliferation, and poly(ADP-ribose) polymerase (PARP) and phosphorylated histone H2AX, markers of DNA damage. Concentration- and time-dependent increases in mRNA and protein expression of eicosanoid biosynthetic enzymes including COX-2, 5-lipoxygenase, microsomal PGE₂ synthases, leukotriene (LT) A₄ hydrolase and LTC₄ synthase were observed in CEES-treated skin equivalents, as well as in antioxidant enzymes, glutathione S-transferases A1-2 (GSTA1-2), GSTA3 and GSTA4. These data demonstrate that CEES induces rapid cellular damage, cytotoxicity and inflammation in full-thickness skin equivalents. These effects are similar to human responses to vesicants in vivo and suggest that the full thickness skin equivalent is a useful in vitro model to characterize the biological effects of mustards and to develop potential therapeutics. Copyright © 2010 Elsevier Inc. All rights reserved.

A Computing Platform for Parallel Sparse Matrix Computations

DTIC Science & Technology

2016-01-05

REPORT NUMBER 19a. NAME OF RESPONSIBLE PERSON 19b. TELEPHONE NUMBER Ahmed Sameh Ahmed H. Sameh, Alicia Klinvex, Yao Zhu 611103 c. THIS PAGE The...PERCENT_SUPPORTEDNAME FTE Equivalent: Total Number: Discipline Yao Zhu 0.50 Alicia Klinvex 0.10 0.60 2 Names of Post Doctorates Names of Faculty Supported...PERCENT_SUPPORTEDNAME FTE Equivalent: Total Number: NAME Total Number: NAME Total Number: Yao Zhu Alicia Klinvex 2 ...... ...... Sub Contractors (DD882) Names of other

Physician need. An alternative projection from a study of large, prepaid group practices.

PubMed

Mulhausen, R; McGee, J

1989-04-07

To model a base level of physician demand in a managed health care system, we examined in 1983 the ratios by specialty of full-time equivalent physicians to health maintenance organization members in seven large, closed-panel health maintenance organizations, each with more than 100,000 members. The medical director of each plan was surveyed by mailed questionnaire and telephone interview to determine the plan's number of full-time equivalent physicians by specialty and members served. Out-of-plan physicians contracted by the group were included within the specialty distribution wherever possible. We compared our findings (4779.4 full-time equivalent physicians serving 4,297,790 members) with Graduate Medical Education National Advisory Committee and others' projections of physician need and supply. Based on this model and unknowns that might affect utilization, our study suggests that at least 111 physicians per 100,000 population would be necessary in a system that emphasized reduced utilization of services and that more primary care physicians would be needed than the Graduate Medical Education National Advisory Committee predicted would be available.

Primary medical care in Irish prisons

PubMed Central

2010-01-01

Background An industrial dispute between prison doctors and the Irish Prison Service (IPS) took place in 2004. Part of the resolution of that dispute was that an independent review of prison medical and support services be carried out by a University Department of Primary Care. The review took place in 2008 and we report here on the principal findings of that review. Methods This study utilised a mixed methods approach. An independent expert medical evaluator (one of the authors, DT) inspected the medical facilities, equipment and relevant custodial areas in eleven of the fourteen prisons within the IPS. Semistructured interviews took place with personnel who had operational responsibility for delivery of prison medical care. Prison doctors completed a questionnaire to elicit issues such as allocation of clinician's time, nurse and administrative support and resources available. Results There was wide variation in the standard of medical facilities and infrastructure provided across the IPS. The range of medical equipment available was generally below that of the equivalent general practice scheme in the community. There is inequality within the system with regard to the ratio of doctor-contracted time relative to the size of the prison population. There is limited administrative support, with the majority of prisons not having a medical secretary. There are few psychiatric or counselling sessions available. Conclusions People in prison have a wide range of medical care needs and there is evidence to suggest that these needs are being met inconsistently in Irish prisons. PMID:20307311

Seeking the Path to Adjunct Justice at Marquette University

ERIC Educational Resources Information Center

Maguire, Daniel C.

2008-01-01

This article presents the outcomes from a case at Marquette University (USA), brought by seven Ph.D. adjuncts who had completed their doctoral programs and were currently teaching part-time as they sought full-time positions elsewhere. The case identified a disparity that is happening at many U.S. colleges and universities that increasing rely…

29 CFR 4.176 - Payment of fringe benefits to temporary and part-time employees.

Code of Federal Regulations, 2011 CFR

2011-07-01

... paid vacation for full-time employees is one week of 40 hours, a part-time employee working a regularly scheduled workweek of 16 hours is entitled to 16 hours of paid vacation time or its equivalent each year, if... paying such employees a proportion of the holiday or vacation benefits due full-time employees based on...

42 CFR 57.302 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... FACILITIES, EDUCATIONAL IMPROVEMENTS, SCHOLARSHIPS AND STUDENT LOANS Nursing Student Loans § 57.302... constitutes a full-time academic workload, as determined by the school, leading to a diploma in nursing, an associate degree in nursing or an equivalent degree, a baccalaureate degree in nursing or an equivalent...

[Current status and issues in development of occupational physicians in Japan].

PubMed

Mori, Koji

2013-10-01

Training systems for occupational physicians (OPs) have existed since the Industrial Safety and Health Act was enacted in 1972. However, it is necessary to enhance them because of changes in the business environment of Japanese corporations and working patterns have brought about new needs of occupational health (OH) activities. In this paper, OPs were classified into three categories; doctors who spend a part of working time on OH activities, i.e. "non-specialist OPs", doctors who engage in OH activities full-time, i.e. "specialists OPs", and doctors who manage corporate-wide occupational health programs or lead programs at OH service institutes, i.e. "lead OPs", and the status and the issues were reviewed. The major concern identified for each of the three categories in training were found to be quality management for non-specialist OPs, short supply for specialists OPs, and development of competencies such as leadership and management skills for lead OPs, respectively. Current efforts and ideas to improve the training systems were discussed.

Professional fulfillment and parenting work-life balance in female physicians in Basic Sciences and medical research: a nationwide cross-sectional survey of all 80 medical schools in Japan.

PubMed

Yamazaki, Yuka; Uka, Takanori; Marui, Eiji

2017-09-15

In Japan, the field of Basic Sciences encompasses clinical, academic, and translational research, as well as the teaching of medical sciences, with both an MD and PhD typically required. In this study, it was hypothesized that the characteristics of a Basic Sciences career path could offer the professional advancement and personal fulfillment that many female medical doctors would find advantageous. Moreover, encouraging interest in Basic Sciences could help stem shortages that Japan is experiencing in medical fields, as noted in the three principal contributing factors: premature resignation of female clinicians, an imbalance of female physicians engaged in research, and a shortage of medical doctors in the Basic Sciences. This study examines the professional and personal fulfillment expressed by Japanese female medical doctors who hold positions in Basic Sciences. Topics include career advancement, interest in medical research, and greater flexibility for parenting. A cross-sectional questionnaire survey was distributed at all 80 medical schools in Japan, directed to 228 female medical doctors whose academic rank was assistant professor or higher in departments of Basic Sciences in 2012. Chi-square tests and the binary logistic regression model were used to investigate the impact of parenthood on career satisfaction, academic rank, salary, etc. The survey response rate of female physicians in Basic Sciences was 54.0%. Regardless of parental status, one in three respondents cited research interest as their rationale for entering Basic Sciences, well over twice other motivations. A majority had clinical experience, with clinical duties maintained part-time by about half of respondents and particularly parents. Only one third expressed afterthoughts about relinquishing full-time clinical practice, with physicians who were parents expressing stronger regrets. Parental status had little effect on academic rank and income within the Basic Sciences, CONCLUSION: Scientific curiosity and a desire to improve community health are hallmarks of those choosing a challenging career in medicine. Therefore, it is unsurprising that interest in research is the primary motivation for a female medical doctor to choose a career in Basic Sciences. Additionally, as with many young professionals with families, female doctors seek balance in professional and private lives. Although many expressed afterthoughts relinquishing a full-time clinical practice, mothers generally benefited from greater job flexibility, with little significant effect on career development and income as Basic Scientists.

[Goya and doctors].

PubMed

Vargas-Origel, Arturo

2009-01-01

This is a brief analysis of the different diseases the Spanish painter Goya suffered, particularly the one that caused his deafness. We also discussed the probable relationship the artist had with his physicians throughout his life, and how this relationship is portrayed in four of his works, with such variety of feelings that go from indifference, satire and mockery to gratefulness and full recognition to the medical profession. This last point is exemplified in a self-portrait of the sick artist being assisted by Dr. Eugenio Garcia Arrieta which was his personal doctor during that time. This work is considered a representation of an adequate patient-physician relationship.

34 CFR 674.55 - Teacher cancellation-Defense loans.

Code of Federal Regulations, 2013 CFR

2013-07-01

... cancellation—Defense loans. (a) Cancellation for full-time teaching. (1) An institution shall cancel up to 50 percent of the outstanding balance on a borrower's Defense loan for full-time teaching in— (i) A public or... of qualifying service, for each complete year, or its equivalent, of teaching. (b) Cancellation for...

34 CFR 674.55 - Teacher cancellation-Defense loans.

Code of Federal Regulations, 2014 CFR

2014-07-01

... cancellation—Defense loans. (a) Cancellation for full-time teaching. (1) An institution shall cancel up to 50 percent of the outstanding balance on a borrower's Defense loan for full-time teaching in— (i) A public or... of qualifying service, for each complete year, or its equivalent, of teaching. (b) Cancellation for...

34 CFR 674.55 - Teacher cancellation-Defense loans.

Code of Federal Regulations, 2012 CFR

2012-07-01

... cancellation—Defense loans. (a) Cancellation for full-time teaching. (1) An institution shall cancel up to 50 percent of the outstanding balance on a borrower's Defense loan for full-time teaching in— (i) A public or... of qualifying service, for each complete year, or its equivalent, of teaching. (b) Cancellation for...

Chancellor's Report, 1979-1983.

ERIC Educational Resources Information Center

Ohio Board of Regents, Columbus.

A summary of developments in higher education in Ohio during 1979-1983 is presented by the Chancellor of the Ohio Board of Regents. Information is provided on: public and private college enrollments; full- and part-time enrollments; degrees awarded at public institutions; the number of full-time-equivalent faculty and staff employed by public…

13 CFR 120.824 - Professional management and staff.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false Professional management and staff... management and staff. A CDC must have full-time professional management, including an Executive Director (or the equivalent) managing daily operations. It must also have a full-time professional staff qualified...

13 CFR 120.824 - Professional management and staff.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Professional management and staff... management and staff. A CDC must have full-time professional management, including an Executive Director (or the equivalent) managing daily operations. It must also have a full-time professional staff qualified...

13 CFR 120.824 - Professional management and staff.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false Professional management and staff... management and staff. A CDC must have full-time professional management, including an Executive Director (or the equivalent) managing daily operations. It must also have a full-time professional staff qualified...

13 CFR 120.824 - Professional management and staff.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false Professional management and staff... management and staff. A CDC must have full-time professional management, including an Executive Director (or the equivalent) managing daily operations. It must also have a full-time professional staff qualified...

Language and Literature Division, Faculty of Education, Hong Kong University

ERIC Educational Resources Information Center

Qin, Xie; Andrews, Stephen

2010-01-01

The Language and Literature Division (LLD) is the largest of the six divisions of the Faculty of Education, University of Hong Kong (HKU). It is currently home to 34 academic staff, who specialize either in the fields of Chinese Language, English Language and/or Literature Education, and to 60 full-time and 28 part-time doctoral students, who are…

10 CFR 35.51 - Training for an authorized medical physicist.

Code of Federal Regulations, 2013 CFR

2013-01-01

... all candidates for certification to: (1) Hold a master's or doctor's degree in physics, medical physics, other physical science, engineering, or applied mathematics from an accredited college or university; (2) Have 2 years of full-time practical training and/or supervised experience in medical physics...

10 CFR 35.51 - Training for an authorized medical physicist.

Code of Federal Regulations, 2012 CFR

2012-01-01

... all candidates for certification to: (1) Hold a master's or doctor's degree in physics, medical physics, other physical science, engineering, or applied mathematics from an accredited college or university; (2) Have 2 years of full-time practical training and/or supervised experience in medical physics...

10 CFR 35.51 - Training for an authorized medical physicist.

Code of Federal Regulations, 2014 CFR

2014-01-01

... all candidates for certification to: (1) Hold a master's or doctor's degree in physics, medical physics, other physical science, engineering, or applied mathematics from an accredited college or university; (2) Have 2 years of full-time practical training and/or supervised experience in medical physics...

10 CFR 35.51 - Training for an authorized medical physicist.

Code of Federal Regulations, 2010 CFR

2010-01-01

... all candidates for certification to: (1) Hold a master's or doctor's degree in physics, medical physics, other physical science, engineering, or applied mathematics from an accredited college or university; (2) Have 2 years of full-time practical training and/or supervised experience in medical physics...

Trends in job satisfaction among German nurses from 1990 to 2012.

PubMed

Alameddine, Mohamad; Bauer, Jan Michael; Richter, Martin; Sousa-Poza, Alfonso

2016-04-01

Improving the job satisfaction of nurses is essential to enhance their productivity and retention and to improve patient care. Our aim was to analyse trends in German nurses' job satisfaction to enhance understanding of the nursing labour market and inform future policies. We used 1990-2012 German Socioeconomic Panel data for trends in nurses' job satisfaction. Comparisons were drawn with doctors, other health care workers, and employees in other sectors of employment. Analysis explored associations between job satisfaction trends and other aspects of employment, such as whether full time or part time and pay. To account for fluctuations across the period of analysis, linear trends were generated using ordinary least squares. Over 23 years, job satisfaction of German nurses underwent a steady and gradual decline, dropping by an average 7.5%, whereas that of doctors and other health care workers increased by 14.4% and 1%, respectively. The decline for part-time nurses (13%) was more pronounced than that for full-time nurses (3%). At the same time, nurses' pay rose by only 3.8% compared to a 23.8% increase for doctors. The steady decline in nurses' job satisfaction over the last two decades may be attributable to the multiple reforms and associated policy changes that generally disadvantaged nurses. Contributing factors to job satisfaction decline include lower pay and the demanding and strenuous work environment. Irrespective of the reason, health services researchers, leaders, and policy makers should investigate the reasons for this decline given the forecast growth in work load and complexity of care. Supportive policies for nurses would help enhance the quality and sustainability of German health care. © The Author(s) 2015.

On the relationship between weight status and doctor shopping behavior-evidence from Australia.

PubMed

Feng, Xiaoqi

2013-11-01

A recent study has suggested that overweight and obese people are more likely to consult a range of physicians (doctor shopping). The consistency of this finding with multiple measures of doctor shopping and controls for socioeconomic circumstances was interrogated. Ninety-nine thousand four hundred seven Australians aged 45 and over who had sought primary healthcare at least five times within 6 months of a survey (2006-2008). (i) The count of different physicians consulted; a binary indicator of (ii) >= three different physicians; (iii) >= five different physicians; and iv) a measure that took into account multiple consultations with the same physician were investigated. Weight status was measured using Body Mass Index (BMI) based on self-reported height and weight. Controls included socioeconomic circumstances, demographics, health, and neighborhood factors. In comparison to people with "normal" BMI, the likelihood of doctor shopping was lower among overweight (Incidence Rate Ratio: 0.97, 95%CI: 0.96, 0.98) and obese people (0.95: 0.93, 0.96). This negative correlation between doctor shopping behavior and weight status was consistent after full adjustment and across different outcome measures. In contrast with recent evidence from the US, overweight and obese Australians are less prone to doctor shopping behavior than their peers with "normal" BMI. Copyright © 2013 The Obesity Society.

Hospital payroll costs, productivity, and employment under prospective reimbursement.

PubMed

Kidder, D; Sullivan, D

1982-12-01

This paper reports preliminary findings from the National Hospital Rate-Setting Study regarding the effects of State prospective reimbursement (PR) programs on measures of payroll costs and employment in hospitals. PR effects were estimated through reduced-form equations, using American Hospital Association Annual Survey data on over 2,700 hospitals from 1969 through 1978. These tests suggest that hospitals responded to PR by lowering payroll expenditures. PR also seems to have been associated with reductions in full-time equivalent staff per adjusted inpatient day. However, tests did not confirm the hypothesis that hospitals reduce payroll per full-time equivalent staff as a result of PR.

Hospital Payroll Costs, Productivity, and Employment Under Prospective Reimbursement

PubMed Central

Kidder, David; Sullivan, Daniel

1982-01-01

This paper reports preliminary findings from the National Hospital Rate-Setting Study regarding the effects of State prospective reimbursement (PR) programs on measures of payroll costs and employment in hospitals. PR effects were estimated through reduced-form equations, using American Hospital Association Annual Survey data on over 2,700 hospitals from 1969 through 1978. These tests suggest that hospitals responded to PR by lowering payroll expenditures. PR also seems to have been associated with reductions in full-time equivalent staff per adjusted inpatient day. However, tests did not confirm the hypothesis that hospitals reduce payroll per full-time equivalent staff as a result of PR. PMID:10309913

Computer-based teaching is as good as face to face lecture-based teaching of evidence based medicine: a randomised controlled trial

PubMed Central

2007-01-01

Background At postgraduate level evidence based medicine (EBM) is currently taught through tutor based lectures. Computer based sessions fit around doctors' workloads, and standardise the quality of educational provision. There have been no randomized controlled trials comparing computer based sessions with traditional lectures at postgraduate level within medicine. Methods This was a randomised controlled trial involving six postgraduate education centres in the West Midlands, U.K. Fifty five newly qualified foundation year one doctors (U.S internship equivalent) were randomised to either computer based sessions or an equivalent lecture in EBM and systematic reviews. The change from pre to post-intervention score was measured using a validated questionnaire assessing knowledge (primary outcome) and attitudes (secondary outcome). Results Both groups were similar at baseline. Participants' improvement in knowledge in the computer based group was equivalent to the lecture based group (gain in score: 2.1 [S.D = 2.0] versus 1.9 [S.D = 2.4]; ANCOVA p = 0.078). Attitudinal gains were similar in both groups. Conclusion On the basis of our findings we feel computer based teaching and learning is as effective as typical lecture based teaching sessions for educating postgraduates in EBM and systematic reviews. PMID:17659076

Borges & Bikes Riders: Toward an Understanding of Autoethnography

ERIC Educational Resources Information Center

Wamsted, John O.

2012-01-01

In this article the author--a full-time high school mathematics teacher and concurrent doctoral candidate in Department of Middle-Secondary Education and Instructional Technology at Georgia State University--will make a case for the use of an autoethnographic methodological tool he is calling "narrative mining." He will begin by briefly…

40 CFR 312.10 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... property but for a street, road, or other public thoroughfare separating the properties. Data gap means: a..., tribe, or U.S. territory (or the Commonwealth of Puerto Rico) and have the equivalent of three (3) years... defined in § 312.21 and have the equivalent of three (3) years of full-time relevant experience; or (iii...

Treatment decisions on antidepressants in nursing homes: a qualitative study.

PubMed

Iden, Kristina Riis; Hjørleifsson, Stefan; Ruths, Sabine

2011-12-01

To explore decision-making on treatment with antidepressants among doctors and nurses in nursing homes. A qualitative study based on interviews with three focus groups comprising eight physicians engaged full time, eight physicians engaged part time, and eight registered nurses, respectively. The interview guide comprised questions on initiating, evaluating, and withdrawing treatment with antidepressants. The interviews were audio-recorded, transcribed, and analysed by systematic text condensation. The first theme was the diagnostic process. The informants expressed difficulty in differentiating between depression and sorrow resulting from loss in old age. Further, the doctors reported that they relied on nurses' observations and rarely carried out systematic diagnostic work and follow-up of patients with depression. The second theme was treatment. Antidepressants were usually the only type of treatment provided, and patients were kept on medication even though staff felt uncertain whether this was effective. The third theme was who really determines the treatment. Registered nurses reported that unskilled and auxiliary nursing staff requested drug treatment, and doctors felt some pressure from the nurses to prescribe antidepressants. This study suggests that the quality of diagnosis and treatment for depression in nursing homes needs to be improved in Norway. Doctors should be more available and take responsibility and leadership in medical decisions.

Career success after flexible training in psychiatry: a survey of former flexible trainees in the Thames regions.

PubMed

Etchegoyen, A; Stormont, F; Goldberg, I

2001-06-01

This article outlines the findings of a study which indicate that flexible training in psychiatry was considered adequate to prepare doctors for both full-time and part-time work and that those wishing to work part time had no difficulty in finding jobs after accreditation. However, there was evidence to suggest that part-time consultants experienced more problems and less job satisfaction and that part-time training and working may restrict opportunities for an academic career.

Can a senior house officer's time be used more effectively?

PubMed

Mitchell, J; Hayhurst, C; Robinson, S M

2004-09-01

To determine the amount of time senior house officers (SHO) spent performing tasks that could be delegated to a technician or administrative assistant and therefore to quantify the expected benefit that could be obtained by employing such physicians' assistants (PA). SHOs working in the emergency department were observed for one week by pre-clinical students who had been trained to code and time each task performed by SHOs. Activity was grouped into four categories (clinical, technical, administrative, and other). Those activities in the technical and administrative categories were those we believed could be performed by a PA. The SHOs worked 430 hours in total, of which only 25 hours were not coded due to lack of an observer. Of the 405 hours observed 86.2% of time was accounted for by the various codes. The process of taking a history and examining patients accounted for an average of 22% of coded time. Writing the patient's notes accounted for an average of 20% of coded time. Discussion with relatives and patients accounted for 4.7% of coded time and performing procedures accounted for 5.2% of coded time. On average across all shifts, 15% of coded time was spent doing either technical or administrative tasks. In this department an average of 15% of coded SHOs working time was spent performing administrative and technical tasks, rising to 17% of coded time during a night shift. This is equivalent to an average time of 78 minutes per 10 hour shift/SHO. Most tasks included in these categories could be performed by PAs thus potentially decreasing patient waiting times, improving risk management, allowing doctors to spend more time with their patients, and possibly improving doctors' training.

The ethics of medical involvement in torture: commentary

PubMed Central

Hare, R M

1993-01-01

Torture does need to be defined if we are to know exactly what we are seeking to ban; but no single definition will do, because there are many possible ones, and we may want to treat different practices that might be called torture differently. Compare the case of homicide; we do not want to punish manslaughter as severely as murder, and may not want to punish killing in self-defence at all. There are degrees of torture as of murder. Unclarities simply play into the hands of would-be torturers. Downie is unsuccessful in deriving the duty of doctors not to be involved in torture from an analysis of the word `doctor'. It may be contrary to the role-duty of doctors to participate in torture; but there might be other duties which overrode this role-duty. The right approach is to ask what principles for the conduct of doctors have the highest acceptance-utility, or, as Kant might have equivalently put it, what the impartial furtherance of everyone's ends demands. This approach yields the result that torture (suitably defined) should be banned absolutely. It also yields prescriptions for the conduct of doctors where, in spite of them, torture is taking place. PMID:8230144

42 CFR 482.62 - Condition of participation: Special staff requirements for psychiatric hospitals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the leadership required for an intensive treatment program. The number and qualifications of doctors... clinical director, service chief, or equivalent must meet the training and experience requirements for..., or be qualified by education and experience in the care of the mentally ill. The director must...

Changing practice: are memes the answer?

PubMed

Pediani, R; Walsh, M

Nurses are insistent that they have a great deal more to offer than being merely doctors handmaidens. This article examines how nursing education and practice can be changed by increasing our knowledge of 'memes'--the cultural equivalent of genes--and the ways traditional beliefs are passed down to generations of nurses.

Practitioners, patients, and their visits: a description of accident and medical (A&M) clinics in New Zealand, 2001/2.

PubMed

Hider, Phil; Lay-Yee, Roy; Davis, Peter

2007-05-18

The National Primary Medical Care survey was undertaken to describe primary health care in New Zealand, including the characteristics of accident and medical (A and M) clinic providers, their practices, the patients they see, the problems presented, and the management offered. Data were collected from a 50% random sample of all A and M clinics in New Zealand as part of the National Primary Medical Care survey carried out in 2001/2. Data were obtained from 12 A and M clinics throughout New Zealand between usual hours (Monday-Friday 8 am-6 pm) and at other times. A and M clinics were staffed by an average of 2.7 full-time equivalent (FTE) A and M practitioners . Most clinics operated as a limited liability company. The majority of A and M practitioners were male and aged between 35-44 years. On average, A and M doctors had been in practice for over 10 years and had been in the sampled practice for only 2.9 years. More than a third of doctors had not trained in New Zealand. The doctors worked, on average, 6.3 half days and saw nearly 90 patients per week. The findings suggest that young patients and a diverse ethnic range attend A and M practices. Community Services Card holders were not usual patients. Few patients had an ongoing relationship with the practices. Most visits related to a single, new, and short-term problem that was often an injury or a respiratory illness. About a fifth of visits were associated with an order for an investigation or an X-ray, fewer investigations were arranged outside usual hours. About half the visits resulted in a prescription but more visits outside normal hours received pharmacological treatment and the number of items was higher. The most frequently prescribed items were antibiotics and analgesics. Follow-up was arranged for between a third to a half of visits, depending on the time of day. Referrals were often made to non-medical destinations. While patient and visit characteristics were generally similar regardless of whether the visit occurred during usual working hours or at other times, some differences were apparent in the type of problems that were presented out of hours and their management. The main impression is that the medical A and M clinics provide episodic treatment for relatively young patients mainly related to a new, short-term problem, particularly an injury or a respiratory illness. This picture is consistent with previous research and the role of similar clinics overseas. Further work is needed to compare A and M clinics with established general practice in relation to the services that are provided as well as the acceptability and quality of these services.

Reflections of Single Turkish International Graduate Students: Studies on Life at a Midwestern University

ERIC Educational Resources Information Center

Burkholder, Jessica Reno

2010-01-01

The research was guided by the research question: How do full-time single Turkish international graduate students conceptualize their experiences as international students? Participants in the study included three doctoral students and three master's students who participated in a series of semi-structured interviews. The data was transcribed and…

Postgraduation Activities: All Degree Levels in Pennsylvania, 1984.

ERIC Educational Resources Information Center

Brehman, George E., Jr.

Results of a survey of 1984 Pennsylvania college graduates are presented. A total of 47,055 graduates of 145 institutions were surveyed, including the associate, bachelor's, master's, doctoral, and first-professional levels. Information is provided on proportions of graduates in each degree field and level that are: employed full-time in their…

EMERGENCY VICTIM CARE AND RESCUE, TEXTBOOK FOR SQUADMEN.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus. Trade and Industrial Education Service.

DESIGNED FOR TRAINING EMERGENCY SQUAD PERSONNEL IN RESCUE PROCEDURES AND VICTIM CARE BEYOND BASIC FIRST AID, THIS TEXTBOOK WAS DEVELOPED BY A COMMITTEE OF SQUADMEN, DOCTORS, NURSES, FIREMEN, AND STATE TRADE AND INDUSTRIAL PERSONNEL TO BE USED IN ADULT TRAINING CLASSES OF FULL-TIME OR VOLUNTEER SQUADMEN. THE INSTRUCTIONAL MATERIAL INCLUDES 26…

The potential impact of Brexit and immigration policies on the GP workforce in England: a cross-sectional observational study of GP qualification region and the characteristics of the areas and population they served in September 2016.

PubMed

Esmail, Aneez; Panagioti, Maria; Kontopantelis, Evangelos

2017-11-16

The UK is dependent on international doctors, with a greater proportion of non-UK qualified doctors working in its universal health care system than in any other European country, except Ireland and Norway. The terms of the UK exit from the European Union can reduce the ability of European Economic Area (EEA) qualified doctors to work in the UK, while new visa requirements will significantly restrict the influx of non-EEA doctors. We aimed to explore the implications of policy restrictions on immigration, by regionally and spatially describing the characteristics of general practitioners (GPs) by region of medical qualification and the characteristics of the populations they serve. This is a cross-sectional study on 37,792 of 41,865 GPs in England, as of 30 September 2016. The study involved age, sex, full-time equivalent (FTE), country and region of qualification and geography (organisational regions) of individual GPs. Additionally at the practice and geography levels, we studied patient list size by age groups, average patient location deprivation, the overall morbidity as measured by the Quality and Outcomes Framework (QOF) and the average payment made to primary care per patient. Non-UK qualified GPs comprised 21.1% of the total numbers of GPs, with the largest percentage observed in East England (29.8%). Compared to UK qualified GPs, EEA and elsewhere qualified GPs had higher FTE (medians were 0.80, 0.89 and 0.93, respectively) and worked in practices with higher median patient location deprivation (18.3, 22.5 and 25.2, respectively). Practices with high percentages of EEA and elsewhere qualified GPs served patients who resided in more deprived areas, had lower GP-to-patient ratios and lower GP-to-cumulative QOF register ratios. A decrease in pay as the percentage of elsewhere qualified GPs increased was observed; a 10% increase in elsewhere qualified GPs was linked to a £1 decrease (95% confidence interval 0.5-1.4) in average pay per patient. A large percentage of the UK general practice workforce consists of non-UK qualified GPs who work longer hours, are older and serve a larger number of patients in more deprived areas. Following Brexit, difficulties in replacing this valuable workforce will primarily threaten the care delivery in deprived areas.

Doctor-certified sickness absence in first and second trimesters of pregnancy among native and immigrant women in Norway.

PubMed

Brekke, Idunn; Berg, John E; Sletner, Line; Jenum, Anne Karen

2013-03-01

The authors sought to estimate differences in doctor-certified sickness absence during pregnancy among immigrant and native women. Population-based cohort study of pregnant women attending three Child Health Clinics in Groruddalen, Oslo, and their offspring. Questionnaire data were collected at gestational weeks 10-20 and 28. The participation rate was 74%. A multivariate Poisson regression was used to analyse differences in sickness absence in pregnancy between immigrant and native women. A total of 573 women who were employed prior to their pregnancies were included, 51% were immigrants. After adjusting for age, years of education, marital status, number of children, occupation, part-time/full-time work, health status, severe pregnancy-induced emesis and language proficiency, the immigrant/native differences in number of weeks with sickness absence decreased from 2.0 to 1.2 weeks. Part-time/full-time work, health status, severe pregnancy-induced emesis and language proficiency were significant predictors of sickness absence. Immigrant women had higher sickness absence than native women during pregnancy. The difference in average number of weeks between native and immigrant women was partly explained by poorer health status prior to pregnancy, severe pregnancy-induced emesis and poorer proficiency in the Norwegian language among the immigrant women.

Pilot study on doctors working in departments of forensic medicine in German-speaking areas.

PubMed

Gauthier, S; Buddeberg-Fischer, B; Bucher, M; Thali, M; Bartsch, Ch

2013-11-01

Several directors of institutes of forensic and legal medicine in German-speaking areas have noticed a lack of young doctors with specialty qualifications (full board certification) in forensic medicine during recent years. The pilot study was intended to brainstorm the possible reasons for this shortage, by carrying out a survey of doctors working in departments of forensic medicine, paying particular attention to job satisfaction and opinions as to why there are fewer forensic specialists. We sent the link to an online questionnaire to all members of the societies of forensic medicine in Germany, Switzerland and Austria. Altogether, 129 respondents completed the questionnaire and were included in the study. Slightly more men than women replied; the mean age of all respondents was 41. Most respondents had completed their specialty training and worked full-time. In general, participants were moderately satisfied with their careers. Men reported greater career success than women, as determined by objective criteria. Career support was considered to be suboptimal. For most of the respondents, the level of enjoyment of working in forensic medicine was either higher than or approximately the same as the level recalled from five years earlier. Possible reasons for the lack of qualified doctors in forensic medicine institutes are the non-availability of both senior posts and specialty training posts. Career opportunities in forensic medicine are not considered to be attractive. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

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

Black, Adrienne T.; Hayden, Patrick J.; Casillas, Robert P.

Sulfur mustard is a potent vesicant that induces inflammation, edema and blistering following dermal exposure. To assess molecular mechanisms mediating these responses, we analyzed the effects of the model sulfur mustard vesicant, 2-chloroethyl ethyl sulfide, on EpiDerm-FT{sup TM}, a commercially available full-thickness human skin equivalent. CEES (100-1000 {mu}M) caused a concentration-dependent increase in pyknotic nuclei and vacuolization in basal keratinocytes; at high concentrations (300-1000 {mu}M), CEES also disrupted keratin filament architecture in the stratum corneum. This was associated with time-dependent increases in expression of proliferating cell nuclear antigen, a marker of cell proliferation, and poly(ADP-ribose) polymerase (PARP) and phosphorylated histonemore » H2AX, markers of DNA damage. Concentration- and time-dependent increases in mRNA and protein expression of eicosanoid biosynthetic enzymes including COX-2, 5-lipoxygenase, microsomal PGE{sub 2} synthases, leukotriene (LT) A{sub 4} hydrolase and LTC{sub 4} synthase were observed in CEES-treated skin equivalents, as well as in antioxidant enzymes, glutathione S-transferases A1-2 (GSTA1-2), GSTA3 and GSTA4. These data demonstrate that CEES induces rapid cellular damage, cytotoxicity and inflammation in full-thickness skin equivalents. These effects are similar to human responses to vesicants in vivo and suggest that the full thickness skin equivalent is a useful in vitro model to characterize the biological effects of mustards and to develop potential therapeutics.« less

Equivalent model construction for a non-linear dynamic system based on an element-wise stiffness evaluation procedure and reduced analysis of the equivalent system

NASA Astrophysics Data System (ADS)

Kim, Euiyoung; Cho, Maenghyo

2017-11-01

In most non-linear analyses, the construction of a system matrix uses a large amount of computation time, comparable to the computation time required by the solving process. If the process for computing non-linear internal force matrices is substituted with an effective equivalent model that enables the bypass of numerical integrations and assembly processes used in matrix construction, efficiency can be greatly enhanced. A stiffness evaluation procedure (STEP) establishes non-linear internal force models using polynomial formulations of displacements. To efficiently identify an equivalent model, the method has evolved such that it is based on a reduced-order system. The reduction process, however, makes the equivalent model difficult to parameterize, which significantly affects the efficiency of the optimization process. In this paper, therefore, a new STEP, E-STEP, is proposed. Based on the element-wise nature of the finite element model, the stiffness evaluation is carried out element-by-element in the full domain. Since the unit of computation for the stiffness evaluation is restricted by element size, and since the computation is independent, the equivalent model can be constructed efficiently in parallel, even in the full domain. Due to the element-wise nature of the construction procedure, the equivalent E-STEP model is easily characterized by design parameters. Various reduced-order modeling techniques can be applied to the equivalent system in a manner similar to how they are applied in the original system. The reduced-order model based on E-STEP is successfully demonstrated for the dynamic analyses of non-linear structural finite element systems under varying design parameters.

9 CFR 161.2 - Requirements and application procedures for accreditation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1-36A, “Application for Veterinary Accreditation,” including certification that the applicant is... veterinarian is a graduate with a Doctorate of Veterinary Medicine or an equivalent degree (any degree that qualifies the holder to be licensed by a State to practice veterinary medicine) from a college of veterinary...

Postdoctoral Fellow | Center for Cancer Research

Cancer.gov

A post-doctoral fellowship is currently available for productive, highly-motivated, and energetic individuals in the Inflammation and Tumorigenesis Section of Dr. Yinling Hu at the NCI-Frederick campus.  A dynamic research environment and outstanding resources are available for enthusiastic individuals.  Requirements include a Ph.D., M.D., or equivalent degree and experience

[A new working shift model for anesthesiologists: an analysis 3 years after implementation].

PubMed

Maschmann, J; Holderried, M; Blumenstock, G; Rieger, M A; Bamberg, M; Rosenberger, P; Wagner, T

2012-11-01

The aim of this study was to assess the efficacy, appropriateness and cost-effectiveness of a new working shift model for anesthesiologists complying with the European working time directive (EWTD) at the University Hospital of Tübingen (UKT), Germany 3 years after implementation Applying the standards of the EWTD is challenging for university hospitals as doctors must comply with the challenge of combining patient care, research and teaching. So far there have been no data available for German university hospitals on how these requirements can be met. As the department of anesthesiology is also a service-providing department it is essential not to increase staffing costs with a new shift model. In 2007 a new working shift model for the department of anesthesiology was designed and introduced in 2008. Shift planning and documentation of working hours were implemented electronically. The calculated number of doctors to run this model was 87.6 full time equivalents (FTE). For 2009 and 2010 the compliance with the EWTD parameters was checked for 1) average weekly working time limit (AWWTL) and 2) compliance to the maximum daily working time limit of 10 h (10 h DWTL). Furthermore, staffing costs for doctors in 2010 were compared to 2007. To check for the time spent in patient care the period of anesthetic attendance (PAA) was chosen, i.e. the total time of patient contact by anesthesiology staff. Data were analyzed descriptively for AWWTL and for 10 h DWTL. FTE, staff costs and PAA were evaluated by one-way ANOVA. The new shift model allowed 84.4 % of all doctors to comply with the individual AWWT limits of 54 h and 48 h in 2009 (81/96) and 76.0 % in 2010 (79/104). In 2009 61.5 % of anesthesiologists voted for opt-out (59/96) and 53.8 % did so in 2010 (56/104). The 10 h DWTL was respected by 84.0 % in 2009 and by 85.9 % in 2010. The mean number of anesthesiologists rose significantly from 78.4 FTE in 2007 to 82.5 FTE in 2009 and 84.6 FTE in 2010 (p < 0.001 for 2010 vs. 2007, p = 0.004 for 2009 vs. 2007 and was not significant for 2010 vs. 2009). Staff costs per FTE increased from 7,524.79 /month to 7,800.66 /month and 7,966.11 /month in 2007, 2009 and 2010, respectively with the differences being non-significant. The PAA increased significantly from a mean of 6,124 h/month in 2007 to 6,581 h/month in 2009 and 6,872 h/month in 2010 (p < 0.001 for 2010 vs. 2007, whereas 2009 vs. 2007 and 2010 vs. 2009 were not significant). Thus, labour costs increased from 96.59 /h PAA in 2007 to 98.53 /h in both 2009 and 2010, the differences being not significant. The newly designed shift model allowed a fair compliance with the EWTD in respect to AWTL and 10 h DWTL, although the calculated number of doctors to run the shift model could not be met in 2009 and 2010. Violations of the 10 h DWT limits were stable in 2009 and 2010; however the number of doctors exceeding the AWWT limits appeared to increase. The compliance with opt-out decreased from 2009 to 2010 and a high proportion of AWWTL violations resulted from the group of non-opt-out voters. The staff costs per hour PAA after implementation of the new shift model did not differ significantly from the year before although staffing costs increased by 7.2 % between 2007 and 2010. Costs increased by 162,454 /year for all PAA hours in 2010. Further evaluation of staff satisfaction with the new shift models is needed and already under way.

Counselling for burnout in Norwegian doctors: one year cohort study.

PubMed

Rø, Karin E Isaksson; Gude, Tore; Tyssen, Reidar; Aasland, Olaf G

2008-11-11

To investigate levels and predictors of change in dimensions of burnout after an intervention for stressed doctors. Cohort study followed by self reported assessment at one year. Norwegian resource centre. 227 doctors participating in counselling intervention, 2003-5. Counselling (lasting one day (individual) or one week (group based)) aimed at motivating reflection on and acknowledgement of the doctors' situation and personal needs. Levels of burnout (Maslach burnout inventory) and predictors of reduction in emotional exhaustion investigated by linear regression. 185 doctors (81%, 88 men, 97 women) completed one year follow-up. The mean level of emotional exhaustion (scale 1-5) was significantly reduced from 3.00 (SD 0.94) to 2.53 (SD 0.76) (t=6.76, P<0.001), similar to the level found in a representative sample of 390 Norwegian doctors. Participants had reduced their working hours by 1.6 hours/week (SD 11.4). There was a considerable reduction in the proportion of doctors on full time sick leave, from 35% (63/182) at baseline to 6% (10/182) at follow-up and a parallel increase in the proportion who had undergone psychotherapy, from 20% (36/182) to 53% (97/182). In the whole cohort, reduction in emotional exhaustion was independently associated with reduced number of work hours/week (beta=0.17, P=0.03), adjusted for sex, age, and personality dimensions. Among men "satisfaction with the intervention" (beta=0.25, P=0.04) independently predicted reduction in emotional exhaustion. A short term counselling intervention could contribute to reduction in emotional exhaustion in doctors. This was associated with reduced working hours for the whole cohort and, in men, was predicted by satisfaction with the intervention.

UK doctors' views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis.

PubMed

Clarke, Rachel T; Pitcher, Alex; Lambert, Trevor W; Goldacre, Michael J

2014-02-06

To report on what doctors at very different levels of seniority wrote, in their own words, about their concerns about the European Working Time Directive (EWTD) and its implementation in the National Health Service (NHS). All medical school graduates from 1993, 2005 and 2009 were surveyed by post and email in 2010. The UK. Using qualitative methods, we analysed free-text responses made in 2010, towards the end of the first year of full EWTD implementation, of three cohorts of the UK medical graduates (graduates of 1993, 2005 and 2009), surveyed as part of the UK Medical Careers Research Group's schedule of multipurpose longitudinal surveys of doctors. Of 2459 respondents who gave free-text comments, 279 (11%) made unprompted reference to the EWTD; 270 of the 279 comments were broadly critical. Key themes to emerge included frequent dissociation between rotas and actual hours worked, adverse effects on training opportunities and quality, concerns about patient safety, lowering of morale and job satisfaction, and attempts reportedly made in some hospitals to persuade junior doctors to collude in the inaccurate reporting of compliance. Further work is needed to determine whether problems perceived with the EWTD, when they occur, are attributable to the EWTD itself, and shortened working hours, or to the way that it has been implemented in some hospitals.

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…

Annual Review of Competence Progression (ARCP) performance of doctors who passed Professional and Linguistic Assessments Board (PLAB) tests compared with UK medical graduates: national data linkage study

PubMed Central

Illing, Jan; Kasim, Adetayo S; McLachlan, John C

2014-01-01

Objective To determine whether use of the Professional and Linguistic Assessments Board (PLAB) examination system used to grant registration for international medical graduates results in equivalent postgraduate medical performance, as evaluated at Annual Review of Competence Progression (ARCP), between UK based doctors who qualified overseas and those who obtained their primary medical qualification from UK universities. Design Observational study linking ARCP outcome data from the UK deaneries with PLAB test performance and demographic data held by the UK General Medical Council (GMC). Setting Doctors in postgraduate training for a medical specialty or general practice in the UK and doctors obtaining GMC registration via the PLAB system. Participants 53 436 UK based trainee doctors with at least one competency related ARCP outcome reported during the study period, of whom 42 017 were UK medical graduates and 11 419 were international medical graduates who were registered following a pass from the PLAB route. Main outcome measure Probability of obtaining a poorer versus a more satisfactory category of outcome at ARCP following successful registration as a doctor in the UK. Results International medical graduates were more likely to obtain a less satisfactory outcome at ARCP compared with UK graduates. This finding persisted even after adjustment for the potential influence of sex, age, years of UK based practice, and ethnicity and exclusion of outcomes associated with postgraduate examination failure (odds ratio 1.63, 95% confidence interval 1.30 to 2.06). However, international medical graduates who scored in the highest twelfth at part 1 of the PLAB (at least 32 points above the pass mark) had ARCP outcomes that did not differ significantly from those of UK graduates. Conclusions These findings suggest that the PLAB test used for registration of international medical graduates is not generally equivalent to the requirements for UK graduates. The differences in postgraduate performance, as captured at ARCP, following the two routes to registration might be levelled out by raising the standards of English language competency required as well as the pass marks for the two parts of the PLAB test. An alternative might be to introduce a different testing system. PMID:24742539

Rank-Order Distribution of Administrative Salaries Paid, 1985-86. Nineteenth Annual Report.

ERIC Educational Resources Information Center

Arkansas Univ., Fayetteville. Office of Institutional Research.

Results of a survey of salaries of full-time administrators at public, doctoral-granting institutions for 1985-1986 are presented. Rank order distributions of 12-month administrative salaries are provided for 156 state universities in 49 states and 33 university systems in 27 states. Salary data for 151 universities in 47 states are also arranged…

Rank-Order Distribution of Administrative Salaries Paid, 1986-87. Twentieth Annual Report.

ERIC Educational Resources Information Center

Arkansas Univ., Fayetteville. Office of Institutional Research.

Results of a survey of salaries of full-time administrators at public, doctoral-granting institutions for 1986-1987 are presented. Rank order distributions of 12-month administrative salaries are provided for 151 state universities in 49 states and 29 university systems in 23 states. Salary data for 151 universities are also arranged into the nine…

Effectiveness of feedback to physicians in reducing inappropriate use of hospitalization: a study in a Spanish hospital.

PubMed

Moya-Ruiz, Carles; Peiró, Salvador; Meneu, Ricard

2002-08-01

To evaluate the effectiveness of feedback to medical staff in reducing inappropriate hospital days, particularly those attributable to conservative medical discharge policies. Quasi-experimental pre-test/post-test with non-equivalent control group. A publicly funded hospital in industrial belt in Barcelona (Spain), serving a predominantly urban population of 100,000. Two non-equivalent groups: control group (surgery department) and intervention group (internal medicine department). Meetings between hospital management and medical staff of the intervention group to inform clinicians of percentages and reasons for inappropriate stays in their departments. Total inappropriate hospital days and percentage attributable to physicians, measured with the Appropriateness Evaluation Protocol before, during, and after intervention. There were no relevant differences in the characteristics of the populations whose stays were reviewed during each of the periods. The total number of inappropriate stays and the percentage attributable to the doctor in the control group did not show any differences between the periods. In the intervention group, inappropriate stays attributable to the doctor decreased from 35.9% in the period to intervention to 27.7% during intervention (relative drop of 22.8%; P < 0.01), and rose to 32.7% after intervention. Differences in total inappropriate days were not significant. Providing physicians with feedback about percentage of inappropriate hospital days produced a significant reduction in the number of inappropriate stays attributable to the doctor, although the impact on overall inappropriate stays is inconclusive.

Agreement between Yuba Community College District and Yuba College Faculty Association, Effective July 1, 1987, Terminates June 30, 1990.

ERIC Educational Resources Information Center

Yuba Coll., Marysville, CA.

This contractual agreement outlines the terms of employment for all full-time instructors, librarians, and counselors; those whose contractual obligation equals or exceeds .60 full-time equivalent (FTE); and those who have completed at least a .10 FTE semester assignment during three of the last six semesters. The articles in the agreement set…

A Distance Blended Learning Program to Upgrade the Clinical Competence of District Non-doctor Anesthesia Providers in Nepal.

PubMed

Shah, Shristi; Knoble, Stephen; Ross, Oliver; Pickering, Stephen

2017-12-01

Across Nepal, anesthesia at a district level is provided mostly by non-doctor anesthesia providers (anesthesia assistants-AAs). Nepal's Government recognized the need to sustain competence with continuous professional development and to upgrade 6-month trained working AAs to professional equivalence with the new national standard of 12-month training. As they are essential district health workers and AA clinical training sites are full, an innovative distance blended learning, competency-based, upgrade 1-year course was developed and conducted in 2014-2017 for two batches. The course content was developed over 18 months by a team of Nepali and overseas AA training experts. The 1-year course started with a refresher course, continued with tablet-based 12-month self-learning modules and clinical case logs, regular educational mentor communication, midcourse 2-week contact time in an AA training site, regular text messaging and ended with clinical examination and multiple-choice questions. Tablet content included 168 new case studies, pre- and posttests, video lectures, matching exercises and a resource library. All module work and logged clinical cases were uploaded centrally, where clinical mentors were able to review work. Clinical skills were upgraded, as needed, through direct clinical contact midway through the course. Quantitative and qualitative course assessments were included. Fourteen working AAs in first batch and eight working AAs in second batch from district, zonal and mission hospitals across Nepal were enrolled. All remained working at their hospitals throughout the course, and there were no significant tablet problems inhibiting course completion. Twenty-one AAs completed all modules successfully with time required for module completion averaging 19.2 h (range 11.2-32). One AA left the course after 3 months with a personal problem. Subjectively, AAs felt that the obstetric and pediatric modules were more difficult; lowest marks were objectively seen in the airway module. Clinical mentors averaged 8.2 h mentoring review work per module with direct student communication of 2.9 h per module per month. Participants logged a total of 5473 clinical cases, ranging between 50 and 788 cases each. Complications were recorded; outcomes were good. Challenges were the national IT infrastructure making data synchronization difficult and the lack of clinical exposure at some AA's hospitals. Nineteen AAs attended the final examination, and all passed. Two AAs withdrew before the final examination period due to personal and logistic reasons. This is the first use of distance blended learning to upgrade district health workers in Nepal and perhaps for non-doctor anesthesia providers globally. Key success factors were motivated students, cultural and contextualized clinical content, good educational mentoring relationships with regular communication, central IT and motivational support, and face-to-face midcourse clinical contact time.

32 CFR 199.14 - Provider reimbursement methods.

Code of Federal Regulations, 2014 CFR

2014-07-01

... for neonatal services which has standardized costs that exceed a threshold of the greater of two times... CHAMPUS discharges in fiscal year 1988. (iv) Hold harmless provision. At such time as the weights... direct medical education costs. (x) Total full-time equivalents for: (A) Residents. (B) Interns. (xi...

32 CFR 199.14 - Provider reimbursement methods.

Code of Federal Regulations, 2013 CFR

2013-07-01

... for neonatal services which has standardized costs that exceed a threshold of the greater of two times... CHAMPUS discharges in fiscal year 1988. (iv) Hold harmless provision. At such time as the weights... direct medical education costs. (x) Total full-time equivalents for: (A) Residents. (B) Interns. (xi...

Who administers? Who cares? Medical administrative and clinical employment in the United States and Canada.

PubMed Central

Himmelstein, D U; Lewontin, J P; Woolhandler, S

1996-01-01

OBJECTIVES. We compared US and Canadian health administration costs using national medical care employment data for both countries. METHODS. Data from census surveys on hospital, nursing home, and outpatient employment in the United States (1968 to 1993) and Canada (1971 and 1986) were analyzed. RESULTS. Between 1968 and 1993, US medical care employment grew from 3.976 to 10.308 million full-time equivalents. Administration grew from 0.719 to 2.792 million full-time equivalents, or from 18.1% to 27.1% of the total employment. In 1986, the United States deployed 33,666 health care full-time equivalent personnel per million population, and Canada deployed 31,529. The US excess was all administrative; Canada employed more clinical personnel, especially registered nurses. Between 1971 and 1986, hospital employment per capita grew 29% in the United States (mostly because of administrative growth) and fell 14% in Canada. In 1986, Canadian hospitals still employed more clinical staff per million. Outpatient employment was larger and grew faster in the United States. Per capita nursing home employment was substantially higher in Canada. CONCLUSIONS. If US hospitals and outpatient facilities adopted Canada's staffing patterns, 1,407,000 fewer managers and clerks would be necessary. Despite lower medical spending, Canadians receive slightly more nursing and other clinical care than Americans, as measured by labor inputs. PMID:8633732

Doctor Julius Robert Mayer and Energy Processes in Living Systems

ERIC Educational Resources Information Center

Erlichson, Herman

2007-01-01

The overwhelming majority of important papers in physics are written by physicists. But the physician Julius Robert Mayer (1814-1878, see photo) did a valid theoretical calculation of the mechanical equivalent of heat just before Joule reported on his results from his well-known paddle-wheel experiments. Joule is well-known to physics people and…

The ethics of telling the patient

PubMed Central

Goldie, Lawrence

1982-01-01

The author, a consultant psychotherapist who works with dying patients in a National Health Service (NHS) hospital, argues that the moral issue is not simply whether or not to tell cancer patients the truth, but more importantly how to do so. Lies and the bald unprepared-for truth may both be damaging. Time and trouble is needed to understand patients and help them understand their situation. Dr Goldie warns that putting oneself into the patient's shoes, as doctors so often do, is the best way of not knowing what another feels. Such misunderstanding may lead to medical decisions based on `nothing more than fantasies - uninspired guesses about what other people think and feel. It is the equivalent of prescribing for patients without examination'. PMID:7131498

Unifying Temporal and Structural Credit Assignment Problems

NASA Technical Reports Server (NTRS)

Agogino, Adrian K.; Tumer, Kagan

2004-01-01

Single-agent reinforcement learners in time-extended domains and multi-agent systems share a common dilemma known as the credit assignment problem. Multi-agent systems have the structural credit assignment problem of determining the contributions of a particular agent to a common task. Instead, time-extended single-agent systems have the temporal credit assignment problem of determining the contribution of a particular action to the quality of the full sequence of actions. Traditionally these two problems are considered different and are handled in separate ways. In this article we show how these two forms of the credit assignment problem are equivalent. In this unified frame-work, a single-agent Markov decision process can be broken down into a single-time-step multi-agent process. Furthermore we show that Monte-Carlo estimation or Q-learning (depending on whether the values of resulting actions in the episode are known at the time of learning) are equivalent to different agent utility functions in a multi-agent system. This equivalence shows how an often neglected issue in multi-agent systems is equivalent to a well-known deficiency in multi-time-step learning and lays the basis for solving time-extended multi-agent problems, where both credit assignment problems are present.

Ask your doctor: the construction of smoking in advertising posters produced in 1946 and 2004.

PubMed

Street, Annette F

2004-12-01

This paper examines two full-page A3 poster advertisements in mass magazines produced at two time points over a 60-year period depicting smoking and its effects, with particular relation to lung cancer. Each poster represents the social and cultural milieu of its time. The writings of Foucault are used to explore the disciplinary technologies of sign systems as depicted in the two posters. The relationships between government, tobacco companies and drug companies and the technologies of production are examined with regard to the development of smoking cessation strategies. The technologies of power are associated with the constructions of risk and lifestyles. The technologies of the self locate smokers as culpable subjects responsible for their individual health. Finally, the meshing of these technologies places the doctor in the frame as "authoritative knower" and representative of expert systems.

32 CFR 199.14 - Provider reimbursement methods.

Code of Federal Regulations, 2010 CFR

2010-07-01

... services which has standardized costs that exceed a threshold of the greater of two times the DRG-based... fiscal year 1988. (iv) Hold harmless provision. At such time as the weights initially assigned to... direct medical education costs. (x) Total full-time equivalents for: (A) Residents. (B) Interns. (xi...

32 CFR 199.14 - Provider reimbursement methods.

Code of Federal Regulations, 2012 CFR

2012-07-01

... services which has standardized costs that exceed a threshold of the greater of two times the DRG-based... fiscal year 1988. (iv) Hold harmless provision. At such time as the weights initially assigned to... direct medical education costs. (x) Total full-time equivalents for: (A) Residents. (B) Interns. (xi...

32 CFR 199.14 - Provider reimbursement methods.

Code of Federal Regulations, 2011 CFR

2011-07-01

... services which has standardized costs that exceed a threshold of the greater of two times the DRG-based... fiscal year 1988. (iv) Hold harmless provision. At such time as the weights initially assigned to... direct medical education costs. (x) Total full-time equivalents for: (A) Residents. (B) Interns. (xi...

From here and now to infinity and eternity: a message to new medical doctors(*).

PubMed

Lapeña, José Florencio F

2014-01-01

Commencement means both an end and a beginning; the end of the academic year and the beginning of the rest of your life as new physicians. For such a beginning, it is useful to view it in retrospect, from the point of view of the end, by conducting a pre-mortem on your life. Taking the existentialist (ex sistere, to stand forth) stance, each of us can be classified into one of four basic types of person, based on our characteristic space and time (or spatio-temporal) context or horizon. Our space can be limited to the "here" and our time to the "now;" or our space may extend to "infinity" and our time embark on "eternity." In-between these poles, most have space contexts rooted in their home and work "turf" and time involving their "lifetime," while some expand their space to include the "world" and their time to encompass "history." From the "here and now" and "turf and lifetime" contexts, the horizons of "world and history," and "infinity and eternity" are examined, challenging new medical doctors to realize their full potential. The new physician is exhorted not to wait for a post-mortem to define (des finitus, to set limits) his or her life. He or she should stand forth, to live, and give life. The new medical doctor is encouraged to look to the sunrise, draw strength from the sunshine, to be brave, and strong and true.

Nurse aide agency staffing and quality of care in nursing homes.

PubMed

Castle, Nicholas G; Engberg, John; Aiju Men

2008-04-01

Data from a large sample of nursing homes are used to examine the association between use of nurse aide agency staff and quality. Agency use data come from a survey conducted in 2005 (N = 2,840), and the quality indicators come from the Nursing Home Compare Web site. The authors found a nonlinear relationship between nurse aide agency levels and quality; however, in general, higher nurse aide agency levels were associated with low quality. The results have policy and practice implications, the most significant of which is that use of nurse aide agency staff of less than 14 full-time equivalents per 100 beds has little influence on quality, whereas nurse aide agency staff of more than 25 full-time equivalents per 100 beds has a substantial influence on quality.

Being a Proud Academic Dinosaur: My Career in the Foundations of Education

ERIC Educational Resources Information Center

Janak, Edward

2015-01-01

In this article, Edward Janak shares his experience with Educational Foundations for the past thirty years. It spans from being an undergraduate pre-service educator in the 1980s, to being a master's degree student and a doctoral student in Educational Foundations from the 1990s and early 2000s, to being a full-time faculty member in Educational…

Take the "Ow!" Out of Taxes Now: How to Plan for and Increase Your Medical Deductions

ERIC Educational Resources Information Center

Medisky, Shannon M.

2009-01-01

Each year countless taxpayers overpay simply because they're not taking full advantage of medical deductions. Individuals with disabilities are especially at risk. Time and energy spent running around to doctor visits, therapy sessions, and the like can leave little left to spend on preparing taxes. Fortunately, with a little effort year round and…

The Persistence Pyramid: Factors Related to Persistence for Low-Income Students in Baccalaureate Programs

ERIC Educational Resources Information Center

Opatz, Leslie Joseph

2013-01-01

Low-income students earn bachelor's degrees at significantly lower rates than their high-income peers. This qualitative study interviewed 21 Fall 2008 full-time first-year Pell Grant recipients in May 2012 when almost all were near the point of baccalaureate degree completion at a large urban doctoral-granting institution with very high research…

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

PubMed

Scharfenberg, Janna; Schaper, Katharina; Krummenauer, Frank

2014-01-01

The German "Dr med" plays a specific role in doctoral thesis settings since students may start the underlying doctoral project during their studies at medical school. If a Medical Faculty principally encourages this approach, then it should support the students in performing the respective projects as efficiently as possible. Consequently, it must be ensured that students are able to implement and complete a doctoral project in parallel to their studies. As a characteristic efficiency feature of these "Dr med" initiatives, the proportion of doctoral projects successfully completed shortly after graduating from medical school is proposed and illustrated. The proposed characteristic can be estimated by the time period between the state examination (date of completion of the qualifying medical examination) and the doctoral examination. Completion of the doctoral project "during their medical studies" was then characterised by a doctoral examination no later than 12 months after the qualifying medical state examination. To illustrate the estimation and interpretation of this characteristic, it was retrospectively estimated on the basis of the full sample of all doctorates successfully completed between July 2009 and June 2012 at the Department of Human Medicine at the Faculty of Health of the University of Witten/Herdecke. During the period of investigation defined, a total number of 56 doctoral examinations were documented, 30 % of which were completed within 12 months after the qualifying medical state examination (95% confidence interval 19 to 44 %). The median duration between state and doctoral examination was 27 months. The proportion of doctoral projects completed parallel to the medical studies increased during the investigation period from 14 % in the first year (July 2009 till June 2010) to 40 % in the third year (July 2011 till June 2012). Only about a third of all "Dr med" projects at the Witten/Herdecke Faculty of Health were completed during or close to the qualifying medical studies. This proportion, however, increased after the introduction of a curriculum on research methodology and practice in 2010; prospective longitudinal studies will have to clarify whether this is causal or mere chronological coincidence. In summary, the proposed method for determining the process efficiency of a medical faculty's "Dr med" programme has proven to be both feasible and informative. Copyright © 2014. Published by Elsevier GmbH.

Prevalence and determinations of physical inactivity among public hospital employees in Shanghai, China: a cross-sectional study.

PubMed

Li, Xinjian; Cheng, Minna; Zhang, Hao; Ke, Ting; Chen, Yisheng

2015-03-01

This study aims to explore the prevalence and determinations of physical inactivity among hospital employees in Shanghai, China. A cross-sectional study of 4612 employees aged 19 to 68 years was conducted through stratified cluster sampling from different classes of Shanghai hospitals in 2011. The total physical activity was evaluated using the metabolic equivalent according to the Global Physical Activity Questionnaire. Among the participants, 38.5%, 32.3%, and 64.6% of the employees are inactive at work, commuting, and taking leisure time, respectively. Up to 41.8% of the men and 37.8% of the women (P = 0.012) are physically inactive. When the age and educational level are adjusted, male doctors and medical technicians show a higher percentage of physical inactivity than male workers in logistics (P = 0.001). Among females, employees who are working in second- and third-class hospitals show a higher proportion of physical inactivity than those who are working in community health care centers. Logistic regression analyses show that the odds ratios (ORs) of leisure-time physical inactivity associated with the intensity of physical activity at work are 2.259, 2.897, and 4.266 for men (P < 0.001) and 2.456, 3.259, and 3.587 for women (P < 0.001), respectively. The time during commuting activities is significantly associated with leisure-time physical inactivity in either sex (OR = 2.116 for men and 2.173 for women, P < 0.001). Hospital employees, particularly doctors and medical technicians, show a higher proportion of physical inactivity than other inhabitants in Shanghai. The time and intensity of activity at work and commuting are associated with leisure-time activities.

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

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…

[Checklist Development for Women-Doctor-Friendly Working Conditions in a Hospital Setting].

PubMed

Horie, Saki; Takeuchi, Masumi; Yamaoka, Kazue; Nohara, Michiko; Hasunuma, Naoko; Okinaga, Hiroko; Nomura, Kyoko

2015-01-01

This study aims to develop a scale of "women-doctor-friendly working conditions in a hospital setting". A task team consisting of relevant people including a medical doctor and a hospital personnel identified 36 items related to women-doctor-friendly working conditions. From December in 2012 to January in 2013, we sent a self-administered questionnaire to 807 full-time employees including faculty members and medical doctors who worked for a university-affiliated hospital. We asked them to score the extent to which they think it is necessary for women doctors to balance between work and gender role responsibilities on the basis of the Likert scale. We carried out a factor analysis and computed Cronbach's alpha to develop a scale and investigated its construct validity and reliability. Of the 807 employees, 291 returned the questionnaires (response rate, 36.1%). The item-total correlation (between an individual item score and the total score) coefficient was in the range from 0.44 to 0.68. In factor analysis, we deleted six items, and five factors were extracted on the basis of the least likelihood method with the oblique Promax rotation. The factors were termed "gender equality action in an organization", "the compliance of care leave in both sexes and parental leave in men", "balance between life events and work", "childcare support at the workplace", and "flexible employment status". The Cronbach's alpha values of all the factors and the total items were 0.82-0.89 and 0.93, respectively, suggesting that the scale we developed has high reliability. The result indicated that the scale of women-doctor-friendly working conditions consisting of five factors with 30 items is highly validated and reliable.

Think It Through: Managing the Benefits and Risks of Medicines

MedlinePlus

... full benefits of medicines: Talk With Your Doctor, Pharmacist, or Other Health Care Professionals Keep an up- ... the label and the directions from your doctor, pharmacist, or other health care professional. If you stop ...

Cost-effective analysis of conventional and nurse-led clinics for common otological procedures.

PubMed

Uppal, S; Jose, J; Banks, P; Mackay, E; Coatesworth, A P

2004-03-01

The need to reduce costs while providing a first-class service has led to the expansion in the role of nurses in recent years. We present results of a comparison of the cost-effectiveness of conventional and nurse-led out-patient ear clinics. Our results indicate that cost-effective health care is a distinct competitive advantage for nurses taking up some roles conventionally performed by doctors. The difference in mean cost of out-patient visit per patient between the two groups is 75.28 pounds. This is equivalent to a reduction in cost to the hospital of more than 47,000 pounds for the 626 patients seen in a nurse-led ear clinic in a year. The nurse-led service is thus more cost-effective and presents an opportunity by freeing up otolaryngologists' time to see more complex patients and has the potential for reducing out-patient access time in the NHS.

The increased financial burden of further proposed orthopaedic resident work-hour reductions.

PubMed

Kamath, Atul F; Baldwin, Keith; Meade, Lauren K; Powell, Adam C; Mehta, Samir

2011-04-06

Increased funding for graduate medical education was not provided during implementation of the eighty-hour work week. Many teaching hospitals responded to decreased work hours by hiring physician extenders to maintain continuity of care. Recent proposals have included a further decrease in work hours to a total of fifty-six hours. The goal of this study was to determine the direct cost related to a further reduction in orthopaedic-resident work hours. A survey was delivered to 152 residency programs to determine the number of full-time equivalent (FTE) physician extenders hired after implementation of the eighty-hour work-week restriction. Thirty-six programs responded (twenty-nine university-based programs and seven community-based programs), encompassing 1021 residents. Previous published data were used to determine the change in resident work hours with implementation of the eighty-hour regulation. A ratio between change in full-time equivalent staff per resident and number of reduced hours was used to determine the cost of the proposed further decrease. After implementation of the eighty-hour work week, the average reduction among orthopaedic residents was approximately five work hours per week. One hundred and forty-three physician extenders (equal to 142 full-time equivalent units) were hired to meet compliance at a frequency-weighted average cost of $96,000 per full-time equivalent unit. A further reduction to fifty-six hours would increase the cost by $64,000 per resident. With approximately 3200 orthopaedic residents nationwide, sensitivity analyses (based on models of eighty and seventy-three-hour work weeks) demonstrate that the increased cost would be between $147 million and $208 million per fiscal year. For each hourly decrease in weekly work hours, the cost is $8 million to $12 million over the course of a fiscal year. Mandated reductions in resident work hours are a costly proposition, without a clear decrease in adverse events. The federal government should consider these data prior to initiating unfunded work-hour mandates, as further reductions in resident work hours may make resident education financially unsustainable. © 2011 by the Journal of Bone and Joint Surgery, Incorporated

45 CFR 1801.4 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Regulations Relating to Public Welfare (Continued) HARRY S. TRUMAN SCHOLARSHIP FOUNDATION HARRY S. TRUMAN SCHOLARSHIP PROGRAM General § 1801.4 Definitions. As used in this part: Academic year means the period of time..., or the equivalent. Foundation means the Harry S. Truman Scholarship Foundation. Full-time student...

45 CFR 1801.4 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Regulations Relating to Public Welfare (Continued) HARRY S. TRUMAN SCHOLARSHIP FOUNDATION HARRY S. TRUMAN SCHOLARSHIP PROGRAM General § 1801.4 Definitions. As used in this part: Academic year means the period of time..., or the equivalent. Foundation means the Harry S. Truman Scholarship Foundation. Full-time student...

45 CFR 1801.4 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Regulations Relating to Public Welfare (Continued) HARRY S. TRUMAN SCHOLARSHIP FOUNDATION HARRY S. TRUMAN SCHOLARSHIP PROGRAM General § 1801.4 Definitions. As used in this part: Academic year means the period of time..., or the equivalent. Foundation means the Harry S. Truman Scholarship Foundation. Full-time student...

Increasing Trends in Schedule II Opioid Use and Doctor Shopping during 1999–2007 in California

PubMed Central

Han, Huijun; Kass, Philip H.; Wilsey, Barth L.; Li, Chin-Shang

2013-01-01

Purpose To examine the age and gender-specific trends of schedule II opioid use among California residents, with special reference to multiple provider users (“doctor shoppers”). Methods Utilizing data from the California Prescription Drug Monitoring Program, we examined age and gender-specific trends of Schedule II opioid use during calendar years 1999–2007. Specifically, we analyzed: 1) the prevalence of Schedule II opioid users among California’s population, and 2) the proportion of these opioid users who were doctor shoppers (defined as an individual who used more than five different prescribers for all schedule II opioids he/she obtained in a calendar year). Results Among all age and gender groups, the prevalence of Schedule II opioid users in California increased by 150%–280% and the prevalence of doctor shoppers among users increased by 111%–213% over nine years. The prevalence of opioid users was lowest among 18–44 year-old males (1.25%) and highest among 65 years and older females (5.31%) by 2007. The prevalence of doctor shoppers was approximately 1.4% among those up to age 64 and 0.5% among those 65 years and older. The gender difference in doctor shoppers among all age groups was negligible. On average, the cumulative morphine-equivalent amount of Schedule II opioid per individual obtained per year was three- to six-fold higher for doctor shoppers than for the general population across different age and gender groups. Conclusions Age and gender differences in opioid use were relatively small, while the trends for use of opioids and multiple providers grew at a disquieting rate. PMID:23956137

Understanding and perceptions of final-year Doctor of Pharmacy students about generic medicines in Karachi, Pakistan: a quantitative insight

PubMed Central

Jamshed, Shazia Qasim; Ibrahim, Mohamad Izham Mohamad; Hassali, Mohamad Azmi; Sharrad, Adheed Khalid; Shafie, Asrul Akmal; Babar, Zaheer-Ud-Din

2015-01-01

General objective To evaluate the understanding and perceptions of generic medicines among final-year Doctor of Pharmacy students in Karachi, Pakistan. Methods A 23-item survey instrument that included a question on the bioequivalence limits and Likert-type scale questions regarding the understanding and perceptions of generic medicines among the students was executed. Cronbach’s alpha was found to be 0.62. Results Responses were obtained from 236 final-year Doctor of Pharmacy students (n=85 from a publicly funded institute; n=151 from a privately funded institute). When comparing a brand-name medicine to a generic medicine, pharmacy students scored poorly on bioequivalence limits. More than 80% of the students incorrectly answered that all the products that are rated as generic equivalents are therapeutically equivalent to each other (P<0.04). Half of the students agreed that a generic medicine is bioequivalent to the brand-name medicine (P<0.001). With regard to quality, effectiveness, and safety, more than 75% of the students disagreed that generic medicines are of inferior quality and are less effective than brand-name medicines (P<0.001). More than 50% of the students disagreed that generic medicines produce more side effects than brand-name medicines (P<0.001). Conclusion The current study identified a positive perception toward generic medicines but also gaps in the understanding of generic medicines. Pharmacy students lacked a thorough understanding of the concepts of bioequivalence. Pharmacy academia should address these issues, which will help build confidence in generic medicines and increase the generic medicine use in Pakistan. PMID:26028981

77 FR 45636 - Food Safety Modernization Act Domestic and Foreign Facility Reinspection, Recall, and Importer...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-01

... of a Supported Direct FDA Work Hour for FY 2013 FDA is required to estimate 100 percent of its costs... operating costs. A. Estimating the Full Cost per Direct Work Hour in FY 2011 In general, the starting point for estimating the full cost per direct work hour is to estimate the cost of a full-time-equivalent...

All in a day's work: an observational study to quantify how and with whom doctors on hospital wards spend their time.

PubMed

Westbrook, Johanna I; Ampt, Amanda; Kearney, Leanne; Rob, Marilyn I

2008-05-05

To quantify time doctors in hospital wards spend on specific work tasks, and with health professionals and patients. Observational time and motion study. 400-bed teaching hospital in Sydney. 19 doctors (seven registrars, five residents, seven interns) in four wards were observed between 08:30 and 19:00 for a total of 151 hours between July and December 2006. Proportions of time in categories of work; proportions of tasks performed with health professionals and patients; proportions of tasks using specific information tools; rates of multitasking and interruptions. The greatest proportions of doctors' time were in professional communication (33%; 95% CI, 29%-38%); social activities, such as non-work communication and meal breaks (17%; 95% CI, 13%-21%), and indirect care, such as planning care (17%; 95% CI, 15%-19%). Multitasking involved 20% of time, and on average, doctors were interrupted every 21 minutes. Most tasks were completed with another doctor (56%; 95% CI, 55%-57%), while 24% (95% CI, 23%-25%) were undertaken alone and 15% (95% CI, 15%-16%) with a patient. Interns spent more time completing documentation and administrative tasks, and less time in direct care than residents and registrars. The time interns spent documenting (22%) was almost double the time they were engaged in direct patient care. Two-thirds of doctors' time was consumed by three work categories: professional communication, social activities and indirect care. Doctors on wards are interrupted at considerably lower rates than those in emergency and intensive care units. The results confirm interns' previously reported dissatisfaction with their level of administrative work and documentation.

Interruptions and multitasking in surgery: a multicentre observational study of the daily work patterns of doctors and nurses.

PubMed

Bellandi, Tommaso; Cerri, Alessandro; Carreras, Giulia; Walter, Scott; Mengozzi, Cipriana; Albolino, Sara; Mastrominico, Eleonora; Renzetti, Fernando; Tartaglia, Riccardo; Westbrook, Johanna

2018-01-01

The aim of this study was to obtain baseline data on doctors' and nurses' work activities and rates of interruptions and multitasking to improve work organisation and processes. Data were collected in six surgical units with the WOMBAT (Work Observation Method by Activity Timing) tool. Results show that doctors and nurses received approximately 13 interruptions per hour, or one interruption every 4.5 min. Compared to doctors, nurses were more prone to interruptions in most activities, while doctors performed multitasking (33.47% of their time, 95% CI 31.84-35.17%) more than nurses (15.23%, 95% CI 14.24-16.25%). Overall, the time dedicated to patient care is relatively limited for both professions (37.21%, 95% CI 34.95-39.60% for doctors, 27.22%, 95% CI 25.18-29.60% for nurses) compared to the time spent for registration of data and professional communication, that accounts for two-thirds of doctors' time and nearly half of nurses' time. Further investigation is needed on strategies to manage job demands and professional communications. Practitioner Summary: This study offers further findings on the characteristics and frequency of multitasking and interruptions in surgery, with a comparison of how they affect doctors and nurses. Further investigation is needed to improve the management of job demands and communications according to the results.

Dedication increases productivity: an analysis of the implementation of a dedicated medical team in the emergency department.

PubMed

Ramos, Pedro; Paiva, José Artur

2017-12-01

In several European countries, emergency departments (EDs) now employ a dedicated team of full-time emergency medicine (EM) physicians, with a distinct leadership and bed-side emergency training, in all similar to other hospital departments. In Portugal, however, there are still two very different models for staffing EDs: a classic model, where EDs are mostly staffed with young inexperienced physicians from different medical departments who take turns in the ED in 12-h shifts and a dedicated model, recently implemented in some hospitals, where the ED is staffed by a team of doctors with specific medical competencies in emergency medicine that work full-time in the ED. Our study assesses the effect of an intervention in a large academic hospital ED in Portugal in 2002, and it is the first to test the hypothesis that implementing a dedicated team of doctors with EM expertise increases the productivity and reduces costs in the ED, maintaining the quality of care provided to patients. A pre-post design was used for comparing the change on the organisational model of delivering care in our medical ED. All emergency medical admissions were tracked in 2002 (classic model with 12-h shift in the ED) and 2005/2006 (dedicated team with full-time EM physicians), and productivity, costs with medical human resources and quality of care measures were compared. We found that medical productivity (number of patients treated per hour of medical work) increased dramatically after the creation of the dedicated team (X 2 KW = 31.135; N = 36; p < 0.001) and costs with ED medical work reduced both in regular hours and overtime. Moreover, hospitalisation rates decreased and the length of stay in the ED increased significantly after the creation of the dedicated team. Implementing a dedicated team of doctors increased the medical productivity and reduced costs in our ED. Our findings have straightforward implication for Portuguese policymakers aiming at reducing hospital costs while coping with increased ED demand.

Development of a resource model for infection prevention and control programs in acute, long term, and home care settings: conference proceedings of the Infection Prevention and Control Alliance.

PubMed

Morrison, Judith

2004-02-01

There is mounting concern about the impact of health care restructuring on the provision of infection prevention services across the health care continuum. In response to this, Health Canada hosted two meetings of Canadian infection control experts to develop a model upon which the resources required to support an effective, integrated infection prevention and control program across the health care continuum could be based. The final models project the IPCP needs as three full time equivalent infection control professionals/500 beds in acute care hospitals and one full time equivalent infection control professional/150-250 beds in long term care facilities. Non human resource requirements are also described for acute, long term, community, and home care settings.

Review of registration requirements for new part-time doctors in New Zealand, Australia, the United Kingdom, Ireland and Canada.

PubMed

Leitch, Sharon; Dovey, Susan M

2010-12-01

By the time medical students graduate many wish to work part-time while accommodating other lifestyle interests. To review flexibility of medical registration requirements for provisional registrants in New Zealand, Australia, the United Kingdom, Ireland and Canada. Internet-based review of registration bodies of each country, and each state or province in Australia and Canada, supplemented by emails and phone calls seeking clarification of missing or obscure information. Data from 20 regions were examined. Many similarities were found between study countries in their approaches to the registration of new doctors, although there are some regional differences. Most regions (65%) have a provisional registration period of one year. Extending this period was possible in 91% of regions. Part-time options were possible in 75% of regions. All regions required trainees to work in approved practice settings. Only the UK provided comprehensive documentation of their requirements in an accessible format and clearly explaining the options for part-time work. Australia appeared to be more flexible than other countries with respect to part- and full-time work requirements. All countries need to examine their registration requirements to introduce more flexibility wherever possible, as a strategy for addressing workforce shortages.

Diagnostic Utility of the Shortened Version of the Wisconsin Card Sorting Test in Patients With Sporadic Late Onset Alzheimer Disease.

PubMed

Sánchez, Juan Luis; Martín, Javier; López, Carolina

2017-12-01

The classic version of the Wisconsin Card Sorting Test (WCST) consists of correctly sorting 128 cards according to changing sorting criteria. Its application is costly in terms of the time employed, with all the negative consequences this entails (decrease in motivation, frustration, and fatigue). The main objective of this study was to test the usefulness of the shortened version of the WCST as compared to the full test by analyzing the equivalence between the two decks comprising the full 128-card version on a sample of patients diagnosed with sporadic late onset Alzheimer disease (SLOAD) and to check its clinical usefulness. The variables showed equivalence between the two decks and their ability to differentiate between the control group (CG) and the Alzheimer disease (AD) group. The scores obtained suggest equivalence between decks and that the application of only the first deck is sufficient.

Full waveform time domain solutions for source and induced magnetotelluric and controlled-source electromagnetic fields using quasi-equivalent time domain decomposition and GPU parallelization

NASA Astrophysics Data System (ADS)

Imamura, N.; Schultz, A.

2015-12-01

Recently, a full waveform time domain solution has been developed for the magnetotelluric (MT) and controlled-source electromagnetic (CSEM) methods. The ultimate goal of this approach is to obtain a computationally tractable direct waveform joint inversion for source fields and earth conductivity structure in three and four dimensions. This is desirable on several grounds, including the improved spatial resolving power expected from use of a multitude of source illuminations of non-zero wavenumber, the ability to operate in areas of high levels of source signal spatial complexity and non-stationarity, etc. This goal would not be obtainable if one were to adopt the finite difference time-domain (FDTD) approach for the forward problem. This is particularly true for the case of MT surveys, since an enormous number of degrees of freedom are required to represent the observed MT waveforms across the large frequency bandwidth. It means that for FDTD simulation, the smallest time steps should be finer than that required to represent the highest frequency, while the number of time steps should also cover the lowest frequency. This leads to a linear system that is computationally burdensome to solve. We have implemented our code that addresses this situation through the use of a fictitious wave domain method and GPUs to speed up the computation time. We also substantially reduce the size of the linear systems by applying concepts from successive cascade decimation, through quasi-equivalent time domain decomposition. By combining these refinements, we have made good progress toward implementing the core of a full waveform joint source field/earth conductivity inverse modeling method. From results, we found the use of previous generation of CPU/GPU speeds computations by an order of magnitude over a parallel CPU only approach. In part, this arises from the use of the quasi-equivalent time domain decomposition, which shrinks the size of the linear system dramatically.

Distributed source model for the full-wave electromagnetic simulation of nonlinear terahertz generation.

PubMed

Fumeaux, Christophe; Lin, Hungyen; Serita, Kazunori; Withayachumnankul, Withawat; Kaufmann, Thomas; Tonouchi, Masayoshi; Abbott, Derek

2012-07-30

The process of terahertz generation through optical rectification in a nonlinear crystal is modeled using discretized equivalent current sources. The equivalent terahertz sources are distributed in the active volume and computed based on a separately modeled near-infrared pump beam. This approach can be used to define an appropriate excitation for full-wave electromagnetic numerical simulations of the generated terahertz radiation. This enables predictive modeling of the near-field interactions of the terahertz beam with micro-structured samples, e.g. in a near-field time-resolved microscopy system. The distributed source model is described in detail, and an implementation in a particular full-wave simulation tool is presented. The numerical results are then validated through a series of measurements on square apertures. The general principle can be applied to other nonlinear processes with possible implementation in any full-wave numerical electromagnetic solver.

The careers of women graduates from St Mary's Hospital Medical School, London, 1961--72.

PubMed

Shaw, H E

1979-07-01

The careers of women doctors who qualified from St Mary's Hospital Medical School between 1961 and 1972 inclusive have been studied. Thirty-eight per cent were in full-time work, 47% were working part-time, and 15% were not practising medicine at the time of the survey. Those working full-time were predominantly single women and married women with no children. With the birth of children most women stopped working for a time, and 38% of those whose children were all under school age were not working. However, 90% returned to medicine, usually to part-time jobs that were compatible with family responsibilities. Eighty-six per cent of the respondents held one or more postgraduate qualifications. More of those with higher qualifications were in full-time work than was the case for women with a basic medical degree only, and fewer were not practising medicine. An equal proportion of single and married women intended to make their career in general practice. Fewer married women than single women chose a hospital career, because the possibilities of part-time work in this field were seen as limited.

Becoming Academics: Experiencing Legitimate Peripheral Participation in Part-Time Doctoral Studies

ERIC Educational Resources Information Center

Teeuwsen, Phil; Ratkovic, Snežana; Tilley, Susan A.

2014-01-01

An important element of doctoral studies is identification with the academic community. Such identification is often complicated by part-time student status. In this paper, two part-time doctoral students and their supervisor employ Lave and Wenger's concept of legitimate peripheral participation to explore, through a critical socio-cultural lens,…

From Here and Now to Infinity and Eternity: A Message to New Medical Doctors*

PubMed Central

Lapeña, José Florencio F.

2014-01-01

Commencement means both an end and a beginning; the end of the academic year and the beginning of the rest of your life as new physicians. For such a beginning, it is useful to view it in retrospect, from the point of view of the end, by conducting a pre-mortem on your life. Taking the existentialist (ex sistere, to stand forth) stance, each of us can be classified into one of four basic types of person, based on our characteristic space and time (or spatio-temporal) context or horizon. Our space can be limited to the “here” and our time to the “now;” or our space may extend to “infinity” and our time embark on “eternity.” In-between these poles, most have space contexts rooted in their home and work “turf” and time involving their “lifetime,” while some expand their space to include the “world” and their time to encompass “history.” From the “here and now” and “turf and lifetime” contexts, the horizons of “world and history,” and “infinity and eternity” are examined, challenging new medical doctors to realize their full potential. The new physician is exhorted not to wait for a post-mortem to define (des finitus, to set limits) his or her life. He or she should stand forth, to live, and give life. The new medical doctor is encouraged to look to the sunrise, draw strength from the sunshine, to be brave, and strong and true. PMID:24891804

78 FR 16486 - Commission Information Collection Activities (FERC-606); Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-15

...-time employment). \\4\\ Average salary plus benefits per full-time equivalent employee. Comments... Requests for Further Information), to the Office of Management and Budget (OMB) for review of the... intended to allow agencies to assist the Commission to make better informed decisions in establishing due...

34 CFR 668.2 - General definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... (Authority: 20 U.S.C. 1078-1) Federal Work Study (FWS) program: The part-time employment program for students... degree; and (3) Has completed the equivalent of at least three years of full-time study either prior to... of study to eligible financially needy undergraduate students who successfully complete rigorous...

42 CFR 415.208 - Services of moonlighting residents.

Code of Federal Regulations, 2010 CFR

2010-10-01

... IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Services of Residents § 415.208 Services of... payment is made for services of a “teaching physician” associated with moonlighting services, and the time spent furnishing these services is not included in the teaching hospital's full-time equivalency count...

Preventing falls in hospital.

PubMed

Pearce, Lynne

2017-02-27

Essential facts Falls are the most frequent adverse event reported in hospitals, usually affecting older patients. Every year, more than 240,000 falls are reported in acute hospitals and mental health trusts in England and Wales, equivalent to more than 600 a day, according to the Royal College of Physicians (RCP). But research shows that when nurses, doctors and therapists work together, falls can be reduced by 20-30%.

Negotiating for more: the multiple equivalent simultaneous offer.

PubMed

Heller, Richard E

2014-02-01

Whether a doctor, professional baseball manager, or a politician, having successful negotiation skills is a critical part of being a leader. Building upon prior journal articles on negotiation strategy, the author presents the concept of the multiple equivalent simultaneous offer (MESO). The concept of a MESO is straightforward: as opposed to making a single offer, make multiple offers with several variables. Each offer alters the different variables, such that the end result of each offer is equivalent from the perspective of the party making the offer. Research has found several advantages to the use of MESOs. For example, using MESOs, an offer was more likely to be accepted, and the counterparty was more likely to be satisfied with the negotiated deal. Additional benefits have been documented as well, underscoring why a prepared radiology business leader should understand the theory and practice of MESO. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

[Equivalency examinations for foreign physicians in Baden-Wuerttemberg].

PubMed

Farhan, N; Wiesemann, A; Wirsching, M

2014-05-01

Recent years have seen an increasing number of foreign doctors starting to practice medicine in German hospitals (or more rarely, in surgeries). In order to be granted the German license to practice medicine, doctors with a medical degree from outside the European Union have to undergo an equivalency examination. The supervisory authority for this is the examination office of the relevant federal state, which is why different procedures are being applied in the individual states. The aim of this paper is to point out the problems that frequently arise when conducting this specialist exam and to make suggestions as to how to improve the quality of the procedure. 6 senior professors from the examination boards of the 4 medical schools in Baden-Wuerttemberg formed a focus group and discussed the difficulties associated with the exam, recorded problems in its actual implementation and then analysed the minutes of the meeting in a results-based manner in order to compile proposals for optimisation. In view of the deficits in subject knowledge, general communication skills and specific communication skills, the difficulties of the current recognition procedure and the existing equivalency exam fall into 3 categories: structure and content of the exam, examiners and exam candidates. In consultation with the State Examination Office Stuttgart, some processes for optimisation have been devised, e. g., to develop a special curriculum which could be used for guidance and to recruit more examiners. The recommendations of the focus group from Baden-Wuerttemberg are an important step towards more transparency and possibly towards a Germany-wide standardisation of this exam. © Georg Thieme Verlag KG Stuttgart · New York.

What Is a Doctorate? A Concept-Mapped Analysis of Process versus Product in the Supervision of Lab-Based PhDs

ERIC Educational Resources Information Center

Kandiko, Camille B.; Kinchin, Ian M.

2012-01-01

Background: Concept-mapping and interview techniques are used to track knowledge and understanding over the duration of PhD study amongst four students and their supervisors in the course of full-time research towards their PhDs. This work is in contrast to much PhD supervision research and policy research that focuses on supervisory styles and…

Looking to the Future--The Role of Master's Programs in Counseling Psychology: A Response to Quality of Master's Education: A Concern for Counseling Psychology?

ERIC Educational Resources Information Center

Horne, Arthur M.

2013-01-01

The predoctoral relationship that counseling psychology programs have had with master's programs over the decades is being challenged in current times. A model that is developing is one that provides greater responsibility for program definition and then full faculty engagement from doctoral program faculty. With change occurring in training…

Cost-effectiveness of staff and workload profiles in retaining patients on antiretroviral therapy in KwaZulu-Natal, South Africa.

PubMed

Vella, Venanzio; Govender, Thiloshini; Dlamini, Sicelo S; Moodley, Indres; David, Verona; Taylor, Myra; Jinabhai, Champaklal C

2011-09-01

There is paucity of information on the cost-effectiveness of delivery strategies to retain patients on antiretroviral therapy (ART) and this study tries to fill this gap. The analysis is based on a representative sample of 2835 patients attending 32 ART sites in KwaZulu-Natal (KZN), South Africa. Extended Cox regression and Kaplan Meier were used to estimate the transition probabilities to remain on ART among patients who attended sites with different staff and workload profiles. Annual costs per patient-year of observation for these delivery profiles were estimated. Probabilistic sensitivity analysis took into account parameters' uncertainty. The delivery sites with a full-time doctor and a full-time senior professional nurse and an intake of less than 200 new patients per doctor per year were the most cost-effective in retaining patients on ART. If 1000 new patients were followed up by this type of site, 724 patients would still be on ART after 10 years at a discounted cost of US$8.41 million at 2006 value with an incremental cost-effectiveness ratio of US$12,271 per extra retained patient over the second not dominated site profile. The results could be used to estimate the human resources needed for a sustainable scaling up of ART in KZN.

Shared responsibility for employers regarding health coverage. Final regulations.

PubMed

2014-02-12

This document contains final regulations providing guidance to employers that are subject to the shared responsibility provisions regarding employee health coverage under section 4980H of the Internal Revenue Code (Code), enacted by the Affordable Care Act. These regulations affect employers referred to as applicable large employers (generally meaning, for each year, employers that had 50 or more full-time employees, including full-time equivalent employees, during the prior year). Generally, under section 4980H an applicable large employer that, for a calendar month, fails to offer to its full-time employees health coverage that is affordable and provides minimum value may be subject to an assessable payment if a full-time employee enrolls for that month in a qualified health plan for which the employee receives a premium tax credit.

Are Dropout and Degree Completion in Doctoral Study Significantly Dependent on Type of Financial Support and Field of Research?

ERIC Educational Resources Information Center

van der Haert, Margaux; Arias Ortiz, Elena; Emplit, Philippe; Halloin, Véronique; Dehon, Catherine

2014-01-01

In this article, the determinants of "time to dropout" from doctoral studies and "time to PhD completion" are studied using a discrete-time competing risks survival analysis for a sample of 3092 doctoral candidates from the Université libre de Bruxelles. Not surprisingly, results show that students supported with research…

Achieving compliance with the European Working Time Directive in a large teaching hospital: a strategic approach.

PubMed

Jones, Gareth J; Vanderpump, Mark P J; Easton, Mark; Baker, Daryll M; Ball, Carol; Leenane, Michael; O'Brien, Heather; Turner, Nigel; Else, Martin; Reid, Wendy M N; Johnson, Margaret

2004-01-01

This paper describes the strategy which achieved European Working Time Directive (EWTD) compliance at the Royal Free Hampstead NHS Trust in medicine and surgery. Compliance with EWTD regulations was assessed by diary card exercise, clinical care assessed through critical incident reports, electronic handover documents and nursing reports, training opportunities assessed by unit training directors, cost controls assessed by finance department analysis, and workload assessed by staff attendance on wards, in casualty and in theatres. There was a change in focus of care to a consultant-led, specialist registrar- (SpR-)driven service extending into evenings and on weekends, coupled with a move to a multi-skilled team for night cover, and to a move from traditional on-call shifts to a full shift system across both medicine and surgery. Compliance with the EWTD was achieved whilst maintaining good standards of clinical care, ensuring training opportunities for doctors in training, controlling payroll costs, removing the need for locums, and reducing workload for both junior doctors and consultants.

The Relationship between Doctoral Completion Time, Gender, and Future Salary Prospects for Physical Scientists

NASA Astrophysics Data System (ADS)

Potvin, Geoff; Tai, Robert H.

2012-03-01

Drawing from a national survey of Ph.D.-holding physical scientists, we present evidence that doctoral completion time is a strong predictor of future salary prospects: each additional year in graduate school corresponds to a substantially lower average salary. This is true even while controlling for typical measures of scientific merit (grant funding and publication rates) and several other structural and career factors expected to influence salaries. Extending this picture to include gender effects, we show that women earn significantly less than men overall and experience no effect of doctoral completion time on their salaries, while men see a significant gain in salary stemming from earlier completion times. Doctoral completion time is shown to be largely unconnected to measures of prior academic success, research independence, and scientific merit suggesting that doctoral completion time is, to a great extent, out of the control of individual graduate students. Nonetheless, it can be influential on an individual's future career prospects, as can gender-related effects.

Needs Analysis for the West Hills College at Lemoore, West Hills Community College District. Commission Report.

ERIC Educational Resources Information Center

California State Postsecondary Education Commission, Sacramento.

This report reviews the proposal by the West Hills Community College District (WHCCD) (California) to transition its off-campus center to full college status. The proposal's objectives include: (1) establishing a new comprehensive college that will serve approximately 1,700 full-time-equivalent students by 2015; and (2) providing greater access to…

77 FR 45639 - Prescription Drug User Fee Rates for Fiscal Year 2013

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-01

... compensation and benefits (PC&B) paid per full-time equivalent position (FTE) at FDA for the first 3 of the 4... preceding FY 2013. The 3 year average is 2.17 percent. Table 1--FDA Personnel Compensation and Benefits (PC... 108.25 122.3 The FY 2013 application fee is estimated by dividing the average number of full...

Married Thai Working Mothers: Coping with Initial Part-Time Doctoral Study

ERIC Educational Resources Information Center

Thinnam, Thanit

2011-01-01

Advanced educational attainment can "grow" a career. But acquiring a doctoral qualification adds study to existing work and family responsibilities, especially for women. This phenomenological research explores the experiences of eight Thai working mothers enrolled in the initial stage of part-time doctoral programs in Thailand. A…

Metrix Matrix: A Cloud-Based System for Tracking Non-Relative Value Unit Value-Added Work Metrics.

PubMed

Kovacs, Mark D; Sheafor, Douglas H; Thacker, Paul G; Hardie, Andrew D; Costello, Philip

2018-03-01

In the era of value-based medicine, it will become increasingly important for radiologists to provide metrics that demonstrate their value beyond clinical productivity. In this article the authors describe their institution's development of an easy-to-use system for tracking value-added but non-relative value unit (RVU)-based activities. Metrix Matrix is an efficient cloud-based system for tracking value-added work. A password-protected home page contains links to web-based forms created using Google Forms, with collected data populating Google Sheets spreadsheets. Value-added work metrics selected for tracking included interdisciplinary conferences, hospital committee meetings, consulting on nonbilled outside studies, and practice-based quality improvement. Over a period of 4 months, value-added work data were collected for all clinical attending faculty members in a university-based radiology department (n = 39). Time required for data entry was analyzed for 2 faculty members over the same time period. Thirty-nine faculty members (equivalent to 36.4 full-time equivalents) reported a total of 1,223.5 hours of value-added work time (VAWT). A formula was used to calculate "value-added RVUs" (vRVUs) from VAWT. VAWT amounted to 5,793.6 vRVUs or 6.0% of total work performed (vRVUs plus work RVUs [wRVUs]). Were vRVUs considered equivalent to wRVUs for staffing purposes, this would require an additional 2.3 full-time equivalents, on the basis of average wRVU calculations. Mean data entry time was 56.1 seconds per day per faculty member. As health care reimbursement evolves with an emphasis on value-based medicine, it is imperative that radiologists demonstrate the value they add to patient care beyond wRVUs. This free and easy-to-use cloud-based system allows the efficient quantification of value-added work activities. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Differences in antibiotic use between patients with and without a regular doctor in Hong Kong.

PubMed

Lam, Tai Pong; Wun, Yuk Tsan; Lam, Kwok Fai; Sun, Kai Sing

2015-12-15

Literature shows that continuity of care from a primary care physician is associated with better patient satisfaction and preventive care. This may also have an effect on patients' use of antibiotics. This study investigated the differences in antibiotic use between patients with and without a regular doctor in a pluralistic health care system. A cross-sectional telephone questionnaire survey using randomly selected household phone numbers was conducted in Hong Kong. Several key areas about antibiotic use were compared between the respondents with a regular doctor and those without. The response rate was 68.3 %. Of the 2,471 respondents, 1,450 (58.7 %) had a regular doctor, 942 (38.1 %) without, and 79 (3.2 %) did not give a clear answer. The respondents with a regular doctor were more likely to report that they always finished the full course of antibiotics (74.2 % vs 62.4 %), as well as using antibiotics for their last upper respiratory tract infections (17.4 % vs 10.1 %). The association with antibiotic use remained significant in the multivariable logistic regression analysis after adjusting for other confounding factors (P < 0.001, OR = 1.76, 95 % CI:(1.27, 2.48)). While patients with a regular doctor, compared to those without, were more likely to report finishing the full course of antibiotics, they also had nearly twice the chance of reporting antibiotic use for upper respiratory tract infections. This challenges the common belief of the benefits in having a regular doctor.

A Project Perspective on Doctoral Studies--A Student Point of View

ERIC Educational Resources Information Center

Backlund, Fredrik

2017-01-01

Purpose: Many doctoral students never obtain a doctoral degree, and many do not finish their studies in time. To promote aspects of effectiveness and efficiency in doctoral studies, the purpose of this paper is to explore a project perspective, more specifically how doctoral students experience their studies in terms of key dimensions of projects.…

3D biomaterial matrix to support long term, full thickness, immuno-competent human skin equivalents with nervous system components.

PubMed

Vidal, Sarah E Lightfoot; Tamamoto, Kasey A; Nguyen, Hanh; Abbott, Rosalyn D; Cairns, Dana M; Kaplan, David L

2018-04-24

Current commercially available human skin equivalents (HSEs) are used for relatively short term studies (∼1 week) due in part to the time-dependent contraction of the collagen gel-based matrix and the limited cell types and skin tissue components utilized. In contrast, here we describe a new matrix consisting of a silk-collagen composite system that provides long term, stable cultivation with reduced contraction and degradation over time. This matrix supports full thickness skin equivalents which include nerves. The unique silk-collagen composite system preserves cell-binding domains of collagen while maintaining the stability and mechanics of the skin system for long-term culture with silk. The utility of this new composite protein-based biomaterial was demonstrated by bioengineering full thickness human skin systems using primary cells, including nerves and immune cells to establish an HSE with a neuro-immuno-cutaneous system. The HSEs with neurons and hypodermis, compared to in vitro skin-only HSEs controls, demonstrated higher secretion of pro-inflammatory cytokines. Proteomics analysis confirmed the presence of several proteins associated with inflammation across all sample groups, but HSEs with neurons had the highest amount of detected protein due to the complexity of the model. This improved, in vitro full thickness HSE model system utilizes cross-linked silk-collagen as the biomaterial and allows reduced reliance on animal models and provides a new in vitro tissue system for the assessment of chronic responses related to skin diseases and drug discovery. Copyright © 2018 Elsevier Ltd. All rights reserved.

The impact of complaints procedures on the welfare, health and clinical practise of 7926 doctors in the UK: a cross-sectional survey

PubMed Central

Bourne, Tom; Wynants, Laure; Peters, Mike; Van Audenhove, Chantal; Timmerman, Dirk; Van Calster, Ben; Jalmbrant, Maria

2015-01-01

Objectives The primary aim was to investigate the impact of complaints on doctors’ psychological welfare and health. The secondary aim was to assess whether doctors report exposure to a complaints process is associated with defensive medical practise. Design This was a cross-sectional anonymous survey study. Participants were stratified into recent/current, past, no complaints. Each group completed tailored versions of the survey. Participants 95 636 doctors were invited to participate. A total of 10 930(11.4%) responded, 7926 (8.3%) completed the full survey and were included in the complete analysis. Main outcome measures Anxiety and depression were assessed using the standardised Generalised Anxiety Disorder scale and Physical Health Questionnaire. Defensive practise was evaluated using a new measure. Single-item questions measured stress-related illnesses, complaints-related experience, attitudes towards complaints and views on improving complaints processes. Results 16.9% of doctors with current/recent complaints reported moderate/severe depression (relative risk (RR) 1.77 (95% CI 1.48 to 2.13) compared to doctors with no complaints (9.5%)). Fifteen per cent reported moderate/severe anxiety (RR=2.08 (95% CI 1.61 to 2.68) compared to doctors with no complaints (7.3%)). Distress increased with complaint severity, with highest levels after General Medical Council (GMC) referral (26.3% depression, 22.3% anxiety). Doctors with current/recent complaints were 2.08 (95% CI 1.61 to 2.68) times more likely to report thoughts of self-harm or suicidal ideation. Most doctors reported defensive practise: 82–89% hedging and 46–50% avoidance. Twenty per cent felt victimised after whistleblowing, 38% felt bullied, 27% spent over 1 month off work. Over 80% felt processes would improve with transparency, managerial competence, capacity to claim lost earnings and action against vexatious complainants. Conclusions Doctors with recent/current complaints have significant risks of moderate/severe depression, anxiety and suicidal ideation. Morbidity was greatest in cases involving the GMC. Most doctors reported practising defensively, including avoidance of procedures and high-risk patients. Many felt victimised as whistleblowers or reported bullying. Suggestions to improve complaints processes included transparency and managerial competence. PMID:25592686

Side-effects of generic.

PubMed

Ruzić, Klementina; Medved, Paola; Dadić-Hero, Elizabeta; Graovac, Mirjana; Tatalović-Vorkapić, Sanja; Grzeta, Ika Roncević

2010-03-01

New trends in medicine which are much more oriented towards pharmacoeconomy, are ever so common these days. There's an aim within the focus of the health system which is cutting down treatment expenses, and that relates to psychiatry practice too. Prescription drugs issued by specialist doctors are allowed to be switched with cheaper ones of the same group of drugs by GP doctors, with an aim of cost reduction. "Instead of the medicament prescribed, a GP doctor is allowed to prescribe an alternative medicament of the same efficacy in the dosage of an adequate strength" (taken from the specialist medical report form). A 74 years old man is treated for psychotic depression. Exogenic environmental factors caused the symptoms manifestation due to which hospitalization in a psychiatric ward occurred in two incidences. At the risperidone introduction soon after the second hospitalization event, a long term remission was obtained which lasted for several years. Despite a stable dose of psychopharmacs, new episode of the illness occurred. Researching the potential factors which lead towards the aggravation of the course of the illness disclosed that instead of the original risperidone, the pharmacist issued a generic in an equivalent dose.

[Doctors in love].

PubMed

de Leeuw, Peter W

2012-01-01

To investigate how often doctors fall in love or are in a relationship with a colleague. Descriptive questionnaire. Doctors and medical students completed an online questionnaire during the summer of 2012. The questions concerned baseline characteristics as well as their feelings of happiness. In addition, we asked them whether they were in love or had ever been with a colleague and whether this had resulted in a steady relationship. A total of 401 individuals participated, of which 41% were male and 59% female. Their mean age was 40 years. Altogether, 40% of the participants indicated to be or have been in love with a colleague. This occurred more often in women than men. In 82% the relationship was of an equivalent nature; it was hierarchical in the remainder. In only 23% of cases, the relationship was steady; this was independent of age. Dermatologists appeared to be the least apt to fall in love with a colleague, while obstetricians had the highest rate. Although love between colleagues is a frequently occurring phenomenon, this is associated with a steady relationship in only about 25% of cases. There is wide variation among specialists in their proneness to intercollegial love.

Are Danish doctors comfortable teaching in English?

PubMed

Nilas, L; Løkkegaard, E C; Laursen, J B; Kling, J; Cortes, D

2016-08-27

From 2012-2015, the Departments of Obstetrics and Gynecology and of Pediatrics at the University of Copenhagen conducted a project, "Internationalization at Home ", offering clinical teaching in English. The project allowed international students to work with Danish speaking students in a clinical setting. Using semi-quantitative questionnaires to 89 clinicians about use of English and need for training, this paper considers if Danish clinical doctors are prepared to teach in English. The majority self-assessed their English proficiency between seven and eight on a 10 unit visual analogue scale, with 10 equivalent to working in Danish, while 15 % rated five or less. However, one-fourth found teaching and writing in English to be twice as difficult than in Danish, and 12 % rated all teaching tasks in English at four or less compared to Danish. The self-assessed need for additional English skills was perceived low. Teaching in English was rated as 30 % more difficult than in Danish, and a significant subgroup of doctors had difficulties in all forms of communication in English, resulting in challenges when introducing international students in non-native English speaking medical departments.

A Deep Learning-Based Method for Similar Patient Question Retrieval in Chinese.

PubMed

Tang, Guo Yu; Ni, Yuan; Xie, Guo Tong; Fan, Xin Li; Shi, Yan Ling

2017-01-01

The online patient question and answering (Q&A) system, either as a website or a mobile application, attracts an increasing number of users in China. Patients will post their questions and the registered doctors then provide the corresponding answers. A large amount of questions with answers from doctors are accumulated. Instead of awaiting the response from a doctor, the newly posted question could be quickly answered by finding a semantically equivalent question from the Q&A achive. In this study, we investigated a novel deep learning based method to retrieve the similar patient question in Chinese. An unsupervised learning algorithm using deep neural network is performed on the corpus to generate the word embedding. The word embedding was then used as the input to a supervised learning algorithm using a designed deep neural network, i.e. the supervised neural attention model (SNA), to predict the similarity between two questions. The experimental results showed that our SNA method achieved P@1 = 77% and P@5 = 84%, which outperformed all other compared methods.

The Doctor of Philosophy Experience of Athletic Trainers: Facilitators and Barriers to Anticipatory Faculty Socialization.

PubMed

Bowman, Thomas G; Klossner, Joanne C; Mazerolle, Stephanie M

2017-10-01

  It is important to understand the process whereby athletic trainers learn about their future roles, particularly when the roles can be complex and demanding. Little is known about the experiences of athletic training doctoral students, including facilitators and barriers to socialization as aspiring faculty members.   To investigate factors influencing the anticipatory socialization of athletic training doctoral students into future faculty roles.   Qualitative study.   Universities with athletic training doctoral students.   We recruited 28 students (19 women, 9 men, age = 28 ± 3 years) with a minimum of 1 year of doctoral coursework completed and participating in an assistantship at the time of the study to reach data saturation. Participants were certified for 6 ± 3 years and represented 5 National Athletic Trainers' Association districts and 9 institutions.   We completed semistructured, 1-on-1 telephone interviews with participants. We transcribed each interview verbatim and analyzed the data using an inductive approach. Peer review, multiple-analyst triangulation, and member checks ensured trustworthiness.   We uncovered 4 themes from our analysis related to facilitators and barriers to professional socialization. Participants described comprehensive autonomous experiences in research that allowed them to feel confident they could sustain a scholarly agenda. Independent experiences and lack of pedagogy training yielded mixed preparedness relative to teaching responsibilities. Limited formal experience led to incomplete role understanding related to the service component of the professoriate. Finally, with regard to the administrative duties associated with athletic training faculty positions, participants noted a lack of direct exposure to common responsibilities.   Role occupation in various aspects of the professoriate helped doctoral students prepare as future faculty members, although full role understanding was limited. Intentional exposure to research, teaching, service, and administrative expectations during doctoral experiences may facilitate the socialization of future athletic training faculty into academic roles.

Application of queuing theory to patient satisfaction at a tertiary hospital in Nigeria

PubMed Central

Ameh, Nkeiruka; Sabo, B.; Oyefabi, M. O.

2013-01-01

Background: Queuing theory is the mathematical approach to the analysis of waiting lines in any setting where arrival rate of subjects is faster than the system can handle. It is applicable to healthcare settings where the systems have excess capacity to accommodate random variations. Materials and Methods: A cross-sectional descriptive survey was done. Questionnaires were administered to patients who attended the general outpatient department. Observations were also made on the queuing model and the service discipline at the clinic. Questions were meant to obtain demographic characteristics and the time spent on the queue by patients before being seen by a doctor, time spent with the doctor, their views about the time spent on the queue and useful suggestions on how to reduce the time spent on the queue. A total of 210 patients were surveyed. Results: Majority of the patients (164, 78.1%) spent 2 h or less on the queue before being seen by a doctor and less than 1 h to see the doctor. Majority of the patients (144, 68.5%) were satisfied with the time they spent on the queue before being seen by a doctor. Useful suggestions proffered by the patients to decrease the time spent on the queue before seeing a doctor at the clinic included: that more doctors be employed (46, 21.9%), that doctors should come to work on time (25, 11.9%), that first-come-first served be observed strictly (32, 15.2%) and others suggested that the records staff should desist from collecting bribes from patients in order to place their cards before others. The queuing method employed at the clinic is the multiple single channel type and the service discipline is priority service. The patients who spent less time on the queue (<1 h) before seeing the doctor were more satisfied than those who spent more time (P < 0.05). Conclusion: The study has revealed that majority of the patients were satisfied with the practice at the general outpatient department. However, there is a need to employ measures to respond to the suggestions given by the patients who are the beneficiaries of the hospital services. PMID:23661902

Post-Monolingual Research Methodology: Multilingual Researchers Democratizing Theorizing and Doctoral Education

ERIC Educational Resources Information Center

Singh, Michael

2017-01-01

This paper reports on the ground-breaking research in the study of languages in doctoral education. It argues for democratizing the production and dissemination of original contributions to knowledge through activating and mobilizing multilingual Higher Degree Researchers' (HDRs) capabilities for theorizing through them using their full linguistic…

Colleagues in Training: How Senior Faculty View Doctoral Education

ERIC Educational Resources Information Center

Pardun, Carol J.; McKeever, Robert; Pressgrove, Geah N.; McKeever, Brooke Weberling

2015-01-01

A survey of 241 full professors in journalism and mass communication were asked their views on doctoral education. Results indicated that the expected number of publications students should generate from their dissertations was positively correlated with the number of publications professors produced from their own dissertations, supporting the…

45 CFR 233.39 - Age.

Code of Federal Regulations, 2010 CFR

2010-10-01

...; or age 18 if a full-time student in a secondary school, or in the equivalent level of vocational or... AABD with respect to the blind, any age; (iv) In APTD or AABD with respect to the disabled, 18 years of...

Association between patient-centered medical home rating and operating cost at federally funded health centers.

PubMed

Nocon, Robert S; Sharma, Ravi; Birnberg, Jonathan M; Ngo-Metzger, Quyen; Lee, Sang Mee; Chin, Marshall H

2012-07-04

Little is known about the cost associated with a health center's rating as a patient-centered medical home (PCMH). To determine whether PCMH rating is associated with operating cost among health centers funded by the US Health Resources and Services Administration. Cross-sectional study of PCMH rating and operating cost in 2009. PCMH rating was assessed through surveys of health center administrators conducted by Harris Interactive of all 1009 Health Resources and Services Administration–funded community health centers. The survey provided scores from 0 (worst) to 100 (best) for total PCMH score and 6 subscales: access/communication, care management, external coordination, patient tracking, test/referral tracking, and quality improvement. Costs were obtained from the Uniform Data System reports submitted to the Health Resources and Services Administration. We used generalized linear models to determine the relationship between PCMH rating and operating cost. Operating cost per physician full-time equivalent, operating cost per patient per month, and medical cost per visit. Six hundred sixty-nine health centers (66%) were included in the study sample, with 340 excluded because of nonresponse or incomplete data. Mean total PCMH score was 60 (SD, 12; range, 21-90). For the average health center, a 10-point higher total PCMH score was associated with a $2.26 (4.6%) higher operating cost per patient per month (95% CI, $0.86-$4.12). Among PCMH subscales, a 10-point higher score for patient tracking was associated with higher operating cost per physician full-time equivalent ($27,300; 95% CI, $3047-$57,804) and higher operating cost per patient per month ($1.06; 95% CI, $0.29-$1.98). A 10-point higher score for quality improvement was also associated with higher operating cost per physician full-time equivalent ($32,731; 95% CI, $1571-$73,670) and higher operating cost per patient per month ($1.86; 95% CI, $0.54-$3.61). A 10-point higher PCMH subscale score for access/communication was associated with lower operating cost per physician full-time equivalent ($39,809; 95% CI, $1893-$63,169). According to a survey of health center administrators, higher scores on a scale that assessed 6 aspects of the PCMH were associated with higher health center operating costs. Two subscales of the medical home were associated with higher cost and 1 with lower cost.

Effectiveness of a learner-centred training programme for primary care physicians in using a patient-centred consultation style.

PubMed

Moral, R R; Alamo, M M; Jurado, M A; de Torres, L P

2001-02-01

The aim of the present study was to find out if a training programme adapted to family physicians with several years of clinical experience changes their behaviour when they deal with fibromyalgic patients in the sense of introducing the communication skills that define the 'patient-centred' approach. A randomized, and simple blind, educative study was carried out. Twenty full-time family physicians were invited to participate. They were allocated randomly to two groups: an intervention and a control group. A total of 110 patients were recruited from people attending physicians' surgeries for the first time and who complained of generalized pain that finally fulfilled criteria for generalized musculoskeletal chronic pain/fibromyalgia. This was done for an entire year. The intervention group received an 18 hour intensive course. One week after the course, all doctors carried out a video-recorded encounter with a patient who played the part of a typical fibromyalgia clinical case. The interviews were coded by an observer blind to the training status of the participants, using the GATHARES-CP questionnaire. All patients were contacted by telephone during a 1-2-month period by a different interviewer who was 'blinded' to the patient's experimental status. They were asked to respond to three questions that represent the key components of patient-centred style. The average score on the GATHARES-CP questionnaire was 11.3 +/- 0.9 and 9 +/- 2.3, for doctors from the intervention and control groups, respectively (P < 0.01). For 11 items, scores were higher in the intervention group. The patients' answers to all three questions showed statistically significant differences in a positive direction for the trained doctors. The doctors improved the use of strategies and skills for carrying out patient-centred consultations after they had received an interactive course. The doctors' behaviour appeared to have changed as much in a more experimental situation as in the actual consultations. Moreover, the gain was observed immediately after the intervention was completed, and after having run for a variable period of time up to 1 year.

Adverse effects on health and wellbeing of working as a doctor: views of the UK medical graduates of 1974 and 1977 surveyed in 2014.

PubMed

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

2017-05-01

Objective To report on any adverse effects on health and wellbeing of working as a doctor, as described by senior doctors. Design Questionnaires sent in 2014 to all medical graduates of 1974 and 1977. Participants 3695 UK medical graduates. Setting United Kingdom. Main outcome measures Statements about adverse effects upon health, wellbeing and career. Results The aggregated response rate from contactable doctors was 84.6% (3695/4369). In response to the question 'Do you feel that working as a doctor has had any adverse effects on your own health or wellbeing?', 44% of doctors answered 'yes'. More GPs (47%) than hospital doctors (42%) specified that this was the case. Three-quarters of doctors who answered 'yes' cited 'stress/work-life balance/workload' as an adverse effect, and 45% mentioned illness. In response to the statement 'The NHS of today is a good employer when doctors become ill themselves', 28% of doctors agreed, 29% neither agreed nor disagreed and 43% disagreed. More women doctors (49%) than men doctors (40%) disagreed with this statement. More general practitioners (49%) disagreed than hospital doctors (37%). Conclusions Chronic stress and illness, which these doctors attributed to their work, were widely reported. Although recent changes may have alleviated some of these issues, there are lessons for the present and future if the NHS is to ensure that its medical workforce receives the support which enables current doctors to enjoy a full and satisfying career and to contribute fully to health service provision in the UK. Older doctors, in particular, need support to be able to continue successfully in their careers.

Adverse effects on health and wellbeing of working as a doctor: views of the UK medical graduates of 1974 and 1977 surveyed in 2014

PubMed Central

Goldacre, Michael J; Lambert, Trevor W

2017-01-01

Summary Objective To report on any adverse effects on health and wellbeing of working as a doctor, as described by senior doctors. Design Questionnaires sent in 2014 to all medical graduates of 1974 and 1977. Participants 3695 UK medical graduates. Setting United Kingdom. Main outcome measures Statements about adverse effects upon health, wellbeing and career. Results The aggregated response rate from contactable doctors was 84.6% (3695/4369). In response to the question ‘Do you feel that working as a doctor has had any adverse effects on your own health or wellbeing?’, 44% of doctors answered ‘yes’. More GPs (47%) than hospital doctors (42%) specified that this was the case. Three-quarters of doctors who answered ‘yes’ cited ‘stress/work–life balance/workload’ as an adverse effect, and 45% mentioned illness. In response to the statement ‘The NHS of today is a good employer when doctors become ill themselves’, 28% of doctors agreed, 29% neither agreed nor disagreed and 43% disagreed. More women doctors (49%) than men doctors (40%) disagreed with this statement. More general practitioners (49%) disagreed than hospital doctors (37%). Conclusions Chronic stress and illness, which these doctors attributed to their work, were widely reported. Although recent changes may have alleviated some of these issues, there are lessons for the present and future if the NHS is to ensure that its medical workforce receives the support which enables current doctors to enjoy a full and satisfying career and to contribute fully to health service provision in the UK. Older doctors, in particular, need support to be able to continue successfully in their careers. PMID:28504070

Implications of aligning full registration of doctors with medical school graduation: a qualitative study of stakeholder perspectives.

PubMed

Mattick, K L; Kaufhold, K; Kelly, N; Cole, J A; Scheffler, G; Rees, C E; Bullock, A; Gormley, G J; Monrouxe, L V

2016-02-23

The Shape of Training report recommended that full registration is aligned with medical school graduation. As part of a General Medical Council-funded study about the preparedness for practice of UK medical graduates, we explored UK stakeholders' views about this proposal using qualitative interviews (30 group and 87 individual interviews) and Framework Analysis. Four UK study sites, one in each country. 185 individuals from eight stakeholder groups: (1) foundation year 1 (F1) doctors (n=34); (2) fully registered trainee doctors (n=33); (3) clinical educators (n=32); (4) undergraduate/postgraduate Deans, and Foundation Programme Directors (n=30); (5) other healthcare professionals (n=13); (6) employers (n=7); (7) policy and government (n=11); (8) patient and public representatives (n=25). We identified four main themes: (1) The F1 year as a safety net: patients were protected by close trainee supervision and 'sign off' to prevent errors; trainees were provided with a safe environment for learning on the job; (2) Implications for undergraduate medical education: if the proposal was accepted, a 'radical review' of undergraduate curricula would be needed; undergraduate education might need to be longer; (3) Implications for F1 work practice: steps to protect healthcare team integration and ensure that F1 doctors stay within competency limits would be required; (4) Financial, structural and political implications: there would be cost implications for trainees; clarification of responsibilities between undergraduate and postgraduate medical education would be needed. Typically, each theme comprised arguments for and against the proposal. A policy change to align the timing of full registration with graduation would require considerable planning and preliminary work. These findings will inform policymakers' decision-making. Regardless of the decision, medical students should take on greater responsibility for patient care as undergraduates, assessment methods in clinical practice and professionalism domains need development, and good practice in postgraduate supervision and support must be shared. 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/

[Mikhail Bulgakov--a colleague and cult figure].

PubMed

Olsen, B

1995-12-10

Mikhail Bulgakov (1891-1940) was medically qualified, but practised as a doctor only a few years before he launched on a full time career as a writer. His writings are marked by exuberant satire and burlesque phantasy, a genre condemned anti-Sovietic. Throughout his writing life, Bulgakov found it extremely difficult to get his writings published. He did not become known to the reading public inside and outside USSR until 30 years after his death.

Referral Finder: Saving Time and Improving The Quality of In-hospital Referrals.

PubMed

Cathcart, Jennifer; Cowan, Neil; Tully, Vicki

2016-01-01

Making referrals to other hospital specialties is one of the key duties of the foundation doctor, which can be difficult and time consuming. In Ninewells hospital, Scotland, in our experience the effectiveness of referrals is limited by contact details not being readily accessible and foundation doctors not knowing what information is relevant to each specialty. We surveyed foundation doctors on their experience of the existing referral process to identify where we needed to focus to improve the process. The doctors reported significant delays in obtaining contact details from the operator, and found they did not know the specific information needed in each referral. To increase the information available to foundation doctors, we set up a page on the staff intranet called 'Referral Finder'. This page includes contact details, guidelines for referral, and links to relevant protocols for each specialty. By making this information readily accessible our objective was to increase the speed and quality of referrals. When surveyed two months after the web page was established, foundation doctors reported a reduction in calls to operator from baseline and reported achieving more effective referrals. When asked to comment, many doctors asked if the page could include details for other hospitals in our health board and provide more specialty specific information. This feedback prompted us to extend the scope of the page to include the district general hospital in our region, and update many of the existing details. Doctors were then surveyed after the updates, 100% agreed that the website saved time and there was a 49.3% reduction in doctors who reported not knowing the specific information needed for a referral. Having adequate information improved referrals and resulted in time saved. This would allow more time for patient care. The quality improvement project was praised among doctors as a useful, innovative and replicable project.

Referral Finder: Saving Time and Improving The Quality of In-hospital Referrals

PubMed Central

Cathcart, Jennifer; Cowan, Neil; Tully, Vicki

2016-01-01

Making referrals to other hospital specialties is one of the key duties of the foundation doctor, which can be difficult and time consuming. In Ninewells hospital, Scotland, in our experience the effectiveness of referrals is limited by contact details not being readily accessible and foundation doctors not knowing what information is relevant to each specialty. We surveyed foundation doctors on their experience of the existing referral process to identify where we needed to focus to improve the process. The doctors reported significant delays in obtaining contact details from the operator, and found they did not know the specific information needed in each referral. To increase the information available to foundation doctors, we set up a page on the staff intranet called ‘Referral Finder’. This page includes contact details, guidelines for referral, and links to relevant protocols for each specialty. By making this information readily accessible our objective was to increase the speed and quality of referrals. When surveyed two months after the web page was established, foundation doctors reported a reduction in calls to operator from baseline and reported achieving more effective referrals. When asked to comment, many doctors asked if the page could include details for other hospitals in our health board and provide more specialty specific information. This feedback prompted us to extend the scope of the page to include the district general hospital in our region, and update many of the existing details. Doctors were then surveyed after the updates, 100% agreed that the website saved time and there was a 49.3% reduction in doctors who reported not knowing the specific information needed for a referral. Having adequate information improved referrals and resulted in time saved. This would allow more time for patient care. The quality improvement project was praised among doctors as a useful, innovative and replicable project. PMID:27158494

[Comment on “Doctorate time rising sharply: How long should it take” by William Glen] Defining TTD

NASA Astrophysics Data System (ADS)

Jedlovec, Gary J.

In response to the Forum article “Doctorate Time Rising Sharply: How long should it take?” by William Glen (March 27, 1990), I contend that Glen (and the authors of a book he cites) may be overlooking a possible explanation for the rise in time to doctorate (TTD). Is the time one spends working in his/her field between degrees considered and tabulated? It might be that after obtaining a bachelors or masters degree, the student seeks employment for a number of years before returning to school.Using myself as an example, after graduating with a masters degree in 1981 (bachelors in 1979), I worked as a research associate for NASA before returning to school in 1984. I completed my doctorate degree in 1987, making my actual time in school between the bachelors and doctorate degrees only 5 years. The TTD as defined in Forum would yield 8 years. I know of many others who have proceeded in getting a doctorate degree in a similar fashion. My TTD of 8 years in no way reflects institutional factors as suggested in the article.

Medical doctors profile in Ethiopia: production, attrition and retention. In memory of 100-years Ethiopian modern medicine & the new Ethiopian millennium.

PubMed

Berhan, Yifru

2008-01-01

Although the practice of western medicine in Ethiopia dates back to the time of King Libne Dengel (1520-1535), organized and sustainable modern medical practice started after the battle of Adwa (1896). To review hospitals construction, medical doctors production and attrition, and to suggest alternative medical doctors retention mechanisms in the public sector and production scale up options. In this article, 100 years Ethiopian modern medical history is revised from old and recent medical chronicles. Until December 2006 primary data was collected from 87 public hospitals. Much emphasis is given to medical doctors profile (1906-2006), hospitals profile (1906-2005), medical doctors to population and hospitals ratio (1965-2006), Ethiopian public medical schools 42 years attainment (1964-2006), annual attrition rate (1984-2006), organizational structure of medical faculties & university hospitals, medical doctors remuneration by the Ministry of Health (MOH), Ministry of Education (MOE), NGOs and private health institutions. This article also addresses the way forward from physician training and retention perspectives, multiple alternate mechanisms to increase physicians' motivation to work in government institutions and reveres the loss. Medical doctors production scale up option is also given much emphasis. Most data are presented using line and bar graphs. Literature review showed that the first three hospitals were constructed in 1896 (Russian hospital), 1903 (Harar Ras Mekonnen hospital) and 1906 (Menelik II hospital). In 2005, 139 hospitals (87 public and 52 others) were reported. Remarkable hospital construction was done between 1935 and 1948, and recently between 1995 and 2005; however, in the latter case, private hospitals construction took the lions share. By the time MOH was established (1948), 110 Ethiopian and expatriate medical doctors were working, mainly in the capital, and 46 hospitals constructed. Physician number increment was very slow till 1980 at which time it started to get doubled every five years and reached peak (1658 medical doctors of all type) in 1989 in the public sector. As there was sharp increment in physician number, on the contrary, there was sharp decline in the last 15 years (1990-2006) to nadir 638 doctors in 2006 in the public sector. The last 25 years of Ethiopian modern medical history, in reference to physician number, forms a triangle with the lower and upper base 1980 and 2006, respectively. Since MOH of Ethiopia started registering health professionals with qualifications in 1987, 5743 (76.5% Ethiopian and 23.5% expatriate) medical doctors were registered for the first time. Out of these, 3717 were general practitioners. The three prestigious medical schools (Addis Ababa, Gondar, Jimma) were established in 1964, 1978 and 1984, respectively. Since establishment till 2006, about 3728 medical doctors were graduated with MD degree from the three medical schools. Addis Ababa university medical faculty alone graduated 1890 general practitioners (1964-2006) and 862 clinical specialists (1979-2006). In the 23 years period (1984-2006), the highest and lowest physician to population ratios in the public sector were found to be in 1989 (1:28,000) and 2006 (1:118,000), respectively. In 2006, the physician to population ratio in Amhara, Oromia and SNNPR regional states was computed to be 1:280,000, 1:220,000, and 1:230,000, respectively. The physician deficit analysis in the last 23 years in relation to the WHO standard for developing countries (1:10,000) revealed the lowest record at the national and regional states in the last 12-years. Average physician to hospital ratio in five regional states in December 2006 was 3.6 (Tigray), 4.3 (Amhara), 6.1 (Oromia) and 5.3 (SNNPR). As the December 2006 direct interview with 76 public hospitals outside Addis Ababa showed, there was no specialist in 36 hospitals and no doctor at all in 3 hospitals. Seven public hospitals located in big regional states' town took the lions share of medical doctors. In short, in December 2006, 80.3% of regional hospitals were equipped with 0-2 specialists of one kind, and in 48.7% there were 0-3 General practitioners. Highest medical doctors annual attrition rates (20%-54.3%) were found in 1991-1992, 1998, 2002-2006. In general, in 20 years period (1987-2006), 73.2% of Ethiopian medical doctors left the public sector mainly due to attractive remuneration in overseas countries and local NGOs/private sectors. The number of postgraduate programme in Addis Ababa, Jimma and Gondar medical schools in December 2006 was 22, 12 and 3, respectively. The total number of fully employed academic staff of the medical schools in declining order was Addis Ababa 181, Gondar 118, Jimma 71, Hawassa 63 and Mekele 52: those with second degree and above being 97.2%, 35.6%, 90.1%, 55.6% and 15.4%, respectively. Currently (2006), there are about 416 clinical residents in 3 medical schools. High annual attrition rate, fast population growth, governmental and nongovernmental health institution expansion, low production and increased postgraduate enrollment in the last 3-4 years contributed for extremely low physician-to-population ratio in Ethiopia. Although the Ethiopian government and private sector worked and achieved much on health infrastructure construction and midlevel health professionals training, it does not appear that medical doctors retention mechanisms are sorted out so far. As a result, even despite salary equivalent top up payments in some regions, more than 80% of public hospitals outside Addis Ababa were found ill-equipped with the most important human element--physicians. This implies that the push factors may not invariably correlate with remuneration. It is high time that the government discusses the possible solutions among health professional associations/societies and other health stakeholders, and apply concrete medical doctors retention mechanisms before the public medical schools and hospitals dry off doctors. Among actions to be undertaken from the current Ethiopian perspective: providing land plot for physicians for residential house construction, giving priority to physicians in providing low cost houses, low interest or interest free loan for residential house construction and automobile procurement, allowing duty free automobile procurement, improving the fully employed academic staff taxation system, approving the different remuneration options proposed, adopting the other countries experience of dual employment to academic staff working in teaching hospitals, modifying the academic rank promotion based on year of training, for university hospitals either establishing hospital organizational structure in the Ministry of Education or letting them be under MOH, establishing joint appointment (mutual beneficiary) agreement between medical schools and local hospitals, directing donors and stakeholders to work on the line of reducing internal and external medical doctors brain drain, making independent MOH and higher institutions from Civil Service Agency are proposed as short term solutions. Retention as a strategy & production as a programme, medical doctors production scale up options are proposed as a long term solution to achieve physician to population ratio of 1:15,000. and 1:8,000 by the year 2015 and 2020, respectively.

Doctoral Writing in the Visual and Performing Arts: Two Ends of a Continuum

ERIC Educational Resources Information Center

Paltridge, Brian; Starfield, Sue; Ravelli, Louise; Nicholson, Sarah

2012-01-01

Doctoral degrees in the visual and performing arts are a fairly recent entrant in the research higher degree landscape in Australian universities. At the same time, a new kind of doctorate is evolving, a doctorate in which significant aspects of the claim for the doctoral characteristics of originality, mastery and contribution to the field are…

Medical scribes in emergency medicine produce financially significant productivity gains for some, but not all emergency physicians.

PubMed

Walker, Katherine J; Ben-Meir, Michael; Phillips, David; Staples, Margaret

2016-06-01

The present study aims to determine if a scribe in an Australian ED can assist emergency physicians to work with increased productivity and to investigate when and where to allocate a scribe and to whom. This was a prospective observational single-centre study conducted at a private ED in Melbourne. It evaluated one American scribe and five doctors over 6 months. A scribe is a trained assistant who performs non-clinical tasks usually performed by the doctor. The primary outcomes were patients/hour/doctor and billings/patient. Additional analyses included individual doctor productivity, productivity by ED region, shift time, day of the week and physician learning curves. Door-to-doctor time, time spent on ambulance bypass and door-to-discharge time were examined, also complaints or issues with the scribe. There was an overall increase in doctor consultations of 0.11 (95%CI 0.07-0.15) primary consultations per hour (13%). There was variation seen between individual doctors (lowest increase 0.06 [6%] to highest increase 0.12 [15%]). Billings per patients, door-to-doctor, door-to-discharge and ambulance bypass times remained the same. There was no advantage to allocating a scribe to a specific time of day, day of week or region of the ED. There was no learning period found. In the present study, scribe usage was associated with overall improvements in primary consultations per hour of 13% per scribed hour, and this varied depending on the physician. There is an economic argument for allocating scribes to some emergency physicians on days, evenings and weekends, not to trainees. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

The impact of shift patterns on junior doctors' perceptions of fatigue, training, work/life balance and the role of social support

PubMed Central

Brown, M; Rapport, F; Hutchings, H; Dahlgren, A; Davies, G; Ebden, P

2010-01-01

Background The organisation of junior doctors' work hours has been radically altered following the partial implementation of the European Working Time Directive. Poorly designed shift schedules cause excessive disruption to shift workers' circadian rhythms. Method Interviews and focus groups were used to explore perceptions among junior doctors and hospital managers regarding the impact of the European Working Time Directive on patient care and doctors' well-being. Results Four main themes were identified. Under “Doctors shift rotas”, doctors deliberated the merits and demerits of working seven nights in row. They also discussed the impact on fatigue of long sequences of day shifts. “Education and training” focused on concerns about reduced on-the-job learning opportunities under the new working time arrangements and also about the difficulties of finding time and energy to study. “Work/life balance” reflected the conflict between the positive aspects of working on-call or at night and the impact on life outside work. “Social support structures” focused on the role of morale and team spirit. Good support structures in the work place counteracted and compensated for the effects of negative role stressors, and arduous and unsocial work schedules. Conclusions The impact of junior doctors' work schedules is influenced by the nature of specific shift sequences, educational considerations, issues of work/life balance and by social support systems. Poorly designed shift rotas can have negative impacts on junior doctors' professional performance and educational training, with implications for clinical practice, patient care and the welfare of junior doctors. PMID:21127102

The impact of shift patterns on junior doctors' perceptions of fatigue, training, work/life balance and the role of social support.

PubMed

Brown, M; Tucker, P; Rapport, F; Hutchings, H; Dahlgren, A; Davies, G; Ebden, P

2010-12-01

The organisation of junior doctors' work hours has been radically altered following the partial implementation of the European Working Time Directive. Poorly designed shift schedules cause excessive disruption to shift workers' circadian rhythms. Interviews and focus groups were used to explore perceptions among junior doctors and hospital managers regarding the impact of the European Working Time Directive on patient care and doctors' well-being. Four main themes were identified. Under "Doctors shift rotas", doctors deliberated the merits and demerits of working seven nights in row. They also discussed the impact on fatigue of long sequences of day shifts. "Education and training" focused on concerns about reduced on-the-job learning opportunities under the new working time arrangements and also about the difficulties of finding time and energy to study. "Work/life balance" reflected the conflict between the positive aspects of working on-call or at night and the impact on life outside work. "Social support structures" focused on the role of morale and team spirit. Good support structures in the work place counteracted and compensated for the effects of negative role stressors, and arduous and unsocial work schedules. The impact of junior doctors' work schedules is influenced by the nature of specific shift sequences, educational considerations, issues of work/life balance and by social support systems. Poorly designed shift rotas can have negative impacts on junior doctors' professional performance and educational training, with implications for clinical practice, patient care and the welfare of junior doctors.

The continuing medical education activities and attitudes of Australian doctors working in different clinical specialties and practice locations.

PubMed

Stewart, Grant D; Khadra, Mohamed H

2009-02-01

Currently, it is not clear which continuing medical education (CME) methods are being used by senior doctors and what their attitudes towards them are. The aims of this study were to investigate which modes of CME delivery senior Australian doctors utilise, to assess doctors' attitudes towards CME and to determine any differences in modes used and attitudes between clinical specialties and practice locations. A 52-statement questionnaire enquiring about doctors' current CME activities and their attitudes towards CME was distributed to 1336 senior Australian doctors. 494 doctors responded to the questionnaire. Traditional forms of CME (eg, meetings, conferences, journals and lectures) were most commonly used. Doctors thought CME involving face-to-face interaction was superior to electronic forms of CME. All doctors, especially those in hospital practice, had a positive attitude towards CME but found lack of time a barrier to learning. Rural doctors found CME sessions more difficult to attend than did their metropolitan colleagues. Traditional forms of CME were more popular than modern CME approaches, such as e-learning. Australian doctors had a positive attitude towards undertaking CME despite struggling to find time to perform CME. The differences in attitudes towards CME demonstrated between specialties and different practice location will aid future CME planning.

Sex Differences Among Career Development Awardees in the Attainment of Independent Research Funding in a Department of Medicine.

PubMed

Kalyani, Rita Rastogi; Yeh, Hsin-Chieh; Clark, Jeanne M; Weisfeldt, Myron L; Choi, Terry; MacDonald, Susan M

2015-11-01

National data suggest that women are overall less likely than men to attain independent research funding. However, it remains unclear whether such sex differences are also observed in academic institutions that have integrated diversity in the workplace as a priority. During 1999-2008, all National Institutes of Health (NIH) Career Development (K01, K08, or K23) awardees in the Department of Medicine at Johns Hopkins University School of Medicine were identified to investigate differences in the attainment of independent funding by sex, including NIH Research Project Grant (R01) or equivalent awards, (U01, P01, P50), and any R award (also R03, R21, R34) through 2012. A similar number of men (n = 49) and women (n = 43) received a K award. There were no significant sex differences in attaining an R01/equivalent award or any R award. The median time to attaining the first R01/equivalent award was similar for men and women (5.6 vs. 5.3 years, p = 0.93). The actuarial rate of R01/equivalent award attainment at 10 years was 64% overall (56% among men vs. 74% among women; log-rank p = 0.41). For any R award, the rate was 72% overall (70% among men vs. 76% among women; log-rank p = 0.63). In Cox proportional hazards models, adjusting for race/ethnicity, age, Doctor of Medicine (MD) degree, and funding period, sex was not an independent predictor of R01/equivalent or any R award attainment. Interestingly, black race and/or Hispanic ethnicity significantly predicted any R award attainment (adjusted hazard ratio [HR] = 2.34, 95% confidence interval [CI] 1.02-5.37). No sex differences were found in the attainment of independent funding by K awardees in our study. Future studies to investigate the impact of specific diversity initiatives on subsequent success in attaining independent research funding are needed.

["Is there a doctor on board?" - legal aspects of medical care in emergency situations during spare time].

PubMed

Lindner, Christina; Lindner, Gregor; Exadaktylos, Aristomenis K

2013-12-11

Medical emergencies on international flights are not uncommon. In these situations the question often arises whether physicians are obliged to render first aid and whether omission leads to legal consequences. The general obligation to aid those in need applies to everyone, not only to physicians. Evading this duty makes liable to prosecution for omittance of defence of a third person in line with Art. 128 of the Swiss Penal Code, punishable by custodial sentence up to three years or an equivalent punitive fine. Vocational and professional law extend the duty to aid for physicians to urgent cases. Although resulting from the performance of a legal obligation, malpractice occurred in the course of first aid can lead to claims for compensation - even from foreign patients, and that according to their own domestic law.

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

PubMed

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

2017-11-23

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

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.

In vitro 3D full thickness skin equivalent tissue model using silk and collagen biomaterials

PubMed Central

Bellas, Evangelia; Seiberg, Miri; Garlick, Jonathan; Kaplan, David L.

2013-01-01

Current approaches to develop skin equivalents often only include the epidermal and dermal components. Yet, full thickness skin includes the hypodermis, a layer below the dermis of adipose tissue containing vasculature, nerves and fibroblasts, necessary to support the epidermis and dermis. In the present study, we developed a full thickness skin equivalent including an epidermis, dermis and hypodermis that could serve as an in vitro model for studying skin development, disease or as a platform for consumer product testing as a means to avoid animal testing. The full thickness skin equivalent was easy to handle and was maintained in culture for greater than 14 days while expressing physiologically relevant morphologies of both the epidermis and dermis, as seen by keratin 10, collagen I and collagen IV expression. The skin equivalent produced glycerol and leptin, markers of adipose tissue metabolism. This work serves as a foundation for our understanding of some of the necessary factors needed to develop a stable, functional model of full-thickness skin. PMID:23161763

UK doctors’ views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis

PubMed Central

Clarke, Rachel T; Pitcher, Alex; Lambert, Trevor W; Goldacre, Michael J

2014-01-01

Objectives To report on what doctors at very different levels of seniority wrote, in their own words, about their concerns about the European Working Time Directive (EWTD) and its implementation in the National Health Service (NHS). Design All medical school graduates from 1993, 2005 and 2009 were surveyed by post and email in 2010. Setting The UK. Methods Using qualitative methods, we analysed free-text responses made in 2010, towards the end of the first year of full EWTD implementation, of three cohorts of the UK medical graduates (graduates of 1993, 2005 and 2009), surveyed as part of the UK Medical Careers Research Group's schedule of multipurpose longitudinal surveys of doctors. Results Of 2459 respondents who gave free-text comments, 279 (11%) made unprompted reference to the EWTD; 270 of the 279 comments were broadly critical. Key themes to emerge included frequent dissociation between rotas and actual hours worked, adverse effects on training opportunities and quality, concerns about patient safety, lowering of morale and job satisfaction, and attempts reportedly made in some hospitals to persuade junior doctors to collude in the inaccurate reporting of compliance. Conclusions Further work is needed to determine whether problems perceived with the EWTD, when they occur, are attributable to the EWTD itself, and shortened working hours, or to the way that it has been implemented in some hospitals. PMID:24503304

The Analysis of Slovenian Political Party Programs Regarding Doctors and Health Workers from 1992 to 2014.

PubMed

Maksuti, Alem; Rotar Pavlič, Danica; Deželan, Tomaž

2016-03-01

The study focuses on the programmatic bases of Slovenian political parties since independence. It presents an analysis of party programs and their preferences regarding doctors and other health workers, as well as the contents most commonly related to them. At the same time, the study also highlights the intensity of the presence of doctors on the policy agenda through time. In the study, 83 program documents of political parties have been analysed. The study includes programmes of political parties that have occurred in parliamentary elections in Slovenia between 1992 and 2014 and have exceeded the parliamentary threshold. The data were analysed using the content analysis method, which is suitable for analysing policy texts. The analysis was performed using ATLAS.ti, the premier software tool for qualitative data analysis. The results showed that doctors and other health workers are an important political topic in non-crisis periods. At that time, the parties in the context of doctors mostly dealt with efficiency and the quality of services in the health system. They often criticize doctors and expose the need for their control. In times of economic crisis, doctors and other health workers are less important in normative commitments of parties. Slovenian political parties and their platforms cannot be distinguished ideologically, but primarily on the principle of access to government. It seems reasonable to conclude that parties do not engage in dialogue with doctors, and perceive the latter aspassive recipients of government decisions-politics.

The Analysis of Slovenian Political Party Programs Regarding Doctors and Health Workers from 1992 to 2014

PubMed Central

MAKSUTI, Alem; ROTAR PAVLIČ, Danica; DEŽELAN, Tomaž

2016-01-01

Introduction The study focuses on the programmatic bases of Slovenian political parties since independence. It presents an analysis of party programs and their preferences regarding doctors and other health workers, as well as the contents most commonly related to them. At the same time, the study also highlights the intensity of the presence of doctors on the policy agenda through time. Methods In the study, 83 program documents of political parties have been analysed. The study includes programmes of political parties that have occurred in parliamentary elections in Slovenia between 1992 and 2014 and have exceeded the parliamentary threshold. The data were analysed using the content analysis method, which is suitable for analysing policy texts. The analysis was performed using ATLAS.ti, the premier software tool for qualitative data analysis. Results The results showed that doctors and other health workers are an important political topic in non-crisis periods. At that time, the parties in the context of doctors mostly dealt with efficiency and the quality of services in the health system. They often criticize doctors and expose the need for their control. In times of economic crisis, doctors and other health workers are less important in normative commitments of parties. Conclusions Slovenian political parties and their platforms cannot be distinguished ideologically, but primarily on the principle of access to government. It seems reasonable to conclude that parties do not engage in dialogue with doctors, and perceive the latter aspassive recipients of government decisions—politics. PMID:27647091

Views of UK medical graduates about flexible and part-time working in medicine: a qualitative study.

PubMed

Evans, J; Goldacre, M J; Lambert, T W

2000-05-01

To report on the views of doctors about flexible and part-time working in medicine. As part of ongoing studies of doctors' careers, postal questionnaires were sent in 1995 and 1996 to all doctors who qualified from UK medical schools in 1977, 1988 and 1993. Structured questions about recipients' careers were accompanied by a form which invited free-text comment. Comments about flexible and part-time working were extracted for analysis. All respondents who commented on flexible and part-time working. Most doctors who commented believed there were insufficient opportunities to meet demand. They also commonly commented that there was not enough information about flexible training opportunities. Some men, as well as women, expressed a wish to work part-time. The most frequently cited reasons for part-time working were to balance career with family responsibilities, and to reduce work-related stress. Cited disadvantages of part-time working were mainly financial and included the problems of paying for childcare and professional subscriptions when on a reduced income. Some respondents perceived negative attitudes towards doctors in part-time jobs. It is well-recognised that more flexible medical career structures are needed so that doctors can vary their time commitment according to their needs at particular stages in their lives. Until recently, needs have not been adequately met. Changes in arrangements for flexible training accompanying the implementation of the specialist registrar grade may have begun to alleviate some of the problems, but others, such as negative attitudes towards part-time work, may take time to change.

30 CFR 57.5060 - Limit on exposure to diesel particulate matter.

Code of Federal Regulations, 2012 CFR

2012-07-01

... diesel particulate matter (DPM) in an underground mine must not exceed an average eight-hour equivalent... particulate matter (DPM) in an underground mine must not exceed an average eight-hour equivalent full shift... mine must not exceed an average eight-hour equivalent full shift airborne concentration of 350...

30 CFR 57.5060 - Limit on exposure to diesel particulate matter.

Code of Federal Regulations, 2011 CFR

2011-07-01

... diesel particulate matter (DPM) in an underground mine must not exceed an average eight-hour equivalent... particulate matter (DPM) in an underground mine must not exceed an average eight-hour equivalent full shift... mine must not exceed an average eight-hour equivalent full shift airborne concentration of 350...

30 CFR 57.5060 - Limit on exposure to diesel particulate matter.

Code of Federal Regulations, 2013 CFR

2013-07-01

... diesel particulate matter (DPM) in an underground mine must not exceed an average eight-hour equivalent... particulate matter (DPM) in an underground mine must not exceed an average eight-hour equivalent full shift... mine must not exceed an average eight-hour equivalent full shift airborne concentration of 350...

30 CFR 57.5060 - Limit on exposure to diesel particulate matter.

Code of Federal Regulations, 2010 CFR

2010-07-01

... diesel particulate matter (DPM) in an underground mine must not exceed an average eight-hour equivalent... particulate matter (DPM) in an underground mine must not exceed an average eight-hour equivalent full shift... mine must not exceed an average eight-hour equivalent full shift airborne concentration of 350...

Should non-disclosures be considered as morally equivalent to lies within the doctor-patient relationship?

PubMed

Cox, Caitriona L; Fritz, Zoe

2016-10-01

In modern practice, doctors who outright lie to their patients are often condemned, yet those who employ non-lying deceptions tend to be judged less critically. Some areas of non-disclosure have recently been challenged: not telling patients about resuscitation decisions; inadequately informing patients about risks of alternative procedures and withholding information about medical errors. Despite this, there remain many areas of clinical practice where non-disclosures of information are accepted, where lies about such information would not be. Using illustrative hypothetical situations, all based on common clinical practice, we explore the extent to which we should consider other deceptive practices in medicine to be morally equivalent to lying. We suggest that there is no significant moral difference between lying to a patient and intentionally withholding relevant information: non-disclosures could be subjected to Bok's 'Test of Publicity' to assess permissibility in the same way that lies are. The moral equivalence of lying and relevant non-disclosure is particularly compelling when the agent's motivations, and the consequences of the actions (from the patient's perspectives), are the same. We conclude that it is arbitrary to claim that there is anything inherently worse about lying to a patient to mislead them than intentionally deceiving them using other methods, such as euphemism or non-disclosure. We should question our intuition that non-lying deceptive practices in clinical practice are more permissible and should thus subject non-disclosures to the same scrutiny we afford to lies. 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/

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

PubMed

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

2010-07-01

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

Structural evaluation of asphalt pavements with full-depth reclaimed base.

DOT National Transportation Integrated Search

2012-12-01

Currently, MnDOT pavement design recommends granular equivalency, GE = 1.0 for non-stabilized full-depth : reclamation (FDR) material, which is equivalent to class 5 material. For stabilized full-depth reclamation (SFDR), : there was no guideline for...

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 significant differences were found in the level of satisfaction by age, parity, marital status, education or occupation of women. Women's satisfaction with MA service provided by trained nurses or auxiliary nurse-midwives was similar to that provided by doctors. The findings, therefore, provide support for extending safe and accessible medical abortion services by government-trained nurses and auxiliary nurse midwives to women seeking early first trimester pregnancy termination. The trial was retrospectively registered with ClinicalTrials.gov (identifier: NCT01186302 ). Registered August 20, 2010.

Patients' perceptions of entitlement to time in general practice consultations for depression: qualitative study

PubMed Central

Pollock, Kristian; Grime, Janet

2002-01-01

Objective: To investigate patients' perceptions of entitlement to time in general practice consultations for depression. Design: Qualitative study based on interviews with patients with mild to moderate depression. Setting: Eight general practices in the West Midlands and the regional membership of the Depression Alliance. Participants: 32 general practice patients and 30 respondents from the Depression Alliance. Results: An intense sense of time pressure and a self imposed rationing of time in consultations were key concerns among the interviewees. Anxiety about time affected patients' freedom to talk about their problems. Patients took upon themselves part of the responsibility for managing time in the consultation to relieve the burden they perceived their doctors to be working under. Respondents' accounts often showed a mismatch between their own sense of time entitlement and the doctors' capacity to respond flexibly and constructively in offering extended consultation time when this was necessary. Patients valued time to talk and would often have liked more, but they did not necessarily associate length of consultation with quality. The impression doctors gave in handling time in consultations sent strong messages about legitimising the patients' illness and their decision to consult. Conclusions: Patients' self imposed restraint in taking up doctors' time has important consequences for the recognition and treatment of depression. Doctors need to have a greater awareness of patients' anxieties about time and should move to allay such anxieties by pre-emptive reassurance and reinforcing patients' sense of entitlement to time. Far from acting as “consumers,” patients voluntarily assume responsibility for conserving scarce resources in a health service that they regard as a collective rather than a personal resource. What is already known on this topicA widespread concern is that pressure of work is reducing the length of general practice consultations and that doctors can't deal adequately with patients' problems in the time availableLittle is known about patients' experience of time in consultationsWhat this study addsPatients with depression feel under such acute pressure of time that they are often inhibited from fully disclosing their problems, preventing them making best use of the consultationThere is often a disparity between patients' sense of time shortage and the amount of time their doctors are willing and able to provideDoctors should be more aware of patients' anxieties about time and allay these anxieties by providing pre-emptive reassurance as a means of reinforcing patients' sense of entitlement to consultation time PMID:12351362

The Status of Former CSWE Ethnic Minority Doctoral Fellows in Social Work Academia.

ERIC Educational Resources Information Center

Schiele, Jerome H.; Francis, E. Aracelis

1996-01-01

A survey of 90 former Council on Social Work Education (CSWE) Ethnic Minority Doctoral Fellows found Hispanic Americans were most likely to be full, tenured professors, and that more males than females were tenured, most who applied had been awarded promotion and tenure, scholarly productivity was attributed to a minority of respondents, and…

A Case Study: New Doctor of Arts Program, Illinois State University.

ERIC Educational Resources Information Center

Gray, Charles E.

The development of a Doctor of Arts (D.A.) program in history at Illinois State University's Department of History is presented. The program proposal was approved in 1974 and a full complement of graduate students were accepted into the program by summer 1975. The overall objective of the program is the improvement of history instruction and…

Synthesis, Microstructure and Properties of Nickel Aluminide Foams

NASA Technical Reports Server (NTRS)

Dunand, David C.

2003-01-01

Two Ph.D. students were involved in the project: Mr. Christopher Schuh (part-time, graduated in Spring 2001) and Ms. Andrea Hodge (full-time, graduated Summer 2002). One post-doctoral fellow, Dr. Heeman Choe, worked full-time on the project from July to December 2002. A new process to aluminize and chromize nickel foams was created. A kinetic aluminization model was developed. Creep testing was conducted on the foams. A finite-element model and a simplified analytical model for foam creep were produced. Four articles were written: one is published, two are accepted for publication, and one is in preparation. Ms. Hodge spent four months at NASA Glenn Research Center (9-12/2001 and 2-3/2002) under the supervision of Dr. Nathal. She conducted research on NiAl foam fabrication, mechanical testing and numerical modeling. She gave a talk at the ASM annual conference in November 2001 and presented her results at NASA in December 2001.

A cross-Canada survey of infection prevention and control in long-term care facilities.

PubMed

Zoutman, Dick E; Ford, B Douglas; Gauthier, Jim

2009-06-01

Residents in long-term care facilities (LTCFs) are at considerable risk for developing infections. This is the first comprehensive examination of infection control programs in Canadian LTCFs in almost 20 years. A survey designed to assess resident and LTCF characteristics; personnel, laboratory, computer, and reference resources; and surveillance and control activities of infection prevention and control programs was sent in 2005 to all eligible LTCFs across Canada. One third of LTCFs (34%, 488/1458) responded. Eighty-seven percent of LTCFs had infection control committees. Most LTCFs (91%) had 24-hour care by registered nurses, and 84% had on-site infection control staff. The mean number of full-time equivalent infection control professionals (ICPs) per 250 beds was 0.6 (standard deviation [SD], 1.0). Only 8% of ICPs were certified by the Certification Board of Infection Control and Epidemiology. Only one fifth of LTCFs had physicians or doctoral level professionals providing service to the infection control program. The median surveillance index score was 63 out of a possible 100, and the median control index score was 79 of 100. Influenza vaccinations were received by 93.0% (SD, 11.3) of residents in 2004. To bring infection control programs in Canadian LTCFs up to expert suggested resource and intensity levels will necessitate considerable investment. More and better trained ICPs are essential to providing effective infection prevention and control programs in LTCFs and protecting vulnerable residents from preventable infections.

Staffing benchmarks for clinical laboratories: a College of American Pathologists Q-Probes study of laboratory staffing at 98 institutions.

PubMed

Jones, Bruce A; Darcy, Teresa; Souers, Rhona J; Meier, Frederick A

2012-02-01

Publicly available information concerning laboratory staffing benchmarks is scarce. One of the few publications on this topic summarized the findings of a Q-Probes study performed in 2004. This publication reports a similar survey with data collected in 2010. To assess the relationship between staffing levels in specified laboratory sections and test volumes in these sections and quantify management span of control. The study defined 4 laboratory sections: anatomic pathology (including cytology), chemistry/hematology/immunology, microbiology, and transfusion medicine. It divided staff into 3 categories: management, nonmanagement (operational or bench staff), and doctoral (MD, PhD) supervisory staff. People in these categories were tabulated as full-time equivalents and exclusions specified. Tests were counted in uniform formats, specified for each laboratory section, according to Medicare rules for the bundling and unbundling of tests. Ninety-eight participating institutions provided data that showed significant associations between test volumes and staffing for all 4 sections. There was wide variation in productivity based on volume. There was no relationship between testing volume per laboratory section and management span of control. Higher productivity in chemistry/hematology/immunology was associated with a higher fraction of tests coming from nonacute care patients. In both the 2004 and 2010 studies, productivity was inseparably linked to test volume. Higher test volume was associated with higher productivity ratios in chemistry/hematology/immunology and transfusion medicine sections. The impact of various testing services on productivity is section-specific.

Get a Life? The Impact of the European Working Time Directive: The Case of UK Senior Doctors.

PubMed

Dolton, Peter J; Kidd, Michael P; Fooken, Jonas

2015-10-01

This paper seeks to identify the effect of the implementation of the European Working Time Directive on the working hours of UK doctors. The Labour Force Survey is used to compare the working hours of doctors with a variety of control groups before and after the implementation of the directive. The controls include those unconstrained by the directive and doctor counterparts working in Europe. We use differences-in-differences and matching methods to estimate the impact of this natural experiment, distinguishing between the anticipation and enactment of the European Working Time Directive. We find that the legislation reduced the hours of senior doctors by around 8 hours in total including the component attributable to anticipation effects and allowing for (exogenously set) rising wages. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

Building a Library for Microelectronics Verification with Topological Constraints

DTIC Science & Technology

2017-03-01

Tables 1d, 3b); 1-bit full adder cell (Fig. 1), respectively. Table 5. Frequency distributions for the genus of logically equivalent circuit...Figure 1 shows that switching signal pairs produces logically- equivalent topologies of the 1-bit full adder cell with three values of the genus (g = 3 [1...case], 4, 5, 6). Figure 1. Frequency distribution for logically equivalent circuit topologies of the 1-bit full adder cell (2048) in Table 1(e

[Electronic medical records: Evolution of physician-patient relationship in the Primary Care clinic].

PubMed

Pérez-Santonja, T; Gómez-Paredes, L; Álvarez-Montero, S; Cabello-Ballesteros, L; Mombiela-Muruzabal, M T

2017-04-01

The introduction of electronic medical records and computer media in clinics, has influenced the physician-patient relationship. These modifications have many advantages, but there is concern that the computer has become too important, going from a working tool to the centre of our attention during the clinical interview, decreasing doctor interaction with the patient. The objective of the study was to estimate the percentage of time that family physicians spend on computer media compared to interpersonal communication with the patient, and whether this time is modified depending on different variables such as, doctor's age or reason for the consultation. An observational and descriptive study was conducted for 10 weeks, with 2 healthcare centres involved. The researchers attended all doctor- patient interviews, recording the patient time in and out of the consultation. Each time the doctor fixed his gaze on computer media the time was clocked. A total of 436 consultations were collected. The doctors looked at the computer support a median 38.33% of the total duration of an interview. Doctors of 45 years and older spent more time fixing their eyes on computer media (P<.05). Family physicians used almost 40% of the consultation time looking at computer media, and depends on age of physician, number of queries, and number of medical appointments. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

77 FR 16850 - Notice of Reclassification of One Investigative Field Office to Regional Office: Denver, CO

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-22

... control and effectiveness, and reduce travel costs of management by reducing region size. 4. Return to the... presently being reduced from a high average of around 730 full time equivalents (FTEs) to a target level of... core mission and at the same time become better prepared to respond to inevitable but unpredictable...

Tricks of the trade: time management tips for newly qualified doctors.

PubMed

Offiah, Gozie; Doherty, Eva

2018-03-01

The transition from medical student to doctor is an important milestone. The discovery that their time is no longer their own and that the demands of their job are greater than the time they have available is extremely challenging. At a recent surgical boot camp training programme, 60 first-year surgical trainees who had just completed their internship were invited to reflect on the lessons learnt regarding effective time management and to recommend tips for their newly qualified colleagues. They were asked to identify clinical duties that were considered urgent and important using the time management matrix and the common time traps encountered by newly qualified doctors. The surgical trainees identified several practical tips that ranged from writing a priority list to working on relationships within the team. These tips are generic and so applicable to all newly qualified medial doctors. We hope that awareness of these tips from the outset as against learning them through experience will greatly assist newly qualified doctors. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Time to the Doctorate and Labor Demand for New PhD Recipients

ERIC Educational Resources Information Center

Groen, Jeffrey A.

2012-01-01

This paper considers the influence of labor demand for new PhD recipients on time to the doctorate. I use student-level data on all doctorates awarded by U.S. universities in seven humanities and social science fields together with the annual number of job listings by field from 1975 to 2005. An increase in the number of job listings in a field…

The Future of Marketing Scholarship: Recruiting for Marketing Doctoral Programs

ERIC Educational Resources Information Center

Davis, Donna F.; McCarthy, Teresa M.

2005-01-01

As demand for business education is rising, the production of business doctorates continues to fall. Between 1995 and 2001, new business doctorates declined 18%, dropping to the lowest point since 1987. In the same time frame, new marketing doctorates dropped by 32%. This article reports the results of a study designed to (1) assess enrollment…

Alternative and Professional Doctoral Programs: What Is Driving the Demand?

ERIC Educational Resources Information Center

Servage, Laura

2009-01-01

As part of an overall massification of higher education, enrollments in doctoral programs are expanding. At the same time, doctoral studies are subject to much scrutiny and reform in Australia, the UK and the United States. This work examines policy documents related to doctoral reform from these countries in order to offer a critique of their…

Weekly working hours for Norwegian hospital doctors since 1994 with special attention to postgraduate training, work–home balance and the European Working Time Directive: a panel study

PubMed Central

Rosta, Judith; Aasland, Olaf G

2014-01-01

Objectives To examine the weekly working hours of Norwegian hospital doctors from 1994 to 2012 with special emphasis on the quality of postgraduate training and work–home balance, and in relation to the requirements of the European Working Time Directive (EWTD). Design Panel study based on postal questionnaires. Setting Norway. Participants Unbalanced cohort of 1300–1600 doctors in 1994, 1995, 1996, 1997, 2000, 2002, 2004, 2006, 2008, 2010 and 2012. Outcome measures Self-reported total weekly working hours and whether 45 weekly working hours are too short, sufficient, or too long to meet the quality requirements of obligatory postgraduate training for junior doctors. Results From 1994 to 2012, the number of weekly working hours was stable for senior (46–47 h) and junior (45–46 h) hospital doctors. In 2012, significantly more senior (27–35%) than junior (11–20%) doctors reported suboptimal work–home balance, defined as working more than 48 h a week. The majority perceived the present situation with an average of 45 h per week for juniors as sufficient for obligatory postgraduate specialist training, but doctors of higher age (OR 1.04, 95% CI 1.01 to 1.08), senior doctors (1.07, 1.04 to 1.11) and doctors working in surgical specialties (OR 1 vs laboratory medicine 0.03, 0.01 to 0.25, internal medicine 0.31, 0.17 to 0.58, psychiatry 0.12, 0.04 to 0.36, paediatrics 0.36, 0.12 to 1.07, anaesthesiology 0.08, 0.02 to 0.39, gynaecology 0.07, 0.01 to 0.56 and others 0.39, 0.04 to 3.56) were more likely to want the work-week to be longer. Conclusions The weekly working hours of Norwegian hospital doctors were always below the EWTD requirements. A significant growth of hospital doctor density over the past two decades, national regulations and cultural values might be important factors. Specialty differences in perception of sufficient training time may call for more flexibility in working time regulations. PMID:25311038

Doctor-Shopping Behavior among Patients with Eye Floaters

PubMed Central

Tseng, Gow-Lieng; Chen, Cheng-Yu

2015-01-01

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

Doctor-Shopping Behavior among Patients with Eye Floaters.

PubMed

Tseng, Gow-Lieng; Chen, Cheng-Yu

2015-07-13

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

The use of medical quality indices as a performance-enhancement tool for community clinics.

PubMed

Elhayany, A

2001-12-01

One of the most important issues for a country, its population and doctors is the effective use of its health system. The extensive variation in doctors' performance leads to a tremendous waste of resources. To combat this, and at the same time ensure that medical quality plays a role when making decisions on interventions, it is essential to equip doctors and clinic directors with information on the quality of the medical care they are providing. In order to assist clinic directors in maintaining medical quality, Clalit Health Services has developed comparative medical indices enabling doctors to compare their performance to that of their colleagues, as well as to the standard and their performance over time. The development of an index to evaluate the quality of medical treatment offered in clinics provides doctors and the health system with an essential tool to lessen the existing variation among doctors and to enhance and evaluate performance.

Interpretation of medical information acts by UK occupational physicians.

PubMed

Batty, Lucia; Glozier, Nick; Holland-Elliott, Kevin

2009-05-01

Difficulties arise in applying the Data Protection Act 1998 and the Access to Medical Reports Act 1988 in occupational health practice. There is no guidance on detailed aspects of applying these Acts in practice and consistent advice has proved difficult to obtain. To audit the understanding and practice of UK occupational physicians to see if a consensus view existed. A postal questionnaire sent to all UK-based Society of Occupational Medicine (SOM) members between December 2005 and June 2006. Responses were analysed using the SPSS 13.0 software. Responses were received from 726 SOM members, a response rate of 48%. The study revealed wide variation and a limited consensus in practice. Significant differences existed between doctors with a Diploma in Occupational Medicine and those with higher Faculty qualifications, between part-time and full-time practitioners and between doctors who qualified pre- and post-1974. The audit revealed wide variation in responding to clinical scenarios in relation to both the Access to Medical Reports and the Data Protection Acts. The findings have implications for clinical practice, policy and research. The majority of respondents reported that national guidance is needed.

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.

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 academic support and is more practice orientated. It is suggested that the move towards doctoral programmes for nurses will present one of the most important evolutionary changes in the practice of nursing. It is suggested that doctoral education for nurses will increase in prevalence and that this process of change is already underway. Doctoral education will provide practitioners with the experience and skills required to conduct research and further develop practice. For individual practitioners, doctoral education will enhance self-confidence in an increasingly technical and complex arena and in a practice discipline that is becoming ever more politically charged. The professional doctorate appears to be particularly suited to senior nurse practitioners. What remains is for us to accept this new challenge and to shape its development for the benefit of the practice of nursing.

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

PubMed

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

2015-10-01

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

Frequencies and Flutter Speed Estimation for Damaged Aircraft Wing Using Scaled Equivalent Plate Analysis

NASA Technical Reports Server (NTRS)

Krishnamurthy, Thiagarajan

2010-01-01

Equivalent plate analysis is often used to replace the computationally expensive finite element analysis in initial design stages or in conceptual design of aircraft wing structures. The equivalent plate model can also be used to design a wind tunnel model to match the stiffness characteristics of the wing box of a full-scale aircraft wing model while satisfying strength-based requirements An equivalent plate analysis technique is presented to predict the static and dynamic response of an aircraft wing with or without damage. First, a geometric scale factor and a dynamic pressure scale factor are defined to relate the stiffness, load and deformation of the equivalent plate to the aircraft wing. A procedure using an optimization technique is presented to create scaled equivalent plate models from the full scale aircraft wing using geometric and dynamic pressure scale factors. The scaled models are constructed by matching the stiffness of the scaled equivalent plate with the scaled aircraft wing stiffness. It is demonstrated that the scaled equivalent plate model can be used to predict the deformation of the aircraft wing accurately. Once the full equivalent plate geometry is obtained, any other scaled equivalent plate geometry can be obtained using the geometric scale factor. Next, an average frequency scale factor is defined as the average ratio of the frequencies of the aircraft wing to the frequencies of the full-scaled equivalent plate. The average frequency scale factor combined with the geometric scale factor is used to predict the frequency response of the aircraft wing from the scaled equivalent plate analysis. A procedure is outlined to estimate the frequency response and the flutter speed of an aircraft wing from the equivalent plate analysis using the frequency scale factor and geometric scale factor. The equivalent plate analysis is demonstrated using an aircraft wing without damage and another with damage. Both of the problems show that the scaled equivalent plate analysis can be successfully used to predict the frequencies and flutter speed of a typical aircraft wing.

20 CFR 628.710 - Period of program operation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... be conducted during the school vacation period occurring duri the summer months. (b) An SDA operating... full-time basis may offer SYETP activities to participants in such a jurisdiction during the school vacation period(s) treated as the period(s) equivalent to a school summer vacation. ...

20 CFR 628.710 - Period of program operation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... be conducted during the school vacation period occurring duri the summer months. (b) An SDA operating... full-time basis may offer SYETP activities to participants in such a jurisdiction during the school vacation period(s) treated as the period(s) equivalent to a school summer vacation. ...

42 CFR 493.1483 - Standard: Cytotechnologist qualifications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... person examining cytology slide preparations must meet the qualifications of § 493.1449 (b) or (k), or... laboratory directed by a pathologist or other physician providing cytology services; and (iii) Completed 2..., have full-time experience of at least 2 years or equivalent examining cytology slide preparations...

42 CFR 493.1483 - Standard: Cytotechnologist qualifications.

Code of Federal Regulations, 2013 CFR

2013-10-01

... person examining cytology slide preparations must meet the qualifications of § 493.1449 (b) or (k), or... laboratory directed by a pathologist or other physician providing cytology services; and (iii) Completed 2..., have full-time experience of at least 2 years or equivalent examining cytology slide preparations...

42 CFR 493.1483 - Standard: Cytotechnologist qualifications.

Code of Federal Regulations, 2014 CFR

2014-10-01

... person examining cytology slide preparations must meet the qualifications of § 493.1449 (b) or (k), or... laboratory directed by a pathologist or other physician providing cytology services; and (iii) Completed 2..., have full-time experience of at least 2 years or equivalent examining cytology slide preparations...

42 CFR 493.1483 - Standard: Cytotechnologist qualifications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... person examining cytology slide preparations must meet the qualifications of § 493.1449 (b) or (k), or... laboratory directed by a pathologist or other physician providing cytology services; and (iii) Completed 2..., have full-time experience of at least 2 years or equivalent examining cytology slide preparations...

42 CFR 493.1483 - Standard: Cytotechnologist qualifications.

Code of Federal Regulations, 2012 CFR

2012-10-01

... person examining cytology slide preparations must meet the qualifications of § 493.1449 (b) or (k), or... laboratory directed by a pathologist or other physician providing cytology services; and (iii) Completed 2..., have full-time experience of at least 2 years or equivalent examining cytology slide preparations...

Report on Staffing and Salaries, Fall 1993.

ERIC Educational Resources Information Center

California Community Colleges, Sacramento. Office of the Chancellor.

Thirteenth in a series of annual reports, this document presents fall 1993 demographic, staffing, salary, and workload information on California community college employees, based on data collected from all 71 California community college districts. Section I presents data on primary occupational activity, full-time equivalency, and type of…

45 CFR 617.5 - Self-evaluation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Self-evaluation. 617.5 Section 617.5 Public... Self-evaluation. (a) Each recipient (including subrecipients) employing the equivalent of fifteen or more full-time employees shall complete a written self-evaluation of its compliance under this part...

Association Between Patient-Centered Medical Home Rating and Operating Cost at Federally Funded Health Centers

PubMed Central

Nocon, Robert S.; Sharma, Ravi; Birnberg, Jonathan M.; Ngo-Metzger, Quyen; Lee, Sang Mee; Chin, Marshall H.

2013-01-01

Context Little is known about the cost associated with a health center’s rating as a patient-centered medical home (PCMH). Objective To determine whether PCMH rating is associated with operating cost among health centers funded by the US Health Resources and Services Administration. Design, Setting, and Participants Cross-sectional study of PCMH rating and operating cost in 2009. PCMH rating was assessed through surveys of health center administrators conducted by Harris Interactive of all 1009 Health Resources and Services Administration–funded community health centers. The survey provided scores from 0 (worst) to 100 (best) for total PCMH score and 6 subscales: access/communication, care management, external coordination, patient tracking, test/referral tracking, and quality improvement. Costs were obtained from the Uniform Data System reports submitted to the Health Resources and Services Administration. We used generalized linear models to determine the relationship between PCMH rating and operating cost. Main Outcome Measures Operating cost per physician full-time equivalent, operating cost per patient per month, and medical cost per visit. Results Six hundred sixty-nine health centers (66%) were included in the study sample, with 340 excluded because of nonresponse or incomplete data. Mean total PCMH score was 60 (SD,12; range, 21–90). For the average health center, a 10-point higher total PCMH score was associated with a $2.26 (4.6%) higher operating cost per patient per month (95% CI, $0.86–$4.12). Among PCMH subscales, a 10-point higher score for patient tracking was associated with higher operating cost per physician full-time equivalent ($27 300; 95% CI,$3047–$57 804) and higher operating cost per patient per month ($1.06;95%CI,$0.29–$1.98). A 10-point higher score for quality improvement was also associated with higher operating cost per physician full-time equivalent ($32 731; 95% CI, $1571–$73 670) and higher operating cost per patient per month ($1.86; 95% CI, $0.54–$3.61). A 10-point higher PCMH subscale score for access/communication was associated with lower operating cost per physician full-time equivalent ($39 809; 95% CI, $1893–$63 169). Conclusions According to a survey of health center administrators, higher scores on a scale that assessed 6 aspects of the PCMH were associated with higher health center operating costs. Two subscales of the medical home were associated with higher cost and 1 with lower cost. PMID:22729481

Bayesian analysis of time-series data under case-crossover designs: posterior equivalence and inference.

PubMed

Li, Shi; Mukherjee, Bhramar; Batterman, Stuart; Ghosh, Malay

2013-12-01

Case-crossover designs are widely used to study short-term exposure effects on the risk of acute adverse health events. While the frequentist literature on this topic is vast, there is no Bayesian work in this general area. The contribution of this paper is twofold. First, the paper establishes Bayesian equivalence results that require characterization of the set of priors under which the posterior distributions of the risk ratio parameters based on a case-crossover and time-series analysis are identical. Second, the paper studies inferential issues under case-crossover designs in a Bayesian framework. Traditionally, a conditional logistic regression is used for inference on risk-ratio parameters in case-crossover studies. We consider instead a more general full likelihood-based approach which makes less restrictive assumptions on the risk functions. Formulation of a full likelihood leads to growth in the number of parameters proportional to the sample size. We propose a semi-parametric Bayesian approach using a Dirichlet process prior to handle the random nuisance parameters that appear in a full likelihood formulation. We carry out a simulation study to compare the Bayesian methods based on full and conditional likelihood with the standard frequentist approaches for case-crossover and time-series analysis. The proposed methods are illustrated through the Detroit Asthma Morbidity, Air Quality and Traffic study, which examines the association between acute asthma risk and ambient air pollutant concentrations. © 2013, The International Biometric Society.

Direct-to-Consumer Prescription Medicine Advertising and Seniors' Knowledge of Alzheimer's Disease.

PubMed

Park, Jin Seong

2016-02-01

This study examined whether seniors' exposure to direct-to-consumer advertising (DTCA) for Alzheimer's disease (AD) medicine contributes to his or her subjective and objective knowledge of AD. A self-administered survey was conducted with a sample of 626 US seniors who were registered for an online consumer research panel. The study found that (1) exposure to DTCA for AD medicine was positively related to seniors' subjective knowledge of AD, (2) DTCA exposure had no significant relationship with overall objective knowledge of AD, and (3) DTCA exposure might influence knowledge of specific features of AD. Although DTCA for AD medicine may induce people to "feel" knowledgeable about AD, it may not result in an equivalent increase in actual knowledge. Therefore, to enhance doctor-patient interactions, both patients and doctors should be aware that although DTCA delivers important and potentially useful health information, it does not necessarily enhance actual knowledge. © The Author(s) 2014.

On lying and deceiving.

PubMed Central

Bakhurst, D

1992-01-01

This article challenges Jennifer Jackson's recent defence of doctors' rights to deceive patients. Jackson maintains there is a general moral difference between lying and intentional deception: while doctors have a prima facie duty not to lie, there is no such obligation to avoid deception. This paper argues 1) that an examination of cases shows that lying and deception are often morally equivalent, and 2) that Jackson's position is premised on a species of moral functionalism that misconstrues the nature of moral obligation. Against Jackson, it is argued that both lying and intentional deception are wrong where they infringe a patient's right to autonomy or his/her right to be treated with dignity. These rights represent 'deontological constraints' on action, defining what we must not do whatever the functional value of the consequences. Medical ethics must recognise such constraints if it is to contribute to the moral integrity of medical practice. PMID:1619626

On lying and deceiving.

PubMed

Bakhurst, D

1992-06-01

This article challenges Jennifer Jackson's recent defence of doctors' rights to deceive patients. Jackson maintains there is a general moral difference between lying and intentional deception: while doctors have a prima facie duty not to lie, there is no such obligation to avoid deception. This paper argues 1) that an examination of cases shows that lying and deception are often morally equivalent, and 2) that Jackson's position is premised on a species of moral functionalism that misconstrues the nature of moral obligation. Against Jackson, it is argued that both lying and intentional deception are wrong where they infringe a patient's right to autonomy or his/her right to be treated with dignity. These rights represent 'deontological constraints' on action, defining what we must not do whatever the functional value of the consequences. Medical ethics must recognise such constraints if it is to contribute to the moral integrity of medical practice.

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

PubMed

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

2012-07-01

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

Increasing Completion Rates in Norwegian Doctoral Training: Multiple Causes for Efficiency Improvements

ERIC Educational Resources Information Center

Kyvik, Svein; Olsen, Terje Bruen

2014-01-01

This article examines changes in completion rates and time-to-degree in Norwegian doctoral training over the last 30 years. A steadily increasing share of doctoral candidates holding a fellowship have been awarded their doctoral degree within five years; from 30% of those admitted in 1980 to 60% of those admitted 25 years later. Furthermore, the…

Development of a telepresence robot for medical consultation

NASA Astrophysics Data System (ADS)

Bugtai, Nilo T.; Ong, Aira Patrice R.; Angeles, Patrick Bryan C.; Cervera, John Keen P.; Ganzon, Rachel Ann E.; Villanueva, Carlos A. G.; Maniquis, Samuel Nazirite F.

2017-02-01

There are numerous efforts to add value for telehealth applications in the country. In this study, the design of a telepresence doctor to facilitate remote medical consultations in the wards of Philippine General Hospital is proposed. This includes the design of a robot capable of performing a medical consultation with clear audio and video information for both ends. It also provides the operating doctor full control of the telepresence robot and gives a user-friendly interface for the controlling doctor. The results have shown that it provides a stable and reliable mobile medical service through the use of the telepresence robot.

Practice of forensic medicine and pathology in Sri Lanka.

PubMed

Balachandra, A Thambirajah; Vadysinghe, Amal N; William, Anita L

2011-02-01

The practice of forensic medicine and pathology in Sri Lanka is based on the British model. Medical students during their third and fourth years receive approximately 50 hours of lectures and tutorials in forensic medicine and pathology and then undergo an examination. After completing an internship, these doctors are sent to various hospitals throughout Sri Lanka where they may be asked to perform medicolegal examinations on victims and suspects in rape cases, persons suspected of being under the influence of drugs and/or alcohol, and, injured live patients. As well, they may be asked to perform medicolegal autopsies. Depending upon their experience, some medical officers may be designated as judicial medical officers and appointed full time to do medicolegal work. Up until 1980, judicial medical officers with at least 2 years of work experience were allowed to obtain their postgraduate qualifications in the United Kingdom. However, since 1981 and the establishment of its own Postgraduate Institute of Medicine in Colombo, Sri Lanka, medical officers are offered 2 postgraduate programs in forensic medicine and pathology, a diploma in legal medicine and a doctorate in medicine (forensic medicine). After completing the doctorate in forensic medicine, doctors are allowed to train abroad for a further year in an approved center. Upon return they can then be appointed as consultant judicial medical officers. The practice of forensic medicine and pathology in Sri Lanka is unique and vibrant. However, due to the country's prevailing civil war, the practice of forensic medicine and pathology is suboptimal.

The accuracy of the 24-h activity recall method for assessing sedentary behaviour: the physical activity measurement survey (PAMS) project.

PubMed

Kim, Youngwon; Welk, Gregory J

2017-02-01

Sedentary behaviour (SB) has emerged as a modifiable risk factor, but little is known about measurement errors of SB. The purpose of this study was to determine the validity of 24-h Physical Activity Recall (24PAR) relative to SenseWear Armband (SWA) for assessing SB. Each participant (n = 1485) undertook a series of data collection procedures on two randomly selected days: wearing a SWA for full 24-h, and then completing the telephone-administered 24PAR the following day to recall the past 24-h activities. Estimates of total sedentary time (TST) were computed without the inclusion of reported or recorded sleep time. Equivalence testing was used to compare estimates of TST. Analyses from equivalence testing showed no significant equivalence of 24PAR for TST (90% CI: 443.0 and 457.6 min · day -1 ) relative to SWA (equivalence zone: 580.7 and 709.8 min · day -1 ). Bland-Altman plots indicated individuals that were extremely or minimally sedentary provided relatively comparable sedentary time between 24PAR and SWA. Overweight/obese and/or older individuals were more likely to under-estimate sedentary time than normal weight and/or younger individuals. Measurement errors of 24PAR varied by the level of sedentary time and demographic indicators. This evidence informs future work to develop measurement error models to correct for errors of self-reports.

Time to talk, time to see: changing microeconomies of professional practice among nurses and doctors in Australian general practice.

PubMed

Phillips, Christine; Dwan, Kathryn; Pearce, Christopher; Hall, Sally; Porritt, Julie; Yates, Rachel; Sibbald, Bonnie

2007-08-01

In Australia, more nurses are entering general practice, and nurses' work is being funded in increasingly complex ways through Medicare. Little research has explored the ways doctors and nurses realign their priorities and activities when working together in general practice. We undertook rapid, intensive multimethod studies of 25 general practices to explore the ways in which the labour of nurses and doctors was structured, and the implicit decisions made by both professions about the values placed on different ways of working and on their time. Data collected included photographs, floor-plans, interviews with 37 nurses, 24 doctors and 22 practice managers, and 50 hours of structured observation. Nursing time was constructed by both nurses and doctors as being fluid and non-contingent; they were regarded as being 'available' to patients in a way that doctors were not. Compared to medical time, nursing time could be disposed more flexibly, underpinning a valorized attribute of nursing: deep clinical and personal contact with patients. The location of practice nurses' desks in areas of traffic, such as administrative stations, or in the treatment room, underpinned this valuable unstructured contact with patients. Changes to the practice nurse role through direct fee-for-service items for nurses may lead to greater congruence between the microeconomies of nursing and medicine in general practice. In a time of pressure upon a primary care workforce, this is likely to lead to more independent clinical work by nurses, but may also lead to a decrease in flexible contact with patients.

Career destinations, views and future plans of the UK medical qualifiers of 1988.

PubMed

Taylor, Kathryn; Lambert, Trevor; Goldacre, Michael

2010-01-01

To report the career destinations, views and future plans of a cohort of senior doctors who qualified in the 1980s. Postal questionnaire survey of all doctors who qualified from all UK medical schools in 1988. The response rate was 69%. We estimated that 81% of the total cohort was working in the NHS, 16 years after qualification; and that at least 94% of graduates who, when students, were from UK homes, were working in medicine. Of NHS doctors, 30% worked part-time. NHS doctors rated their job satisfaction highly (median score 19.9, scale 5-25) but were less satisfied with the amount of leisure time available to them (median score 5.4, scale 1-10). NHS doctors were very positive about their careers, but were less positive about working hours and some other aspects of the NHS. Women were more positive than men about working conditions; general practitioners were more positive than hospital doctors. Twenty-five percent reported unmet needs for further training or career-related advice, particularly about career development. Twenty-nine percent intended to reduce their hours in future, while 6%, mainly part-time women, planned to increase their hours. Overall, 10% of NHS doctors planned to do more service work in future and 24% planned to do less; among part-time women, 18% planned to do more and only 14% less. These NHS doctors, now in their 40s, had a high level of satisfaction with their jobs and their careers but were less satisfied with some other aspects of their working environment. A substantial percentage had expectations about future career development and change.

Career destinations, views and future plans of the UK medical qualifiers of 1988

PubMed Central

Taylor, Kathryn; Lambert, Trevor; Goldacre, Michael

2010-01-01

Summary Objectives To report the career destinations, views and future plans of a cohort of senior doctors who qualified in the 1980s. Methods Postal questionnaire survey of all doctors who qualified from all UK medical schools in 1988. Results The response rate was 69%. We estimated that 81% of the total cohort was working in the NHS, 16 years after qualification; and that at least 94% of graduates who, when students, were from UK homes, were working in medicine. Of NHS doctors, 30% worked part-time. NHS doctors rated their job satisfaction highly (median score 19.9, scale 5–25) but were less satisfied with the amount of leisure time available to them (median score 5.4, scale 1–10). NHS doctors were very positive about their careers, but were less positive about working hours and some other aspects of the NHS. Women were more positive than men about working conditions; general practitioners were more positive than hospital doctors. Twenty-five percent reported unmet needs for further training or career-related advice, particularly about career development. Twenty-nine percent intended to reduce their hours in future, while 6%, mainly part-time women, planned to increase their hours. Overall, 10% of NHS doctors planned to do more service work in future and 24% planned to do less; among part-time women, 18% planned to do more and only 14% less. Conclusions These NHS doctors, now in their 40s, had a high level of satisfaction with their jobs and their careers but were less satisfied with some other aspects of their working environment. A substantial percentage had expectations about future career development and change. PMID:20056666

To what extent has doctoral (PhD) education supported academic nurse educators in their teaching roles: an integrative review.

PubMed

Bullin, Carol

2018-01-01

A doctoral degree, either a PhD or equivalent, is the academic credential required for an academic nurse educator position in a university setting; however, the lack of formal teaching courses in doctoral programs contradict the belief that these graduates are proficient in teaching. As a result, many PhD prepared individuals are not ready to meet the demands of teaching. An integrative literature review was undertaken. Four electronic databases were searched including the Cumulative Index to Nursing & Allied Health Literature (CINAHL), PubMed, Educational Resources Information Center (ERIC) and ProQuest. Date range and type of peer-reviewed literature was not specified. Conditions and factors that influenced or impacted on academic nurse educators' roles and continue to perpetuate insufficient pedagogical preparation include the requirement of a research focused PhD, lack of mentorship in doctoral programs and the influence of epistemic cultures (including institutional emphasis and reward system). Other factors that have impacted the academic nurse educator's role are society's demand for highly educated nurses that have increased the required credential, the assumption that all nurses are considered natural teachers, and a lack of consensus on the practice of the scholarship of teaching. Despite recommendations from nursing licensing bodies and a major US national nursing education study, little has been done to address the issue of formal pedagogical preparation in doctoral (PhD) nursing programs. There is an expectation of academic nurse educators to deliver quality nursing education yet, have very little or no formal pedagogical preparation for this role. While PhD programs remain research-intensive, the PhD degree remains a requirement for a role in which teaching is the major responsibility.

Narcotic Use and Postoperative Doctor Shopping by Patients with Nephrolithiasis Requiring Operative Intervention: Implications for Patient Safety.

PubMed

Kappa, Stephen F; Green, Elizabeth A; Miller, Nicole L; Herrell, Stanley D; Mitchell, Christopher R; Mir, Hassan R; Resnick, Matthew J

2016-09-01

We sought to determine perioperative patterns of narcotic use and the prevalence of postoperative doctor shopping among patients with nephrolithiasis requiring operative management. We retrospectively reviewed the records of consecutive patients residing in Tennessee who required ureteroscopy with laser lithotripsy for nephrolithiasis at a single institution from January to December 2013. Using the Tennessee CSMD (Controlled Substances Medication Database) patients were categorized by the number of postoperative narcotic providers. Doctor shopping behavior was identified as any patient seeking more than 1 narcotic provider within 3 months of surgery. Demographic and clinical characteristics associated with doctor shopping behavior were identified. During the study period 200 eligible patients underwent ureteroscopy with laser lithotripsy for nephrolithiasis, of whom 48 (24%) were prescribed narcotics by more than 1 provider after surgery. Compared to those receiving narcotics from a single provider, patients with multiple narcotic providers were younger (48.1 vs 54.2 years, p <0.001), less educated (high school education or less in 83.3% vs 58.7%, p = 0.014), more likely to have a history of mental illness (37.5% vs 16%, p <0.01) and more likely to have undergone prior stone procedures (66% vs 42%, p <0.01). Additionally, these patients demonstrated more frequent preoperative narcotic use (87.5% vs 63.2%), longer postoperative narcotic use (39.1 vs 6.0 days) and a higher morphine equivalent dose per prescription (44.7 vs 35.2 dose per day, each p <0.001). Postoperative doctor shopping is common among patients with nephrolithiasis who require operative management. Urologists should be aware of available registry data to decrease the likelihood of redundant narcotic prescribing. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

A qualitative investigation of Foundation Year 2 doctors' views on the European Working Time Directive.

PubMed

Duncan, Myanna; Haslam, Cheryl

2015-01-01

PURPOSE - The purpose of this paper is to examine the personal views and experiences of Foundation Year 2 doctors operating under the European Working Time Directive (EWTD). DESIGN/METHODOLOGY/APPROACH - In total, 36 Foundation Year 2 doctors from a single UK-based Deanery participated in this semistructured interview study. FINDINGS - Findings indicated that Foundation doctors typically welcomed a regulation of working hours, but reported frustration at the manner in which the Directive had been implemented. Participants reported concerns at reducing hours by removing out-of-hours working in order to meet EWTD requirements. Out-of-hours shifts were highly valued owing to their increased opportunities for autonomous clinical decision making. By contrast, day-shifts were regarded as heavily administrative in nature and were perceived as service provision. Foundation doctors discussed the unique nature of the out-of-hours working period which appeared to provide specific learning opportunities as doctors draw on time management and prioritisation skills. ORIGINALITY/VALUE - Given the challenges the EWTD presents, careful rota planning is essential. First, the authors would encourage the restructuring of day-shift work to provide a greater emphasis on hands-on skills experience in a supportive, supervised environment. Second, where possible, Foundation doctors might benefit from the opportunity to engage in some out-of-hours working, such as with multi-professional "Hospital at Night" teams. Third, the authors would encourage junior doctor involvement in rota design and planning which may increase their perceived autonomy and therefore buy-in of working practices.

Tests and visits before surgery

MedlinePlus

Before surgery - tests; Before surgery - doctor visits ... Pre-op is the time before your surgery. It means "before operation." During this time, you will meet with one of your doctors. This may be your surgeon or primary care ...

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. However, turnover has been increasing in recent years for both groups. There is a need for the MoH to review and improve upon the project implementation.

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

What Makes Industries Strategic

DTIC Science & Technology

1990-01-01

1988, America’s dollar GNP per employee fell below the average of the next six largest market econo- mies for the first time in this century (chart...manufacturing value added divided by full-time equivalent employees (with and without SIC 35, which contains computers). Chart 2. Productivity in...been available in English. Employees at Convex, a mini-supercomputer maker, had to learn the Japanese alphabet before they realized the opportunity

A systematic review of burnout among doctors in China: a cultural perspective.

PubMed

Lo, Dana; Wu, Florence; Chan, Mark; Chu, Rodney; Li, Donald

2018-01-01

Numerous studies around the world has already suggested that burnout among doctors is a global phenomenon. However, studies for burnout in doctors are relatively limited in Chinese communities when compared to the West. As risk factors, barriers to intervention and strategies combatting burnout in different parts of the world can vary a lot due to different social culture and healthcare system, study with a focus at doctors in China from a cultural perspective is a worthful endeavor. Systematic searches of databases were conducted for papers published in peer-reviewed journals from 2006 to 2016. Selection criteria included practicing doctors in Mainland China and publications written in English or Chinese. Keywords searched including "burnout", "doctors" and "China" in 3 electronic databases has been undergone. Traditional understanding of "work attitude" and "doctors' humanity" from ancient Chinese literature has also been retrieved. Eleven full papers, including 9302 participants, were included in this review. The overall prevalence of burnout symptoms among doctors in China ranged from 66.5 to 87.8%. The review suggested that negative impact of burnout include association with anxiety symptoms and low job satisfaction at the individual doctors' level, and prone to committing medical mistakes affecting patient safety and higher turnover intention at the society/organizational level. Burnout was higher among doctors who worked over 40 h/week, working in tertiary hospitals, on younger age group within the profession (at age 30-40), and with negative individual perception to work and life. The overall prevalence and adverse impact of burnout among doctors in China echo with the findings from Western studies. Young doctors and doctors working in tertiary hospitals are more at risk of burnout, probably related to shift of social culture related to the loss of medical humanities and a weak primary healthcare system. Potential strategies of managing burnout in Chinese doctors should therefore take consideration from the Chinese cultural perspective, with renaissance of medical humanities and strengthening the primary healthcare system in China.

Paperless Payroll: Implementation of a Paperless Payroll Certification.

ERIC Educational Resources Information Center

Reese, Larry D.

1991-01-01

The University of Florida has implemented an online payroll certification system that exemplifies how computer applications can result in higher quality information and provide real cost savings. In this case, the combined personnel savings exceeded 6.5 full-time-equivalent positions, more than twice the computing costs incurred. (MSE)

34 CFR 686.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

...): (1) One complete school year, or two complete and consecutive half-years from different school years... full-time employment as a teacher. For an individual teaching in more than one school, the... performance for tests and assignments yielded a numeric equivalent of a 3.25 GPA on a 4.0 scale; and (ii) For...

34 CFR 686.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

...): (1) One complete school year, or two complete and consecutive half-years from different school years... full-time employment as a teacher. For an individual teaching in more than one school, the... performance for tests and assignments yielded a numeric equivalent of a 3.25 GPA on a 4.0 scale; and (ii) For...

34 CFR 686.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) One complete school year, or two complete and consecutive half-years from different school years... full-time employment as a teacher. For an individual teaching in more than one school, the... performance for tests and assignments yielded a numeric equivalent of a 3.25 GPA on a 4.0 scale; and (ii) For...

34 CFR 686.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

...): (1) One complete school year, or two complete and consecutive half-years from different school years... full-time employment as a teacher. For an individual teaching in more than one school, the... performance for tests and assignments yielded a numeric equivalent of a 3.25 GPA on a 4.0 scale; and (ii) For...

34 CFR 686.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

...): (1) One complete school year, or two complete and consecutive half-years from different school years... full-time employment as a teacher. For an individual teaching in more than one school, the... performance for tests and assignments yielded a numeric equivalent of a 3.25 GPA on a 4.0 scale; and (ii) For...

12 CFR 365.103 - Registration of mortgage loan originators.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OF GENERAL POLICY REAL ESTATE LENDING STANDARDS Registration of Residential Mortgage Loan Originators... not act as mortgage loan originators unless the bank has 10 or fewer full time or equivalent employees...) identified in paragraphs (e)(1)(i)(E) and (F) of this section must comply with Registry protocols to verify...

12 CFR 365.103 - Registration of mortgage loan originators.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OF GENERAL POLICY REAL ESTATE LENDING STANDARDS Registration of Residential Mortgage Loan Originators... not act as mortgage loan originators unless the bank has 10 or fewer full time or equivalent employees...) identified in paragraphs (e)(1)(i)(E) and (F) of this section must comply with Registry protocols to verify...

12 CFR 365.103 - Registration of mortgage loan originators.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF GENERAL POLICY REAL ESTATE LENDING STANDARDS Registration of Residential Mortgage Loan Originators... not act as mortgage loan originators unless the bank has 10 or fewer full time or equivalent employees...) identified in paragraphs (e)(1)(i)(E) and (F) of this section must comply with Registry protocols to verify...

12 CFR 365.103 - Registration of mortgage loan originators.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OF GENERAL POLICY REAL ESTATE LENDING STANDARDS Registration of Residential Mortgage Loan Originators... not act as mortgage loan originators unless the bank has 10 or fewer full time or equivalent employees...) identified in paragraphs (e)(1)(i)(E) and (F) of this section must comply with Registry protocols to verify...

45 CFR 1801.4 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... means a student who is carrying a sufficient number of credit hours or their equivalent to secure the... taken at his or her institution. Graduate study means the courses of study beyond the baccalaureate..., has one more year of full-time course work to receive a baccalaureate degree. President means the...

Assessing Significance in Continuing Education: A Needed Adition to Productivity.

ERIC Educational Resources Information Center

Burnham, Byron R.

1986-01-01

A process whereby continuing education administrators can quantitatively measure FTEs (full-time equivalency), courses, registration, costs, and student hours and relate these measurements to staff productivity is evaluated and its limitations explored. The author also presents a framework of accounting for adult education productivity and values.…

The Devil Is in the Details.

ERIC Educational Resources Information Center

Dempsey, William M.

1997-01-01

A Rochester Institute of Technology (New York) program costing model designed to reflect costs more accurately allocates indirect costs according to salaries and wages, modified total direct costs, square footage of space used, credit hours, and student and faculty full-time equivalents. It allows administrators to make relative value judgments…

42 CFR 493.649 - Methodology for determining fee amount.

Code of Federal Regulations, 2010 CFR

2010-10-01

... fringe benefit costs to support the required number of State inspectors, management and direct support... full time equivalent employee. Included in this cost are salary and fringe benefit costs, necessary... 42 Public Health 5 2010-10-01 2010-10-01 false Methodology for determining fee amount. 493.649...

An Interinstitutional Analysis of Faculty Teaching Load.

ERIC Educational Resources Information Center

Ahrens, Stephen W.

A two-year interinstitutional study among 15 cooperating universities was conducted to determine whether significant differences exist in teaching loads among the selected universities as measured by student credit hours produced by full-time equivalent faculty. The statistical model was a multivariate analysis of variance with fixed effects and…

34 CFR 110.24 - Recipient assessment of age distinctions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... FINANCIAL ASSISTANCE Duties of ED Recipients § 110.24 Recipient assessment of age distinctions. (a) As part... recipient employing the equivalent of 15 or more full-time employees to complete a written self-evaluation... Federal financial assistance from ED to assess the recipient's compliance with the Act. (b) Whenever an...

Report on Staffing and Salaries, Fall 1989.

ERIC Educational Resources Information Center

California Community Colleges, Sacramento. Office of the Chancellor.

This report presents fall 1989 demographic, staffing, salary, and workload information on California community college employees, based on data collected from 70 of the 71 districts in the state. First, tables present the total number of district employees by primary occupational activity; the number of full-time equivalent (FTE) employees by…

Certificated Personnel and Related Information, Fall 1997.

ERIC Educational Resources Information Center

Wamboldt, Martina

Information on Colorado's certificated school personnel and related information was gathered from the state's public school districts and Boards of Cooperative Services during fall 1997. This information shows that the fall 1997 average salary for Colorado's 37,840.9 full-time-equivalent (FTE) public school teachers was $37,240, which represented…

Report on Staffing and Salaries, Fall 1990.

ERIC Educational Resources Information Center

Shymoniak, Leonard; And Others

Tenth in a series of annual reports, this report presents fall 1990 demographic, staffing, salary, and workload information on California community college employees, based on data collected from all 71 California community college districts. Section I presents data on primary occupational activity, full-time equivalency, and type of assignment…

Washington Community Colleges Fall Quarter Report, 1980.

ERIC Educational Resources Information Center

Story, Sherie; And Others

This three-part report presents a series of 46 tables providing data about enrollments, student characteristics, and personnel in the Washington community college system for Fall Quarter 1980. After a summary of the statistical highlights of the study, Chapter I offers historical data on Fall Quarter, full-time equivalent (FTE) and student…

MATC Fact Book, January 1987.

ERIC Educational Resources Information Center

Milwaukee Area Technical Coll., WI. Dept. of Research, Planning, and Development.

This 1986-87 fact book for Milwaukee Area Technical College (MATC) presents data on institutional characteristics, faculty and staff, full-time equivalent enrollments, student characteristics, and facilities for the MATC district and each of the college campuses. Highlights derived from an analysis of data and trends include the following: (1)…

Tertiary Education in New Zealand: Radical Changes to Funding and Accountability.

ERIC Educational Resources Information Center

Coy, David; And Others

1991-01-01

The main provisions of New Zealand's new requirements for financial reporting by higher education institutions and the new funding system based on full-time-equivalent enrollment are summarized. It is concluded that the requirements will improve accountability to the public. Some weaknesses are also identified. (Author/MSE)

24 CFR 585.4 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... who has dropped out of high school,” “institution of higher education,” “limited-English proficiency... out of high school. (2) An exception of not more than 25 percent of all full-time participants is... educational needs despite attainment of a high school diploma or its equivalent. Private nonprofit...

24 CFR 585.4 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... who has dropped out of high school,” “institution of higher education,” “limited-English proficiency... out of high school. (2) An exception of not more than 25 percent of all full-time participants is... educational needs despite attainment of a high school diploma or its equivalent. Private nonprofit...

24 CFR 585.4 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... who has dropped out of high school,” “institution of higher education,” “limited-English proficiency... out of high school. (2) An exception of not more than 25 percent of all full-time participants is... educational needs despite attainment of a high school diploma or its equivalent. Private nonprofit...

Space Guidelines for Libraries.

ERIC Educational Resources Information Center

Wisconsin Coordinating Committee for Higher Education, Madison.

The following guidelines are recommended: stack space--for each 10 volumes, one square foot of space; reading room--25 square feet per station x 20% of the total undergraduate population; carrel space--25% of the graduate enrollment x 45 square feet; office and auxilliary space--135 square feet x full time equivalent staff. (NI)

Doctors' use of electronic medical records systems in hospitals: cross sectional survey

PubMed Central

Lærum, Hallvard; Ellingsen, Gunnar; Faxvaag, Arild

2001-01-01

Objectives To compare the use of three electronic medical records systems by doctors in Norwegian hospitals for general clinical tasks. Design Cross sectional questionnaire survey. Semistructured telephone interviews with key staff in information technology in each hospital for details of local implementation of the systems. Setting 32 hospital units in 19 Norwegian hospitals with electronic medical records systems. Participants 227 (72%) of 314 hospital doctors responded, equally distributed between the three electronic medical records systems. Main outcome measures Proportion of respondents who used the electronic system, calculated for each of 23 tasks; difference in proportions of users of different systems when functionality of systems was similar. Results Most tasks listed in the questionnaire (15/23) were generally covered with implemented functions in the electronic medical records systems. However, the systems were used for only 2-7 of the tasks, mainly associated with reading patient data. Respondents showed significant differences in frequency of use of the different systems for four tasks for which the systems offered equivalent functionality. The respondents scored highly in computer literacy (72.2/100), and computer use showed no correlation with respondents' age, sex, or work position. User satisfaction scores were generally positive (67.2/100), with some difference between the systems. Conclusions Doctors used electronic medical records systems for far fewer tasks than the systems supported. What is already known on this topicElectronic information systems in health care have not undergone systematic evaluation, and few comparisons between electronic medical records systems have been madeGiven the information intensive nature of clinical work, electronic medical records systems should be of help to doctors for most clinical tasksWhat this study addsDoctors in Norwegian hospitals reported a low level of use of all electronic medical records systemsThe systems were mainly used for reading patient data, and doctors used the systems for less than half of the tasks for which the systems were functionalAnalyses of actual use of electronic medical records provide more information than user satisfaction or functionality of such records systems PMID:11739222

Becoming a Doctoral Researcher in a Digital World: Reflections on the Role of Twitter for Reflexivity and the Internal Conversation

ERIC Educational Resources Information Center

Rainford, Jon

2016-01-01

Twitter and other social networking sites have much to offer doctoral students, especially given that models for doctoral education are increasingly becoming more diverse with more students studying part-time for traditional PhDs, or on programmes such as professional doctorates. Prior research has highlighted the benefits of Twitter but, as other…

Effectiveness of a role-play simulation program involving the sbar technique: A quasi-experimental study.

PubMed

Yu, Mi; Kang, Kyung Ja

2017-06-01

Accurate, skilled communication in handover is of high priority in maintaining patients' safety. Nursing students have few chances to practice nurse-to-doctor handover in clinical training, and some have little knowledge of what constitutes effective handover or lack confidence in conveying information. This study aimed to develop a role-play simulation program involving the Situation, Background, Assessment, Recommendation technique for nurse-to-doctor handover; implement the program; and analyze its effects on situation, background, assessment, recommendation communication, communication clarity, handover confidence, and education satisfaction in nursing students. Non-equivalent control-group pretest-posttest quasi-experimental. A convenience sample of 62 senior nursing students from two Korean universities. The differences in SBAR communication, communication clarity, handover confidence, and education satisfaction between the control and intervention groups were measured before and after program participation. The intervention group showed higher Situation, Background, Assessment, Recommendation communication scores (t=-3.05, p=0.003); communication clarity scores in doctor notification scenarios (t=-5.50, p<0.001); and Situation, Background, Assessment, Recommendation education satisfaction scores (t=-4.94, p<0.001) relative to those of the control group. There was no significant difference in handover confidence between groups (t=-1.97, p=0.054). The role-play simulation program developed in this study could be used to promote communication skills in nurse-to-doctor handover and cultivate communicative competence in nursing students. Copyright © 2017. Published by Elsevier Ltd.

UK doctors' views on the implementation of the European Working Time Directive as applied to medical practice: a quantitative analysis.

PubMed

Maisonneuve, Jenny J; Lambert, Trevor W; Goldacre, Michael J

2014-02-06

To report on doctors' views, from all specialty backgrounds, about the European Working Time Directive (EWTD) and its impact on the National Health Service (NHS), senior doctors and junior doctors. All medical school graduates from 1999 to 2000 were surveyed by post and email in 2012. The UK. Among other questions, in a multipurpose survey on medical careers and career intentions, doctors were asked to respond to three statements about the EWTD on a five-point scale (from strongly agree to strongly disagree): 'The implementation of the EWTD has benefited the NHS', 'The implementation of the EWTD has benefited senior doctors' and 'The implementation of the EWTD has benefited junior doctors'. The response rate was 54.4% overall (4486/8252), 55.8% (2256/4042) of the 1999 cohort and 53% (2230/4210) of the 2000 cohort. 54.1% (2427) of all respondents were women. Only 12% (498/4136 doctors) agreed that the EWTD has benefited the NHS, 9% (377) that it has benefited senior doctors and 31% (1289) that it has benefited junior doctors. Doctors' views on EWTD differed significantly by specialty groups: 'craft' specialties such as surgery, requiring extensive experience in performing operations, were particularly critical. These cohorts have experience of working in the NHS before and after the implementation of EWTD. Their lack of support for the EWTD 4 years after its implementation should be a concern. However, it is unclear whether problems rest with the current ceiling on hours worked or with the ways in which EWTD has been implemented.

Do Medical Students' Narrative Representations of "The Good Doctor" Change Over Time? Comparing Humanism Essays From a National Contest in 1999 and 2013.

PubMed

Rutberg, Pooja C; King, Brandy; Gaufberg, Elizabeth; Brett-MacLean, Pamela; Dinardo, Perry; Frankel, Richard M

2017-04-01

To explore medical students' conceptions of "the good doctor" at two points in time separated by 14 years. The authors conducted qualitative analysis of narrative-based essays. Following a constant comparative method, an emergent relational coding scheme was developed which the authors used to characterize 110 essays submitted to the Arnold P. Gold Foundation Humanism in Medicine Essay Contest in 1999 (n = 50) and 2013 (n = 60) in response to the prompt, "Who is the good doctor?" The authors identified five relational themes as guiding the day-to-day work and lives of physicians: doctor-patient, doctor-self, doctor-learner, doctor-colleague, and doctor-system/society/profession. The authors noted a highly similar distribution of primary and secondary relational themes for essays from 1999 and 2013. The majority of the essays emphasized the centrality of the doctor-patient relationship. Student essays focused little on teamwork, systems innovation, or technology use-all important developments in contemporary medicine. Medical students' narrative reflections are increasingly used as rich sources of information about the lived experience of medical education. The findings reported here suggest that medical students understand the "good doctor" as a relational being, with an enduring emphasis on the doctor-patient relationship. Medical education would benefit from including an emphasis on the relational aspects of medicine. Future research should focus on relational learning as a pedagogical approach that may support the formation of caring, effective physicians embedded in a complex array of relationships within clinical, community, and larger societal contexts.

An analysis of the current educational status and future training needs of China's rural doctors in 2011.

PubMed

Li, Xingming; Liu, Juyuan; Huang, Jianshi; Qian, Yunliang; Che, Lu

2013-04-01

To analyse the educational status and future training needs of China's rural doctors and provide a basis to improve their future training. A cross-sectional epidemiological survey was used for the analysis, and 17 954 rural doctors chosen randomly from the eastern, central and western regions of China in 2009-2010 were surveyed to ascertain their average training time and the methods used for and content of their training. In general, 8671/17 778 (48.77%) of respondents received less than 12 days of training in a year. Conference sessions seemed to be the major route of training, with 10 150/17 925 respondents (56.62%). Clinical skills, with a response rate of 14 441/17 926 (80.56%), seemed to be the most popular training content. With regard to the general needs for training time received, 6547/18 255 (35.86%) of respondents hoped the average training time received a year would be less than 12 days; on-site guidance from a senior doctor was the most popular training method with response rate of 10 109/17 976 (56.24%), and clinical skills was what rural doctors wished to study the most, with a positive response of 16 744/17 962 (93.22%). Statistically significant differences existed in the current status and training time, training method and training content needs of China's rural doctors. Our results suggest that the training status and needs of China's rural doctors are still disjointed; measures including the introduction of remote education and clinical further education, extended training time and more clinical skills training should be adopted.

Manpower Assessment Brief #44: NUCLEAR ENGINEERING Enrollments Decreased at All Levels in 1998. Undergraduate and Doctoral Degrees Decreased, While Master's Degrees Increased Slightly.

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

Shirley, Duveen

1999-05-04

The survey of "Nuclear Engineering Enrollments and Degrees, 1998" was sent to 45 institutions offering a major in nuclear engineering or an option program in another discipline or department (for example, electrical or mechanical engineering) equivalent to a major that qualifies the graduates to perform as nuclear engineers. This document provides statistical data on undergraduate and graduate enrollments and degrees, employment and post-graduation plans, and foreign national participation.

Manpower Assessment Brief #45: HEALTH PHYSICS Enrollments Decreased at All Levels in 1998.Undergraduate and Master's Degrees Decreased, While Doctoral Degrees Increased Slightly.

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

Shirley, Duveen

1999-05-04

The "Health Physics Enrollments and Degrees, 1998" survey consisted of 47 institutions (49 programs) offering a major in health physics/radiation protection or radiation health, or an option program equivalent to a major (for example, in radiobiology or biophysics) that prepare the graduates to perform as health physicists. This document provides statistical data on undergraduate and graduate enrollment and degrees, employment or post-graduation plans, and foreign national participation.

Ordered Rate Constitutive Theories: Development of Rate Constitutive Equations for Solids, Liquids, and Gases

DTIC Science & Technology

2010-08-18

the author(s) and should not contrued as an official Department of the Army position, policy or decision, unless so designated by other documentation...Daniel S. Nunez 0.50 Yong-Ting Ma 0.50 Tristan Moody 0.50 1.50FTE Equivalent: 3Total Number: Names of Post Doctorates PERCENT_SUPPORTEDNAME FTE...demonstrated that the constitutive theory for ordered thermofluids of all orders is indeed rate constitutive theory. The reseach work presented in this chapter

Fuel Cell Using the Protic Ionic Liquid and Rotator Phase Solid Electrolyte Principles

DTIC Science & Technology

2008-07-15

appropriate host for the ionic liquid. (a) Papers published in peer-reviewed journals (N/A for none) [1] Thompson J, Dunn P, Holmes L, Belieres J-P...Names of Post Doctorates PERCENT_SUPPORTEDNAME Jean-Philippe Belieres 0.50 Xiaoguang Sun 0.50 1.00FTE Equivalent: 2Total Number: Names of Faculty...chemical shift for transferred protons (co-worker Jean-Philippe Belieres ) This is a fundamental study of the chemical state of the proton on the cation

Patient opinion of the doctor-patient relationship in a public hospital in Qatar.

PubMed

Weber, Alan S; Verjee, Mohamud A; Musson, David; Iqbal, Navid A; Mosleh, Tayseer M; Zainel, Abdulwahed A; Al-Salamy, Yassir

2011-03-01

To analyze the factors associated with the level of satisfaction of outpatients in their relationship with their doctor at the largest public hospital in Qatar. This study was a cross-sectional survey of attitudes. Researchers surveyed 626 outpatients at Hamad General Hospital in Doha, Qatar from September 2009 to January 2010 using a novel questionnaire assessing satisfaction with patients' interaction(s) with their doctor (spent time with patient, took case seriously, maintained confidentiality, and the overall quality of visit). Mean responses on 4 Likert scale items (one to 5) were as follows: "spent enough time with patient" = 4.39; "doctor took case seriously" = 4.57; "satisfaction with doctor-patient confidentiality" = 4.71; "overall quality of visit" = 4.46. Age, gender, citizenship, level of education, and number of visits did not significantly impact the level of satisfaction. For 73.1% of patients, the physician's qualification was the most important factor in choosing a doctor. Of those surveyed, 40.7% of men and 28.1% of women preferred to see a doctor of their own gender. A positive correlation between perceived communication and satisfaction with the doctor-patient encounter was established. This study found that patients in the Out-Patient Department at Hamad Hospital were highly satisfied with their relationships with their doctors, and physician qualification was the most significant factor in choosing a doctor. A significant number of males and females preferred a physician of their own gender. Communication difficulty correlated with lower satisfaction.

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.

Junior doctors in their first year: mental health, quality of life, burnout and heart rate variability.

PubMed

Henning, Marcus A; Sollers, John; Strom, Joanna M; Hill, Andrew G; Lyndon, Mataroria P; Cumin, David; Hawken, Susan J

2014-04-01

There is a burgeoning interest in, and evidence of, quality of life and burnout issues among doctors. It was hypothesized that the junior doctors in this study would experience psychosocial and physiological changes over time, and that the obtained measures would indicate psychosocial and physiological anomalies. In addition, it was hypothesized that their psychosocial perceptions would be significantly associated with their physiological measures. A total sample of 17 junior doctors in their first year of training volunteered for this study. Over four time periods separated by 6 week phases, the doctors completed a set of quality of life and psychosocial inventories and wore a Polar RS800 Heart Rate Monitor over a day and night time interval. The findings showed that this sample of doctors did not report any problems associated with depression, anxiety, stress, burnout or quality of life (psychosocial measures). In addition, their heart rate variability scores (physiological measures) did not show any significant fluctuations. Furthermore, the responses from the self-report instruments measuring stress, anxiety, depression, quality of life and burnout did not consistently correlate with the HRV information suggesting a mind-body disconnection. More work needs to be done on larger samples to investigate these findings further given that the literature shows that junior doctors are likely to be stressed and working in stress-provoking environments.

Weekly working hours for Norwegian hospital doctors since 1994 with special attention to postgraduate training, work-home balance and the European working time directive: a panel study.

PubMed

Rosta, Judith; Aasland, Olaf G

2014-10-13

To examine the weekly working hours of Norwegian hospital doctors from 1994 to 2012 with special emphasis on the quality of postgraduate training and work-home balance, and in relation to the requirements of the European Working Time Directive (EWTD). Panel study based on postal questionnaires. Norway. Unbalanced cohort of 1300-1600 doctors in 1994, 1995, 1996, 1997, 2000, 2002, 2004, 2006, 2008, 2010 and 2012. Self-reported total weekly working hours and whether 45 weekly working hours are too short, sufficient, or too long to meet the quality requirements of obligatory postgraduate training for junior doctors. From 1994 to 2012, the number of weekly working hours was stable for senior (46-47 h) and junior (45-46 h) hospital doctors. In 2012, significantly more senior (27-35%) than junior (11-20%) doctors reported suboptimal work-home balance, defined as working more than 48 h a week. The majority perceived the present situation with an average of 45 h per week for juniors as sufficient for obligatory postgraduate specialist training, but doctors of higher age (OR 1.04, 95% CI 1.01 to 1.08), senior doctors (1.07, 1.04 to 1.11) and doctors working in surgical specialties (OR 1 vs laboratory medicine 0.03, 0.01 to 0.25, internal medicine 0.31, 0.17 to 0.58, psychiatry 0.12, 0.04 to 0.36, paediatrics 0.36, 0.12 to 1.07, anaesthesiology 0.08, 0.02 to 0.39, gynaecology 0.07, 0.01 to 0.56 and others 0.39, 0.04 to 3.56) were more likely to want the work-week to be longer. The weekly working hours of Norwegian hospital doctors were always below the EWTD requirements. A significant growth of hospital doctor density over the past two decades, national regulations and cultural values might be important factors. Specialty differences in perception of sufficient training time may call for more flexibility in working time regulations. 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.

Administrative work consumes one-sixth of U.S. physicians' working hours and lowers their career satisfaction.

PubMed

Woolhandler, Steffie; Himmelstein, David U

2014-01-01

Doctors often complain about the burden of administrative work, but few studies have quantified how much time clinicians devote to administrative tasks. We quantified the time U.S. physicians spent on administrative tasks, and its relationship to their career satisfaction, based on a nationally representative survey of 4,720 U.S. physicians working 20 or more hours per week in direct patient care. The average doctor spent 8.7 hours per week (16.6% of working hours) on administration. Psychiatrists spent the highest proportion of their time on administration (20.3%), followed by internists (17.3%) and family/general practitioners (17.3%). Pediatricians spent the least amount of time, 6.7 hours per week or 14.1 percent of professional time. Doctors in large practices, those in practices owned by a hospital, and those with financial incentives to reduce services spent more time on administration. More extensive use of electronic medical records was associated with a greater administrative burden. Doctors spending more time on administration had lower career satisfaction, even after controlling for income and other factors. Current trends in U.S. health policy--a shift to employment in large practices, the implementation of electronic medical records, and the increasing prevalence of financial risk sharing--are likely to increase doctors' paperwork burdens and may decrease their career satisfaction.

Implementation of the European Working Time Directive in an NHS trust: impact on patient care and junior doctor welfare.

PubMed

McIntyre, Hugh F; Winfield, Sarah; Te, Hui Sen; Crook, David

2010-04-01

To comply with the European Working Time Directive (EWTD), from 1 August 2009, junior doctors are required to work no more than 48 hours per week. In accordance with this, East Sussex Hospitals Trust introduced changes to working practice in August 2007. To assess the impact upon patient care and junior doctor welfare a retrospective observational survey comparing data from the year prior to and the year following August 2007 was conducted. No impact on the standard of patient care, as measured by length of stay, death during admission or readmission was found. However, there was a notable increase in episodes of sick leave among junior doctors. Implementation of the EWTD may maintain standards of patient care but may be detrimental to the welfare of doctors in training.

International Doctoral Graduates from China and South Korea: A Trend Analysis of the Association between the Selectivity of Undergraduate and That of US Doctoral Institutions

ERIC Educational Resources Information Center

Kim, Dongbin; Roh, Jin-young

2017-01-01

This study explores whether patterns of doctorate attainment among Chinese and Korean international students in the USA have changed over time, both in terms of quantity (i.e., number of international students) and quality (i.e., the selectivity of the undergraduate and doctoral institutions), and whether these changes reflect the improvements in…

Improving compliance with requirements on junior doctors' hours

PubMed Central

Cass, Hilary D; Smith, Isabel; Unthank, Cheryl; Starling, Colin; Collins, Jane E

2003-01-01

Problem Compliance with UK regulations on junior doctors' working hours cannot be achieved by manipulating rotas that maintain existing tiers of cover and work practices. More radical solutions are needed. Design Audit of change. Setting Paediatric night rota in large children's hospital. Key measures for improvement Compliance with regulations on working hours assessed by diary cards; workload assessed by staff attendance on wards; patient safety assessed through critical incident reports. Strategies for change Development of new staff roles, followed by change from a partial shift rota comprising 11 doctors and one senior nurse, to a full shift night team comprising three middle grade doctors and two senior nurses. Effects of change Compliance with regulations on working hours increased from 33% to 77%. Workload changed little and was well within the capacity of the new night team. The effect on patient care and on medical staff requires further evaluation. Lessons learnt Reduction of junior doctors' working hours requires changes to roles, processes, and practices throughout the organisation. PMID:12896942

Cardiac-CT and Cardiac-MR examinations cost analysis, based on data of four Italian Centers.

PubMed

Centonze, Maurizio; Lorenzin, Giuseppe; Francesconi, Andrea; Cademartiri, Filippo; Casagranda, Giulia; Fusaro, Michele; Ligabue, Guido; Zanetti, Giovanna; Spanti, Demetrio; De Cobelli, Francesco

2016-01-01

To establish the appropriate number of Cardiac-CT and Cardio-MR examinations, to determine an economically justified and sustainable investment in these two technologies, for an exclusive cardiologic use. From July 2013 to July 2014, through a survey in four different Italian Departments of Radiology, data on the costs of Cardiac-CT and Cardiac-MR examinations were collected. For the evaluation of the costs of examinations, it was used an analytical accounting system, considering only the direct costs (consumables, health personnel work time, equipment amortization/maintenance) and other costs (utilities, services, etc.). Indirect costs (general costs) were not assessed. It was made a simulation, assuming an exclusive use of the CT and MR equipments for Cardiac-CT and Cardiac-MR examinations, calculating the annual number necessary to arrive at the Break Even Point (BEP: the point at which cost or expenses and revenue are equal). On the basis of the CT costs, in order to reach the BEP, performing only Cardiac-CT examinations, an average of 2641-2752 examinations/year is needed. The annual time commitment of the Medical Professional to ensure the number of examinations to reach the BEP is 2625-2750 h/year, equivalent to two Medical Doctors in a Cardiology Department. The recent Cardiac-CT Italian Registry, in the period January-June 2011, reports a number of examinations of 3455 patients in 47 different Centers, distributed throughout the whole national territory. With regard to MR, in order to reach the BEP, performing only Cardiac-MR examinations, an average of 2435-3123 examinations/year is needed. The annual time commitment of the Medical Professional to ensure the number of examinations to reach the BEP is 2437-3125 h/year, equivalent to two Medical Doctors in a Cardiology Department. The recent Cardiac-MR Italian Registry reports a number of examinations of 3776 patients in 40 Centers, distributed throughout the whole national territory. This research has shown that, only on the basis of costs, currently in Italy is anti-economic an exclusive use of CT or MR equipment for cardiac exams, unless it's not decided, regardless of the recent guidelines and clinical indications, to submit all patients with cardiac diseases (diseases of the coronary arteries and cardiomyopathies) to Cardiac-CT and Cardiac-MR examinations. This might likely to increase both the inappropriate examinations and either health spending and in the case of CT with important repercussions, in terms of radio-exposure, subject to forensic procedures.

Recruiting patients for postgraduate medical training in a community family planning clinic: how do patients want to be asked?

PubMed

Heathcote, Jennifer

2008-01-01

To look at patients' views about the way in which they are recruited to assist with postgraduate medical training (i.e. Who is the best person to ask patients to participate? When is the best time for patients to be asked?) and to compare these with clinical practice. Questionnaire surveys of 103 female family planning clinic (FPC) patients and 40 Diploma of the Faculty of Family Planning (DFFP) instructing doctors. Patients were recruited from the waiting room of a community FPC, and DFFP instructing doctors from the North West of England were recruited at an updating meeting. Patients preferred to be recruited by non-medical staff (i.e. receptionist and nurses). Few patients wanted to be asked by the training doctor. Only 9% would find it difficult to refuse a receptionist, 47% would find it difficult to refuse the instructing doctor and 65% would find it difficult to refuse the training doctor. In practice, the commonest person to recruit patients is the instructing doctor. Patients wanted to be given some time to consider the request; this was not always given. Patients may feel coerced into seeing training doctors because they find it difficult to refuse requests, particularly when they are being recruited by doctors. Non-medical staff may be more appropriate for the initial recruitment of patients. Patients need time to consider their involvement. The provision of written information may be useful. Further research is indicated to empower patients' decision-making and reduce the likelihood of coercion.

Does money or the law reduce doctors' working hours in the UK?

PubMed

Moreton, Adam; Collier, Andrew

2015-08-01

What can be learned from a 45-year journey to reduced junior doctors' working hours? The authors investigated the impact of financially punitive measures (the 2001 New Deal contract) and legislation (Working Time Regulations) on the average working week for doctors-in-training.

The physician's breach of the duty to inform the parent of deformities and abnormalities in the foetus: "wrongful life" actions, a new frontier of medical responsibility.

PubMed

Frati, Paola; Gulino, Matteo; Turillazzi, Emanuela; Zaami, Simona; Fineschi, Vittorio

2014-07-01

A recent decision of the Italian Highest Court for the first time legitimized wrongful life suits. The Court stated the following principles: (a) the contract between the mother and the doctor has also protective effects in favour of third parties (father, siblings and the disabled child) who have the right to be compensated; (b) the right to compensation is neither based on the right not to be born nor on the right to be born healthy, but rather it is based on the breach of duty of care which coincides with the child's disabled status; (c) siblings may suffer the reduced availability of their parents; (d) the doctor is held responsible for not providing full information to the mother about the foetal deformity. The Supreme Court once again emphasized the importance of information on the matter of very personal choices, such as termination of pregnancy in case of foetal malformations. In the present case, the gynaecologist breached the duty to inform, especially after the patient requested diagnostic tests designed to highlight any foetal malformations and informed the doctor of the possibility of an eventual subsequent termination of pregnancy if foetal malformations were found.

The virtual continuity in learning programme: results.

PubMed

Wood, Eleanor; Tso, Simon

2012-08-01

The implementation of the European Working Time Directive and specialty-driven care has resulted in the loss of continuity of patient care, and thus a loss of continuity in learning. We proposed a potential solution to this fragmentation of junior doctor workplace learning in the Virtual Continuity in Learning Programme (VCLP). The VCLP enables the doctor to follow the virtual patient journey (of an actual patient who is no longer under their care) using the Virtual Consulting Room (VcR), and to understand the rationale behind clinical decision making prior to completing their case-based discussion (CbD) work-based assessments. Fifty-seven out of 62 (92%) of foundation doctors (Homerton University Hospital, London, UK) consented to participate in the study. Web-tracking software was used. Fifty-three out of 57 (93%) doctors completed an initial questionnaire. Twenty-nine out of 57 (51%) doctors returned a follow-up questionnaire 6 months later. Eleven doctors were interviewed in three focus groups: the VcR user group; the VcR non-user group; and a mixed group. The data was analysed qualitatively. Tracking showed 33.3 per cent (19/57) of doctors used the VcR over a 6-month period. Interestingly doctors used the VcR in a range of situations, not solely as instructed. Results enabled us to understand how doctors learn and their perception of using the VCLP to support their learning and completion of work-based assessments. Foundation doctors use the educational resources available, including the VcR, to help structure their workplace learning. The majority of VcR users found it particularly useful for just-in-time learning. The VCLP offers support to junior doctors learning during their preparation for case-based discussion. © Blackwell Publishing Ltd 2012.

Sex Differences Among Career Development Awardees in the Attainment of Independent Research Funding in a Department of Medicine

PubMed Central

Yeh, Hsin-Chieh; Clark, Jeanne M.; Weisfeldt, Myron L.; Choi, Terry; MacDonald, Susan M.

2015-01-01

Abstract Background: National data suggest that women are overall less likely than men to attain independent research funding. However, it remains unclear whether such sex differences are also observed in academic institutions that have integrated diversity in the workplace as a priority. Methods: During 1999–2008, all National Institutes of Health (NIH) Career Development (K01, K08, or K23) awardees in the Department of Medicine at Johns Hopkins University School of Medicine were identified to investigate differences in the attainment of independent funding by sex, including NIH Research Project Grant (R01) or equivalent awards, (U01, P01, P50), and any R award (also R03, R21, R34) through 2012. Results: A similar number of men (n = 49) and women (n = 43) received a K award. There were no significant sex differences in attaining an R01/equivalent award or any R award. The median time to attaining the first R01/equivalent award was similar for men and women (5.6 vs. 5.3 years, p = 0.93). The actuarial rate of R01/equivalent award attainment at 10 years was 64% overall (56% among men vs. 74% among women; log-rank p = 0.41). For any R award, the rate was 72% overall (70% among men vs. 76% among women; log-rank p = 0.63). In Cox proportional hazards models, adjusting for race/ethnicity, age, Doctor of Medicine (MD) degree, and funding period, sex was not an independent predictor of R01/equivalent or any R award attainment. Interestingly, black race and/or Hispanic ethnicity significantly predicted any R award attainment (adjusted hazard ratio [HR] = 2.34, 95% confidence interval [CI] 1.02–5.37). Conclusions: No sex differences were found in the attainment of independent funding by K awardees in our study. Future studies to investigate the impact of specific diversity initiatives on subsequent success in attaining independent research funding are needed. PMID:26291588

Personal Study Planning in Doctoral Education in Industrial Engineering

ERIC Educational Resources Information Center

Lahenius, K.; Martinsuo, M.

2010-01-01

The duration of doctoral studies has increased in Europe. Personal study planning has been considered as one possible solution to help students in achieving shorter study times. This study investigates how doctoral students experience and use personal study plans in one university department of industrial engineering. The research material…

The Agile Approach with Doctoral Dissertation Supervision

ERIC Educational Resources Information Center

Tengberg, Lars Göran Wallgren

2015-01-01

Several research findings conclude that many doctoral students fail to complete their studies within the allowable time frame, in part because of problems related to the research and supervision process. Surveys show that most doctoral students are generally satisfied with their dissertation supervision. However, these surveys also reveal some…

The Invisible Student: Benefits and Challenges of Part-Time Doctoral Studies

ERIC Educational Resources Information Center

Bates, Peter; Goff, Lori

2012-01-01

This autoethnographic study explores the experiences of two part-time doctoral students as we document our journey of balancing our multiple competing roles. As we reflected and consulted the literature, we began to identify many benefits and challenges that part-time candidature brings to students, universities and employers. Through our…

What do ICU doctors do? A multisite time and motion study of the clinical work patterns of registrars.

PubMed

Li, Ling; Hains, Isla; Hordern, Toni; Milliss, David; Raper, Ray; Westbrook, Johanna

2015-09-01

To quantify the time that intensive care unit registrars spend on different work tasks with other health professionals and patients and using information resources, and to compare them with those of clinicians in general wards and the emergency department (ED). A prospective, observational time-and-motion study of two ICUs with a total of 71 beds at two major teaching hospitals in Sydney. Twenty-six registrars were observed between 08:00 and 18:00 on weekdays for a total of 160.52 hours. Proportions of time spent on different tasks, using specific information resources, working with other health professionals and patients, and rates of multitasking and interruptions. A total of 12 043 distinct tasks were observed. Registrars spent 69.2% of time working at patients' bedsides, 49.6% in professional communication and 39.0% accessing information resources. Half of their time (53.8%) was spent with other ICU doctors and 29.2% with nurses. Compared with doctors and nurses on general wards, and doctors in the ED, ICU registrars were more likely to multitask (40.1 times/hour [24.4% of their time]). ICU registrars had a higher interruption rate than ward clinicians, (4.2 times/hour), but a lower rate than ED doctors. Face-to-face communication and information seeking consume a vast proportion of ICU registrars' time. Multitasking and handling frequent interruptions characterise their work, and such behaviours may create an increased risk of task errors. Electronic clinical information systems may be particularly beneficial in this information-rich environment.

34 CFR 607.23 - What special funding consideration does the Secretary provide?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false What special funding consideration does the Secretary... Does the Secretary Make an Award? § 607.23 What special funding consideration does the Secretary... for library materials per full-time equivalent enrolled student which is less than the average...

12 CFR 34.103 - Registration of mortgage loan originators.

Code of Federal Regulations, 2011 CFR

2011-01-01

....103 Section 34.103 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY REAL... not act as mortgage loan originators unless the bank has 10 or fewer full time or equivalent employees... paragraphs (e)(1)(i)(E) and (F) of this section must comply with Registry protocols to verify their identity...

12 CFR 34.103 - Registration of mortgage loan originators.

Code of Federal Regulations, 2013 CFR

2013-01-01

....103 Section 34.103 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY REAL... not act as mortgage loan originators unless the bank has 10 or fewer full time or equivalent employees... paragraphs (e)(1)(i)(E) and (F) of this section must comply with Registry protocols to verify their identity...

12 CFR 34.103 - Registration of mortgage loan originators.

Code of Federal Regulations, 2012 CFR

2012-01-01

....103 Section 34.103 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY REAL... not act as mortgage loan originators unless the bank has 10 or fewer full time or equivalent employees... paragraphs (e)(1)(i)(E) and (F) of this section must comply with Registry protocols to verify their identity...

12 CFR 34.103 - Registration of mortgage loan originators.

Code of Federal Regulations, 2014 CFR

2014-01-01

....103 Section 34.103 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY REAL... not act as mortgage loan originators unless the bank has 10 or fewer full time or equivalent employees... paragraphs (e)(1)(i)(E) and (F) of this section must comply with Registry protocols to verify their identity...

Certificated Personnel and Related Information, Fall 1995.

ERIC Educational Resources Information Center

Wamboldt, Martina

Information to prepare this publication was collected from Colorado school districts. Tables present data about the certificated personnel and related data for Colorado public schools as of fall 1995. The fall 1995 average salary for the state's 35,387.9 full-time-equivalent (FTE) teachers was $35,364, which represented a 2.3% increase over the…

Report on Staffing and Salaries, Fall 1988. Report Number 89-2.

ERIC Educational Resources Information Center

California Community Colleges, Sacramento. Office of the Chancellor.

This report presents fall 1989 demographic, staffing, salary, and workload information on all California community college employees, based on data from 69 of the 71 districts in the state. First, tables present the total number of district employees by primary occupational activity; full-time equivalency; type of assignment; weekly faculty…

Economies of Scale and Scope in Australian Higher Education

ERIC Educational Resources Information Center

Worthington, A. C.; Higgs, H.

2011-01-01

This paper estimates economies of scale and scope for 36 Australian universities using a multiple-input, multiple-output cost function over the period 1998-2006. The three inputs included in the analysis are full-time equivalent academic and non-academic staff and physical capital. The five outputs are undergraduate, postgraduate and PhD…

When Less Is More: Prioritizing Open Access

ERIC Educational Resources Information Center

Mullin, Christopher M.

2017-01-01

In policy circles, the first question of the year often relates to college enrollment. Most common is the question: "Are you up or down in enrollment?" More often than not, the enrollment question may be answered in terms of full-time equivalent (FTE) enrollment. While the answer does have programmatic implications, the initial interest…

A Comparative Analysis of Community Colleges and Two-Year Technical Colleges.

ERIC Educational Resources Information Center

Wilkinson, David

Community colleges (CC's) are institutions using postsecondary instruction adapted in context, level, and schedule, to the needs of the community in which they are located, offering programs intended for normal completion over a two-year, full-time equivalent period, and usually offering a comprehensive curriculum with transfer, career, and…

MICRO-U 70.1: Training Model of an Instructional Institution, Users Manual.

ERIC Educational Resources Information Center

Springer, Colby H.

MICRO-U is a student demand driven deterministic model. Student enrollment, by degree program, is used to develop an Instructional Work Load Matrix. Linear equations using Weekly Student Contact Hours (WSCH), Full Time Equivalent (FTE) students, FTE faculty, and number of disciplines determine library, central administration, and physical plant…

School District Employment Reductions Slow. Get the Facts. #1

ERIC Educational Resources Information Center

Tallman, Mark

2012-01-01

Kansas school districts reduced employment by 327 full-time equivalent positions this school year, the smallest reduction in three years of cuts to district operating budgets. Districts reduced positions by 561 in FY 2010 and 1,626 in FY 2011. Districts eliminated nearly 400 "regular" teaching positions this year, but added 114 special…

20 CFR 332.7 - Consideration of evidence.

Code of Federal Regulations, 2011 CFR

2011-04-01

... miles or hours' credit earned in rotating extra board, pool, or chain gang service shall, in the absence... equivalent of full-time work during the period covered by his claim. When it appears clear that an employee in rotating extra board, pool, or chain gang service who fails to report the number of miles or hours...

20 CFR 332.7 - Consideration of evidence.

Code of Federal Regulations, 2012 CFR

2012-04-01

... miles or hours' credit earned in rotating extra board, pool, or chain gang service shall, in the absence... equivalent of full-time work during the period covered by his claim. When it appears clear that an employee in rotating extra board, pool, or chain gang service who fails to report the number of miles or hours...

Efficiency, Technology and Productivity Change in Australian Universities, 1998-2003

ERIC Educational Resources Information Center

Worthington, Andrew C.; Lee, Boon L.

2008-01-01

In this study, productivity growth in 35 Australian universities is investigated using non-parametric frontier techniques over the period 1998-2003. The five inputs included in the analysis are full-time equivalent academic and non-academic staff, non-labor expenditure and undergraduate and postgraduate student load while the six outputs are…

45 CFR 1156.12 - Self-evaluation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Self-evaluation. 1156.12 Section 1156.12 Public... Endowment Recipients § 1156.12 Self-evaluation. (a) Each recipient employing the equivalent of 15 or more full time employees may be required to complete a written self-evaluation, in a manner specified by the...

Interlibrary Loan Trends: Staffing and Organization. SPEC Kit #187.

ERIC Educational Resources Information Center

Dearie, Tammie Nickelson, Comp.; Steel, Virginia, Comp.

Topics related to research library interlibrary loan staffing and organizational structures were explored through a survey conducted by the Systems and Procedures Exchange Center (SPEC) of the Association of Research Libraries. Data gathered from 82 libraries show a very small increase in the number of full-time equivalents in loan units between…

Pima Community College Summary of 2000-2001 Student Enrollment.

ERIC Educational Resources Information Center

Attinasi, Louis; Hennessey, Brendan; Reece, Dee

This report summarizes the annual unduplicated headcount enrollment and the annual full-time student equivalents (FTSE) generated by students in credit classes and by completers of clock-hour programs during fiscal year 2000-2001 at Pima Community College (Arizona). Highlights include: (1) Pima's total annual unduplicated headcount was 65,221 and…

Patient turnover and nursing employment in Massachusetts hospitals before and after health insurance reform: implications for the Patient Protection and Affordable Care Act.

PubMed

Shindul-Rothschild, Judith; Gregas, Matt

2013-01-01

The Affordable Care Act is modeled after Massachusetts insurance reforms enacted in 2006. A linear mixed effect model examined trends in patient turnover and nurse employment in Massachusetts, New York, and California nonfederal hospitals from 2000 to 2011. The linear mixed effect analysis found that the rate of increase in hospital admissions was significantly higher in Massachusetts hospitals (p<.001) than that in California and New York (p=.007). The rate of change in registered nurses full-time equivalent hours per patient day was significantly less (p=.02) in Massachusetts than that in California and was not different from zero. The rate of change in admissions to registered nurses full-time equivalent hours per patient day was significantly greater in Massachusetts than California (p=.001) and New York (p<.01). Nurse staffing remained flat in Massachusetts, despite a significant increase in hospital admissions. The implications of the findings for nurse employment and hospital utilization following the implementation of national health insurance reform are discussed.

Toward a more professional and practical medical education: a novel Central European approach.

PubMed

Drexel, Heinz; Vonbank, Alexander; Fraunberger, Peter; Riesen, Walter F; Saely, Christoph H

2015-01-01

We here present an innovative curriculum for a complete medical education that conforms to the current European Bologna system of academic training. The curriculum aims at raising doctors who are excellently prepared for clinical work over as short a time as 5 years; it provides a comprehensive, yet shorter than usual, education that strongly pronounces the importance of increasing the students' practical clinical competences and rigorously excludes superfluous contents. The curriculum encompasses 52 modules, 32 at the bachelor's and 20 at the master's level. Already at the level of the bachelor degree, full employability is given; the students finish the master's course as medical doctors optimally prepared to manage patients at the level of postgraduate medical education. The structure of the curriculum is modular; each modular component is essential for medical education and contains an average of five European Credit Transfer System credits, amounting to 150 hours of education. Depending on the subspecialty, the courses include lectures, seminars, practical laboratory training, and clinical training at varying quantities. In addition to attendance times, sufficient time slots are prepared for self-study in lectures, seminars, and practical work. With our curriculum, we provide an easily applicable backbone for a modern course of medicine that can be installed also at smaller academic institutions.

Opportunities outside private practice before 1860.

PubMed

Deacon, Harriet; van Heyningen, Elizabeth

2004-01-01

This chapter discusses the restrictions and opportunities which salaried employment offered Cape doctors in the pay of government and charitable organisations during the first two thirds of the nineteenth century. Although Cape doctors often acted as agents of the colonial state there were many nuances within this relationship. While military doctors played an important role in the profession during the first few decades of the century, by the 1840s civilian doctors were beginning to assert greater influence in Cape Town, if not yet in the Eastern Cape. Hospital posts and an expanding network of charitable organisations and government-funded district surgeoncies provided part-time employment for some doctors throughout the colony. This helped urban-based doctors to sustain practices and encouraged more doctors to practice in the smaller country towns serving large farming areas.

Depo-Provera: An Injectable Contraceptive

MedlinePlus

... time. To prevent pregnancy, you have to get 1 shot from your doctor 4 times a year, about ... who use Depo-Provera stop having periods after 1 year. This is not harmful. ... pregnant after your last shot. Contact your doctor right away if you have ...

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

PubMed

Fogel, Joshua; Teichman, Chaim

2014-01-01

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

[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.

Perspectives of Nurses Pursuing Doctoral Degrees in Georgia: Implications for Recruitment.

PubMed

Wheeler, Rebecca McCombs; Eichelberger, Lisa Wright

2017-08-01

Increasing the number of nurses with doctorates is a goal of the nursing profession. The Georgia Nursing Leadership Coalition developed a survey to understand the perspectives of nurses pursuing doctoral degrees in Georgia to improve recruitment and retention strategies. A 26-item online survey was distributed to all students enrolled in Georgia-based doctoral programs in nursing in spring 2014. One hundred fifty responses were received (54% response rate). Most students first seriously considered doctoral education during their master's programs or more than 5 years into practice. For most, obtaining a doctoral degree was a personal life goal. Work-life balance was the most significant barrier. Recruitment of nurses to doctoral programs should focus on messaging, timing, and highlighting the unique aspects of programs. Schools should work to reduce barriers. Understanding students' perspectives of doctoral education in nursing can improve recruitment strategies and increase the number of nurses graduating with doctorates in Georgia. [J Nurs Educ. 2017;56(8):466-470.]. Copyright 2017, SLACK Incorporated.

How a mobile app supports the learning and practice of newly qualified doctors in the UK: an intervention study.

PubMed

Bullock, Alison; Dimond, Rebecca; Webb, Katie; Lovatt, Joseph; Hardyman, Wendy; Stacey, Mark

2015-04-08

The transition from medical school to the workplace can be demanding, with high expectations placed on newly qualified doctors. The provision of up-to-date and accurate information is essential to support doctors at a time when they are managing increased responsibility for patient care. In August 2012, the Wales Deanery issued the Dr.Companion© software with five key medical textbooks (the iDoc app) to newly qualified doctors (the intervention). The aim of the study was to examine how a smartphone app with key medical texts was used in clinical workplace settings by newly qualified doctors in relation to other information sources and to report changes over time. Participants (newly qualified - Foundation Year 1 - doctors) completed a baseline questionnaire before downloading the iDoc app to their own personal smartphone device. At the end of Foundation Year 1 participants (n = 125) completed exit questionnaires one year later. We used Wilcoxon Signed Rank test to analyse matched quantitative data. We report significant changes in our participants' use of workplace information resources over the year. Respondents reduced their use of hard-copy and electronic versions of texts on PCs but made more use of senior medical staff. There was no significant difference in the use of peers and other staff as information sources. We found a significant difference in how doctors felt about using a mobile device containing textbooks in front of patients and senior medical staff in the workplace. Our study indicates that a mobile app enabling timely, internet-free access to key textbooks supports the learning and practice of newly qualified doctors. Although participants changed their use of other resources in the workplace, they continued to consult with seniors. Rather than over-reliance on technology, these findings suggest that the app was used strategically to complement, not replace discussion with members of the medical team. Participants' uncertainty about using a mobile device with textbook app in front of others eased over time.

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.

Usefulness of an Internet-based thematic learning network: comparison of effectiveness with traditional teaching.

PubMed

Coma Del Corral, María Jesús; Guevara, José Cordero; Luquin, Pedro Abáigar; Peña, Horacio J; Mateos Otero, Juan José

2006-03-01

UniNet is an Internet-based thematic network for a virtual community of users (VCU). It supports one multidisciplinary community of doctoral students, who receive most of the courses on the network. The evident advantages of distance learning by Internet, in terms of costs, comfort, etc., require a previous evaluation of the system, focusing on the learning outcomes of the student. The aim was to evaluate the real learning of the students of doctorate courses, by comparing the effectiveness of distance learning in UniNet with traditional classroom-based teaching. Five doctorate courses were taught simultaneously to two independent groups of students in two ways: one, through the UniNet Network, and the other in a traditional classroom. The academic knowledge of students was evaluated at the beginning and end of each course. The difference in score was considered as a knowledge increase. The comparison was made using Student's t-test for independent groups. There were no significant statistical differences in the outcomes of the two groups of students. This suggests that both teaching systems were equivalent in increasing the knowledge of the students. Both educational methods, the traditional system and the online system in a thematic network, are effective and similar for increasing knowledge.

Ministry of Health Clinical Practice Guidelines: Prevention, Diagnosis and Management of Tuberculosis

PubMed Central

Wang, Yee Tang Sonny; Chee, Cynthia Bin Eng; Hsu, Li Yang; Jagadesan, Raghuram; Kaw, Gregory Jon Leng; Kong, Po Marn; Lew, Yii Jen; Lim, Choon Seng; Lim, Ting Ting Jayne; Lu, Kuo Fan Mark; Ooi, Peng Lim; Sng, Li-Hwei; Thoon, Koh Cheng

2016-01-01

The Ministry of Health (MOH) has developed the clinical practice guidelines on Prevention, Diagnosis and Management of Tuberculosis to provide doctors and patients in Singapore with evidence-based treatment for tuberculosis. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on Prevention, Diagnosis and Management of Tuberculosis, for the information of SMJ readers. The chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines. PMID:26996216

A longitudinal study of well-being, confidence and competence in junior doctors and the impact of emergency medicine placements.

PubMed

Mason, Suzanne; O'Keeffe, Colin; Carter, Angela; Stride, Chris

2016-02-01

To measure levels of, and change in junior doctor well-being, confidence and self-reported competence over their second postgraduate training year and the impact of emergency department (ED) placements on these outcomes. A longitudinal study using an online survey administered at four time points (2010-2011). 28 Acute Hospital Trusts, drawn from nine participating Postgraduate Deaneries in England. Junior doctors who had a placement in an ED as part of their second postgraduate training year. Levels of anxiety, depression, motivation, job satisfaction, confidence and self-reported competence, collected at four time points spread over the period of the doctor's second training year (F2). 217 junior doctors were recruited to the study. Over the year there was a significant increase in their overall job satisfaction, confidence and self-reported competence. Junior doctors also reported significantly increased levels of motivation and anxiety, and significantly decreased levels of extrinsic job satisfaction when working in ED compared with other specialties. There were also significant increases in both junior doctor confidence and self-reported competence after their placement in ED relative to other specialties. While elements of junior doctor well-being worsened in their ED placement compared with their time spent in other specialties, the increased levels of anxiety and reduced extrinsic job satisfaction were within the normal range for other healthcare workers. These deficits were also balanced by greater improvements in motivation, confidence in managing common acute clinical conditions and perceived competence in performing acute procedures compared with benefits offered by placements in other specialties. 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/

A longitudinal study of well-being, confidence and competence in junior doctors and the impact of emergency medicine placements

PubMed Central

Mason, Suzanne; O'Keeffe, Colin; Carter, Angela; Stride, Chris

2016-01-01

Objectives To measure levels of, and change in junior doctor well-being, confidence and self-reported competence over their second postgraduate training year and the impact of emergency department (ED) placements on these outcomes. Design A longitudinal study using an online survey administered at four time points (2010–2011). Setting 28 Acute Hospital Trusts, drawn from nine participating Postgraduate Deaneries in England. Participants Junior doctors who had a placement in an ED as part of their second postgraduate training year. Main outcome measures Levels of anxiety, depression, motivation, job satisfaction, confidence and self-reported competence, collected at four time points spread over the period of the doctor's second training year (F2). Results 217 junior doctors were recruited to the study. Over the year there was a significant increase in their overall job satisfaction, confidence and self-reported competence. Junior doctors also reported significantly increased levels of motivation and anxiety, and significantly decreased levels of extrinsic job satisfaction when working in ED compared with other specialties. There were also significant increases in both junior doctor confidence and self-reported competence after their placement in ED relative to other specialties. Conclusions While elements of junior doctor well-being worsened in their ED placement compared with their time spent in other specialties, the increased levels of anxiety and reduced extrinsic job satisfaction were within the normal range for other healthcare workers. These deficits were also balanced by greater improvements in motivation, confidence in managing common acute clinical conditions and perceived competence in performing acute procedures compared with benefits offered by placements in other specialties. PMID:26338523

Doctor-patient communication: a comparison between telemedicine consultation and face-to-face consultation.

PubMed

Liu, Xiao; Sawada, Yoshie; Takizawa, Takako; Sato, Hiroko; Sato, Mahito; Sakamoto, Hironosuke; Utsugi, Toshihiro; Sato, Kunio; Sumino, Hiroyuki; Okamura, Shinichi; Sakamaki, Tetsuo

2007-01-01

The objective of this study was to compare doctor-patient communications in clinical consultations via telemedicine technology to doctor-patient communications in face-to-face clinical consultations. Five doctors who had been practicing internal medicine for 8 to 18 years, and twenty patients were enrolled in this study; neither doctors nor patients had previous experience of telemedicine. The patients received both a telemedicine consultation and a face-to-face consultation. Three measures--video observation, medical record volume, and participants' satisfaction--were used for the assessment. It was found that the time spent on the telemedicine consultation was substantially longer than the time spent on the face-to-face consultation. No statistically significant differences were found in the number of either closed or open-ended questions asked by doctors between both types of consultation. Empathy-utterances, praise-utterances, and facilitation-utterances were, however, seen less in the telemedicine consultations than in the face-to-face consultations. The volume of the medical records was statistically smaller in the telemedicine consultations than in the face-to-face consultations. Patients were satisfied with the telemedicine consultation, but doctors were dissatisfied with it and felt hampered by the communication barriers. This study suggests that new training programs are needed for doctors to develop improved communication skills and the ability to express empathy in telemedicine consultations.

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.

[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.

Air Force Commanders and Barriers to Entry into a Doctoral Business Program

ERIC Educational Resources Information Center

Williams, Tony; LeMire, Steven D.

2011-01-01

The authors examined professionally qualified Air Force commanders' barriers to entry into a business doctoral degree program related to the factors of time, financial means, academics, and motivation. Of the 116 present commanders, 63% were interested in pursuing a doctorate in business. For the commanders interested in obtaining a doctorate…

The Mathematics Doctorate: A Time for Change? Carnegie Essays on the Doctorate: Mathematics.

ERIC Educational Resources Information Center

Chan, Tony F.

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

Student Satisfaction with Graduate Supervision in Doctoral Programs Primarily Delivered in Distance Education Settings

ERIC Educational Resources Information Center

Erichsen, Elizabeth Anne; Bolliger, Doris U.; Halupa, Colleen

2014-01-01

There are no universal, precise, or explicit criteria for completing a doctoral degree successfully. Researchers and practitioners have pointed out how difficult and time consuming the supervision of graduate student research can be. When students in doctoral programs complete their degrees via distance delivery, supervision of graduate students…

Political Transformation and Research Methodology in Doctoral Education

ERIC Educational Resources Information Center

Herman, Chaya

2010-01-01

This paper examines the relationship between political change and epistemologies and methodologies employed at doctorate level. It does so by analysing the range of topics, questions and methodologies used by doctoral students at the University of Pretoria's Faculty of Education between 1985 and 2005--a time-frame that covers the decade before and…

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…

What Works for Doctoral Students in Completing Their Thesis?

ERIC Educational Resources Information Center

Lindsay, Siân

2015-01-01

Writing a thesis is one of the most challenging activities that a doctoral student must undertake and can represent a barrier to timely completion. This is relevant in light of current and widespread concerns regarding doctoral completion rates. This study explored thesis writing approaches of students post or near Ph.D. completion through…

Doctors' service orientation in public, private, and foreign hospitals.

PubMed

Andaleeb, Syed Saad; Siddiqui, Nazlee; Khandakar, Shahjahan

2007-01-01

The purpose of this study is to propose a doctors' service orientation (DSO) scale and uses it to compare the services received in public, private and foreign hospitals in a developing country from the patient's perspective. The scale was derived from the service quality literature and qualitative research. A questionnaire was designed next. Data were collected from patients who had used the services of doctors in a hospital. The scale demonstrated appropriate psychometric properties. Two clear patterns emerge from the study results: on 10 out of 12 measures of doctors' service orientation, there was no significant difference in their perceived behaviors between public and private hospitals and foreign doctors were "always" rated significantly higher. This study focused on one major city because of time and resource constraints. The findings are thus not generalizable to hospitals across the country. Also, because of translation and retranslation issues, the scale ought to be further tested for wider use. The scale may be used periodically in a comprehensive quality assurance program to exhort doctors to become more service oriented and to improve their performance over time.

Managing poorly performing clinicians: health care providers' willingness to pay for independent help.

PubMed

Watson, Verity; Sussex, Jon; Ryan, Mandy; Tetteh, Ebenezer

2012-03-01

To determine the willingness to pay (WTP) of senior managers in the UK National Health Service (NHS) for services to help manage performance concerns with doctors, dentists and pharmacists. A discrete choice experiment (DCE) was used to elicit senior managers' preferences for a support service to help manage clinical performance concerns. The DCE was based on: a literature review; interviews with support service providers and clinical professional bodies; and discussion groups with managers. From the DCE responses, we estimate marginal WTP for aspects of support services. 451 NHS managers completed the DCE questionnaire. NHS managers are willing to pay for: advice, 'facilitation', and behavioural, health, clinical and organisational assessments. Telephone advice with written confirmation was valued most highly. NHS managers were willing to pay £161.56 (CI: £160.81-£162.32) per year per whole time equivalent doctor, dentist or pharmacist, for support to help manage clinical performance concerns. Marginal WTP varied across respondent subgroups but was always positive. Health care managers valued help in managing the clinicians' performance, and were willing to pay for it from their organisations' limited funds. Their WTP exceeds the current cost of a UK body providing similar support. Establishing a central body to provide such services across a health care system, with the associated economies of scale including cumulative experience, is an option that policy makers should consider seriously. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Completion Time Dynamics for Master's and Doctoral Studies at Makerere University

ERIC Educational Resources Information Center

Wamala, Robert; Oonyu, Joseph C.

2012-01-01

This paper examines the dynamics of completion time of master's studies and how such dynamics relate to those of doctoral studies at Makerere University, Uganda. The assessment is based on administrative data of 605 master's degree students at the University in the 2004 and 2005 enrollment cohorts. The total elapsed time from first enrollment to…

Completion Time Dynamics of Doctoral Studies at Makerere University: A Hazard Model Evaluation

ERIC Educational Resources Information Center

Wamala, Robert; Oonyu, Joseph; Ocaya, Bruno

2011-01-01

Issues related to attrition and completion time of graduate studies are certainly an internationally challenging and important area of higher education literature. In this paper, completion time dynamics of doctoral studies at Makerere University were investigated based on data extracted for all 295 candidates in the commencement cohorts from 2000…

A generic discrete-event simulation model for outpatient clinics in a large public hospital.

PubMed

Weerawat, Waressara; Pichitlamken, Juta; Subsombat, Peerapong

2013-01-01

The orthopedic outpatient department (OPD) ward in a large Thai public hospital is modeled using Discrete-Event Stochastic (DES) simulation. Key Performance Indicators (KPIs) are used to measure effects across various clinical operations during different shifts throughout the day. By considering various KPIs such as wait times to see doctors, percentage of patients who can see a doctor within a target time frame, and the time that the last patient completes their doctor consultation, bottlenecks are identified and resource-critical clinics can be prioritized. The simulation model quantifies the chronic, high patient congestion that is prevalent amongst Thai public hospitals with very high patient-to-doctor ratios. Our model can be applied across five different OPD wards by modifying the model parameters. Throughout this work, we show how DES models can be used as decision-support tools for hospital management.

Effects of income supplementation on health of the poor elderly: the case of Mexico.

PubMed

Aguila, Emma; Kapteyn, Arie; Smith, James P

2015-01-06

We use an income supplementation experiment we designed in the state of Yucatan in Mexico for residents 70 y and older to evaluate health impacts of additional income. Two cities in the State of Yucatan, Valladolid (treatment) and Motul (control), were selected for the income supplementation experiment. Elderly residents of Valladolid were provided the equivalent of an additional $67 per month, a 44% increase in average household income. We designed a survey given to residents of both cities before and 6 mo after the income supplement about their health and other aspects of overall well-being. Both baseline and follow-up surveys collect self-reported data on health, physical functioning, and biomarkers. Anthropometric measurements for every age-eligible respondent, including height, weight, and waist circumference, were collected. We also collected lung capacity, grip strength, a series of balance tests, and a timed walk. Our results show significant health benefits associated with the additional income. Relative to the control site, there was a statistically significant improvement in lung function and an improvement in memory. These improvements are equivalent to a reduction in age of 5-10 y. Residents used their extra income to go to the doctor, buy their medications, and alleviate their hunger. The fear that this extra income could be undone by reduced transfers from other family members or unwise expenditures by the poor elderly appears to be unfounded.

It was the best of times, it was the worst of times: doctoral students' experiences of family therapy research training through alternative forms of data representation.

PubMed

Piercy, Fred P; McWey, Lenore; Tice, Susan; James, Ebony Joy; Morris, Matt; Arthur, Kristin

2005-09-01

In this study, we interviewed 14 doctoral students from 10 COAMFTE-accredited doctoral programs to learn more about how they experienced their research training and what they might suggest to strengthen the research culture in their training programs. We solicited somewhat unconventional data--metaphors, poetry, free associations, critical experiences--to (a) tap into our participants' underlying thought processes, (b) capture the multifaceted nature of their doctoral research training, and (c) represent the richness of our participants' subjective experiences. The themes we identified reflect both positive and negative research training experiences and suggest several ways that family therapy program faculty might improve their programs' research training and culture.

Nursing Professional Development Organizational Value Demonstration Project.

PubMed

Harper, Mary G; Aucoin, Julia; Warren, Joan I

2016-01-01

A common question nursing professional development (NPD) practitioners ask is, "How many NPD practitioners should my organization have?" This study examined correlations among facility size and structure, NPD practitioner characteristics and time in service, and organizational outcomes. Organizations with a higher rate of NPD full-time equivalents per bed had higher patient satisfaction with nurses' communication and provision of discharge instruction on their HCAHPS (Hospital Consumer Assessment of Healthcare Provider and Systems) scores.

["Linguistitis" of medical terminology (II). Language-policy and questions from a perspective of younger physicians].

PubMed

Høy, A

1996-12-02

In a previous article in the Journal of the Danish Medical Association, "Medical Terminology Linguistitis (I)", the author pointed out the importance of involving the users in connection with the definition of a language policy concerning Danish medical terminology and future medical doctors' need for language proficiency. A recent inquiry, involving 11 medical doctors (Ph.D. students), suggests that there is in fact a need for a language policy. Also, the respondents expressed strong antipathy against a full nationalization of the terms which can in some cases be observed in the Danish version of ICD-10. On the basis of this survey, the following questions are discussed in this article: Future medical doctors' need for knowledge of Latin and English, medical doctors' opinions concerning a terminology based on Latin, or Danish, and some important aspects concerning the definition of a language policy in the medical area.

[Salary and clinical productivity among physicians in Norwegian somatic hospitals 2001-2008].

PubMed

Johannessen, Karl-Arne

2010-09-23

Analysis of the future need for medical doctors necessitates an assessment of their productivity. The goals of this study were to analyze the relation between doctors' work force and the increased activity in hospitals, and to describe the development of working hours and salary for hospital doctors in a gender perspective. Information about man-labour years, working time and salary for doctors in Norwegian somatic hospitals was retrieved for the period 2001-2008. Number of hospital stays, DRG points and outpatient consultations per man-labour year are used as measures of doctors' clinical productivity. The percentage of female doctors increased from 34.7 % to 42.2 %. The mean annual salary increased more for men (14.4 % higher in 2001 and 16.6 % higher in 2008) than women. Total salary costs for doctors increased by 69.9 % (from 3.66 bill to 6.22 bill. NOK); 42.6 % of this increase was generated by new positions (1 306 man-labour years, + 21.2 %). Labour years from extended working hours increased by 6.8 % (constituting 1043 labour years in 2008; 12.2 % of the total), but the average extended labour time per doctor decreased (-16.7 % for women and -9.6 % for men). The number of hospital stays increased by 13.2 %, DRG points increased by 12.4 % and outpatient consultations increased by 9.3 % per doctor's work year in the period 2001-2008. Higher salaries for men may be explained by age, more men in senior positions and longer working hours than for women. The productivity of Norwegian doctors still increased from 2001 to 2008 (taking into account the increase in salary).

[Women's education according to the first women to receive doctorates in medicine from Spanish universities, 1882].

PubMed

Flecha Garcia, C

1999-01-01

This study looks at the topic of women's education as considered by the first two women to receive the degree of Doctor in Medicine from a Spanish university. Delores Aleu and Martina Castells decided to present as a doctoral thesis the development of an issue of particular relevance during the final decades of the 19th century. The importance given to public education and the difficulties young women encountered in participating under the same conditions as young men led these two women--who both held a bachelor's degree--to raise the issue and defend personal and social reasons that justified their full participation in different levels of education.

Starlight suppression from the starshade testbed at NGAS

NASA Astrophysics Data System (ADS)

Samuele, Rocco; Glassman, Tiffany; Johnson, Adam M. J.; Varshneya, Rupal; Shipley, Ann

2009-08-01

We report on progress at the Northrop Grumman Aerospace Systems (NGAS) starshade testbed. The starshade testbed is a 42.8 m, vacuum chamber designed to replicate the Fresnel number of an equivalent full-scale starshade mission, namely the flagship New Worlds Observer (NWO) configuration. Subscale starshades manufactured by the NGAS foundry have shown 10-7 starlight suppression at an equivalent full-mission inner working angle of 85 milliarseconds. In this paper, we present an overview of the experimental set up, scaling relationships to an equivalent full-scale mission, and preliminary results from the testbed. We also discuss potential limitations of the current generation of starshades and improvements for the future.

Exploring the relationship between mentoring and doctors' health and wellbeing: a narrative review.

PubMed

Wilson, Gemma; Larkin, Valerie; Redfern, Nancy; Stewart, Jane; Steven, Alison

2017-05-01

The health and wellbeing of doctors are crucial, both for the individuals themselves and their ability to deliver optimum patient care. With increased pressures on healthcare, support mechanisms that attend to doctors' health and wellbeing may require greater emphasis to safeguard those working in frontline services. To inform future developments, this systematic narrative review aimed to identify, explore and map empirical and anecdotal evidence indicating the relationships between mentoring activities and the health and wellbeing of doctors. Twelve databases were searched for publications printed between January 2006 and January 2016. Articles were included if they involved doctors' engagement in mentoring activities and, either health or wellbeing, or the benefits, barriers or impact of mentoring. The initial search returned 4669 papers, after exclusions a full-text analysis of 37 papers was conducted. Reference lists and citations of each retrieved paper were also searched. Thirteen papers were accepted for review. The Business in the Community model was used as a theoretical framework for analysis. Mentoring influenced collegiate relationships, networking and aspects of personal wellbeing, such as confidence and stress management, and was valued by doctors as a specialist support mechanism. This review contributes to the evidence base concerning mentoring and doctors' health and wellbeing. However, it highlights that focused research is required to explore the relationship between mentoring, and health and wellbeing.

The effect of improving primary care depression management on employee absenteeism and productivity. A randomized trial.

PubMed

Rost, Kathryn; Smith, Jeffrey L; Dickinson, Miriam

2004-12-01

To test whether an intervention to improve primary care depression management significantly improves productivity at work and absenteeism over 2 years. Twelve community primary care practices recruiting depressed primary care patients identified in a previsit screening. Practices were stratified by depression treatment patterns before randomization to enhanced or usual care. After delivering brief training, enhanced care clinicians provided improved depression management over 24 months. The research team evaluated productivity and absenteeism at baseline, 6, 12, 18, and 24 months in 326 patients who reported full-or part-time work at one or more completed waves. Employed patients in the enhanced care condition reported 6.1% greater productivity and 22.8% less absenteeism over 2 years. Consistent with its impact on depression severity and emotional role functioning, intervention effects were more observable in consistently employed subjects where the intervention improved productivity by 8.2% over 2 years at an estimated annual value of US 1982 dollars per depressed full-time equivalent and reduced absenteeism by 28.4% or 12.3 days over 2 years at an estimated annual value of US 619 dollars per depressed full-time equivalent. This trial, which is the first to our knowledge to demonstrate that improving the quality of care for any chronic disease has positive consequences for productivity and absenteeism, encourages formal cost-benefit research to assess the potential return-on-investment employers of stable workforces can realize from using their purchasing power to encourage better depression treatment for their employees.

Do Expenditures Other than Instructional Expenditures Affect Graduation and Persistence Rates in American Higher Education?

ERIC Educational Resources Information Center

Webber, Douglas A.; Ehrenberg, Ronald G.

2010-01-01

During the last two decades, median instructional spending per full-time equivalent (FTE) student at American 4-year colleges and universities has grown at a slower rate than median spending per FTE student in a number of other expenditure categories, including academic support, student services and research. Our paper uses institutional level…

A Tax for Higher Education

ERIC Educational Resources Information Center

Blumenstyk, Goldie

2012-01-01

Higher education pays off handsomely for society. Yet on a nationwide basis, states' support for higher education per full-time-equivalent student has fallen to just $6,290, the lowest in 15 years. A dedicated source of funds for higher education is problematic. But what if state and federal lawmakers applied the impeccable logic of the gas tax to…

Made in Maine: A State Report Card on Public Higher Education

ERIC Educational Resources Information Center

Markley, Eric; Poliakoff, Michael

2011-01-01

Maine is blessed with universities that have records of significant achievement. The seven campuses of the University of Maine System (UMS) together educated over 23,000 students (full-time equivalent) during the past year. But for good reason, in recent years public confidence in higher education throughout the nation has fallen. Half of the…

Who Pays for Blended Learning? A Cost-Benefit Analysis

ERIC Educational Resources Information Center

Taplin, Ross H.; Kerr, Rosemary; Brown, Alistair M.

2013-01-01

Using cost-benefit analysis, the purpose of this study is to analyse the monetary value students place on having access, via the internet, to recorded lectures in a blended learning context. The principal results are that the average price students are willing to pay to download iLectures is approximately $30 per equivalent full time student.…

Report on Staffing and Salaries, Fall 1987. California Community Colleges Report Number 88-6.

ERIC Educational Resources Information Center

California Community Colleges, Sacramento. Office of the Chancellor.

This report presents fall 1987 demographic, staffing, salary, and workload information on California community college employees, based on data provided by 68 of the 70 districts in the state. First, tables present the total number of district employees by: primary occupational activity; the number of full-time equivalent (FTE) employees by…

76 FR 45831 - Prescription Drug User Fee Rates for Fiscal Year 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-01

... annual change in cost, per FDA full time equivalent (FTE), of all personnel compensation and benefits... and benefits per FTE over the previous 5 of the most recent 6 FYs (FY 2006 through FY 2010). The data... percent. Table 1--FDA Personnel Compensation and Benefits (PC&B) Each Year and Percent Change Annual...

75 FR 46952 - Prescription Drug User Fee Rates for Fiscal Year 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-04

... average change in pay per FTE (4.53 percent) is the highest of the three factors, it becomes the inflation... pay change for the previous fiscal year for Federal employees stationed in the Washington, DC metropolitan area; or (3) the average annual change in cost, per full time equivalent (FTE) FDA position, of...

Projected Supply, Demand, and Shortages of Registered Nurses, 2000-2020.

ERIC Educational Resources Information Center

Health Resources and Services Administration (DHHS/PHS), Rockville, MD. National Center for Health Workforce Analysis.

The supply, demand, and shortages of registered nurses (RNs) were projected and analyzed for 2000-2020. According to the analysis, the national supply of full-time-equivalent registered nurses in 2000 was estimated at 1.89 million versus an estimated demand of 2 million, leaving a shortage of 110,000 (6%). The shortage is expected to grow…

Explaining Increases in Higher Education Costs

ERIC Educational Resources Information Center

Archibald, Robert B.; Feldman, David H.

2008-01-01

The real cost of higher education per full-time equivalent student has grown substantially over the last 75 years, and the rapid rise since the early 1980s is a cause of considerable public concern. Opinion surveys consistently find that how much one has to pay for a college education is a serious national issue. In his July 1996 congressional…

Trends in Student Aid, 2016. Trends in Higher Education Series

ERIC Educational Resources Information Center

Baum, Sandy; Ma, Jennifer; Pender, Matea; Welch, Meredith

2016-01-01

Data on student aid for 2015-16 confirm that the dramatic increases in aid awarded in 2009-10 and 2010-11 were products of extreme economic circumstances, not harbingers of long-run changes in financing for postsecondary education. Both total federal education loans and federal loans per full-time equivalent (FTE) student declined for the fifth…

42 CFR 412.424 - Methodology for calculating the Federal per diem payment amount.

Code of Federal Regulations, 2014 CFR

2014-10-01

... facilities located in a rural area as defined in § 412.402. (iii) Teaching adjustment. CMS adjusts the Federal per diem base rate by a factor to account for indirect teaching costs. (A) An inpatient psychiatric facility's teaching adjustment is based on the ratio of the number of full-time equivalent...

42 CFR 412.424 - Methodology for calculating the Federal per diem payment amount.

Code of Federal Regulations, 2013 CFR

2013-10-01

... facilities located in a rural area as defined in § 412.402. (iii) Teaching adjustment. CMS adjusts the Federal per diem base rate by a factor to account for indirect teaching costs. (A) An inpatient psychiatric facility's teaching adjustment is based on the ratio of the number of full-time equivalent...

42 CFR 412.424 - Methodology for calculating the Federal per diem payment amount.

Code of Federal Regulations, 2011 CFR

2011-10-01

... facilities located in a rural area as defined in § 412.402. (iii) Teaching adjustment. CMS adjusts the Federal per diem base rate by a factor to account for indirect teaching costs. (A) An inpatient psychiatric facility's teaching adjustment is based on the ratio of the number of full-time equivalent...

42 CFR 412.424 - Methodology for calculating the Federal per diem payment amount.

Code of Federal Regulations, 2010 CFR

2010-10-01

... facilities located in a rural area as defined in § 412.402. (iii) Teaching adjustment. CMS adjusts the Federal per diem base rate by a factor to account for indirect teaching costs. (A) An inpatient psychiatric facility's teaching adjustment is based on the ratio of the number of full-time equivalent...

42 CFR 412.424 - Methodology for calculating the Federal per diem payment amount.

Code of Federal Regulations, 2012 CFR

2012-10-01

... facilities located in a rural area as defined in § 412.402. (iii) Teaching adjustment. CMS adjusts the Federal per diem base rate by a factor to account for indirect teaching costs. (A) An inpatient psychiatric facility's teaching adjustment is based on the ratio of the number of full-time equivalent...

Washington Community Colleges Factbook. Addendum A: Student Enrollments, Academic Year 1977-78.

ERIC Educational Resources Information Center

Meier, Terre; Story, Sherie

In order to reveal trends in community college enrollments in Washington, student demographic and enrollment data for academic year 1977-78 were compiled and compared with figures for previous years. The report provides annualized averages for full-time equivalent (FTE) enrollments for the system for the years 1967 to 1977, and for FTE students by…

Washington Community College Factbook Addendum A: Student Enrollments, Academic Year 1978-79.

ERIC Educational Resources Information Center

Meier, Terre

In order to reveal trends in community college enrollments in Washington, student demographic and enrollment data for academic year 1978-79 were compiled and compared with figures for previous years. The study report provides annualized averages for full-time equivalent (FTE) enrollments for the years 1968-69 to 1978-79 and quarterly and…

The FrankensTEin Monster

ERIC Educational Resources Information Center

Blodget, Alden

2009-01-01

In budget meetings trustees tend to dehumanize teachers by looking at them as FTEs (full-time equivalents) instead of as flesh-and-blood people doing impossibly difficult jobs, a transformation that makes it easier to talk about reducing their number. So I created a model to try to humanize the FTE by looking at the number of hours a teacher needs…

Information Literacy Development at a Distance: Embedded or Reality?

ERIC Educational Resources Information Center

Chisholm, Elizabeth; Lamond, Heather M.

2012-01-01

A small library using two full time equivalent (FTE) professional staff integrated into the Moodle environment of over 40 postgraduate distance courses with the potential to reach over 1,800 students and getting results. How? This is not embedding as many would think of it, with the librarian an active teacher throughout the entire length of the…

PROCEDURE FOR THE ESTABLISHMENT OF COMMUNITY JUNIOR COLLEGES IN ARKANSAS.

ERIC Educational Resources Information Center

Arkansas State Commission on Coordination of Higher Educational Finance, Little Rock.

CRITERIA FOR ESTABLISHMENT OF JUNIOR COLLEGE DISTRICTS IN ARKANSAS INCLUDE (1) A PROJECTED ENROLLMENT OF AT LEAST 300 FULL TIME EQUIVALENT STUDENTS IN THE THIRD YEAR OF OPERATION, (2) ASSESSED VALUATION ADEQUATE TO PROVIDE FROM LOCAL PROPERTY TAXES ONE-THIRD OF THE ANNUAL OPERATING COST AND THE TOTAL DEBT SERVICE REQUIREMENTS FOR CAPITAL OUTLAY,…

A Planning and Assessment Model for Developing Effective CMS Support

ERIC Educational Resources Information Center

Johnson, Douglas F.

2004-01-01

At the University of Florida, in Spring 2003, more than 32,000 individuals enrolled in courses using the centrally-supported Course Management System (CMS). Because less than 1 full time equivalent (FTE) was allocated to support the CMS, this created problems for both users and support providers. In the face of rapid growth, support resources for…

The impact of the European Working Time Directive 10 years on: views of the UK medical graduates of 2002 surveyed in 2013-2014.

PubMed

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

2016-03-01

To report doctors' views about the European Working Time Directive ('the Directive'). Survey of the medical graduates of 2002 (surveyed in 2013-2014). Medical graduates. UK. Questions on views about the Directive. The response rate was 64% (2056/3196). Twelve per cent of respondents agreed that the Directive had benefited senior doctors, 39% that it benefited junior doctors, and 17% that it had benefited the NHS. More women (41%) than men (35%) agreed that the Directive had benefited junior doctors. Surgeons (6%) and adult medical specialists (8%) were least likely to agree that the Directive had benefited senior doctors. Surgeons (20%) were less likely than others to agree that the Directive had benefited junior doctors, whilst specialists in emergency medicine (57%) and psychiatry (52%) were more likely to agree. Surgeons (7%) were least likely to agree that the Directive had benefited the NHS. Most respondents (62%) reported a positive effect upon work-life balance. With regard to quality of patient care, 45% reported a neutral effect, 40% reported a negative effect, and 15% a positive effect. Most respondents (71%) reported a negative effect of the Directive on continuity of patient care, and 71% felt that the Directive had a negative effect upon junior doctors' training opportunities. Fifty-two per cent reported a negative effect on efficiency in managing patient care. Senior doctors agreed that the Directive benefited doctors' work-life balance. In other respects, they were more negative about it. Surgeons were the least positive about aspects of the Directive.

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.

Challenges Faced by Second Language Doctoral Student Writers in Hong Kong and Their Writing Strategies

ERIC Educational Resources Information Center

Hyland, Fiona

2016-01-01

Writing at the doctoral level presents many challenges for second language writers. This paper reports on a longitudinal study investigating English as a second language (ESL) doctoral students' writing problems and the strategies they developed to meet these challenges. Eight students were interviewed four times over a two-year period during…

Soulfully Resistant Transferistas: Understanding the Chicana Transfer Experience from Community College and into the Doctorate

ERIC Educational Resources Information Center

Rivas, Martha Alicia

2012-01-01

U.S. doctoral production rates between 1990-2000 indicate Chicana recipients continue to be less than one percent in the nation (Solorzano, Rivas, & Velez, 2005; Watford, Rivas, Burciaga, & Solorzano 2006). However, during this time frame, one out of four Chicana/o doctoral recipients began their postsecondary pathway at the community…

Supporting Professional Doctorate Women Students through Identity Change and Turbulent Times: Who Cares?

ERIC Educational Resources Information Center

Webber, Louise

2017-01-01

Professional doctorates are designed to enable students to blend their doctorate level study with their working lives. During the course of their studies women undergo identity change and transformation as their perspectives change, this has knock on effects at home and at work. Women students, who are mothers, also have to balance and juggle…

Seizures and Teens: Using Technology to Develop Seizure Preparedness

ERIC Educational Resources Information Center

Shafer, Patricia O.; Schachter, Steven C.

2007-01-01

Most people learn about seizures from their doctors, but others know only what they have seen on television. Unfortunately, visits to doctor's office aren't long enough to learn all that is needed, and often times, doctors and nurses aren't available to teach this information. Seizures are often represented inaccurately and too dramatically on…

[Travel times of patients to ambulatory care physicians in Germany].

PubMed

Schang, Laura; Kopetsch, Thomas; Sundmacher, Leonie

2017-12-01

The time needed by patients to get to a doctor's office represents an important indicator of realised access to care. In Germany, findings on travel times are only available from surveys or for some regions. For the first time, this study examines nationwide and physician group-specific travel times in the ambulatory care sector in Germany and describes demographic, supply-side and spatial determinants of variations. Using a full review of patient consultations in the statutory health insurance system from 2009/2010 for 14 physician groups (approximately 518 million cases), case-related travel times by car between patients' places of residence and physician's practices were estimated at the municipal level. Physicians were reached in less than 30 min in 90.8% of cases for primary care physicians and up to 63% of cases for radiologists. Patients between 18 and under 30 years of age travel longer to get to the doctor than other age groups. The average travel time at the county level systematically differs between urban and rural planning areas. In the case of gynecologists, dermatologists and ophthalmologists, the average journey time decreases with increasing physician density at the county level, but remains approximately constant from a recognisable point of inflection. There is no association between primary care physician density and travel time at the district level. Spatial analyses show physician group-specific patterns of regional concentrations with an increased proportion of cases with very long travel times. Patients' travel times are influenced by supply- and demand-side determinants. Interactions between influential determinants should be analysed in depth to examine the extent to which the time travelled is an expression of regional under- or over-supply rather than an expression of patient preferences.

Manpower and portfolio of European ENT.

PubMed

Luxenberger, W; Lahousen, T; Mollenhauer, H; Freidl, W

2014-03-01

The aim of this study is to evaluate highly variable ENT manpower among European countries. A descriptive study design is used. Manpower in medicine is highly variable among European countries. EU and associated countries are keeping officially appointed representatives to the European Union of medical specialists--otorhinolaryngology section (UEMS--ORL section). UEMS--ORL section is running a working group for manpower in ENT collecting data regarding demographics and ENT manpower in European countries. These ENT manpower data are presented in this paper and compared to available data concerning manpower in European medicine in general. To further evaluate these huge differences, representatives of the particular countries were also asked to fill out a questionnaire concerning specifics of ENT healthcare in their country. Furthermore, typical tasks of ENT doctors based on the official UEMS logbook for ENT training were listed and could be rated regarding their frequency, performed in everyday routine of an average ENT doctor of the country. Divergences in doctors/inhabitants ratios were remarkable within European countries, but disparities in ENT manpower were even more so. The ratio of ENT doctors/inhabitants was the lowest in Ireland (1:80,000) and Great Britain (1:65,000). Greece (1:10,000), Italy, Czech Republic, Lithuania, Poland and Slovakia (1:12,000) were--at the time of the study--the countries with the highest density of ENT doctors. The EU average for 2009 was (1:21,000). The presence of non-surgical working ENT doctors was significantly associated with higher densities of ENT doctors, whereas the necessity of being referred to an ENT doctor (gatekeeping or similar measures) was not. Estimated average waiting times for an appointment in non-urgent, chronic conditions, respectively, diseases were highly variable and predominantly showed a significant correlation to the ENT doctors/inhabitants ratio in the investigated countries. But also for acute conditions like acute hypacusis, dysphonia and hemoptysis, significant differences correlating to the ENT doctors/inhabitants ratio in waiting times for an ENT appointment were found. Estimated frequencies of different ENT tasks in everyday routine were extremely diverse as well, however, without detectable correlations to the ENT doctors/inhabitants ratio. In countries like Great Britain, Ireland, Malta and The Netherlands ENT doctors are primarily seen and serving as surgeons. In most Central European countries like Germany, Austria, Czech Republic, Poland and Slovakia, ENT doctors aside of surgery are also dealing with high percentages of conservative medicine, which may include vast fields like the management of Allergology, Phoniatrics, Audiology, etc. In some countries ENT doctors are even playing a significant role in primary health care as well. These various portfolios of ENT may be one explanation for the huge difference in numbers of European ENT manpower.

Challenges of Supervising Part-Time PhD Students: Towards Student-Centred Practice

ERIC Educational Resources Information Center

Watts, Jacqueline H.

2008-01-01

The supervision of part-time doctoral students is a long-term academic enterprise requiring stamina both on the part of the supervisor and the student. Because of the fractured student identity of the part-time doctoral candidate, who is usually balancing a range of work, study, and family commitments, strategies to support their progress have to…

Scribes in an Australian private emergency department: A description of physician productivity.

PubMed

Walker, Katherine; Ben-Meir, Michael; O'Mullane, Phebe; Phillips, David; Staples, Margaret

2014-12-01

The study aims to determine if trained scribes in an Australian ED can assist emergency physicians (EPs) to work with increased productivity. This was a pilot, prospective, observational study conducted at a private ED in Melbourne. A scribe is a trained assistant who works with an EP and performs non-clinical tasks that reduce the time spent providing clinical care for patients. Shifts with and without a scribe were compared. The primary outcomes were patients per hour per doctor and billings per patient. Additional analyses included total patient time in ED; individual doctor productivity; time to see a doctor; time on ambulance bypass; and complaints/issues identified with scribes. There was an overall increase in doctor consultations per hour of 0.32 patients (95% confidence interval (CI) 0.17, 0.47). This varied between doctors from an increase in patients per hour of 0.16 (95% CI -0.09, 0.40) to 0.65 (95% CI 0.41, 0.89). Billings per patient were increased (AUD15.24; 95% CI -AUD18.51, AUD48.99), but the increase was not statistically significant; time to see a doctor reduced by 22 min (95% CI 11, 33); bypass episodes reduced by 66 min per shift (95% CI 11, 122), total patient ED stay remained constant. In this pilot study, scribe usage was feasible, and overall improvements in consultations per hour were seen. Overall income improved by AUD104.86 (95% CI AUD38.52, AUD171.21) per scribed hour. Further study is recommended to determine if results are sustained or improved over a longer period. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Inductive Reasoning in Zambia, Turkey, and the Netherlands Establishing Cross-Cultural Equivalence.

ERIC Educational Resources Information Center

van de Vijver, Fons J. R.

2002-01-01

Administered tasks of inductive reasoning to 704 Zambian, 877 Turkish, and 632 Dutch students from the highest 2 grades of primary and the lowest 2 grades of secondary school. Results show strong evidence for structural equivalence and partial evidence for measurement unit equivalence, but did not support full score equivalence. (SLD)

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.

Multiple and multidimensional transitions from trainee to trained doctor: a qualitative longitudinal study in the UK.

PubMed

Gordon, Lisi; Jindal-Snape, Divya; Morrison, Jill; Muldoon, Janine; Needham, Gillian; Siebert, Sabina; Rees, Charlotte

2017-12-01

To explore trainee doctors' experiences of the transition to trained doctor, we answer three questions: (1) What multiple and multidimensional transitions (MMTs) are experienced as participants move from trainee to trained doctor? (2) What facilitates and hinders doctors' successful transition experiences? (3) What is the impact of MMTs on trained doctors? A qualitative longitudinal study underpinned by MMT theory. Four training areas (health boards) in the UK. 20 doctors, 19 higher-stage trainees within 6 months of completing their postgraduate training and 1 staff grade, associate specialist or specialty doctor, were recruited to the 9-month longitudinal audio-diary (LAD) study. All completed an entrance interview, 18 completed LADs and 18 completed exit interviews. Data were analysed cross-sectionally and longitudinally using thematic Framework Analysis. Participants experienced a multiplicity of expected and unexpected, positive and negative work-related transitions (eg, new roles) and home-related transitions (eg, moving home) during their trainee-trained doctor transition. Factors facilitating or inhibiting successful transitions were identified at various levels: individual (eg, living arrangements), interpersonal (eg, presence of supportive relationships), systemic (eg, mentoring opportunities) and macro (eg, the curriculum provided by Medical Royal Colleges). Various impacts of transitions were also identified at each of these four levels: individual (eg, stress), interpersonal (eg, trainees' children spending more time in childcare), systemic (eg, spending less time with patients) and macro (eg, delayed start in trainees' new roles). Priority should be given to developing supportive relationships (both formal and informal) to help trainees transition into their trained doctor roles, as well as providing more opportunities for learning. Further longitudinal qualitative research is now needed with a longer study duration to explore transition journeys for several years into the trained doctor role. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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 1.366 (95% CI 1.337-1.395), respectively. Quantitatively, traditional Chinese medicine doctors (P<.001) and gynecology-obstetrics-pediatrics doctors (P<.001) received more reviews than the combined small specialty areas. But internal medicine doctors received fewer reviews than the combined small specialty areas (P<.001). Also, the majority of quantitative reviews were positive-about 88% were positive for the doctors' treatment effect measure and 91% were positive for the bedside manner measure. This was the case for the four major specialty areas, which had the most number of doctors—internal medicine, gynecology-obstetrics-pediatrics, surgery, and traditional Chinese medicine. Like consumers in the United States and Europe, Chinese consumers have started to use online doctor reviews. Similar to previous research on other countries' online doctor reviews, the online reviews in China covered almost every medical specialty, and most of the reviews were positive even though all of the reviewing procedures and the final available information were anonymous. The average number of reviews per rated doctor received in this dataset was 6, which was higher than that for doctors in the United States or Germany, probably because this dataset covered a longer time period than did the US or German dataset. But this number is still very small compared to any doctor's real patient population, and it cannot represent the reality of that population. Also, since all the data used for analysis were from one single website, the data might be biased and might not be a representative national sample of China.

[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.

Views of senior UK doctors about working in medicine: questionnaire survey.

PubMed

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

2014-11-01

We surveyed the UK medical qualifiers of 1993. We asked closed questions about their careers; and invited them to give us comments, if they wished, about any aspect of their work. Our aim in this paper is to report on the topics that this senior cohort of UK-trained doctors who work in UK medicine raised with us. Questionnaire survey. 3479 contactable UK-trained medical graduates of 1993. UK. Comments made by doctors about their work, and their views about medical careers and training in the UK. Postal and email questionnaires. Response rate was 72% (2507); 2252 were working in UK medicine, 816 (36%) of whom provided comments. Positive comments outweighed negative in the areas of their own job satisfaction and satisfaction with their training. However, 23% of doctors who commented expressed dissatisfaction with aspects of junior doctors' training, the impact of working time regulations, and with the requirement for doctors to make earlier career decisions than in the past about their choice of specialty. Some doctors were concerned about government health service policy; others were dissatisfied with the availability of family-friendly/part-time work, and we are concerned about attitudes to gender and work-life balance. Though satisfied with their own training and their current position, many senior doctors felt that changes to working hours and postgraduate training had reduced the level of experience gained by newer graduates. They were also concerned about government policy interventions.

[Effective communication with talkative patients: 10 tips].

PubMed

Giroldi, Esther; Veldhuijzen, Wemke; Bareman, Frits; Bueving, Herman; van der Weijden, Trudy; van der Vleuten, Cees; Muris, Jean

2016-01-01

Consultations with talkative patients present a challenge to doctors. It is difficult to gather all the necessary information within the available time, without damaging the doctor-patient relationship. Based on the listed existing literature and doctors' experiences, we present ten tips for gathering information from talkative patients in an effective manner whilst maintaining a good therapeutic alliance. In consultations with talkative patients, it is important to explore the cause of patients' talkativeness and to adapt one's communication approach accordingly.- Familiar communication strategies such as 'summarizing' can still be applied. When taking this route, a more directive communication approach--e.g. by means of a 'closed-ended summary'--can prevent the patient interrupting the doctor or departing from his subject. There are strategies aimed at avoiding a damaging effect to the doctor-patient relationship when applying this approach: don't be overly directive, make the patient co-responsible for efficient time management in the consultation, and make use of empathic interrupting and humour.

Perceived future career prospects in general practice: quantitative results from questionnaire surveys of UK doctors

PubMed Central

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

2016-01-01

Background There are more studies of current job satisfaction among GPs than of their views about their future career prospects, although both are relevant to commitment to careers in general practice. Aim To report on the views of GPs compared with clinicians in other specialties about their future career prospects. Design and setting Questionnaire surveys were sent to UK medical doctors who graduated in selected years between 1974 and 2008. Method Questionnaires were sent to the doctors at different times after graduation, ranging from 3 to 24 years. Results Based on the latest survey of each graduation year of the 20 940 responders, 66.2% of GPs and 74.2% of hospital doctors were positive about their prospects and 9.7% and 8.3%, respectively, were negative. However, with increasing time since graduation and increasing levels of seniority, GPs became less positive about their prospects; by contrast, over time, surgeons became more positive. Three to 5 years after graduation, 86.3% of those training in general practice were positive about their prospects compared with 52.9% of surgical trainees: in surveys conducted 12–24 years after graduation, 60.2% of GPs and 76.6% of surgeons were positive about their prospects. Conclusion GPs held broadly positive views of their career prospects, as did other doctors. However, there was an increase in negativity with increasing time since graduation that was not seen in hospital doctors. Research into the causes of this negativity and policy measures to ameliorate it would contribute to the continued commitment of GPs and may help to reduce attrition. PMID:27578813

Greek physicians' and dentists' compliance with the British society for antimicrobial chemotherapy (BSAC) guidelines for preventing bacterial endocarditis.

PubMed

Panos, G; Giamarellou, H; Papazachos, G; Birbilis, T; Toutouzas, P

1996-08-01

Two thousand questionnaires inquiring about applied prophylaxis for bacterial endocarditis were sent to practicing doctors in Greece. Two hundred and ninety-nine questionnaires were completed and returned (15% response rate) and were subsequently divided into two groups: Group A (163) consisting of responses from dentists, chest physicians and ear, nose and throat (ENT) specialists and group B (136) including responses from gastroenterologists, gynecologists, urologists and radiologists. The percentage of correct answers given in response by clinicians in Groups A and B to the main questions and in accordance with the 1992 guidelines of the British Society for Antimicrobial Chemotherapy (BSAC) were respectively: (a) 53% vs 35% asked patients their previous history pertaining to valve disease, rheumatic fever or prosthetic valve surgery; (b) 55% vs 33% administered prophylaxis to patients with relevant history prior to medical procedures; (c) 67% vs 0% of prescribing doctors administered the appropriate antibacterials; (d) 33% vs 31% initiated prophylaxis in proper timing prior to medical procedure; (e) 14% vs 13% administered antibiotics in correct time/route/duration of infusion where applicable, prior to medical procedure; (f) 7% of group A doctors administering recommended antibiotics, implemented prophylaxis with correct time/route/dosage while, although none of group B doctors administered recommended antibiotics, 7% implemented prophylaxis with correct time/route recommendations; (g) an overall 2% of doctors from both groups met the BSAC recommendations. In conclusion, it is imperative that the appropriate training of doctors in all subspecialties regarding prophylaxis of bacterial endocarditis and according to current recommendations be carried out.

Index to Army Times 1988

DTIC Science & Technology

1992-08-01

LAW AND LEGISLATION Army family gets $1.56 million for medical mishap. Army Times; Dec. 26, 1988; 49(20): p. 11. House passes military malpractice suit...Times; May 16, 1938; 48(40): p. 24. 79 MALPRACTICE Com4puter databank will raise aler’ on doctors with malpractice woes. Army Times; Oct. 24, 1988; 49...Special pay for doctors . Army Times; Dec. 26, 1988; 49(20): p. 20. PHYSICIANS--SUPPLY AND DEMANO Women-oriented specialties fail to make medical

Training doctors to manage patients with multimorbidity: a systematic review.

PubMed

Lewis, Cliona; Wallace, Emma; Kyne, Lorraine; Cullen, Walter; Smith, Susan M

2016-01-01

Patients with multimorbidity (two or more chronic conditions) are now the norm in clinical practice, and place an increasing burden on the healthcare system. Management of these patients is challenging, and requires doctors who are skilled in the complexity of multiple chronic diseases. To perform a systematic review of the literature to ascertain whether there are education and training formats which have been used to train postgraduate medical doctors in the management of patients with multimorbidity in primary and/or secondary care, and which have been shown to improve knowledge, skills, attitudes, and/or patient outcomes. Overall, 75,110 citations were screened, of which 65 full-text articles were then independently assessed for eligibility by two reviewers, and two studies met the inclusion criteria for the review. The two included studies implemented and evaluated multimorbidity workshops, and highlight the need for further research addressing the learning needs of doctors tasked with managing patients with multimorbidity in their daily practice. While much has been published about the challenges presented to medical staff by patients with multimorbidity, published research regarding education of doctors to manage these problems is lacking. Further research is required to determine whether there is a need for, or benefit from, specific training for doctors to manage patients with multimorbidity. PROSPERO registration number: CRD42013004010.

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 1.483 (95% CI 1.442-1.525) and an OR of 1.366 (95% CI 1.337-1.395), respectively. Quantitatively, traditional Chinese medicine doctors (P<.001) and gynecology-obstetrics-pediatrics doctors (P<.001) received more reviews than the combined small specialty areas. But internal medicine doctors received fewer reviews than the combined small specialty areas (P<.001). Also, the majority of quantitative reviews were positive—about 88% were positive for the doctors' treatment effect measure and 91% were positive for the bedside manner measure. This was the case for the four major specialty areas, which had the most number of doctors—internal medicine, gynecology-obstetrics-pediatrics, surgery, and traditional Chinese medicine. Conclusions Like consumers in the United States and Europe, Chinese consumers have started to use online doctor reviews. Similar to previous research on other countries’ online doctor reviews, the online reviews in China covered almost every medical specialty, and most of the reviews were positive even though all of the reviewing procedures and the final available information were anonymous. The average number of reviews per rated doctor received in this dataset was 6, which was higher than that for doctors in the United States or Germany, probably because this dataset covered a longer time period than did the US or German dataset. But this number is still very small compared to any doctor’s real patient population, and it cannot represent the reality of that population. Also, since all the data used for analysis were from one single website, the data might be biased and might not be a representative national sample of China. PMID:26032933

"I Don't Even Have Time to Be Their Friend!" Ethical Dilemmas in Ph.D. Supervision in the Hard Sciences

ERIC Educational Resources Information Center

Löfström, Erika; Pyhältö, Kirsi

2015-01-01

This study focused on exploring students' and supervisors' perceptions of ethical problems in doctoral supervision in the natural sciences. Fifteen supervisors and doctoral students in one research community in the natural sciences were interviewed about their practices and experiences in the doctoral process and supervision. We explored to what…

[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.

[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 PhD degree, especially, was the significant mark for clearly displaying the abilities and outcomes of the doctors. Lastly, the research career, education experience, clinical training and such that the Korean doctors of the period had built up were weak at the time, however, they were important sources for the future medical science development. Indeed, after Liberation, the rapid settlement and growth of Korea's medical science field were largely beholden to thus. Therefore, the growth of the Koreans as doctors did not cease in colonial Korea, but instead continued onto the history of future generations. In spite of the fact that the Korean doctors's growth and activities were greatly limited under the forceful policy of colonial domination of the era, the efforts the Korean doctors had put were not in vain. Likewise, if we do not fix our attention at the dominating policy and system, but rather put together the actors' correspondence and struggles of the period, then the Korean doctors will be a part of the living history. Hereby, the clue to the paradox between the suppression of medical science in colonial Korea and its leap after Liberation can be untied.

Science and Engineering Doctorate Production among Minorities with Non-Traditional Backgrounds.

ERIC Educational Resources Information Center

Brazziel, William F.; Brazziel, Marian E.

This study examined the extent to which minority individuals with baccalaureate origins as non-traditional students (baccalaureates completed at age 25 or over) completed doctoral degrees in science and engineering. It compared the efficacy of their degree completion, i.e., elapsed time and registered time to degree, with that of counterparts with…

Measuring up: musings of a family doctor on the employee time clock.

PubMed

Kannai, Ruth

2013-01-01

Recently, at the health maintenance organization (HMO) where I work, they introduced an employee time clock. As in many other workplaces, doctors across the country are now obligated to punch the clock at the beginning and end of their workday. This is the final act in an ongoing attempt to enhance management of doctors' schedules: limit nonurgent appointments to 10 minutes, define planned or urgent home visits, and control a physician's time, as well as managerial and clinical decisions. In this story I describe a day in the life of a family doctor, a salaried employee at a large HMO where there is now a time clock. I provide details on how the introduction of the clock influences small everyday clinical decisions that potentially affect the quality and depth of treatment while sharing the internal dialogue that accompanies me as I reaffirm my professional integrity again and again with each hastened visit. I also bring the internal dialogue of 2 of my patients, to illustrate the emotional world on the other side of these 10-minute interventions.

A comparison of Dutch family doctors' and patients' perspectives on nutrition communication.

PubMed

van Dillen, S M E; Hiddink, G J

2008-12-01

In recent years, we have investigated both patients' and family doctors' communicative characteristics towards nutrition communication in general practice with several qualitative and quantitative studies. A sound comparison of the survey results between both conversation partners has not been made before. The aim of the present study was to put together data obtained by earlier studies for the first time in order to make comparisons of patients' and family doctors' communicative characteristics regarding nutrition communication. In The Netherlands, 603 patients completed a face-to-face interview-assisted questionnaire (65% response rate) and 267 family doctors completed a questionnaire (45% response rate). When comparing communicative characteristics, patients stronger believed that nutrition was an influence on health than family doctors. They also attributed a greater role to personal hygiene, stress and heredity, while family doctors were more convinced of the role of alcohol use and smoking on health. Patients more often rated their own nutrition knowledge as good than family doctors. In contrast, family doctors showed higher interest in nutrition and nutrition information than patients. As a result, a collinear model for family doctors and nutrition communication towards patients was provided. Significant differences between patients and family doctors were found for several communicative characteristics towards nutrition communication. It is important that family doctors become convinced that patients perceive them as a reliable and expert source of nutrition information. It is recommended that family doctors raise nutrition awareness among patients. Finally, we advise family doctors to pay attention to nutrition communication styles.

Facilitating Secure Sharing of Personal Health Data in the Cloud.

PubMed

Thilakanathan, Danan; Calvo, Rafael A; Chen, Shiping; Nepal, Surya; Glozier, Nick

2016-05-27

Internet-based applications are providing new ways of promoting health and reducing the cost of care. Although data can be kept encrypted in servers, the user does not have the ability to decide whom the data are shared with. Technically this is linked to the problem of who owns the data encryption keys required to decrypt the data. Currently, cloud service providers, rather than users, have full rights to the key. In practical terms this makes the users lose full control over their data. Trust and uptake of these applications can be increased by allowing patients to feel in control of their data, generally stored in cloud-based services. This paper addresses this security challenge by providing the user a way of controlling encryption keys independently of the cloud service provider. We provide a secure and usable system that enables a patient to share health information with doctors and specialists. We contribute a secure protocol for patients to share their data with doctors and others on the cloud while keeping complete ownership. We developed a simple, stereotypical health application and carried out security tests, performance tests, and usability tests with both students and doctors (N=15). We developed the health application as an app for Android mobile phones. We carried out the usability tests on potential participants and medical professionals. Of 20 participants, 14 (70%) either agreed or strongly agreed that they felt safer using our system. Using mixed methods, we show that participants agreed that privacy and security of health data are important and that our system addresses these issues. We presented a security protocol that enables patients to securely share their eHealth data with doctors and nurses and developed a secure and usable system that enables patients to share mental health information with doctors.

Improving Emergency Department Door to Doctor Time and Process Reliability

PubMed Central

El Sayed, Mazen J.; El-Eid, Ghada R.; Saliba, Miriam; Jabbour, Rima; Hitti, Eveline A.

2015-01-01

Abstract The aim of this study is to determine the effectiveness of using lean management methods on improving emergency department door to doctor times at a tertiary care hospital. We performed a before and after study at an academic urban emergency department with 49,000 annual visits after implementing a series of lean driven interventions over a 20 month period. The primary outcome was mean door to doctor time and the secondary outcome was length of stay of both admitted and discharged patients. A convenience sample from the preintervention phase (February 2012) was compared to another from the postintervention phase (mid-October to mid-November 2013). Individual control charts were used to assess process stability. Postintervention there was a statistically significant decrease in the mean door to doctor time measure (40.0 minutes ± 53.44 vs 25.3 minutes ± 15.93 P < 0.001). The postintervention process was more statistically in control with a drop in the upper control limits from 148.8 to 72.9 minutes. Length of stay of both admitted and discharged patients dropped from 2.6 to 2.0 hours and 9.0 to 5.5 hours, respectively. All other variables including emergency department visit daily volumes, hospital occupancy, and left without being seen rates were comparable. Using lean change management techniques can be effective in reducing door to doctor time in the Emergency Department and improving process reliability. PMID:26496278

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.

Factors influencing junior doctors' choices of future specialty: trends over time and demographics based on results from UK national surveys.

PubMed

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

2015-10-01

To study trends in factors influencing junior doctors' choice of future specialty. Respondents were asked whether each of 15 factors had a great deal of influence on their career choice, a little influence or no influence on it. Percentages are reported of those who specified that a factor had a great deal of influence on their career choice. UK. A total of 15,765 UK-trained doctors who graduated between 1999 and 2012. Questions about career choices and factors which may have influenced those choices, in particular comparing doctors who qualified in 2008-2012 with those who qualified in 1999-2002. Enthusiasm for and commitment to the specialty was a greater influence on career choice in the 2008-2012 qualifiers (81%) than those of 1999-2002 (64%), as was consideration of their domestic circumstances (43% compared with 20%). Prospects for promotion were less important to recent cohorts (16%) than older cohorts (21%), as were financial prospects (respectively, 10% and 14%). Domestic circumstances and working hours were considered more important, and financial prospects less important, by women than men. Inclination before medical school was rated as important by 41% of doctors who were over 30 years old, compared with 13% of doctors who were under 21, at the time of starting medical school. The increasing importance of both domestic circumstances and enthusiasm for their specialty choice in recent cohorts suggest that today's young doctors prize both work-life balance and personal fulfilment at work more highly than did their predecessors. The differences in motivations of older and younger generations of doctors, men and women, and doctors who start medical school relatively late are worthy of note. © The Royal Society of Medicine.

[Higher salary as an incentive for scientific activity?].

PubMed

Gulsvik, Amund; Aasland, Olaf Gjerløw

2007-08-23

Few publications are available on how salaries are established for physicians with science as their main occupation. The results of a questionnaire survey to medical doctors are reported. A questionnaire was sent to members of The Norwegian Medical Association's branch for doctors in academic medicine in spring 2005. Questions concerned how they thought scientific qualifications and production affected their present salary and what they considered to be a reasonable salary for a researcher with their qualifications and production. 304 of 487 (62%) doctors answered. The study included 128 full-time professors, 101 associate professors or post-doctoral scientists with a PhD, 44 scientists without a PhD and 31 PhD-students. The average age was 52 years, and 28% were women. 71% had a university as their main employer. The median number of peer-reviewed scientific publications was 19 per physician-scientist for the last 5 years. The average annual salary was 498,000 NOK, and the average increase in salary considered to be reasonable was 279,000 NOK. A reasonable salary for evaluating a PhD-thesis was considered to be 18,700 NOK and that for giving a 45-minute lecture was 3,200 NOK. In a multiple linear regression analysis on actual salary, the significant predictors were employer, scientific qualifications, age, and sex. Predictors for the difference between reasonable and actual salary was scientific production and employer. Age, employer or scientific qualifications could not predict who considered a doubling of the present salary (for a 45-minute lecture and evaluating a PhD) to be appropriate. Universities should be aware of the large gap between salaries to physician-scientists employed by universities and to those employed by other institutions. Scientific production should be more emphasized in future negotiations on salaries.

[Murderers in white coats--the physicians' plot against Stalin].

PubMed

Olsen, B

1997-12-10

During the Moscow trials in 1936-38 several doctors were sentenced for participating in the murders of party leaders. As others who were accused, the doctors willingly confessed to crimes they could not possibly have committed. A second doctors' plot took place in the autumn of 1952. This time nine doctors, six of them Jews, were arrested for the attempted murder of political leaders. Only the unexpected death of Josef Stalin prevented a new wave of terror. With the single exception of Genrikh Grigorjevitsj Jagoda (1891-1938), head of the NKVD (KGB's predecessor), all those sentenced under the Moscow process are now rehabilitated. The participants of the second doctors' plot were rehabilitated immediately after Stalin's death.

GPs’ use of defibrillators and the national radio network in emergency primary healthcare in Norway

PubMed Central

Zakariassen, Erik; Hunskaar, Steinar

2008-01-01

Objective To study the geographic size of out-of-hours districts, the availability of defibrillators and use of the national radio network in Norway. Design Survey. Setting The emergency primary healthcare system in Norway. Subjects A total of 282 host municipalities responsible for 260 out-of-hours districts. Main outcome measures Size of out-of-hours districts, use of national radio network and access to a defibrillator in emergency situations. Results The out-of-hours districts have a wide range of areas, which gives a large variation in driving time for doctors on call. The median longest transport time for doctors in Norway is 45 minutes. In 46% of out-of-hours districts doctors bring their own defibrillator on emergency callouts. Doctors always use the national radio network in 52% of out-of-hours districts. Use of the radio network and access to a defibrillator are significantly greater in out-of-hours districts with a host municipality of fewer then 5000 inhabitants compared with host municipalities of more than 20 000 inhabitants. Conclusion In half of out-of-hours districts doctors on call always use the national radio network. Doctors in out-of-hours districts with a host municipality of fewer than 5000 inhabitants are in a better state of readiness to attend an emergency, compared with doctors working in larger host municipalities. PMID:18570012

Racial/Ethnic disparities in patient experience with communication in hospitals: real differences or measurement errors?

PubMed

Zhu, Junya; Weingart, Saul N; Ritter, Grant A; Tompkins, Christopher P; Garnick, Deborah W

2015-05-01

An important aspect of medical care is clear and effective communication, which can be particularly challenging for individuals based on race/ethnicity. Quality of communication is measured systematically in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, and analyzed frequently such as in the National Healthcare Disparities Report. Caution is needed to discern differences in communication quality from racial/ethnic differences in perceptions about concepts or expectations about their fulfillment. To examine assumptions about the degree of commonality across racial/ethnic groups in their perceptions and expectations, and to investigate the validity of conclusions regarding racial/ethnic differences in communication quality. We used 2007 HCAHPS data from the National CAHPS Benchmarking Database to construct racial/ethnic samples that controlled for other patient characteristics (828 per group). Using multiple-groups confirmatory factor analyses, we tested whether the factor structure and model parameters (ie, factor loadings, intercepts) differed across groups. We identified support for basic tests of equivalence across 7 racial/ethnic groups in terms of equivalent factor structure and loadings. Even stronger support was found for Communication with Doctors and Nurses. However, potentially important nonequivalence was found for Communication about Medicines, including instances of statistically significant differences between non-Hispanic whites and non-Hispanic blacks, Asians, and Native Hawaiian/other Pacific Islanders. Our results provide strongest support for racial/ethnic comparisons on Communication with Nurses and Doctors, and reason to caution against comparisons on Communication about Medicines due to significant differences in model parameters across groups; that is, a lack of invariance in the intercept.

Trends in Student Aid, 2014. Trends in Higher Education Series

ERIC Educational Resources Information Center

Baum, Sandy; Elliott, Diane Cardenas; Ma, Jennifer; Bell, D'Wayne

2014-01-01

After increasing by 18% (in inflation-adjusted dollars) between 2007-08 and 2010-11, the total amount students borrowed in federal and non-federal education loans declined by 13% between 2010-11 and 2013-14. Growth in full-time equivalent (FTE) postsecondary enrollment of 16% over the first three years, followed by a decline of 4% over the next…

Financial Report of the County Colleges of the State of New Jersey for the Fiscal Year Ended June 30, 1978.

ERIC Educational Resources Information Center

New Jersey State Dept. of Higher Education, Trenton.

Financial information and an analytic narrative concerning the New Jersey community college system are presented for the following major areas: (1) enrollments and educational cost per full-time equivalent student; (2) sources of current revenue; (3) educational and general expenditures; and (4) fixed assets and capital data. The New Jersey county…

State Higher Education Finance in Ohio and the United States, FY 1995 to FY 2009: Results from 2009 SHEEO Finance Survey

ERIC Educational Resources Information Center

Ohio Board of Regents, 2010

2010-01-01

This report summarizes full-time equivalent enrollment, state and local higher education appropriations, and tuition revenue data collected through the State Higher Education Executive Officers (SHEEO) finance survey. The intent is to examine trends in higher education revenues per FTE and compare Ohio and U.S. outcomes. All dollar figures…

State government regulation of forestry practices applied to nonfederal forests: extent and intensity of agency involvement

Treesearch

Paul V. Ellefson; Michael A. Kilgore; James E. Granskog

2006-01-01

In 2003, 276 state governmental agencies regulated forestry practices applied to nonfederal forests. Fifty-four percent of these agencies were moderately to extensively involved in such regulation, and 68% engaged in moderate to extensive regulatory coordination with a state's lead forestry agency. The agencies employed an estimates 1,047 full-time equivalents (...

Characteristics of Career and Technical Education Faculty across Institutions of Higher Education in the United States

ERIC Educational Resources Information Center

Fletcher, Edward C., Jr.

2018-01-01

The purpose of this article was to examine faculty characteristics of CTE programs across the nation as well as identify the challenges and successes of implementing programs. Findings pointed to the overall decline of CTE full-time-equivalent faculty and the increase of adjunct faculty. In addition, findings demonstrated a lack of ethnic and…

Student Enrollment, Full-time Equivalent (FTE), Staff/Faculty Information, Annual Statistical Report. 1995-96. Volume 31.

ERIC Educational Resources Information Center

Ijames, Steve; Byers, Carl

This document contains statistical information about the North Carolina Community College System for the academic year 1995-1996. It presents a summary of the 1995-1996 information collected from each of the 58 community colleges in North Carolina, as well as historical information for an 11-year period. This report is organized in sections that…

Can academic radiology departments become more efficient and cost less?

PubMed

Seltzer, S E; Saini, S; Bramson, R T; Kelly, P; Levine, L; Chiango, B F; Jordan, P; Seth, A; Elton, J; Elrick, J; Rosenthal, D; Holman, B L; Thrall, J H

1998-11-01

To determine how successful two large academic radiology departments have been in responding to market-driven pressures to reduce costs and improve productivity by downsizing their technical and support staffs while maintaining or increasing volume. A longitudinal study was performed in which benchmarking techniques were used to assess the changes in cost and productivity of the two departments for 5 years (fiscal years 1992-1996). Cost per relative value unit and relative value units per full-time equivalent employee were tracked. Substantial cost reduction and productivity enhancement were realized as linear improvements in two key metrics, namely, cost per relative value unit (decline of 19.0% [decline of $7.60 on a base year cost of $40.00] to 28.8% [$12.18 of $42.21]; P < or = .001) and relative value unit per full-time equivalent employee (increase of 46.0% [increase of 759.55 units over a base year productivity of 1,651.45 units] to 55.8% [968.28 of 1,733.97 units]; P < .001), during the 5 years of study. Academic radiology departments have proved that they can "do more with less" over a sustained period.

Role of the family doctor in the management of adults with obesity: a scoping review

PubMed Central

Elmitt, Nicholas; Haelser, Emily; Douglas, Kirsty A

2018-01-01

Objectives Obesity management is an important issue for the international primary care community. This scoping review examines the literature describing the role of the family doctor in managing adults with obesity. The methods were prospectively published and followed Joanna Briggs Institute methodology. Setting Primary care. Adult patients. Included papers Peer-reviewed and grey literature with the keywords obesity, primary care and family doctors. All literature published up to September 2015. 3294 non-duplicate papers were identified and 225 articles included after full-text review. Primary and secondary outcome measures Data were extracted on the family doctors’ involvement in different aspects of management, and whether whole person and person-centred care were explicitly mentioned. Results 110 papers described interventions in primary care and family doctors were always involved in diagnosing obesity and often in recruitment of participants. A clear description of the provider involved in an intervention was often lacking. It was difficult to determine if interventions took account of whole person and person-centredness. Most opinion papers and clinical overviews described an extensive role for the family doctor in management; in contrast, research on current practices depicted obesity as undermanaged by family doctors. International guidelines varied in their description of the role of the family doctor with a more extensive role suggested by guidelines from family medicine organisations. Conclusions There is a disconnect between how family doctors are involved in primary care interventions, the message in clinical overviews and opinion papers, and observed current practice of family doctors. The role of family doctors in international guidelines for obesity may reflect the strength of primary care in the originating health system. Reporting of primary care interventions could be improved by enhanced descriptions of the providers involved and explanation of how the pillars of primary care are used in intervention development. PMID:29453301

Doctors' enjoyment of their work and satisfaction with time available for leisure: UK time trend questionnaire-based study.

PubMed

Surman, Geraldine; Lambert, Trevor W; Goldacre, Michael

2016-04-01

Doctors' job satisfaction is important to the health service to ensure commitment, effective training, service provision and retention. Job satisfaction matters to doctors for their personal happiness, fulfilment, service to patients and duty to employers. Monitoring job satisfaction trends informs workforce planning. We surveyed UK-trained doctors up to 5 years after graduation for six graduation year cohorts: 1996, 1999, 2002, 2005, 2008, 2012. Doctors scored their job enjoyment (Enjoyment) and satisfaction with time outside work (Leisure) on a scale from 1 (lowest enjoyment/satisfaction) to 10 (highest). Overall, 47% had a high level of Enjoyment (scores 8-10) 1 year after graduation and 56% after 5 years. For Leisure, the corresponding figures were 19% and 37% at 1 and 5 years, respectively. For Leisure at 1 year, high scores were given by about 10% in the 1990s, rising to about 25% in the mid-2000s. Low scores (1-3) for Enjoyment were given by 15% of qualifiers of 1996, falling to 5% by 2008; corresponding figures for Leisure were 42% and 19%. At 5 years, the corresponding figures were 6% and 4%, and 23% and 17%. Enjoyment and Leisure were scored higher by general practitioners than doctors in other specialties. Both measures varied little by sex, ethnicity or medical school attended. Scores for Enjoyment were generally high; those for Leisure were lower. Policy initiatives should address why this aspect of satisfaction is low, particularly in the first year after graduation but also among hospital doctors 5 years after graduation. 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/

What drives the 'August effect'? A observational study of the effect of junior doctor changeover on out of hours work.

PubMed

Blakey, John D; Fearn, Andrew; Shaw, Dominick E

2013-01-01

To investigate whether measurements of junior doctor on-call workload and performance can clarify the mechanisms underlying the increase in morbidity and mortality seen after junior doctor changeover: the 'August effect'. Quantitative retrospective observational study of routinely collected data on junior doctor workload. Two large teaching hospitals in England. Task level data from a wireless out of hours system (n = 29,885 requests) used by medical staff, nurses, and allied health professionals. Number and type of tasks requested by nurses, time to completion of tasks by junior doctors. There was no overall change in the number of tasks requested by nurses out of hours around the August changeover (median requests per hour 15 before and 14 after, p = 0.46). However, the number of tasks classified as urgent was greater (p = 0.016) equating to five more urgent tasks per day. After changeover, doctors took less time to complete tasks overall due to a reduction in time taken for routine tasks (median 74 vs. 66 min; p = 3.9 × 10(-9)). This study suggests that the 'August effect' is not due to new junior doctors completing tasks more slowly or having a greater workload. Further studies are required to investigate the causes of the increased number of urgent tasks seen, but likely factors are errors, omissions, and poor prioritization. Thus, improved training and quality control has the potential to address this increased duration of unresolved patient risk. The study also highlights the potential of newer technologies to facilitate quantitative study of clinical activity.

Evaluation of the efficacy of six supraglottic devices for airway management in dark conditions: a crossover randomized simulation trial.

PubMed

Ohchi, Fumihiro; Komasawa, Nobuyasu; Imagawa, Kentaro; Okamoto, Kaori; Minami, Toshiaki

2015-12-01

During out-of-hospital cardiopulmonary resuscitation, several factors can render tracheal intubation more difficult, such as when rescuers must secure the airway in complete darkness or with limited illumination. The purpose of this study was to evaluate the efficacy of six supraglottic devices (SGDs), ProSeal(®) (ProSeal), Classic(®) (Classic), Supreme(®) (Supreme), Laryngeal Tube(®) (LT), air-Q(®) (air-Q), and i-gel(®) (i-gel), for airway management under light and dark conditions using a manikin. Seventeen novice doctors and 15 experienced doctors performed insertion of six SGDs under light and dark conditions using an adult manikin. Insertion time, successful ventilation rate, and subjective insertion difficulty on a visual analogue scale (VAS) were measured. Both novice and experienced doctors had a significantly lower ventilation success rate in the dark than in the light when ProSeal and Classic were used, but not with the other four SGDs. Novice doctors required a significantly longer insertion time in the dark than in the light with all SGDs. Experienced doctors required a significantly longer insertion time in the dark than in the light with ProSeal or Classic, but not with the other four SGDs. VAS was significantly higher for both novice and experienced doctors when ProSeal and Classic were used, as compared with the other four SGDs in the dark. Compared to ProSeal and Classic, Supreme, i-gel, LT, and air-Q are more effective for airway management in the dark. Our findings suggest that anatomically shaped SGDs may help novice doctors secure the airway under dark conditions.

AMO Teledioptric System for age-related macular degeneration

NASA Astrophysics Data System (ADS)

Chou, Jim-Son; Ting, Albert C.

1994-05-01

A 2.5 X magnification system consisting of a two-zone intraocular implant and a spectacle was developed, tested, and clinically tried by fifty patients with cataract ad age-related macular degeneration. Optical bench testing results and clinical data confirmed that the field of view of the system was 2.6 times wider than an equivalent external telescope. The study also demonstrated that the implant itself was clinically equivalent to a standard monofocal intraocular lens for cataract. The clinical study indicated that higher magnification without compromising the compactness and optical quality was needed as the disease progressed. Also, a sound vision rehabilitation process is important to provide patients the full benefits of the system.

Credential Inflation and The Professional Doctorate in California Higher Education. Research & Occasional Paper Series: CSHE.1.04

ERIC Educational Resources Information Center

La Belle, Thomas J.

2004-01-01

The article argues that the time has come to change California's 1960 Master Plan for higher education by permitting the California State University (CSU) to award the doctorate in selected professional programs. The article also addresses the inadequacies of the joint doctorate as the means to remedy degree or credential creep; the CSU's focus on…

Doctors, Lawyers and Advance Care Planning: Time for Innovation to Work Together to Meet Client Needs

PubMed Central

Douglas, Maureen; Simon, Jessica; Fassbender, Konrad

2016-01-01

Health organizations in Canada have invested considerable resources in strategies to improve knowledge and uptake of advance care planning (ACP). Yet barriers persist and many Canadians do not engage in the full range of ACP behaviours, including writing an advance directive and appointing a legally authorized decision-maker. Not engaging effectively in ACP disadvantages patients, their loved ones and their healthcare providers. This article advocates for greater collaboration between health and legal professionals to better support clients in ACP and presents a framework for action to build connections between these typically siloed professions. PMID:28032821

Working hours of obstetrics and gynaecology trainees in Australia and New Zealand.

PubMed

Acton, Jade; Tucker, Paige E; Bulsara, Max K; Cohen, Paul A

2017-10-01

The importance of doctors' working hours has gained significant attention with evidence suggesting long hours and fatigue may compromise the safety and wellbeing of both patients and doctors. This study aims to quantify the working hours of The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) specialist trainees in order to better inform discussions of working hours and safety within our region. An anonymous, online survey of RANZCOG trainees was conducted. Demographic data were collected. The primary outcomes were: hours per week at work and hours per week on-call. Secondary outcomes included the frequency of long days (>12 h) and 24-h shifts, time spent studying, staff shortages and opinions regarding current rostering. Response rate was 49.5% (n = 259). Full-time trainees worked an average of 53.1 ± 10.0 h/week, with 11.6% working on-call. Long-day shifts were reported by 85.8% of respondents, with an average length of 14.2 h. Fifteen percent reported working 24-h shifts, with a median duration of uninterrupted sleep during this shift being 1-2 h. Trainees in New Zealand worked 7.0 h/week more than Australian trainees (P ≤0.001), but reported less on-call (P = 0.021). Trainees in Western Australia were more likely to work on-call (P ≤0.001) and 24-h shifts (P ≤0.001). While 53.1 h/week at work is similar to the average Australian hospital doctor, high rates of long days and 24-h shifts with minimal sleep were reported by RANZCOG trainees in this survey. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Exploring the Pursuit of Doctoral Education by Nurses Seeking or Intending to Stay in Faculty Roles.

PubMed

Dreifuerst, Kristina Thomas; McNelis, Angela M; Weaver, Michael T; Broome, Marion E; Draucker, Claire Burke; Fedko, Andrea S

2016-01-01

The purpose of this study was to describe the factors influencing the pursuit and completion of doctoral education by nurses intending to seek or retain faculty roles. Traditionally, doctoral education evolved to focus on the preparation of nurses to conduct scientific research, primarily through the doctor of philosophy programs. Most recently, the doctor of nursing practice degree emerged and was designed for advanced practice nurses to be clinical leaders who translate research into practice and policy. Nurses who pursue doctoral education in order to assume or maintain faculty roles must choose between these degrees if they desire a doctorate within the discipline; however, factors influencing their decisions and the intended outcomes of their choice are not clear. During this study, 548 nurses (current students or recent graduates of doctoral programs) completed a comprehensive survey to generate critical evidence about the factors influencing the choices made. Principal findings are related to the issues of time, money, and program selection. These findings can be used to develop strategies to increase enrollment and, therefore, the number of doctorally prepared faculty who are specifically prepared to excel as nursing faculty. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

Method of Analysis of the Topic of Doctoral Thesis in the Field of Castings Production. Case Study on the Situation in Romania

NASA Astrophysics Data System (ADS)

Soporan, V. F.; Samoilă, V.; Lehene, T. R.; Pădureţu, S.; Crişan, M. D.; Vescan, M. M.

2018-06-01

The paper presents a method of analysis of doctoral theses in castings production, elaborated in Romania, the analysis period ranging from 1918 to 2016. The procedure, based on the evolution of the analyzed problem, consists of the following steps: establishment of a coding system for the domains and subdomains established in the thematic characterization of doctoral theses; the establishment of the doctoral organizing institutions, the doctoral specialties, the doctoral supervisors and the time frame for the analysis; selecting the doctoral thesis that will be included in the analysis; establishing the key words for characterization of doctoral theses, based on their title; the assignment of theses to the domains and subdomains according to the meaning of the keywords, to the existing groups of the coding system; statistical processing of results and determination of shares for each domain and subdomain; conclusions on the results obtained and their interpretation in the context of economic and social developments. The proposed method being considered as general, the case study is carried out at the level of the specific field of castings production, the territory of the analysis refers to the institutions organizing doctoral studies.

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

PubMed Central

Smith, Fay; Goldacre, Michael J

2015-01-01

Objectives 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. Design Questionnaires about career intentions, destinations and views sent in 2011 to all medical graduates of 2008. Participants 3228 UK medical graduates. Main outcome measures Comments on work, education and training. Results 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. Conclusions 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. PMID:26664735

Instrumental and socioemotional communications in doctor-patient interactions in urban and rural clinics.

PubMed

Desjarlais-deKlerk, Kristen; Wallace, Jean E

2013-07-08

Location of practice, such as working in a rural or urban clinic, may influence how physicians communicate with their patients. This exploratory pilot study examines the communication styles used during doctor-patient interactions in urban and rural family practice settings in Western Canada. We analyzed observation and interview data from four physicians practicing in these different locations. Using a grounded theory approach, communications were categorized as either instrumental or socioemotional. Instrumental communication refers to "cure-oriented interactions" and tends to be more task-oriented focusing on the patient's health concerns and reason for the appointment. In contrast, socioemotional communication refers to more "care-oriented interactions" that may make the patient feel comfortable, relieve patient anxiety and build a trusting relationship. The physicians in small, rural towns appear to know their patients and their families on a more personal level and outside of their office, and engage in more socioemotional communications compared to those practicing in suburban clinics in a large urban centre. Knowing patients outside the clinic seems to change the nature of the doctor-patient interaction, and, in turn, the doctor-patient relationship itself. Interactions between urban doctors and their patients had a mixture of instrumental and socioemotional communications, while interactions between rural doctors and their patients tended to be highly interpersonal, often involving considerable socioemotional communication and relationship-building. Despite the different ways that doctors and patients communicate with each other in the two settings, rural and urban doctors spend approximately the same amount of time with their patients. Thus, greater use of socioemotional communication by rural doctors, which may ease patient anxiety and increase patient trust, did not appear to add extra time to the patient visit. Research suggests that socioemotional communication may ultimately lead to better patient outcomes, which implies that health differences between rural and urban settings could be linked to differences in doctor-patient communication styles.