Associations between United States Medical Licensing Examination (USMLE) and Internal Medicine In-Training Examination (IM-ITE) scores.

PubMed

McDonald, Furman S; Zeger, Scott L; Kolars, Joseph C

2008-07-01

Little is known about the associations of previous standardized examination scores with scores on subsequent standardized examinations used to assess medical knowledge in internal medicine residencies. To examine associations of previous standardized test scores on subsequent standardized test scores. Retrospective cohort study. One hundred ninety-five internal medicine residents. Bivariate associations of United States Medical Licensing Examination (USMLE) Steps and Internal Medicine In-Training Examination (IM-ITE) scores were determined. Random effects analysis adjusting for repeated administrations of the IM-ITE and other variables known or hypothesized to affect IM-ITE score allowed for discrimination of associations of individual USMLE Step scores on IM-ITE scores. In bivariate associations, USMLE scores explained 17% to 27% of the variance in IME-ITE scores, and previous IM-ITE scores explained 66% of the variance in subsequent IM-ITE scores. Regression coefficients (95% CI) for adjusted associations of each USMLE Step with IM-ITE scores were USMLE-1 0.19 (0.12, 0.27), USMLE-2 0.23 (0.17, 0.30), and USMLE-3 0.19 (0.09, 0.29). No single USMLE Step is more strongly associated with IM-ITE scores than the others. Because previous IM-ITE scores are strongly associated with subsequent IM-ITE scores, appropriate modeling, such as random effects methods, should be used to account for previous IM-ITE administrations in studies for which IM-ITE score is an outcome.

Use of Curricular and Extracurricular Assessments to Predict Performance on the United States Medical Licensing Examination (USMLE) Step 1: A Multi-Year Study

ERIC Educational Resources Information Center

Gandy, Robyn A.; Herial, Nabeel A.; Khuder, Sadik A.; Metting, Patricia J.

2008-01-01

This paper studies student performance predictions based on the United States Medical Licensure Exam (USMLE) Step 1. Subjects were second-year medical students from academic years of 2002 through 2006 (n = 711). Three measures of basic science knowledge (two curricular and one extracurricular) were evaluated as predictors of USMLE Step 1 scores.…

Student Failures on First-Year Medical Basic Science Courses and the USMLE Step 1: A Retrospective Study over a 20-Year Period

ERIC Educational Resources Information Center

Burns, E. Robert; Garrett, Judy

2015-01-01

Correlates of achievement in the basic science years in medical school and on the Step 1 of the United States Medical Licensing Examination® (USMLE®), (Step 1) in relation to preadmission variables have been the subject of considerable study. Preadmissions variables such as the undergraduate grade point average (uGPA) and Medical College Admission…

Exploring the Relationships Between USMLE Performance and Disciplinary Action in Practice: A Validity Study of Score Inferences From a Licensure Examination.

PubMed

Cuddy, Monica M; Young, Aaron; Gelman, Andrew; Swanson, David B; Johnson, David A; Dillon, Gerard F; Clauser, Brian E

2017-12-01

Physicians must pass the United States Medical Licensing Examination (USMLE) to obtain an unrestricted license to practice allopathic medicine in the United States. Little is known, however, about how well USMLE performance relates to physician behavior in practice, particularly conduct inconsistent with safe, effective patient care. The authors examined the extent to which USMLE scores relate to the odds of receiving a disciplinary action from a U.S. state medical board. Controlling for multiple factors, the authors used non-nested multilevel logistic regression analyses to estimate the relationships between scores and receiving an action. The sample included 164,725 physicians who graduated from U.S. MD-granting medical schools between 1994 and 2006. Physicians had a mean Step 1 score of 214 (standard deviation [SD] = 21) and a mean Step 2 Clinical Knowledge (CK) score of 213 (SD = 23). Of the physicians, 2,205 (1.3%) received at least one action. Physicians with higher Step 2 CK scores had lower odds of receiving an action. A 1-SD increase in Step 2 CK scores corresponded to a decrease in the chance of disciplinary action by roughly 25% (odds ratio = 0.75; 95% CI = 0.70-0.80). After accounting for Step 2 CK scores, Step 1 scores were unrelated to the odds of receiving an action. USMLE Step 2 CK scores provide useful information about the odds a physician will receive an official sanction for problematic practice behavior. These results provide validity evidence supporting current interpretation and use of Step 2 CK scores.

Preparing to take the USMLE Step 1: a survey on medical students' self-reported study habits.

PubMed

Kumar, Andre D; Shah, Monisha K; Maley, Jason H; Evron, Joshua; Gyftopoulos, Alex; Miller, Chad

2015-05-01

The USA Medical Licensing Examination Step 1 is a computerised multiple-choice examination that tests the basic biomedical sciences. It is administered after the second year in a traditional four-year MD programme. Most Step 1 scores fall between 140 and 260, with a mean (SD) of 227 (22). Step 1 scores are an important selection criterion for residency choice. Little is known about which study habits are associated with a higher score. To identify which self-reported study habits correlate with a higher Step 1 score. A survey regarding Step 1 study habits was sent to third year medical students at Tulane University School of Medicine every year between 2009 and 2011. The survey was sent approximately 3 months after the examination. 256 out of 475 students (54%) responded. The mean (SD) Step 1 score was 229.5 (22.1). Students who estimated studying more than 8-11 h per day had higher scores (p<0.05), but there was no added benefit with additional study time. Those who reported studying <40 days achieved higher scores (p<0.05). Those who estimated completing >2000 practice questions also obtained higher scores (p<0.01). Students who reported studying in a group, spending the majority of study time on practice questions or taking >40 preparation days did not achieve higher scores. Certain self-reported study habits may correlate with a higher Step 1 score compared with others. Given the importance of achieving a high Step 1 score on residency choice, it is important to further identify which characteristics may lead to a higher score. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A National Cohort Study of U.S. Medical School Students Who Initially Failed Step 1 of the United States Medical Licensing Examination

PubMed Central

Andriole, Dorothy A.; Jeffe, Donna B.

2012-01-01

Purpose To describe educational outcomes for a national cohort of U.S. medical students who initially failed Step 1 of the United States Medical Licensing Examination Method The authors analyzed de-identified, individualized records for the 1993–2000 cohort of U.S. medical school matriculants who both initially failed Step l and were no longer in medical school as of March 2, 2009, using multivariable logistic regression to identify factors associated with attempting, and initially passing, Step 2 Clinical Knowledge (CK). Results Of 6,594 students who failed Step l, 5,985 (90.8%) took Step 2CK. Women and Asian/Pacific Islander students were more likely to attempt Step 2CK; more recent matriculants and students with lower failing Step 1 scores were less likely. Of the 5,985 students who attempted Step 2CK, 4,168 (69.6%) initially passed. Women, students with higher Medical College Admission Test scores, and more recent matriculants were more likely to pass Step 2CK; Asian/Pacific Islander students, underrepresented minority students, older students, and students with lower failing Step 1 scores were less likely. Ninety percent of students in the study sample (5,952/6,594) ultimately graduated from medical school, including 99.5% (4,148/4,168) of those who initially passed, 96.7% (1,757/1,817) of those who initially failed, and 7.7% (47/609) of those who never attempted Step 2CK. Conclusions The authors identified variables associated with educational outcomes among students who failed Step l. These findings can inform medical schools’ efforts to develop tailored interventions to maximize the likelihood that students will take Step 2CK and pass it on the first attempt. PMID:22361789

The association of USMLE Step 1 and Step 2 CK scores with residency match specialty and location.

PubMed

Gauer, Jacqueline L; Jackson, J Brooks

2017-01-01

For future physicians, residency programs offer necessary extended training in specific medical specialties. Medical schools benefit from an understanding of factors that lead their students to match into certain residency specialties. One such factor, often used during the residency application process, is scores on the USA Medical Licensing Exam (USMLE). To determine the relationship between USMLE Step 1 and Step 2 Clinical Knowledge (CK) scores and students' residency specialty match, and the association between both USMLE scores and state of legal residency (Minnesota) at the time of admission with students staying in-state or leaving the state for residency program. USMLE scores and residency match data were analyzed from five graduating classes of students at the University of Minnesota Medical School (N = 1054). A MANOVA found significant differences (p < 0.001) between residency specialties and both USMLE Step 1 and Step 2 CK scores, as well as the combination of the two. Students who matched in Dermatology had the highest mean USMLE scores overall, while students who matched in Family Medicine had the lowest mean scores. Students who went out of state for residency had significantly higher Step 1 scores (p = 0.027) than students who stayed in-state for residency, while there was no significant difference between the groups for Step 2 scores. A significant positive association was found between a student who applied as a legal resident of Minnesota and whether the student stayed in Minnesota for their residency program. Residency specialty match was significantly associated with USMLE Step 1 and USMLE Step 2 CK scores, as was staying in-state or leaving the state for residency. Students who were legal residents of the state at the time of application were more likely to stay in-state for residency, regardless of USMLE score. CK: Clinical knowledge; COMLEX: Comprehensive Osteopathic Medical Licensing Examination; GME: Graduate medical education; NRMP: National Resident Matching Program; UME: Undergraduate medical education; USMLE: United States Medical Licensing Examination.

The association of USMLE Step 1 and Step 2 CK scores with residency match specialty and location

PubMed Central

Gauer, Jacqueline L.; Jackson, J. Brooks

2017-01-01

ABSTRACT Background: For future physicians, residency programs offer necessary extended training in specific medical specialties. Medical schools benefit from an understanding of factors that lead their students to match into certain residency specialties. One such factor, often used during the residency application process, is scores on the USA Medical Licensing Exam (USMLE). Objectives: To determine the relationship between USMLE Step 1 and Step 2 Clinical Knowledge (CK) scores and students’ residency specialty match, and the association between both USMLE scores and state of legal residency (Minnesota) at the time of admission with students staying in-state or leaving the state for residency program. Design: USMLE scores and residency match data were analyzed from five graduating classes of students at the University of Minnesota Medical School (N = 1054). Results: A MANOVA found significant differences (p < 0.001) between residency specialties and both USMLE Step 1 and Step 2 CK scores, as well as the combination of the two. Students who matched in Dermatology had the highest mean USMLE scores overall, while students who matched in Family Medicine had the lowest mean scores. Students who went out of state for residency had significantly higher Step 1 scores (p = 0.027) than students who stayed in-state for residency, while there was no significant difference between the groups for Step 2 scores. A significant positive association was found between a student who applied as a legal resident of Minnesota and whether the student stayed in Minnesota for their residency program. Conclusions: Residency specialty match was significantly associated with USMLE Step 1 and USMLE Step 2 CK scores, as was staying in-state or leaving the state for residency. Students who were legal residents of the state at the time of application were more likely to stay in-state for residency, regardless of USMLE score. Abbreviations: CK: Clinical knowledge; COMLEX: Comprehensive Osteopathic Medical Licensing Examination; GME: Graduate medical education; NRMP: National Resident Matching Program; UME: Undergraduate medical education; USMLE: United States Medical Licensing Examination PMID:28762297

Electronic Residency Application Service Application Characteristics Associated with Successful Residency Matching in Neurosurgery in 2009-2016.

PubMed

Leschke, John M; Hunt, Matthew A

2018-05-01

Resident applicants in neurosurgery often wonder what factors impact their chances of successfully matching. Using data published by the National Residency Match Program for 2009-2016, we examined which components of the Electronic Residency Application Service application correlated with successful residency matching. Data were collected from the National Residency Match Program publication Charting Outcomes in the Match from all years it was available for neurosurgery (2009, 2011, 2014, 2016). Individual factors reported (number of contiguous ranks, research projects, publications and presentations, work experiences, volunteer experiences, United States Medical Licensing Examination Step 1 and 2 score deciles, categorical data about Alpha Omega Alpha status, Ph.D. degree, other degree, and strength of medical school National Institutes of Health funding) were aggregated for all 3 years. Categorical data were available only for U.S. seniors. Spearman correlation and χ 2 were used for ranked data and categorical data, respectively. Separate analyses were run for U.S. seniors and independent applicants. For U.S. seniors applying to neurosurgery, number of contiguous ranks, United States Medical Licensing Examination Step 1 and 2 scores, research projects, Alpha Omega Alpha status, and medical school top 40 National Institutes of Health funding were significantly associated with successful matching of applicants. Number of volunteer experiences was nearly statistically significant. For independent applicants, only United States Medical Licensing Examination Step 1 and 2 scores and number of research projects were statistically significant. This is the first study to analyze National Residency Match Program data for predictors of success in neurosurgical matching. Students applying to neurosurgery residency and their mentors should be aware of which baseline objective factors are associated with match success. Copyright © 2018 Elsevier Inc. All rights reserved.

Assessment of Clinical Skills in Medical Practice

ERIC Educational Resources Information Center

Scoles, Peter V.; Hawkins, Richard E.; LaDuca, Anthony

2003-01-01

The introduction of a clinical skills examination (CSE) to Step 2 of the U.S. Medical Licensing Examination (USMLE) has focused attention on the design and delivery of large-scale standardized tests of clinical skills and raised the question of the appropriateness of evaluation of these competencies across the span of a physician's career. This…

Academic and Professional Career Outcomes of Medical School Graduates Who Failed USMLE Step 1 on the First Attempt

ERIC Educational Resources Information Center

McDougle, Leon; Mavis, Brian E.; Jeffe, Donna B.; Roberts, Nicole K.; Ephgrave, Kimberly; Hageman, Heather L.; Lypson, Monica L.; Thomas, Lauree; Andriole, Dorothy A.

2013-01-01

This study sought to determine the academic and professional outcomes of medical school graduates who failed the United States Licensing Examination Step 1 on the first attempt. This retrospective cohort study was based on pooled data from 2,003 graduates of six Midwestern medical schools in the classes of 1997-2002. Demographic, academic, and…

Evaluation and treatment of students with difficulties passing the Step examinations.

PubMed

Laatsch, Linda

2009-05-01

The author designed this retrospective case series study both to systematically examine characteristics of individuals referred for treatment after multiple failures on the United States Medical Licensing Examinations (USMLE) Step 1 or 2 administered by the National Board of Medical Examiners and to evaluate treatment effectiveness in a uniform sample. Six medical students referred to rehabilitation psychology met selection criteria. All students completed the requisite neuropsychological, academic, and psychological testing to identify cognitive and emotional strengths and weaknesses. All six underwent individualized cognitive rehabilitation (CR) with a primary focus on reading fluency and accuracy. All participants improved on a quantitative measure of reading speed and accuracy, and five of the six passed their next USLME Step examination in spite of past failures. Medical students with identified difficulties on reading fluency, but no history of a learning disability, may benefit from systematic CR that addresses cognitive weaknesses related to test-taking abilities. The strong relationships between language and reading skills and the USMLE Step examinations suggest that some students may fail these examinations because of a relative weakness in language processing and reading fluency that may prohibit their successful completion of the Step examinations.

Does the NBME Surgery Shelf exam constitute a "double jeopardy" of USMLE Step 1 performance?

PubMed

Ryan, Michael S; Colbert-Getz, Jorie M; Glenn, Salem N; Browning, Joel D; Anand, Rahul J

2017-02-01

Scores from the NBME Subject Examination in Surgery (Surgery Shelf) positively correlate with United States Medical Licensing Examination Step 1 (Step 1). Based on this relationship, the authors evaluated the predictive value of Step 1 on the Surgery Shelf. Surgery Shelf standard scores were substituted for Step 1 standard scores for 395 students in 2012-2014 at one medical school. Linear regression was used to determine how well Step 1 scores predicted Surgery Shelf scores. Percent match between original (with Shelf) and modified (with Step 1) clerkship grades were computed. Step 1 scores significantly predicted Surgery Shelf scores, R 2  = 0.42, P < 0.001. For every point increase in Step 1, a Surgery Shelf score increased by 0.30 points. Seventy-seven percent of original grades matched the modified grades. Replacing Surgery Shelf scores with Step 1 scores did not have an effect on the majority of final clerkship grades. This observation raises concern over use of Surgery Shelf scores as a measure of knowledge obtained during the Surgery clerkship. Copyright © 2016 Elsevier Inc. All rights reserved.

Are Scores From NBME Subject Examinations Valid Measures of Knowledge Acquired During Clinical Clerkships?

PubMed

Ryan, Michael S; Bishop, Steven; Browning, Joel; Anand, Rahul J; Waterhouse, Elizabeth; Rigby, Fidelma; Al-Mateen, Cheryl S; Lee, Clifton; Bradner, Melissa; Colbert-Getz, Jorie M

2017-06-01

The National Board of Medical Examiners' Clinical Science Subject Examinations are a component used by most U.S. medical schools to determine clerkship grades. The purpose of this study was to examine the validity of this practice. This was a retrospective cohort study of medical students at the Virginia Commonwealth University School of Medicine who completed clerkships in 2012 through 2014. Linear regression was used to determine how well United States Medical Licensing Examination Step 1 scores predicted Subject Examination scores in seven clerkships. The authors then substituted each student's Subject Examination standard scores with his or her Step 1 standard score. Clerkship grades based on the Step 1 substitution were compared with actual grades with the Wilcoxon rank test. A total of 2,777 Subject Examination scores from 432 students were included in the analysis. Step 1 scores significantly predicted between 23% and 44% of the variance in Subject Examination scores, P < .001 for all clerkship regression equations. Mean differences between expected and actual Subject Examination scores were small (≤ 0.2 points). There was a match between 73% of Step 1 substituted final clerkship grades and actual final clerkship grades. The results of this study suggest that performance on Step 1 can be used to identify and counsel students at risk for poor performance on the Subject Examinations. In addition, these findings call into the question the validity of using scores from Subject Examinations as a high-stakes assessment of learning in individual clerkships.

A new license plate extraction framework based on fast mean shift

NASA Astrophysics Data System (ADS)

Pan, Luning; Li, Shuguang

2010-08-01

License plate extraction is considered to be the most crucial step of Automatic license plate recognition (ALPR) system. In this paper, a region-based license plate hybrid detection method is proposed to solve practical problems under complex background in which existing large quantity of disturbing information. In this method, coarse license plate location is carried out firstly to get the head part of a vehicle. Then a new Fast Mean Shift method based on random sampling of Kernel Density Estimate (KDE) is adopted to segment the color vehicle images, in order to get candidate license plate regions. The remarkable speed-up it brings makes Mean Shift segmentation more suitable for this application. Feature extraction and classification is used to accurately separate license plate from other candidate regions. At last, tilted license plate regulation is used for future recognition steps.

[Technology transfer between academic laboratories and industrial laboratories: licensing].

PubMed

Salauze, D

2010-09-01

The time when academic and industrial research were operating in two separate worlds is now over. Technology transfer from one to the other is now frequent and organized. It starts by filing a patent. Of course, provided the amounts at stake for developing a product, especially in the healthcare field, a non patent-protected invention has virtually no chance of eventually reaching the community. But this is only the first step of a long process which starts by licensing deals of which we will examine the main common clauses. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

Higher clinical performance during a surgical clerkship is independently associated with matriculation of medical students into general surgery.

PubMed

Daly, Shaun C; Deal, Rebecca A; Rinewalt, Daniel E; Francescatti, Amanda B; Luu, Minh B; Millikan, Keith W; Anderson, Mary C; Myers, Jonathan A

2014-04-01

The purpose of our study was to determine the predictive impact of individual academic measures for the matriculation of senior medical students into a general surgery residency. Academic records were evaluated for third-year medical students (n = 781) at a single institution between 2004 and 2011. Cohorts were defined by student matriculation into either a general surgery residency program (n = 58) or a non-general surgery residency program (n = 723). Multivariate logistic regression was performed to evaluate independently significant academic measures. Clinical evaluation raw scores were predictive of general surgery matriculation (P = .014). In addition, multivariate modeling showed lower United States Medical Licensing Examination Step 1 scores to be independently associated with matriculation into general surgery (P = .007). Superior clinical aptitude is independently associated with general surgical matriculation. This is in contrast to the negative correlation United States Medical Licensing Examination Step 1 scores have on general surgery matriculation. Recognizing this, surgical clerkship directors can offer opportunities for continued surgical education to students showing high clinical aptitude, increasing their likelihood of surgical matriculation. Copyright © 2014 Elsevier Inc. All rights reserved.

Evaluating Validity Evidence for USMLE Step 2 Clinical Skills Data Gathering and Data Interpretation Scores: Does Performance Predict History-Taking and Physical Examination Ratings for First-Year Internal Medicine Residents?

PubMed

Cuddy, Monica M; Winward, Marcia L; Johnston, Mary M; Lipner, Rebecca S; Clauser, Brian E

2016-01-01

To add to the small body of validity research addressing whether scores from performance assessments of clinical skills are related to performance in supervised patient settings, the authors examined relationships between United States Medical Licensing Examination (USMLE) Step 2 Clinical Skills (CS) data gathering and data interpretation scores and subsequent performance in history taking and physical examination in internal medicine residency training. The sample included 6,306 examinees from 238 internal medicine residency programs who completed Step 2 CS for the first time in 2005 and whose performance ratings from their first year of residency training were available. Hierarchical linear modeling techniques were used to examine the relationships among Step 2 CS data gathering and data interpretation scores and history-taking and physical examination ratings. Step 2 CS data interpretation scores were positively related to both history-taking and physical examination ratings. Step 2 CS data gathering scores were not related to either history-taking or physical examination ratings after other USMLE scores were taken into account. Step 2 CS data interpretation scores provide useful information for predicting subsequent performance in history taking and physical examination in supervised practice and thus provide validity evidence for their intended use as an indication of readiness to enter supervised practice. The results show that there is less evidence to support the usefulness of Step 2 CS data gathering scores. This study provides important information for practitioners interested in Step 2 CS specifically or in performance assessments of medical students' clinical skills more generally.

License Compliance Issues For Biopharmaceuticals: Special Challenges For Negotiations Between Companies And Non-Profit Research Institutions.

PubMed

Ponzio, Todd A; Feindt, Hans; Ferguson, Steven

2011-09-01

Biopharmaceuticals are therapeutic products based on biotechnology. They are manufactured by or from living organisms and are the most complex of all commercial medicines to develop, manufacture and qualify for regulatory approval. In recent years biopharmaceuticals have rapidly increased in number and importance with over 400() already marketed in the U.S. and European markets alone. Many companies throughout the world are now ramping up investments in biopharmaceutical R&D and expanding their portfolios through licensing of early-stage biotechnologies from universities and other non-profit research institutions, and there is an increasing number of license agreements for biopharmaceutical product development relative to traditional small molecule drug compounds. This trend will only continue as large numbers of biosimilars and biogenerics enter the market.A primary goal of technology transfer offices associated with publicly-funded, non-profit research institutions is to establish patent protection for inventions deemed to have commercial potential and license them for product development. Such licenses help stimulate economic development and job creation, bring a stream of royalty revenue to the institution and, hopefully, advance the public good or public health by bringing new and useful products to market. In the course of applying for such licenses, a commercial development plan is usually put forth by the license applicant. This plan indicates the path the applicant expects to follow to bring the licensed invention to market. In the case of small molecule drug compounds, there exists a widely-recognized series of clinical development steps, dictated by regulatory requirements, that must be met to bring a new drug to market, such as completion of preclinical toxicology, Phase 1, 2 and 3 testing and product approvals. These steps often become the milestone/benchmark schedule incorporated into license agreements which technology transfer offices use to monitor the licensee's diligence and progress; most exclusive licenses include a commercial development plan, with penalties, financial or even revocation of the license, if the plan is not followed, e.g., the license falls too far behind.This study examines whether developmental milestone schedules based on a small molecule drug development model are useful and realistic in setting expectations for biopharmaceutical product development. We reviewed the monitoring records of all exclusive Public Health Service (PHS) commercial development license agreements for small molecule drugs or therapeutics based on biotechnology (biopharmaceuticals) executed by the National Institutes of Health (NIH) Office of Technology Transfer (OTT) between 2003 and 2009. We found that most biopharmaceutical development license agreements required amending because developmental milestones in the negotiated schedule could not be met by the licensee. This was in stark contrast with license agreements for small molecule chemical compounds which rarely needed changes to their developmental milestone schedules. As commercial development licenses for biopharmaceuticals make up the vast majority of NIH's exclusive license agreements, there is clearly a need to: 1) more closely examine how these benchmark schedules are formed, 2) try to understand the particular risk factors contributing to benchmark schedule non-compliance, and 3) devise alternatives to the current license benchmark schedule structural model. Schedules that properly weigh the most relevant risk factors such as technology classification (e.g., vaccine vs recombinant antibody vs gene therapy), likelihood of unforeseen regulatory issues, and company size/structure may help assure compliance with original license benchmark schedules. This understanding, coupled with a modified approach to the license negotiation process that makes use of a clear and comprehensive term sheet to minimize ambiguities should result in a more realistic benchmark schedule.

License Compliance Issues For Biopharmaceuticals: Special Challenges For Negotiations Between Companies And Non-Profit Research Institutions

PubMed Central

Ponzio, Todd A.; Feindt, Hans; Ferguson, Steven

2011-01-01

Summary Biopharmaceuticals are therapeutic products based on biotechnology. They are manufactured by or from living organisms and are the most complex of all commercial medicines to develop, manufacture and qualify for regulatory approval. In recent years biopharmaceuticals have rapidly increased in number and importance with over 4001 already marketed in the U.S. and European markets alone. Many companies throughout the world are now ramping up investments in biopharmaceutical R&D and expanding their portfolios through licensing of early-stage biotechnologies from universities and other non-profit research institutions, and there is an increasing number of license agreements for biopharmaceutical product development relative to traditional small molecule drug compounds. This trend will only continue as large numbers of biosimilars and biogenerics enter the market. A primary goal of technology transfer offices associated with publicly-funded, non-profit research institutions is to establish patent protection for inventions deemed to have commercial potential and license them for product development. Such licenses help stimulate economic development and job creation, bring a stream of royalty revenue to the institution and, hopefully, advance the public good or public health by bringing new and useful products to market. In the course of applying for such licenses, a commercial development plan is usually put forth by the license applicant. This plan indicates the path the applicant expects to follow to bring the licensed invention to market. In the case of small molecule drug compounds, there exists a widely-recognized series of clinical development steps, dictated by regulatory requirements, that must be met to bring a new drug to market, such as completion of preclinical toxicology, Phase 1, 2 and 3 testing and product approvals. These steps often become the milestone/benchmark schedule incorporated into license agreements which technology transfer offices use to monitor the licensee’s diligence and progress; most exclusive licenses include a commercial development plan, with penalties, financial or even revocation of the license, if the plan is not followed, e.g., the license falls too far behind. This study examines whether developmental milestone schedules based on a small molecule drug development model are useful and realistic in setting expectations for biopharmaceutical product development. We reviewed the monitoring records of all exclusive Public Health Service (PHS) commercial development license agreements for small molecule drugs or therapeutics based on biotechnology (biopharmaceuticals) executed by the National Institutes of Health (NIH) Office of Technology Transfer (OTT) between 2003 and 2009. We found that most biopharmaceutical development license agreements required amending because developmental milestones in the negotiated schedule could not be met by the licensee. This was in stark contrast with license agreements for small molecule chemical compounds which rarely needed changes to their developmental milestone schedules. As commercial development licenses for biopharmaceuticals make up the vast majority of NIH’s exclusive license agreements, there is clearly a need to: 1) more closely examine how these benchmark schedules are formed, 2) try to understand the particular risk factors contributing to benchmark schedule non-compliance, and 3) devise alternatives to the current license benchmark schedule structural model. Schedules that properly weigh the most relevant risk factors such as technology classification (e.g., vaccine vs recombinant antibody vs gene therapy), likelihood of unforeseen regulatory issues, and company size/structure may help assure compliance with original license benchmark schedules. This understanding, coupled with a modified approach to the license negotiation process that makes use of a clear and comprehensive term sheet to minimize ambiguities should result in a more realistic benchmark schedule. PMID:22162900

The relationship between internal medicine residency graduate performance on the ABIM certifying examination, yearly in-service training examinations, and the USMLE Step 1 examination.

PubMed

Kay, Cynthia; Jackson, Jeffrey L; Frank, Michael

2015-01-01

To explore the relationship between United States Medical Licensing Examination (USMLE) Step 1 scores, yearly in-service training exam (ITE) scores, and passing the American Board of Internal Medicine certifying examination (ABIM-CE). The authors conducted a retrospective database review of internal medicine residents from the Medical College of Wisconsin from 2004 through 2012. Residents' USMLE Step 1, ITE, and ABIM-CE scores were extracted. Pearson rho, chi-square, and logistic regression were used to determine whether relationships existed between the scores and if Step 1 and ITE scores correlate with passing the ABIM-CE. There were 241 residents, who participated in 728 annual ITEs. There were Step 1 scores for 195 (81%) residents and ABIM-CE scores for 183 (76%). Step 1 and ABIM-CE scores had a modest correlation (rho: 0.59), as did ITE and ABIM-CE scores (rho: 0.48-0.67). Failing Step 1 or being in the bottom ITE quartile during any year of testing markedly increased likelihood of failing the boards (Step 1: relative risk [RR]: 2.4; 95% CI: 1.0-5.9; first-year residents' RR: 1.3; 95% CI: 1.0-1.6; second-year residents' RR: 1.3; 95% CI: 1.1-1.5; third-year residents' RR: 1.3; 95% CI: 1.1-1.5). USMLE Step 1 and ITE scores have a modest correlation with board scores. Failing Step 1 or scoring in the bottom quartile of the ITE increased the risk of failing the boards. What effective intervention, if any, program directors may use with at-risk residents is a question deserving further research.

Medical School Performance of Socioeconomically Disadvantaged and Underrepresented Minority Students Matriculating after a Multiple Mini-Interview.

PubMed

Jerant, Anthony; Henderson, Mark C; Griffin, Erin; Talamantes, Efrain; Fancher, Tonya; Sousa, Francis; Franks, Peter

2018-01-01

Multiple Mini-Interviews (MMIs) are increasingly used in medical school admissions. We previously reported that while under-represented minority (URM) status was not associated with MMI scores, self-designated disadvantaged applicants had lower MMI scores, possibly affecting their matriculation prospects. No studies have examined how URM status or socioeconomic disadvantage (SED) are associated with academic performance following admission through an MMI. We examined the adjusted associations of MMI scores, SED, and URM status with U.S. Medical Licensing Examination Steps 1 and 2 performance and third-year clerkship Honors, measures affecting residency matching. While URM status was not associated with the measures, students with greater SED had lower Step 1 scores and fewer Honors. Students with higher MMI scores had more Step 1 failures, but more Honors. The findings identify areas to address in medical school admissions, student support, and evaluation processes, which is important given the need for a more representative physician workforce.

Validation and Application of the Survey of Teaching Beliefs and Practices for Undergraduates (STEP-U): Identifying Factors Associated with Valuing Important Workplace Skills among Biology Students.

PubMed

Marbach-Ad, Gili; Rietschel, Carly; Thompson, Katerina V

2016-01-01

We present a novel assessment tool for measuring biology students' values and experiences across their undergraduate degree program. Our Survey of Teaching Beliefs and Practices for Undergraduates (STEP-U) assesses the extent to which students value skills needed for the workplace (e.g., ability to work in groups) and their experiences with teaching practices purported to promote such skills (e.g., group work). The survey was validated through factor analyses in a large sample of biology seniors (n = 1389) and through response process analyses (five interviewees). The STEP-U skills items were characterized by two underlying factors: retention (e.g., memorization) and transfer (e.g., knowledge application). Multiple linear regression models were used to examine relationships between classroom experiences, values, and student characteristics (e.g., gender, cumulative grade point average [GPA], and research experience). Student demographic and experiential factors predicted the extent to which students valued particular skills. Students with lower GPAs valued retention skills more than those with higher GPAs. Students with research experience placed greater value on scientific writing and interdisciplinary understanding. Greater experience with specific teaching practices was associated with valuing the corresponding skills more highly. The STEP-U can provide feedback vital for designing curricula that better prepare students for their intended postgraduate careers. © 2016 G. Marbach-Ad et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Overview and current management of computerized adaptive testing in licensing/certification examinations.

PubMed

Seo, Dong Gi

2017-01-01

Computerized adaptive testing (CAT) has been implemented in high-stakes examinations such as the National Council Licensure Examination-Registered Nurses in the United States since 1994. Subsequently, the National Registry of Emergency Medical Technicians in the United States adopted CAT for certifying emergency medical technicians in 2007. This was done with the goal of introducing the implementation of CAT for medical health licensing examinations. Most implementations of CAT are based on item response theory, which hypothesizes that both the examinee and items have their own characteristics that do not change. There are 5 steps for implementing CAT: first, determining whether the CAT approach is feasible for a given testing program; second, establishing an item bank; third, pretesting, calibrating, and linking item parameters via statistical analysis; fourth, determining the specification for the final CAT related to the 5 components of the CAT algorithm; and finally, deploying the final CAT after specifying all the necessary components. The 5 components of the CAT algorithm are as follows: item bank, starting item, item selection rule, scoring procedure, and termination criterion. CAT management includes content balancing, item analysis, item scoring, standard setting, practice analysis, and item bank updates. Remaining issues include the cost of constructing CAT platforms and deploying the computer technology required to build an item bank. In conclusion, in order to ensure more accurate estimations of examinees' ability, CAT may be a good option for national licensing examinations. Measurement theory can support its implementation for high-stakes examinations.

Overview and current management of computerized adaptive testing in licensing/certification examinations

PubMed Central

2017-01-01

Computerized adaptive testing (CAT) has been implemented in high-stakes examinations such as the National Council Licensure Examination-Registered Nurses in the United States since 1994. Subsequently, the National Registry of Emergency Medical Technicians in the United States adopted CAT for certifying emergency medical technicians in 2007. This was done with the goal of introducing the implementation of CAT for medical health licensing examinations. Most implementations of CAT are based on item response theory, which hypothesizes that both the examinee and items have their own characteristics that do not change. There are 5 steps for implementing CAT: first, determining whether the CAT approach is feasible for a given testing program; second, establishing an item bank; third, pretesting, calibrating, and linking item parameters via statistical analysis; fourth, determining the specification for the final CAT related to the 5 components of the CAT algorithm; and finally, deploying the final CAT after specifying all the necessary components. The 5 components of the CAT algorithm are as follows: item bank, starting item, item selection rule, scoring procedure, and termination criterion. CAT management includes content balancing, item analysis, item scoring, standard setting, practice analysis, and item bank updates. Remaining issues include the cost of constructing CAT platforms and deploying the computer technology required to build an item bank. In conclusion, in order to ensure more accurate estimations of examinees’ ability, CAT may be a good option for national licensing examinations. Measurement theory can support its implementation for high-stakes examinations. PMID:28811394

Are United States Medical Licensing Exam Step 1 and 2 scores valid measures for postgraduate medical residency selection decisions?

PubMed

McGaghie, William C; Cohen, Elaine R; Wayne, Diane B

2011-01-01

United States Medical Licensing Examination (USMLE) scores are frequently used by residency program directors when evaluating applicants. The objectives of this report are to study the chain of reasoning and evidence that underlies the use of USMLE Step 1 and 2 scores for postgraduate medical resident selection decisions and to evaluate the validity argument about the utility of USMLE scores for this purpose. This is a research synthesis using the critical review approach. The study first describes the chain of reasoning that underlies a validity argument about using test scores for a specific purpose. It continues by summarizing correlations of USMLE Step 1 and 2 scores and reliable measures of clinical skill acquisition drawn from nine studies involving 393 medical learners from 2005 to 2010. The integrity of the validity argument about using USMLE Step 1 and 2 scores for postgraduate residency selection decisions is tested. The research synthesis shows that USMLE Step 1 and 2 scores are not correlated with reliable measures of medical students', residents', and fellows' clinical skill acquisition. The validity argument about using USMLE Step 1 and 2 scores for postgraduate residency selection decisions is neither structured, coherent, nor evidence based. The USMLE score validity argument breaks down on grounds of extrapolation and decision/interpretation because the scores are not associated with measures of clinical skill acquisition among advanced medical students, residents, and subspecialty fellows. Continued use of USMLE Step 1 and 2 scores for postgraduate medical residency selection decisions is discouraged.

Relationship between admissions committee review and student performance in medical school and internship.

PubMed

Gilliland, William R; Dong, Ting; Artino, Anthony R; Waechter, Donna M; Cruess, David F; DeZee, Kent J; McManigle, John E; Durning, Steven J

2012-09-01

To investigate the association between tertiary reviewer (admissions committee member) comments and medical students' performance during medical school and into internship. We collected data from seven year-groups (1993-1999) and coded tertiary reviewer comments into 14 themes. We then conducted an exploratory factor analysis to reduce the dimensions of the themes (excluding the Overall impression theme). Subsequently, we performed Pearson correlation analyses and multiple linear regression analysis to examine the relationship between the factors and seven outcome measures: medical school preclinical grade point average (GPA), medical school clinical GPA, cumulative medical school GPA, U.S. Medical Licensing Examination Step 1 and 2 scores, and scores on a program director's evaluation measuring intern professionalism and expertise. We extracted seven factors from the 13 themes and found small-to-moderate, significant correlations between the factors, the Overall impression theme, and the outcome measures. In particular, positive comments on Test and Maturity were associated with higher U.S. Medical Licensing Examination Step 1 and 2 scores. Negative comments on Interview and Recommendations were associated with lower ratings of professionalism during internship. Comments on Overall impression were significantly associated with all the outcome measures. Tertiary reviewer comments were weakly associated with performance in medical school and internship. Compared with positive comments, negative comments had stronger associations with medical school and internship performance measures.

Dual process theory and intermediate effect: are faculty and residents' performance on multiple-choice, licensing exam questions different?

PubMed

Dong, Ting; Durning, Steven J; Artino, Anthony R; van der Vleuten, Cees; Holmboe, Eric; Lipner, Rebecca; Schuwirth, Lambert

2015-04-01

Clinical reasoning is essential for the practice of medicine. Dual process theory conceptualizes reasoning as falling into two general categories: nonanalytic reasoning (pattern recognition) and analytic reasoning (active comparing and contrasting of alternatives). The debate continues regarding how expert performance develops and how individuals make the best use of analytic and nonanalytic processes. Several investigators have identified the unexpected finding that intermediates tend to perform better on licensing examination items than experts, which has been termed the "intermediate effect." We explored differences between faculty and residents on multiple-choice questions (MCQs) using dual process measures (both reading and answering times) to inform this ongoing debate. Faculty (board-certified internists; experts) and residents (internal medicine interns; intermediates) answered live licensing examination MCQs (U.S. Medical Licensing Examination Step 2 Clinical Knowledge and American Board of Internal Medicine Certifying Examination) while being timed. We conducted repeated analysis of variance to compare the 2 groups on average reading time, answering time, and accuracy on various types of items. Faculty and residents did not differ significantly in reading time [F (1,35) = 0.01, p = 0.93], answering time [F (1,35) = 0.60, p = 0.44], or accuracy [F (1,35) = 0.24, p = 0.63] regardless of easy or hard items. Dual process theory was not evidenced in this study. However, this lack of difference between faculty and residents may have been affected by the small sample size of participants and MCQs may not reflect how physicians made decisions in actual practice setting. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Nucleosomes influence multiple steps during replication initiation

PubMed Central

Azmi, Ishara F; Watanabe, Shinya; Maloney, Michael F; Kang, Sukhyun; Belsky, Jason A; MacAlpine, David M; Peterson, Craig L; Bell, Stephen P

2017-01-01

Eukaryotic replication origin licensing, activation and timing are influenced by chromatin but a mechanistic understanding is lacking. Using reconstituted nucleosomal DNA replication assays, we assessed the impact of nucleosomes on replication initiation. To generate distinct nucleosomal landscapes, different chromatin-remodeling enzymes (CREs) were used to remodel nucleosomes on origin-DNA templates. Nucleosomal organization influenced two steps of replication initiation: origin licensing and helicase activation. Origin licensing assays showed that local nucleosome positioning enhanced origin specificity and modulated helicase loading by influencing ORC DNA binding. Interestingly, SWI/SNF- and RSC-remodeled nucleosomes were permissive for origin licensing but showed reduced helicase activation. Specific CREs rescued replication of these templates if added prior to helicase activation, indicating a permissive chromatin state must be established during origin licensing to allow efficient origin activation. Our studies show nucleosomes directly modulate origin licensing and activation through distinct mechanisms and provide insights into the regulation of replication initiation by chromatin. DOI: http://dx.doi.org/10.7554/eLife.22512.001 PMID:28322723

Cause or effect? The relationship between student perception of the medical school learning environment and academic performance on USMLE Step 1.

PubMed

Wayne, Sharon J; Fortner, Sally A; Kitzes, Judith A; Timm, Craig; Kalishman, Summers

2013-05-01

A school's learning environment is believed to influence academic performance yet few studies have evaluated this association controlling for prior academic ability, an important factor since students who do well in school tend to rate their school's environment more highly than students who are less academically strong. To evaluate the effect of student perception of the learning environment on their performance on a standardized licensing test while controlling for prior academic ability. We measured perception of the learning environment after the first year of medical school in 267 students from five consecutive classes and related that measure to performance on United States Medical Licensing Examination (USMLE) Step 1, taken approximately six months later. We controlled for prior academic performance by including Medical College Admission Test score and undergraduate grade point average in linear regression models. Three of the five learning environment subscales were statistically associated with Step 1 performance (p < 0.05): meaningful learning environment, emotional climate, and student-student interaction. A one-point increase in the rating of the subscales (scale of 1-4) was associated with increases of 6.8, 6.6, and 4.8 points on the Step 1 exam. Our findings provide some evidence for the widely held assumption that a positively perceived learning environment contributes to better academic performance.

Licensing of future mobile satellite systems

NASA Technical Reports Server (NTRS)

Lepkowski, Ronald J.

1990-01-01

The regulatory process for licensing mobile satellite systems is complex and can require many years to complete. This process involves frequency allocations, national licensing, and frequency coordination. The regulatory process that resulted in the establishment of the radiodetermination satellite service (RDSS) between 1983 and 1987 is described. In contrast, each of these steps in the licensing of the mobile satellite service (MSS) is taking a significantly longer period of time to complete.

The relationship between communication scores from the USMLE Step 2 Clinical Skills examination and communication ratings for first-year internal medicine residents.

PubMed

Winward, Marcia L; Lipner, Rebecca S; Johnston, Mary M; Cuddy, Monica M; Clauser, Brian E

2013-05-01

This study extends available evidence about the relationship between scores on the Step 2 Clinical Skills (CS) component of the United States Medical Licensing Examination and subsequent performance in residency. It focuses on the relationship between Step 2 CS communication and interpersonal skills scores and communication skills ratings that residency directors assign to residents in their first postgraduate year of internal medicine training. It represents the first large-scale evaluation of the extent to which Step 2 CS communication and interpersonal skills scores can be extrapolated to examinee performance in supervised practice. Hierarchical linear modeling techniques were used to examine the relationships among examinee characteristics, residency program characteristics, and residency-director-provided ratings. The sample comprised 6,306 examinees from 238 internal medicine residency programs who completed Step 2 CS for the first time in 2005 and received ratings during their first year of internal medicine residency training. Although the relationship is modest, Step 2 CS communication and interpersonal skills scores predict communication skills ratings for first-year internal medicine residents after accounting for other factors. The results of this study make a reasonable case that Step 2 CS communication and interpersonal skills scores provide useful information for predicting the level of communication skill that examinees will display in their first year of internal medicine residency training. This finding demonstrates some level of extrapolation from the testing context to behavior in supervised practice, thus providing validity-related evidence for using Step 2 CS communication and interpersonal skills scores in high-stakes decisions.

Family-centered rounds and medical student performance on the NBME pediatrics subject (shelf) examination: a retrospective cohort study.

PubMed

Kimbrough, Tiffany N; Heh, Victor; Wijesooriya, N Romesh; Ryan, Michael S

2016-01-01

Objective To determine the association between family-centered rounds (FCR) and medical student knowledge acquisition as assessed by the National Board of Medical Examiners (NBME) pediatric subject (shelf) exam. Methods A retrospective cohort study was conducted of third-year medical students who graduated from Virginia Commonwealth University School of Medicine between 2009 and 2014. This timeframe represented the transition from 'traditional' rounds to FCR on the pediatric inpatient unit. Data collected included demographics, United States Medical Licensing Examination (USMLE) Step 1 and 2 scores, and NBME subject examinations in pediatrics (PSE), medicine (MSE), and surgery (SSE). Results Eight hundred and sixteen participants were included in the analysis. Student performance on the PSE could not be statistically differentiated from performance on the MSE for any year except 2011 (z-score=-0.17, p=0.02). Average scores on PSE for years 2009, 2010, 2013, and 2014 were significantly higher than for SSE, but not significantly different for all other years. The PSE was highly correlated with USMLE Step 1 and Step 2 examinations (correlation range 0.56-0.77) for all years. Conclusions Our results showed no difference in PSE performance during a time in which our institution transitioned to FCR. These findings should be reassuring for students, attending physicians, and medical educators.

Family-centered rounds and medical student performance on the NBME pediatrics subject (shelf) examination: a retrospective cohort study.

PubMed

Kimbrough, Tiffany N; Heh, Victor; Wijesooriya, N Romesh; Ryan, Michael S

2016-01-01

To determine the association between family-centered rounds (FCR) and medical student knowledge acquisition as assessed by the National Board of Medical Examiners (NBME) pediatric subject (shelf) exam. A retrospective cohort study was conducted of third-year medical students who graduated from Virginia Commonwealth University School of Medicine between 2009 and 2014. This timeframe represented the transition from 'traditional' rounds to FCR on the pediatric inpatient unit. Data collected included demographics, United States Medical Licensing Examination (USMLE) Step 1 and 2 scores, and NBME subject examinations in pediatrics (PSE), medicine (MSE), and surgery (SSE). Eight hundred and sixteen participants were included in the analysis. Student performance on the PSE could not be statistically differentiated from performance on the MSE for any year except 2011 (z-score=-0.17, p=0.02). Average scores on PSE for years 2009, 2010, 2013, and 2014 were significantly higher than for SSE, but not significantly different for all other years. The PSE was highly correlated with USMLE Step 1 and Step 2 examinations (correlation range 0.56-0.77) for all years. Our results showed no difference in PSE performance during a time in which our institution transitioned to FCR. These findings should be reassuring for students, attending physicians, and medical educators.

The Associations Between Clerkship Objective Structured Clinical Examination (OSCE) Grades and Subsequent Performance.

PubMed

Dong, Ting; Zahn, Christopher; Saguil, Aaron; Swygert, Kimberly A; Yoon, Michelle; Servey, Jessica; Durning, Steven

2017-01-01

Construct: We investigated the extent of the associations between medical students' clinical competency measured by performance in Objective Structured Clinical Examinations (OSCE) during Obstetrics/Gynecology and Family Medicine clerkships and later performance in both undergraduate and graduate medical education. There is a relative dearth of studies on the correlations between undergraduate OSCE scores and future exam performance within either undergraduate or graduate medical education and almost none on linking these simulated encounters to eventual patient care. Of the research studies that do correlate clerkship OSCE scores with future performance, these often have a small sample size and/or include only 1 clerkship. Students in USU graduating classes of 2007 through 2011 participated in the study. We investigated correlations between clerkship OSCE grades with United States Medical Licensing Examination Step 2 Clinical Knowledge, Clinical Skills, and Step 3 Exams scores as well as Postgraduate Year 1 program director's evaluation scores on Medical Expertise and Professionalism. We also conducted contingency table analysis to examine the associations between poor performance on clerkship OSCEs with failing Step 3 and receiving poor program director ratings. The correlation coefficients were weak between the clerkship OSCE grades and the outcomes. The strongest correlations existed between the clerkship OSCE grades and the Step 2 CS Integrated Clinical Encounter component score, Step 2 Clinical Skills, and Step 3 scores. Contingency table associations between poor performances on both clerkships OSCEs and poor Postgraduate Year 1 Program Director ratings were significant. The results of this study provide additional but limited validity evidence for the use of OSCEs during clinical clerkships given their associations with subsequent performance measures.

California Child Care Workforce Study: Family Child Care Providers and Assistants in Alameda County, Kern County, Monterey County, San Benito County, San Francisco County, San Mateo County, Santa Cruz County, and Santa Clara County.

ERIC Educational Resources Information Center

Whitebook, Marcy; Almaraz, Mirella; Jo-Yung, Joon; Sakai, Laura; Boots, Shelley Waters; Voisin, Irene; Young, Marci; Burton, Alice; Duff, Brian; Laverty, Kassin; Bellm, Dan; Jay, E. Deborah; Krishnaswamy, Nandini; Kipnis, Fran

An important first step toward more effectively addressing the complexities of child care as a service for families and as an employment setting for workers in California is to develop a detailed picture of the child care workforce. On this premise, a study examined licensed family child care provider demographics, professional preparation, length…

A Structured Educational Curriculum Including Online Training Positively Impacts American Board of Surgery In-Training Examination Scores.

PubMed

Kelly, Dympna M; London, Daniel A; Siperstein, Allan; Fung, John J; Walsh, Matthew R

2015-01-01

To assess the effect of a structured postgraduate year 1 educational curriculum, including online surgical training, on American Board of Surgery In-Training Examination (ABSITE) scores. This was a retrospective cohort study. The study was performed in an academic surgical residency program in a tertiary care hospital, Cleveland Clinic Foundation, Cleveland, Ohio. The participants were 140 surgical postgraduate year 1 residents from 2000 to 2009. Interns from 2000 to 2004 were grouped together and completed a self-directed learning curriculum. Interns from 2005 to 2009 participated in a structured educational curriculum that included lectures and the use of an online program. Lectures were based on the American College of Surgeons curriculum. The online program consisted of 8 to 12 hours of assigned tutorials and quizzes that corresponded to the lectures and 3 multiple-choice (MC) examinations. Use of a structured educational curriculum led to improved ABSITE scores (66 ± 9%) compared with that of those who had no curriculum (55 ± 10%, p < 0.001). Several variables positively correlated with the ABSITE score: United States Medical Licensing Examination step 1 score (p < 0.001), monthly quiz scores (p = 0.003), average MC examination scores (p = 0.005), lecture attendance (p = 0.02), and time spent online (p = 0.04). Multivariable analysis demonstrated that the step 1 United States Medical Licensing Examination score, time spent online, and MC examination score are predictive of total the ABSITE score. When ABSITE subscores (basic science and clinical science) were compared, the online curriculum had a greater effect on basic science subscores, whereas lectures had a greater effect on clinical science subscores. Providing surgery residents a structured curriculum with lectures and an online component positively impacts ABSITE scores. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

15 CFR 732.4 - Steps regarding License Exceptions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Exception STA. The types of aircraft controlled under ECCN 9A610.a that have been determined to be eligible... of ECCN 9A610. Supplement No. 2 to part 748, paragraph (w) (License Exception STA eligibility...

Does the MCAT predict medical school and PGY-1 performance?

PubMed

Saguil, Aaron; Dong, Ting; Gingerich, Robert J; Swygert, Kimberly; LaRochelle, Jeffrey S; Artino, Anthony R; Cruess, David F; Durning, Steven J

2015-04-01

The Medical College Admissions Test (MCAT) is a high-stakes test required for entry to most U. S. medical schools; admissions committees use this test to predict future accomplishment. Although there is evidence that the MCAT predicts success on multiple choice-based assessments, there is little information on whether the MCAT predicts clinical-based assessments of undergraduate and graduate medical education performance. This study looked at associations between the MCAT and medical school grade point average (GPA), Medical Licensing Examination (USMLE) scores, observed patient care encounters, and residency performance assessments. This study used data collected as part of the Long-Term Career Outcome Study to determine associations between MCAT scores, USMLE Step 1, Step 2 clinical knowledge and clinical skill, and Step 3 scores, Objective Structured Clinical Examination performance, medical school GPA, and PGY-1 program director (PD) assessment of physician performance for students graduating 2010 and 2011. MCAT data were available for all students, and the PGY PD evaluation response rate was 86.2% (N = 340). All permutations of MCAT scores (first, last, highest, average) were weakly associated with GPA, Step 2 clinical knowledge scores, and Step 3 scores. MCAT scores were weakly to moderately associated with Step 1 scores. MCAT scores were not significantly associated with Step 2 clinical skills Integrated Clinical Encounter and Communication and Interpersonal Skills subscores, Objective Structured Clinical Examination performance or PGY-1 PD evaluations. MCAT scores were weakly to moderately associated with assessments that rely on multiple choice testing. The association is somewhat stronger for assessments occurring earlier in medical school, such as USMLE Step 1. The MCAT was not able to predict assessments relying on direct clinical observation, nor was it able to predict PD assessment of PGY-1 performance. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

75 FR 28499 - Medical Certification Requirements as Part of the Commercial Driver's License (CDL); Technical...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-21

... Driver's License (CDL); Technical, Organizational, and Conforming Amendments AGENCY: Federal Motor... ``medical examiner's license or certificate number'' to refer to the number on a medical examiner's license... examiner qualifies him or her to drive. This inconsistency has been clarified in today's final rule so that...

Assessing potentially dangerous medical actions with the computer-based case simulation portion of the USMLE step 3 examination.

PubMed

Harik, Polina; Cuddy, Monica M; O'Donovan, Seosaimhin; Murray, Constance T; Swanson, David B; Clauser, Brian E

2009-10-01

The 2000 Institute of Medicine report on patient safety brought renewed attention to the issue of preventable medical errors, and subsequently specialty boards and the National Board of Medical Examiners were encouraged to play a role in setting expectations around safety education. This paper examines potentially dangerous actions taken by examinees during the portion of the United States Medical Licensing Examination Step 3 that is particularly well suited to evaluating lapses in physician decision making, the Computer-based Case Simulation (CCS). Descriptive statistics and a general linear modeling approach were used to analyze dangerous actions ordered by 25,283 examinees that completed CCS for the first time between November 2006 and January 2008. More than 20% of examinees ordered at least one dangerous action with the potential to cause significant patient harm. The propensity to order dangerous actions may vary across clinical cases. The CCS format may provide a means of collecting important information about patient-care situations in which examinees may be more likely to commit dangerous actions and the propensity of examinees to order dangerous tests and treatments.

47 CFR 13.211 - Commercial radio operator license examination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Commercial radio operator license examination. 13.211 Section 13.211 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL RADIO OPERATORS Examination System § 13.211 Commercial radio operator license examination. (a) Each session where...

History of the medical licensing examination (uieop) in Korea’s Goryeo Dynasty (918-1392)

PubMed Central

Lee, Kyung-Lock

2015-01-01

This article aims to describe the training and medical licensing system (uieop) for becoming a physician officer (uigwan) during Korea’s Goryeo Dynasty (918-1392). In the Goryeo Dynasty, although no license was necessary to provide medical services to the common people, there was a licensing examination to become a physician officer. No other national licensing system for healthcare professionals existed in Korea at that time. The medical licensing examination was administered beginning in 958. Physician officers who passed the medical licensing examination worked in two main healthcare institutions: the Government Hospital (Taeuigam) and Pharmacy for the King (Sangyakguk). The promotion and expansion of medical education differed depending on the historical period. Until the reign of King Munjong (1046-1083), medical education as a path to licensure was encouraged in order to increase the number of physician officers qualifying for licensure by examination; thus, the number of applicants sitting for the examination increased. However, in the late Goryeo Dynasty, after the officer class of the local authorities (hyangri) showed a tendency to monopolize the examination, the Goryeo government limited the examination applications by this group. The medical licensing examination was divided into two parts: medicine and ‘feeling the pulse and acupuncture’ (jugeumeop). The Goryeo Dynasty followed the Chinese Dang Dynasty’s medical system while also taking a strong interest in the Chinese Song Dynasty’s ideas about medicine. PMID:26008917

Arms Sales: Congressional Review Process

DTIC Science & Technology

2015-12-17

the Arms Export Control Act (AECA), Congress must be formally notified 30 calendar days before the Administration can take the final steps to...Commercially licensed arms sales also must be formally notified to Congress 30 calendar days before the export license is issued if they involve the sale...also be formally notified to Congress for review 30 days prior to the license for export being approved. In the case of proposed licences for such

Educational intervention as an effective step for reducing blood culture contamination: a prospective cohort study.

PubMed

Park, W B; Myung, S J; Oh, M-d; Lee, J; Kim, N-J; Kim, E-C; Park, J S

2015-10-01

Contaminated blood cultures lead to diagnostic challenges and place a burden on healthcare services. To determine the impact of introducing a clinical skills test (CST) as part of the medical licensing examination and an institutional education programme on the contamination rates of blood cultures. A prospective cohort study was conducted from 2009 through 2013 in all wards of a tertiary-care teaching hospital. We evaluated the effects of the CST, which was added to the National Medical Licensing Examination in Korea (KMLE) in 2010 and our institutional education programme, which began in 2013. The medical interns in charge of collection of blood for culture were divided in three groups with presence or absence of CST and the institutional education programme. The primary outcome was the percentage of blood cultures contaminated in each group, which were compared using the Poisson regression model. Participants' self-rated scores for the blood draw procedure were also analysed. Although introduction of the CST in the KMLE failed to reduce blood culture contamination rate (1.36% vs 1.35%; P = 0.734), the institutional education programme significantly reduced the contamination rate (1.35% vs 1.00%; P < 0.0001). Most participants answered that they always followed each step correctly except for waiting the recommended contact time after applying the antiseptic. The educational intervention, not the introduction of CST in the KMLE, was effective in reducing overall contamination rates. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Assessing the effectiveness of combining evaluation methods for the early identification of students with inadequate knowledge during a clerkship.

PubMed

Hemmer, Paul A.; Grau, Thomas; Pangaro, Louis N.

2001-10-01

This study examined the predictive validity of in-clerkship evaluation methods to identify medical students who have insufficient knowledge. Study subjects were 124 third-year medical students at the Uniformed Services University. Insufficient knowledge was defined by: (1) a clerkship 'pre-test' score one standard deviation below the mean or lower; or (2) any teacher verbally rating a student's general knowledge as 'marginal' or less; or (3) a student did not pass Step One of the United States Medical Licensing Examination (USMLE). We determined sensitivity and specificity using a standard score of 90%. Using USMLE Step One pass-fail performance did not improve sensitivity. Combining a 'pre-test' and instructors' formal evaluation session comments improves the early identification of students with insufficient knowledge, allowing for formative feedback and remediation during the clerkship.

15 CFR 752.5 - Steps you must follow to apply for an SCL.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Steps you must follow to apply for an... COMPREHENSIVE LICENSE § 752.5 Steps you must follow to apply for an SCL. (a) Step One: Establish applicant...; and (iv) Evidence of all parties knowledge of all provisions of the EAR. (b) Step Two: Establish...

The impact of effective patents on future innovations in nanomedicine.

PubMed

Bosetti, Rita; Vereeck, Lode

2012-03-01

The success of nanomedicine is dependent upon an effective protection of IP rights. Unfortunately, the US nanomedicine patent system is dysfunctional because long R&D procedures as well as the patent pendency are insufficiently taken into account. This could be solved by changing the patent-protection starting point and increasing the capacity of the US PTO. The nanotechnology industry also suffers from overlapping patents. This could be avoided by improving the expertise of the PTO, using a more accurate definition of nanotechnology and devising a generally accepted nomenclature that enhances prior-art searches. To avoid disputes, inference practices and strategic patenting can be used. In the case of a dispute, parties can fall back on re-examination, cross-licensing and patent litigation. Cross-licensing agreements are recommended since they allows parties to access technology, create synergies and exclude third-party competitors. Solving the patent problems in the nanotechnology industry is a necessary step for future success.

36 CFR 25.2 - License.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Director of the National Park Service, who will likewise supervise the marking of examination papers and the rating of applicants. (d) The names of applicants who successfully pass the examination will be...) , having successfully passed the examination prescribed for license, is hereby licensed to offer his...

Benchmark for license plate character segmentation

NASA Astrophysics Data System (ADS)

Gonçalves, Gabriel Resende; da Silva, Sirlene Pio Gomes; Menotti, David; Shwartz, William Robson

2016-09-01

Automatic license plate recognition (ALPR) has been the focus of many researches in the past years. In general, ALPR is divided into the following problems: detection of on-track vehicles, license plate detection, segmentation of license plate characters, and optical character recognition (OCR). Even though commercial solutions are available for controlled acquisition conditions, e.g., the entrance of a parking lot, ALPR is still an open problem when dealing with data acquired from uncontrolled environments, such as roads and highways when relying only on imaging sensors. Due to the multiple orientations and scales of the license plates captured by the camera, a very challenging task of the ALPR is the license plate character segmentation (LPCS) step, because its effectiveness is required to be (near) optimal to achieve a high recognition rate by the OCR. To tackle the LPCS problem, this work proposes a benchmark composed of a dataset designed to focus specifically on the character segmentation step of the ALPR within an evaluation protocol. Furthermore, we propose the Jaccard-centroid coefficient, an evaluation measure more suitable than the Jaccard coefficient regarding the location of the bounding box within the ground-truth annotation. The dataset is composed of 2000 Brazilian license plates consisting of 14000 alphanumeric symbols and their corresponding bounding box annotations. We also present a straightforward approach to perform LPCS efficiently. Finally, we provide an experimental evaluation for the dataset based on five LPCS approaches and demonstrate the importance of character segmentation for achieving an accurate OCR.

An international survey of medical licensing requirements for immigrating physicians, focusing on communication evaluation

PubMed Central

Weedle, Rebecca; Morris, Marie; Ridgway, Paul

2016-01-01

Objectives To identify current entry requirements set by international medical licensing bodies for immigrating physicians, focusing on postgraduate level communication skills, clinical and technical skill assessments. Methods A standardised, author developed survey was administered to a selection of national, state and provincial licensing institutions across 6 continents. Representative institutions were selected from the most populated regions of each continent. Surveys were administered by email and telephone. The information was also searched by website review. Website information alone was used if no response was received by the targeted institution after 2 phone/2 email attempts. Statistical analysis of the non-parametric data was conducted using SPSS (v.21). Results Thirty-seven licensing bodies were contacted from 30 countries; verifiable information was available for 29; twenty-six responded to the communication inquiry. Sixty five 65.4% (n=17) surveyed communication skills, 100% involved language proficiency testing; 11.5% tested other forms of communication skills. For clinical and technical skills, 86.2% (n=25) assessed candidates by credential review, 72.4% (n=21) required both credential review and exam and 62.1% (n=18) used country-specific examination. A mentorship period were required by 37.9% (n=11), ranging from 3 months to 1 year. Only 2 countries identified examinations for recertification. No technical/clinical skills nor communication skill evaluation (beyond language proficiency) are routinely assessed at the postgraduate level. Conclusions International assessments of migrating physicians are heterogeneous. Communication skills, beyond language proficiency, are not routinely assessed in foreign trained physicians seeking entry. The majority of clinical and technical skills are assessed by credential review only. This study highlights the lack of standardisation of assessment internationally and the need for steps toward a global agreement on training schemes and summative assessment. PMID:26851517

An international survey of medical licensing requirements for immigrating physicians, focusing on communication evaluation.

PubMed

Gillis, Amy; Weedle, Rebecca; Morris, Marie; Ridgway, Paul

2016-02-06

To identify current entry requirements set by international medical licensing bodies for immigrating physicians, focusing on postgraduate level communication skills, clinical and technical skill assessments. A standardised, author developed survey was administered to a selection of national, state and provincial licensing institutions across 6 continents. Representative institutions were selected from the most populated regions of each continent. Surveys were administered by email and telephone. The information was also searched by website review. Website information alone was used if no response was received by the targeted institution after 2 phone/2 email attempts. Statistical analysis of the non-parametric data was conducted using SPSS (v.21). Thirty-seven licensing bodies were contacted from 30 countries; verifiable information was available for 29; twenty-six responded to the communication inquiry. Sixty five 65.4% (n=17) surveyed communication skills, 100% involved language proficiency testing; 11.5% tested other forms of communication skills. For clinical and technical skills, 86.2% (n=25) assessed candidates by credential review, 72.4% (n=21) required both credential review and exam and 62.1% (n=18) used country-specific examination. A mentorship period were required by 37.9% (n=11), ranging from 3 months to 1 year. Only 2 countries identified examinations for recertification. No technical/clinical skills nor communication skill evaluation (beyond language proficiency) are routinely assessed at the postgraduate level. International assessments of migrating physicians are heterogeneous. Communication skills, beyond language proficiency, are not routinely assessed in foreign trained physicians seeking entry. The majority of clinical and technical skills are assessed by credential review only. This study highlights the lack of standardisation of assessment internationally and the need for steps toward a global agreement on training schemes and summative assessment.

A bill to require the Secretary of Transportation to establish accelerated licensing procedures to assist veterans to acquire commercial driver's licenses, and for other purposes.

THOMAS, 112th Congress

Sen. Snowe, Olympia J. [R-ME

2012-02-09

Senate - 02/09/2012 Read twice and referred to the Committee on Commerce, Science, and Transportation. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

History of the national licensing examination for the health professions under the Japanese Government-General of Korea (1910-1945)

PubMed Central

Park, In-Soon

2015-01-01

During the reign of Japanese Government-General of Korea (Joseon) from 1910 to 1945, the main health professionals who were educated about modern medicine were categorized into physicians, dentists, pharmacists, midwives, and nurses. They were clearly distinguished from traditional health professionals. The regulations on new health professionals were enacted, and the licensing system was enforced in earnest. There were two kinds of licensing systems: the license without examination through an educational institution and the license with the national examination. The Japanese Government-General of Korea (Joseon) combined education with a national examination system to produce a large number of health professionals rapidly; however, it was insufficient to fulfill the increasing demand for health services. Therefore, the government eased the examination several times and focused on quantitative expansion of the health professions. The proportion of professionals licensed through national examination had increased. This system had produced the maximum number of available professionals at low cost. Furthermore, this system was significant in three respects: first, the establishment of the framework of the national licensing examination still used today for health professionals; second, the protection of people from the poor practices of unqualified practitioners; and third, the standardization of the quality of health. PMID:26013111

Learning Disabilities/Attention Deficit Hyperactivity Disorder and Test Accommodations in Professional Licensing under the Americans with Disabilities Act.

ERIC Educational Resources Information Center

Latham, Patricia H.; Latham, Peter S.

1998-01-01

Reviews court decisions regarding the documentation of disabilities and accommodations for individuals with learning disabilities and/or attention-deficit disorders taking licensing examinations from the National Board of Medical Examiners and the State Bar Examiners. Professional schools and licensing authorities are urged to work toward…

Effects of Test Item Disclosure on Medical Licensing Examination

ERIC Educational Resources Information Center

Yang, Eunbae B.; Lee, Myung Ae; Park, Yoon Soo

2018-01-01

In 2012, the National Health Personnel Licensing Examination Board of Korea decided to publicly disclose all test items and answers to satisfy the test takers' right to know and enhance the transparency of tests administered by the government. This study investigated the effects of item disclosure on the medical licensing examination (MLE),…

A novel method to accurately locate and count large numbers of steps by photobleaching.

PubMed

Tsekouras, Konstantinos; Custer, Thomas C; Jashnsaz, Hossein; Walter, Nils G; Pressé, Steve

2016-11-07

Photobleaching event counting is a single-molecule fluorescence technique that is increasingly being used to determine the stoichiometry of protein and RNA complexes composed of many subunits in vivo as well as in vitro. By tagging protein or RNA subunits with fluorophores, activating them, and subsequently observing as the fluorophores photobleach, one obtains information on the number of subunits in a complex. The noise properties in a photobleaching time trace depend on the number of active fluorescent subunits. Thus, as fluorophores stochastically photobleach, noise properties of the time trace change stochastically, and these varying noise properties have created a challenge in identifying photobleaching steps in a time trace. Although photobleaching steps are often detected by eye, this method only works for high individual fluorophore emission signal-to-noise ratios and small numbers of fluorophores. With filtering methods or currently available algorithms, it is possible to reliably identify photobleaching steps for up to 20-30 fluorophores and signal-to-noise ratios down to ∼1. Here we present a new Bayesian method of counting steps in photobleaching time traces that takes into account stochastic noise variation in addition to complications such as overlapping photobleaching events that may arise from fluorophore interactions, as well as on-off blinking. Our method is capable of detecting ≥50 photobleaching steps even for signal-to-noise ratios as low as 0.1, can find up to ≥500 steps for more favorable noise profiles, and is computationally inexpensive. © 2016 Tsekouras et al. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

78 FR 58535 - Hydropower Regulatory Efficiency Act of 2013; Supplemental Notice of Workshop

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-24

... license for hydropower development at non-powered dams and closed-loop pumped storage projects in... for licensing hydropower development at non-powered dams and closed-loop pumped storage projects... closed- loop pumped storage) affect the steps included in a two-year process? 3.9 Should there be a...

Saving Teenage Lives: The Case for Graduated Driver Licensing.

ERIC Educational Resources Information Center

National Highway Traffic Safety Administration (DOT), Washington, DC.

This manual explains what graduated driver licensing (GDL) is and why the National Highway Traffic Safety Administration believes it is so important for every jurisdiction to take steps towards its implementation. Section I introduces the need by defining the teen driving problem: inexperience, risk-taking behavior and immaturity, and greater risk…

Licensing procedures for older drivers.

DOT National Transportation Integrated Search

2013-09-01

This study examined the driver licensing procedures in all 50 States as they apply to the older (65+) driver. A literature review examined reports of possible declines in older driver capabilities and the ability of a driver licensing agency to scree...

Performance in physical examination on the USMLE Step 2 Clinical Skills examination.

PubMed

Peitzman, Steven J; Cuddy, Monica M

2015-02-01

To provide descriptive information about history-taking (HX) and physical examination (PE) performance for U.S. medical students as documented by standardized patients (SPs) during the Step 2 Clinical Skills (CS) component of the United States Medical Licensing Examination. The authors examined two hypotheses: (1) Students perform worse in PE compared with HX, and (2) for PE, students perform worse in the musculoskeletal system and neurology compared with other clinical domains. The sample included 121,767 student-SP encounters based on 29,442 examinees from U.S. medical schools who took Step 2 CS for the first time in 2011. The encounters comprised 107 clinical presentations, each categorized into one of five clinical domains: cardiovascular, gastrointestinal, musculoskeletal, neurological, and respiratory. The authors compared mean percent-correct scores for HX and PE via a one-tailed paired-samples t test and examined mean score differences by clinical domain using analysis of variance techniques. Average PE scores (59.6%) were significantly lower than average HX scores (78.1%). The range of scores for PE (51.4%-72.7%) was larger than for HX (74.4%-81.0%), and the standard deviation for PE scores (28.3) was twice as large as the HX standard deviation (14.7). PE performance was significantly weaker for musculoskeletal and neurological encounters compared with other encounters. U.S. medical students perform worse on PE than HX; PE performance was weakest in musculoskeletal and neurology clinical domains. Findings may reflect imbalances in U.S. medical education, but more research is needed to fully understand the relationships among PE instruction, assessment, and proficiency.

Multi-instrument assessment of physical activity in female office workers.

PubMed

Can, Sema; Gündüz, Nevin; Arslan, Erşan; Biernat, Elżbieta; Ersöz, Gülfem; Kilit, Bülent

2016-11-18

The aim of this study was to examine the multi-instrument assessment of physical activity in female office workers. Fifty healthy women (age (mean ± standard deviation): 34.8±5.9 years, body height: 158±0.4 cm, body weight: 61.8±7.5 kg, body mass index: 24.6±2.7 kg/m²) workers from the same workplace volunteered to participate in the study. Physical activity was measured with the 7-day Physical Activity Assessment Questionnaire (7-d PAAQ), an objective multi-sensor armband tool, and also a waist-mounted pedometer, which were both worn for 7 days. A significant correlation between step numbers measured by armband and pedometer was observed (r = 0.735), but the step numbers measured by these 2 methods were significantly different (10 941±2236 steps/ day and 9170±2377 steps/day, respectively; p < 0.001). There was a weak correlation between the value of 7-d PAAQ total energy expenditure and the value of armband total energy expenditure (r = 0.394, p = 0.005). However, total energy expenditure values measured by armband and 7-d PAAQ were not significantly different (2081±370 kcal/ day and 2084±197 kcal/day, respectively; p = 0.96). In addition, physical activity levels (average daily metabolic equivalents (MET)) measured by armband and 7-d PAAQ were not significantly different (1.45±0.12 MET/day and 1.47±0.24 MET/day, respectively; p = 0.44). The results of this study showed that the correlation between pedometer and armband measurements was higher than that between armband measurements and 7-d PAAQ selfreports. Our results suggest that none of the assessment methods examined here, 7-d PAAQ, pedometer, or armband, is sufficient when used as a single tool for physical activity level determination. Therefore, multi-instrument assessment methods are preferable. Int J Occup Med Environ Health 2016;29(6):937-945. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Predicting Success of Preliminary Surgical Residents: A Multi-Institutional Study.

PubMed

Al Fayyadh, Mohammed J; Heller, Stephanie F; Rajab, Taufiek Konrad; Gardner, Aimee K; Bloom, Jordan P; Rawlings, Jeremy A; Mullen, John T; Smink, Douglas S; Farley, David R; Willis, Ross E; Dent, Daniel L

A nondesignated preliminary surgery (NDPS) position encompasses 1 year of training provided by many general surgery residencies. Our aim was to assess factors predicting success and provide evidence for program directors to support career guidance to preliminary residents. Retrospective cohort study of 221 NDPS residents who entered 5 university-based institutions were identified from 2009 to 2013. Records for trainees were reviewed. We defined primary success as obtaining a categorical position in the specialty of choice and secondary success as obtaining a categorical position in any specialty immediately after finishing their NDPS training. Statistical evaluation was performed using chi-square analysis, independent t-test and logistic regression using α <0.05. Of the 221 NDPS residents, 217 (98%) completed postgraduate year (PGY)-1 and 65 (29%) completed PGY-2. Totally, 90 (41%) obtained categorical general surgery positions, 89 (40%) obtained categorical positions in other specialties, and 42 (19%) failed to obtain a categorical position immediately after their NDPS years. Ultimately, 139 (63%) of residents achieved primary success and 40 (18%) additional residents obtained categorical positions in specialties other than their first choice, resulting in a total of 179 (81%) of residents obtaining categorical positions. Mean United States Medical Licensing Examination step 1 and step 2 scores for those who obtained secondary success were 227 and 234 vs. 214 and 219, respectively, for those who failed to secure a categorical position (p < 0.01). United States Medical Licensing Examination step 2 score was a significant predictor of primary (p < 0.03) and secondary success (p < 0.02). Of 65 PGY-2 NDPS residents, 32 (49%) achieved primary success, and 11 (17%) others achieved secondary success for a total of 43 (66%). For PGY-2 NDPS, American Board of Surgery In-Training Examination was the only significant predictor of primary and secondary success (p < 0.02 and p < 0.05). NDPS training provides a viable and successful opportunity for at least 81% of young physicians to pursue their career goals even after an unsuccessful first match. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Effect of January vacations and prior night call status on resident ABSITE performance.

PubMed

Sugar, Jane G; Chu, Quyen D; Cole, Philip A; Li, Benjamin D L; Kim, Roger H

2013-01-01

To determine if vacations in January or on-call status have an effect on American Board of Surgery In-Training Examination (ABSITE) scores. Retrospective review of the performance of general surgery residents on ABSITE. Data collected included ABSITE scores, United States Medical Licensing Examination Step 2 scores, January vacation schedules, and call schedules. ABSITE performance was examined for correlation with vacation or call schedules. Student t test was used for statistical analysis, with a p value of less than 0.05 considered significant. General surgery residency program at the Louisiana State University Health Sciences Center-Shreveport, a university hospital-based program with 5 categorical residents per year. Postgraduate year (PGY) 1 through 5 general surgery categorical residents from 2006 to 2012. A total of 170 ABSITE scores from 55 residents were reviewed. The mean score when vacation was taken was 48.6 as compared with 36.3 when no vacation was taken (p = 0.02). Residents who took a January vacation at least once in their residency had a mean score of 42.8 as compared with 37.7 of those who did not (p = 0.43). The mean United States Medical Licensing Examination Step 2 score of residents who took a January vacation at least once in their residency was 218 as compared with 217 for their peers (p = 0.78). Among residents who took January vacations, the mean score in the years they took vacation was 49.4 as compared with 35.4 in the years they did not (p = 0.02). Prior night call status had no effect on the examination scores (44.2 vs 38.6, p = 0.30). Mean ABSITE scores were higher for residents who took a January vacation before the examination, despite no apparent difference in baseline test-taking ability. Among residents who took January vacations, mean scores were higher in the years they took vacation than in other years. On-call status did not have an effect on ABSITE performance. Vacation schedules in January can have a significant effect on ABSITE scores. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

76 FR 20052 - Notice of Issuance of Regulatory Guide

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-11

... Guide 1.149, ``Nuclear Power Plant Simulation Facilities for Use in Operator Training, License..., ``Nuclear Power Plant Simulation Facilities for Use in Operator Training, License Examinations, and... simulation facility for use in operator and senior operator training, license examination operating tests...

Obtaining Your License: Careers in Real Estate.

ERIC Educational Resources Information Center

Lyon, Robert

Two steps are required to obtain a real estate salesperson's license in Texas: (1) selecting a broker to serve as an advisor, and (2) meeting personal requirements (at least 18 years old, a Texas resident, completion of a minimum of 12 semester hours of real estate and related courses, application, acceptable score on state exam, and payment of…

78 FR 62322 - Hydropower Regulatory Efficiency Act of 2013; Notice of Rescheduled Two-Year Licensing Process...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-16

... at non-powered dams and closed-loop pumped storage projects in compliance with section 6 of the... process for licensing hydropower development at non-powered dams and closed-loop pumped storage projects...-powered dam versus closed- loop pumped storage) affect the steps included in a two-year process? 3.9...

Detection of License Plate using Sliding Window, Histogram of Oriented Gradient, and Support Vector Machines Method

NASA Astrophysics Data System (ADS)

Astawa, INGA; Gusti Ngurah Bagus Caturbawa, I.; Made Sajayasa, I.; Dwi Suta Atmaja, I. Made Ari

2018-01-01

The license plate recognition usually used as part of system such as parking system. License plate detection considered as the most important step in the license plate recognition system. We propose methods that can be used to detect the vehicle plate on mobile phone. In this paper, we used Sliding Window, Histogram of Oriented Gradient (HOG), and Support Vector Machines (SVM) method to license plate detection so it will increase the detection level even though the image is not in a good quality. The image proceed by Sliding Window method in order to find plate position. Feature extraction in every window movement had been done by HOG and SVM method. Good result had shown in this research, which is 96% of accuracy.

Correlation of USMLE Step 1 scores with performance on dermatology in-training examinations.

PubMed

Fening, Katherine; Vander Horst, Anthony; Zirwas, Matthew

2011-01-01

Although United States Medical Licensing Examination (USMLE) Step 1 was not designed to predict resident performance, scores are used to compare residency applicants. Multiple studies have displayed a significant correlation among Step 1 scores, in-training examination (ITE) scores, and board passage, although no such studies have been performed in dermatology. The purpose of this study is to determine if this correlation exists in dermatology, and how much of the variability in ITE scores is a result of differences in Step 1 scores. This study also seeks to determine if it is appropriate to individualize expectations for resident ITE performance. This project received institutional review board exemption. From 5 dermatology residency programs (86 residents), we collected Step 1 and ITE scores for each of the 3 years of dermatology residency, and recorded passage/failure on boards. Bivariate Pearson correlation analysis was used to assess correlation between USMLE and ITE scores. Ordinary least squares regression was computed to determine how much USMLE scores contribute to ITE variability. USMLE and ITE score correlations were highly significant (P < .001). Correlation coefficients with USMLE were: 0.467, 0.541, and 0.527 for ITE in years 1, 2, and 3, respectively. Variability in ITE scores caused by differences in USMLE scores were: ITE first-year residency = 21.8%, ITE second-year residency = 29.3%, and ITE third-year residency = 27.8%. This study had a relatively small sample size, with data from only 5 programs. There is a moderate correlation between USMLE and ITE scores, with USMLE scores explaining ∼26% of the variability in ITE scores. Copyright © 2009 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Student failures on first-year medical basic science courses and the USMLE step 1: a retrospective study over a 20-year period.

PubMed

Burns, E Robert; Garrett, Judy

2015-01-01

Correlates of achievement in the basic science years in medical school and on the Step 1 of the United States Medical Licensing Examination® (USMLE®), (Step 1) in relation to preadmission variables have been the subject of considerable study. Preadmissions variables such as the undergraduate grade point average (uGPA) and Medical College Admission Test® (MCAT®) scores, solely or in combination, have previously been found to be predictors of achievement in the basic science years and/or on the Step 1. The purposes of this retrospective study were to: (1) determine if our statistical analysis confirmed previously published relationships between preadmission variables (MCAT, uGPA, and applicant pool size), and (2) study correlates of the number of failures in five M1 courses with those preadmission variables and failures on Step 1. Statistical analysis confirmed previously published relationships between all preadmission variables. Only one course, Microscopic Anatomy, demonstrated significant correlations with all variables studied including the Step 1 failures. Physiology correlated with three of the four variables studied, but not with the Step 1 failures. Analyses such as these provide a tool by which administrators will be able to identify what courses are or are not responding in appropriate ways to changes in the preadmissions variables that signal student performance on the Step 1. © 2014 American Association of Anatomists.

A Cross-sectional Analysis of Minimum USMLE Step 1 and 2 Criteria Used by Orthopaedic Surgery Residency Programs in Screening Residency Applications.

PubMed

Schrock, John B; Kraeutler, Matthew J; Dayton, Michael R; McCarty, Eric C

2017-06-01

The purpose of this study was to analyze how program directors (PDs) of orthopaedic surgery residency programs use United States Medical Licensing Examination (USMLE) Step 1 and 2 scores in screening residency applicants. A survey was sent to each allopathic orthopaedic surgery residency PD. PDs were asked if they currently use minimum Step 1 and/or 2 scores in screening residency applicants and if these criteria have changed in recent years. Responses were received from 113 of 151 PDs (75%). One program did not have the requested information and five declined participation, leaving 107 responses analyzed. Eighty-nine programs used a minimum USMLE Step 1 score (83%). Eighty-three programs (78%) required a Step 1 score ≥210, 80 (75%) required a score ≥220, 57 (53%) required a score ≥230, and 22 (21%) required a score ≥240. Multiple PDs mentioned the high volume of applications as a reason for using a minimum score and for increasing the minimum score in recent years. A large proportion of orthopaedic surgery residency PDs use a USMLE Step 1 minimum score when screening applications in an effort to reduce the number of applications to be reviewed.

47 CFR 0.484 - Amateur radio operator examinations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Amateur radio operator examinations. 0.484....484 Amateur radio operator examinations. Generally, examinations for amateur radio operation licenses... FCC conducts examinations for amateur radio operator licenses, they shall take place at locations and...

AP1000{sup R} licensing and deployment in the United States

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

Jordan, R. P.; Russ, P. A.; Filiak, P. P.

2012-07-01

In recent years, both domestic and foreign utilities have turned to the standardized Westinghouse AP1000 plant design in satisfying their near - and long-term - sustainable energy needs. As direct support to these actions, licensing the AP1000 design has played a significant role by providing one of the fundamental bases in clearing regulatory hurdles leading to the start of new plant construction. Within the U.S. alone, Westinghouse AP1000 licensing activities have reached unprecedented milestones with the approvals of both AP1000 Design Certification and Southern Company's combined construction permit and operating license (COL) application directly supporting the construction of two newmore » nuclear plants in Georgia. Further COL application approvals are immediately pending for an additional two AP1000 plants in South Carolina. And, across the U.S. nuclear industry spectrum, there are 10 other COL applications under regulatory review representing some 16 new plants at 10 sites. In total, these actions represent the first wave of new plant licensing under the regulatory approval process since 1978. Fundamental to the Nuclear Regulatory Commission's AP1000 Design Certification is the formal recognition of the AP1000 passive safety design through regulatory acceptance rulemaking. Through recognition and deployment of the AP1000 Design Certification, the utility licensee / operator of this reactor design are now offered an opportunity to use a simplified 'one-step' combined license process, thereby managing substantial back-end construction schedule risk from regulatory and intervention delays. Application of this regulatory philosophy represents both acceptance and encouragement of standardized reactor designs like the AP1000. With the recent AP1000 Design Certification and utility COL acceptances, the fundamental licensing processes of this philosophy have successfully proven the attainment of significant milestones with the next stage licensing actions directed towards deployment. AP1000 Design Certification and COL deployment, and management of the plant construction in accordance with the conditions within these approvals, remain as significant site and corporate responsibilities. These licensing-construction integrated activities must now focus on identifying and resolving 'as-built' departures from the standardized design as assessed against the certified AP1000 technical and licensing basis. Within this paper, significant aspects of the AP1000 U.S. licensing will be discussed, including identifying systems and processes used in ensuring compliance while deploying the standardized design. Critical licensing steps, licensing deployment actions as plant construction progresses and defining the road forward to a successful completion of licensing actions will be addressed. (authors)« less

The predictive validity of the MCAT exam in relation to academic performance through medical school: a national cohort study of 2001-2004 matriculants.

PubMed

Dunleavy, Dana M; Kroopnick, Marc H; Dowd, Keith W; Searcy, Cynthia A; Zhao, Xiaohui

2013-05-01

Most research examining the predictive validity of the Medical College Admission Test (MCAT) has focused on the relationship between MCAT scores and scores on the United States Medical Licensing Examination Step exams. This study examined whether MCAT scores predict students' unimpeded progress toward graduation (UP), which the authors defined as not withdrawing or being dismissed for academic reasons, graduating within five years of matriculation, and passing the Step 1, Step 2 Clinical Knowledge, and Step 2 Clinical Skills exams on the first attempt. Students who matriculated during 2001-2004 at 119 U.S. medical schools were included in the analyses. Logistic regression analyses were used to estimate the relationships between UP and MCAT total scores alone, undergraduate grade point averages (UGPAs) alone, and UGPAs and MCAT total scores together. All analyses were conducted at the school level and were considered together to evaluate relationships across schools. The majority of matriculants experienced UP. Together, UGPAs and MCAT total scores predicted UP well. MCAT total scores alone were a better predictor than UGPAs alone. Relationships were similar across schools; however, there was more variability across schools in the relationship between UP and UGPAs than between UP and MCAT total scores. The combination of UGPAs and MCAT total scores performs well as a predictor of UP. Both UGPAs and MCAT total scores are strong predictors of academic performance in medical school through graduation, not just the first two years. Further, these relationships generalize across medical schools.

Orthopedic surgery postgraduate year 1 intern curriculum improves initial orthopedic in-training examination performance.

PubMed

Roberts, Craig S; Nyland, John; Broome, Brandon

2012-04-01

To determine the efficacy of an educational curriculum designed for orthopedic surgery postgraduate year 1 (PGY-1) interns to improve initial Orthopedic In-Training Examination (OITE) performance. A retrospective cohort study was performed that evaluated the PGY-1 intern OITE performance of one residency training program (n = 55) during 7-year periods before (1996-2002) and after structured curriculum implementation (2003-2009). Linear regression analysis revealed insignificant changes in median PGY-1 intern OITE percentile rank during the precurriculum period (R = 0.08, P = 0.53). Postcurriculum period comparisons revealed significantly improving PGY-1 intern OITE percentile rank (R = 0.46, P = 0.048). Pre- and postcurriculum median US Medical Licensing Examination (USMLE) Step I scores did not display statistically significant differences (218.2 ± 6.6 vs 229.1 ± 13.8, Mann-Whitney U test, z = -1.5, P = 0.10). Spearman rho correlations revealed a moderate relation (r = 0.61) between postcurriculum PGY-1 intern OITE percentile rank and USMLE Step I score, but not during the precurriculum period. A moderate relation (r = 0.50) also was observed between postcurriculum USMLE Step I score and average OITE percentile rank during the 5-year residency program, but not during the precurriculum period. PGY-1 intern OITE percentile rank improved significantly with the addition of a specially designed educational curriculum. The stronger USMLE Step I score and PGY-1 intern OITE percentile rank relation observed during the postcurriculum period suggests that interns who participated in the educational curriculum were better prepared to translate general medical and patient care knowledge into orthopedic surgery knowledge.

Stability, chromatin association and functional activity of mammalian pre-replication complex proteins during the cell cycle

PubMed Central

Okuno, Yukiko; McNairn, Adrian J.; den Elzen, Nicole; Pines, Jonathon; Gilbert, David M.

2001-01-01

We have examined the behavior of pre-replication complex (pre-RC) proteins in relation to key cell cycle transitions in Chinese Hamster Ovary (CHO) cells. ORC1, ORC4 and Cdc6 were stable (T1/2 >2 h) and associated with a chromatin-containing fraction throughout the cell cycle. Green fluorescent protein-tagged ORC1 associated with chromatin throughout mitosis in living cells and co-localized with ORC4 in metaphase spreads. Association of Mcm proteins with chromatin took place during telophase, ∼30 min after the destruction of geminin and cyclins A and B, and was coincident with the licensing of chromatin to replicate in geminin-supplemented Xenopus egg extracts. Neither Mcm recruitment nor licensing required protein synthesis throughout mitosis. Moreover, licensing could be uncoupled from origin specification in geminin-supplemented extracts; site-specific initiation within the dihydrofolate reductase locus required nuclei from cells that had passed through the origin decision point (ODP). These results demonstrate that mammalian pre-RC assembly takes place during telophase, mediated by post-translational modifications of pre-existing proteins, and is not sufficient to select specific origin sites. A subsequent, as yet undefined, step selects which pre-RCs will function as replication origins. PMID:11483529

Driver License Examiner Supervisors; Basic Training Program. Trainee Study Guide.

ERIC Educational Resources Information Center

Pendleton, John T.; Patton, C. Duane

This is the third part of a four-part systematized training program intended for driver license examiner supervisors. The purpose of this study guide is to act as a program compendium to aid the trainee in successfully completing the program. The lesson material presented, apart from the introduction, is: orientation to license examiner…

Science communication: a career where PhDs can make a difference.

PubMed

Irion, Robert

2015-02-15

Among careers for biologists with PhDs, science communication is one of the most diverse and rewarding pathways. Myriad options exist, from traditional journalism to new media, from writing for specialists to working in public outreach. Textbooks, mass-market books, and freelance writing that combines many of these pursuits are all viable choices. Communicating about science allows researchers to step away from the minutiae of a subdiscipline and to once again explore the breadth of science more fully through an ever-evolving array of stories. A doctoral degree can confer distinct advantages in the eyes of prospective editors and employers. Here I describe those advantages, possible career directions, and steps toward making such a transition. © 2015 Irion. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Numerical Versus Pass/Fail Scoring on the USMLE: What Do Medical Students and Residents Want and Why?

PubMed

Lewis, Catherine E; Hiatt, Jonathan R; Wilkerson, Luann; Tillou, Areti; Parker, Neil H; Hines, O Joe

2011-03-01

Although the primary purpose of the US Medical Licensing Examination (USMLE) is assessment for licensure, USMLE scores often are used for other purposes, more prominently resident selection. The Committee to Evaluate the USMLE Program currently is considering a number of substantial changes, including conversion to pass/fail scoring. A survey was administered to third-year (MS3) and fourth-year (MS4) medical students and residents at a single institution to evaluate opinions regarding pass/fail scoring on the USMLE. Response rate was 59% (n  =  732 of 1249). Reported score distribution for Step 1 was 30% for <220, 38% for 220-240, and 32% for >240, with no difference between MS3s, MS4s, and residents (P  =  .89). Score distribution for Step 2 Clinical Knowledge (CK) was similar. Only 26% of respondents agreed that Step 1 should be pass/fail; 38% agreed with pass/fail scoring for Step 2 CK. Numerical scoring on Step 1 was preferred by respondents who: (1) agreed that the examination gave an accurate estimate of knowledge (odds ratio [OR], 4.23; confidence interval [CI], 2.41-7.43; P < .001); (2) scored >240 (OR, 4.0; CI, 1.92-8.33; P < .001); and (3) felt that acquisition of knowledge might decrease if the examination were pass/fail (OR, 10.15; CI, 3.32-31.02; P < .001). For Step 2 CK, numerical scoring was preferred by respondents who: (1) believed they gained a large amount of knowledge preparing for the examination (OR, 2.63; CI, 1.52-4.76; P < .001); (2) scored >240 (OR, 4.76; CI, 2.86-8.33; P < .001); (3) felt that the amount of knowledge acquired might decrease if it were pass/fail (OR, 28.16; CI, 7.31-108.43; P < .001); and (4) believed their Step 2 CK score was important when applying for residency (OR, 2.37; CI, 1.47-3.84; P < .001). Students and residents prefer the ongoing use of numerical scoring because they believe that scores are important in residency selection, that residency applicants are advantaged by examination scores, and that scores provide an important impetus to review and solidify medical knowledge.

Numerical Versus Pass/Fail Scoring on the USMLE: What Do Medical Students and Residents Want and Why?

PubMed Central

Lewis, Catherine E; Hiatt, Jonathan R; Wilkerson, LuAnn; Tillou, Areti; Parker, Neil H; Hines, O. Joe

2011-01-01

Background Although the primary purpose of the US Medical Licensing Examination (USMLE) is assessment for licensure, USMLE scores often are used for other purposes, more prominently resident selection. The Committee to Evaluate the USMLE Program currently is considering a number of substantial changes, including conversion to pass/fail scoring. Methods A survey was administered to third-year (MS3) and fourth-year (MS4) medical students and residents at a single institution to evaluate opinions regarding pass/fail scoring on the USMLE. Results Response rate was 59% (n  =  732 of 1249). Reported score distribution for Step 1 was 30% for <220, 38% for 220–240, and 32% for >240, with no difference between MS3s, MS4s, and residents (P  =  .89). Score distribution for Step 2 Clinical Knowledge (CK) was similar. Only 26% of respondents agreed that Step 1 should be pass/fail; 38% agreed with pass/fail scoring for Step 2 CK. Numerical scoring on Step 1 was preferred by respondents who: (1) agreed that the examination gave an accurate estimate of knowledge (odds ratio [OR], 4.23; confidence interval [CI], 2.41–7.43; P < .001); (2) scored >240 (OR, 4.0; CI, 1.92–8.33; P < .001); and (3) felt that acquisition of knowledge might decrease if the examination were pass/fail (OR, 10.15; CI, 3.32–31.02; P < .001). For Step 2 CK, numerical scoring was preferred by respondents who: (1) believed they gained a large amount of knowledge preparing for the examination (OR, 2.63; CI, 1.52–4.76; P < .001); (2) scored >240 (OR, 4.76; CI, 2.86–8.33; P < .001); (3) felt that the amount of knowledge acquired might decrease if it were pass/fail (OR, 28.16; CI, 7.31–108.43; P < .001); and (4) believed their Step 2 CK score was important when applying for residency (OR, 2.37; CI, 1.47–3.84; P < .001). Conclusions Students and residents prefer the ongoing use of numerical scoring because they believe that scores are important in residency selection, that residency applicants are advantaged by examination scores, and that scores provide an important impetus to review and solidify medical knowledge. PMID:22379524

Class-Wide Access to a Commercial Step 1 Question Bank During Preclinical Organ-Based Modules: A Pilot Project.

PubMed

Baños, James H; Pepin, Mark E; Van Wagoner, Nicholas

2018-03-01

The authors examined the usefulness of a commercially available Step 1 question bank as a formative academic support tool throughout organ-based modules in an integrated preclinical medical curriculum. The authors also determined the extent to which correlation between question bank utilization and academic metrics varied with Medical College Admission Test (MCAT) scores. In 2015, a cohort of 185 first-year medical students at University of Alabama School of Medicine were provided with 18-month full access to a commercially available Step 1 question bank of over 2,100 items throughout organ-based modules, although there were no requirements for use. Data on student use of the question bank were collected via an online administrative portal. Relationships between question bank utilization and academic outcomes including exams, module grades, and United States Medical Licensing Examination (USMLE) Step 1 were determined using multiple linear regression. MCAT scores and number of items attempted in the question bank significantly predicted all academic measures, with question bank utilization as the stronger predictor. The association between question bank utilization and academic outcome was stronger for individuals with lower MCAT scores. The findings elucidate a novel academic support mechanism that, for some programs, may help bridge the gap between holistic and mission-based admissions practices and a residency match process that places a premium on USMLE exam scores. Distributed formative use of USMLE Step 1 practice questions may be of value as an academic support tool that benefits all students, but particularly those entering with lower MCAT scores.

Performance on the Cardiovascular In-Training Examination in Relation to the ABIM Cardiovascular Disease Certification Examination.

PubMed

Indik, Julia H; Duhigg, Lauren M; McDonald, Furman S; Lipner, Rebecca S; Rubright, Jonathan D; Haist, Steven A; Botkin, Naomi F; Kuvin, Jeffrey T

2017-06-13

The American College of Cardiology In-Training Exam (ACC-ITE) is incorporated into most U.S. training programs, but its relationship to performance on the American Board of Internal Medicine Cardiovascular Disease (ABIM CVD) Certification Examination is unknown. ACC-ITE scores from third-year fellows from 2011 to 2014 (n = 1,918) were examined. Covariates for regression analyses included sex, age, medical school country, U.S. Medical Licensing Examination Step, and ABIM Internal Medicine Certification Examination scores. A secondary analysis examined fellows (n = 511) who took the ACC-ITE in the first and third years. ACC-ITE scores were the strongest predictor of ABIM CVD scores (p < 0.0001), and the most significant predictor of passing (p < 0.0001). The change in ACC-ITE scores from first to third year was a strong predictor of the ABIM CVD score (p < 0.001). The ACC-ITE is strongly associated with performance on the ABIM CVD Certification Examination. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

77 FR 64947 - Amateur Service Rules

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-24

... correspondingly; and to reduce to two the number of volunteer examiners needed to administer an amateur license... amateur license may be renewed, to reduce the number of volunteer examiners needed to administer an... rules to revise Sec. 97.505 to require that volunteer examiners (VEs) give examination credit to an...

10 CFR 55.21 - Medical examination.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 2 2012-01-01 2012-01-01 false Medical examination. 55.21 Section 55.21 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES Medical Requirements § 55.21 Medical examination. An applicant for a license shall have a medical examination by a physician. A licensee shall have a medical...

10 CFR 55.21 - Medical examination.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 2 2013-01-01 2013-01-01 false Medical examination. 55.21 Section 55.21 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES Medical Requirements § 55.21 Medical examination. An applicant for a license shall have a medical examination by a physician. A licensee shall have a medical...

10 CFR 55.21 - Medical examination.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Medical examination. 55.21 Section 55.21 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES Medical Requirements § 55.21 Medical examination. An applicant for a license shall have a medical examination by a physician. A licensee shall have a medical...

10 CFR 55.21 - Medical examination.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Medical examination. 55.21 Section 55.21 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES Medical Requirements § 55.21 Medical examination. An applicant for a license shall have a medical examination by a physician. A licensee shall have a medical...

10 CFR 55.21 - Medical examination.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Medical examination. 55.21 Section 55.21 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES Medical Requirements § 55.21 Medical examination. An applicant for a license shall have a medical examination by a physician. A licensee shall have a medical...

How Institutionalized Are Model License Use Terms? An Analysis of E-Journal License Use Rights Clauses from 2000 to 2009

ERIC Educational Resources Information Center

Eschenfelder, Kristin R.; Tsai, Tien-I; Zhu, Xiaohua; Stewart, Brenton

2013-01-01

This paper explored the degree to which use terms proposed by model licenses have become institutionalized across different publishers' licenses. It examined model license use terms in four areas: downloading, scholarly sharing, interlibrary loan, and electronic reserves. Data collection and analysis involved content analysis of 224 electronic…

Negotiating Terms and Conditions: An Overview of the Federal Energy Regulatory Commission Hydropower Settlement Agreement Process

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

Levine, Aaron L; Curtis, Taylor L; Shields, Laura

The process for obtaining, transferring, or surrendering a Federal Energy Regulatory Commission (FERC) hydropower license or exemption from licensing can be a series of complex negotiations. In many instances, the process may include stakeholders with different and/or competing perspectives or objectives related to the original license, new license (i.e., relicense), transfer of a license, or surrender of a license. Divergent perspectives and objectives can lead to disputes among project participants, which may impact the development of FERC license terms and conditions. One mechanism to resolve disputes between project participants involving a FERC authorization is informal and formal settlement agreement conferences,more » which often result in settlement agreements addressing the disputed issues. This report provides hydropower stakeholders with a better understanding of the FERC settlement agreement process, including information on: How to initiate a settlement agreement. The procedural steps associated with the settlement agreement process. The legal standards the Commission must adhere to when determining whether settlement agreement provisions can become lawful and enforceable terms or conditions of a FERC authorization. Examples of settlement agreement provisions included as license terms and conditions or in off-license agreements from a collection of settlement agreements and Commission orders.« less

Export Controls: License Screening and Compliance Procedures Need Strengthening.

DTIC Science & Technology

1994-06-01

agreements between Commerce and Customs . While this represents a significant step towards a cooperative relationship , we have not verified that real...license applications, (2) how well these agencies cooperate with each other and the U.S. Customs Service, (3) whether State is monitoring reexports...other than a foreign government). Customs serves as State’s enforcement arm for AECA. In contrast, EAA has no registration or U.S. person

78 FR 5840 - Notice of License Termination for University of Illinois Advanced TRIGA Reactor, License No. R-115

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-28

... University of Illinois Advanced TRIGA Reactor, License No. R-115 The U.S. Nuclear Regulatory Commission (NRC) is noticing the termination of Facility Operating License No. R-115, for the University of Illinois... Operating License No. R-115 is terminated. The above referenced documents may be examined, and/or copied for...

7 CFR 61.30 - Examination of sampler.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Examination of sampler. 61.30 Section 61.30... Cottonseed Samplers § 61.30 Examination of sampler. Each applicant for a license as a sampler and each... examination or test to show his ability properly to perform the duties for which he is applying for a license...

27 CFR 478.23 - Right of entry and examination.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., FIREARMS, AND EXPLOSIVES, DEPARTMENT OF JUSTICE FIREARMS AND AMMUNITION COMMERCE IN FIREARMS AND AMMUNITION... ammunition kept or stored by any licensed manufacturer, licensed importer, or licensed dealer at such premises or any firearms curios or relics or ammunition kept or stored by any licensed collector at such...

27 CFR 478.23 - Right of entry and examination.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., FIREARMS, AND EXPLOSIVES, DEPARTMENT OF JUSTICE FIREARMS AND AMMUNITION COMMERCE IN FIREARMS AND AMMUNITION... ammunition kept or stored by any licensed manufacturer, licensed importer, or licensed dealer at such premises or any firearms curios or relics or ammunition kept or stored by any licensed collector at such...

27 CFR 478.23 - Right of entry and examination.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., FIREARMS, AND EXPLOSIVES, DEPARTMENT OF JUSTICE FIREARMS AND AMMUNITION COMMERCE IN FIREARMS AND AMMUNITION... ammunition kept or stored by any licensed manufacturer, licensed importer, or licensed dealer at such premises or any firearms curios or relics or ammunition kept or stored by any licensed collector at such...

27 CFR 478.23 - Right of entry and examination.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., FIREARMS, AND EXPLOSIVES, DEPARTMENT OF JUSTICE FIREARMS AND AMMUNITION COMMERCE IN FIREARMS AND AMMUNITION... ammunition kept or stored by any licensed manufacturer, licensed importer, or licensed dealer at such premises or any firearms curios or relics or ammunition kept or stored by any licensed collector at such...

27 CFR 478.23 - Right of entry and examination.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., FIREARMS, AND EXPLOSIVES, DEPARTMENT OF JUSTICE FIREARMS AND AMMUNITION COMMERCE IN FIREARMS AND AMMUNITION... ammunition kept or stored by any licensed manufacturer, licensed importer, or licensed dealer at such premises or any firearms curios or relics or ammunition kept or stored by any licensed collector at such...

The relationship between performance on the Infectious Diseases In-Training and Certification Examinations.

PubMed

Grabovsky, Irina; Hess, Brian J; Haist, Steven A; Lipner, Rebecca S; Hawley, Janine L; Woodward, Stephanie; Engleberg, N Cary

2015-03-01

The Infectious Diseases Society of America In-Training Examination (IDSA ITE) is a feedback tool used to help fellows track their knowledge acquisition during fellowship training. We determined whether the scores on the IDSA ITE and from other major medical knowledge assessments predict performance on the American Board of Internal Medicine (ABIM) Infectious Disease Certification Examination. The sample was 1021 second-year fellows who took the IDSA ITE and ABIM Infectious Disease Certification Examination from 2008 to 2012. Multiple regression analysis was used to determine if ABIM Infectious Disease Certification Examination scores were predicted by IDSA ITE scores, prior United States Medical Licensing Examination (USMLE) scores, ABIM Internal Medicine Certification Examination scores, fellowship director ratings of medical knowledge, and demographic variables. Logistic regression was used to evaluate if these same assessments predicted a passing outcome on the certification examination. IDSA ITE scores were the strongest predictor of ABIM Infectious Disease Certification Examination scores (β = .319), followed by prior ABIM Internal Medicine Certification Examination scores (β = .258), USMLE Step 1 scores (β = .202), USMLE Step 3 scores (β = .130), and fellowship directors' medical knowledge ratings (β = .063). IDSA ITE scores were also a significant predictor of passing the Infectious Disease Certification Examination (odds ratio, 1.017 [95% confidence interval, 1.013-1.021]). The significant relationship between the IDSA ITE score and performance on the ABIM Infectious Disease Certification Examination supports the use of the ITE as a valid feedback tool in fellowship training. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

A Primer for Developing Measures of Science Content Knowledge for Small-Scale Research and Instructional Use.

PubMed

Bass, Kristin M; Drits-Esser, Dina; Stark, Louisa A

2016-01-01

The credibility of conclusions made about the effectiveness of educational interventions depends greatly on the quality of the assessments used to measure learning gains. This essay, intended for faculty involved in small-scale projects, courses, or educational research, provides a step-by-step guide to the process of developing, scoring, and validating high-quality content knowledge assessments. We illustrate our discussion with examples from our assessments of high school students' understanding of concepts in cell biology and epigenetics. Throughout, we emphasize the iterative nature of the development process, the importance of creating instruments aligned to the learning goals of an intervention or curricula, and the importance of collaborating with other content and measurement specialists along the way. © 2016 K. M. Bass et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Psychometric properties and podiatric medical student perceptions of USMLE-style items in a general anatomy course.

PubMed

D'Antoni, Anthony V; DiLandro, Anthony C; Chusid, Eileen D; Trepal, Michael J

2012-01-01

In 2010, the New York College of Podiatric Medicine general anatomy course was redesigned to emphasize clinical anatomy. Over a 2-year period, United States Medical Licensing Examination (USMLE)-style items were used in lecture assessments with two cohorts of students (N =200). Items were single-best-answer and extended-matching formats. Psychometric properties of items and assessments were evaluated, and anonymous student post-course surveys were administered. Mean grades for each assessment were recorded over time and compared between cohorts using analysis of variance. Correlational analyses were used to investigate the relationship between final course grades and lecture examinations. Post-course survey response rates for the cohorts were 71 of 97 (73%) and 81 of 103 (79%). The USMLE-style items had strong psychometric properties. Point biserial correlations were 0.20 and greater, and the range of students answering the items correctly was 25% to 75%. Examinations were highly reliable, with Kuder-Richardson 20 coefficients of 0.71 to 0.76. Students (>80%) reported that single-best-answer items were easier than extended-matching items. Students (>76%) believed that the items on the quizzes/examinations were similar to those found on USMLE Step 1. Most students (>84%) believed that they would do well on the anatomy section of their boards (American Podiatric Medical Licensing Examination [APMLE] Part I). Students valued USMLE-style items. These data, coupled with the psychometric data, suggest that USMLE-style items can be successfully incorporated into a basic science course in podiatric medical education. Outcomes from students who recently took the APMLE Part I suggest that incorporation of USMLE-style items into the general anatomy course was a successful measure and prepared them well.

The ASEAN economic community and medical qualification

PubMed Central

Kittrakulrat, Jathurong; Jongjatuporn, Witthawin; Jurjai, Ravipol; Jarupanich, Nicha; Pongpirul, Krit

2014-01-01

Background In the regional movement toward ASEAN Economic Community (AEC), medical professions including physicians can be qualified to practice medicine in another country. Ensuring comparable, excellent medical qualification systems is crucial but the availability and analysis of relevant information has been lacking. Objective This study had the following aims: 1) to comparatively analyze information on Medical Licensing Examinations (MLE) across ASEAN countries and 2) to assess stakeholders’ view on potential consequences of AEC on the medical profession from a Thai perspective. Design To search for relevant information on MLE, we started with each country's national body as the primary data source. In case of lack of available data, secondary data sources including official websites of medical universities, colleagues in international and national medical student organizations, and some other appropriate Internet sources were used. Feasibility and concerns about validity and reliability of these sources were discussed among investigators. Experts in the region invited through HealthSpace.Asia conducted the final data validation. For the second objective, in-depth interviews were conducted with 13 Thai stakeholders, purposely selected based on a maximum variation sampling technique to represent the points of view of the medical licensing authority, the medical profession, ethicists and economists. Results MLE systems exist in all ASEAN countries except Brunei, but vary greatly. Although the majority has a national MLE system, Singapore, Indonesia, and Vietnam accept results of MLE conducted at universities. Thailand adopted the USA's 3-step approach that aims to check pre-clinical knowledge, clinical knowledge, and clinical skills. Most countries, however, require only one step. A multiple choice question (MCQ) is the most commonly used method of assessment; a modified essay question (MEQ) is the next most common. Although both tests assess candidate's knowledge, the Objective Structured Clinical Examination (OSCE) is used to verify clinical skills of the examinee. The validity of the medical license and that it reflects a consistent and high standard of medical knowledge is a sensitive issue because of potentially unfair movement of physicians and an embedded sense of domination, at least from a Thai perspective. Conclusions MLE systems differ across ASEAN countries in some important aspects that might be of concern from a fairness viewpoint and therefore should be addressed in the movement toward AEC. PMID:25215908

Study Behaviors and USMLE Step 1 Performance: Implications of a Student Self-Directed Parallel Curriculum.

PubMed

Burk-Rafel, Jesse; Santen, Sally A; Purkiss, Joel

2017-11-01

To determine medical students' study behaviors when preparing for the United States Medical Licensing Examination (USMLE) Step 1, and how these behaviors are associated with Step 1 scores when controlling for likely covariates. The authors distributed a study-behaviors survey in 2014 and 2015 at their institution to two cohorts of medical students who had recently taken Step 1. Demographic and academic data were linked to responses. Descriptive statistics, bivariate correlations, and multiple linear regression analyses were performed. Of 332 medical students, 274 (82.5%) participated. Most students (n = 211; 77.0%) began studying for Step 1 during their preclinical curriculum, increasing their intensity during a protected study period during which they averaged 11.0 hours studying per day (standard deviation [SD] 2.1) over a period of 35.3 days (SD 6.2). Students used numerous third-party resources, including reading an exam-specific 700-page review book on average 2.1 times (SD 0.8) and completing an average of 3,597 practice multiple-choice questions (SD 1,611). Initiating study prior to the designated study period, increased review book usage, and attempting more practice questions were all associated with higher Step 1 scores, even when controlling for Medical College Admission Test scores, preclinical exam performance, and self-identified score goal (adjusted R = 0.56, P < .001). Medical students at one public institution engaged in a self-directed, "parallel" Step 1 curriculum using third-party study resources. Several study behaviors were associated with improved USMLE Step 1 performance, informing both institutional- and student-directed preparation for this high-stakes exam.

Step training improves reaction time, gait and balance and reduces falls in older people: a systematic review and meta-analysis.

PubMed

Okubo, Yoshiro; Schoene, Daniel; Lord, Stephen R

2017-04-01

To examine the effects of stepping interventions on fall risk factors and fall incidence in older people. Electronic databases (PubMed, EMBASE, CINAHL, Cochrane, CENTRAL) and reference lists of included articles from inception to March 2015. Randomised (RCT) or clinical controlled trials (CCT) of volitional and reactive stepping interventions that included older (minimum age 60) people providing data on falls or fall risk factors. Meta-analyses of seven RCTs (n=660) showed that the stepping interventions significantly reduced the rate of falls (rate ratio=0.48, 95% CI 0.36 to 0.65, p<0.0001, I 2 =0%) and the proportion of fallers (risk ratio=0.51, 95% CI 0.38 to 0.68, p<0.0001, I 2 =0%). Subgroup analyses stratified by reactive and volitional stepping interventions revealed a similar efficacy for rate of falls and proportion of fallers. A meta-analysis of two RCTs (n=62) showed that stepping interventions significantly reduced laboratory-induced falls, and meta-analysis findings of up to five RCTs and CCTs (n=36-416) revealed that stepping interventions significantly improved simple and choice stepping reaction time, single leg stance, timed up and go performance (p<0.05), but not measures of strength. The findings indicate that both reactive and volitional stepping interventions reduce falls among older adults by approximately 50%. This clinically significant reduction may be due to improvements in reaction time, gait, balance and balance recovery but not in strength. Further high-quality studies aimed at maximising the effectiveness and feasibility of stepping interventions are required. CRD42015017357. 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/.

Property and Propriety in the Digital Environment: Towards an Examination Copy License.

ERIC Educational Resources Information Center

Kahin, Brian

1988-01-01

Discussion of copyright issues involving computer software focuses on faculty examination of software for evaluation purposes. Two model examination copy licenses are proposed: one a circulating evaluation copy, for libraries and other centers where individual evaluators are not involved in copying; and one a distributable evaluation copy. (five…

46 CFR 11.903 - Licenses requiring examinations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... OFFICER ENDORSEMENTS Subjects of Examinations and Practical Demonstrations of Competence § 11.903 Licenses... industry vessels; (22) Chief engineer steam/motor vessels; (23) First assistant engineer steam/motor vessels; (24) Second assistant engineer steam/motor vessels; (25) Third assistant engineer steam/motor...

Conference attendance does not correlate with emergency medicine residency in-training examination scores.

PubMed

Gene Hern, H; Wills, Charlotte; Alter, Harrison; Bowman, Steven H; Katz, Eric; Shayne, Philip; Vahidnia, Farnaz

2009-12-01

The residency review committee for emergency medicine (EM) requires residents to have greater than 70% attendance of educational conferences during residency training, but it is unknown whether attendance improves clinical competence or scores on the American Board of Emergency Medicine (ABEM) in-training examination (ITE). This study examined the relationship between conference attendance and ITE scores. The hypothesis was that greater attendance would correlate to a higher examination score. This was a multi-center retrospective cohort study using conference attendance data and examination results from residents in four large county EM residency training programs. Longitudinal multi-level models, adjusting for training site, U.S. Medical Licensing Examination (USMLE) Step 1 score, and sex were used to explore the relationship between conference attendance and in-training examination scores according to year of training. Each year of training was studied, as well as the overall effect of mean attendance as it related to examination score. Four training sites reported data on 405 residents during 2002 to 2008; 386 residents had sufficient data to analyze. In the multi-level longitudinal models, attendance at conference was not a significant predictor of in-training percentile score (coefficient = 0.005, 95% confidence interval [CI] = -0.053 to 0.063, p = 0.87). Score on the USMLE Step 1 examination was a strong predictor of ITE score (coefficient = 0.186, 95% CI = 0.155 to 0.217; p < 0.001), as was female sex (coefficient = 2.117, 95% CI = 0.987 to 3.25; p < 0.001). Greater conference attendance does not correlate with performance on an individual's ITE scores. Conference attendance may represent an important part of EM residency training but perhaps not of ITE performance. (c) 2009 by the Society for Academic Emergency Medicine.

An evaluation of outcomes following the replacement of traditional histology laboratories with self-study modules.

PubMed

Thompson, Andrew R; Lowrie, Donald J

2017-06-01

Changes in medical school curricula often require educators to develop teaching strategies that decrease contact hours while maintaining effective pedagogical methods. When faced with this challenge, faculty at the University of Cincinnati College of Medicine converted the majority of in-person histology laboratory sessions to self-study modules that utilize multiple audiovisual modalities and a virtual microscope platform. Outcomes related to this shift were investigated through performance on in-house examinations, results of the United States Medical Licensing Examination ® (USMLE ® ) Step 1 Examination, and student feedback. Medical School College Admissions Test ® (MCAT ® ) scores were used as a covariate when comparing in-house examinations. Results revealed no significant change in performance on in-house examinations when the content being assessed was controlled (F(2, 506) = 0.676, P = 0.51). A significant improvement in overall practical examination grade averages was associated with the self-study modules (F(6, 1164) = 10.213, P < 0.01), but gradual changes in examination content may explain this finding. The histology and cell biology portion of USMLE Step 1 Examination remained consistent throughout the time period that was investigated. Student feedback regarding the self-study modules was positive and suggested that features such as instructor narrated videos were an important component of the self-study modules because they helped recreate the experience of in-person laboratory sessions. Positive outcomes from the student perspective and no drop in examination performance suggests that utilizing self-study modules for histology laboratory content may be an option for educators faced with the challenge of reducing contact hours without eliminating content. Anat Sci Educ 10: 276-285. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

Claims Licensing Advancement for Interstate Matters Act

THOMAS, 112th Congress

Rep. Fincher, Stephen Lee [R-TN-8

2012-09-14

House - 10/01/2012 Referred to the Subcommittee on Insurance, Housing and Community Opportunity. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Differential Weighting for Subcomponent Measures of Integrated Clinical Encounter Scores Based on the USMLE Step 2 CS Examination: Effects on Composite Score Reliability and Pass-Fail Decisions.

PubMed

Park, Yoon Soo; Lineberry, Matthew; Hyderi, Abbas; Bordage, Georges; Xing, Kuan; Yudkowsky, Rachel

2016-11-01

Medical schools administer locally developed graduation competency examinations (GCEs) following the structure of the United States Medical Licensing Examination Step 2 Clinical Skills that combine standardized patient (SP)-based physical examination and the patient note (PN) to create integrated clinical encounter (ICE) scores. This study examines how different subcomponent scoring weights in a locally developed GCE affect composite score reliability and pass-fail decisions for ICE scores, contributing to internal structure and consequential validity evidence. Data from two M4 cohorts (2014: n = 177; 2015: n = 182) were used. The reliability of SP encounter (history taking and physical examination), PN, and communication and interpersonal skills scores were estimated with generalizability studies. Composite score reliability was estimated for varying weight combinations. Faculty were surveyed for preferred weights on the SP encounter and PN scores. Composite scores based on Kane's method were compared with weighted mean scores. Faculty suggested weighting PNs higher (60%-70%) than the SP encounter scores (30%-40%). Statistically, composite score reliability was maximized when PN scores were weighted at 40% to 50%. Composite score reliability of ICE scores increased by up to 0.20 points when SP-history taking (SP-Hx) scores were included; excluding SP-Hx only increased composite score reliability by 0.09 points. Classification accuracy for pass-fail decisions between composite and weighted mean scores was 0.77; misclassification was < 5%. Medical schools and certification agencies should consider implications of assigning weights with respect to composite score reliability and consequences on pass-fail decisions.

Obstetrics and gynecology clerkship for males and females: similar curriculum, different outcomes?

PubMed Central

Craig, LaTasha B.; Smith, Chad; Crow, Sheila M.; Driver, Whitney; Wallace, Michelle; Thompson, Britta M.

2013-01-01

Objective To determine if performance differences exist between male and female students on a 6-week obstetrics and gynecology (Ob/Gyn) clerkship and to evaluate potential variables that might underlie any observed variations. Study Design Final clerkship grades and component scores (clinical evaluations, objective structured clinical examination [OSCE], oral examination, and National Board of Medical Examiners [NBME] subject examination) from July 2007 to June 2010 were matched by student and analyzed by gender. Basic science grade point average (GPA) and initial United States Medical Licensing Exam (USMLE) Step 1 scores were used to establish students’ baseline medical knowledge. On a post-clerkship questionnaire, a subset of students reported the numbers of procedures they performed during the clerkship; students also completed online pre- and post-clerkship questionnaires reflecting their self-assessed confidence in women's health clinical skills. Results Scores were analyzed for 136 women and 220 men. Final clerkship grades were significantly higher for females than for males (89.05 vs. 87.34, p=0.0004, η 2=0.08). Specifically, females outscored males on the OSCE, oral, and NBME subject examination portions of the clerkship but not clinical evaluations. Males reported completing fewer breast examinations (p=0.001, η 2=0.14). Pre-clerkship, males were significantly less confident than females in women's health clinical skills (p<0.01) but reached similar levels upon completion of the clerkship. No gender differences were detected for basic science GPA and USMLE Step 1 scores. Conclusion Student gender is associated with final grades on an Ob/Gyn clerkship. Further research regarding these differences should be explored. PMID:24300748

A comparison of statistical criteria for setting optimally discriminating MCAT and GPA thresholds in medical school admissions.

PubMed

Albanese, Mark A; Farrell, Philip; Dottl, Susan L

2005-01-01

Using Medical College Admission Test-grade point average (MCAT-GPA) scores as a threshold has the potential to address issues raised in recent Supreme Court cases, but it introduces complicated methodological issues for medical school admissions. To assess various statistical indexes to determine optimally discriminating thresholds for MCAT-GPA scores. Entering classes from 1992 through 1998 (N = 752) are used to develop guidelines for cut scores that optimize discrimination between students who pass and do not pass the United States Medical Licensing Examination (USMLE) Step 1 on the first attempt. Risk differences, odds ratios, sensitivity, and specificity discriminated best for setting thresholds. Compensatory versus noncompensatory procedures both accounted for 54% of Step 1 failures, but demanded different performance requirements (noncompensatory MCAT-biological sciences = 8, physical sciences = 7, verbal reasoning = 7--sum of scores = 22; compensatory MCAT total = 24). Rational and defensible intellectual achievement thresholds that are likely to comply with recent Supreme Court decisions can be set from MCAT scores and GPAs.

Handgun Licensing and Registration Act of 2013

THOMAS, 113th Congress

Rep. Holt, Rush [D-NJ-12

2013-01-03

House - 01/25/2013 Referred to the Subcommittee on Crime, Terrorism, Homeland Security, And Investigations. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

18 CFR 158.10 - Examination of accounts.

Code of Federal Regulations, 2013 CFR

2013-04-01

... accountant, or independent licensed public accountant (licensed on or before December 31, 1970), certified or... matters by the independent accountant will facilitate their early resolution and that the independent accountant will seek advisory rulings by the Commission on such items. This examination shall be deemed...

18 CFR 158.10 - Examination of accounts.

Code of Federal Regulations, 2011 CFR

2011-04-01

... accountant, or independent licensed public accountant (licensed on or before December 31, 1970), certified or... matters by the independent accountant will facilitate their early resolution and that the independent accountant will seek advisory rulings by the Commission on such items. This examination shall be deemed...

18 CFR 158.10 - Examination of accounts.

Code of Federal Regulations, 2014 CFR

2014-04-01

... accountant, or independent licensed public accountant (licensed on or before December 31, 1970), certified or... matters by the independent accountant will facilitate their early resolution and that the independent accountant will seek advisory rulings by the Commission on such items. This examination shall be deemed...

18 CFR 158.10 - Examination of accounts.

Code of Federal Regulations, 2012 CFR

2012-04-01

... accountant, or independent licensed public accountant (licensed on or before December 31, 1970), certified or... matters by the independent accountant will facilitate their early resolution and that the independent accountant will seek advisory rulings by the Commission on such items. This examination shall be deemed...

Is orthopedics more competitive today than when my attending matched? An analysis of National Resident Matching Program data for orthopedic PGY1 applicants from 1984 to 2011.

PubMed

Karnes, Jonathan M; Mayerson, Joel L; Scharschmidt, Thomas J

2014-01-01

This study evaluated supply and demand trends for orthopedic postgraduate year 1 (PGY1) positions from 1984 to 2011 for the purpose of estimating national intercandidate competition over time. National Resident Matching Program (NRMP) data for orthopedic surgery from 1984 to 2011 were collected. Proxy variables including (total number of orthopedic applicants/number of orthopedic PGY1 positions), (number of US senior applicants to orthopedics/number of orthopedic PGY1 positions), (number of US seniors matching into orthopedics/number of US senior orthopedic applicants), (total number of matched orthopedic applicants/total number of orthopedic applicants), and (total number of US applicants who fail to match into orthopedics/total number of US senior applicants into orthopedics) as well as average United States Medical Licensing Examination Step 1 scores were used to gauge the level of competition between candidates and were compared over time. Academic medical center in the Midwestern United States. Medical professors and medical students. The NRMP data suggested that the number of positions per applicant decreased or remained stable since 1984 and that the percentage of applicants who did not match was no higher now than in the past. This finding was primarily because of the relative decrease in the ratio of applicants to available PGY1 positions, which stems from the number of positions increasing more rapidly than the number of applicants. The NRMP data from 1984 to 2011 supported our hypothesis that intercandidate competition intensity for orthopedic PGY1 positions has not increased over time. The misconception that orthopedics is becoming more competitive likely arises from the increased number of applications submitted per candidate and the resulting relative importance placed on objective criteria such as United States Medical Licensing Examination Step 1 scores when programs select interview cohorts. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

CDC Vital Signs: Teen Drinking and Driving

MedlinePlus

... involvement, minimum legal drinking age and zero tolerance laws, and graduated driver licensing systems. These proven steps ... Driving: What Works Minimum legal drinking age (MLDA) laws in every state make it illegal to sell ...

Reasonable Policies on Automated License Plate Readers Act

THOMAS, 113th Congress

Rep. Capuano, Michael E. [D-MA-7

2013-07-10

House - 09/13/2013 Referred to the Subcommittee on Crime, Terrorism, Homeland Security, and Investigations. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Nonprofit Mortgage Licensing Clarification Act of 2010

THOMAS, 111th Congress

Sen. Hagan, Kay R. [D-NC

2010-03-11

Senate - 03/11/2010 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

47 CFR 13.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL RADIO OPERATORS General § 13.3 Definitions. The definitions of terms used in part 13 are: (a) COLEM. Commercial operator license examination manager. (b) Commercial radio operator. A person holding a license or licenses specified in § 13.7(b). (c...

46 CFR 11.903 - Licenses requiring examinations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OFFICER ENDORSEMENTS Subjects of Examinations and Practical Demonstrations of Competence § 11.903 Licenses... STCW regulations and standards of competence and those in part A of the STCW Code (incorporated by... section, who meets the requirements of the appropriate regulations and standards of competence in STCW and...

Tort Liability That May Attach to Intellectual Property Licensing.

ERIC Educational Resources Information Center

Norris, William R.

1979-01-01

Examined are elements that complicate the relationship between tort law and intellectual property licensing (patents): governmental regulation of products, legal standards, the evolution of tort doctrine, international law and practice, trademark, technology and patent licensing. Available from P.O. Box 2600, Arlington, VA 22202. (MSE)

Is there an agreement among the items of the Korean physical therapist licensing examination, learning objectives of class subjects, and physical therapists’ job descriptions?

PubMed Central

2016-01-01

Purpose: To determine the agreement among the items of the Korean physical therapist licensing examination, learning objectives of class subjects, and physical therapists’ job descriptions. Methods: The main tasks of physical therapists were classified, and university courses related to the main tasks were also classified. Frequency analysis was used to determine the proportions of credits for the classified courses out of the total credits of major subjects, exam items related to the classified courses out of the total number of exam items, and universities that offer courses related to the Korean physical therapist licensing examination among the surveyed universities. Results: The proportions of credits for clinical decision making and physical therapy diagnosis-related courses out of the total number credits for major subjects at universities were relatively low (2.06% and 2.58%, respectively). Although the main tasks of physical therapists are related to diagnosis and evaluation, the proportion of physiotherapy intervention-related items (35%) was higher than that of examination and evaluation-related items (25%) on the Korean physical therapist licensing examination. The percentages of universities that offer physical therapy diagnosis and clinical decision making-related courses were 58.62% and 68.97%, respectively. Conclusion: Both the proportion of physiotherapy diagnosis and evaluation-related items on the Korean physical therapist licensing examination, and the number of subjects related to clinical decision making and physical therapy diagnosis in the physical therapy curriculum, should be increased to ensure that the examination items and physical therapy curriculum reflect the practical tasks of physical therapists. PMID:26767720

Is there an agreement among the items of the Korean physical therapist licensing examination, learning objectives of class subjects, and physical therapists' job descriptions?

PubMed

Kang, Min-Hyeok; Kwon, Oh-Yun; Kim, Yong-Wook; Kim, Ji-Won; Kim, Tae-Ho; Oh, Tae-Young; Weon, Jong-Hyuk; Lee, Tae-Sik; Oh, Jae-Seop

2016-01-01

To determine the agreement among the items of the Korean physical therapist licensing examination, learning objectives of class subjects, and physical therapists' job descriptions. The main tasks of physical therapists were classified, and university courses related to the main tasks were also classified. Frequency analysis was used to determine the proportions of credits for the classified courses out of the total credits of major subjects, exam items related to the classified courses out of the total number of exam items, and universities that offer courses related to the Korean physical therapist licensing examination among the surveyed universities. The proportions of credits for clinical decision making and physical therapy diagnosis-related courses out of the total number credits for major subjects at universities were relatively low (2.06% and 2.58%, respectively). Although the main tasks of physical therapists are related to diagnosis and evaluation, the proportion of physiotherapy intervention-related items (35%) was higher than that of examination and evaluation-related items (25%) on the Korean physical therapist licensing examination. The percentages of universities that offer physical therapy diagnosis and clinical decision making-related courses were 58.62% and 68.97%, respectively. Both the proportion of physiotherapy diagnosis and evaluation-related items on the Korean physical therapist licensing examination, and the number of subjects related to clinical decision making and physical therapy diagnosis in the physical therapy curriculum, should be increased to ensure that the examination items and physical therapy curriculum reflect the practical tasks of physical therapists.

Image simulation for automatic license plate recognition

NASA Astrophysics Data System (ADS)

Bala, Raja; Zhao, Yonghui; Burry, Aaron; Kozitsky, Vladimir; Fillion, Claude; Saunders, Craig; Rodríguez-Serrano, José

2012-01-01

Automatic license plate recognition (ALPR) is an important capability for traffic surveillance applications, including toll monitoring and detection of different types of traffic violations. ALPR is a multi-stage process comprising plate localization, character segmentation, optical character recognition (OCR), and identification of originating jurisdiction (i.e. state or province). Training of an ALPR system for a new jurisdiction typically involves gathering vast amounts of license plate images and associated ground truth data, followed by iterative tuning and optimization of the ALPR algorithms. The substantial time and effort required to train and optimize the ALPR system can result in excessive operational cost and overhead. In this paper we propose a framework to create an artificial set of license plate images for accelerated training and optimization of ALPR algorithms. The framework comprises two steps: the synthesis of license plate images according to the design and layout for a jurisdiction of interest; and the modeling of imaging transformations and distortions typically encountered in the image capture process. Distortion parameters are estimated by measurements of real plate images. The simulation methodology is successfully demonstrated for training of OCR.

78 FR 73898 - Operator Licensing Examination Standards for Power Reactors

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-09

... Reactors AGENCY: Nuclear Regulatory Commission. ACTION: Draft NUREG; request for comment. SUMMARY: The U.S..., Revision 10, ``Operator Licensing Examination Standards for Power Reactors.'' DATES: Submit comments [email protected] . Both of the Office of New Reactors; or Timothy Kolb, Office of Nuclear Reactor Regulation, U...

76 FR 45545 - Foreign Institutions-Federal Student Aid Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-29

... U.S. Medical Licensing Examination (USMLE) and citizenship data by foreign graduate medical schools...' scores on the U.S. Medical Licensing Examination (USMLE), and the school's citizenship rate (i.e., the... medical schools must submit a statement of the foreign graduate medical school's citizenship rate for 2010...

75 FR 5620 - New Date for April 2010 Customs Brokers License Examination

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-03

... types of infractions. In the case of an applicant for an individual broker's license, section 641... regularly scheduled examination date conflicts with a national holiday, religious observance, or other... (April 5) coincides with the observance of Passover. In consideration of this conflict with Passover, CBP...

English for the Health Sciences: Special Projects Report.

ERIC Educational Resources Information Center

Gray-Richards, Barbara; Kirley, Elizabeth

A study assessing the need for English instruction to increase the proficiency of nonnative speakers taking licensing examinations in 24 health sciences in British Columbia is described. Ten areas of study are reported: groups of potential learners, language screening used before the licensing examinations, why nonnative speakers fail the…

Blair Holt's Firearm Licensing and Record of Sale Act of 2013

THOMAS, 113th Congress

Rep. Rush, Bobby L. [D-IL-1

2013-01-03

House - 01/25/2013 Referred to the Subcommittee on Crime, Terrorism, Homeland Security, And Investigations. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

78 FR 5818 - Government-Owned Inventions; Availability for Licensing

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-28

... followed by irradiation with near infrared light (NIR) was shown to kill cancer cells in a highly specific... significantly enhanced by the administration of one or more anti-cancer agents following the irradiation step...

Facilitating police recording of the alcohol‐related characteristics of assault incidents: A stepped wedge implementation trial

PubMed Central

Hacker, Andrew; Kingsland, Melanie; Lecathelinais, Christophe; Tindall, Jennifer; Bowman, Jennifer A.; Wolfenden, Luke

2015-01-01

Abstract Introduction and Aims Enforcement of liquor licensing laws is limited by inadequate police information systems. This study aimed to: (i) determine the effectiveness of an intervention in facilitating police recording of the alcohol consumption characteristics of people involved in assaults; and (ii) describe such characteristics by geographic area and setting of alcohol consumption. Design and Methods A stepped wedge trial was conducted across New South Wales, Australia. An intervention to facilitate police recording of alcohol consumption information for people involved in incidents was implemented. For people involved in an assault the proportion for which alcohol consumption information was recorded was assessed. The proportion of assaults that were alcohol related, the proportions of people that consumed alcohol prior to the assault, were intoxicated, and had consumed alcohol in various settings, are described. Results Post‐intervention, alcohol consumption information was recorded for 85–100% of people involved in an assault incident. The proportion of incidents recorded as alcohol‐related increased significantly (26–44.5%; P < 0.0001). The proportion of assaults classified as alcohol related was significantly greater in regional/rural areas (50–47%) than in metropolitan areas (38%). More people in metropolitan areas (54%) consumed alcohol on licensed premises prior to an assault than in regional/rural areas (39–42%), with approximately 70% of persons intoxicated regardless of setting of alcohol consumption. Twenty per cent of premises accounted for 60% of assaults linked to licensed premises. Discussion and Conclusions The intervention was effective in enhancing the recording of alcohol‐related information for assault incidents. Such information could enhance targeted policing of liquor licensing laws. [Wiggers JH, Hacker A, Kingsland M, Lecathelinais C, Tindall J, Bowman JA, Wolfenden L. Facilitating police recording of the alcohol‐related characteristics of assault incidents: A stepped wedge implementation trial. Drug Alcohol Rev 2015;00:000–000] PMID:26332276

47 CFR 0.483 - Applications for amateur or commercial radio operator licenses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Applications for amateur or commercial radio operator licenses. 0.483 Section 0.483 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL..., and for Taking Examinations § 0.483 Applications for amateur or commercial radio operator licenses. (a...

47 CFR 13.201 - Qualifying for a commercial operator license or endorsement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Qualifying for a commercial operator license or endorsement. 13.201 Section 13.201 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL RADIO OPERATORS Examination System § 13.201 Qualifying for a commercial operator license or endorsement...

42 CFR Appendix F to Part 75 - Standards for Licensing Radiographers, Nuclear Medicine Technologists, and Radiation Therapy...

Code of Federal Regulations, 2011 CFR

2011-10-01

... licensed as Radiographers, Nuclear Medicine Technologists, or Radiation Therapy Technologists. 2. Licenses... radiography, nuclear medicine technology, or radiation therapy technology. 2. Special eligibility to take the...-referenced examination in radiography, nuclear medicine technology, or radiation therapy technology shall be...

42 CFR Appendix F to Part 75 - Standards for Licensing Radiographers, Nuclear Medicine Technologists, and Radiation Therapy...

Code of Federal Regulations, 2012 CFR

2012-10-01

... licensed as Radiographers, Nuclear Medicine Technologists, or Radiation Therapy Technologists. 2. Licenses... radiography, nuclear medicine technology, or radiation therapy technology. 2. Special eligibility to take the...-referenced examination in radiography, nuclear medicine technology, or radiation therapy technology shall be...

42 CFR Appendix F to Part 75 - Standards for Licensing Radiographers, Nuclear Medicine Technologists, and Radiation Therapy...

Code of Federal Regulations, 2013 CFR

2013-10-01

... licensed as Radiographers, Nuclear Medicine Technologists, or Radiation Therapy Technologists. 2. Licenses... radiography, nuclear medicine technology, or radiation therapy technology. 2. Special eligibility to take the...-referenced examination in radiography, nuclear medicine technology, or radiation therapy technology shall be...

42 CFR Appendix F to Part 75 - Standards for Licensing Radiographers, Nuclear Medicine Technologists, and Radiation Therapy...

Code of Federal Regulations, 2014 CFR

2014-10-01

... licensed as Radiographers, Nuclear Medicine Technologists, or Radiation Therapy Technologists. 2. Licenses... radiography, nuclear medicine technology, or radiation therapy technology. 2. Special eligibility to take the...-referenced examination in radiography, nuclear medicine technology, or radiation therapy technology shall be...

Use of the National Board of Medical Examiners® Comprehensive Basic Science Exam: survey results of US medical schools.

PubMed

Wright, William S; Baston, Kirk

2017-01-01

The National Board of Medical Examiners ® (NBME) Comprehensive Basic Science Exam (CBSE) is a subject exam offered to US medical schools, where it has been used for external validation of student preparedness for the United States Medical Licensing Examination ® (USMLE) Step 1 in new schools and schools undergoing curricular reform. Information regarding the actual use of the NBME CBSE is limited. Therefore, the aim of the survey was to determine the scope and utilization of the NBME CBSE by US medical schools. A survey was sent in May 2016 to curriculum leadership of the 139 US medical schools listed on the Liaison Committee on Medical Education (LCME ® ) website with provisional or full accreditation as of February 29, 2016. Responses were received from 53 schools (38% response rate). A series of different follow-up questions were asked if respondents stated "yes" or "no" to the initial question "Does your institution administer the NBME CBSE prior to the USMLE Step 1?". A total of 37 schools (70%) administered the NBME CBSE. In all, 36 of the 37 schools responded to follow-up questions. Of 36 schools, 13 schools (36%) used the NBME CBSE for curriculum modification. Six schools (17%) used the NBME CBSE for formative assessment for a course, and five schools (14%) used the NBME CBSE for summative assessment for a course. A total of 28 schools (78%) used the NBME CBSE for identifying students performing below expectations and providing targeted intervention strategies. In all, 24 schools (67%) of the 36 responding schools administering the NBME CBSE administered the test once prior to the administration of the USMLE Step 1, whereas 10 (28%) schools administered the NBME CBSE two or more times prior to the administration of the USMLE Step 1. Our data suggest that the NBME CBSE is administered by many US medical schools. However, the objective, timing, and number of exams administered vary greatly among schools.

[Causes of death among pilots: "acute myocardial infarction"--are the present examination methods for airworthiness sufficient?].

PubMed

Germerott, Tanja; Fieguth, Armin; Albrecht, Knut; Eidam, Joachim; Breitmeier, Dirk

2009-01-01

The European Union plans to harmonize the aviation requirements, in particular the flight crew licensing requirements. On 23 May 2007, the German Federal Ministry of Transport, Building and Urban Affairs published the Flight Crew Licensing Requirements, which are based on the Joint Aviation Requirements, Flight Crew Licensing 3, Amendment 5. These guidelines also list the examination methods to be used for testing the medical fitness of pilots. In this Amendment some examinations which were part of the routine tests before JAR-FCL3 became effective have been deleted, e.g. the exercise ECG. This article presents two cases from the autopsy material of the Institute of Legal Medicine in Hanover and discusses the problems associated with the new examination guidelines.

78 FR 18999 - Prospective Grant of Start-Up Exclusive License: Photosensitizing Antibody-Fluorophore Conjugates...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

.... Binding of such conjugates to targeted cancer cells followed by irradiation with near infrared light (NIR... more anti-cancer agents following the irradiation step. This is achieved by the markedly rapid...

[Perceptions on item disclosure for the Korean medical licensing examination].

PubMed

Yang, Eunbae B

2015-09-01

This study analyzed the perceptions of medical students and faculty regarding disclosure of test items on the Korean medical licensing examination. I conducted a survey of medical students from medical colleges and professional medical schools nationwide. Responses were analyzed from 718 participants as well as 69 faculty members who participated in creating the medical licensing examination item sets. Data were analyzed using descriptive statistics and the chi-square test. It is important to maintain test quality and to keep the test items unavailable to the public. There are also concerns among students that disclosure of test items would prompt increasing difficulty of test items (48.3%). Further, few students found it desirable to disclose test items regardless of any considerations (28.5%). The professors, who had experience in designing the test items, also expressed their opposition to test item disclosure (60.9%). It is desirable not to disclose the test items of the Korean medical licensing examination to the public on the condition that students are provided with a sufficient amount of information regarding the examination. This is so that the exam can appropriately identify candidates with the required qualifications.

Medical review practices for driver licensing volume 2: case studies of medical referrals and licensing outcomes in Maine, Ohio, Oregon, Texas, Washington, and Wisconsin.

DOT National Transportation Integrated Search

2017-03-01

This is the second of three reports examining driver medical review practices in the United States and how : they fulfill the basic functions of identifying, assessing, and rendering licensing decisions on medically at-risk : drivers. This volume pre...

The Impact of Open Licensing on the Early Reader Ecosystem

ERIC Educational Resources Information Center

Butcher, Neil; Hoosen, Sarah; Levey, Lisbeth; Moore, Derek

2016-01-01

The Impact of Open Licensing on the Early Reader Ecosystem examines how to use open licensing to promote quality learning resources for young children that are relevant and interesting. Research in early reading tends to focus on traditional publishing value and supply chains, without taking much consideration of new approaches and solutions…

Computer Software: Copyright and Licensing Considerations for Schools and Libraries. ERIC Digest.

ERIC Educational Resources Information Center

Reed, Mary Hutchings

This digest notes that the terms and conditions of computer software package license agreements control the use of software in schools and libraries, and examines the implications of computer software license agreements for classroom use and for library lending policies. Guidelines are provided for interpreting the Copyright Act, and insuring the…

The need for national medical licensing examination in Saudi Arabia

PubMed Central

Bajammal, Sohail; Zaini, Rania; Abuznadah, Wesam; Al-Rukban, Mohammad; Aly, Syed Moyn; Boker, Abdulaziz; Al-Zalabani, Abdulmohsen; Al-Omran, Mohammad; Al-Habib, Amro; Al-Sheikh, Mona; Al-Sultan, Mohammad; Fida, Nadia; Alzahrani, Khalid; Hamad, Bashir; Al Shehri, Mohammad; Abdulrahman, Khalid Bin; Al-Damegh, Saleh; Al-Nozha, Mansour M; Donnon, Tyrone

2008-01-01

Background Medical education in Saudi Arabia is facing multiple challenges, including the rapid increase in the number of medical schools over a short period of time, the influx of foreign medical graduates to work in Saudi Arabia, the award of scholarships to hundreds of students to study medicine in various countries, and the absence of published national guidelines for minimal acceptable competencies of a medical graduate. Discussion We are arguing for the need for a Saudi national medical licensing examination that consists of two parts: Part I (Written) which tests the basic science and clinical knowledge and Part II (Objective Structured Clinical Examination) which tests the clinical skills and attitudes. We propose this examination to be mandated as a licensure requirement for practicing medicine in Saudi Arabia. Conclusion The driving and hindering forces as well as the strengths and weaknesses of implementing the licensing examination are discussed in details in this debate. PMID:19032779

Curriculum Type as a Differentiating Factor in Medical Licensing Examinations.

ERIC Educational Resources Information Center

Shen, Linjun

This study assessed the effects of the type of medical curriculum on differential item functioning (DIF) and group differences at the test level in Level 1 of the Comprehensive Osteopathic Medical Licensing Examinations (COMLEX). The study also explored the relationship of the DIF and group differences at the test level. There are generally two…

Pedagogy and Culture: An Educational Initiative in Supporting UAE Nursing Graduates Prepare for a High-Stakes Nurse Licensing Examination

ERIC Educational Resources Information Center

Brownie, Sharon M.; Williams, Ged; Barnewall, Kate; Bishaw, Suzanne; Cooper, Jennifer L.; Robb, Walter; Younis, Neima; Kuzemski, Dawn

2015-01-01

Graduates of an Abu Dhabi transnational nursing degree struggled with the mandatory national licensing examination. Poor pass rates undermine graduate career futures and impact on the workforce capacity building contributions of the partnering transnational educational providers. This paper describes how the design and delivery of an intensive…

78 FR 31958 - Privacy Act of 1974; Department of Homeland Security U.S. Customs and Border Protection-007...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-28

...; Secondary Examination Status, and License Plate number (or Vehicle Identification Number (VIN), if no plate... License Plate number of the conveyance (or VIN number when no plate exists). Under the Entry/Exist Program... Driver's License (EDL); (5) another Federal Agency that has issued a valid travel document, such as...

Your EHR license agreement: critical issues.

PubMed

Shay, Daniel F

2014-01-01

This article discusses several key provisions and concepts in software license agreements for electronic health records. It offers insight into what physician practices can expect to find in their license agreements, as well as practical advice on beneficial provisions. The article examines contractual language relating to term and termination, technical specifications and support, and compliance with governmental programs.

75 FR 30864 - NUREG-1520, “Standard Review Plan for the Review of a License Application for a Fuel Cycle...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-02

... a License Application for a Fuel Cycle Facility''; Notice of Availability AGENCY: Nuclear Regulatory... Cycle Facility,'' dated May 2010. ADDRESSES: NRC's Public Document Room (PDR): The public may examine... INFORMATION: The SRP for the review of a license application for a fuel cycle facility (NUREG-1520), Revision...

Sequential steps in DNA replication are inhibited to ensure reduction of ploidy in meiosis

PubMed Central

Hua, Hui; Namdar, Mandana; Ganier, Olivier; Gregan, Juraj; Méchali, Marcel; Kearsey, Stephen E.

2013-01-01

Meiosis involves two successive rounds of chromosome segregation without an intervening S phase. Exit from meiosis I is distinct from mitotic exit, in that replication origins are not licensed by Mcm2-7 chromatin binding, but spindle disassembly occurs during a transient interphase-like state before meiosis II. The absence of licensing is assumed to explain the block to DNA replication, but this has not been formally tested. Here we attempt to subvert this block by expressing the licensing control factors Cdc18 and Cdt1 during the interval between meiotic nuclear divisions. Surprisingly, this leads only to a partial round of DNA replication, even when these factors are overexpressed and effect clear Mcm2-7 chromatin binding. Combining Cdc18 and Cdt1 expression with modulation of cyclin-dependent kinase activity, activation of Dbf4-dependent kinase, or deletion of the Spd1 inhibitor of ribonucleotide reductase has little additional effect on the extent of DNA replication. Single-molecule analysis indicates this partial round of replication results from inefficient progression of replication forks, and thus both initiation and elongation replication steps may be inhibited in late meiosis. In addition, DNA replication or damage during the meiosis I–II interval fails to arrest meiotic progress, suggesting absence of checkpoint regulation of meiosis II entry. PMID:23303250

Recent Development: Church Licensed Professors: The Curran Controversy.

ERIC Educational Resources Information Center

Andrews, Judith L.; And Others

1987-01-01

The legal aspects and policy implications of Catholic University's withdrawal of a tenured faculty priest's ecclesiastical license to teach theology, in response to a Vatican judgment, are examined. (MSE)

Understanding the Complex Relationship between Critical Thinking and Science Reasoning among Undergraduate Thesis Writers.

PubMed

Dowd, Jason E; Thompson, Robert J; Schiff, Leslie A; Reynolds, Julie A

2018-01-01

Developing critical-thinking and scientific reasoning skills are core learning objectives of science education, but little empirical evidence exists regarding the interrelationships between these constructs. Writing effectively fosters students' development of these constructs, and it offers a unique window into studying how they relate. In this study of undergraduate thesis writing in biology at two universities, we examine how scientific reasoning exhibited in writing (assessed using the Biology Thesis Assessment Protocol) relates to general and specific critical-thinking skills (assessed using the California Critical Thinking Skills Test), and we consider implications for instruction. We find that scientific reasoning in writing is strongly related to inference , while other aspects of science reasoning that emerge in writing (epistemological considerations, writing conventions, etc.) are not significantly related to critical-thinking skills. Science reasoning in writing is not merely a proxy for critical thinking. In linking features of students' writing to their critical-thinking skills, this study 1) provides a bridge to prior work suggesting that engagement in science writing enhances critical thinking and 2) serves as a foundational step for subsequently determining whether instruction focused explicitly on developing critical-thinking skills (particularly inference ) can actually improve students' scientific reasoning in their writing. © 2018 J. E. Dowd et al. CBE—Life Sciences Education © 2018 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Croton megalobotrys Müll Arg. and Vitex doniana (Sweet): Traditional medicinal plants in a three-step treatment regimen that inhibit in vitro replication of HIV-1.

PubMed

Tietjen, Ian; Gatonye, Teresia; Ngwenya, Barbara N; Namushe, Amos; Simonambanga, Sundana; Muzila, Mbaki; Mwimanzi, Philip; Xiao, Jianbo; Fedida, David; Brumme, Zabrina L; Brockman, Mark A; Andrae-Marobela, Kerstin

2016-09-15

Human Immunodeficiency Virus (HIV) strains resistant to licensed anti-retroviral drugs (ARVs) continue to emerge. On the African continent, uneven access to ARVs combined with occurrence of side-effects after prolonged ARV therapy have led to searches for traditional medicines as alternative or complementary remedies to conventional HIV/AIDS management. Here we characterize a specific three-step traditional HIV/AIDS treatment regimen consisting of Cassia sieberiana root, Vitex doniana root, and Croton megalobotrys bark by combining qualitative interviews of traditional medical knowledge users in Botswana with in vitro HIV replication studies. Crude extracts from a total of seven medicinal plants were tested for in vitro cytotoxicity and inhibition of wild-type (NL4.3) and ARV-resistant HIV-1 replication in an immortalized GFP-reporter CD4+ T-cell line. C. sieberiana root, V. doniana root, and C. megalobotrys bark extracts inhibited HIV-1NL4.3 replication with dose-dependence and without concomitant cytotoxicity. C. sieberiana and V. doniana extracts inhibited HIV-1 replication by 50% at 84.8µg/mL and at 25µg/mL, respectively, while C. megalobotrys extracts inhibited HIV-1 replication by a maximum of 45% at concentrations as low as 0.05µg/mL. Extracts did not interfere with antiviral activities of licensed ARVs when applied in combination and exhibited comparable efficacies against viruses harboring major resistance mutations to licensed protease, reverse-transcriptase, or integrase inhibitors. We report for the first time a three-step traditional HIV/AIDS regimen, used alone or in combination with standard ARV regimens, where each step exhibited more potent ability to inhibit HIV replication in vitro. Our observations support the "reverse pharmacology" model where documented clinical experiences are used to identify natural products of therapeutic value. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Correlation of the National Board of Medical Examiners Emergency Medicine Advanced Clinical Examination Given in July to Intern American Board of Emergency Medicine in-training Examination Scores: A Predictor of Performance?

PubMed

Hiller, Katherine; Franzen, Doug; Heitz, Corey; Emery, Matthew; Poznanski, Stacy

2015-11-01

There is great variation in the knowledge base of Emergency Medicine (EM) interns in July. The first objective knowledge assessment during residency does not occur until eight months later, in February, when the American Board of EM (ABEM) administers the in-training examination (ITE). In 2013, the National Board of Medical Examiners (NBME) released the EM Advanced Clinical Examination (EM-ACE), an assessment intended for fourth-year medical students. Administration of the EM-ACE to interns at the start of residency may provide an earlier opportunity to assess the new EM residents' knowledge base. The primary objective of this study was to determine the correlation of the NBME EM-ACE, given early in residency, with the EM ITE. Secondary objectives included determination of the correlation of the United States Medical Licensing Examination (USMLE) Step 1 or 2 scores with early intern EM-ACE and ITE scores and the effect, if any, of clinical EM experience on examination correlation. This was a multi-institutional, observational study. Entering EM interns at six residencies took the EM-ACE in July 2013 and the ABEM ITE in February 2014. We collected scores for the EM-ACE and ITE, age, gender, weeks of clinical EM experience in residency prior to the ITE, and USMLE Step 1 and 2 scores. Pearson's correlation and linear regression were performed. Sixty-two interns took the EM-ACE and the ITE. The Pearson's correlation coefficient between the ITE and the EM-ACE was 0.62. R-squared was 0.5 (adjusted 0.4). The coefficient of determination was 0.41 (95% CI [0.3-0.8]). For every increase of one in the scaled EM-ACE score, we observed a 0.4% increase in the EM in-training score. In a linear regression model using all available variables (EM-ACE, gender, age, clinical exposure to EM, and USMLE Step 1 and Step 2 scores), only the EM-ACE score was significantly associated with the ITE (p<0.05). We observed significant colinearity among the EM-ACE, ITE and USMLE scores. Gender, age and number of weeks of EM prior to the ITE had no effect on the relationship between EM-ACE and the ITE. Given early during intern year, the EM-ACE score showed positive correlation with ITE. Clinical EM experience prior to the in-training exam did not affect the correlation.

Correlation of the National Board of Medical Examiners Emergency Medicine Advanced Clinical Examination Given in July to Intern American Board of Emergency Medicine in-training Examination Scores: A Predictor of Performance?

PubMed Central

Hiller, Katherine; Franzen, Doug; Heitz, Corey; Emery, Matthew; Poznanski, Stacy

2015-01-01

Introduction There is great variation in the knowledge base of Emergency Medicine (EM) interns in July. The first objective knowledge assessment during residency does not occur until eight months later, in February, when the American Board of EM (ABEM) administers the in-training examination (ITE). In 2013, the National Board of Medical Examiners (NBME) released the EM Advanced Clinical Examination (EM-ACE), an assessment intended for fourth-year medical students. Administration of the EM-ACE to interns at the start of residency may provide an earlier opportunity to assess the new EM residents’ knowledge base. The primary objective of this study was to determine the correlation of the NBME EM-ACE, given early in residency, with the EM ITE. Secondary objectives included determination of the correlation of the United States Medical Licensing Examination (USMLE) Step 1 or 2 scores with early intern EM-ACE and ITE scores and the effect, if any, of clinical EM experience on examination correlation. Methods This was a multi-institutional, observational study. Entering EM interns at six residencies took the EM-ACE in July 2013 and the ABEM ITE in February 2014. We collected scores for the EM-ACE and ITE, age, gender, weeks of clinical EM experience in residency prior to the ITE, and USMLE Step 1 and 2 scores. Pearson’s correlation and linear regression were performed. Results Sixty-two interns took the EM-ACE and the ITE. The Pearson’s correlation coefficient between the ITE and the EM-ACE was 0.62. R-squared was 0.5 (adjusted 0.4). The coefficient of determination was 0.41 (95% CI [0.3–0.8]). For every increase of one in the scaled EM-ACE score, we observed a 0.4% increase in the EM in-training score. In a linear regression model using all available variables (EM-ACE, gender, age, clinical exposure to EM, and USMLE Step 1 and Step 2 scores), only the EM-ACE score was significantly associated with the ITE (p<0.05). We observed significant colinearity among the EM-ACE, ITE and USMLE scores. Gender, age and number of weeks of EM prior to the ITE had no effect on the relationship between EM-ACE and the ITE. Conclusion Given early during intern year, the EM-ACE score showed positive correlation with ITE. Clinical EM experience prior to the in-training exam did not affect the correlation. PMID:26594299

Burnout is Associated With Emotional Intelligence but not Traditional Job Performance Measurements in Surgical Residents.

PubMed

Cofer, Kevin D; Hollis, Robert H; Goss, Lauren; Morris, Melanie S; Porterfield, John R; Chu, Daniel I

2018-02-23

To evaluate whether burnout was associated with emotional intelligence and job performance in surgical residents. General surgery residents at a single institution were surveyed using the Maslach Burnout Inventory (MBI) and trait EI questionnaire (TEIQ-SF). Burnout was defined as scoring in 2 of the 3 following domains; Emotional Exhaustion (high), Depersonalization (high), and Personal Accomplishment (low). Job performance was evaluated using faculty evaluations of clinical competency-based surgical milestones and standardized test scores including the American Board of Surgery In-Training Exam (ABSITE) and the United States Medical Licensing Examination (USMLE) Step 3. USMLE Step 1 and USMLE Step 2, which were taken prior to residency training, were included to examine possible associations of burnout with USMLE examinations. Statistical comparison was made using Pearson correlation and simple linear regression adjusting for PGY level. This study was conducted at the University of Alabama at Birmingham (UAB) general surgery residency program. All current and incoming general surgery residents at UAB were invited to participate in this study. Forty residents participated in the survey (response rate 77%). Ten residents, evenly distributed from incoming residents to PGY-4, had burnout (25%). Mean global EI was lower in residents with burnout versus those without burnout (3.71 vs 3.9, p = 0.02). Of the 4 facets of EI, mean self-control values were lower in residents with burnout versus those without burnout (3.3 vs 4.06, p < 0.01). Each component of burnout was associated with global EI, with the strongest correlation being with personal accomplishment (r = 0.64; p < 0.01). Residents with burnout did not have significantly different mean scores for USMLE Step 1 (229 vs 237, p = 0.12), Step 2 (248 vs 251, p = 0.56), Step 3 (223 vs 222, p = 0.97), or ABSITE percentile (44.6 vs 58, p = 0.33) compared to residents without burnout. Personal accomplishment was associated with ABSITE percentile scores (r = 0.35; p = 0.049). None of the 16 surgical milestone scores were significantly associated with burnout. Burnout is present in surgery residents and associated with emotional intelligence. There was no association of burnout with USMLE scores, ABSITE percentile, or surgical milestones. Traditional methods of assessing resident performance may not be capturing burnout and strategies to reduce burnout should consider targeting emotional intelligence. Published by Elsevier Inc.

North Korean defectors seeking health certification to take the national medical licensing examination in the Republic of Korea: figures and procedures.

PubMed

Kim, Yoon Hee

2012-01-01

In May 2011, the Ministry of Unification of the Republic of Korea (Korea) announced that 21,165 defectors from Democratic People's Republic of Korea (North Korea) had settled in Korea. Since healthcare workers are counted among these defectors, it is necessary to provide them with a pathway to certification to work in Korea. This report summarizes the vetting and approval process defectors from North Korea must pass through to be eligible to take the national medical licensing examination. Defectors must pass an oral test conducted by the National Health Personnel Licensing Examination Board to be eligible to sit for the exam. From 2002 to August 2011, 41 North Korean defectors applied for the approval process to take the exam. Twenty-nine were approved (70.7%): 23 physicians, 1 dentist, 2 oriental medical doctor, 1 nurse, and 2 pharmacists. Out of 29 approved, 11 passed the licensing examination (39.3%). This report also highlights the difficulty in assessing North Korean defectors' eligibility by oral test, and suggests that adequate competency should be emphasized to recognize their unique abilities as healthcare personnel.

Other High-Risk Factors for Young Drivers--How Graduated Licensing Does, Doesn't, or Could Address Them.

ERIC Educational Resources Information Center

Ferguson, Susan A.

2003-01-01

Examines the risk factors underlying the high crash rates of newly licensed drivers and assesses the extent to which existing graduated driver-licensing programs address these risks. Discusses such risks as driver fatigue, not using seat belts, high speeds, high-powered vehicles, and in-vehicle distractions. (Contains 66 references.) (AUTHOR/WFA)

Development and Field Test of Competency Based Instructional Material for a Career Mobility Program for Licensed Practical Nurses. Final Report.

ERIC Educational Resources Information Center

Bergen Community Coll., Paramus, NJ.

The Associate Degree Nursing Program at Bergen Community College developed and field tested competency-based instructional modules in a program designed to allow licensed practical nurses to qualify to take the certification examination for registered nurses after a year of study. Thirteen licensed practical nurses were enrolled in the first class…

Results from a National Study of Social Workers Sanctioned by State Licensing Boards

ERIC Educational Resources Information Center

Boland-Prom, Kim W.

2009-01-01

This article presents the results of a descriptive study, synthesizing the reports of 27 state regulatory boards about their actions against certified and licensed social workers (N = 874) during the period of 1999 to 2004. The purpose of this study was to examine the unprofessional behavior of certified and licensed social workers, the results of…

Unmatched U.S. Allopathic Seniors in the 2015 Main Residency Match: A Study of Applicant Behavior, Interview Selection, and Match Outcome.

PubMed

Liang, Mei; Curtin, Laurie S; Signer, Mona M; Savoia, Maria C

2017-07-01

The application and interview behaviors of unmatched U.S. allopathic medical school senior students (U.S. seniors) participating in the 2015 National Resident Matching Program (NRMP) Main Residency Match were studied in conjunction with their United States Medical Licensing Examination (USMLE) Step 1 scores and ranking preferences to understand their effects on Match outcome. USMLE Step 1 score and preferred specialty information were reviewed for U.S. seniors who responded to the 2015 NRMP Applicant Survey. Unmatched U.S. seniors were categorized as "strong," "solid," "marginal," or "weak" based on the perceived competitiveness of their Step 1 scores compared with U.S. seniors who matched in the same preferred specialty. The numbers of applications sent, interviews obtained, and programs ranked also were examined by Match outcome. Strong unmatched U.S. seniors submitted significantly more applications to achieve and attend approximately the same number of interviews as strong matched U.S. seniors. Strong unmatched seniors ranked fewer programs than their matched counterparts. As a group, unmatched U.S. seniors were less likely than their matched counterparts to rank a mix of competitive and less competitive programs and more likely to rank programs based on their perceived likelihood of matching. A small number of unmatched U.S. seniors would have matched if they had ranked programs that ranked them. U.S. seniors' Match outcomes may be affected by applicant characteristics that negatively influence their selection for interviews, and their difficulties may be exacerbated by disadvantageous ranking behaviors.

The job analysis of Korean nurses as a strategy to improve the Korean Nursing Licensing Examination.

PubMed

Park, In Sook; Suh, Yeon Ok; Park, Hae Sook; Ahn, Soo Yeon; Kang, So Young; Ko, Il Sun

2016-01-01

This study aimed at characterizing Korean nurses' occupational responsibilities to apply the results for improvement of the Korean Nursing Licensing Examination. First, the contents of nursing job were defined based on a focus group interview of 15 nurses. Developing a Curriculum (DACOM) method was used to examine those results and produce the questionnaire by 13 experts. After that, the questionnaire survey to 5,065 hospital nurses was done. The occupational responsibilities of nurses were characterized as involving 8 duties, 49 tasks, and 303 task elements. Those 8 duties are nursing management and professional development, safety and infection control, the management of potential risk factors, basic nursing and caring, the maintenance of physiological integrity, medication and parenteral treatments, socio-psychological integrity, and the maintenance and improvement of health. The content of Korean Nursing Licensing Examination should be improved based on 8 duties and 49 tasks of the occupational responsibilities of Korean nurses.

Young driver licensing: examination of population-level rates using New Jersey's state licensing database.

PubMed

Curry, Allison E; Pfeiffer, Melissa R; Durbin, Dennis R; Elliott, Michael R; Kim, Konny H

2015-03-01

Recent surveys have provided insight on the primary reasons why US teens delay licensure but are limited in their ability to estimate licensing rates and trends. State administrative licensing data are the ideal source to provide this information but have not yet been analyzed for this purpose. Our objective was to analyze New Jersey's (NJ) licensing database to: (1) describe population-based rates of licensure among 17- to 20-year-olds, overall and by gender and zip code level indicators of household income, population density, and race/ethnicity; and (2) examine recent trends in licensure. We obtained records on all licensed NJ drivers through June 2012 from the NJ Motor Vehicle Commission's licensing database and determined each young driver's age at the time of intermediate and full licensure. Data from the US Census and American Community Survey were used to estimate a fixed cohort of NJ residents who turned 17 years old in 2006-2007 (n=255,833). Licensing data were used to estimate the number of these drivers who obtained an intermediate license by each month of age (numerators) and, among those who obtained an intermediate license, time to graduation to full licensure. Overall, 40% of NJ residents-and half of those who ultimately obtained a license by age 21-were licensed within a month of NJ's minimum licensing age of 17, 64% by their 18th birthday, and 81% by their 21st birthday. Starkly different patterns of licensure were observed by socioeconomic indicators; for example, 65% of 17-year-olds residing in the highest-income zip codes were licensed in the first month of eligibility compared with 13% of residents living in the lowest-income zip codes. The younger an individual obtained their intermediate license, the earlier they graduated to a full license. Finally, the rate and timing of licensure in NJ has been relatively stable from 2006 to 2012, with at most a 1-3% point decline in rates. These findings support the growing body of literature suggesting that teens delay licensure primarily for economic reasons and that a substantial proportion of potentially high-risk teens may be obtaining licenses outside the auspices of a graduated driver licensing system. Finally, our finding of a relatively stable trend in licensure in recent years is in contrast to national-level reports of a substantial decline in licensure rates. Copyright © 2015 Elsevier Ltd. All rights reserved.

[The Medical Examination - Between Desire and Reality - Analysis of Consensus Between the Second Part of the Medical Licensing Exam (IMPP) and the National Catalogue of Expertise-based Learning Goals in Surgery (NKLC)].

PubMed

Sterz, Jasmina; Rüsseler, Miriam; Britz, Vanessa; Stefanescu, Christina; Hoefer, Sebastian H; Adili, Farzin; Schreckenbach, Teresa; Schleicher, Iris; Weber, Roxane; Hofmann, Hans-Stefan; Voß, Friedericke; König, Sarah; Heinemann, Markus K; Kadmon, Martina

2017-12-01

Background The working party of the German Society for Surgery (DGCH) on undergraduate surgical education has developed a national expertise-based catalogue of learning goals in surgery (NKLC). This study analyses the extent to which the questions of the German second medical licensing examination compiled by the IMPP are congruent with the NKLC and which thematic focus is emphasised. Materials and Methods Firstly, a guideline and evaluation sheet were developed in order to achieve documentation of the individual examination questions of the second licensing examination with respect to the learning goals of the NKLC. In a retrospective analysis from autumn 2009 to autumn 2014, eleven licensing examinations in human medicine were screened independently by three different reviewers. In accordance with the guideline, the surgical questions were identified and subsequently matched to the learning goals of the NKLC. The analysis included the number of surgical learning goals as well as the number of surgical questions for each examination, learning goal, and different levels of expertise (LE). Results Thirteen reviewers from six surgical disciplines participated in the analysis. On average, reviewers agreed on the differentiation between surgical and non-surgical questions in 79.1% of all 3480 questions from 11 licensing examinations. For each examination (n = 320 questions), 98.8 ± 22.6 questions (min.: 69, max.: 150) were rated as surgical. For each surgical learning goal addressed, 2.2 ± 0.3 questions (min.: 1, max.: 16) were asked. For each examination, 23.5 ± 6.3 questions (min.: 11; max.: 31) referred to learning goals of LE 3, 52.5 ± 16.7 questions (min.: 34; max.: 94) addressed learning goals of LE 2 and 22.8 ± 7.7 questions (min.: 9; max.: 34) were related to learning goals of LE 1. 64 learning goals (27.8% of all learning goals of the NKLC) were not reflected in the examinations. With a total of 70 questions, the most frequently examined surgical topic was "disorders of the rheumatic spectrum". Conclusion The number of surgical examination questions in the German second medical licensing examination seems to be sufficient. However, the questions seem to be unevenly distributed between different surgical areas of undergraduate education. In order to achieve a more homogenous representation of relevant surgical topics, improved alignment is needed between the state examination with existing catalogues of learning goals by the IMPP. Georg Thieme Verlag KG Stuttgart · New York.

Perceptions, intentions and behavioral norms that affect pre-license driving among Arab youth in Israel.

PubMed

Gesser-Edelsburg, Anat; Zemach, Mina; Lotan, Tsippy; Elias, Wafa; Grimberg, Einat

2018-02-01

The present study examines reported pre-license driving among youth from the population of Arab citizens of Israel. The purpose of the present study is to examine which sociodemographic variables, attitudes and perceptions about safe driving and individual and societal behavioral norms are associated with pre-license driving. The research distinguished between the factors that actually contribute to pre-license driving (reported behavior, peer norms, gender and parents' messages) and the factors that explain the intention (parental authority, social norms, parents' messages and fear of road crashes). Even though there was a significant partial overlap (84%) between those who intend to drive without a license and those who reported driving without a license, the main factors that distinguish pre-license driving groups are different from the factors that distinguish the intention to drive before receiving a license. What is unique about the findings is the identification of the context in which social norms are influential and that in which parental authority is influential. The study indicated that in the case of pre-license driving, the main motivating factor is subjective norms, whereas in the case of expecting to drive without a license, the main motivating factor is the interaction between parental authority and the messages that parents convey. While actual behavior pertains to the behavioral level, we argue that intended behavior pertains to the cognitive level. At this level, rational considerations arise, such as fear of parental punishment and fear of accidents. These considerations compete with the influence of friends and their norms, and may outweigh them. The findings suggest that it is important to safeguard youth against the influence of peer pressure as early as the stage of behavioral intentions. Follow-up studies can simulate situations of pre-license driving due to social pressure and identify the factors that might affect young people's decision-making. Moreover, providing parents with training before the accompaniment period is highly recommended. Copyright © 2017 Elsevier Ltd. All rights reserved.

Predicting Intention Perform Breast Self-Examination: Application of the Theory of Reasoned Action

PubMed

Dewi, Triana Kesuma; Zein, Rizqy Amelia

2017-11-26

Objective: The present study aimed to examine the applicability of the theory of reasoned action to explain intention to perform breast self-examination (BSE). Methods: A questionnaire was constructed to collect data. The hypothesis was tested in two steps. First, to assess the strength of the correlation among the constructs of theory of reasoned action (TRA), Pearson’s product moment correlations were applied. Second, multivariate relationships among the constructs were examined by performing hierarchical multiple linear regression analysis. Result: The findings supported the TRA model, explaining 45.8% of the variance in the students’ BSE intention, which was significantly correlated with attitude (r = 0.609, p = 0.000) and subjective norms (r = 0.420, p =0 .000). Conclusion: TRA could be a suitable model to predict BSE intentions . Participants who believed that doing BSE regularly is beneficial for early diagnosis of breast cancer and also believed that their significant referents think that doing BSE would significantly detect breast cancer earlier, were more likely to intend to perform BSE regularly. Therefore, the research findings supported the conclusion that promoting the importance of BSE at the community/social level would enhance individuals to perform BSE routinely. Creative Commons Attribution License

Context-Sensitive Ethics in School Psychology

ERIC Educational Resources Information Center

Lasser, Jon; Klose, Laurie McGarry; Robillard, Rachel

2013-01-01

Ethical codes and licensing rules provide foundational guidance for practicing school psychologists, but these sources fall short in their capacity to facilitate effective decision-making. When faced with ethical dilemmas, school psychologists can turn to decision-making models, but step-wise decision trees frequently lack the situation…

75 FR 69427 - PPL Holtwood, LLC; Notice of Application for Amendment of License and Soliciting Comments...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-12

... Susquehanna River, in Lancaster and York Counties, Pennsylvania. g. Filed Pursuant to: Federal Power Act, 16 U... a 33.8-acre parcel on which the Indian Steps Museum and Ulmer-Root-Haines Memorial Park and nature...

Development and Evaluation of a Student-Initiated Test Preparation Program for the USMLE Step 1 Examination.

PubMed

Schwartz, Lindsay F; Lineberry, Matthew; Park, Yoon Soo; Kamin, Carol S; Hyderi, Abbas A

2018-01-01

Studies have documented performance on the United States Medical Licensing Examination® (USMLE) Step 1 exam as an important factor that residency program directors consider when deciding which applicants to interview and rank. Therefore, success on this exam, though only one aspect of applicant evaluation, is important in determining future career prospects for medical students. Unfortunately, mean test scores at the University of Illinois College of Medicine at Chicago (UIC) have historically been below the national average. This retrospective and quasi-experimental mixed-methods study describes the development, evaluation, and effects of a student-initiated USMLE Step 1 preparatory program at UIC. The program provided second year students with First Aid for the USMLE Step 1 at the beginning of the academic year, as well as a six month subscription to the USMLE World question bank midyear. In addition, optional peer review sessions covering basic sciences and organ systems were taught by high-performing upperclassmen. The goals of the program were to raise mean USMLE Step 1 exam scores and increase the percentage of students passing the exam on their first time. The program premiered during the 2012-13 academic year. Data from this cohort as well as four others (N = 830; 2010-2014 examinees) were gathered. Performances between preintervention (2010-12 examinees) and postintervention (2013-14 examinees) cohorts of students were compared. Focus groups and interviews with staff and students were conducted, recorded, and analyzed to investigate the impact that the program had on student interactions and perceptions of the learning environment. There was a significant difference in exam performance pre- versus postintervention, with average USMLE Step 1 scores improving by 8.82 points following the implementation of the student-initiated program, t(5.61) = 828, p < .001. The average first-attempt pass rate also increased significantly by 8%, χ 2 (1) = 23.13, p < .001. Taking age, sex, Medical College Admission Test® scores, and undergraduate grade point average into account, students who participated in the program scored 6.57 points higher than students who did not participate in the program (R 2 = 0.3), F(5, 886) = 76.71, p < .01, and had higher odds of passing USMLE Step 1 (odds ratio = 3.08, SE = 1.07, p < .01). Students and staff commented on the sense of community and empowerment the program created as well as the unique student-driven nature of the program. This study demonstrates the efficacy of a student-initiated curriculum and provides guidance for development and implementation of examination preparatory efforts at other institutions.

Examining the effectiveness of Utah's law allowing for telephonic testimony at ALR hearings

DOT National Transportation Integrated Search

2003-07-01

Difficulties associated with conducting administrative license hearings regarding Driving While Intoxicated (DWI) offenses have often resulted in sporadic or ineffective use of administrative license revocation/suspension (ALR/ALS) laws around the Un...

Deterrent effects of mandatory license suspension for DWI conviction

DOT National Transportation Integrated Search

1987-06-01

The present study examined the specific and general deterrent effects of Wisconsin's 1982 law mandating three to six month license suspensions for first-time convicted drinking drivers. Specific deterrence (stopping repeat drinking and driving among ...

Training program for driver licensing screening for medical impairment

DOT National Transportation Integrated Search

1977-08-01

The purpose of the contract was to create a complete curriculum package, for training motor vehicle license examiners to identify individuals with potentially unsafe physical or mental conditions. The present report describes the process followed in ...

Effectiveness of graduated driver licensing in reducing motor vehicle crashes.

PubMed

Foss, R D; Evenson, K R

1999-01-01

To determine whether graduated driver licensing (GDL) systems and nighttime curfews reduce motor vehicle crashes, fatalities, or injuries among young drivers. We used Cochrane Collaboration search strategies to locate studies of graduated licensing or night driving restrictions. Studies were selected if they examined the effects of either (1) a comprehensive graduated driver licensing system including well-integrated components, or (2) nighttime driving restrictions/curfews that could affect young persons' nighttime driving, on a clearly defined crash or injury outcome. Seven studies met inclusion criteria. Two independent studies of the New Zealand graduated licensing program found a sustained 7%-8% reduction in teen driver crash injuries attributable to the program. No other full graduated licensing system has been evaluated to date. Four studies of either a general curfew or a nighttime driving restriction for teens, a key element of graduated licensing, found substantial crash reductions during restricted hours, with 23%-25% lower crash injury and fatality rates for curfews beginning prior to midnight. One study found no change in late night crashes before and after a 1 a.m.-6 a.m. night driving restriction took effect. The logic and empirical bases for graduated licensing are sound. Moreover, there is evidence that one central element, a restriction on nighttime driving by novices, reduces young driver crashes. However, a definitive conclusion about the effectiveness of GDL systems for reducing motor vehicle crashes or crash-related injuries must await examination of other GDL systems. This should be possible within the next few years, as several states and Canadian provinces have recently enacted GDL programs.

A Research on Mathematical Thinking Skills: Mathematical Thinking Skills of Athletes in Individual and Team Sports

ERIC Educational Resources Information Center

Onal, Halil; Inan, Mehmet; Bozkurt, Sinan

2017-01-01

The aim of this research is to examine the mathematical thinking skills of licensed athletes engaged in individual and team sports. The research is designed as a survey model. The sample of the research is composed of 59 female and 170 male licensed athletes (n = 229) and (aged 14 to 52) licensed who do the sports of shooting, billiards, archery,…

Medicine Handbook.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Office of the Professions.

A reference guide to laws, rules, and regulations that govern medical practice in New York State is presented. After an overview of professional regulation in the state, licensing requirements/procedures for medicine are described including education and postgraduate training requirements, state licensing examinations, and application…

The importance of context in logic model construction for a multi-site community-based Aboriginal driver licensing program.

PubMed

Cullen, Patricia; Clapham, Kathleen; Byrne, Jake; Hunter, Kate; Senserrick, Teresa; Keay, Lisa; Ivers, Rebecca

2016-08-01

Evidence indicates that Aboriginal people are underrepresented among driver licence holders in New South Wales, which has been attributed to licensing barriers for Aboriginal people. The Driving Change program was developed to provide culturally responsive licensing services that engage Aboriginal communities and build local capacity. This paper outlines the formative evaluation of the program, including logic model construction and exploration of contextual factors. Purposive sampling was used to identify key informants (n=12) from a consultative committee of key stakeholders and program staff. Semi-structured interviews were transcribed and thematically analysed. Data from interviews informed development of the logic model. Participants demonstrated high level of support for the program and reported that it filled an important gap. The program context revealed systemic barriers to licensing that were correspondingly targeted by specific program outputs in the logic model. Addressing underlying assumptions of the program involved managing local capacity and support to strengthen implementation. This formative evaluation highlights the importance of exploring program context as a crucial first step in logic model construction. The consultation process assisted in clarifying program goals and ensuring that the program was responding to underlying systemic factors that contribute to inequitable licensing access for Aboriginal people. Copyright © 2016 Elsevier Ltd. All rights reserved.

Tobacco retail regulation: the next frontier in tobacco control?

PubMed

Smyth, Colleen; Freeman, Becky; Maag, Audrey

2015-07-09

Australia has experienced significant reductions in smoking rates in recent decades, and public health scrutiny is turning to how further gains will be made. Regulatory controls, such as licensing to reduce retailer density or limit tobacco proximity to schools or licensed premises, have been suggested by some public health advocates as appropriate next steps. This paper summarises best-practice evidence in relation to tobacco retailer regulation, noting measures undertaken in New South Wales (NSW). Research on controlling the display of tobacco products and supply of tobacco to minors is well established. The evidence shows that a combination of licensing, enforcement, education, promotion restrictions at the point of sale and a well-funded compliance program to prevent sales to minors is a best-practice approach to tobacco retail regulation. The evidence for other measures - such as restricting the number of retail outlets, and restricting how and where tobacco is sold - is far less developed. There is insufficient evidence to determine if a positive licensing system and controls on the density and location of tobacco outlets would be effective in the Australian context. More evidence is required from jurisdictions that have implemented a positive licensing scheme to evaluate the effect of such schemes on smoking rates, the potential cost benefits and any unintended consequences.

A bill to prohibit the use of Federal funds to approve certain biologics license applications by the Food and Drug Administration.

THOMAS, 111th Congress

Sen. Brownback, Sam [R-KS

2009-03-17

Senate - 03/17/2009 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

9 CFR 116.1 - Applicability and general considerations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... manufacturer of biological products imported into the United States shall maintain, at the licensed or foreign... of successive steps in the development and preparation of biological products, including new products... the preparation of biological products; and shall be verified by initials or signature of the person...

9 CFR 116.1 - Applicability and general considerations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... manufacturer of biological products imported into the United States shall maintain, at the licensed or foreign... of successive steps in the development and preparation of biological products, including new products... the preparation of biological products; and shall be verified by initials or signature of the person...

9 CFR 116.1 - Applicability and general considerations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... manufacturer of biological products imported into the United States shall maintain, at the licensed or foreign... of successive steps in the development and preparation of biological products, including new products... the preparation of biological products; and shall be verified by initials or signature of the person...

10 CFR 781.66 - Third-party termination proceedings.

Code of Federal Regulations, 2010 CFR

2010-01-01

... sent to the Secretary, ATTN: Invention Licensing Appeal Board, and shall be verified and accompanied by... steps, necessary to accomplish substantial utilization of the invention. (b) Upon receipt of such a... utilization of the invention and has presented sufficent proof, in accordance with paragraph (b) of this...

A bill to improve the transition between experimental permits and commercial licenses for commercial reusable launch vehicles.

THOMAS, 113th Congress

Sen. Heinrich, Martin [D-NM

2014-03-13

Senate - 12/12/2014 By Senator Rockefeller from Committee on Commerce, Science, and Transportation filed written report. Report No. 113-318. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

9 CFR 116.1 - Applicability and general considerations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... manufacturer of biological products imported into the United States shall maintain, at the licensed or foreign... of successive steps in the development and preparation of biological products, including new products... the preparation of biological products; and shall be verified by initials or signature of the person...

46 CFR 310.6 - Entrance requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... obligated to (i) complete the Naval Science curriculum (ii) take all necessary and positive steps to obtain...) Meet the physical standards specified by the United States Coast Guard for original licensing as a merchant marine officer. The written certification of the Superintendent of the school, based on a physical...

46 CFR 310.6 - Entrance requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... obligated to (i) complete the Naval Science curriculum (ii) take all necessary and positive steps to obtain...) Meet the physical standards specified by the United States Coast Guard for original licensing as a merchant marine officer. The written certification of the Superintendent of the school, based on a physical...

46 CFR 310.6 - Entrance requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... obligated to (i) complete the Naval Science curriculum (ii) take all necessary and positive steps to obtain...) Meet the physical standards specified by the United States Coast Guard for original licensing as a merchant marine officer. The written certification of the Superintendent of the school, based on a physical...

Nine Easy Steps to Avoiding Software Copyright Infringement.

ERIC Educational Resources Information Center

Gamble, Lanny R.; Anderson, Larry S.

1989-01-01

To avoid microcomputer software copyright infringement, administrators must be aware of the law, read the software agreements, maintain good records, submit all software registration cards, provide secure storage, post warnings, be consistent when establishing and enforcing policies, consider a site license, and ensure the legality of currently…

Visions and reality: the idea of competence-oriented assessment for German medical students is not yet realised in licensing examinations

PubMed Central

Huber-Lang, Markus; Palmer, Annette; Grab, Claudia; Boeckers, Anja; Boeckers, Tobias Maria; Oechsner, Wolfgang

2017-01-01

Objective: Competence orientation, often based on the CanMEDS model, has become an important goal for modern curricula in medical education. The National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM) has been adopted in Germany. However, it is currently unknown whether the vision of competence orientation has also reached the licensing examination procedures. Methods: Therefore, a prospective, descriptive, single-centre, exemplary study design was applied to evaluate 4051 questions/tasks (from 28 examiners at 7 two-day licensing oral-practical exams) for undergraduate medical students at the University of Ulm. The oral and practical questions/tasks as well as the real bedside assessment were assigned to specific competence roles (NKLM section I), categories (NKLM section II) and taxonomy levels of learning domains. Results: Numerous questions/tasks were set per candidate (day 1/2: 70±24/86±19 questions) in the licensing oral-practical exam. Competence roles beyond the “medical expert” were scarcely considered. Furthermore, practical and communication skills at the bedside were hardly addressed (less than 3/15 min). Strikingly, there was a significant predominance of questions with a low-level taxonomy. Conclusions: The data indicate a misalignment of competence-oriented frameworks and the “real world” licensing practical-oral medical exam, which needs improvement in both evaluation and education processes. PMID:28584873

Location, location, location: Assessing the spatial patterning between marijuana licenses, alcohol outlets and neighborhood characteristics within Washington state.

PubMed

Tabb, Loni Philip; Fillmore, Christina; Melly, Steven

2018-04-01

The availability of marijuana products is becoming increasingly prevalent across the United States (US), many states are allowing for the production, processing, and retailing of these products for medical and/or recreational use. The purpose of this study is to: (1) examine the spatial patterning of marijuana licenses, and (2) examine the impact of alcohol outlets in addition to other neighborhood characteristics on marijuana licenses within the state of Washington. This cross-sectional observational study examined 1458 census tracts in Washington state from 2017, using marijuana and alcohol data from the Washington State Liquor and Cannabis Board as well as neighborhood characteristics data from the American Community Survey 2011-2015 5-year estimates. We used exploratory and formal spatial regression methods, including integrated nested Laplace approximation within a Bayesian statistical framework, to address the study aims. Our results indicate there is significant spatial patterning of marijuana producers and processors across the state. We also found that all marijuana licenses are located in poorer census tracts, and marijuana retailers are co-located in census tracts with off-premises alcohol outlets. Our study provides empirical evidence of the relationship between marijuana licenses, alcohol outlets, and neighborhood characteristics, and has important implications for policymakers in other states currently considering legalizing marijuana-products for medical and/or recreational use. Copyright © 2018 Elsevier B.V. All rights reserved.

The new final Clinical Skills examination in human medicine in Switzerland: Essential steps of exam development, implementation and evaluation, and central insights from the perspective of the national Working Group

PubMed Central

Berendonk, Christoph; Schirlo, Christian; Balestra, Gianmarco; Bonvin, Raphael; Feller, Sabine; Huber, Philippe; Jünger, Ernst; Monti, Matteo; Schnabel, Kai; Beyeler, Christine; Guttormsen, Sissel; Huwendiek, Sören

2015-01-01

Objective: Since 2011, the new national final examination in human medicine has been implemented in Switzerland, with a structured clinical-practical part in the OSCE format. From the perspective of the national Working Group, the current article describes the essential steps in the development, implementation and evaluation of the Federal Licensing Examination Clinical Skills (FLE CS) as well as the applied quality assurance measures. Finally, central insights gained from the last years are presented. Methods: Based on the principles of action research, the FLE CS is in a constant state of further development. On the foundation of systematically documented experiences from previous years, in the Working Group, unresolved questions are discussed and resulting solution approaches are substantiated (planning), implemented in the examination (implementation) and subsequently evaluated (reflection). The presented results are the product of this iterative procedure. Results: The FLE CS is created by experts from all faculties and subject areas in a multistage process. The examination is administered in German and French on a decentralised basis and consists of twelve interdisciplinary stations per candidate. As important quality assurance measures, the national Review Board (content validation) and the meetings of the standardised patient trainers (standardisation) have proven worthwhile. The statistical analyses show good measurement reliability and support the construct validity of the examination. Among the central insights of the past years, it has been established that the consistent implementation of the principles of action research contributes to the successful further development of the examination. Conclusion: The centrally coordinated, collaborative-iterative process, incorporating experts from all faculties, makes a fundamental contribution to the quality of the FLE CS. The processes and insights presented here can be useful for others planning a similar undertaking. PMID:26483853

Compulsory licensing in Canada and Thailand: comparing regimes to ensure legitimate use of the WTO rules.

PubMed

Lybecker, Kristina M; Fowler, Elisabeth

2009-01-01

This paper examines two recent examples of compulsory licensing legislation: one globally embraced regime and one internationally controversial regime operating under the same WTO rules. In particular, we consider Canadian legislation and the use of compulsory licensing for HIV/AIDS drugs destined for a developing country. This is then contrasted with the conditions under which Thai authorities are pursuing compulsory licenses, the outcomes of their compulsory licenses, as well as the likely impact of the Thai policy. Finally, we construct a rubric to evaluate characteristics of a successful regime. This is used to analyze the Canadian and Thai regimes and frame the expected implications of each national policy. It is hoped that the assessment will guide changes to compulsory licensing design to ensure that legitimate regimes are embraced while illegitimate ones are disallowed.

New Measures Assessing Predictors of Academic Persistence for Historically Underrepresented Racial/Ethnic Undergraduates in Science.

PubMed

Byars-Winston, Angela; Rogers, Jenna; Branchaw, Janet; Pribbenow, Christine; Hanke, Ryan; Pfund, Christine

2016-01-01

An important step in broadening participation of historically underrepresented (HU) racial/ethnic groups in the sciences is the creation of measures validated with these groups that will allow for greater confidence in the results of investigations into factors that predict their persistence. This study introduces new measures of theoretically derived factors emanating from social cognitive and social identity theories associated with persistence for HU racial/ethnic groups in science disciplines. The purpose of this study was to investigate: 1) the internal reliability and factor analyses for measures of research-related self-efficacy beliefs, sources of self-efficacy, outcome expectations, and science identity; and 2) potential group differences in responses to the measures, examining the main and interaction effects of gender and race/ethnicity. Survey data came from a national sample of 688 undergraduate students in science majors who were primarily black/African American and Hispanic/Latino/a with a 2:1 ratio of females to males. Analyses yielded acceptable validity statistics and race × gender group differences were observed in mean responses to several measures. Implications for broadening participation of HU groups in the sciences are discussed regarding future tests of predictive models of student persistence and training programs to consider cultural diversity factors in their design. © 2016 A. Byars-Winston et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

47 CFR 13.201 - Qualifying for a commercial operator license or endorsement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... must pass an examination for the issuance of a new Ship Radar Endorsement. Each application for the... License: Written Elements 1, 3, and 9. (7) Ship Radar Endorsement: Written Element 8. [58 FR 9124, Feb. 19...

47 CFR 13.201 - Qualifying for a commercial operator license or endorsement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... must pass an examination for the issuance of a new Ship Radar Endorsement. Each application for the... License: Written Elements 1, 3, and 9. (7) Ship Radar Endorsement: Written Element 8. [58 FR 9124, Feb. 19...

Inter-rater reliability and generalizability of patient note scores using a scoring rubric based on the USMLE Step-2 CS format.

PubMed

Park, Yoon Soo; Hyderi, Abbas; Bordage, Georges; Xing, Kuan; Yudkowsky, Rachel

2016-10-01

Recent changes to the patient note (PN) format of the United States Medical Licensing Examination have challenged medical schools to improve the instruction and assessment of students taking the Step-2 clinical skills examination. The purpose of this study was to gather validity evidence regarding response process and internal structure, focusing on inter-rater reliability and generalizability, to determine whether a locally-developed PN scoring rubric and scoring guidelines could yield reproducible PN scores. A randomly selected subsample of historical data (post-encounter PN from 55 of 177 medical students) was rescored by six trained faculty raters in November-December 2014. Inter-rater reliability (% exact agreement and kappa) was calculated for five standardized patient cases administered in a local graduation competency examination. Generalizability studies were conducted to examine the overall reliability. Qualitative data were collected through surveys and a rater-debriefing meeting. The overall inter-rater reliability (weighted kappa) was .79 (Documentation = .63, Differential Diagnosis = .90, Justification = .48, and Workup = .54). The majority of score variance was due to case specificity (13 %) and case-task specificity (31 %), indicating differences in student performance by case and by case-task interactions. Variance associated with raters and its interactions were modest (<5 %). Raters felt that justification was the most difficult task to score and that having case and level-specific scoring guidelines during training was most helpful for calibration. The overall inter-rater reliability indicates high level of confidence in the consistency of note scores. Designs for scoring notes may optimize reliability by balancing the number of raters and cases.

Assessing the Effects of the 2003 Resident Duty Hours Reform on Internal Medicine Board Scores

PubMed Central

Romano, Patrick S.; Itani, Kamal M.F.; Rosen, Amy K.; Small, Dylan; Lipner, Rebecca S.; Bosk, Charles L.; Wang, Yanli; Halenar, Michael J.; Korovaichuk, Sophia; Even-Shoshan, Orit; Volpp, Kevin G.

2014-01-01

Purpose To determine whether the 2003 Accreditation Council for Graduate Medical Education (ACGME) duty hours reform affected medical knowledge as reflected by written board scores for internal medicine (IM) residents. Method The authors conducted a retrospective cohort analysis of postgraduate year 1 (PGY-1) Internal Medicine residents who started training before and after the 2003 duty hour reform using a merged data set of American Board of Internal Medicine (ABIM) Board examination and the National Board of Medical Examiners (NMBE) United States Medical Licensing Examination (USMLE) Step 2 Clinical Knowledge test scores. Specifically, using four regression models, the authors compared IM residents beginning PGY-1 training in 2000 and completing training unexposed to the 2003 duty hours reform (PGY-1 2000 cohort, n = 5,475) to PGY-1 cohorts starting in 2001 through 2005 (n = 28,008), all with some exposure to the reform. Results The mean ABIM board score for the unexposed PGY-1 2000 cohort (n = 5,475) was 491, SD = 85. Adjusting for demographics, program, and USMLE Step 2 exam score, the mean differences (95% CI) in ABIM board scores between the PGY-1 2001, 2002, 2003, 2004 and 2005 cohorts minus the PGY-1 2000 cohort were −5.43 (−7.63, −3.23), −3.44 (−5.65, −1.24), 2.58 (0.36, 4.79), 11.10 (8.88, 13.33) and 11.28 (8.98, 13.58) points respectively. None of these differences exceeded one-fifth of an SD in ABIM board scores. Conclusions The duty hours reforms of 2003 did not meaningfully affect medical knowledge as measured by scores on the ABIM board examinations. PMID:24556772

Assessing the effects of the 2003 resident duty hours reform on internal medicine board scores.

PubMed

Silber, Jeffrey H; Romano, Patrick S; Itani, Kamal M F; Rosen, Amy K; Small, Dylan; Lipner, Rebecca S; Bosk, Charles L; Wang, Yanli; Halenar, Michael J; Korovaichuk, Sophia; Even-Shoshan, Orit; Volpp, Kevin G

2014-04-01

To determine whether the 2003 Accreditation Council for Graduate Medical Education (ACGME) duty hours reform affected medical knowledge as reflected by written board scores for internal medicine (IM) residents. The authors conducted a retrospective cohort analysis of postgraduate year 1 (PGY-1) Internal Medicine residents who started training before and after the 2003 duty hour reform using a merged data set of American Board of Internal Medicine (ABIM) Board examination and the National Board of Medical Examiners (NMBE) United States Medical Licensing Examination (USMLE) Step 2 Clinical Knowledge test scores. Specifically, using four regression models, the authors compared IM residents beginning PGY-1 training in 2000 and completing training unexposed to the 2003 duty hours reform (PGY-1 2000 cohort, n = 5,475) to PGY-1 cohorts starting in 2001 through 2005 (n = 28,008), all with some exposure to the reform. The mean ABIM board score for the unexposed PGY-1 2000 cohort (n = 5,475) was 491, SD = 85. Adjusting for demographics, program, and USMLE Step 2 exam score, the mean differences (95% CI) in ABIM board scores between the PGY-1 2001, 2002, 2003, 2004 and 2005 cohorts minus the PGY-1 2000 cohort were -5.43 (-7.63, -3.23), -3.44 (-5.65, -1.24), 2.58 (0.36, 4.79), 11.10 (8.88, 13.33) and 11.28 (8.98, 13.58) points respectively. None of these differences exceeded one-fifth of an SD in ABIM board scores. The duty hours reforms of 2003 did not meaningfully affect medical knowledge as measured by scores on the ABIM board examinations.

Use of the National Board of Medical Examiners® Comprehensive Basic Science Exam: survey results of US medical schools

PubMed Central

Wright, William S; Baston, Kirk

2017-01-01

Purpose The National Board of Medical Examiners® (NBME) Comprehensive Basic Science Exam (CBSE) is a subject exam offered to US medical schools, where it has been used for external validation of student preparedness for the United States Medical Licensing Examination® (USMLE) Step 1 in new schools and schools undergoing curricular reform. Information regarding the actual use of the NBME CBSE is limited. Therefore, the aim of the survey was to determine the scope and utilization of the NBME CBSE by US medical schools. Methods A survey was sent in May 2016 to curriculum leadership of the 139 US medical schools listed on the Liaison Committee on Medical Education (LCME®) website with provisional or full accreditation as of February 29, 2016. Responses were received from 53 schools (38% response rate). A series of different follow-up questions were asked if respondents stated “yes” or “no” to the initial question “Does your institution administer the NBME CBSE prior to the USMLE Step 1?”. Results A total of 37 schools (70%) administered the NBME CBSE. In all, 36 of the 37 schools responded to follow-up questions. Of 36 schools, 13 schools (36%) used the NBME CBSE for curriculum modification. Six schools (17%) used the NBME CBSE for formative assessment for a course, and five schools (14%) used the NBME CBSE for summative assessment for a course. A total of 28 schools (78%) used the NBME CBSE for identifying students performing below expectations and providing targeted intervention strategies. In all, 24 schools (67%) of the 36 responding schools administering the NBME CBSE administered the test once prior to the administration of the USMLE Step 1, whereas 10 (28%) schools administered the NBME CBSE two or more times prior to the administration of the USMLE Step 1. Conclusion Our data suggest that the NBME CBSE is administered by many US medical schools. However, the objective, timing, and number of exams administered vary greatly among schools. PMID:28670149

Critical Technology Assessment: Fine Grain, High Density Graphite

DTIC Science & Technology

2010-04-01

Control Classification Number ( ECCN ) 1C107.a on the Commerce Control List (CCL). The parameters of 1C107.a stem from controls established by the Missile...Technology Control Regime (MTCR). In this assessment, BIS specifically examined: • The application of ECCN 1C107.a and related licensing...export licensing process for fine grain, high density graphite controlled by ECCN 1C107.a, especially to China, requires more license conditions and

The Contractual Nature of a Driver's License.

ERIC Educational Resources Information Center

Sariola, Sakari

1989-01-01

Calls for programed administrative change which would reflect concern not only with skills and aptitudes of individual drivers, and with their physical and mental condition, but also with drivers in responsible and enlightened partnership under mutual agreement with society. Presents contractual obligation as one step in solving problem of…

Improving CD-ROM Management through Networking.

ERIC Educational Resources Information Center

Rutherford, John

1990-01-01

Summarizes advantages, components, and manufacturers of CD-ROM networks based on experiences at the Central Connecticut State University library. Three configurations are described, and the steps in installing a network where a large number of databases are shared by a number of microcomputers are detailed. Licensing and network performance issues…

To expand eligibility for Pell grants to certain students who are pursuing a postbaccalaureate professional certification or licensing credential required for employment as a teacher.

THOMAS, 111th Congress

Rep. Melancon, Charlie [D-LA-3

2010-07-15

House - 10/13/2010 Referred to the Subcommittee on Higher Education, Lifelong Learning, and Competitiveness. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

34 CFR 395.3 - Application for designation as State licensing agency; content.

Code of Federal Regulations, 2010 CFR

2010-07-01

... agency to the vendors, including their selection, duties, supervision, transfer, promotion, financial..., and take adequate steps to assure that each vendor understands the provisions of the permit and any agreement under which he operates, as evidenced by his signed statements: (vii) Submit to an arbitration...

15 CFR 732.3 - Steps regarding the ten general prohibitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... The CCL and the Country Chart are taken together to define these license requirements. The applicable... 'bundled' with controlled U.S.-origin software, foreign-made software that is commingled with controlled U.S.-origin software, or foreign-made technology that is commingled with controlled U.S.-origin...

75 FR 29785 - Draft Regulatory Guide: Issuance, Availability

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-27

... Guide, DG-1248, ``Nuclear Power Plant Simulation Facilities for Use in Operator Training, License..., ``Nuclear Power Plant Simulation Facilities for Use in Operator Training, License Examinations, and... or acceptance of a nuclear power plant simulation facility for use in operator and senior operator...

18 CFR 41.10 - Examination of accounts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... thereafter until December 31, 1975, the services of an independent certified public accountant, or independent licensed public accountant, certified or licensed by a regulatory authority of a State or other...) Beginning January 1, 1976, and each year thereafter, only independent certified public accountants, or...

Copyright, Licensing Agreements and Gateways.

ERIC Educational Resources Information Center

Elias, Arthur W.

1990-01-01

Discusses technological developments in information distribution and management in relation to concepts of ownership. A historical overview of the concept of copyright is presented; licensing elements for databases are examined; and implications for gateway systems are explored, including ownership, identification of users, and allowable uses of…

10 CFR 55.43 - Written examination: Senior operators.

Code of Federal Regulations, 2014 CFR

2014-01-01

... operator will contain a representative selection of questions on the knowledge, skills, and abilities needed to perform licensed senior operator duties. The knowledge, skills, and abilities will be identified, in part, from learning objectives derived from a systematic analysis of licensed senior operator...

10 CFR 55.43 - Written examination: Senior operators.

Code of Federal Regulations, 2013 CFR

2013-01-01

... operator will contain a representative selection of questions on the knowledge, skills, and abilities needed to perform licensed senior operator duties. The knowledge, skills, and abilities will be identified, in part, from learning objectives derived from a systematic analysis of licensed senior operator...

10 CFR 55.43 - Written examination: Senior operators.

Code of Federal Regulations, 2012 CFR

2012-01-01

... operator will contain a representative selection of questions on the knowledge, skills, and abilities needed to perform licensed senior operator duties. The knowledge, skills, and abilities will be identified, in part, from learning objectives derived from a systematic analysis of licensed senior operator...

Monopoly Profits: The Market for Taxi Licenses.

ERIC Educational Resources Information Center

Keane, Michael

1981-01-01

Presents a case study dealing with open versus closed markets for use in college economics classes. Using the example of the taxi license monopoly in Dublin, Ireland, students examine how theories of supply and demand explain the characteristics of open and closed markets. (AM)

18 CFR 41.10 - Examination of accounts.

Code of Federal Regulations, 2013 CFR

2013-04-01

... thereafter until December 31, 1975, the services of an independent certified public accountant, or independent licensed public accountant, certified or licensed by a regulatory authority of a State or other... that identification of questionable matters by the independent accountant will facilitate their early...

18 CFR 41.10 - Examination of accounts.

Code of Federal Regulations, 2014 CFR

2014-04-01

... thereafter until December 31, 1975, the services of an independent certified public accountant, or independent licensed public accountant, certified or licensed by a regulatory authority of a State or other... that identification of questionable matters by the independent accountant will facilitate their early...

18 CFR 41.10 - Examination of accounts.

Code of Federal Regulations, 2012 CFR

2012-04-01

... thereafter until December 31, 1975, the services of an independent certified public accountant, or independent licensed public accountant, certified or licensed by a regulatory authority of a State or other... that identification of questionable matters by the independent accountant will facilitate their early...

18 CFR 41.10 - Examination of accounts.

Code of Federal Regulations, 2011 CFR

2011-04-01

... thereafter until December 31, 1975, the services of an independent certified public accountant, or independent licensed public accountant, certified or licensed by a regulatory authority of a State or other... that identification of questionable matters by the independent accountant will facilitate their early...

Graduated driver licensing and differential deterrence: The effect of license type on intentions to violate road rules.

PubMed

Poirier, Brigitte; Blais, Etienne; Faubert, Camille

2018-01-01

In keeping with the differential deterrence theory, this article assesses the moderating effect of license type on the relationship between social control and intention to violate road rules. More precisely, the article has two objectives: (1) to assess the effect of license type on intentions to infringe road rules; and (2) to pinpoint mechanisms of social control affecting intentions to violate road rules based on one's type of driver license (a restricted license or a full license). This effect is examined among a sample of 392 young drivers in the province of Quebec, Canada. Drivers taking part in the Graduated Driver Licensing (GDL) program have limited demerit points and there is zero tolerance for drinking-and-driving. Propensity score matching techniques were used to assess the effect of the license type on intentions to violate road rules and on various mechanisms of social control. Regression analyses were then conducted to estimate the moderating effect of license type. Average treatment effects from propensity score matching analyses indicate that respondents with a restricted license have lower levels of intention to infringe road rules. While moral commitment and, to a lesser extent, the perceived risk of arrest are both negatively associated with intentions to violate road rules, the license type moderates the relationship between delinquent peers and intentions to violate road rules. The effect of delinquent peers is reduced among respondents with a restricted driver license. Finally, a diminished capability to resist peer pressure could explain the increased crash risk in months following full licensing. Copyright © 2017 Elsevier Ltd. All rights reserved.

Medical review practices for driver licensing volume 3: guidelines and processes in the United States.

DOT National Transportation Integrated Search

2017-04-01

This is the third of three reports examining driver medical review practices in the United States and how : they fulfill the basic functions of identifying, assessing, and rendering licensing decisions on medically or : functionally at-risk drivers. ...

18 CFR 158.10 - Examination of accounts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... to January 1, 1984 shall secure for each year, the services of an independent certified public accountant, or independent licensed public accountant (licensed on or before December 31, 1970), certified or... matters by the independent accountant will facilitate their early resolution and that the independent...

Assuring the Quality of Licensing and Certification Programs.

ERIC Educational Resources Information Center

Shimberg, Benjamin

When one considers the importance and social significance of licensing and certification examinations, it is amazing that the enterprise operates with virtually no societal oversight. The "Standards for Educational and Psychological Testing" and the "Code of Fair Testing Practices in Education" of the American Psychological…

Librarian Certification and Licensing: A Brief Accounting.

ERIC Educational Resources Information Center

Kaatrude, Peter B.

1992-01-01

Examines certification and licensing of librarians in the United States and Canada from the perspective of differences between the two concepts and through historical analysis of applications of each. A contextual framework for studying applications of these concepts to other professions is provided. (nine references) (MES)

Current issues and areas for improvement in the Korean Dental Hygienist National Licensing Examination: an expert Delphi survey among dental hygienists

PubMed Central

2017-01-01

Purpose This study aimed to investigate current issues and areas for improvement in the Korean Dental Hygienist National Licensing Examination (KDHNLE) through an expert Delphi survey. Methods A Delphi survey was conducted from May through August 2016 in Korea. This Delphi survey included 20 persons representing the field of dental hygiene (7 groups from various dental hygiene-related organizations). The Delphi survey was administered through e-mail as 3 rounds of questionnaire surveys regarding the issues facing the KDHNLE and potential solutions to those challenges. The primary Delphi survey was an open questionnaire. In each round, subjects’ responses were categorized according to the detailed themes of their responses. The minimum value of the content validity ratio of the survey results was determined by the number of panels participating in the Delphi survey. Results Issues facing the KDHNLE were identified from the results of the Delphi survey. The following 4 items had an average importance score of 4.0 or higher and were considered as important by over 85% of the panels: the failure of the practical test to reflect actual clinical settings, the focus of the practical test on dental scaling, the gap between the items evaluated on the national examination and actual practical work, and insufficiency in strengthening the expertise of licensed dental hygienists. The following items were suggested for improvement: more rigorous rater training, adjustment of the difficulty of the licensing examination, the introduction of a specialized dental hygienist system, and more rigorous refresher training for licensed dental hygienists. Conclusion Based on the above results, the KDHNLE should be improved according to the core competencies of dental hygienists, including on-site clinical practice experience. PMID:28900069

Current issues and areas for improvement in the Korean Dental Hygienist National Licensing Examination: an expert Delphi survey among dental hygienists.

PubMed

Hwang, Yoon-Sook; Kang, Hyun-Sook; Kim, Soo-Hwa; Moon, Hee-Jung; Lee, Sun-Mi; Jung, Jae-Yeon; Hwang, Su-Jeong; Ha, Jung-Eun

2017-01-01

This study aimed to investigate current issues and areas for improvement in the Korean Dental Hygienist National Licensing Examination (KDHNLE) through an expert Delphi survey. A Delphi survey was conducted from May through August 2016 in Korea. This Delphi survey included 20 persons representing the field of dental hygiene (7 groups from various dental hygiene-related organizations). The Delphi survey was administered through e-mail as 3 rounds of questionnaire surveys regarding the issues facing the KDHNLE and potential solutions to those challenges. The primary Delphi survey was an open questionnaire. In each round, subjects' responses were categorized according to the detailed themes of their responses. The minimum value of the content validity ratio of the survey results was determined by the number of panels participating in the Delphi survey. Issues facing the KDHNLE were identified from the results of the Delphi survey. The following 4 items had an average importance score of 4.0 or higher and were considered as important by over 85% of the panels: the failure of the practical test to reflect actual clinical settings, the focus of the practical test on dental scaling, the gap between the items evaluated on the national examination and actual practical work, and insufficiency in strengthening the expertise of licensed dental hygienists. The following items were suggested for improvement: more rigorous rater training, adjustment of the difficulty of the licensing examination, the introduction of a specialized dental hygienist system, and more rigorous refresher training for licensed dental hygienists. Based on the above results, the KDHNLE should be improved according to the core competencies of dental hygienists, including on-site clinical practice experience.

Global benchmarking of medical student learning outcomes? Implementation and pilot results of the International Foundations of Medicine Clinical Sciences Exam at The University of Queensland, Australia.

PubMed

Wilkinson, David; Schafer, Jennifer; Hewett, David; Eley, Diann; Swanson, Dave

2014-01-01

To report pilot results for international benchmarking of learning outcomes among 426 final year medical students at the University of Queensland (UQ), Australia. Students took the International Foundations of Medicine (IFOM) Clinical Sciences Exam (CSE) developed by the National Board of Medical Examiners, USA, as a required formative assessment. IFOM CSE comprises 160 multiple-choice questions in medicine, surgery, obstetrics, paediatrics and mental health, taken over 4.5 hours. Significant implementation issues; IFOM scores and benchmarking with International Comparison Group (ICG) scores and United States Medical Licensing Exam (USMLE) Step 2 Clinical Knowledge (CK) scores; and correlation with UQ medical degree cumulative grade point average (GPA). Implementation as an online exam, under university-mandated conditions was successful. Mean IFOM score was 531.3 (maximum 779-minimum 200). The UQ cohort performed better (31% scored below 500) than the ICG (55% below 500). However 49% of the UQ cohort did not meet the USMLE Step 2 CK minimum score. Correlation between IFOM scores and UQ cumulative GPA was reasonable at 0.552 (p < 0.001). International benchmarking is feasible and provides a variety of useful benchmarking opportunities.

Development of a longitudinal integrated clerkship at an academic medical center.

PubMed

Poncelet, Ann; Bokser, Seth; Calton, Brook; Hauer, Karen E; Kirsch, Heidi; Jones, Tracey; Lai, Cindy J; Mazotti, Lindsay; Shore, William; Teherani, Arianne; Tong, Lowell; Wamsley, Maria; Robertson, Patricia

2011-04-04

In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants' career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center.

Development of a longitudinal integrated clerkship at an academic medical center

PubMed Central

Poncelet, Ann; Bokser, Seth; Calton, Brook; Hauer, Karen E.; Kirsch, Heidi; Jones, Tracey; Lai, Cindy J.; Mazotti, Lindsay; Shore, William; Teherani, Arianne; Tong, Lowell; Wamsley, Maria; Robertson, Patricia

2011-01-01

In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants' career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center. PMID:21475642

Actomyosin contractility regulators stabilize the cytoplasmic bridge between the two primordial germ cells during Caenorhabditis elegans embryogenesis.

PubMed

Goupil, Eugénie; Amini, Rana; Hall, David H; Labbé, Jean-Claude

2017-12-15

Stable cytoplasmic bridges arise from failed cytokinesis, the last step of cell division, and are a key feature of syncytial architectures in the germline of most metazoans. Whereas the Caenorhabditis elegans germline is syncytial, its formation remains poorly understood. We found that the germline precursor blastomere, P 4 , fails cytokinesis, leaving a stable cytoplasmic bridge between the two daughter cells, Z 2 and Z 3 Depletion of several regulators of actomyosin contractility resulted in a regression of the membrane partition between Z 2 and Z 3 , indicating that they are required to stabilize the cytoplasmic bridge. Epistatic analysis revealed a pathway in which Rho regulators promote accumulation of the nonc annonical anillin ANI-2 at the stable cytoplasmic bridge, which in turns promotes the accumulation of the nonm uscle myosin II NMY-2 and the midbody component CYK-7 at the bridge, in part by limiting the accumulation of canonical anillin ANI-1. Our results uncover key steps in C. elegans germline formation and define a set of conserved regulators that are enriched at the primordial germ cell cytoplasmic bridge to ensure its stability during embryonic development. © 2017 Goupil, Amini, et al. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Vehicle license plate recognition based on geometry restraints and multi-feature decision

NASA Astrophysics Data System (ADS)

Wu, Jianwei; Wang, Zongyue

2005-10-01

Vehicle license plate (VLP) recognition is of great importance to many traffic applications. Though researchers have paid much attention to VLP recognition there has not been a fully operational VLP recognition system yet for many reasons. This paper discusses a valid and practical method for vehicle license plate recognition based on geometry restraints and multi-feature decision including statistical and structural features. In general, the VLP recognition includes the following steps: the location of VLP, character segmentation, and character recognition. This paper discusses the three steps in detail. The characters of VLP are always declining caused by many factors, which makes it more difficult to recognize the characters of VLP, therefore geometry restraints such as the general ratio of length and width, the adjacent edges being perpendicular are used for incline correction. Image Moment has been proved to be invariant to translation, rotation and scaling therefore image moment is used as one feature for character recognition. Stroke is the basic element for writing and hence taking it as a feature is helpful to character recognition. Finally we take the image moment, the strokes and the numbers of each stroke for each character image and some other structural features and statistical features as the multi-feature to match each character image with sample character images so that each character image can be recognized by BP neural net. The proposed method combines statistical and structural features for VLP recognition, and the result shows its validity and efficiency.

Impact of a scholarly track on quality of residency program applicants.

PubMed

Celebi, Julie M; Nguyen, Cathina T; Sattler, Amelia L; Stevens, Michael B; Lin, Steven Y

2016-11-01

It is generally believed that residency programs offering scholarly tracks attract higher quality applicants, although there is little evidence of this in the literature. We explored the impact of a clinician-educator track on the quality of applicants to our residency program by comparing the volume and characteristics of applicants before (2008-2011) and after (2012-2015) the track was introduced. The total number of applications received was compared between the pre-track and post-track years. Among interviewees, data on United States Medical Licensing Examination (USMLE) Step 1 scores, Step 2 Clinical Knowledge (CK) scores, Medical Student Performance Evaluation (MSPE) scores, and proportion of candidates with an advanced degree (e.g. MPH, PhD) were compared. An online survey was administered to all interviewees in 2014-2015 to measure interest in the track. The total number of applications to the residency program increased significantly from the pre-track to the post-track years. Compared to the pre-track years, interviewees during the post-track years had statistically higher USMLE Step 1 and Step 2 CK scores, better MSPE scores, and were more likely to have an advanced degree. Two-thirds of survey respondents reported that the track increased their interest in the residency program. A residency clinician-educator track may be associated with increased overall interest from applicants, higher application volume, and better measures of applicant quality based on USMLE scores, MSPE scores, and proportion of candidates with an advanced degree. Residency programs may consider a potential increase in the quality of their applicants as an added benefit of offering a scholarly track.

SCAMP: Automatic Astrometric and Photometric Calibration

NASA Astrophysics Data System (ADS)

Bertin, Emmanuel

2010-10-01

Astrometric and photometric calibrations have remained the most tiresome step in the reduction of large imaging surveys. SCAMP has been written to address this problem. The program efficiently computes accurate astrometric and photometric solutions for any arbitrary sequence of FITS images in a completely automatic way. SCAMP is released under the GNU General Public License.

A bill to amend title 38, United States Code, to require States to recognize the military experience of veterans when issuing licenses and credentials to veterans, and for other purposes.

THOMAS, 113th Congress

Sen. Burr, Richard [R-NC

2013-03-07

Senate - 06/12/2013 Committee on Veterans' Affairs. Hearings held. Hearings printed: S.Hrg. 113-111. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

The Fascinating World of Radio Communications.

ERIC Educational Resources Information Center

Green, Wayne, Ed.

Intended mainly for the amateur radio operator, or "ham," this book outlines some of the pleasures to be had in amateur radio, including DXing (calling distant stations) and helping in emergencies. The steps in starting out on this hobby, including getting Citizens' Band (CB) gear, a CB license, and a receiver and antenna, are described.…

A bill to establish driver education curriculum for teenage drivers and to provide grants to States and tribal governments to carry out driver education training for licensed teenage drivers.

THOMAS, 111th Congress

Sen. Schumer, Charles E. [D-NY

2009-09-30

Senate - 09/30/2009 Read twice and referred to the Committee on Commerce, Science, and Transportation. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

10 CFR 61.72 - Filing of proposals for State and Tribal participation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... participation in the review of a license application. Proposals must be submitted within the following time... referencing steps in the review and calendar dates for planned submittals should be included. (3) A... those issues it wishes to review. (2) A description of material and information which the State or tribe...

15 CFR 732.3 - Steps regarding the ten general prohibitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

.... The CCL and the Country Chart are taken together to define these license requirements. The applicable... commodity that is ‘bundled’ with controlled U.S.-origin software, foreign-made software that is commingled with controlled U.S.-origin software, or foreign-made technology that is commingled with controlled U.S...

First Steps to Success. A Guide to Preparing Students for the Job Market.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY.

This guide, based on a survey of more than 100 New York City employers, lists the qualifications needed for 20 entry-level positions. The occupations profiled are as follows: bookkeeper, carpenter, child care worker, computer data entry/programmer, food service aide, home attendant, janitor/cleaner, legal assistant/paralegal, licensed practical…

Commercialization of University Research for Technology-Based Economic Development

ERIC Educational Resources Information Center

Ferguson, W. Ker

2011-01-01

This empirical study investigates the hypothesized relationship between US federally funded university research and development (R&D) and its resulting economic impact, as measured by the level of licensing revenue generated by US universities. The author also examines the key operating statistics of the top-ten licensing income-producing…

Alpena Community College Commercial Driver's License Program. Evaluation Summary.

ERIC Educational Resources Information Center

Alpena Community Coll., MI.

The Alpena Community College (ACC) Drivers Education Program was developed to deliver a basic skills program providing specific job-related basic skills instruction to approximately 300 workers throughout Michigan who desired to pass the Commercial Drivers License (CDL) examination. Other program goals were to establish greater partnerships…

75 FR 77947 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-14

... 2010 and certified that he does not have diabetic retinopathy. He holds a Class A operator's license... diabetic retinopathy. He holds a Class D operator's license from Kentucky. Allen C. Cornelius Mr. Cornelius...). His ophthalmologist examined him in 2010 and certified that he does not have diabetic retinopathy. He...

Age vs. experience : evaluation of a video feedback intervention for newly licensed teen drivers.

DOT National Transportation Integrated Search

2013-02-06

This project examines the effects of age, experience, and video-based feedback on the rate and type of safety-relevant events captured on video event : recorders in the vehicles of three groups of newly licensed young drivers: : 1. 14.5- to 15.5-year...

Occupational radiation Exposure at Agreement State-Licensed Materials Facilities, 1997-2010

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

U.S. Nuclear Regulatory Commission, Office of Nuclear Regulatory Research

The purpose of this report is to examine occupational radiation exposures received under Agreement State licensees. As such, this report reflects the occupational radiation exposure data contained in the Radiation Exposure Information and Reporting System (REIRS) database, for 1997 through 2010, from Agreement State-licensed materials facilities.

47 CFR 97.507 - Preparing an examination.

Code of Federal Regulations, 2013 CFR

2013-10-01

... each written question set administered to an examinee must be prepared by a VE holding an Amateur Extra Class operator license. A telegraphy message or written question set may also be prepared for the... message and each written question set administered to an examinee for an amateur operator license must be...

47 CFR 97.507 - Preparing an examination.

Code of Federal Regulations, 2011 CFR

2011-10-01

... each written question set administered to an examinee must be prepared by a VE holding an Amateur Extra Class operator license. A telegraphy message or written question set may also be prepared for the... message and each written question set administered to an examinee for an amateur operator license must be...

47 CFR 97.507 - Preparing an examination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... each written question set administered to an examinee must be prepared by a VE holding an Amateur Extra Class operator license. A telegraphy message or written question set may also be prepared for the... message and each written question set administered to an examinee for an amateur operator license must be...

47 CFR 97.507 - Preparing an examination.

Code of Federal Regulations, 2012 CFR

2012-10-01

... each written question set administered to an examinee must be prepared by a VE holding an Amateur Extra Class operator license. A telegraphy message or written question set may also be prepared for the... message and each written question set administered to an examinee for an amateur operator license must be...

10 CFR 55.35 - Re-applications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Re-applications. 55.35 Section 55.35 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES Applications § 55.35 Re-applications. (a) An applicant whose application for a license has been denied because of failure to pass the written examination or...

19 CFR 111.96 - Fees.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Monetary Penalty and Payment of Fees § 111.96 Fees. (a) License fee; examination fee; fingerprint fee. Each... submits an application for a license must also pay a fingerprint check and processing fee; the port... fingerprint checks and the Customs fingerprint processing fee, the total of which must be paid to Customs...

19 CFR 111.96 - Fees.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Monetary Penalty and Payment of Fees § 111.96 Fees. (a) License fee; examination fee; fingerprint fee. Each... submits an application for a license must also pay a fingerprint check and processing fee; the port... fingerprint checks and the Customs fingerprint processing fee, the total of which must be paid to Customs...

19 CFR 111.96 - Fees.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Monetary Penalty and Payment of Fees § 111.96 Fees. (a) License fee; examination fee; fingerprint fee. Each... submits an application for a license must also pay a fingerprint check and processing fee; the port... fingerprint checks and the Customs fingerprint processing fee, the total of which must be paid to Customs...

19 CFR 111.96 - Fees.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Monetary Penalty and Payment of Fees § 111.96 Fees. (a) License fee; examination fee; fingerprint fee. Each... submits an application for a license must also pay a fingerprint check and processing fee; the port... fingerprint checks and the Customs fingerprint processing fee, the total of which must be paid to Customs...

19 CFR 111.96 - Fees.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Monetary Penalty and Payment of Fees § 111.96 Fees. (a) License fee; examination fee; fingerprint fee. Each... submits an application for a license must also pay a fingerprint check and processing fee; the port... fingerprint checks and the Customs fingerprint processing fee, the total of which must be paid to Customs...

21 CFR 601.20 - Biologics licenses; issuance and conditions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Biologics licenses; issuance and conditions. 601.20 Section 601.20 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... only upon examination of the product and upon a determination that the product complies with the...

An Economic Analysis of Occupational Licensure. Final Report.

ERIC Educational Resources Information Center

Rayack, Elton

To examine the hypothesis that occupational licensure is primarily a restrictive device to protect those licensed from competition, analysis focused on the licensure of non-professional occupations in Rhode Island, Massachusetts, and Connecticut, covering 36 licenses issued by the three states for 12 occupations (e.g. electricians, barbers,…

Medical Student Perspectives of Active Learning: A Focus Group Study.

PubMed

Walling, Anne; Istas, Kathryn; Bonaminio, Giulia A; Paolo, Anthony M; Fontes, Joseph D; Davis, Nancy; Berardo, Benito A

2017-01-01

Phenomenon: Medical student perspectives were sought about active learning, including concerns, challenges, perceived advantages and disadvantages, and appropriate role in the educational process. Focus groups were conducted with students from all years and campuses of a large U.S. state medical school. Students had considerable experience with active learning prior to medical school and conveyed accurate understanding of the concept and its major strategies. They appreciated the potential of active learning to deepen and broaden learning and its value for long-term professional development but had significant concerns about the efficiency of the process, the clarity of expectations provided, and the importance of receiving preparatory materials. Most significantly, active learning experiences were perceived as disconnected from grading and even as impeding preparation for school and national examinations. Insights: Medical students understand the concepts of active learning and have considerable experience in several formats prior to medical school. They are generally supportive of active learning concepts but frustrated by perceived inefficiencies and lack of contribution to the urgencies of achieving optimal grades and passing United States Medical Licensing Examinations, especially Step 1.

Manufacturing challenges in the commercial production of recombinant coagulation factor VIII.

PubMed

Jiang, R; Monroe, T; McRogers, R; Larson, P J

2002-03-01

Advances in gene technology have led to the development of a method to manufacture recombinant coagulation Factor VIII (rFVIII) for haemophilia A. Because rFVIII is a large and complex protein, its commercialization has required that many challenges in manufacturing, purification and processing be overcome. In order to license the first generation of rFVIII (Kogenate) in 1993, Bayer Corporation invested over 10 years in research and manufacturing development. Seven additional years were subsequently devoted to research and manufacturing improvements in order to accomplish the recent licensing of a second rFVIII product (KOGENATE Bayer or Kogenate FS). This product differs from its predecessor, in that human albumin is removed from the purification and the formulation steps. In addition, fewer chromatography steps are involved resulting in greater yields per mL of conditioned medium, and a solvent-detergent viral inactivation step replaces the heat-processing step used for the previous product. Despite these changes in the manufacturing, the protein backbone and carbohydrate structure of the final rFVIII molecule are identical. The complexity of the production processes is reflected by over 100 000 manufacturing data entries and by 600 quality control tests for each batch of rFVIII. Manufacturers are continuing to develop the next generation of rFVIII, which will be produced without the addition of any human or animal proteins or byproducts. Investments in research, development and manufacturing technology are expected to result in the development of new products with enhanced safety profiles, and in an increase in the production capacity for products that are chronically in short supply.

Pc-based car license plate reading

NASA Astrophysics Data System (ADS)

Tanabe, Katsuyoshi; Marubayashi, Eisaku; Kawashima, Harumi; Nakanishi, Tadashi; Shio, Akio

1994-03-01

A PC-based car license plate recognition system has been developed. The system recognizes Chinese characters and Japanese phonetic hiragana characters as well as six digits on Japanese license plates. The system consists of a CCD camera, vehicle sensors, a strobe unit, a monitoring center, and an i486-based PC. The PC includes in its extension slots: a vehicle detector board, a strobe emitter board, and an image grabber board. When a passing vehicle is detected by the vehicle sensors, the strobe emits a pulse of light. The light pulse is synchronized with the time the vehicle image is frozen on an image grabber board. The recognition process is composed of three steps: image thresholding, character region extraction, and matching-based character recognition. The recognition software can handle obscured characters. Experimental results for hundreds of outdoor images showed high recognition performance within relatively short performance times. The results confirmed that the system is applicable to a wide variety of applications such as automatic vehicle identification and travel time measurement.

The trend and features of physician workforce supply in China: after national medical licensing system reform.

PubMed

Tang, Chengxiang; Tang, Daisheng

2018-04-03

The annual number of newly licensed physicians is an important indicator of medical workforce supply, which can accurately reflect an inflow into the health care market over a period. In order to both regulate medical professions and improve the quality of health care services, China established its medical licensing system from the point of the implementation of 'Law on Practising Doctors' in 1999. The objective of this study is to depict the trend and structure of newly licensed physicians thereafter. This study analyses a unique census data set that provides the headcount of newly licensed physicians from 2005 to 2015 in China. We also review a short history of medical licensing system reform in China since the 1990s. The annual number of first-time licensed physicians in China increased from 159 489 in 2005 to 221 639 in 2015. Up to 2015, over half of newly licensed physicians had not received a medical education equivalent to a bachelor degree or higher. Around 51% of China's newly licensed physicians were female in 2005, while the same ratio for females in 2015 was 56%. This article first provides an exploratory analysis of physician inflow into health care market in China using physician licensing data. The medical licensing system in China allows entering physicians with a broad range of educational levels. Moreover, the feminisation of the physician supply in China has become increasingly apparent and its impacts on health care provision still require more rigorous examination.

Prematriculation variables associated with suboptimal outcomes for the 1994 – 1999 cohort of U.S. medical-school matriculants

PubMed Central

Andriole, Dorothy A.; Jeffe, Donna B.

2010-01-01

Context The relationship between increasing numbers and diversity of medical-school enrollees and the US physician workforce size and composition has not been described. Objective Identify demographic and pre-matriculation factors associated with medical-school matriculants’ outcomes. Design, Setting, and Participants De-identified data for the 1994–1999 national cohort of 97445 matriculants, followed through March 2, 2009 to graduation or withdrawal/dismissal, were analyzed using multivariable logistic regression to identify factors associated with suboptimal outcomes. Main Outcome Measures Academic withdrawal/dismissal, non-academic withdrawal/dismissal, and graduation without first-attempt passing scores on United States Medical Licensing Examination (USMLE) Step 1 and/or Step 2CK, each compared with graduation with first-attempt passing scores on both examinations. Results Of 84018 (86.2%) matriculants, 74494 (88.7%) graduated with first-attempt passing scores on Step 1 and Step 2CK, 6743 (8.0%) graduated without first-attempt passing scores on Step 1 and/or Step 2CK, 1049 (1.2%) withdrew/were dismissed for academic reasons, and 1732 (2.1%) withdrew/were dismissed for non-academic reasons. Variables associated with greater likelihood of graduation without first-attempt passing scores on Step 1 and/or Step 2CK and of academic withdrawal/dismissal included Medical College Admission Test (MCAT) scores (MCAT 18–20 [2.9% of sample]: adjusted odds ratio [OR]=13.06, 95% confidence interval [95% CI]=11.56–14.76 and OR=11.08, 95% CI=8.50–14.45, respectively; MCAT 21–23 [5.6%]: OR=7.52, 95% CI=6.79–8.33 and OR=5.97, 95% CI=4.68–7.62; MCAT 24–26 [13.9%]: OR=4.27, 95% CI=3.92–4.65 and OR=3.56, CI=2.88–4.40) each compared with MCAT>29; Asian/Pacific Islander ([18.2%]: OR=2.15, 95% CI=2.00–2.32 and OR=1.69, 95% CI = 1.37–2.09) or underrepresented minority ([14.9%]: OR=2.30, 95% CI=2.13–2.48 and OR=2.96, 95% CI=2.48–3.54) compared with white race/ethnicity, and premedical debt > $50,000 ([1.0%]:OR=1.68, 95% CI=1.35–2.08 and OR=2.33, 95% CI=1.57–3.46) compared with no debt. Conclusions Lower MCAT scores, non-white race/ethnicity, and premedical debt > $50,000 were independently associated with greater likelihood of academic withdrawal/dismissal and graduating without first-attempt passing scores on USMLE Step 1 and/or Step 2CK. PMID:20841535

Cold Test Operation of the German VEK Vitrification Plant

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

Fleisch, J.; Schwaab, E.; Weishaupt, M.

2008-07-01

In 2007 the German High-Level Liquid Waste (HLLW) Vitrification plant VEK (Verglasungseinrichtung Karlsruhe) has passed a three months integral cold test operation as final step before entering the hot phase. The overall performance of the vitrification process equipment with a liquid-fed ceramic glass melter as main component proved to be completely in line with the requirements of the regulatory body. The retention efficiency of main radioactive-bearing elements across melter and wet off-gas treatment system exceeded the design values distinctly. The strategy to produce a specified waste glass could be successfully demonstrated. The results of the cold test operation allow enteringmore » the next step of hot commissioning, i.e. processing of approximately 2 m{sup 3} of diluted HLLW. In summary: An important step of the VEK vitrification plant towards hot operation has been the performance of the cold test operation from April to July 2007. This first integral operation was carried out under boundary conditions and rules established for radioactive operation. Operation and process control were carried out following the procedure as documented in the licensed operational manuals. The function of the process technology and the safe operation could be demonstrated. No severe problems were encountered. Based on the positive results of the cold test, application of the license for hot operation has been initiated and is expected in the near future. (authors)« less

Considering Student Voices: Examining the Experiences of Underrepresented Students in Intervention Programs.

PubMed

Gibau, Gina Sanchez

2015-01-01

Qualitative studies that examine the experiences of underrepresented minority students in science, technology, engineering, and mathematics fields are comparatively few. This study explores the self-reported experiences of underrepresented graduate students in the biomedical sciences of a large, midwestern, urban university. Document analysis of interview transcripts from program evaluations capture firsthand accounts of student experiences and reveal the need for a critical examination of current intervention programs designed to reverse the trend of underrepresentation in the biomedical sciences. Findings point to themes aligned around the benefits and challenges of program components, issues of social adjustment, the utility of supportive relationships, and environmental impacts. © 2015 G. S. Gibau. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

US policies to enhance older driver safety: a systematic review of the literature.

PubMed

Dugan, Elizabeth; Barton, Kelli N; Coyle, Caitlin; Lee, Chae Man

2013-01-01

The purpose of this study was to conduct a systematic review of the literature related to state policies concerning older drivers and to draw policy conclusions about which policies appear to work to reduce older driver crashes and to identify areas needed for further research. Specific policies examined in this paper concern medical reporting and medical review, license renewal processes, and driver testing. A study was included in the systematic review if it met the following criteria: published in English between 1991and January 2013; included data on human subjects aged 65 and older residing in the United States; included information on at least one policy related to older drivers; and had a transportation-related outcome variable (e.g., crash, fatality, renewal). A total of 29 studies met inclusion criteria. Twenty-two studies investigated license renewal and seven articles examined medical reporting. In-person license renewal requirements were associated with reduced risk for fatal crashes. Restricted licenses were associated with reduced number of miles driven per week. More intensive renewal requirements and being the subject of a medical report to the licensing authority was associated with delicensure. Given the importance of driving to mobility, quality of life, and public safety, more research is needed.

Feasibility Study for Electronic Fitness for Duty Medical Examination Reporting and Oversight.

DOT National Transportation Integrated Search

2016-11-01

This report examines the institutional and high-level technology aspects associated with potential mandated : electronic reporting of every commercial driver license (CDL) driver fitness-for-duty medical examination : performed by a medical examiner ...

Behaviors of providers of traditional korean medicine therapy and complementary and alternative medicine therapy for the treatment of cancer patients.

PubMed

Yu, Jun-Sang; Kim, Chun-Bae; Kim, Ki-Kyong; Lee, Ji-Eun; Kim, Min-Young

2015-03-01

In Korea, cancer is one of the most important causes of death. Cancer patients have sought alternative methods, like complementary and alternative medicine (CAM) together with Western medicine, to treat cancer. Also, there are many kinds of providers of CAM therapy, including providers of Korean oriental medicine therapy. The purpose of this study is to identify the behaviors of Korean oriental medicine therapy and CAM therapy providers who treat cancer patients and to provide background knowledge for establishing a new policy with the management and quality control of CAM. Structured and well organized questionnaires were made, and 350 persons were surveyed concerning the providers of CAM or Korean oriental medicine. The questionnaires were collected and analyzed. The questionnaires (182) were collected. The questionnaires identified a total of 73 known providers, such as medicinal professionals or other providers of CAM suppliers, 35.6% of whom had had experience with treating cancer patients (52.6% vs. 29.6%). The treatment methods were a little different: alternative therapy and nutritional therapy being preferred by medicinal professionals and mind body modulation therapy and alternative therapy being preferred by other CAM providers. Four patients (7.4%) experienced side effects, and 6 patients (12.5%) experienced legal problems. As the method for managing the therapy, CAM providers, medicinal professionals, and other CAM providers had different viewpoints. For example, some CAM providers stated that both legislation and an official education on CAM or a national examination were needed as a first step to establish the provider's qualifications and that as a second step, a license test was needed for quality control. To the contrary, medicinal professionals stated that a license test was needed before legislation. Adequate management and quality control of CAM providers is thought to involve both education and legislation.

Medical review practices for driver licensing : Volume 1 : a case study of guidelines and processes in seven U.S. States.

DOT National Transportation Integrated Search

2016-10-01

This report is the first of three examining driver medical review practices in the United States and how they fulfilled the basic functions of identifying, assessing, and rendering licensing decisions on medically at-risk drivers. The aim was not to ...

76 FR 20073 - Qualification of Drivers; Exemption Applications; Diabetes Mellitus

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-11

... does not have diabetic retinopathy. He holds a Class D operator's license from Massachusetts. Kyle T... that he does not have diabetic retinopathy. He holds a Class B Commerical Driver's License (CDL) from... examined him in 2010 and certified that he does not have diabetic retinopathy. He holds a Class A CDL from...

49 CFR 398.3 - Qualifications of drivers or operators.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., nervous, organic, or functional disease, likely to interfere with safe driving. (3) No loss of fingers... (b)(8) of this section by a licensed doctor of medicine or osteopathy as meeting the requirements of... licensed doctor of medicine or osteopathy based on a physical examination as required by paragraph (b)(7...

49 CFR 398.3 - Qualifications of drivers or operators.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., nervous, organic, or functional disease, likely to interfere with safe driving. (3) No loss of fingers... (b)(8) of this section by a licensed doctor of medicine or osteopathy as meeting the requirements of... licensed doctor of medicine or osteopathy based on a physical examination as required by paragraph (b)(7...

49 CFR 398.3 - Qualifications of drivers or operators.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., nervous, organic, or functional disease, likely to interfere with safe driving. (3) No loss of fingers... (b)(8) of this section by a licensed doctor of medicine or osteopathy as meeting the requirements of... licensed doctor of medicine or osteopathy based on a physical examination as required by paragraph (b)(7...

49 CFR 398.3 - Qualifications of drivers or operators.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., nervous, organic, or functional disease, likely to interfere with safe driving. (3) No loss of fingers... (b)(8) of this section by a licensed doctor of medicine or osteopathy as meeting the requirements of... licensed doctor of medicine or osteopathy based on a physical examination as required by paragraph (b)(7...

Residency Applicants Misinterpret Their United States Medical Licensing Exam Scores

ERIC Educational Resources Information Center

Jones, Roger C.; Desbiens, Norman A.

2009-01-01

Proper interpretation of the results of the United States Medical Licensing Exam (USMLE) is important for program directors, residents, and faculty who advise applicants about applying for residency positions. We suspected that applicants often misinterpreted their performance in relationship to others who took the same examination. In 2005, 54…

Preparing MSW Students for Social Work Licensure: A Curricular Case Example

ERIC Educational Resources Information Center

Miller, J. Jay; Grise-Owens, Erlene; Escobar-Ratliff, Laura

2015-01-01

Licensing has been a dynamic tension for the social work profession for many years, specifically in social work education. Increasingly, social work programs are using factors related to social work licensing (pass rates, number of test takers, etc.) as an indicator of programmatic success. Yet few, if any, published papers examine curricular…

UCC2B: The Impact on Information Professionals.

ERIC Educational Resources Information Center

Ebbinghouse, Carol

1998-01-01

Discusses the impact of the Uniform Commercial Code (UCC) Article 2B, dealing with licenses of information and software contracts, on information professionals. Mass market licenses, copyrights, standard form contracts, and impact on first sale are examined. A sidebar lists key World Wide Web sites and includes a sample letter of concern. (LRW)

20 CFR 656.15 - Applications for labor certification for Schedule A occupations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Schedule A labor certification for an alien to be employed as a physical therapist (§ 656.5(a)(1)) must... state physical therapy licensing official in the state of intended employment, stating the alien is qualified to take that state's written licensing examination for physical therapists. Application for...

20 CFR 656.15 - Applications for labor certification for Schedule A occupations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Schedule A labor certification for an alien to be employed as a physical therapist (§ 656.5(a)(1)) must... state physical therapy licensing official in the state of intended employment, stating the alien is qualified to take that state's written licensing examination for physical therapists. Application for...

20 CFR 656.15 - Applications for labor certification for Schedule A occupations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Schedule A labor certification for an alien to be employed as a physical therapist (§ 656.5(a)(1)) must... state physical therapy licensing official in the state of intended employment, stating the alien is qualified to take that state's written licensing examination for physical therapists. Application for...

45 CFR 60.8 - Reporting licensure actions taken by Boards of Medical Examiners.

Code of Federal Regulations, 2014 CFR

2014-10-01

... must report to the NPDB any action based on reasons relating to a physician's or dentist's professional... dentist's license, (2) Which censures, reprimands, or places on probation a physician or dentist, or (3) Under which a physician's or dentist's license is surrendered. (b) Information that must be reported...

45 CFR 60.8 - Reporting licensure actions taken by Boards of Medical Examiners.

Code of Federal Regulations, 2013 CFR

2013-10-01

... must report to the NPDB any action based on reasons relating to a physician's or dentist's professional... dentist's license, (2) Which censures, reprimands, or places on probation a physician or dentist, or (3) Under which a physician's or dentist's license is surrendered. (b) Information that must be reported...

21 CFR 601.20 - Biologics licenses; issuance and conditions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Biologics licenses; issuance and conditions. 601.20 Section 601.20 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... examination of the product and upon a determination that the product complies with the standards established...

75 FR 52456 - Customs Broker License Examination Individual Eligibility Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-26

... statements made in the application, the business integrity of the applicant, and the moral character and... partnership) must hold a valid customs broker's license and permit in order to transact customs business on... relating to the customs business of brokers as necessary to protect importers and the revenue of the United...

Untangling the Licensing Web and Other Copyright Questions

ERIC Educational Resources Information Center

Sparkler, Andrew; Poliniak, Susan

2010-01-01

Copyright law is a daunting subject for most lawyers, so it's no surprise that many music educators feel uneasy dealing with it as well. But in truth, obtaining permissions for using copyrighted works can be a very simple and straightforward process. This article walks the readers through the steps of obtaining permission for a fictional piece of…

76 FR 72697 - Central Vermont Public Service Corporation; Notice of License Application Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-25

... by 33 feet containing four vertical shaft turbines: three 750-kilowatt (kW) units and one 1,680-kW...-kilovolt (kV) single phase transformer; (9) a 0.48/46-kV step-up transformer; (10) three winding... turbine/generators; and install new electrical switchgear, breakers, controls, and relays, resulting in an...

47 CFR 13.209 - Examination procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL RADIO OPERATORS Examination System § 13.209 Examination procedures. (a) Each examination for a commercial radio operator license must be administered at a... examinee to comply with its instructions. (b) Each examinee, when taking an examination for a commercial...

Perspectives on the manufacture of combination vaccines.

PubMed

Vose, J R

2001-12-15

Evolving regulatory requirements in the United States and Europe create major challenges for manufacturers tasked with production of vaccines that contain > or =9 separate antigens capable of protecting against infectious diseases, such as diphtheria, tetanus, pertussis, polio, hepatitis B, and Haemophilus influenza b, in a single shot. This article describes 10 steps that can facilitate the process of licensing these complex vaccines. It also points out problems associated with the use of animal tests for the crucial step of potency testing for batch release caused by the inherent variability of such tests and the difficulties of interpreting their results.

Relationships between study habits, burnout, and general surgery resident performance on the American Board of Surgery In-Training Examination.

PubMed

Smeds, Matthew R; Thrush, Carol R; McDaniel, Faith K; Gill, Roop; Kimbrough, Mary K; Shames, Brian D; Sussman, Jeffrey J; Galante, Joseph M; Wittgen, Catherine M; Ansari, Parswa; Allen, Steven R; Nussbaum, Michael S; Hess, Donald T; Knight, David C; Bentley, Frederick R

2017-09-01

The American Board of Surgery In-Training Examination (ABSITE) is used by programs to evaluate the knowledge and readiness of trainees to sit for the general surgery qualifying examination. It is often used as a tool for resident promotion and may be used by fellowship programs to evaluate candidates. Burnout has been associated with job performance and satisfaction; however, its presence and effects on surgical trainees' performance are not well studied. We sought to understand factors including burnout and study habits that may contribute to performance on the ABSITE examination. Anonymous electronic surveys were distributed to all residents at 10 surgical residency programs (n = 326). Questions included demographics as well as study habits, career interests, residency characteristics, and burnout scores using the Oldenburg Burnout Inventory, which assesses burnout because of both exhaustion and disengagement. These surveys were then linked to the individual's 2016 ABSITE and United States Medical Licensing Examination (USMLE) step 1 and 2 scores provided by the programs to determine factors associated with successful ABSITE performance. In total, 48% (n = 157) of the residents completed the survey. Of those completing the survey, 48 (31%) scored in the highest ABSITE quartile (≥75th percentile) and 109 (69%) scored less than the 75th percentile. In univariate analyses, those in the highest ABSITE quartile had significantly higher USMLE step 1 and step 2 scores (P < 0.001), significantly lower burnout scores (disengagement, P < 0.01; exhaustion, P < 0.04), and held opinions that the ABSITE was important for improving their surgical knowledge (P < 0.01). They also read more frequently to prepare for the ABSITE (P < 0.001), had more disciplined study habits (P < 0.001), were more likely to study at the hospital or other public settings (e.g., library, coffee shop compared with at home; P < 0.04), and used active rather than passive study strategies (P < 0.04). Gender, marital status, having children, and debt burden had no correlation with examination success. Backward stepwise multiple regression analysis identified the following independent predictors of ABSITE scores: study location (P < 0.0001), frequency of reading (P = 0.0001), Oldenburg Burnout Inventory exhaustion (P = 0.02), and USMLE step 1 and 2 scores (P = 0.007 and 0.0001, respectively). Residents who perform higher on the ABSITE have a regular study schedule throughout the year, report less burnout because of exhaustion, study away from home, and have shown success in prior standardized tests. Further study is needed to determine the effects of burnout on clinical duties, career advancement, and satisfaction. Copyright © 2017 Elsevier Inc. All rights reserved.

Cystic Fibrosis Patents: A Case Study of Successful Licensing

PubMed Central

Minear, Mollie A.; Kapustij, Cristina; Boden, Kaeleen; Chandrasekharan, Subhashini; Cook-Deegan, Robert

2013-01-01

From 2006–2010, Duke University’s Center for Public Genomics prepared eight case studies examining the effects of gene patent licensing practices on clinical access to genetic testing for ten clinical conditions. One of these case studies focused on the successful licensing practices employed by the University of Michigan and the Hospital for Sick Children in Toronto for patents covering the CFTR gene and its ΔF508 mutation that causes a majority of cystic fibrosis cases. Since the licensing of these patents has not impeded clinical access to genetic testing, we sought to understand how this successful licensing model was developed and whether it might be applicable to other gene patents. We interviewed four key players who either were involved in the initial discussions regarding the structure of licensing or who have recently managed the licenses and collected related documents. Important features of the licensing planning process included thoughtful consideration of potential uses of the patent; anticipation of future scientific discoveries and technological advances; engagement of relevant stakeholders, including the Cystic Fibrosis Foundation; and using separate licenses for in-house diagnostics versus kit manufacture. These features led to the development of a licensing model that has not only allowed the patent holders to avoid the controversy that has plagued other gene patents, but has also allowed research, development of new therapeutics, and wide-spread dissemination of genetic testing for cystic fibrosis. Although this licensing model may not be applicable to all gene patents, it serves as a model in which gene patent licensing can successfully enable innovation, investment in therapeutics research, and protect intellectual property while respecting the needs of patients, scientists, and public health. PMID:24231943

Step by Step: Biology Undergraduates' Problem-Solving Procedures during Multiple-Choice Assessment.

PubMed

Prevost, Luanna B; Lemons, Paula P

2016-01-01

This study uses the theoretical framework of domain-specific problem solving to explore the procedures students use to solve multiple-choice problems about biology concepts. We designed several multiple-choice problems and administered them on four exams. We trained students to produce written descriptions of how they solved the problem, and this allowed us to systematically investigate their problem-solving procedures. We identified a range of procedures and organized them as domain general, domain specific, or hybrid. We also identified domain-general and domain-specific errors made by students during problem solving. We found that students use domain-general and hybrid procedures more frequently when solving lower-order problems than higher-order problems, while they use domain-specific procedures more frequently when solving higher-order problems. Additionally, the more domain-specific procedures students used, the higher the likelihood that they would answer the problem correctly, up to five procedures. However, if students used just one domain-general procedure, they were as likely to answer the problem correctly as if they had used two to five domain-general procedures. Our findings provide a categorization scheme and framework for additional research on biology problem solving and suggest several important implications for researchers and instructors. © 2016 L. B. Prevost and P. P. Lemons. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Endothelial cells use dynamic actin to facilitate lymphocyte transendothelial migration and maintain the monolayer barrier.

PubMed

Mooren, Olivia L; Li, Jinmei; Nawas, Julie; Cooper, John A

2014-12-15

The vascular endothelium is a highly dynamic structure, and the integrity of its barrier function is tightly regulated. Normally impenetrable to cells, the endothelium actively assists lymphocytes to exit the bloodstream during inflammation. The actin cytoskeleton of the endothelial cell (EC) is known to facilitate transmigration, but the cellular and molecular mechanisms are not well understood. Here we report that actin assembly in the EC, induced by Arp2/3 complex under control of WAVE2, is important for several steps in the process of transmigration. To begin transmigration, ECs deploy actin-based membrane protrusions that create a cup-shaped docking structure for the lymphocyte. We found that docking structure formation involves the localization and activation of Arp2/3 complex by WAVE2. The next step in transmigration is creation of a migratory pore, and we found that endothelial WAVE2 is needed for lymphocytes to follow a transcellular route through an EC. Later, ECs use actin-based protrusions to close the gap behind the lymphocyte, which we discovered is also driven by WAVE2. Finally, we found that ECs in resting endothelial monolayers use lamellipodial protrusions dependent on WAVE2 to form and maintain contacts and junctions between cells. © 2014 Mooren et al. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

An overview of the regulation of influenza vaccines in the United States.

PubMed

Weir, Jerry P; Gruber, Marion F

2016-09-01

Influenza virus vaccines are unique among currently licensed viral vaccines. The vaccines designed to protect against seasonal influenza illness must be updated periodically in an effort to match the vaccine strain with currently circulating viruses, and the vaccine manufacturing timeline includes multiple, overlapping processes with a very limited amount of flexibility. In the United States (U.S.), over 150 million doses of seasonal trivalent and quadrivalent vaccine are produced annually, a mammoth effort, particularly in the context of a vaccine with components that usually change on a yearly basis. In addition, emergence of an influenza virus containing an HA subtype that has not recently circulated in humans is an ever present possibility. Recently, pandemic influenza vaccines have been licensed, and the pathways for licensure of pandemic vaccines and subsequent strain updating have been defined. Thus, there are formidable challenges for the regulation of currently licensed influenza vaccines, as well as for the regulation of influenza vaccines under development. This review describes the process of licensing influenza vaccines in the U.S., the process and steps involved in the annual updating of seasonal influenza vaccines, and some recent experiences and regulatory challenges faced in development and evaluation of novel influenza vaccines. © 2016 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Varying levels of difficulty index of skills-test items randomly selected by examinees on the Korean emergency medical technician licensing examination.

PubMed

Koh, Bongyeun; Hong, Sunggi; Kim, Soon-Sim; Hyun, Jin-Sook; Baek, Milye; Moon, Jundong; Kwon, Hayran; Kim, Gyoungyong; Min, Seonggi; Kang, Gu-Hyun

2016-01-01

The goal of this study was to characterize the difficulty index of the items in the skills test components of the class I and II Korean emergency medical technician licensing examination (KEMTLE), which requires examinees to select items randomly. The results of 1,309 class I KEMTLE examinations and 1,801 class II KEMTLE examinations in 2013 were subjected to analysis. Items from the basic and advanced skills test sections of the KEMTLE were compared to determine whether some were significantly more difficult than others. In the class I KEMTLE, all 4 of the items on the basic skills test showed significant variation in difficulty index (P<0.01), as well as 4 of the 5 items on the advanced skills test (P<0.05). In the class II KEMTLE, 4 of the 5 items on the basic skills test showed significantly different difficulty index (P<0.01), as well as all 3 of the advanced skills test items (P<0.01). In the skills test components of the class I and II KEMTLE, the procedure in which examinees randomly select questions should be revised to require examinees to respond to a set of fixed items in order to improve the reliability of the national licensing examination.

A multicenter analysis of the ophthalmic knowledge assessment program and American Board of Ophthalmology written qualifying examination performance.

PubMed

Lee, Andrew G; Oetting, Thomas A; Blomquist, Preston H; Bradford, Geoffrey; Culican, Susan M; Kloek, Carolyn; Krishnan, Chandrasekharan; Lauer, Andreas K; Levi, Leah; Naseri, Ayman; Rubin, Steven E; Scott, Ingrid U; Tao, Jeremiah; Tuli, Sonal; Wright, Martha M; Wudunn, Darrell; Zimmerman, M Bridget

2012-10-01

To compare the performance on the American Board of Ophthalmology Written Qualifying Examination (WQE) with the performance on step 1 of the United States Medical Licensing Examination (USMLE) and the Ophthalmic Knowledge Assessment Program (OKAP) examination for residents in multiple residency programs. Comparative case series. Fifteen residency programs with 339 total residents participated in this study. The data were extracted from the 5-year American Board of Ophthalmology report to each participating program in 2009 and included residency graduating classes from 2003 through 2007. Residents were included if data were available for the USMLE, OKAP examination in ophthalmology years 1 through 3, and the WQE score. Residents were excluded if one or more of the test scores were not available. Two-sample t tests, logistic regression analysis, and receiver operating characteristic (ROC) curves were used to examine the association of the various tests (USMLE, OKAP examination year 1, OKAP examination year 2, OKAP examination year 3, and maximum OKAP examination score) as a predictor for a passing or failing grade on the WQE. The primary outcome measure of this study was first time pass rate for the WQE. Using ROC analysis, the OKAP examination taken at the third year of ophthalmology residency best predicted performance on the WQE. For the OKAP examination taken during the third year of residency, the probability of passing the WQE was at least 80% for a score of 35 or higher and at least 95% for a score of 72 or higher. The OKAP examination, especially in the third year of residency, can be useful to residents to predict the likelihood of success on the high-stakes WQE examination. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

NBME subject examination in surgery scores correlate with surgery clerkship clinical experience.

PubMed

Myers, Jonathan A; Vigneswaran, Yalini; Gabryszak, Beth; Fogg, Louis F; Francescatti, Amanda B; Golner, Christine; Bines, Steven D

2014-01-01

Most medical schools in the United States use the National Board of Medical Examiners Subject Examinations as a method of at least partial assessment of student performance, yet there is still uncertainty of how well these examination scores correlate with clinical proficiency. Thus, we investigated which factors in a surgery clerkship curriculum have a positive effect on academic achievement on the National Board of Medical Examiners Subject Examination in Surgery. A retrospective analysis of 83 third-year medical students at our institution with 4 unique clinical experiences on the general surgery clerkship for the 2007-2008 academic year was conducted. Records of the United States Medical Licensing Examination Step 1 scores, National Board of Medical Examiners Subject Examination in Surgery scores, and essay examination scores for the groups were compared using 1-way analysis of variance testing. Rush University Medical Center, Chicago IL, an academic institution and tertiary care center. Our data demonstrated National Board of Medical Examiners Subject Examination in Surgery scores from the group with the heavier clinical loads and least time for self-study were statistically higher than the group with lighter clinical services and higher rated self-study time (p = 0.036). However, there was no statistical difference of National Board of Medical Examiners Subject Examination in Surgery scores between the groups with equal clinical loads (p = 0.751). Students experiencing higher clinical volumes on surgical services, but less self-study time demonstrated statistically higher academic performance on objective evaluation, suggesting clinical experience may be of higher value than self-study and reading. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A Conceptual Statement on the Enforcement of Child Day Care Licensing Standards: With Special Reference to Revocation.

ERIC Educational Resources Information Center

Class, Norris E.; And Others

This statement of the enforcement of child day care licensing standards identifies basic concepts of the enforcement process and operational procedures necessary to bring about this process. Two types of enforcement operations, negative and positive enforcement of standards, are identified and examined in detail. Positive enforcement is defined as…

78 FR 14842 - Crystal River Nuclear Generating Plant, Unit 3; Application for Renewal of License to Facility...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-07

... NUCLEAR REGULATORY COMMISSION [Docket No. 50-302; NRC-2009-0039] Crystal River Nuclear Generating... in ADAMS) is provided the first time that a document is referenced. NRC's PDR: You may examine and... operating license DPR-72, which authorizes Florida Power Corporaton (FPC) to operate the Crystal River...

Impact Study on Driving by Special Populations. Final Report, Volume I: Conduct of the Project and State of the Art.

ERIC Educational Resources Information Center

Brainin, Paul A.; And Others

The first of a two-volume report on motor vehicle driving by handicapped persons focuses on driving behavior for 19 types of handicapping conditions. Information is detailed regarding driver education and assessment materials, present state laws regarding licensing, relevant medical opinion regarding licensing and examination, complicating factors…

Institutional Power: Identity, Politics, and Lived Experiences in the Dance License via Portfolio Process

ERIC Educational Resources Information Center

Maloney, Betsy

2015-01-01

In this research study, I examined how institutional power affected the experiences of two dance educators attempting to gain their K-12 dance teaching license in Minnesota. My research analyzed the ways in which candidates applying for the portfolio review process constructed, amended, or abandoned their identities as teachers/artists/individuals…

The Experiences of Licensed Mental Health Professionals Who Have Encountered and Navigated through Compassion Fatigue

ERIC Educational Resources Information Center

Jorgensen, Louise B.

2012-01-01

The purpose of this dissertation study was to increase understanding of licensed mental health professionals' experiences as they have encountered and navigated through compassion fatigue (CF). CF is a complex construct with an attendant constellation of secondary stress responses. In order to examine the complex and varying factors…

Realist evaluation of intersectoral oral health promotion interventions for schoolchildren living in rural Andean communities: a research protocol.

PubMed

Bergeron, Dave A; Talbot, Lise R; Gaboury, Isabelle

2017-02-24

Intersectoral collaboration, known to promote more sustainable change within communities, will be examined in an oral health promotion program (OHPP). In Peru, an OHPP was implemented by the Ministry of Health, to reduce the incidence of caries in schoolchildren. In rural Andean communities, however, these initiatives achieved limited success. The objectives of this project are: (1) to understand the context and the underlying mechanisms associated with Peruvian OHPP's current effects among school children living in rural Andean communities and (2) to validate a theory explaining how and under which circumstances OHP intersectoral interventions on schoolchildren living in rural Andean communities produce their effects. Through a realist evaluation, the context, underlying mechanisms and programme outcomes will be identified. This process will involve five different steps. In the first and second steps, a logic model and an initial theory are developed. In the third step, data collection will permit measurement of the OHHP's outcomes with quantitative data, and exploration of the elements of context and the mechanisms with qualitative data. In the fourth and fifth steps, iterative data analysis and a validation process will allow the identification of Context-Mechanism-Outcome configuration, and validate or refine the initial theory. This research project has received approval from the Comité d'éthique de la recherche en santé chez l'humain du Centre hospitalier universitaire de Sherbrooke. The initial theory and research results will be published in relevant journals in public health and oral health. They will also be presented at realist evaluation and health promotion international conferences. 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/.

Ownership of high-risk ("vicious") dogs as a marker for deviant behaviors: implications for risk assessment.

PubMed

Barnes, Jaclyn E; Boat, Barbara W; Putnam, Frank W; Dates, Harold F; Mahlman, Andrew R

2006-12-01

This study examined the association between ownership of high-risk ("vicious") dogs and the presence of deviant behaviors in the owners as indicated by court convictions. We also explored whether two characteristics of dog ownership (abiding licensing laws and choice of breed) could be useful areas of inquiry when assessing risk status in settings where children are present. Our matched sample consisted of 355 owners of either licensed or cited dogs that represented high or low-risk breeds. Categories of criminal convictions examined were aggressive crimes, drugs, alcohol, domestic violence, crimes involving children, firearm convictions, and major and minor traffic citations. Owners of cited high-risk ("vicious") dogs had significantly more criminal convictions than owners of licensed low-risk dogs. Findings suggest that the ownership of a high-risk ("vicious") dog can be a significant marker for general deviance and should be an element considered when assessing risk for child endangerment.

15 CFR 752.5 - Steps you must follow to apply for an SCL.

Code of Federal Regulations, 2012 CFR

2012-01-01

... satisfactory record established through BIS pre-license checks, or extensive experience as a consignee under... Application, Form BIS-748P-A, Item Appendix, Form BIS-748P-B, End-User Appendix, an ICP, a comprehensive... the instructions found in Supplement Nos. 1 and 2 of this part. (2) Form BIS-748P-B, End-User Appendix...

15 CFR 752.5 - Steps you must follow to apply for an SCL.

Code of Federal Regulations, 2014 CFR

2014-01-01

... satisfactory record established through BIS pre-license checks, or extensive experience as a consignee under... Application, Form BIS-748P-A, Item Appendix, Form BIS-748P-B, End-User Appendix, an ICP, a comprehensive... the instructions found in Supplement Nos. 1 and 2 of this part. (2) Form BIS-748P-B, End-User Appendix...

15 CFR 752.5 - Steps you must follow to apply for an SCL.

Code of Federal Regulations, 2013 CFR

2013-01-01

... satisfactory record established through BIS pre-license checks, or extensive experience as a consignee under... Application, Form BIS-748P-A, Item Appendix, Form BIS-748P-B, End-User Appendix, an ICP, a comprehensive... the instructions found in Supplement Nos. 1 and 2 of this part. (2) Form BIS-748P-B, End-User Appendix...

78 FR 70546 - Erie Boulevard Hydropower, L.P.; Notice of Application Accepted for Filing, Soliciting Motions To...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-26

... (kV) generator leads extending about 25 feet to an adjacent electrical substation containing a 2.4/4.8-kV, 600-kilovolt-amperes, step-up transformer bank. A transmission line owned and operated by... with the electrical grid at the substation. At the time the Commission issued the original license for...

CDC-48/p97 coordinates CDT-1 degradation with GINS chromatin dissociation to ensure faithful DNA replication.

PubMed

Franz, André; Orth, Michael; Pirson, Paul A; Sonneville, Remi; Blow, J Julian; Gartner, Anton; Stemmann, Olaf; Hoppe, Thorsten

2011-10-07

Faithful transmission of genomic information requires tight spatiotemporal regulation of DNA replication factors. In the licensing step of DNA replication, CDT-1 is loaded onto chromatin to subsequently promote the recruitment of additional replication factors, including CDC-45 and GINS. During the elongation step, the CDC-45/GINS complex moves with the replication fork; however, it is largely unknown how its chromatin association is regulated. Here, we show that the chaperone-like ATPase CDC-48/p97 coordinates degradation of CDT-1 with release of the CDC-45/GINS complex. C. elegans embryos lacking CDC-48 or its cofactors UFD-1/NPL-4 accumulate CDT-1 on mitotic chromatin, indicating a critical role of CDC-48 in CDT-1 turnover. Strikingly, CDC-48(UFD-1/NPL-4)-deficient embryos show persistent chromatin association of CDC-45/GINS, which is a consequence of CDT-1 stabilization. Moreover, our data confirmed a similar regulation in Xenopus egg extracts, emphasizing a conserved coordination of licensing and elongation events during eukaryotic DNA replication by CDC-48/p97. Copyright © 2011 Elsevier Inc. All rights reserved.

An automated workflow for parallel processing of large multiview SPIM recordings

PubMed Central

Schmied, Christopher; Steinbach, Peter; Pietzsch, Tobias; Preibisch, Stephan; Tomancak, Pavel

2016-01-01

Summary: Selective Plane Illumination Microscopy (SPIM) allows to image developing organisms in 3D at unprecedented temporal resolution over long periods of time. The resulting massive amounts of raw image data requires extensive processing interactively via dedicated graphical user interface (GUI) applications. The consecutive processing steps can be easily automated and the individual time points can be processed independently, which lends itself to trivial parallelization on a high performance computing (HPC) cluster. Here, we introduce an automated workflow for processing large multiview, multichannel, multiillumination time-lapse SPIM data on a single workstation or in parallel on a HPC cluster. The pipeline relies on snakemake to resolve dependencies among consecutive processing steps and can be easily adapted to any cluster environment for processing SPIM data in a fraction of the time required to collect it. Availability and implementation: The code is distributed free and open source under the MIT license http://opensource.org/licenses/MIT. The source code can be downloaded from github: https://github.com/mpicbg-scicomp/snakemake-workflows. Documentation can be found here: http://fiji.sc/Automated_workflow_for_parallel_Multiview_Reconstruction. Contact: schmied@mpi-cbg.de Supplementary information: Supplementary data are available at Bioinformatics online. PMID:26628585

An automated workflow for parallel processing of large multiview SPIM recordings.

PubMed

Schmied, Christopher; Steinbach, Peter; Pietzsch, Tobias; Preibisch, Stephan; Tomancak, Pavel

2016-04-01

Selective Plane Illumination Microscopy (SPIM) allows to image developing organisms in 3D at unprecedented temporal resolution over long periods of time. The resulting massive amounts of raw image data requires extensive processing interactively via dedicated graphical user interface (GUI) applications. The consecutive processing steps can be easily automated and the individual time points can be processed independently, which lends itself to trivial parallelization on a high performance computing (HPC) cluster. Here, we introduce an automated workflow for processing large multiview, multichannel, multiillumination time-lapse SPIM data on a single workstation or in parallel on a HPC cluster. The pipeline relies on snakemake to resolve dependencies among consecutive processing steps and can be easily adapted to any cluster environment for processing SPIM data in a fraction of the time required to collect it. The code is distributed free and open source under the MIT license http://opensource.org/licenses/MIT The source code can be downloaded from github: https://github.com/mpicbg-scicomp/snakemake-workflows Documentation can be found here: http://fiji.sc/Automated_workflow_for_parallel_Multiview_Reconstruction : schmied@mpi-cbg.de Supplementary data are available at Bioinformatics online. © The Author 2015. Published by Oxford University Press.

19 CFR 111.13 - Written examination for individual license.

Code of Federal Regulations, 2010 CFR

2010-04-01

... and procedures, bookkeeping, accounting, and all other appropriate matters necessary to render... first Monday in April and October unless the regularly scheduled examination date conflicts with a...

45 CFR 675.2 - Medical examinations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... medical and dental examinations may be conducted by a qualified licensed physician or dentist of the... to Antarctica. (c) The candidate's physician/dentist will submit the required medical information on...

45 CFR 675.2 - Medical examinations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... medical and dental examinations may be conducted by a qualified licensed physician or dentist of the... to Antarctica. (c) The candidate's physician/dentist will submit the required medical information on...

45 CFR 675.2 - Medical examinations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... medical and dental examinations may be conducted by a qualified licensed physician or dentist of the... to Antarctica. (c) The candidate's physician/dentist will submit the required medical information on...

45 CFR 675.2 - Medical examinations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... medical and dental examinations may be conducted by a qualified licensed physician or dentist of the... to Antarctica. (c) The candidate's physician/dentist will submit the required medical information on...

45 CFR 675.2 - Medical examinations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... medical and dental examinations may be conducted by a qualified licensed physician or dentist of the... to Antarctica. (c) The candidate's physician/dentist will submit the required medical information on...

Did Ontario's Zero Tolerance & Graduated Licensing Law Reduce Youth Drunk Driving?

ERIC Educational Resources Information Center

Carpenter, Christopher

2006-01-01

On April 1, 1994, Ontario, Canada, instituted a new graduated driver license (GDL) system that effectively set the legal blood alcohol content (BAC) threshold at zero for the first few years of a youth's driving eligibility. I use data from the 1983-2001 Ontario Student Drug Use Surveys (OSDUS) to examine whether the Zero Tolerance (ZT) policy…

Calculating DWI/DWAI Recidivism with Limited Data: Using State Driver License File for Drinking and Driving Research.

ERIC Educational Resources Information Center

Yu, Jiang; Williford, William R.

1991-01-01

Used sample from New York State Driver License File to mathematically extend dimension of file so that data purging procedure exerts minimum influence on calculation of drinking-driving recidivism. Examined impact of dimension of data on recidivism rate and mathematically extended file until impact of data dimension was minimum. Calculated New…

The Pursuit of Quality over Quantity in TESOL Teacher Education: Coursework versus Test Only

ERIC Educational Resources Information Center

Sehlaoui, Abdelilah Salim; Shinge, Manjula

2013-01-01

The purpose of this study was to examine whether licensed in-service teachers of English for speakers of other languages (ESOL) in K-12 schools are more knowledgeable in the area of applied linguistics than their nonlicensed counterparts, and whether the ESOL-licensed teachers who have taken courses toward their licensure are more knowledgeable in…

Modeling the Mental Health Workforce in Washington State: Using State Licensing Data to Examine Provider Supply in Rural and Urban Areas

ERIC Educational Resources Information Center

Baldwin, Laura-Mae; Patanian, Miriam M.; Larson, Eric H.; Lishner, Denise M.; Mauksch, Larry B.; Katon, Wayne J.; Walker, Edward; Hart, L. Gary

2006-01-01

Context: Ensuring an adequate mental health provider supply in rural and urban areas requires accessible methods of identifying provider types, practice locations, and practice productivity. Purpose: To identify mental health shortage areas using existing licensing and survey data. Methods: The 1998-1999 Washington State Department of Health files…

77 FR 35080 - Entergy Nuclear Operations, Inc., Pilgrim Nuclear Power Station; Record of Decision and Issuance...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-12

...., Pilgrim Nuclear Power Station; Record of Decision and Issuance of Renewed Facility Operating License No... as the record of decision for the renewal of facility operating license No. DPR-35, consistent with... referenced. NRC's PDR: You may examine and purchase copies of public documents at the NRC's PDR, Room O1-F21...

The Influence of Fees on Supervision of Licensed Professional Counselor Interns in Texas: A Mixed-Methods Study

ERIC Educational Resources Information Center

Stark, Marcella Dortch

2010-01-01

Purpose. The purpose of this study was to explore the influence of payment status on perceptions of Licensed Professional Counselor (LPC) Interns regarding aspects of the supervisory relationship. Method. Survey responses from 230 LPC Interns in Texas were collected using SurveyMonkey[TM] (2009) to examine how supervision fees influence: (a)…

Unfolding the chaperone story.

PubMed

Hartl, F Ulrich

2017-11-01

Protein folding in the cell was originally assumed to be a spontaneous process, based on Anfinsen's discovery that purified proteins can fold on their own after removal from denaturant. Consequently cell biologists showed little interest in the protein folding process. This changed only in the mid and late 1980s, when the chaperone story began to unfold. As a result, we now know that in vivo, protein folding requires assistance by a complex machinery of molecular chaperones. To ensure efficient folding, members of different chaperone classes receive the nascent protein chain emerging from the ribosome and guide it along an ordered pathway toward the native state. I was fortunate to contribute to these developments early on. In this short essay, I will describe some of the critical steps leading to the current concept of protein folding as a highly organized cellular process. © 2017 Hartl. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Driver licensing: descriptive epidemiology of a social determinant of Aboriginal and Torres Strait Islander health.

PubMed

Ivers, Rebecca Q; Hunter, Kate; Clapham, Kathleen; Helps, Yvonne; Senserrick, Teresa; Byrne, Jake; Martiniuk, Alexandra; Daniels, John; Harrison, James E

2016-08-01

Education, employment and equitable access to services are commonly accepted as important underlying social determinants of health. For most Australians, access to health, education and other services is facilitated by private transport and a driver licence. This study aimed to examine licensing rates and predictors of licensing in a sample of Aboriginal and Torres Strait Islander people, as these have previously been poorly described. Interviewer-administered surveys were conducted with 625 people 16 years or older in four Aboriginal Community Controlled Health Services in New South Wales and South Australia over a two-week period in 2012-2013. Licensing rates varied from 51% to 77% by site. Compared to not having a licence, having a driver licence was significantly associated with higher odds of full-time employment (adjusted OR 4.0, 95%CI 2.5-6.3) and educational attainment (adjusted OR 1.9, 95%CI 1.2-2.8 for trade or certificate; adjusted OR 4.0, 95%CI 1.6-9.5 for degree qualification). Variation in driver licensing rates suggests different yet pervasive barriers to access. There is a strong association between driver licensing, education and employment. Licensing inequality has far-reaching impacts on the broader health and wellbeing of Aboriginal and Torres Strait Islander people, reinforcing the need for appropriate and accessible pathways to achieving and maintaining driver licensing. © 2016 The Authors.

Do Residency Selection Factors Predict Radiology Resident Performance?

PubMed

Agarwal, Vikas; Bump, Gregory M; Heller, Matthew T; Chen, Ling-Wan; Branstetter, Barton F; Amesur, Nikhil B; Hughes, Marion A

2018-03-01

The purpose of our study is to determine what information in medical student residency applications predicts radiology residency success as defined by objective clinical performance data. We performed a retrospective cohort study of residents who entered our institution's residency program through the National Resident Matching Program as postgraduate year 2 residents and completed the program over the past 2 years. Medical school grades, selection to Alpha Omega Alpha (AOA) Honor Society, United States Medical Licensing Examination (USMLE) scores, publication in peer-reviewed journals, and whether the applicant was from a peer institution were the variables examined. Clinical performance was determined by calculating each resident's cumulative major discordance rate for on-call cases the resident read and gave a preliminary interpretation. A major discordance was defined as a difference between the preliminary resident and the final attending interpretations that could immediately impact the care of the patient. A multivariate logistic regression was performed to determine significant variables. Twenty-seven residents provided preliminary reports on call for 67,145 studies. The mean major discordance rate was 1.08% (range 0.34%-2.54%). Higher USMLE Step 1 scores, publication before residency, and election to AOA Honor Society were all statistically significant predictors of lower major discordance rates (P values 0.01, 0.01,  and <0.001, respectively). Overall resident performance was excellent. There are predictors that help select the better performing residents, namely higher USMLE Step 1 scores, one to two publications during medical school, and election to AOA in the junior year of medical school. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

The relationship of written examination performance to safe driving : a literature review with recommended methods for developing exams.

DOT National Transportation Integrated Search

1984-01-01

This report reviews the literature concerning written driver license examinations. The research literature shows that current written examinations are poor predictors of unsafe drivers. Although some studies demonstrate significant relationships betw...

North American Veterinary Licensing Examination pacing study.

PubMed

Subhiyah, Raja G; Boyce, John R

2010-01-01

The National Board of Veterinary Medical Examiners was interested in the possible effects of word count on the outcomes of the North American Veterinary Licensing Examination. In this study, the authors investigated the effects of increasing word count on the pacing of examinees during each section of the examination and on the performance of examinees on the items. Specifically, the authors analyzed the effect of item word count on the average time spent on each item within a section of the examination, the average number of items omitted at the end of a section, and the average difficulty of items as a function of presentation order. The average word count per item increased from 2001 to 2008. As expected, there was a relationship between word count and time spent on the item. No significant relationship was found between word count and item difficulty, and an analysis of omitted items and pacing patterns showed no indication of overall pacing problems.

Deciphering assumptions about stepped wedge designs: the case of Ebola vaccine research.

PubMed

Doussau, Adélaïde; Grady, Christine

2016-12-01

Ethical concerns about randomising persons to a no-treatment arm in the context of Ebola epidemic led to consideration of alternative designs. The stepped wedge (SW) design, in which participants or clusters are randomised to receive an intervention at different time points, gained popularity. Common arguments in favour of using this design are (1) when an intervention is likely to do more good than harm, (2) all participants should receive the experimental intervention at some time point during the study and (3) the design might be preferable for practical reasons. We examine these assumptions when considering Ebola vaccine research. First, based on the claim that a stepped wedge design is indicated when it is likely that the intervention will do more good than harm, we reviewed published and ongoing SW trials to explore previous use of this design to test experimental drugs or vaccines, and found that SW design has never been used for trials of experimental drugs or vaccines. Given that Ebola vaccines were all experimental with no prior efficacy data, the use of a stepped wedge design would have been unprecedented. Second, we show that it is rarely true that all participants receive the intervention in SW studies, but rather, depending on certain design features, all clusters receive the intervention. Third, we explore whether the SW design is appealing for feasibility reasons and point out that there is significant complexity. In the setting of the Ebola epidemic, spatiotemporal variation may have posed problematic challenges to a stepped wedge design for vaccine research. Finally, we propose a set of points to consider for scientific reviewers and ethics committees regarding proposals for SW designs. 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/.

Teenage driver licensing in relation to state laws.

PubMed

Williams, A F; Lund, A K; Preusser, D F

1985-04-01

Previous studies have shown that delaying licensure reduces motor vehicle injuries. This study examined the relationship between licensing laws and the timing of obtaining drivers licenses. The states studied have various laws, including minimum licensing ages of 15, 16 and 17; minimum learners permit ages of 15 and 16; and teenage night driving curfews. A questionnaire survey of 52,304 students was conducted in 75 high schools during the spring of 1983. The schools were selected from Orange County, California; rural Colorado; and most or all of Louisiana, Michigan, Mississippi, New Jersey and New York. The results indicated that the minimum age of licensure has obvious strong effects in delaying licensure. Setting the learners permit age later also apparently delays licensure. The night driving curfew in New York State (9 p.m.-5 a.m.) is seen by students as a factor in their decisions to delay obtaining licenses; Louisiana's 11 p.m.-5 a.m. curfew has a much smaller effect, if any.

On the effectiveness of a license scheme for E-waste recycling: The challenge of China and India

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

Shinkuma, Takayoshi, E-mail: shinkuma@kansai-u.ac.j; Managi, Shunsuke, E-mail: managi@ynu.ac.j

2010-07-15

It is well known that China and India have been recycling centers of WEEE, especially printed circuit boards, and that serious environmental pollution in these countries has been generated by improper recycling methods. After the governments of China and India banned improper recycling by the informal sector, improper recycling activities spread to other places. Then, these governments changed their policies to one of promoting proper recycling by introducing a scheme, under which E-waste recycling requires a license issued by the government. In this paper, the effectiveness of that license scheme is examined by means of an economic model. It canmore » be shown that the license scheme can work effectively only if disposers of E-waste have a responsibility to sell E-waste to license holders. Our results run counter to the idea that international E-waste trade should be banned and provide an alternative solution to the problem.« less

[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.

Varying levels of difficulty index of skills-test items randomly selected by examinees on the Korean emergency medical technician licensing examination

PubMed Central

2016-01-01

Purpose: The goal of this study was to characterize the difficulty index of the items in the skills test components of the class I and II Korean emergency medical technician licensing examination (KEMTLE), which requires examinees to select items randomly. Methods: The results of 1,309 class I KEMTLE examinations and 1,801 class II KEMTLE examinations in 2013 were subjected to analysis. Items from the basic and advanced skills test sections of the KEMTLE were compared to determine whether some were significantly more difficult than others. Results: In the class I KEMTLE, all 4 of the items on the basic skills test showed significant variation in difficulty index (P<0.01), as well as 4 of the 5 items on the advanced skills test (P<0.05). In the class II KEMTLE, 4 of the 5 items on the basic skills test showed significantly different difficulty index (P<0.01), as well as all 3 of the advanced skills test items (P<0.01). Conclusion: In the skills test components of the class I and II KEMTLE, the procedure in which examinees randomly select questions should be revised to require examinees to respond to a set of fixed items in order to improve the reliability of the national licensing examination. PMID:26883810

10 CFR 55.43 - Written examination: Senior operators.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Written examination: Senior operators. 55.43 Section 55.43... Tests § 55.43 Written examination: Senior operators. (a) Content. The written examination for a senior... needed to perform licensed senior operator duties. The knowledge, skills, and abilities will be...

Nursing Distance Learning Course Comparison of Assignments and Examination Scores

ERIC Educational Resources Information Center

Mundine, Jennifer

2016-01-01

Nursing programs have embraced distance learning in their curricula, but discussion is ongoing about course assignments and grading criteria to increase examination scores in nursing distance learning courses. Because course examinations are a predictor of success on the postgraduate licensing examination (NCLEX-RN), the purpose of this study was…

Early stages of functional diversification in the Rab GTPase gene family revealed by genomic and localization studies in Paramecium species.

PubMed

Bright, Lydia J; Gout, Jean-Francois; Lynch, Michael

2017-04-15

New gene functions arise within existing gene families as a result of gene duplication and subsequent diversification. To gain insight into the steps that led to the functional diversification of paralogues, we tracked duplicate retention patterns, expression-level divergence, and subcellular markers of functional diversification in the Rab GTPase gene family in three Paramecium aurelia species. After whole-genome duplication, Rab GTPase duplicates are more highly retained than other genes in the genome but appear to be diverging more rapidly in expression levels, consistent with early steps in functional diversification. However, by localizing specific Rab proteins in Paramecium cells, we found that paralogues from the two most recent whole-genome duplications had virtually identical localization patterns, and that less closely related paralogues showed evidence of both conservation and diversification. The functionally conserved paralogues appear to target to compartments associated with both endocytic and phagocytic recycling functions, confirming evolutionary and functional links between the two pathways in a divergent eukaryotic lineage. Because the functionally diversifying paralogues are still closely related to and derived from a clade of functionally conserved Rab11 genes, we were able to pinpoint three specific amino acid residues that may be driving the change in the localization and thus the function in these proteins. © 2017 Bright et al. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Knowledge and abilities catalog for nuclear power plant operators: Boiling water reactors, Revision 1

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

NONE

1995-08-01

The Knowledge and Abilities Catalog for Nuclear Power Plant Operators: Boiling-Water Reactors (BWRs) (NUREG-1123, Revision 1) provides the basis for the development of content-valid licensing examinations for reactor operators (ROs) and senior reactor operators (SROs). The examinations developed using the BWR Catalog along with the Operator Licensing Examiner Standards (NUREG-1021) and the Examiner`s Handbook for Developing Operator Licensing Written Examinations (NUREG/BR-0122), will cover the topics listed under Title 10, Code of Federal Regulations, Part 55 (10 CFR 55). The BWR Catalog contains approximately 7,000 knowledge and ability (K/A) statements for ROs and SROs at BWRs. The catalog is organized intomore » six major sections: Organization of the Catalog, Generic Knowledge and Ability Statements, Plant Systems grouped by Safety Functions, Emergency and Abnormal Plant Evolutions, Components, and Theory. Revision 1 to the BWR Catalog represents a modification in form and content of the original catalog. The K/As were linked to their applicable 10 CFR 55 item numbers. SRO level K/As were identified by 10 CFR 55.43 item numbers. The plant-wide generic and system generic K/As were combined in one section with approximately one hundred new K/As. Component Cooling Water and Instrument Air Systems were added to the Systems Section. Finally, High Containment Hydrogen Concentration and Plant Fire On Site evolutions added to the Emergency and Abnormal Plant Evolutions section.« less

Workplace Violence and Job Outcomes of Newly Licensed Nurses.

PubMed

Chang, Hyoung Eun; Cho, Sung-Hyun

2016-12-01

The purpose of this study was to examine the prevalence of workplace violence toward newly licensed nurses and the relationship between workplace violence and job outcomes. An online survey was conducted of newly licensed registered nurses who had obtained their license in 2012 or 2013 in South Korea and had been working for 5-12 months after first being employed. The sample consisted of 312 nurses working in hospitals or clinics. The Copenhagen Psychosocial Questionnaire II was used to measure violence and nurse job outcomes. Multiple linear and logistic regression analyses were conducted to examine the relationship between violence and job outcomes. Verbal abuse was most prevalent (59.6%), followed by threats of violence (36.9%), physical violence (27.6%), bullying (25.6%), and sexual harassment (22.4%). Approximately three quarters of the nurses had experienced at least one type of violence. The main perpetrators were patients and nurse colleagues, although the distribution of perpetrators varied depending on the type of violence. Bullying had a significant relationship with all four job outcomes (job satisfaction, burnout, commitment to the workplace, and intent to leave), while verbal abuse was associated with all job outcomes except for intent to leave. Violence perpetrated by nurse colleagues had a significant relationship with all four job outcomes, while violence by physicians had a significant inverse relationship with job satisfaction. Workplace violence is experienced by a high percentage of newly licensed nurses, and is associated with their job outcomes. Copyright © 2016. Published by Elsevier B.V.

Why trash don't pass? pharmaceutical licensing and safety performance of drugs.

PubMed

Banerjee, Tannista; Nayak, Arnab

2017-01-01

This paper examines how asymmetric information in pharmaceutical licensing affects the safety standards of licensed drugs. Pharmaceutical companies often license potential drug molecules at different stages of drug development from other pharmaceutical or biotechnology companies and complete the remaining of research stages before submitting the new drug application(NDA) to the food and drug administration. The asymmetric information associated with the quality of licensed molecules might result in the molecules which are less likely to succeed to be licensed out, while those with greater potential of success being held internally for development. We identify the NDAs submitted between 1993 and 2004 where new molecular entities were acquired through licensing. Controlling for other drug area specific and applicant firm specific factors, we investigate whether drugs developed with licensed molecules face higher probability of safety based recall and ultimate withdrawal from the market than drugs developed internally. Results suggest the opposite of Akerlof's (Q J Econ 84:488-500, 1970) lemons problem. Licensed molecules rather have less probability of facing safety based recalls and ultimate withdrawal from the market comparing to internally developed drug molecules. This suggests that biotechnology and small pharmaceutical firms specializing in pharmaceutical research are more efficient in developing good potential molecules because of their concentrated research. Biotechnology firms license out good potential molecules because it increases their market value and reputation. In addition, results suggest that both the number of previous approved drugs in the disease area, and also the applicant firms' total number of previous approvals in all disease areas reduce the probability that an additional approved drug in the same drug area will potentially be harmful.

Summary of ACOP (American College of Osteopathic Pediatricians) Program Directors' Annual Reports for First-Year Residents and Relationships between Resident Competency Performance Ratings and COMLEX-USA Test Scores

ERIC Educational Resources Information Center

Langenau, Erik E.; Pugliano, Gina; Roberts, William L.; Hostoffer, Robert

2010-01-01

Context: The Accreditation Council for Graduate Medical Education (ACGME) and American Osteopathic Association (AOA) endorsed the use of competency-based assessment, with the intention to improve health care administration [1, 2]. High-stakes licensing exams, such as the Comprehensive Osteopathic Medical Licensing Examination -- USA (COMLEX-USA),…

Training Nurse's Aides to Become Licensed Practical Nurses in Isolated Rural Hospitals. Final Report (May 1, 1971-April 30, 1972).

ERIC Educational Resources Information Center

Arkansas State Dept. of Education, Little Rock. Div. of Vocational Education.

This 1-year pilot project in training nurse's aides to become eligible for licensing as practical nurses in isolated rural hospitals was designed to upgrade their skills, expand their theoretical knowledge, and aid in occupational mobility upon successful completion of the program and the State's examination. Conducted in a typical rural hospital…

Association of Graduated Driver Licensing With Driver, Non-Driver, and Total Fatalities Among Adolescents.

PubMed

Zhu, Motao; Zhao, Songzhu; Long, D Leann; Curry, Allison E

2016-07-01

Graduated driver licensing systems typically require an extended learner permit phase, and create night-time driving or passenger restrictions for adolescent drivers. Restricted driving might increase the use of alternative transportation to replace driving and consequently increase crashes and injuries for passengers, bus riders, pedestrians, and bicyclists. This study examined whether graduated driver licensing increases non-driver fatalities among adolescents, and whether it reduces total traffic fatalities combining drivers and non-drivers. Longitudinal analyses were conducted using data from the 1995-2012 U.S. Fatality Analysis Reporting System. Adjusted rate ratios were estimated for being fatally injured in a crash according to: (1) presence/absence of a graduated driver licensing system; and (2) four levels of graduated driver licensing systems (absent, weak, medium, strong). Analyses were conducted in 2015. Among adolescents aged 16 years, graduated driver licensing was not associated with increased passenger fatalities (adjusted rate ratio, 0.96; 95% CI=0.90, 1.03) or pedestrian and bicyclist fatalities (adjusted rate ratio, 1.09; 95% CI=0.85, 1.39), but was associated with an 11% reduction in total traffic fatalities. Among those aged 17 years, graduated driver licensing was not associated with increased fatalities as passengers, pedestrians, or bicyclists, and was not associated with reduced total traffic fatalities. In general, graduated driver licensing systems were not associated with increased fatalities as passengers, pedestrians, bicyclists, and bus riders. Graduated driver licensing systems were associated with reduced total fatalities of adolescents aged 16 years. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The effect of preceptor role effectiveness on newly licensed registered nurses' perceived psychological empowerment and professional autonomy.

PubMed

Watkins, Chanell; Hart, Patricia L; Mareno, Nicole

2016-03-01

The first year turnover rate for newly licensed registered nurses is roughly 30% and increases to about 57% in the second year (Twibell et al., 2012). An effective preceptorship has been shown to better facilitate the first year transition (Hodges et al., 2008) and increase retention rates (Pine and Tart, 2007). The purpose of this study was to examine the relationships between newly licensed registered nurses' perceived preceptor role effectiveness, psychological empowerment and professional autonomy. A prospective, cross-sectional, descriptive research design was used. Sixty-nine newly licensed registered nurses were recruited and surveyed. Newly licensed registered nurses were found to have moderately high levels of perceived preceptor role effectiveness, psychological empowerment, and professional autonomy. Preceptor role effectiveness had significant, moderately, positive relationships with professional autonomy and psychological empowerment. There was also a significant relationship found between professional autonomy and psychological empowerment. Results show that preceptor role effectiveness is linked to increased professional autonomy and psychological empowerment. Therefore, effective preceptorships are necessary in easing the newly licensed registered nurse's transition to practice. Strategies to ensure effective preceptorships and enhance the NRLN's transition to practice are proposed. Copyright © 2016 Elsevier Ltd. All rights reserved.

10 CFR Appendix B to Part 73 - General Criteria for Security Personnel

Code of Federal Regulations, 2012 CFR

2012-01-01

... or pass an equivalent performance examination designed to measure basic job-related mathematical... equivalent performance examination designed to measure basic mathematical, language, and reasoning skills... administered by a licensed physician. The examination shall be designed to measure the individual's physical...

10 CFR 55.40 - Implementation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES Written Examinations and Operating Tests § 55.40... Standards for Power Reactors,” 1 in effect six months before the examination date to prepare the written... also use the criteria in NUREG-1021 to evaluate the written examinations and operating tests prepared...

10 CFR 55.40 - Implementation.

Code of Federal Regulations, 2013 CFR

2013-01-01

... REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES Written Examinations and Operating Tests § 55.40... Standards for Power Reactors,” 1 in effect six months before the examination date to prepare the written... also use the criteria in NUREG-1021 to evaluate the written examinations and operating tests prepared...

10 CFR 55.40 - Implementation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES Written Examinations and Operating Tests § 55.40... Standards for Power Reactors,” 1 in effect six months before the examination date to prepare the written... also use the criteria in NUREG-1021 to evaluate the written examinations and operating tests prepared...

10 CFR 55.40 - Implementation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES Written Examinations and Operating Tests § 55.40... Standards for Power Reactors,” 1 in effect six months before the examination date to prepare the written... also use the criteria in NUREG-1021 to evaluate the written examinations and operating tests prepared...

10 CFR 55.40 - Implementation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES Written Examinations and Operating Tests § 55.40... Standards for Power Reactors,” 1 in effect six months before the examination date to prepare the written... also use the criteria in NUREG-1021 to evaluate the written examinations and operating tests prepared...

The Relationships Among Licensed Nurse Turnover, Retention, and Rehospitalization of Nursing Home Residents

PubMed Central

Thomas, Kali S.

2013-01-01

Purpose: Individuals receiving postacute care in skilled nursing facilities often require complex, skilled care provided by licensed nurses. It is believed that a stable set of nursing personnel is more likely to deliver better care. The purpose of this study was to determine the relationships among licensed nurse retention, turnover, and a 30-day rehospitalization rate in nursing homes (NHs). Design and Methods: We combined two data sources: NH facility-level data (including characteristics of the facility, the market, and residents) and the Florida Nursing Home Staffing Reports (which provide staffing information for each NH) for 681 Florida NHs from 2002 to 2009. Using a two-way fixed effects model, we examined the relationships among licensed nurse turnover rates, retention rates, and 30-day rehospitalization rates. Results: Results indicate that an NH’s licensed nurse retention rate is significantly associated with the 30-day rehospitalization rate (est. = −.02, p = .04) controlling for demographic characteristics of the patient population, residents’ preferences for hospitalization, and the ownership characteristics of the NH. The NHs experiencing a 10% increase in their licensed nurse retention had a 0.2% lower rehospitalization rate, which equates to 2 fewer hospitalizations per NH annually. Licensed nurse turnover is not significantly related to the 30-day rehospitalization rate. Implications: These findings highlight the need for NH administrators and policy makers to focus on licensed nurse retention, and future research should focus on the measures of staff retention for understanding the staffing/quality relationship. PMID:22936529

Driver licensing: descriptive epidemiology of a social determinant of Aboriginal and Torres Strait Islander health

PubMed Central

Hunter, Kate; Clapham, Kathleen; Helps, Yvonne; Senserrick, Teresa; Byrne, Jake; Martiniuk, Alexandra; Daniels, John; Harrison, James E.

2016-01-01

Abstract Objective: Education, employment and equitable access to services are commonly accepted as important underlying social determinants of health. For most Australians, access to health, education and other services is facilitated by private transport and a driver licence. This study aimed to examine licensing rates and predictors of licensing in a sample of Aboriginal and Torres Strait Islander people, as these have previously been poorly described. Methods: Interviewer‐administered surveys were conducted with 625 people 16 years or older in four Aboriginal Community Controlled Health Services in New South Wales and South Australia over a two‐week period in 2012–2013. Results: Licensing rates varied from 51% to 77% by site. Compared to not having a licence, having a driver licence was significantly associated with higher odds of full‐time employment (adjusted OR 4.0, 95%CI 2.5–6.3) and educational attainment (adjusted OR 1.9, 95%CI 1.2–2.8 for trade or certificate; adjusted OR 4.0, 95%CI 1.6–9.5 for degree qualification). Conclusions: Variation in driver licensing rates suggests different yet pervasive barriers to access. There is a strong association between driver licensing, education and employment. Implications: Licensing inequality has far‐reaching impacts on the broader health and wellbeing of Aboriginal and Torres Strait Islander people, reinforcing the need for appropriate and accessible pathways to achieving and maintaining driver licensing. PMID:27481274

Appealing to the crowd: ethical justifications in Canadian medical crowdfunding campaigns.

PubMed

Snyder, Jeremy; Crooks, Valorie A; Mathers, Annalise; Chow-White, Peter

2017-06-01

Medical crowdfunding is growing in terms of the number of active campaigns, amount of funding raised and public visibility. Little is known about how campaigners appeal to potential donors outside of anecdotal evidence collected in news reports on specific medical crowdfunding campaigns. This paper offers a first step towards addressing this knowledge gap by examining medical crowdfunding campaigns for Canadian recipients. Using 80 medical crowdfunding campaigns for Canadian recipients, we analyse how Canadians justify to others that they ought to contribute to funding their health needs. We find the justifications campaigners tend to fall into three themes: personal connections, depth of need and giving back. We further discuss how these appeals can understood in terms of ethical justifications for giving and how these justifications should be assessed in light of the academic literature on ethical concerns raised by medical crowdfunding. 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/.

Post-hoc simulation study to adopt a computerized adaptive testing (CAT) for a Korean Medical License Examination.

PubMed

Seo, Dong Gi; Choi, Jeongwook

2018-05-17

Computerized adaptive testing (CAT) has been adopted in license examinations due to a test efficiency and accuracy. Many research about CAT have been published to prove the efficiency and accuracy of measurement. This simulation study investigated scoring method and item selection methods to implement CAT in Korean medical license examination (KMLE). This study used post-hoc (real data) simulation design. The item bank used in this study was designed with all items in a 2017 KMLE. All CAT algorithms for this study were implemented by a 'catR' package in R program. In terms of accuracy, Rasch and 2parametric logistic (PL) model performed better than 3PL model. Modal a Posteriori (MAP) or Expected a Posterior (EAP) provided more accurate estimates than MLE and WLE. Furthermore Maximum posterior weighted information (MPWI) or Minimum expected posterior variance (MEPV) performed better than other item selection methods. In terms of efficiency, Rasch model was recommended to reduce test length. Simulation study should be performed under varied test conditions before adopting a live CAT. Based on a simulation study, specific scoring and item selection methods should be predetermined before implementing a live CAT.

Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination Performance

ERIC Educational Resources Information Center

Perez, Jose A., Jr.; Greer, Sharon

2009-01-01

The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical…

47 CFR 13.207 - Preparing an examination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Preparing an examination. 13.207 Section 13.207 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL RADIO OPERATORS Examination System § 13.207... examinee for a commercial radio operator license must be provided by a COLEM. (b) Each question set...

Turnover Begets Turnover

ERIC Educational Resources Information Center

Castle, Nicholas G.

2005-01-01

Purpose: This study examined the association between turnover of caregivers and turnover of nursing home top management. The top managers examined were administrators and directors of nursing, and the caregivers examined were registered nurses, licensed practical nurses, and nurse aides. Design and Methods: The data came from a survey of 419…

A plug-in to Eclipse for VHDL source codes: functionalities

NASA Astrophysics Data System (ADS)

Niton, B.; Poźniak, K. T.; Romaniuk, R. S.

The paper presents an original application, written by authors, which supports writing and edition of source codes in VHDL language. It is a step towards fully automatic, augmented code writing for photonic and electronic systems, also systems based on FPGA and/or DSP processors. An implementation is described, based on VEditor. VEditor is a free license program. Thus, the work presented in this paper supplements and extends this free license. The introduction characterizes shortly available tools on the market which serve for aiding the design processes of electronic systems in VHDL. Particular attention was put on plug-ins to the Eclipse environment and Emacs program. There are presented detailed properties of the written plug-in such as: programming extension conception, and the results of the activities of formatter, re-factorizer, code hider, and other new additions to the VEditor program.

Geothermal : A Regulatory Guide to Leasing, Permitting, and Licensing in Idaho, Montana, Oregon, and Washington.

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

Bloomquist, R.Gordon

1991-10-01

The actual geothermal exploration and development may appear to be a simple and straightforward process in comparison to the legal and institutional maze which the developer must navigate in order to obtain all of the federal, state, and local leases, permits, licenses, and approvals necessary at each step in the process. Finally, and often most difficult, is obtaining a contract for the sale of thermal energy, brine, steam, or electricity. This guide is designed to help developers interested in developing geothermal resource sites in the Bonneville Power Administration Service Territory in the state of Idaho, Montana, Oregon, and Washington bettermore » understand the federal, state, and local institutional process, the roles and responsibilities of each agency, and how and when to make contact in order to obtain the necessary documents.« less

Senior aviation medical examiners conducting FAA first-class medical examinations.

DOT National Transportation Integrated Search

1971-07-01

Airline medical departments have provided a system of preventive health maintenance for their crews that has economically effected rehabilitation of experienced crewmembers who otherwise would have lost their medical licenses and thereby their liveli...

Stepping Stones To Using "Caring for Our Children": National Health and Safety Performance Standards for Out-of-Home Child Care Programs. Protecting Children from Harm.

ERIC Educational Resources Information Center

Colorado Univ. Health Sciences Center, Denver.

Developed in support of state licensing and regulatory agencies as well as state child care, health, and resource and referral agencies, and a variety of other public and private organizations, parents, and advocacy groups, this guide identifies those standards most needed for the prevention of injury, morbidity, and mortality in child care…

Polish Mother and Child Cohort Study (REPRO_PL) - Methodology of the follow-up of the children at the age of 7.

PubMed

Polańska, Kinga; Hanke, Wojciech; Król, Anna; Potocka, Adrianna; Waszkowska, Małgorzata; Jacukowicz, Aleksandra; Gromadzińska, Jolanta; Wąsowicz, Wojciech; Jerzyńska, Joanna; Stelmach, Włodzimierz; Stelmach, Iwona

2016-11-18

Effects of environmental exposures in utero and in the first years of life on early life health and development is a growing research area with major public health implications. The main aim of this work has been to provide an overview of the next step of the Polish Mother and Child Cohort Study (REPRO_PL) covering exposure, health and neurodevelopment assessments of children at 7 years of age. Details regarding methodology of the follow-up of the children are crucial for cross-cohort collaboration and a full understanding of the future research questions. Phase III of the REPRO_PL cohort covers a follow-up of 900 children at the age of 7 years old. The questionnaire filled in by the mothers is composed of: socio-demographic, child exposure and home environment information, nutritional status and health data. In the case of 400 children, environmental (including collection of urine, saliva and buccal cells), health status and psychomotor assessments are performed. Health and development check consists of physical measurements, child health status assessment (including lung function tests, skin prick testing, an interview/examination by an allergist) and psychomotor development tests (the Strength and Difficulties Questionnaire and the Intelligence and Development Scales). The results of the study will become available within the next few years. Extension of the REPRO_PL cohort with examinations of children at the age of 7 years old may provide a better understanding of the relationship between environmental and lifestyle-related factors and children's health and neurodevelopment; and may further strengthen scientific base for policies and interventions promoting healthy lifestyle. Int J Occup Med Environ Health 2016;29(6):883-893. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Perception survey on the introduction of clinical performance examination as part of the national nursing licensing examination in Korea.

PubMed

Shin, Su Jin; Kim, Yeong Kyeong; Suh, Soon-Rim; Jung, Duk Yoo; Kim, Yunju; Yim, Mi Kyoung

2017-01-01

The purpose of this study was to analyze opinions about the action plan for implementation of clinical performance exam as part of the national nursing licensing examination and presents the expected effects of the performance exam and aspects to consider regarding its implementation. This study used a mixed-methods design. Quantitative data were collected by a questionnaire survey, while qualitative data were collected by focus group interviews with experts. The survey targeted 200 nursing professors and clinical nurses with more than 5 years of work experience, and the focus group interviews were conducted with 28 of professors, clinical instructors, and nurses at hospitals. First, nursing professors and clinical specialists agreed that the current written tests have limitations in evaluating examinees' ability, and that the introduction of a clinical performance exam will yield positive results. Clinical performance exam is necessary to evaluate and improve nurses' work ability, which means that the implementation of a performance exam is advisable if its credibility and validity can be verified. Second, most respondents chose direct performance exams using simulators or standardized patients as the most suitable format of the test. In conclusion, the current national nursing licensing exam is somewhat limited in its ability to identify competent nurses. Thus, the time has come for us to seriously consider the introduction of a performance exam. The prerequisites for successfully implementing clinical performance exam as part of the national nursing licensing exam are a professional training process and forming a consortium to standardize practical training.

Perception survey on the introduction of clinical performance examination as part of the national nursing licensing examination in Korea

PubMed Central

2017-01-01

Purpose The purpose of this study was to analyze opinions about the action plan for implementation of clinical performance exam as part of the national nursing licensing examination and presents the expected effects of the performance exam and aspects to consider regarding its implementation. Methods This study used a mixed-methods design. Quantitative data were collected by a questionnaire survey, while qualitative data were collected by focus group interviews with experts. The survey targeted 200 nursing professors and clinical nurses with more than 5 years of work experience, and the focus group interviews were conducted with 28 of professors, clinical instructors, and nurses at hospitals. Results First, nursing professors and clinical specialists agreed that the current written tests have limitations in evaluating examinees’ ability, and that the introduction of a clinical performance exam will yield positive results. Clinical performance exam is necessary to evaluate and improve nurses’ work ability, which means that the implementation of a performance exam is advisable if its credibility and validity can be verified. Second, most respondents chose direct performance exams using simulators or standardized patients as the most suitable format of the test. Conclusion In conclusion, the current national nursing licensing exam is somewhat limited in its ability to identify competent nurses. Thus, the time has come for us to seriously consider the introduction of a performance exam. The prerequisites for successfully implementing clinical performance exam as part of the national nursing licensing exam are a professional training process and forming a consortium to standardize practical training. PMID:29129904

Quantifying the influence of safe road systems and legal licensing age on road mortality among young adolescents: steps towards system thinking.

PubMed

Twisk, Divera; Commandeur, Jacques J F; Bos, Niels; Shope, Jean T; Kok, Gerjo

2015-01-01

Based on existing literature, a system thinking approach was used to set up a conceptual model on the interrelationships among the components influencing adolescent road mortality, distinguishing between components at the individual level and at the system level. At the individual level the role of risk behaviour (sometimes deliberate and sometimes from inexperience or other non-deliberate causes) in adolescent road mortality is well documented. However, little is known about the extent to which the 'road system' itself may also have an impact on younger adolescents' road mortality. This, by providing a safe or unsafe road environment for all road users (System-induced exposure) and by allowing access to high-risk vehicles at a young or older age through the legal licensing age. This study seeks to explore these relationships by analysing the extent to which the road mortality of 10 to 17 year olds in various jurisdictions can be predicted from the System-induced Exposure (SiE) in a jurisdiction and from its legal licensing age to drive motor vehicles. SiE was operationalized as the number of road fatalities per 10(5) inhabitants/all ages together, but excluding the 10 to 17 year olds. Data on road fatalities during the years 2001 through 2008 were obtained from the OECD International Road Traffic Accident Database (IRTAD) and from the USA NHTSA's Fatality Analysis Reporting System (FARS) database for 29 early and 10 late licensing jurisdictions. Linear mixed models were fitted with annual 'Adolescent road mortality per capita' for 2001 through 2008 as the dependent variable, and time-dependent 'SiE' and time-independent 'Licensing system' as predictor variables. To control for different levels of motorisation, the time-dependent variable 'Annual per capita vehicle distance travelled' was used as a covariate. Licensing system of a jurisdiction was entered as a categorical predictor variable with late licensing countries as a baseline group. The study found support for the protective effects of SiE on adolescent safety. If SiE increased by one unit, the mortality rate of 10 to 17 year olds increased by 0.487 units. No support was found for a protective effect of late licensing for this age group. Thus, compared to young adolescents who are allowed to drive motor vehicles in early licensing jurisdictions, late licensing does not provide extra protection for pre-license adolescents. This finding is probably the result of the high risks associated with alternative transport modes, such as moped riding and bicycling. Also, the fact that the study only included risks to young adolescents themselves and did not include the risks they might pose to other road users and passengers may have contributed to this finding, because such risks are greater when driving a motor vehicle than riding a moped or a bicycle. Therefore, to advance our understanding of the impact of licensing systems, more study is needed into the benefits of early or late licensing, thereby considering these wider effects as well. Copyright © 2014 Elsevier Ltd. All rights reserved.

Nursing Care Providers' Perceptions on Their Role Contributions in Patient Care: An Integrative Review.

PubMed

Kusi-Appiah, Elizabeth; Dahlke, Sherry; Stahlke, Sarah

2018-05-18

The aim of this integrative review was to explore registered nurses', licensed practical nurses', and health care aides' perceptions of their own and each other's role contributions. In response to contemporary economic and political pressures, healthcare institutions across the world have endeavored to download job duties to less educated healthcare providers. As a result, nursing care is usually delivered by a team of nursing staff that have different roles. This means that there are fewer registered nurses and more licensed practical nurses and health care aides on nursing teams, despite evidence that increased numbers of registered nurses improve patient safety and care outcomes. This study was an integrative review using Whittemore and Knafl's stages for ensuring rigor. These stages include problem identification, literature searching, data evaluation, data analysis, and presentation. Four electronic databases were searched according to previously designed search strategies. The 14 retrieved articles were appraised using MMATs for quality. Data were extracted and analyzed thematically. The findings of the integrative review revealed that registered nurses, licensed practical nurses, and health care aides had little understanding about the roles of their fellow nursing team members and had difficulties describing their own roles. However, no studies concurrently examined registered nurses', licensed practical nurses' and health care aides' perceptions on their own or each other's roles and little was written about licensed practical nurses. More research is needed to examine the entire nursing team's perceptions about the various nursing roles. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

46 CFR 11.709 - Annual physical examination requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 1 2014-10-01 2014-10-01 false Annual physical examination requirements. 11.709 Section... REQUIREMENTS FOR OFFICER ENDORSEMENTS Professional Requirements for Pilots § 11.709 Annual physical examination...) Every person holding a license or MMC endorsement as first-class pilot must have a thorough physical...

STEM Faculty as Learners in Pedagogical Reform and the Role of Research Articles as Professional Development Opportunities.

PubMed

Mulnix, Amy B

2016-01-01

Discipline-based education research (DBER) publications are opportunities for professional development around science, technology, engineering, and mathematics (STEM) education reform. Learning theory tells us these publications could be more impactful if authors, reviewers, and editors pay greater attention to linking principles and practice. This approach, which considers faculty as learners and STEM education reform as content, has the potential to better support faculty members because it promotes a deeper understanding of the reasons why a pedagogical change is effective. This depth of understanding is necessary for faculty members to successfully transfer new knowledge to their own contexts. A challenge ahead for the emergent learning sciences is to better integrate findings from across sister disciplines; DBER reports can take a step in that direction while improving their usefulness for instructors. © 2016 A. B. Mulnix. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Learning style preferences of surgical residency applicants.

PubMed

Kim, Roger H; Gilbert, Timothy

2015-09-01

The learning style preferences of general surgery residents have been previously reported; there is evidence that residents who prefer read/write learning styles perform better on the American Board of Surgery In-Training Examination (ABSITE). However, little is known regarding the learning style preferences of applicants to general surgery residency and their impact on educational outcomes. In this study, the preferred learning styles of surgical residency applicants were determined. We hypothesized that applicant rank data are associated with specific learning style preferences. The Fleming VARK learning styles inventory was offered to all general surgery residency applicants that were interviewed at a university hospital-based program. The VARK model categorizes learners as visual (V), aural (A), read/write (R), kinesthetic (K), or multimodal (MM). Responses on the inventory were scored to determine the preferred learning style for each applicant. Applicant data, including United States Medical Licensing Examination (USMLE) scores, class rank, interview score, and overall final applicant ranking, were examined for association with preferred learning styles. Sixty-seven applicants were interviewed. Five applicants were excluded due to not completing the VARK inventory or having incomplete applicant data. The remaining 62 applicants (92%) were included for analysis. Most applicants (57%) had a multimodal preference. Sixty-nine percent of all applicants had some degree of preference for kinesthetic learning. There were statistically significant differences between applicants of different learning styles in terms of USMLE step 1 scores (P = 0.001) and USMLE step 2 clinical knowledge scores (P = 0.01), but not for class ranks (P = 0.27), interview scores (P = 0.20), or final ranks (P = 0.14). Multiple comparison analysis demonstrated that applicants with aural preferences had higher USMLE 1 scores (233.2) than those with kinesthetic (211.8, P = 0.005) or multimodal (214.5, P = 0.008) preferences, whereas applicants with visual preferences had higher USMLE 1 scores (230.0) than those with kinesthetic preferences (P = 0.047). Applicants with aural preferences also had higher USMLE 2 scores (249.6) than those with kinesthetic (227.6, P = 0.006) or multimodal (230.1, P = 0.008) preferences. Most applicants to general surgery residency have a multimodal learning style preference. Learning style preferences are associated with higher USMLE step 1 and step 2 scores, in particular for applicants with aural preferences. Students who performed well in lecture-dominated medical school environments because of their aural preferences could be at a disadvantage in the more independent, reading-focused learning environments of surgical residency. Copyright © 2015 Elsevier Inc. All rights reserved.

Dermatology Residency Selection Criteria with an Emphasis on Program Characteristics: A National Program Director Survey

PubMed Central

Gorouhi, Farzam; Alikhan, Ali; Rezaei, Arash; Fazel, Nasim

2014-01-01

Background. Dermatology residency programs are relatively diverse in their resident selection process. The authors investigated the importance of 25 dermatology residency selection criteria focusing on differences in program directors' (PDs') perception based on specific program demographics. Methods. This cross-sectional nationwide observational survey utilized a 41-item questionnaire that was developed by literature search, brainstorming sessions, and online expert reviews. The data were analyzed utilizing the reliability test, two-step clustering, and K-means methods as well as other methods. The main purpose of this study was to investigate the differences in PDs' perception regarding the importance of the selection criteria based on program demographics. Results. Ninety-five out of 114 PDs (83.3%) responded to the survey. The top five criteria for dermatology residency selection were interview, letters of recommendation, United States Medical Licensing Examination Step I scores, medical school transcripts, and clinical rotations. The following criteria were preferentially ranked based on different program characteristics: “advanced degrees,” “interest in academics,” “reputation of undergraduate and medical school,” “prior unsuccessful attempts to match,” and “number of publications.” Conclusions. Our survey provides up-to-date factual data on dermatology PDs' perception in this regard. Dermatology residency programs may find the reported data useful in further optimizing their residency selection process. PMID:24772165

Effects of Examiner Training on Open-Ended, Higher Taxonomic Level Questioning in Oral Certification Examinations.

ERIC Educational Resources Information Center

Des Marchais, Jacques E.; Jean, Pierre

1993-01-01

A 5-year study investigated the effect of training on question-asking skills of 42 licensing examiners in orthopedic surgery. Results indicate that a three-hour training session resulted in examiners' asking many more open-ended and/or problem-solving questions, suggesting the effectiveness of the training program. (Author/MSE)

Are nursing home survey deficiencies higher in facilities with greater staff turnover.

PubMed

Lerner, Nancy B; Johantgen, Meg; Trinkoff, Alison M; Storr, Carla L; Han, Kihye

2014-02-01

To examine CNA and licensed nurse (RN+LPN/LVN) turnover in relation to numbers of deficiencies in nursing homes. A secondary data analysis of information from the National Nursing Home Survey (NNHS) and contemporaneous data from the Online Survey, Certification and Reporting (OSCAR) database. Data were linked by facility as the unit of analysis to determine the relationship of CNA and licensed nurse turnover on nursing home deficiencies. The 2004 NNHS used a multistage sampling strategy to generate a final sample of 1174 nursing homes, which represent 16,100 NHs in the United States. This study focused on the 1151 NNHS facilities with complete deficiency data. Turnover was defined as the total CNAs/licensed nurse full-time equivalents (FTEs) who left during the preceding 3 months (full- and part-time) divided by the total FTE. NHs with high turnover were defined as those with rates above the 75th percentile (25.3% for CNA turnover and 17.9% for licensed nurse turnover) versus all other facilities. This study used selected OSCAR deficiencies from the Quality of Care, Quality of Life, and Resident Behavior categories, which are considered to be more closely related to nursing care. We defined NHs with high deficiencies as those with numbers of deficiencies above the 75th percentile versus all others. Using SUDAAN PROC RLOGIST, we included NNHS sampling design effects and examined associations of CNA/licensed nurse turnover with NH deficiencies, adjusting for staffing, skill mix, bed size, and ownership in binomial logistic regression models. High CNA turnover was associated with high numbers of Quality of Care (OR 1.53, 95% CI 1.10-2.13), Resident Behavior (OR 1.42, 95% CI 1.03-1.97) and total selected deficiencies (OR 1.54, 95% CI 1.12-2.12). Licensed nurse turnover was significantly related to Quality of Care deficiencies (OR 2.06, 95% CI 1.50-2.82) and total selected deficiencies (OR 1.71, 95% CI 1.25-2.33). When both CNA turnover and licensed nurse turnover were included in the same model, high licensed nurse turnover was significantly associated with Quality of Care and total deficiencies, whereas CNA turnover was not associated with that category of deficiencies. Turnover in nursing homes for both licensed nurses and CNAs is associated with quality problems as measured by deficiencies. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Motorcycle safety among motorcycle taxi drivers and nonoccupational motorcyclists in developing countries: A case study of Maoming, South China.

PubMed

Wu, Connor Y H; Loo, Becky P Y

2016-01-01

An increasing number of motorcycle taxis have been involved in traffic crashes in many developing countries. This study examines the characteristics of both motorcycle taxi drivers and nonoccupational motorcyclists, investigates the risks they pose to road safety, and provides recommendations to minimize their risks. Based on the data collected from a questionnaire survey of 867 motorcycle taxi drivers and 2,029 nonoccupational motorcyclists in Maoming, South China, comparisons were made to analyze differences of personal attributes, attitudes toward road safety, and self-reported behavior of the 2 groups. Results of the chi-square tests show that not only motorcycle taxi drivers but also nonoccupational motorcyclists in Maoming held poor attitudes toward road safety and both groups reported unsafe driving behavior. There is much room for improving local road safety education among all motorcyclists in Maoming. Yet, motorcycle taxi drivers were more likely to pose road safety risks than nonoccupational motorcyclists under some circumstances, such as speeding late at night or early in the morning, not requiring passengers to wear helmets, and running a red light. The results of the binary logistic regression model show that possessing a vehicle license for a motorcycle or not was the common significant predictor for unsafe driving behavior of motorcycle taxi drivers and nonoccupational motorcyclists. Therefore, enforcement against all motorcyclists not showing vehicle licenses for their motorcycles should be stepped up. Motorcycle safety is largely poor in Maoming. Therefore, efforts to improve motorcycle safety should be strengthened by targeting not only motorcycle taxi drivers but also nonoccupational motorcyclists.

Emotional intelligence in surgery is associated with resident job satisfaction.

PubMed

Hollis, Robert H; Theiss, Lauren M; Gullick, Allison A; Richman, Joshua S; Morris, Melanie S; Grams, Jayleen M; Porterfield, John R; Chu, Daniel I

2017-03-01

Emotional intelligence (EI) has been associated with improved work performance and job satisfaction in several industries. We evaluated whether EI was associated with higher measures of work performance and job satisfaction in surgical residents. We distributed the validated Trait EI Questionnaire and job satisfaction survey to all general surgery residents at a single institution in 2015. EI and job satisfaction scores were compared with resident performance using faculty evaluations of clinical competency-based surgical milestones and standardized test scores including the United States Medical Licensing Examination (USMLE) and American Board of Surgery In-Training Examination (ABSITE). Statistical comparison was made using Pearson correlation and simple linear regression adjusting for postgraduate year level. The survey response rate was 68.9% with 31 resident participants. Global EI was associated with scores on USMLE Step 2 (r = 0.46, P = 0.01) and Step 3 (r = 0.54, P = 0.01) but not ABSITE percentile scores (r = 0.06, P = 0.77). None of the 16 surgical milestone scores were significantly associated with global EI or EI factors before or after adjustment for postgraduate level. Global EI was associated with overall job satisfaction (r = 0.37, P = 0.04). Of the facets of job satisfaction, global EI was significantly associated with views of supervision (r = 0.42, P = 0.02) and nature of work (r = 0.41, P = 0.02). EI was associated with job satisfaction and USMLE performance but not ACGME competency-based milestones or ABSITE scores. EI may be an important factor for fulfillment in surgical training that is not currently captured with traditional in-training performance measures. Published by Elsevier Inc.

The making of an instrument: from concept to market.

PubMed

Christoudias, G C

1998-01-01

This is an account of the steps one goes through in the development of a new device or instrument. It starts with the conditions that generate the need and then the concept of a new instrument and goes through the process of designing it and protecting it with a patent; it then proceeds through the development of a working prototype and a final refined product. It provides an outline of the steps needed to get the device into the national or international market by selling or licensing it to a company willing to develop it. To be able to demonstrate this process of invention and give real life to the steps involved in the making of an instrument as mentioned above, I describe the circumstances that generated the idea and the development of the Christoudias Tissue Approximator Grasper. The patent is published as issued to demonstrate its different components.

Grants Process Overview

Cancer.gov

This infographic shows the steps in the National Institutes of Health and National Cancer Institute Grants Process. The graphic shows which steps are done by the Principle Investigator, Grantee Institution, and by NIH. The process is represented by a circular flow of steps. Starting from the top and reading clockwise: The Principle Investigator “Initiates Research Idea and Prepares Application” The Grantee Institution “Submits Application” NIH “NIH Center For Scientific Review, Assigns To NCI And To Study Section” NIH “Scientific Review Group (NCI OR CSR) Evaluates for Scientific Merit” NIH “National Cancer Advisory Board Recommends Action” NIH “NCI Evaluates Program Relevance And Need” NIH “NCI Makes Funding Selections And Issues Grant Awards” (NIH) NIH “NCI Monitors Programmatic and Business Management Performance of the Grant” The Grantee Institution “Manages Funds” The Principle Investigator “Conducts Research” Source: www.cancer.gov Icons made by Freepik from http://www.flaticon.com is licensed by CC BY3.0”

Motor-Vehicle Crash History and Licensing Outcomes for Older Drivers Reported as Medically Impaired in Missouri

PubMed Central

Meuser, Thomas M.; Carr, David B.; Ulfarsson, Gudmundur F.

2009-01-01

The identification and evaluation of medically impaired drivers is an important safety issue. Medical fitness to drive is applicable to all ages but is particularly salient for older adults. Voluntary procedures, whereby various professionals and family members may report medical fitness concerns to State driver license bureaus, are common in the United States. This paper examines traffic crashes of drivers reported during 2001–2005 under the State of Missouri’s voluntary reporting law (House Bill HB-1536) and the resulting licensing outcomes. Missouri’s law is non-specific as to age, but the mean age of reported drivers was 80. Reports were submitted by police officers (30%), license office staff (27%), physicians (20%), family members (16%), and others (7%). The most common medical condition was dementia/cognitive (45%). Crash history for reported drivers was higher than that of controls, dating back to 1993, reaching a peak in 2001 when the crash involvement of reported drivers was 9.3% vs. 2.2% for controls—a fourfold difference. The crash involvement of reported drivers decreased rapidly after, indicating the impact of HB-1536 reporting with subsequent license revocation and to a lesser degree, mortality. Of the 4,100 reported individuals, 144 (3.5%) retained a driver’s license after the process. PMID:19245882

Computer Based Procedures for Field Workers - FY16 Research Activities

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

Oxstrand, Johanna; Bly, Aaron

The Computer-Based Procedure (CBP) research effort is a part of the Light-Water Reactor Sustainability (LWRS) Program, which provides the technical foundations for licensing and managing the long-term, safe, and economical operation of current nuclear power plants. One of the primary missions of the LWRS program is to help the U.S. nuclear industry adopt new technologies and engineering solutions that facilitate the continued safe operation of the plants and extension of the current operating licenses. One area that could yield tremendous savings in increased efficiency and safety is in improving procedure use. A CBP provides the opportunity to incorporate context-driven jobmore » aids, such as drawings, photos, and just-in-time training. The presentation of information in CBPs can be much more flexible and tailored to the task, actual plant condition, and operation mode. The dynamic presentation of the procedure will guide the user down the path of relevant steps, thus minimizing time spent by the field worker to evaluate plant conditions and decisions related to the applicability of each step. This dynamic presentation of the procedure also minimizes the risk of conducting steps out of order and/or incorrectly assessed applicability of steps. This report provides a summary of the main research activities conducted in the Computer-Based Procedures for Field Workers effort since 2012. The main focus of the report is on the research activities conducted in fiscal year 2016. The activities discussed are the Nuclear Electronic Work Packages – Enterprise Requirements initiative, the development of a design guidance for CBPs (which compiles all insights gained through the years of CBP research), the facilitation of vendor studies at the Idaho National Laboratory (INL) Advanced Test Reactor (ATR), a pilot study for how to enhance the plant design modification work process, the collection of feedback from a field evaluation study at Plant Vogtle, and path forward to commercialize INL’s CBP system.« less

47 CFR 13.203 - Examination elements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL RADIO OPERATORS Examination System § 13.203... commercial radio operator license. For each Element, the Commission shall establish through public notices or... communications, knowledge of the documents relating to charges for radio communications and knowledge of those...

Compound Separation

NASA Technical Reports Server (NTRS)

1981-01-01

Jet Propulsion Laboratory developed a new one-step liquid-liquid extraction technique which cuts processing time, reduces costs and eliminates much of the equipment required. Technique employs disposable extraction columns, originally developed as an aid to the Los Angeles Police Department, which allow more rapid detection of drugs as part of the department's drug abuse program. Applications include medical treatment, pharmaceutical preparation and forensic chemistry. NASA waived title to Caltech, and Analytichem International is producing Extubes under Caltech license.

77 FR 39502 - New Date for the October 2012 Customs Broker License Examination

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-03

... specified types of infractions. This section also provides that an examination may be conducted to assess an... unless the regularly scheduled examination date conflicts with a national holiday, religious observance... observance of the religious holiday, Sukkot. In consideration of this conflict, CBP has decided to change the...

Assuring access to dental care for low-income families in North Carolina. The NC Institute of Medicine Task Force Study.

PubMed

Silberman, P; Wicker, D A; Smith, S H; DeFriese, G H

2000-01-01

Following publication of the Task Force's recommendations for improving dental care access among low-income populations, North Carolina has taken several steps forward. The Division of Medical Assistance and the NC Dental Society are forming an advisory committee (comprising Medicaid patients, providers, and representatives from all elements of organized dentistry in the state) to review dental coverage and reimbursement rates. Using existing state funds, the NC Office of Research, Demonstrations and Rural Health Development has recruited 15 additional dentists and 1 dental hygienist to practice in community facilities serving low-income and uninsured patients. In 1999, the NC General Assembly revised the NC Dental Practice Act. Now, under the general direction of a licensed public health dentist, specially trained public health dental hygienists can perform oral health screenings and preventive and educational services outside the public school setting. The NC Institute of Medicine has begun exploring how to use dental hygienists to expand preventive dental services to underserved populations in federally-funded community or migrant health centers, state-funded health clinics, and the not-for-profit clinics that serve predominantly Medicaid, low-income or uninsured populations. A report is to be sent to the Governor and the Joint Legislative Commission on Governmental Operations no later than May 1, 2000. In 1999, the General Assembly directed the NC State Board of Dental Examiners to establish a procedure for streamlined licensing of dentists and dental hygienists who have been practicing in other states. This should increase the number of qualified dental practitioners in the state. The proposed rules governing the new licensing pathway are to be prepared by May 15, 2000. The Board of Dental Examiners will determine which new procedures will be needed to allow less burdensome and more timely entry of qualified out-of-state licensed applicants, while still affording the public the same protection as under current law and procedures. The NC Institute of Medicine is organizing a work group to study the feasibility of new residency programs in pediatric dentistry in addition to the current program located in Chapel Hill. The Institute will present a report to the General Assembly, no later than May 1, 2000. On April 1, 1999, the state Medicaid program authorized use of ADA Procedure Code 1203, which allows reimbursement for the application of dental fluoride varnishes without a full prophylaxis. It also authorized pediatricians, nurse practitioners, or physician's assistants to apply these varnishes to the teeth of young children, allowing more rapid dissemination of this proven preventive procedure among the state's low-income children. Implementation began in Carolina Access II and III project sites in the fall, 1999, and should spread statewide in 2000. Furthermore, the General Assembly's 1999 session expanded NC Health Choice to cover dental sealants, fluoride treatment, simple extractions, stainless steel crowns, and pulpotomies. Since publication of the Task Force Report in May 1999, considerable forward movement has taken place. It was apparent that the problems associated with poor dental care were severe, of immediate concern, and needed a broad, nonpolitical analysis followed by action from public and private-sector policy makers and shapers. The key recommendation of the Task Force (to increase the level of payment to dentists for services provided to Medicaid beneficiaries) was not acted on in the 1999 session of the General Assembly, but it was seriously discussed in legislative hearings and will be considered further in the year 2000 legislative session. Given the number of problems surrounding adequate health care for North Carolina's low-income populations, inquiries such as that described here can point the way to the concrete and feasible steps that need to be taken. (ABSTRACT TRUNCATED)

Performance during internal medicine residency training and subsequent disciplinary action by state licensing boards.

PubMed

Papadakis, Maxine A; Arnold, Gerald K; Blank, Linda L; Holmboe, Eric S; Lipner, Rebecca S

2008-06-03

Physicians who are disciplined by state licensing boards are more likely to have demonstrated unprofessional behavior in medical school. Information is limited on whether similar performance measures taken during residency can predict performance as practicing physicians. To determine whether performance measures during residency predict the likelihood of future disciplinary actions against practicing internists. Retrospective cohort study. State licensing board disciplinary actions against physicians from 1990 to 2006. 66,171 physicians who entered internal medicine residency training in the United States from 1990 to 2000 and became diplomates. Predictor variables included components of the Residents' Annual Evaluation Summary ratings and American Board of Internal Medicine (ABIM) certification examination scores. 2 performance measures independently predicted disciplinary action. A low professionalism rating on the Residents' Annual Evaluation Summary predicted increased risk for disciplinary action (hazard ratio, 1.7 [95% CI, 1.3 to 2.2]), and high performance on the ABIM certification examination predicted decreased risk for disciplinary action (hazard ratio, 0.7 [CI, 0.60 to 0.70] for American or Canadian medical school graduates and 0.9 [CI, 0.80 to 1.0] for international medical school graduates). Progressively better professionalism ratings and ABIM certification examination scores were associated with less risk for subsequent disciplinary actions; the risk ranged from 4.0% for the lowest professionalism rating to 0.5% for the highest and from 2.5% for the lowest examination scores to 0.0% for the highest. The study was retrospective. Some diplomates may have practiced outside of the United States. Nondiplomates were excluded. Poor performance on behavioral and cognitive measures during residency are associated with greater risk for state licensing board actions against practicing physicians at every point on a performance continuum. These findings support the Accreditation Council for Graduate Medical Education standards for professionalism and cognitive performance and the development of best practices to remediate these deficiencies.

Theorising and testing environmental pathways to behaviour change: natural experimental study of the perception and use of new infrastructure to promote walking and cycling in local communities.

PubMed

Panter, Jenna; Ogilvie, David

2015-09-03

Some studies have assessed the effectiveness of environmental interventions to promote physical activity, but few have examined how such interventions work. We investigated the environmental mechanisms linking an infrastructural intervention with behaviour change. Natural experimental study. Three UK municipalities (Southampton, Cardiff and Kenilworth). Adults living within 5 km of new walking and cycling infrastructure. Construction or improvement of walking and cycling routes. Exposure to the intervention was defined in terms of residential proximity. Questionnaires at baseline and 2-year follow-up assessed perceptions of the supportiveness of the environment, use of the new infrastructure, and walking and cycling behaviours. Analysis proceeded via factor analysis of perceptions of the physical environment (step 1) and regression analysis to identify plausible pathways involving physical and social environmental mediators and refine the intervention theory (step 2) to a final path analysis to test the model (step 3). Participants who lived near and used the new routes reported improvements in their perceptions of provision and safety. However, path analysis (step 3, n=967) showed that the effects of the intervention on changes in time spent walking and cycling were largely (90%) explained by a simple causal pathway involving use of the new routes, and other pathways involving changes in environmental cognitions explained only a small proportion of the effect. Physical improvement of the environment itself was the key to the effectiveness of the intervention, and seeking to change people's perceptions may be of limited value. Studies of how interventions lead to population behaviour change should complement those concerned with estimating their effects in supporting valid causal inference. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A change to pass/fail grading in the first two years at one medical school results in improved psychological well-being.

PubMed

Bloodgood, Robert A; Short, Jerry G; Jackson, John M; Martindale, James R

2009-05-01

To measure the impact of a change in grading system in the first two years of medical school, from graded (A, B, C, D, F) to pass/fail, on medical students' academic performance, attendance, residency match, satisfaction, and psychological well-being. For both the graded and pass/fail classes, objective data were collected on academic performance in the first- and second-year courses, the clerkships, United States Medical Licensing Examination (USMLE) Steps 1 and 2 Clinical Knowledge (CK), and residency placement. Self-report data were collected using a Web survey (which included the Dupuy General Well-Being Schedule) administered each of the first four semesters of medical school. The study was conducted from 2002 to 2007 at the University of Virginia School of Medicine. The pass/fail class exhibited a significant increase in well-being during each of the first three semesters of medical school relative to the graded class, greater satisfaction with the quality of their medical education during the first four semesters of medical school, and greater satisfaction with their personal lives during the first three semesters of medical school. The graded and pass/fail classes showed no significant differences in performance in first- and second-year courses, grades in clerkships, scores on USMLE Step 1 and Step 2CK, success in residency placement, and attendance at academic activities. A change in grading from letter grades to pass/fail in the first two years of medical school conferred distinct advantages to medical students, in terms of improved psychological well-being and satisfaction, without any reduction in performance in courses or clerkships, USMLE test scores, success in residency placement, or level of attendance.

Inspection of the Department`s export licensing process for dual-use and munitions commodities

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

Not Available

1993-08-10

The purpose of our inspection was to review the Department of Energy`s (Energy) export licensing process for dual-use and military (munitions) commodities subject to nuclear nonproliferation controls. Specifically, we reviewed Energy`s authorities, procedures, and policies pertaining to the export licensing process and examined procedures for safeguarding data transmitted between Energy and other agencies involved in the export licensing process. We also reviewed Energy`s role as a member of the Subgroup on Nuclear Export Coordination. Our review of the sample of 60 export cases did not find evidence to lead us to believe that Energy`s recommendations for these cases were inappropriatemore » or incorrect. We identified, however, problems regarding management systems associated with the export license review process. We found that without documentation supporting export licensing decisions by the Export Control Operations Division (ECOD), we could not determine whether ECOD analysts considered all required criteria in their review of export cases referred to Energy. For example, we found that the ECOD did not retain records documenting the bases for its advice, recommendations, or decisions regarding its reviews of export license cases or revisions to lists of controlled commodities and, therefore, was not in compliance with certain provisions of the Export Administration Act, as amended, and Energy records management directives. Additionally, we found that the degree of compliance by Energy with the export licensing review criteria contained in the Export Administration Regulations and the Nuclear Non-Proliferation Act of 1978 could not be determined because ECOD did not retain records documenting the bases for its advice and recommendations on export cases.« less

Community attitudes towards environmental tobacco smoke in licensed premises: follow-up study after the Sharp case.

PubMed

Tzelepis, Flora; Walsh, Raoul A; Paul, Christine L

2003-10-01

To examine community attitudes towards environmental tobacco smoke in licensed premises after the Sharp case decision. 723 randomly selected New South Wales residents aged 18 years and over completed a telephone survey in November 2001. The vast majority supported some form of smoking restriction in licensed clubs (92.1%) and hotels (90.0%). Compared with a 2000 survey, respondents in the 2001 survey were significantly more likely to support a total smoking ban in licensed clubs and hotels. When support was assessed using a ban-only question, 66.8% supported banning smoking in pubs/clubs. Approximately half reported being less likely to visit non-eating areas of licensed clubs (51.2%) and hotels (49.8%) if smoking were permitted and these proportions were significantly higher than in the 2000 survey. A majority (83.1%) thought bar workers' health should be a major consideration when deciding how to handle smoking in pubs/clubs. More than half (56.8%) believed pubs/clubs would experience significant financial problems if smoking bans were introduced. In New South Wales, majority support exists for banning smoking in pubs and clubs. Legislation banning smoking in all indoor drinking and gaming areas should be introduced immediately.

A study examining senior nursing students' expectations of work and the workforce.

PubMed

Saber, Deborah A; Anglade, Debbie; Schirle, Lori M

2016-03-01

This study explored traditional and accelerated Bachelor of Science nursing students' expectations of nursing work and the workforce. Role transition difficulty is blamed for much of the 15-60% newly licensed registered nurse turnover in their first 3 years of employment. This qualitative study consisted of 14 focus groups (n = 98) to determine Bachelor of Science nursing students' expectations of work as newly licensed registered nurses. Two overriding themes for accelerated and traditional students emerged: stressors and coping strategies. Students believe four stressors will affect their progression into the newly licensed registered nurse role and have developed coping strategies. This study suggests that students have experienced stressors in the clinical environment and anticipate them in the newly licensed registered nurse role. During transition, strategies such as 'fitting in' and 'staying safe' will be employed to ensure work success. Younger generations value a healthy work-life balance and a positive working environment. These nurses will not tolerate positions that do not align with their values. With the aging of citizens in the USA and the predicted nursing shortage, nursing management needs to employ strategies to retain newly licensed registered nurses. © 2015 John Wiley & Sons Ltd.

Quasi-Monopoly Status of a Non-for-Profit Reference Terminology Provider - An Exemplary Approach on Transparency Improvement Regarding Licensing.

PubMed

Dewenter, Heike; Thun, Sylvia

2018-01-01

As the reference terminology SNOMED CT is gaining in significance and seems without alternative in interoperable Electronic Health Records, the holder of its intellectual property, the non-for-profit organization SNOMED International has achieved a quasi-monopoly status as a provider. We examine the current dealing with corporate transparency regarding SNOMED CT licensing together with policy recommendations derived from the research project ASSESS CT, in the context of collaboration with Standardization Organizations. In addition, transparency improvement is proposed based on the economic Principal-Agent-Theory, assuming SNOMED CT Licensees as principals. In this paper we introduce improvement measures with regard to increase transparency in the licensing process addressing to the reference terminology users and especially the terminology provider. The aim is to present strategies towards transparency, with the intent to remove barriers concerning indecisive organization stakeholders and users of a license and fee-based terminology solutions, as well as to overcome resentments connected to the quasi-monopoly status of the provider.

Reasons anglers did not respond to an internet survey and evaluation of data quality

USGS Publications Warehouse

Gigliotti, Larry M.; Henderson, Kjetil R.

2015-01-01

Natural resource management agencies have traditionally used statewide mail surveys to gather information from anglers, but cost savings and faster returns occur using the internet. This study examined mail or internet fishery survey return rates and associated data by license type of South Dakota resident anglers. Junior anglers (ages 16-18; Junior Combination license) had the lowest internet and mail survey return rates (20% and 28%, respectively), followed by adult anglers (ages 19-64; Adult Fishing and Adult Combination licenses; 30% and 39%, respectively), and senior anglers (ages 65+; Senior Fishing and Senior Combination licenses; 42% and 66%, respectively). The three age groups were significantly different on three email use characteristics (shared email, frequency of use, and comfort level). The primary reason for not responding to the internet survey was not receiving or noticing the email request, and secondarily, being too busy to respond. Although having a relatively low response rate, data collected by the internet compared to follow-up mail surveys of internet non-respondents were similar.

Brief Report: The Association of Graduated Driver Licensing with Nondriver Transport-related Injuries Among Adolescents.

PubMed

Zhu, Motao; Zhao, Songzhu; Long, D Leann

2016-09-01

As a phased approach to initiating driving, graduated driver licensing restricts driving by young drivers with the aim of reducing crashes. It might increase riding with parents or on buses, which might be safer, or walking or biking, which might be more dangerous. We examined whether it increases nondriver injuries, and whether it reduces total injuries combining drivers and nondrivers. We conducted longitudinal analyses of 1995-2012 traffic injuries from 43 states. Using Poisson mixed regression, we estimated adjusted rate ratios for visible, incapacitating, and fatal injury. Among 16 year olds, graduated driver licensing was associated with reduced passenger injuries (adjusted rate ratio 0.93, 95% confidence interval: 0.89, 0.97). It was not associated with increased injuries as bus riders, pedestrians, or bicyclists among 16- or 17-year olds. It was associated with a 10% reduction in total injuries among 16-year olds, but not 17-year olds. Graduated driver licensing was associated with reduced passenger injuries and total injuries.

Organizational Characteristics Associated with Staff Turnover in Nursing Homes

ERIC Educational Resources Information Center

Castle, Nicholas G.; Engberg, John

2006-01-01

Purpose: The association between certified nurse aide, licensed practical nurse, and registered nurse turnover and the organizational characteristics of nursing homes are examined. Design and Methods: Hypotheses for eight organizational characteristics are examined (staffing levels, top management turnover, resident case mix, facility quality,…

Commercial suborbital space tourism-proposal on passenger's medical selection

NASA Astrophysics Data System (ADS)

Kluge, Götz; Stern, Claudia; Trammer, Martin; Chaudhuri, Indra; Tuschy, Peter; Gerzer, Rupert

2013-12-01

Commercial human spaceflight has excellent economic and technical perspectives in the next decades. Passengers will be persons from a general population differing from culture, age, gender and health status. They all will have to withstand physical loads of spaceflight such as acceleration and deceleration forces, microgravity, vibration, noise and radiation. There is a necessity to mitigate all negative impacts on the passengers' health. Besides precautionary measures in construction and equipment, a diligent medical selection and pre-flight training is recommended. To ensure an easy and at the same time qualified selection procedure, it is necessary to define medical selection criteria and training methods. As experiences with suborbital spaceflight of private passengers are still few we recommend to implement in the beginning of this new era maximum safety standards. Having performed a satisfactory number of successful flights, some of the selection criteria and training sessions might be loosened or modified. This judicious approach is in the interest of the spaceflight participants as well as of the providing companies. As a guideline we propose a four step approach that allows a quick decision concerning the fitness of participants to fly as well as an intensive preparation of the passengers. For the first two steps positive experiences from medical screening and examination of professional pilots can be utilised. According to JAR-FCL 3 (Joint Aviation Requirements-Flight Crew Licensing, Chapter 3) a questionnaire with medical interview targeting the medical background of the respective person and including no-go criteria provides a first estimation for applicants and medical examiners whether there will be a chance to be accepted as a passenger. The second step of selection comprises the physical examination of the applicant adjusted to the professional pilot's examination procedure. As the physical challenges of the suborbital flight will exceed the impact of general aviation, the standardized diagnostic programme should be purposefully extended. The third part of the selection consists of an intensive training programme, preparing the passengers for the upcoming challenges. In detail this training should comprise lectures about aerospace physiology, countermeasures to g-forces and motion sickness, emergency practices (e.g. rapid decompression or hypoxia) and a centrifuge ride with g-forces adapted to the respective flight profile. An altitude chamber flight, hypoxia experience and participation in a Zero-G-Flight might also be included optionally. The fourth step of the evaluation is caused by a possible delay between medical examination and launch. In the interval, the health status might have changed and serious illnesses might have developed. So, a short re-evaluation should be performed 7-14 days before take-off. A brief check-out procedure for medical re-evaluation of passenger's health status is recommended. As launch of suborbital spaceflights will take place all over the world at so called "Spaceports", the development of standards for medical examinations and the training programmes as well as a mutual acceptance of the participating medical test and training centres will be very helpful for development of this industry. Joint recommendations for the emergency equipment of commercial spaceships will also have to be developed.

Diminished origin licensing capacity specifically sensitises tumour cells to replication stress

PubMed Central

Zimmerman, Kristin M.; Jones, Rebecca M.; Petermann, Eva; Jeggo, Penelope A.

2013-01-01

Previous studies have shown that dormant licensed replication origins can be exploited to enhance recovery from replication stress. Since tumour cells express high levels of origin licensing proteins, we examined whether depletion of such factors might specifically sensitise tumour versus non-tumour cells. Consistent with previous findings, we observed that three tumour-derived cell lines overexpress ORC1, a licensing component, compared to four non-tumour cell lines and that a greater level of ORC1 was required to maintain viability in the tumour cells. We determined siRNA-mediated knockdown conditions for each line that maximally reduced ORC1 but did not impact upon viability, which we considered would optimally deplete dormant origins. ORC1 depletion hypersensitised the tumour-derived cells to hydroxyurea (HU) and H202 but did not affect the sensitivity of the non-tumour lines. Similar results were observed following depletion of ORC6 or CDC6. Further, co-depletion of p53 and ORC1 modestly impaired viability of 1BR3hTERT non-tumour fibroblasts and more dramatically caused hypersensitivity to HU. Finally, overexpression of the c-Myc oncogene combined with ORC1 depletion in non-tumour BJhTERT cells diminished viability. Collectively, these findings suggest that tumour cells may have a reliance on origin licensing capacity, suggesting that licensing factors could represent a target for drug-based cancer therapy. PMID:23364533

The Effectiveness of Six Personality Variables in Predicting Success on the Nursing State Board Examination.

ERIC Educational Resources Information Center

Cusick, Patricia; Harckham, Laura D.

A study was conducted to determine whether six personality variables, presently used in admissions decisions by a nursing school, were effective predictors of success on the State Board Examination (SBE), the nursing licensing examination. The personality variables were measured by subtests of the Personal Preference Schedule of the Psychological…

To require the Director of the United States Patent and Trademark Office to conduct a study on effective ways to provide confirming genetic diagnostic test activity where gene patents and exclusive licensing exist, and for other purposes.

THOMAS, 112th Congress

Rep. Wasserman Schultz, Debbie [D-FL-20

2011-06-22

House - 08/25/2011 Referred to the Subcommittee on Intellectual Property, Competition and the Internet. (All Actions) Notes: For further action, see H.R.1249, which became Public Law 112-29 on 9/16/2011. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Immunization. Safety and Use of Polio Vaccines. Briefing Report to the Chairman, Subcommittee on Natural Resources, Agriculture Research and Environment, Committee on Science, Space, and Technology, House of Representatives.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

This report presents information on the status of the safety and use of polio vaccines in the United States. Topics discussed include: (1) the role of the Food and Drug Administration (FDA) in processing an inactivated polio vaccine license application; (2) the steps the federal government has taken to improve the safety of the vaccine; (3) the…

Longitudinal effects of medical students' communication skills on future performance.

PubMed

Dong, Ting; LaRochelle, Jeffrey S; Durning, Steven J; Saguil, Aaron; Swygert, Kimberly; Artino, Anthony R

2015-04-01

The Essential Elements of Communication (EEC) were developed from the Kalamazoo consensus statement on physician-patient communication. The Uniformed Services University of the Health Sciences (USU) has adopted a longitudinal curriculum to use the EEC both as a learning tool during standardized patient encounters and as an evaluation tool culminating with the end of preclerkship objective-structured clinical examinations (OSCE). Medical educators have recently emphasized the importance of teaching communication skills, as evidenced by the United States Medical Licensing Examination testing both the integrated clinical encounter (ICE) and communication and interpersonal skills (CIS) within the Step 2 Clinical Skills exam (CS). To determine the associations between students' EEC OSCE performance at the end of the preclerkship period with later communication skills assessment and evaluation outcomes in the context of a longitudinal curriculum spanning both undergraduate medical education and graduate medical education. Retrospective data from preclerkship (overall OSCE scores and EEC OSCE scores) and clerkship outcomes (internal medicine [IM] clinical points and average clerkship National Board of Medical Examiners [NBME] scores) were collected from 167 USU medical students from the class of 2011 and compared to individual scores on the CIS and ICE components of Step 2 CS, as well as to the communication skills component of the program directors' evaluation of trainees during their postgraduate year 1 (PGY-1) residency. In addition to bivariate Pearson correlation analysis, we conducted multiple linear regression analysis to examine the predictive power of the EEC score beyond the IM clerkship clinical points and the average NBME Subject Exams score on the outcome measures. The EEC score was a significant predictor of the CIS score and the PGY-1 communication skills score. Beyond the average NBME Subject Exams score and the IM clerkship clinical points, the EEC score explained an additional 13% of the variance in the Step 2 CIS score and an additional 6% of the variance in the PGY-1 communication skills score. In addition, the EEC score was more closely associated with the CIS score than the ICE score. The use of a standardized approach with a communication tool like the EEC can help explain future performance in communication skills independent of other education outcomes. In the context of a longitudinal curriculum, this information may better inform medical educators on learners' communication capabilities and more accurately direct future remediation efforts. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Physician survey examining the impact of an educational tool for responsible opioid prescribing.

PubMed

Young, Aaron; Alfred, Kelly C; Davignon, Philip P; Hughes, LaSharn M; Robin, Lisa A; Chaudhry, Humayun J

2012-01-01

In response to the need for physician education on proper opioid prescribing, the Federation of State Medical Boards (FSMB) and the FSMB Foundation, the philanthropic arm of the FSMB, commissioned and distributed Responsible Opioid Use: A Physician's Guide to more than 165, 000 licensed physicians in the United States. The book, written by pain management specialist Scott Fishman, MD, seeks tofurtherphysicians' continuing medical education by providing information on how to properly prescribe opioids to treat patients in pain. Although the book has been widely distributed, there have been no systematic studies of its impact. To address this knowledge gap, the authors surveyed licensed physicians in Georgia who received a copy of the book to determine whether it added to their knowledge about prescribing opioids, and if they planned to make changes in theirpractice based on reading the book. Six weeks after licensed physicians in Georgia received the book, a survey was sent to 12,666 of them via e-mail. A total of508 physicians completed the online survey. Of these, 82.1 percent rated the book either "very good" or "good" on providing pragmatic steps for improved care forpatients in pain, and more than 80 percent agreed that the book is a useful educational tool. Almost one-third (32.2percent) claimed that they intend to make changes to theirpractice after reading the book. The analysis also showed physicians in a solo practice were more likely to make changes (41.8percent) than their counterparts in office-based group practice (33.3 percent) and hospital-based (25.0 percent) settings. Primary care providers (41.6 percent) were also much more likely to make changes than physicians working in other specialty areas of medicine (22.8 percent). Well over half (57. 7percent) of the respondents indicated the book was better than other publications they had read on opioid prescribing and pain management. The results from this state-wide survey of licensed physicians demonstrate the value of educating physicians about how to appropriately prescribe, document, and treat patients who need opioid medications for pain management. The findings should be of value to organizations seeking to better educate physicians about appropriate opioid prescribing by providing insight into which physician population would be the most receptive to the type of information presented in Dr. Fishman's book. When faced with limited resources, an organizational strategy that first targets solo and primary care practitioners may improve physician educational efforts about prescribing opioids better than a strategy targeting medical and surgical specialists or those physicians participating in group practice settings.

Quality of randomised controlled trials in medical education reported between 2012 and 2013: a systematic review protocol.

PubMed

Tolsgaard, Martin G; Ku, Cheryl; Woods, Nicole N; Kulasegaram, Kulamakan Mahan; Brydges, Ryan; Ringsted, Charlotte

2014-07-30

Research in medical education has increased in volume over the past decades but concerns have been raised regarding the quality of trials conducted within this field. Randomised controlled trials (RCTs) involving educational interventions that are reported in biomedical journals have been criticised for their insufficient conceptual, theoretical framework. RCTs published in journals dedicated to medical education, on the other hand, have been questioned regarding their methodological rigour. The aim of this study is therefore to assess the quality of RCTs of educational interventions reported in 2012 and 2013 in journals dedicated to medical education compared to biomedical journals with respect to objective quality criteria. RCTs published between 1 January 2012 and 31 December 2013 in English are included. The search strategy is developed with the help of experienced librarians to search online databases for key terms. All of the identified RCTs are screened based on their titles and abstracts individually by the authors and then compared in pairs to assess agreement. Data are extracted from the included RCTs by independently scoring each RCT using a data collection form. The data collection form consists of four steps. Step 1 includes confirmation of RCT eligibility; step 2 consists of the CONSORT checklist; step 3 consists of the Medical Education Research Study Quality Instrument framework; step 4 consists of a Medical Education Extension (MEdEx) to the CONSORT checklist. The MEdEx includes the following elements: Description of scientific background, explanation of rationale, quality of research questions and hypotheses, clarity in the description of the use of the intervention and control as well as interpretation of results. This review is the first to systematically examine the quality of RCTs conducted in medical education. We plan to disseminate the results through publications and presentation at relevant conferences. Ethical approval is not sought for this review. 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.

Trends in NRMP Data from 2007-2014 for U.S. Seniors Matching into Emergency Medicine.

PubMed

Manthey, David E; Hartman, Nicholas D; Newmyer, Aileen; Gunalda, Jonah C; Hiestand, Brian C; Askew, Kim L; Lefebvre, Cedric

2017-01-01

Since 1978, the National Residency Matching Program (NRMP) has published data demonstrating characteristics of applicants who have matched into their preferred specialty in the NRMP main residency match. These data have been published approximately every two years. There is limited information about trends within these published data for students matching into emergency medicine (EM). Our objective was to investigate and describe trends in NRMP data to include the following: the ratio of applicants to available EM positions; United State Medical Licensing Examination (USMLE) Step 1 and Step 2 scores (compared to the national means); number of programs ranked; and Alpha Omega Alpha Honor Medical Society (AOA) membership among U.S. seniors matching into EM. This was a retrospective observational review of NRMP data published between 2007 and 2016. We analyzed the data using analysis of variance (ANOVA) or Kruskal-Wallis testing, and Fischer's exact or chi-squared testing, as appropriate to determine statistical significance. The ratio of applicants to available EM positions remained essentially stable from 2007 to 2014 but did increase slightly in 2016. We observed a net upward trend in overall Step 1 and Step 2 scores for EM applicants. However, this did not outpace the national trend increase in Step 1 and 2 scores overall. There was an increase in the mean number of programs ranked by EM applicants over the years studied from 7.8 (SD4.2) to 9.2 (SD5.0, p<0.001), driven predominantly by the cohort of U.S. students successful in the match. Among time intervals, there was a difference in the number of EM applicants with AOA membership (p=0.043) due to a drop in the number of AOA students in 2011. No sustained statistical trend in AOA membership was identified over the seven-year period studied. NRMP data demonstrate trends among EM applicants that are similar to national trends in other specialties for USMLE board scores, and a modest increase in number of programs ranked. AOA membership was largely stable. EM does not appear to have become more competitive relative to other specialties or previous years in these categories.

Association of MCAT scores obtained with standard vs extra administration time with medical school admission, medical student performance, and time to graduation.

PubMed

Searcy, Cynthia A; Dowd, Keith W; Hughes, Michael G; Baldwin, Sean; Pigg, Trey

2015-06-09

Individuals with documented disabilities may receive accommodations on the Medical College Admission Test (MCAT). Whether such accommodations are associated with MCAT scores, medical school admission, and medical school performance is unclear. To determine the comparability of MCAT scores obtained with standard vs extra administration time with respect to likelihood of acceptance to medical school and future medical student performance. Retrospective cohort study of applicants to US medical schools for the 2011-2013 entering classes who reported MCAT scores obtained with standard time (n = 133,962) vs extra time (n = 435), and of students who matriculated in US medical schools from 2000-2004 who reported MCAT scores obtained with standard time (n = 76,262) vs extra time (n = 449). Standard or extra administration time during MCAT. Primary outcome measures were acceptance rates at US medical schools and graduation rates within 4 or 5 years after matriculation. Secondary outcome measures were pass rates on the United States Medical Licensing Examination (USMLE) Step examinations and graduation rates within 6 to 8 years after matriculation. Acceptance rates were not significantly different for applicants who had MCAT scores obtained with standard vs extra time (44.5% [59,585/133,962] vs 43.9% [191/435]; difference, 0.6% [95% CI, -4.1 to 5.3]). Students who tested with extra time passed the Step examinations on first attempt at significantly lower rates (Step 1, 82.1% [344/419] vs 94.0% [70,188/74,668]; difference, 11.9% [95% CI, 9.6% to 14.2%]; Step 2 CK, 85.5% [349/408] vs 95.4% [70,476/73,866]; difference, 9.9% [95% CI, 7.8% to 11.9%]; Step 2 CS, 92.0% [288/313] vs 97.0% [60,039/61,882]; difference, 5.0% [95% CI, 3.1% to 6.9%]). They also graduated from medical school at significantly lower rates at different times (4 years, 67.2% [285/424] vs 86.1% [60,547/70,305]; difference, 18.9% [95% CI, 15.6% to 22.2%]; 5 years, 81.6% [346/424] vs 94.4% [66,369/70,305]; difference, 12.8% [95% CI, 10.6% to 15.0%]; 6 years, 85.4% [362/424] vs 95.8% [67,351/70,305]; difference, 10.4% [95% CI, 8.5% to 12.4%]; 7 years, 88.0% [373/424] vs 96.2% [67,639/70,305]; difference, 8.2% [95% CI, 6.4% to 10.1%]; 8 years, 88.4% [375/424] vs 96.5% [67,847/70,305]; difference, 8.1% [95% CI, 6.3% to 9.8%]). These differences remained after controlling for MCAT scores and undergraduate grade point averages. Among applicants to US medical schools, those with MCAT scores obtained with extra test administration time, compared with standard administration time, had no significant difference in rate of medical school admission but had lower rates of passing the USMLE Step examinations and of medical school graduation within 4 to 8 years after matriculation. These findings raise questions about the types of learning environments and support systems needed by students who test with extra time on the MCAT to enable them to succeed in medical school.

The actual development of European Aviation Safety Requirements in Aviation Medicine: Prospects of Future EASA Requirements

PubMed Central

Siedenburg, J

2009-01-01

Common Rules for Aviation Safety had been developed under the aegis of the Joint Aviation Authorities in the 1990ies. In 2002 the Basic Regulation 1592/2002 was the founding document of a new entity, the European Aviation Safety Agency. Areas of activity were Certification and Maintenance of aircraft. On 18 March the new Basic Regulation 216/2008, repealing the original Basic Regulation was published and applicable from 08 April on. The included Essential Requirements extended the competencies of EASA inter alia to Pilot Licensing and Flight Operations. The future aeromedical requirements will be included as Annex II in another Implementing Regulation on Personnel Licensing. The detailed provisions will be published as guidance material. The proposals for these provisions have been published on 05 June 2008 as NPA 2008- 17c. After public consultation, processing of comments and final adoption the new proposals may be applicable form the second half of 2009 on. A transition period of four year will apply. Whereas the provisions are based on Joint Awiation Requirement - Flight Crew Licensing (JAR-FCL) 3, a new Light Aircraft Pilot Licence (LAPL) project and the details of the associated medical certification regarding general practitioners will be something new in aviation medicine. This paper consists of 6 sections. The introduction outlines the idea of international aviation safety. The second section describes the development of the Joint Aviation Authorities (JAA), the first step to common rules for aviation safety in Europe. The third section encompasses a major change as next step: the foundation of the European Aviation Safety Agency (EASA) and the development of its rules. In the following section provides an outline of the new medical requirements. Section five emphasizes the new concept of a Leisure Pilot Licence. The last section gives an outlook on ongoing rulemaking activities and the opportunities of the public to participate in them. PMID:19561781

The actual development of European aviation safety requirements in aviation medicine: prospects of future EASA requirements.

PubMed

Siedenburg, J

2009-04-01

Common Rules for Aviation Safety had been developed under the aegis of the Joint Aviation Authorities in the 1990s. In 2002 the Basic Regulation 1592/2002 was the founding document of a new entity, the European Aviation Safety Agency. Areas of activity were Certification and Maintenance of aircraft. On 18 March the new Basic Regulation 216/2008, repealing the original Basic Regulation was published and applicable from 08 April on. The included Essential Requirements extended the competencies of EASA inter alia to Pilot Licensing and Flight Operations. The future aeromedical requirements will be included as Annex II in another Implementing Regulation on Personnel Licensing. The detailed provisions will be published as guidance material. The proposals for these provisions have been published on 05 June 2008 as NPA 2008- 17c. After public consultation, processing of comments and final adoption the new proposals may be applicable form the second half of 2009 on. A transition period of four year will apply. Whereas the provisions are based on Joint Aviation Requirement-Flight Crew Licensing (JAR-FCL) 3, a new Light Aircraft Pilot Licence (LAPL) project and the details of the associated medical certification regarding general practitioners will be something new in aviation medicine. This paper consists of 6 sections. The introduction outlines the idea of international aviation safety. The second section describes the development of the Joint Aviation Authorities (JAA), the first step to common rules for aviation safety in Europe. The third section encompasses a major change as next step: the foundation of the European Aviation Safety Agency (EASA) and the development of its rules. In the following section provides an outline of the new medical requirements. Section five emphasizes the new concept of a Leisure Pilot Licence. The last section gives an outlook on ongoing rulemaking activities and the opportunities of the public to participate in them.

10 CFR Appendix B to Part 73 - General Criteria for Security Personnel

Code of Federal Regulations, 2013 CFR

2013-01-01

...-force exercises. (2) Licensee scenarios must be designed to test and challenge any components or... or pass an equivalent performance examination designed to measure basic job-related mathematical... administered by a licensed physician. The examination shall be designed to measure the individual's physical...

10 CFR Appendix B to Part 73 - General Criteria for Security Personnel

Code of Federal Regulations, 2010 CFR

2010-01-01

...-force exercises. (2) Licensee scenarios must be designed to test and challenge any components or... or pass an equivalent performance examination designed to measure basic job-related mathematical... administered by a licensed physician. The examination shall be designed to measure the individual's physical...

10 CFR Appendix B to Part 73 - General Criteria for Security Personnel

Code of Federal Regulations, 2011 CFR

2011-01-01

...-force exercises. (2) Licensee scenarios must be designed to test and challenge any components or... or pass an equivalent performance examination designed to measure basic job-related mathematical... administered by a licensed physician. The examination shall be designed to measure the individual's physical...

10 CFR Appendix B to Part 73 - General Criteria for Security Personnel

Code of Federal Regulations, 2014 CFR

2014-01-01

...-force exercises. (2) Licensee scenarios must be designed to test and challenge any components or... or pass an equivalent performance examination designed to measure basic job-related mathematical... administered by a licensed physician. The examination shall be designed to measure the individual's physical...

Automated Simultaneous Assembly for Multistage Testing

ERIC Educational Resources Information Center

Breithaupt, Krista; Ariel, Adelaide; Veldkamp, Bernard P.

2005-01-01

This article offers some solutions used in the assembly of the computerized Uniform Certified Public Accountancy (CPA) licensing examination as practical alternatives for operational programs producing large numbers of forms. The Uniform CPA examination was offered as an adaptive multistage test (MST) beginning in April of 2004. Examples of…

47 CFR 97.501 - Qualifying for an amateur operator license.

Code of Federal Regulations, 2010 CFR

2010-10-01

....501 Section 97.501 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL... must pass, or otherwise receive examination credit for, the following examination elements: (a) Amateur Extra Class operator: Elements 2, 3, and 4; (b) General Class operator: Elements 2 and 3; (c) Technician...

Article-level assessment of influence and translation in biomedical research.

PubMed

Santangelo, George M

2017-06-01

Given the vast scale of the modern scientific enterprise, it can be difficult for scientists to make judgments about the work of others through careful analysis of the entirety of the relevant literature. This has led to a reliance on metrics that are mathematically flawed and insufficiently diverse to account for the variety of ways in which investigators contribute to scientific progress. An urgent, critical first step in solving this problem is replacing the Journal Impact Factor with an article-level alternative. The Relative Citation Ratio (RCR), a metric that was designed to serve in that capacity, measures the influence of each publication on its respective area of research. RCR can serve as one component of a multifaceted metric that provides an effective data-driven supplement to expert opinion. Developing validated methods that quantify scientific progress can help to optimize the management of research investments and accelerate the acquisition of knowledge that improves human health. © 2017 Santangelo. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Motor Vehicle Crash Risk Among Adolescents and Young Adults With Attention-Deficit/Hyperactivity Disorder.

PubMed

Curry, Allison E; Metzger, Kristina B; Pfeiffer, Melissa R; Elliott, Michael R; Winston, Flaura K; Power, Thomas J

2017-08-01

Attention-deficit/hyperactivity disorder (ADHD) often persists into adolescence, when motor vehicle crash risk peaks. We know little about when adolescents with ADHD get licensed and, once they do, the extent to which they have increased crash risk compared with adolescents without ADHD. To examine the association between ADHD and both driver licensing and crash involvement and whether it varies by sex, licensing age, and/or being prescribed ADHD medication at licensure. This retrospective cohort study was conducted at 6 primary care practices of the Children's Hospital of Philadelphia, a large pediatric health care network in southeastern Pennsylvania and southern New Jersey. Using electronic health records, we defined a cohort of 2479 adolescents and young adults with ADHD and 15 865 without ADHD who were (1) born from 1987 to 1997; (2) residents of New Jersey and patients at 1 of 6 New Jersey primary care practices at age 12 years or older; and (3) age-eligible to obtain a driver's license from 2004 through 2014. Electronic health records data were then linked with New Jersey's statewide driver licensing and crash databases for 2004 through 2014. Acquisition of a driver's license and first involvement as a driver in a police-reported crash. Survival analysis was used to estimate adjusted hazard ratios for licensing and crash outcomes through age 25 years. The median age of individuals at the end of the study was 22.2 years (interquartile range, 19.7-24.8). Compared with individuals without ADHD, the licensing probability of individuals with ADHD 6 months after eligibility was 35% lower (for males: adjusted hazard ratio, 0.65; 95% CI, 0.61-0.70; females: adjusted hazard ratio, 0.64; 95% CI, 0.58-0.70). Among individuals with a driver's license, 764 of 1785 with ADHD (42.8%) and 4715 of 13 221 without ADHD (35.7%) crashed during the study period. The adjusted risk for first crash among licensed drivers with ADHD was 1.36 times higher than for those without ADHD (95% CI, 1.25-1.48) and did not vary by sex, licensing age, or over time. Only 129 individuals with ADHD (12.1%) were prescribed medication in the 30 days before licensure. Adolescents with ADHD get licensed less often and at an older age. Once licensed, this cohort has a greater risk of crashing. Additional research is needed to understand the specific mechanisms by which ADHD influences crash risk.

The impact of the 2007 graduated driver licensing law in Massachusetts on the rate of citations and licensing in teenage drivers.

PubMed

DePesa, Christopher; Raybould, Toby; Hurwitz, Shelley; Lee, Jarone; Gervasini, Alice; Velmahos, George C; Masiakos, Peter T; Kaafarani, Haytham M A

2017-06-01

We recently demonstrated that the 2007 Massachusetts Graduated Driving Licensing (GDL) law decreased the rate of motor vehicle crashes in teenage drivers. To better understand this decrease, we sought to examine the law's impact on the issuance of driving licenses and traffic citations to teenage drivers. Citation and license data were obtained from the Massachusetts Department of Transportation. Census data were obtained from the Census Data Center. Two study periods were defined: pre-GDL (2002-2006) and post-GDL (2007-2012). Two populations were defined: the study population (aged 16-17) and the control population (aged 25-29). The rates of licenses per population were compared pre- vs. post-GDL for the study group. The numbers of total, state, and local citations per population were compared pre- vs. post-GDL for both populations. A sensitivity analysis was performed for the rates of citations using licenses issued as a denominator. While licenses per population obtained by the study group decreased over the entire period, there was no change in the rate of decrease per year pre- vs. post-GDL (2.0% vs. 1.4%; p=0.6392). In the study population, total, state, and local citations decreased post-GDL (17.8% vs. 8.1%, p<0.0001; 3.7% vs. 2.2%, p<0.0001; 14.1% vs. 5.8%, p<0.0001, respectively). In the control group, total and state citations did not change (26.7% vs. 23.9%, p=0.3606; 9.2% vs. 10.2%, p=0.3404, respectively), and local citations decreased (17.5% vs. 13.7%, p=0.0389). The rates of decrease per year for total, state, and local citations were significantly greater in the study population compared with control (p<0.0001, p=0.0002, p<0.0001, respectively). The 2007 GDL law in Massachusetts was associated with fewer traffic citations without a change in the rate of licenses issued to teenagers. These findings suggest that 2007 GDL may be improving driving habits as opposed to motivating teenagers to delay the issuing of licenses. Copyright © 2017. Published by Elsevier Ltd.

15 CFR 255.2 - Qualifications.

Code of Federal Regulations, 2010 CFR

2010-01-01

... STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE FELLOWSHIPS AND RESEARCH ASSOCIATES FELLOWSHIPS IN... than the United States; (b) In possession of a certificate of medical examination issued by a licensed...

Didactic teaching conferences for IM residents: who attends, and is attendance related to medical certifying examination scores?

PubMed

FitzGerald, John D; Wenger, Neil S

2003-01-01

Didactic teaching conferences are a cornerstone of residents' training in internal medicine, yet these programs have received little formal evaluation. This study determines the factors associated with residents' attendance at didactic teaching conferences and the relationship of attendance to residents' scores on medical certification examinations. The attendance of 81 residents was recorded at 199 conferences at one university hospital's internal medicine residency program during the 1996-97 academic year. Characteristics of the conferences were recorded, including the date, whether lunch was provided, the daily census on the medicine general wards, daily ambient temperature, and conference type. Residents' scores on the United States Medical Licensing Examination (USMLE) Step 2 and American Board of Internal Medicine (ABIM) certification examination were collected. Residents' attendance at conferences was 34% overall or 54% excluding excused absences. Adjusting for the conferences' and residents' characteristics, attendance declined by one third as the year progressed. Providing lunch at noon conferences enhanced residents' attendance (odds ratio [OR] 1.26 overall and OR 1.64 for residents on inpatient rotations). Higher attendance was not associated with improvement in standardized medical knowledge test scores. Absenteeism and waning attendance through the year have important implications for structuring didactic internal medicine teaching. Providing lunch improves attendance, but this incentive should be weighed against the potential burdens of the pharmaceutical industry's funding of these lunches. The lack of relationship between attendance and residents' adjusted board scores calls for a better understanding of the value of this high-intensity medical education intervention.

Telehealth among US hospitals: several factors, including state reimbursement and licensure policies, influence adoption.

PubMed

Adler-Milstein, Julia; Kvedar, Joseph; Bates, David W

2014-02-01

Telehealth is widely believed to hold great potential to improve access to, and increase the value of, health care. Gaining a better understanding of why some hospitals adopt telehealth technologies while others do not is critically important. We examined factors associated with telehealth adoption among US hospitals. Data from the Information Technology Supplement to the American Hospital Association's 2012 annual survey of acute care hospitals show that 42 percent of US hospitals have telehealth capabilities. Hospitals more likely to have telehealth capabilities are teaching hospitals, those equipped with additional advanced medical technology, those that are members of a larger system, and those that are nonprofit institutions. Rates of hospital telehealth adoption by state vary substantially and are associated with differences in state policy. Policies that promote private payer reimbursement for telehealth are associated with greater likelihood of telehealth adoption, while policies that require out-of-state providers to have a special license to provide telehealth services reduce the likelihood of adoption. Our findings suggest steps that policy makers can take to achieve greater adoption of telehealth by hospitals.

Inclusion of adolescents in preventive HIV vaccine trials: public health policy and research design at a crossroads.

PubMed

Jaspan, Heather B; Cunningham, Coleen K; Tucker, Tim J P; Wright, Peter F; Self, Steve G; Sheets, Rebecca L; Rogers, Audrey S; Bekker, Linda-Gail; Wilson, Craig M; Duerr, Ann; Wasserheit, Judith N

2008-01-01

The search for a safe effective HIV vaccine has been a centerpiece of HIV research for almost 2 decades. More than 60 clinical HIV vaccine trials have been conducted to date. Several promising candidate HIV vaccines are in advanced clinical development. To date, however, no trial has included adolescents, one of the most important target groups for any preventive HIV vaccine. To license a vaccine for use in this age group, efficacy data or, at a minimum, bridging safety and immunogenicity data in this population are needed. To accomplish this, several critical issues and special challenges in the development and implementation of HIV vaccine trials in adolescents must be addressed, including regulatory considerations, potential differentials in safety and immunogenicity, alternative trial design strategies, recruitment and retention challenges, community involvement models, and approaches to informed consent/assent. This article examines these issues and proposes specific next steps to facilitate the routine inclusion of this high-priority population in preventive HIV vaccine trials as early and seamlessly as possible.

The predictive validity of selection for entry into postgraduate training in general practice: evidence from three longitudinal studies

PubMed Central

Patterson, Fiona; Lievens, Filip; Kerrin, Máire; Munro, Neil; Irish, Bill

2013-01-01

Background The selection methodology for UK general practice is designed to accommodate several thousand applicants per year and targets six core attributes identified in a multi-method job-analysis study Aim To evaluate the predictive validity of selection methods for entry into postgraduate training, comprising a clinical problem-solving test, a situational judgement test, and a selection centre. Design and setting A three-part longitudinal predictive validity study of selection into training for UK general practice. Method In sample 1, participants were junior doctors applying for training in general practice (n = 6824). In sample 2, participants were GP registrars 1 year into training (n = 196). In sample 3, participants were GP registrars sitting the licensing examination after 3 years, at the end of training (n = 2292). The outcome measures include: assessor ratings of performance in a selection centre comprising job simulation exercises (sample 1); supervisor ratings of trainee job performance 1 year into training (sample 2); and licensing examination results, including an applied knowledge examination and a 12-station clinical skills objective structured clinical examination (OSCE; sample 3). Results Performance ratings at selection predicted subsequent supervisor ratings of job performance 1 year later. Selection results also significantly predicted performance on both the clinical skills OSCE and applied knowledge examination for licensing at the end of training. Conclusion In combination, these longitudinal findings provide good evidence of the predictive validity of the selection methods, and are the first reported for entry into postgraduate training. Results show that the best predictor of work performance and training outcomes is a combination of a clinical problem-solving test, a situational judgement test, and a selection centre. Implications for selection methods for all postgraduate specialties are considered. PMID:24267856

The predictive validity of selection for entry into postgraduate training in general practice: evidence from three longitudinal studies.

PubMed

Patterson, Fiona; Lievens, Filip; Kerrin, Máire; Munro, Neil; Irish, Bill

2013-11-01

The selection methodology for UK general practice is designed to accommodate several thousand applicants per year and targets six core attributes identified in a multi-method job-analysis study To evaluate the predictive validity of selection methods for entry into postgraduate training, comprising a clinical problem-solving test, a situational judgement test, and a selection centre. A three-part longitudinal predictive validity study of selection into training for UK general practice. In sample 1, participants were junior doctors applying for training in general practice (n = 6824). In sample 2, participants were GP registrars 1 year into training (n = 196). In sample 3, participants were GP registrars sitting the licensing examination after 3 years, at the end of training (n = 2292). The outcome measures include: assessor ratings of performance in a selection centre comprising job simulation exercises (sample 1); supervisor ratings of trainee job performance 1 year into training (sample 2); and licensing examination results, including an applied knowledge examination and a 12-station clinical skills objective structured clinical examination (OSCE; sample 3). Performance ratings at selection predicted subsequent supervisor ratings of job performance 1 year later. Selection results also significantly predicted performance on both the clinical skills OSCE and applied knowledge examination for licensing at the end of training. In combination, these longitudinal findings provide good evidence of the predictive validity of the selection methods, and are the first reported for entry into postgraduate training. Results show that the best predictor of work performance and training outcomes is a combination of a clinical problem-solving test, a situational judgement test, and a selection centre. Implications for selection methods for all postgraduate specialties are considered.

On Learning Physics.

ERIC Educational Resources Information Center

Kuhn, Thomas, S.

2000-01-01

Examines the required cluster of terms and transmission techniques in Newtonian mechanics. Suggests some characteristics of what a student acquires in the course of becoming a licensed practitioner in the field. (CCM)

The Learning Preferences of Applicants Who Interview for General Surgery Residency: A Multiinstitutional Study.

PubMed

Kim, Roger H; Kurtzman, Scott H; Collier, Ashley N; Shabahang, Mohsen M

Learning styles theory posits that learners have distinct preferences for how they assimilate new information. The VARK model categorizes learners based on combinations of 4 learning preferences: visual (V), aural (A), read/write (R), and kinesthetic (K). A previous single institution study demonstrated that the VARK preferences of applicants who interview for general surgery residency are different from that of the general population and that learning preferences were associated with performance on standardized tests. This multiinstitutional study was conducted to determine the distribution of VARK preferences among interviewees for general surgery residency and the effect of those preferences on United States Medical Licensing Examination (USMLE) scores. The VARK learning inventory was administered to applicants who interviewed at 3 general surgery programs during the 2014 to 2015 academic year. The distribution of VARK learning preferences among interviewees was compared with that of the general population of VARK respondents. Performance on USMLE Step 1 and Step 2 Clinical Knowledge was analyzed for associations with VARK learning preferences. Chi-square, analysis of variance, and Dunnett's test were used for statistical analysis, with p < 0.05 considered statistically significant. The VARK inventory was completed by a total of 140 residency interviewees. Sixty-four percent of participants were male, and 41% were unimodal, having a preference for a single learning modality. The distribution of VARK preferences of interviewees was different than that of the general population (p = 0.02). By analysis of variance, there were no overall differences in USMLE Step 1 and Step 2 Clinical Knowledge scores by VARK preference (p = 0.06 and 0.21, respectively). However, multiple comparison analysis using Dunnett's test revealed that interviewees with R preferences had significantly higher scores than those with multimodal preferences on USMLE Step 1 (239 vs. 222, p = 0.02). Applicants who interview for general surgery residency have a different pattern of VARK preferences than that of the general population. Interviewees with preferences for read/write learning modalities have higher scores on the USMLE Step 1 than those with multimodal preferences. Learning preferences may have impact on residency applicant selection and represents a topic that warrants further investigation. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Program Director Perceptions of Proficiency in the Core Entrustable Professional Activities.

PubMed

Pearlman, R Ellen; Pawelczak, Melissa; Yacht, Andrew C; Akbar, Salaahuddin; Farina, Gino A

2017-10-01

The Association of American Medical Colleges describes 13 core entrustable professional activities (EPAs) that every graduating medical student should be expected to perform proficiently on day 1 of residency, regardless of chosen specialty. Studies have shown wide variability in program director (PD) confidence in interns' abilities to perform these core EPAs. Little is known regarding comparison of United States Medical Licensing Examination (USMLE) scores with proficiency in EPAs. We determined if PDs from a large health system felt confident in their postgraduate year 1 residents' abilities to perform the 13 core EPAs, and compared perceived EPA proficiency with USMLE Step 1 and Step 2 scores. The PDs were asked to rate their residents' proficiency in each EPA and to provide residents' USMLE scores. Timing coincided with the reporting period for resident milestones. Surveys were completed on 204 of 328 residents (62%). PDs reported that 69% of residents (140 of 204) were prepared for EPA 4 (orders/prescriptions), 61% (117 of 192) for EPA 7 (form clinical questions), 68% (135 of 198) for EPA 8 (handovers), 63% (116 of 185) for EPA 11 (consent), and 38% (49 of 129) for EPA 13 (patient safety). EPA ratings and USMLE 1 and 2 were negatively correlated ( r (101) = -0.23, P  = .031). PDs felt that a significant percentage of residents were not adequately prepared in order writing, forming clinical questions, handoffs, informed consent, and promoting a culture of patient safety. We found no positive association between USMLE scores and EPA ratings.

Algae to Bio-Crude in Less Than 60 Minutes

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

Elliott, Doug

Engineers have created a chemical process that produces useful crude oil just minutes after engineers pour in harvested algae -- a verdant green paste with the consistency of pea soup. The PNNL team combined several chemical steps into one continuous process that starts with an algae slurry that contains as much as 80 to 90 percent water. Most current processes require the algae to be dried -- an expensive process that takes a lot of energy. The research has been licensed by Genifuel Corp.

Algae to Bio-Crude in Less Than 60 Minutes

ScienceCinema

Elliott, Doug

2018-01-16

Engineers have created a chemical process that produces useful crude oil just minutes after engineers pour in harvested algae -- a verdant green paste with the consistency of pea soup. The PNNL team combined several chemical steps into one continuous process that starts with an algae slurry that contains as much as 80 to 90 percent water. Most current processes require the algae to be dried -- an expensive process that takes a lot of energy. The research has been licensed by Genifuel Corp.

Detail view looking down at mosaics of everyday objects next ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Detail view looking down at mosaics of everyday objects next to Living Trailer (rear steps seen frame left). "They Last" tile in center surrounded by tiles, irons, glasses, toy guns, license plates, bottle caps, and plastic parts. The mosaic was created in sections as squares and linear strips, as cement was mixed and objects were collected – the edges of these sections and variation of objects is noticeable. View looking north. - Grandma Prisbrey's Bottle Village, 4595 Cochran Street, Simi Valley, Ventura County, CA

Measure Guideline: Buried and/or Encapsulated Ducts

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

Shapiro, C.; Zoeller, W.; Mantha, P.

2013-08-01

Buried and/or encapsulated ducts (BEDs) are a class of advanced, energy-efficiency strategies intended to address the significant ductwork thermal losses associated with ducts installed in unconditioned attics. BEDs are ducts installed in unconditioned attics that are covered in loose-fill insulation and/or encapsulated in closed cell polyurethane spray foam insulation. This Measure Guideline covers the technical aspects of BEDs as well as the advantages, disadvantages, and risks of BEDs compared to other alternative strategies. This guideline also provides detailed guidance on installation of BEDs strategies in new and existing homes through step-by-step installation procedures. Some of the procedures presented here, however,more » require specialized equipment or expertise. In addition, some alterations to duct systems may require a specialized license.« less

A model-based estimation of inter-prefectural migration of physicians within Japan and associated factors: A 20-year retrospective study.

PubMed

Okada, Naoki; Tanimoto, Tetsuya; Morita, Tomohiro; Higuchi, Asaka; Yoshida, Izumi; Kosugi, Kazuhiro; Maeda, Yuto; Nishikawa, Yoshitaka; Ozaki, Akihiko; Tsuda, Kenji; Mori, Jinichi; Ohnishi, Mutsuko; Ward, Larry Wesley; Narimatsu, Hiroto; Yuji, Koichiro; Kami, Masahiro

2018-06-01

Despite an increase in the number of physicians in Japan, misdistribution of physicians within the 47 prefectures remains a major issue. Migration of physicians among prefectures might partly explain the misdistribution. However, geographical differences and the magnitude of physicians' migration are unclear. The aim of this study was to estimate the extent of migration of physicians among prefectures and explore possible factors associated with physicians' migration patterns.Using a publicly available government database from 1995 to 2014, a quantitative estimation of physicians' migration after graduation from a medical school was performed. The inflow and outflow of physicians were ostensibly calculated in each prefecture based on the differences between the number of newly licensed physicians and the actual number of practicing physicians after an adjustment for the number of deceased or retired physicians. Simple and multiple linear regression analyses were conducted to examine socio-demographic background factors.During the 20-year study period, the mean annual numbers of newly licensed physicians, deceased or retired physicians, and increase in practicing physicians in the whole country were 7416, 3382, and 4034, respectively. Among the 47 prefectures, the median annual number of newly licensed physicians to 100,000 population ratio (PPR) was 6.4 (range 1.5-16.5), the median annual adjusted number of newly licensed physicians was 61 (range, -18 to 845; the negative and positive values denote outflow and inflow, respectively), whereas the median annual number of migrating physicians was 13 (range, -171 to 241). The minimum and maximum migration ratios observed were -68% and 245%, respectively. In the final regression model of the 8 variables examined, only "newly licensed PPR" remained significantly associated with physician's migration ratios.A significant inequality in the proportion of the migration of physicians among prefectures in Japan was observed. The multivariate analyses suggest that the newly licensed PPRs, and not from-rural-to-urban migration, might be one of the keys to explaining the migration ratios of physicians. The differences and magnitude of physicians' migration should be factored into mitigate misdistribution of physicians.

Syntactic and semantic restrictions on morphological recomposition: MEG evidence from Greek.

PubMed

Neophytou, K; Manouilidou, C; Stockall, L; Marantz, A

2018-05-16

Complex morphological processing has been extensively studied in the past decades. However, most of this work has either focused on only certain steps involved in this process, or it has been conducted on a few languages, like English. The purpose of the present study is to investigate the spatiotemporal cortical processing profile of the distinct steps previously reported in the literature, from decomposition to re-composition of morphologically complex items, in a relatively understudied language, Greek. Using magnetoencephalography, we confirm the role of the fusiform gyrus in early, form-based morphological decomposition, we relate the syntactic licensing of stem-suffix combinations to the ventral visual processing stream, somewhat independent from lexical access for the stem, and we further elucidate the role of orbitofrontal regions in semantic composition. Thus, the current study offers the most comprehensive test to date of visual morphological processing and additional, crosslinguistic validation of the steps involved in it. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

The accuracy of coin-operated breath analysers installed in licensed premises in the Perth metropolitan area.

PubMed

Hay, Greg; Cercarelli, L Rina

2004-04-01

To examine the accuracy of coin-operated breath analysers installed in licensed premises in the Perth metropolitan area. Two hundred licensed premises were contacted, which resulted in the location of 36 wall-mounted, coin-operated breath analysers. One instrument was removed prior to testing. These premises were then visited and the accuracy of the instruments was tested in situ using National Association of Testing Authorities Australia (NATA) certified 0.080% and 0.100% ethanol in nitrogen gas. The instruments were installed in the licensed premises as follows: 15 in the lounge bar, 10 in the main entrance, six in the public bar, two in the passageway to the toilets, and one in the male toilets. One licensed premise provided a handheld breath instrument. All instruments were accompanied by warning and operating instructions, but only five had any educational material. Only seven of the licensed premises had staff who had received any training in the operation of the wall-mounted instruments. Half of the licensees were unaware of the servicing requirements of the instruments. The testing found that only nine (25%) of the instruments provided acceptable results. The low level of accuracy of coin-operated breath analysers in the Perth metropolitan area is alarming and users should be informed of the potential inaccuracies. This paper, however, does not rule out that some wall-mounted breath analysing instruments may provide accurate results when properly maintained.

The New Zealand graduated driver licensing system: teenagers' attitudes towards and experiences with this car driver licensing system.

PubMed

Begg, D J; Langley, J D; Reeder, A I; Chalmers, D J

1995-09-01

This study examined the attitudes of teenagers towards the New Zealand graduated driver licensing system (GDLS), and the extent to which it affected them. Teenagers, who are members of a longitudinal study of a birth cohort, were interviewed at 15 years of age when the GDLS was first introduced and before they had begun licensure, and again at 18 years of age after they had experience with this licensing system. At both ages the majority (over 70%) agreed with the driving restrictions imposed by this system. After experience with the restrictions, however, significantly more reported being affected a lot by them, than had expected to be at age 15. This was especially true of the restrictions on the carrying of passengers and the night time curfew (10 pm - 5 am). However, few reported that they were affected by the alcohol restriction. Sixty eight per cent of those with a graduated licence reported breaking at least one of the conditions, most frequently carrying passengers. Very few were penalised by the police for this. Generally these young drivers were positively disposed towards the driving restrictions, but noncompliance was common. A full evaluation of all aspects of this licensing system is recommended.

The New Zealand graduated driver licensing system: teenagers' attitudes towards and experiences with this car driver licensing system.

PubMed Central

Begg, D. J.; Langley, J. D.; Reeder, A. I.; Chalmers, D. J.

1995-01-01

OBJECTIVES: This study examined the attitudes of teenagers towards the New Zealand graduated driver licensing system (GDLS), and the extent to which it affected them. METHOD: Teenagers, who are members of a longitudinal study of a birth cohort, were interviewed at 15 years of age when the GDLS was first introduced and before they had begun licensure, and again at 18 years of age after they had experience with this licensing system. RESULTS: At both ages the majority (over 70%) agreed with the driving restrictions imposed by this system. After experience with the restrictions, however, significantly more reported being affected a lot by them, than had expected to be at age 15. This was especially true of the restrictions on the carrying of passengers and the night time curfew (10 pm - 5 am). However, few reported that they were affected by the alcohol restriction. Sixty eight per cent of those with a graduated licence reported breaking at least one of the conditions, most frequently carrying passengers. Very few were penalised by the police for this. CONCLUSIONS: Generally these young drivers were positively disposed towards the driving restrictions, but noncompliance was common. A full evaluation of all aspects of this licensing system is recommended. Images PMID:9346022

Emerging adults without a driver's license engage in more transportation-related physical activity to school/work in certain environmental contexts.

PubMed

Kar, Indra Neal; Li, Kaigang; Haynie, Denise L; Simons-Morton, Bruce G

2017-03-01

The aim was to examine the moderation effect of driving licensure status on the association between different environmental contexts and transportation-related physical activity to and from school and/or work (TPA-SW) among emerging adults. The data were from Wave 4 (n=2026, year 2013) of the NEXT Generation Health Study, an annual assessment of a nationally representative cohort across the nine U.S. Census Divisions. The outcome variable, TPA-SW, was derived from walking or cycling as modes of travel to and from school and/or work. Environmental context variables included residence, college attendance, and work status. Driving licensure status indicated whether or not participants had an independent driver's license. Poisson regression models, adjusted for potential confounders, were used to test interactions between environmental context and driving licensure. There were significant interactions between environmental context and licensure. Interaction contrasts indicated that participants who did not have a driver's license engaged in more TPA-SW than their licensed counterparts if they were living at home (β=1.10, p<0.001), not attending school (β=0.73, p<0.001), attending a technical school/community college (β=1.13, p<0.001), working 1-30 hours/week (β=0.69, p<0.001), or working 30+hours/week (β=1.12, p<0.001). Among non-workers, those without a license engaged in less TPA-SW than participants with a license (β=-0.22, p=0.05). Among emerging adults in certain environmental contexts, delayed driver licensing may result in more physical activity with the possible tradeoff of less transportation mobility. Published by Elsevier Inc.

Graduated driver licensing programs and fatal crashes of 16-year-old drivers: a national evaluation.

PubMed

Chen, Li-Hui; Baker, Susan P; Li, Guohua

2006-07-01

Implementation of graduated driver licensing programs is associated with reductions in crash rates of young drivers, but graduated driver licensing programs vary in their components. The impact of programs with different components is unknown. The purpose of this work was to determine which graduated driver licensing programs are associated with the greatest reductions in fatal motor vehicle crashes involving 16-year-old drivers. We conducted a retrospective study of all 16-year-old drivers involved in fatal crashes in the United States from 1994 through 2004 using data from the Fatality Analysis Reporting System and the US Census Bureau. We measured incidence rate ratios of fatal motor vehicle crashes involving 16-year-old drivers according to graduated driver licensing programs, adjusted for state and year. Compared with state quarters with no graduated driver licensing program components, reductions of 16% to 21% in fatal crash involvement rates of 16-year-old drivers occurred with programs that included > or = 3-month mandatory waiting period, nighttime driving restriction, and either > or = 30 hours of supervised driving or passenger restriction. Reductions of 18% to 21% occurred in state quarters with programs that included > or = 5 of the 7 components examined. Drivers aged 20 to 24 or 25 to 29 years did not experience significant reductions. Comprehensive graduated driver licensing programs are associated with reductions of approximately 20% in 16-year-old drivers' fatal crash involvement rates. The greatest benefit seems to be associated with programs that include age requirements and > or = 3 months of waiting before the intermediate stage, nighttime driving restriction, and either > or = 30 hours of supervised driving or passenger restriction.

Emerging Adults without a Driver’s License Engage in More Transportation-Related Physical Activity to School/Work in Certain Environmental Contexts

PubMed Central

Kar, Indra Neal; Li, Kaigang; Haynie, Denise L.; Simons-Morton, Bruce G.

2017-01-01

The aim was to examine the moderation effect of driving licensure status on the association between different environmental contexts and transportation-related physical activity to and from school and/or work (TPA-SW) among emerging adults. The data were from Wave 4 (n = 2,026, year 2013) of the NEXT Generation Health Study, an annual assessment of a nationally representative cohort across the nine U.S. Census Divisions. The outcome variable, TPA-SW, was derived from walking or cycling as modes of travel to and from school and/or work. Environmental context variables included residence, college attendance, and work status. Driving licensure status indicated whether or not participants had an independent driver’s license. Poisson regression models, adjusted for potential confounders, were used to test interactions between environmental context and driving licensure. There were significant interactions between environmental context and licensure. Interaction contrasts indicated that participants who did not have a driver’s license engaged in more TPA-SW than their licensed counterparts if they were living at home (β = 1.10, p < 0.001), not attending school (β = 0.73, p < 0.001), attending a technical school/community college (β = 1.13, p < 0.001), working 1–30 hours/week (β = 0.69, p < 0.001), or working 30+ hours/week (β = 1.12, p < 0.001). Among nonworkers, those without a license engaged in less TPA-SW than participants with a license (β = − 0.22, p = 0.05). Among emerging adults in certain environmental contexts, delayed driver licensing may result in more physical activity with the possible tradeoff of less transportation mobility. PMID:28011136

Stop waiting and start creating: service learning with an outpatient bone marrow transplant unit art cart program.

PubMed

Fletcher, Tina; Bayer, Christina; Beyer, Emily; Gonzales, Jessica; Ralston, Ashley; Yount, Phyllis

2013-01-01

This paper examines how master of occupational therapy students, their occupational therapy instructor, and a community-based licensed clinical social worker collaborated in a service learning art cart program on an outpatient bone marrow transplant unit. As they progressed through the phases of Kolb's model of service learning, occupational therapy students, their occupational therapy instructor, and the licensed clinical social worker were all able to meet mutual goals of serving a unique patient population, increasing knowledge of best practices, and building and fostering university/community relationships.

20 CFR 404.1503a - Program integrity.

Code of Federal Regulations, 2010 CFR

2010-04-01

... is currently revoked or suspended by any State licensing authority pursuant to adequate due process... psychological consultant, consultative examination provider, or diagnostic test facility. Also see §§ 404.1519...

20 CFR 404.1503a - Program integrity.

Code of Federal Regulations, 2011 CFR

2011-04-01

... is currently revoked or suspended by any State licensing authority pursuant to adequate due process... psychological consultant, consultative examination provider, or diagnostic test facility. Also see §§ 404.1519...

Regulatory Organizations for Physicians’ Status and Administrative Sanctions on Physicians

PubMed Central

MORIOKA, Yasuhiko; HIGUCHI, Norio; KUROYANAGI, Tatsuo; NUDESHIMA, Jiro

2014-01-01

Society bestows professional privilege on physicians. At the same time, it expects physicians to strive constantly to improve their ethics and quality in medical expertise. In every nation, some level of government is responsible for certifying or licensing physicians and imposes strict management, including revoking licenses from inappropriate physicians or providing severe sanctions for misconduct or conduct unbecoming of a physician. In reality, however, it is difficult to reduce the number of inappropriate or indiscreet physicians, and each nation faces its own challenges. We conducted a questionnaire survey of 13 national medical associations, including some major Western countries, regarding the licensing of physicians, the organizations managing their medical practice status, and the data and grounds for administrative sanctioning of physicians. We then examined the circumstances in Japan based on the survey results and pointed out the domestic issues. PMID:25784827

Program Exit Examinations in Nursing Education: Using a Value Added Assessment as a Measure of the Impact of a New Curriculum

ERIC Educational Resources Information Center

Morris, Tama; Hancock, Dawson

2008-01-01

To become a registered nurse in the United States, one must pass the National Council License Examination for Registered Nurses (NCLEX-RN). To address the growing national nursing shortage, nurse preparation programs must better prepare students to pass this national licensure examination. The purpose of this study was to determine whether a new…

78 FR 52814 - Self-Regulatory Organizations; BATS Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-26

... appropriate because, as noted above, the Series 56 is specifically designed to address industry topics and... time, if an individual would like to retain a Series 7 license, the Exchange believes it is appropriate... Qualification Examination (``Series 56'') among the applicable qualification examinations as determined by the...

49 CFR 240.7 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... examiner means a person licensed as a doctor of medicine or doctor of osteopathy. A medical examiner can be..., braking capacity, and in-train force levels throughout the train; and (4) Is computer enhanced so that it... train; and (4) Is computer enhanced so that it can be programmed for specific train consists and the...

49 CFR 240.7 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... examiner means a person licensed as a doctor of medicine or doctor of osteopathy. A medical examiner can be..., braking capacity, and in-train force levels throughout the train; and (4) Is computer enhanced so that it... train; and (4) Is computer enhanced so that it can be programmed for specific train consists and the...

Utilization of Radiographs for a State Dental Hygiene Board Examination.

ERIC Educational Resources Information Center

Potter, Brad G.; And Others

1993-01-01

A study documented the number of x-rays acquired during screening and subsequent treatment of patients for a state dental hygiene licensing examination for 109 candidates. Results indicate that patient exposure guidelines attempt to minimize radiographic exposure but that some exposures should be reevaluated for need and effect on patients. (MSE)

The Influence of Nurse Staffing Levels on Quality of Care in Nursing Homes

ERIC Educational Resources Information Center

Hyer, Kathryn; Thomas, Kali S.; Branch, Laurence G.; Harman, Jeffrey S.; Johnson, Christopher E.; Weech-Maldonado, Robert

2011-01-01

Objective: This study examines the relationship between increasing certified nursing assistants (CNAs) and licensed nurse staffing ratios and deficiencies in Florida nursing homes over a 4-year period. Methods: Data from Florida staffing reports and the Online Survey Certification and Reporting database examine the relationship among staffing…

Think They're Drunk? Alcohol Servers and the Identification of Intoxication.

ERIC Educational Resources Information Center

Burns, Edward D.; Nusbaumer, Michael R.; Reiling, Denise M.

2003-01-01

Examines practices used by servers to assess intoxication. The analysis was based upon questionnaires mailed to a random probability sample of licensed servers from one state (N = 822). Indicators found to be most important were examined in relation to a variety of occupational characteristics. Implications for training curricula, policy…

Rethinking Teacher Preparation: Conceptualizing Skills and Knowledge of Novice Teachers of Secondary Mathematics

ERIC Educational Resources Information Center

Cummings, Margarita Borelli

2010-01-01

This dissertation examines the extent to which novice secondary mathematics teachers (licensed and currently teaching in Utah) perceive they are prepared to do the work of teaching secondary mathematics. It first examined if novice secondary mathematics teachers' perceptions of their knowledge and skills of doing their work fell into four…

Measurements of Quality in Higher Education: The Role of Institutional Research. AIR 1983 Annual Forum Paper.

ERIC Educational Resources Information Center

Gapen, Kaye; Morse, Suzanne

Three areas of quality assessment in higher education are examined: students, faculty, and library resources. Types of student data that institutional researchers should address include: entrance tests scores, retention rate, student outcomes, location and recruitment of graduates, results of licensing examinations, scholarship recipients, and…

49 CFR 242.7 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... means a person licensed as a doctor of medicine or doctor of osteopathy. A medical examiner can be a... metropolitan areas, without regard to whether those systems use new technologies not associated with...

49 CFR 242.7 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... means a person licensed as a doctor of medicine or doctor of osteopathy. A medical examiner can be a... metropolitan areas, without regard to whether those systems use new technologies not associated with...

49 CFR 242.7 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... means a person licensed as a doctor of medicine or doctor of osteopathy. A medical examiner can be a... metropolitan areas, without regard to whether those systems use new technologies not associated with...

Licensing: Learning the Game of Politics and Compromise

ERIC Educational Resources Information Center

Warnath, Charles F.

1978-01-01

The coordinator of a successful legislative effort by Oregon psychologists and chairman of the first Board of Examiners comments on some potential conflicts between professional idealism and political realities. (Author)

30 CFR 62.101 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... American Speech-Language-Hearing Association (ASHA) or licensed by a state board of examiners. Baseline... network and a slow response, expressed in the unit dBA. Standard threshold shift. A change in hearing...

30 CFR 62.101 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... American Speech-Language-Hearing Association (ASHA) or licensed by a state board of examiners. Baseline... network and a slow response, expressed in the unit dBA. Standard threshold shift. A change in hearing...

Admiralty Inlet Pilot Tidal Project Final Technical Report

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

Collar, Craig

This document represents the final report for the Admiralty Inlet Pilot Tidal Project, located in Puget Sound, Washington, United States. The Project purpose was to license, permit, and install a grid-connected deep-water tidal turbine array (two turbines) to be used as a platform to gather operational and environmental data on tidal energy generation. The data could then be used to better inform the viability of commercial tidal energy generation from technical, economic, social, and environmental standpoints. This data would serve as a critical step towards the responsible advancement of commercial scale tidal energy in the United States and around themore » world. In late 2014, Project activities were discontinued due to escalating costs, and the DOE award was terminated in early 2015. Permitting, licensing, and engineering design activities were completed under this award. Final design, deployment, operation, and monitoring were not completed. This report discusses the results and accomplishments achieved under the subject award.« less

Technical clarity in inter-agency negotiations: Lessons from four hydropower projects

USGS Publications Warehouse

Burkardt, Nina; Lamb, Berton Lee; Taylor, Jonathan G.; Waddle, Terry J.

1995-01-01

We investigated the effect of technical clarity on success in multi-party negotiations in the Federal Energy Regulatory Commission (FERC) licensing process. Technical clarity is the shared understanding of dimensions such as the geographic extent of the project, range of flows to be considered, important species and life stages, and variety of water uses considered. The results of four hydropower licensing consultations are reported. Key participants were interviewed to ascertain the level of technical clarity present during the consultations and the degree to which the consultations were successful. Technical clarity appears to be a prerequisite for successful outcomes. Factors that enhance technical clarity include simple project design, new rather than existing projects, precise definition of issues, a sense of urgency to reach agreement, a sense of fairness among participants, and consistency in participation. Negotiators should not neglect the critical pre-negotiation steps of defining technical issues and determining appropriate studies, deciding how to interpret studies, and agreeing on responses to study results.

Voices That Care: Licensed Practical Nurses and the Emotional Labour Underpinning Their Collaborative Interactions with Registered Nurses

PubMed Central

Huynh, Truc; Alderson, Marie; Nadon, Michelle; Kershaw-Rousseau, Sylvia

2011-01-01

Recognizing the emotional labour underlying interprofessional collaborations (IPCs) could be considered a crucial step towards building a cohesive nursing team. Although IPCs between registered nurses (RNs) and licensed practical nurses (LPNs) have been linked to quality nursing care, little is known about the emotions experienced by LPNs during their interactions with RNs or those factors that influence IPCs. A questionnaire administered to 309 LPNs found that (1) the professional identity of LPNs has evolved into a that of a unique social group; (2) LPNs define IPC as an interpersonal process of exploring similar or dissimilar assessments of a patient's status with RNs and, together, establishing a course of nursing actions; (3) the primary organizational factor facilitating IPCs is inclusive nursing leadership; (4) the interpersonal factor promoting IPCs is the level of trust RNs extend to LPNs; and (5) an LPN's emotional labour (i.e., internal emotional regulation) is most tangible during uncollaborative interactions with RNs. PMID:22135732

Comprehensive Osteopathic Medical Licensing Examination-USA level 1 and level 2-cognitive evaluation preparation and outcomes.

PubMed

Maholtz, Danielle E; Erickson, Michael J; Cymet, Tyler

2015-04-01

The Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) assesses the competence of osteopathic physicians in training. It is designed to protect the public by setting minimum competence standards. All osteopathic medical students must pass COMLEX-USA Level 1, Level 2-Cognitive Evaluation, and Level 2-Performance Evaluation before being allowed to graduate from an osteopathic medical school. Residency training programs use COMLEX-USA scores as a major factor in deciding whom they will interview and admit into their programs. In addition, colleges of osteopathic medicine use student COMLEX-USA scores as an external assessment of their success in educating students. Because COMLEX-USA is a high-stakes examination series, it is important to understand predictive factors for performance. The authors review the literature on the relationship between COMLEX-USA scores and correlated student variables. Results from the Council on Osteopathic Student Government Presidents' survey on students' preparation methods and performance are also provided.

Driver licensing and reasons for delaying licensure among young adults ages 18-20, United States, 2012.

PubMed

Tefft, Brian C; Williams, Allan F; Grabowski, Jurek G

2014-12-01

Motor vehicle crashes are the leading cause of death for teens and young adults in the United States. Graduated driver licensing (GDL) systems were designed to protect young novice drivers by limiting their exposure to specific risks while they gain experience driving. In the United States, most states' GDL systems only apply to new drivers younger than 18. Some experts suggest that GDL might encourage young people to wait until age 18 to obtain a license, to avoid GDL requirements, resulting in older teenagers having less driving experience and higher crash risk than they might have had without GDL. This study examined the prevalence and timing of licensure among young adults, and explored factors associated with delaying licensure among those not licensed before age 18. An online questionnaire was completed by 1,039 persons aged 18-20 years, recruited from a representative panel of United States households. Main outcome measures were acquisition of driver's license (a) within 12 months of the state minimum age for licensure, (b) before age 18. Associations of timing of licensure with demographic characteristics were assessed using multivariable logistic regression. Respondents not licensed before age 18 were asked to rate the importance of various possible reasons for delaying licensure. 54% of respondents were licensed before age 18. Blacks (37%; adjusted Prevalence Ratio 0.67, 95% Confidence Interval 0.48-0.93) and Hispanics (29%; adjusted Prevalence Ratio 0.60, 95% Confidence Interval 0.45-0.81) were less likely than non-Hispanic whites (67%) to be licensed before age 18. Lower household income was independently associated with delayed licensure (P < .001). The most common self-reported reasons for not becoming licensed sooner were not having a car, being able to get around without driving, and costs associated with driving. There was little evidence that GDL is a major contributor to delayed licensure; however, a substantial minority of young people do not obtain a driver's license until age 18 or older and thus begin driving outside of the GDL system, which in most states only applies to new drivers younger than 18. More research is needed to investigate the safety of older novice drivers.

76 FR 55069 - Government-Owned Inventions; Availability for Licensing

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-06

... health problem primarily affecting the elderly and women after menopause. More specifically, the... automated bone mineral densitometry in a single examination. J Comput Assist Tomogr. 2011 Mar- Apr;35(2):212...

Application essays and future performance in medical school: are they related?

PubMed

Dong, Ting; Kay, Allen; Artino, Anthony R; Gilliland, William R; Waechter, Donna M; Cruess, David; DeZee, Kent J; Durning, Steven J

2013-01-01

There is a paucity of research on whether application essays are a valid indicator of medical students' future performance. The goal is to score medical school application essays systematically and examine the correlations between these essay scores and several indicators of student performance during medical school and internship. A journalist created a scoring rubric based on the journalism literature and scored 2 required essays of students admitted to our university in 1 year (N = 145). We picked 7 indicators of medical school and internship performance and correlated these measures with overall essay scores: preclinical medical school grade point average (GPA), clinical medical school GPA, cumulative medical school GPA, U.S. Medical Licensing Exam (USMLE) Step 1 and 2 scores, and scores on a program director's evaluation measuring intern professionalism and expertise. We then examined the Pearson and Spearman correlations between essay scores and the outcomes. Essay scores did not vary widely. American Medical College Application Service essay scores ranged from 3.3 to 4.5 (M = 4.11, SD = 0.15), and Uniformed Services University of the Health Sciences essay scores ranged from 2.9 to 4.5 (M = 4.09, SD = 0.17). None of the medical school or internship performance indicators was significantly correlated with the essay scores. These findings raise questions about the utility of matriculation essays, a resource-intensive admission requirement.

Does Residency Selection Criteria Predict Performance in Orthopaedic Surgery Residency?

PubMed

Raman, Tina; Alrabaa, Rami George; Sood, Amit; Maloof, Paul; Benevenia, Joseph; Berberian, Wayne

2016-04-01

More than 1000 candidates applied for orthopaedic residency positions in 2014, and the competition is intense; approximately one-third of the candidates failed to secure a position in the match. However, the criteria used in the selection process often are subjective and studies have differed in terms of which criteria predict either objective measures or subjective ratings of resident performance by faculty. Do preresidency selection factors serve as predictors of success in residency? Specifically, we asked which preresidency selection factors are associated or correlated with (1) objective measures of resident knowledge and performance; and (2) subjective ratings by faculty. Charts of 60 orthopaedic residents from our institution were reviewed. Preresidency selection criteria examined included United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores, Medical College Admission Test (MCAT) scores, number of clinical clerkship honors, number of letters of recommendation, number of away rotations, Alpha Omega Alpha (AOA) honor medical society membership, fourth-year subinternship at our institution, and number of publications. Resident performance was assessed using objective measures including American Board of Orthopaedic Surgery (ABOS) Part I scores and Orthopaedics In-Training Exam (OITE) scores and subjective ratings by faculty including global evaluation scores and faculty rankings of residents. We tested associations between preresidency criteria and the subsequent objective and subjective metrics using linear correlation analysis and Mann-Whitney tests when appropriate. Objective measures of resident performance namely, ABOS Part I scores, had a moderate linear correlation with the USMLE Step 2 scores (r = 0.55, p < 0.001) and number of clinical honors received in medical school (r = 0.45, p < 0.001). OITE scores had a weak linear correlation with the number of clinical honors (r = 0.35, p = 0.009) and USMLE Step 2 scores (r = 0.29, p = 0.02). With regards to subjective outcomes, AOA membership was associated with higher scores on the global evaluation (p = 0.005). AOA membership also correlated with higher global evaluation scores (r = 0.60, p = 0.005) with the strongest correlation existing between AOA membership and the "interpersonal and communication skills" subsection of the global evaluations. We found that USMLE Step 2, number of honors in medical school clerkships, and AOA membership demonstrated the strongest correlations with resident performance. Our goal in analyzing these data was to provide residency programs at large a sense of which criteria may be "high yield" in ranking applicants by analyzing data from within our own pool of residents. Similar studies across a broader scope of programs are warranted to confirm applicability of our findings. The continually emerging complexities of the field of orthopaedic surgery lend increasing importance to future work on the appropriate selection and training of orthopaedic residents.

Fair Play: A Study of Scientific Workforce Trainers' Experience Playing an Educational Video Game about Racial Bias.

PubMed

Kaatz, Anna; Carnes, Molly; Gutierrez, Belinda; Savoy, Julia; Samuel, Clem; Filut, Amarette; Pribbenow, Christine Maidl

2017-01-01

Explicit racial bias has decreased in the United States, but racial stereotypes still exist and conspire in multiple ways to perpetuate the underparticipation of Blacks in science careers. Capitalizing on the potential effectiveness of role-playing video games to promote the type of active learning required to increase awareness of and reduce subtle racial bias, we developed the video game Fair Play, in which players take on the role of Jamal, a Black male graduate student in science, who experiences discrimination in his PhD program. We describe a mixed-methods evaluation of the experience of scientific workforce trainers who played Fair Play at the National Institutes of Health Division of Training Workforce Development and Diversity program directors' meeting in 2013 ( n = 47; 76% female, n = 34; 53% nonwhite, n = 26). The evaluation findings suggest that Fair Play can promote perspective taking and increase bias literacy, which are steps toward reducing racial bias and affording Blacks equal opportunities to excel in science. © 2017 A. Kaatz et al. CBE—Life Sciences Education © 2017 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

The Na+(K+)/H+ exchanger Nhx1 controls multivesicular body-vacuolar lysosome fusion.

PubMed

Karim, Mahmoud Abdul; Brett, Christopher Leonard

2018-02-01

Loss-of-function mutations in human endosomal Na + (K + )/H + exchangers (NHEs) NHE6 and NHE9 are implicated in neurological disorders including Christianson syndrome, autism, and attention deficit and hyperactivity disorder. These mutations disrupt retention of surface receptors within neurons and glial cells by affecting their delivery to lysosomes for degradation. However, the molecular basis of how these endosomal NHEs control endocytic trafficking is unclear. Using Saccharomyces cerevisiae as a model, we conducted cell-free organelle fusion assays to show that transport activity of the orthologous endosomal NHE Nhx1 is important for multivesicular body (MVB)-vacuolar lysosome fusion, the last step of endocytosis required for surface protein degradation. We find that deleting Nhx1 disrupts the fusogenicity of the MVB, not the vacuole, by targeting pH-sensitive machinery downstream of the Rab-GTPase Ypt7 needed for SNARE-mediated lipid bilayer merger. All contributing mechanisms are evolutionarily conserved offering new insight into the etiology of human disorders linked to loss of endosomal NHE function. © 2018 Karim and Brett. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

Was the expansion of the marketing license for nicotine replacement therapy in the United kingdom to include smoking reduction associated with changes in use and incidence of quit attempts?

PubMed

Beard, Emma; Bruguera, Carla; Brown, Jamie; McNeill, Ann; West, Robert

2013-10-01

In December 2009 and January 2010, the UK Medicines and Healthcare Products Regulatory Agency expanded the marketing license for a number of nicotine replacement therapies (NRTs) to include smoking reduction without an intention to stop completely. This study examined whether this was associated with a change in incidence of use of NRT for harm reduction (i.e., smoking reduction and/or temporary abstinence) and in smoking cessation activity. Data were taken from 10,497 smokers who took part in the Smoking Toolkit Study, which involves monthly representative household surveys of adults aged 16+ in England. Incidence of use of NRT for smoking reduction and/or temporary abstinence and attempts to stop smoking in 2009 was compared with the 2 years following the expansion of the marketing license. Expansion of the license was not associated with an increase in incidence of NRT use for harm reduction, which was already substantial prior to the change. The odds of a quit attempt were lower in the second year following the license change relative to the year before, but there was no change in the success of quit attempts. Expansion of the UK marketing license for NRT to include smoking reduction without the intention of quitting was not associated with an increase in use of NRT for this purpose. It was followed by a reduction in the incidence of quit attempts (but not their success) although this may have been a continuation of a pre-existing decline.

Alcohol retail sales licenses and sexually transmitted infections in Texas counties, 2008-2015.

PubMed

Rossheim, Matthew E; Krall, Jenna R; Painter, Julia E; Thombs, Dennis L; Stephenson, Caroline J; Suzuki, Sumihiro; Cannell, M Brad; Livingston, Melvin D; Gonzalez-Pons, Kwynn M; Wagenaar, Alexander C

2018-06-04

Research suggests that reduced retail alcohol outlet density may be associated with lower prevalence of HIV and other sexually transmitted infections (STIs). On-premise sale of alcohol for immediate consumption is theorized as increasing social interactions that can lead to sexual encounters. We examined associations between on- and off-premise retail alcohol sales licenses and number of newly diagnosed HIV and STI cases in Texas counties. Retail alcohol sales license data were obtained from the Texas Alcoholic Beverage Commission. HIV and bacterial STI data were obtained from the Texas Department of State Health Services. Associations between retail alcohol sales licenses and STIs were estimated using spatial linear models and Poisson mixed effects models for over-dispersed count data. Adjusting for county-specific confounders, there was no evidence of residual spatial correlation. In Poisson models, each additional on-premise (e.g., bar and restaurant) alcohol license per 10,000 population in a county was associated with a 1.5% increase (95% CI: 0.4%, 2.6%) in the rate of HIV and a 2.4% increase (95% CI: 1.9%, 3.0%) in the rate of bacterial STIs, adjusting for potential confounders. In contrast, number of off-premise licenses (e.g., take-out stores) was inversely associated with the incidence of STI and HIV, although the association with HIV was not statistically significant. This study adds to the limited literature on the association between retail alcohol availability and STIs. Additional research is needed on the role of alcohol availability (and policies affecting availability) in the spread of HIV and other STIs.

78 FR 52810 - Self-Regulatory Organizations; BATS Y-Exchange, Inc.; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-26

... program should be tailored as well. At the same time, if an individual would like to retain a Series 7... Qualification Examination (``Series 56'') among the applicable qualification examinations as determined by the... proprietary trading to obtain the Series 56 license in order to effect transactions on the Exchange. \\5\\ An...

An Evaluation of Gender Differences in Computer-Based Case Simulations.

ERIC Educational Resources Information Center

Scheuneman, Janice Dowd; And Others

As part of the research leading to the implementation of computer-based case simulations (CCS) for the licensing examinations of the National Board of Medical Examiners, gender differences in performance were studied for one form consisting of 18 cases. A secondary purpose of the study was to note differences in style or approach that might…

Students' Demographic, Academic Characteristics and Performance in Registered General Nursing Licensing Examination in Ghana

ERIC Educational Resources Information Center

Doe, Patience Fakornam; Oppong, Elizabeth Agyeiwaa; Sarfo, Jacob Owusu

2018-01-01

The decreasing performance of student nurses in the professional licensure examinations (LE) in Ghana is a major concern to stakeholders, especially at a time when the nurse-patient ratio stands at 1: 1500. The study sought to determine the effect of students' demographic and academic characteristics on performance in the Registered General…

Gaze Behavior of Gymnastics Judges: Where Do Experienced Judges and Gymnasts Look While Judging?

PubMed

Pizzera, Alexandra; Möller, Carsten; Plessner, Henning

2018-03-01

Gymnastics judges and former gymnasts have been shown to be quite accurate in detecting errors and accurately judging performance. The purpose of the current study was to examine if this superior judging performance is reflected in judges' gaze behavior. Thirty-five judges were asked to judge 21 gymnasts who performed a skill on the vault in a video-based test. Classifying 1 sample on 2 different criteria, judging performance and gaze behavior were compared between judges with a higher license level and judges with a lower license level and between judges who were able to perform the skill (specific motor experience [SME]) and those who were not. The results revealed better judging performance among judges with a higher license level compared with judges with a lower license level and more fixations on the gymnast during the whole skill and the landing phase, specifically on the head and arms of the gymnast. Specific motor experience did not result in any differences in judging performance; however, judges with SME showed similar gaze patterns to those of judges with a high license level, with 1 difference in their increased focus on the gymnasts' feet. Superior judging performance seems to be reflected in a specific gaze behavior. This gaze behavior appears to partly stem from judges' own sensorimotor experiences for this skill and reflects the gymnasts' perspective onto the skill.

Is USMLE Step 1 score a valid predictor of success in surgical residency?

PubMed

Sutton, Erica; Richardson, James David; Ziegler, Craig; Bond, Jordan; Burke-Poole, Molly; McMasters, Kelly M

2014-12-01

Many programs rely extensively on United States Medical Licensing Examination (USMLE) scores for interviews/selection of surgical residents. However, their predictive ability remains controversial. We examined the association between USMLE scores and success in surgical residency. We compared USMLE scores for 123 general surgical residents who trained in the past 20 years and their performance evaluation. Scores were normalized to the mean for the testing year and expressed as a ratio (1 = mean). Performances were evaluated by (1) rotation evaluations; (2) "dropouts;" (3) overall American Board of Surgery pass rate; (4) first-time American Board of Surgery pass rate; and (5) a retrospective comprehensive faculty evaluation. For the latter, 16 surgeons (average faculty tenure 22 years) rated residents on a 1 to 4 score (1 = fair; 4 = excellent). Rotation evaluations by faculty and "drop out" rates were not associated with USMLE score differences (dropouts had average above the mean). One hundred percent of general surgery practitioners achieved board certification regardless of USMLE score but trainees with an average above the mean had a higher first-time pass rate (P = .04). Data from the comprehensive faculty evaluations were conflicting: there was a moderate degree of correlation between board scores and faculty evaluations (r = .287, P = .001). However, a score above the mean was associated with a faculty ranking of 3 to 4 in only 51.7% of trainees. Higher USMLE scores were associated with higher faculty evaluations and first-time board pass rates. However, their positive predictive value was only 50% for higher faculty evaluations and a high overall board pass rate can be achieved regardless of USMLE scores. USMLE Step 1 score is a valid tool for selecting residents but caution might be indicated in using it as a single selection factor. Copyright © 2014 Elsevier Inc. All rights reserved.

Limitations on scientific prediction and how they could affect repository licensing

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

Van Konynenburg, R.A.

The best possibility for gaining an understanding of the likely future behavior of a high level nuclear waste disposal system is to use the scientific method. However, the scientific approach has inherent limitations when it comes to making long-term predictions with confidence. This paper examines some of these limiting factors as well as the criteria for admissibility of scientific evidence in the legal arena, and concludes that the prospects are doubtful for successful licensing of a potential repository under the regulations that are now being reconsidered. Suggestions am made for remedying this situation.

77 FR 18801 - Notice of Application for Non-Capacity Amendment of License and Soliciting Comments, Motions To...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-28

... new high efficiency turbine runners, replacing runner seals, replacing or modifying head covers; (2) conducting non-destructive examination and possible rehabilitation and modification of shafts; (3...

Psychopathy, Sociopathy, and Crime.

ERIC Educational Resources Information Center

Lykken, David T.

1996-01-01

Discusses psychopathology as portrayed in literature, followed by an examination of some theories of psychopathy and the association of sociopathy and crime. Also discusses using parental licensing as a preventive measure against the development of sociopathology in children. (GR)

Standardizing bimanual vaginal examination using cognitive task analysis.

PubMed

Plumptre, Isabella; Mulki, Omar; Granados, Alejandro; Gayle, Claudine; Ahmed, Shahla; Low-Beer, Naomi; Higham, Jenny; Bello, Fernando

2017-10-01

To create a standardized universal list of procedural steps for bimanual vaginal examination (BVE) for teaching, assessment, and simulator development. This observational study, conducted from June-July 2012 and July-December 2014, collected video data of 10 expert clinicians performing BVE in a nonclinical environment. Video data were analyzed to produce a cognitive task analysis (CTA) of the examination steps performed. The CTA was further refined through structured interviews to make it suitable for teaching or assessment. It was validated through its use as a procedural examination checklist to rate expert clinician performance. BVE was deconstructed into 88 detailed steps outlining the complete examination process. These initial 88 steps were reduced to 35 by focusing on the unseen internal examination, then further refined through interviews with five experts into 30 essential procedural steps, five of which are additional steps if pathology is suspected. Using the CTA as a procedural checklist, the mean number of steps performed and/or verbalized was 21.6 ± 3.12 (72% ± 10.4%; range, 15.9-27.9, 53%-93%). This approach identified 30 essential steps for performing BVE, producing a new technique and standardized tool for teaching, assessment, and simulator development. © 2017 International Federation of Gynecology and Obstetrics.

PEPFAR Transitions to Country Ownership: Review of Past Donor Transitions and Application of Lessons Learned to the Eastern Caribbean.

PubMed

Vogus, Abigail; Graff, Kylie

2015-06-17

The US President's Emergency Plan for AIDS Relief (PEPFAR) has shifted from an emergency response to a sustainable, country-owned response. The process of transition to country ownership is already underway in the Eastern Caribbean; the Office of the US Global AIDS Coordinator (OGAC) has advised the region that PEPFAR funding is being redirected away from the Eastern Caribbean toward Caribbean countries with high disease burden to strengthen services for key populations. This article seeks to highlight and apply lessons learned from other donor transitions to support a successful transition of HIV programs in the Eastern Caribbean. Based on a rapid review of both peer-reviewed and gray literature on donor transitions to country ownership in family planning, HIV, and other areas, we identified 48 resources that addressed key steps in the transition process and determinants of readiness for transition. Analysis of the existing literature revealed 6 steps that could help ensure successful transition, including developing a clear roadmap articulated through high-level diplomacy; investing in extensive stakeholder engagement; and supporting monitoring and evaluation during and after the transition to adjust course as needed. Nine specific areas to assess a country's readiness for transition include: leadership and management capacity, political and economic factors, the policy environment, identification of alternative funding sources, integration of HIV programs into the wider health system, the institutionalization of processes, the strength of procurement and supply chain management, identification of staffing and training needs, and engagement of civil society and the private sector. In the Caribbean, key areas requiring strengthening to ensure countries in the region can maintain the gains made under PEPFAR include further engaging civil society and the private sector, building the capacity of NGOs to take on essential program functions, and maintaining donor support for targeted capacity building and long-term monitoring and evaluation efforts. © Vogus et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/3.0/

Association between New Jersey's Graduated Driver Licensing decal provision and crash rates of young drivers with learners' permits.

PubMed

Curry, Allison E; Pfeiffer, Melissa R; Elliott, Michael R; Durbin, Dennis R

2015-12-01

New Jersey (NJ) implemented the first-in-the-US Graduated Driver Licensing (GDL) decal provision in May 2010 for young drivers with learner's permits or intermediate licenses. Previous analyses found an association between the provision and crash reduction among intermediate drivers. The aim of this study is to examine the association between NJ's provision and GDL citation and crash rates among drivers aged <21 years with learner's permits. We estimated monthly per-driver rates from January 2006 through June 2012. Negative binomial modeling compared pre and post decal crash rates adjusted for gender, age, calendar month, and gas price. The monthly GDL citation rate was two per 10,000 drivers in the predecal and postdecal periods. Crashes were rare and rates declined similarly pre and post decal (adjusted rate ratio of postdecal vs predecal slope: 1.04 (0.97 to 1.12)). NJ's GDL decal provision was not associated with a change in citation or crash rates among young NJ drivers with learner's permits. 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/

Injury severity analysis of commercially-licensed drivers in single-vehicle crashes: Accounting for unobserved heterogeneity and age group differences.

PubMed

Osman, Mohamed; Mishra, Sabyasachee; Paleti, Rajesh

2018-05-18

This study analyzes the injury severity of commercially-licensed drivers involved in single-vehicle crashes. Considering the discrete ordinal nature of injury severity data, the ordered response modeling framework was adopted. The moderating effect of driver's age on all other factors was examined by segmenting the parameters by driver's age group. Additional effects of the different drivers' age groups are taken into consideration through interaction terms. Unobserved heterogeneity of the different covariates was investigated using the Mixed Generalized Ordered Response Probit (MGORP) model. The empirical analysis was conducted using four years of the Highway Safety Information System (HSIS) data that included 6247 commercially-licensed drivers involved in single-vehicle crashes in the state of Minnesota. The MGORP model elasticity effects indicate that key factors that increase the likelihood of severe crashes for commercially-licensed drivers across all age groups include: lack of seatbelt usage, collision with a fixed object, speeding, vehicle age of 11 years or more, wind, night time, weekday, and female drivers. Also, the effects of several covariates were found to vary across different age groups. Copyright © 2018 Elsevier Ltd. All rights reserved.

MCAT Verbal Reasoning score: less predictive of medical school performance for English language learners.

PubMed

Winegarden, Babbi; Glaser, Dale; Schwartz, Alan; Kelly, Carolyn

2012-09-01

Medical College Admission Test (MCAT) scores are widely used as part of the decision-making process for selecting candidates for admission to medical school. Applicants who learned English as a second language may be at a disadvantage when taking tests in their non-native language. Preliminary research found significant differences between English language learners (ELLs), applicants who learned English after the age of 11 years, and non-ELL examinees on the Verbal Reasoning (VR) sub-test of the MCAT. The purpose of this study was to determine if relationships between VR sub-test scores and measures of medical school performance differed between ELL and non-ELL students. Scores on the MCAT VR sub-test and student performance outcomes (grades, examination scores, and markers of distinction and difficulty) were extracted from University of California San Diego School of Medicine admissions files and the Association of American Medical Colleges database for 924 students who matriculated in 1998-2005 (graduation years 2002-2009). Regression models were fitted to determine whether MCAT VR sub-test scores predicted medical school performance similarly for ELLs and non-ELLs. For several outcomes, including pre-clerkship grades, academic distinction, US Medical Licensing Examination Step 2 Clinical Knowledge scores and two clerkship shelf examinations, ELL status significantly affects the ability of the VR score to predict performance. Higher correlations between VR score and medical school performance emerged for non-ELL students than for ELL students for each of these outcomes. The MCAT VR score should be used with discretion when assessing ELL applicants for admission to medical school. © Blackwell Publishing Ltd 2012.

Academic Characteristics of Orthopaedic Surgery Residency Applicants from 2007 to 2014.

PubMed

DePasse, J Mason; Palumbo, Mark A; Eberson, Craig P; Daniels, Alan H

2016-05-04

Based on a relatively stable match rate, several authors have concluded that the competition for orthopaedic residency positions has not changed over the past 3 decades. However, the objective measures of applicant competitiveness have not been quantified in detail. National Resident Matching Program (NRMP) data from 2007 to 2014 for U.S. orthopaedic surgery applicants were compared with data for applicants to all specialties. Trends in the United Stated Medical Licensing Examination (USMLE) Step-1 and Step-2 scores, publications and research experiences, Alpha Omega Alpha (AOA) status, and the presence of an advanced degree are reported. From 2007 to 2014, the match rate for orthopaedic surgery applicants remained stable near 80% (p = 0.14). For orthopaedic applicants who matched, the mean USMLE Step-1 scores increased from 234 points in 2007 to 245 points in 2014 (p = 0.005), and the mean scores increased from 220 points in 2007 to 229 points in 2014 for all applicants (p = 0.019). The mean USMLE Step-2 scores of orthopaedic applicants who matched increased from 235 points in 2007 to 251 points in 2014 (p = 0.005), and the mean scores of all applicants increased from 225 points in 2007 to 242 points in 2014 (p = 0.002). The mean number of research publications, presentations, and abstracts reported by orthopaedic applicants who matched more than doubled from 3.0 in 2007 to 6.7 in 2014 (p = 0.02) and increased less dramatically for all applicants from 2.2 in 2007 to 4.2 in 2014 (p = 0.004). The percentage of orthopaedic applicants elected to AOA or with advanced degrees did not significantly change (p > 0.2). Although orthopaedic applicants with AOA status experienced a very high match rate (97.1% in 2014), those with advanced degrees experienced match rates similar to or slightly lower than the applicant pool (73.7% in 2014). The USMLE Step-1 and 2 scores of U.S. orthopaedic surgery residency applicants have increased significantly from 2007 to 2014. Additionally, the number of publications and presentations reported by orthopaedic applicants has more than doubled. These factors signal an increasing level of academic accomplishment in orthopaedic surgery applicants despite a consistent match rate. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Characteristics and Implications of Diagnostic Justification Scores Based on the New Patient Note Format of the USMLE Step 2 CS Exam.

PubMed

Yudkowsky, Rachel; Park, Yoon Soo; Hyderi, Abbas; Bordage, Georges

2015-11-01

To determine the psychometric characteristics of diagnostic justification scores based on the patient note format of the United States Medical Licensing Examination Step 2 Clinical Skills exam, which requires students to document history and physical findings, differential diagnoses, diagnostic justification, and plan for immediate workup. End-of-third-year medical students at one institution wrote notes for five standardized patient cases in May 2013 (n = 180) and 2014 (n = 177). Each case was scored using a four-point rubric to rate each of the four note components. Descriptive statistics and item analyses were computed and a generalizability study done. Across cases, 10% to 48% provided no diagnostic justification or had several missing or incorrect links between history and physical findings and diagnoses. The average intercase correlation for justification scores ranged from 0.06 to 0.16; internal consistency reliability of justification scores (coefficient alpha across cases) was 0.38. Overall, justification scores had the highest mean item discrimination across cases. The generalizability study showed that person-case interaction (12%) and task-case interaction (13%) had the largest variance components, indicating substantial case specificity. The diagnostic justification task provides unique information about student achievement and curricular gaps. Students struggled to correctly justify their diagnoses; performance was highly case specific. Diagnostic justification was the most discriminating element of the patient note and had the greatest variability in student performance across cases. The curriculum should provide a wide range of clinical cases and emphasize recognition and interpretation of clinically discriminating findings to promote the development of clinical reasoning skills.

Predictors of a Top Performer During Emergency Medicine Residency.

PubMed

Bhat, Rahul; Takenaka, Katrin; Levine, Brian; Goyal, Nikhil; Garg, Manish; Visconti, Annette; Oyama, Leslie; Castillo, Edward; Broder, Joshua; Omron, Rodney; Hayden, Stephen

2015-10-01

Emergency Medicine (EM) residency program directors and faculty spend significant time and effort creating a residency rank list. To date, however, there have been few studies to assist program directors in determining which pre-residency variables best predict performance during EM residency. To evaluate which pre-residency variables best correlated with an applicant's performance during residency. This was a retrospective multicenter sample of all residents in the three most recent graduating classes from nine participating EM residency programs. The outcome measure of top residency performance was defined as placement in the top third of a resident's graduating class based on performance on the final semi-annual evaluation. A total of 277 residents from nine institutions were evaluated. Eight of the predictors analyzed had a significant correlation with the outcome of resident performance. Applicants' grade during home and away EM rotations, designation as Alpha Omega Alpha (AOA), U.S. Medical Licensing Examination (USMLE) Step 1 score, interview scores, "global rating" and "competitiveness" on nonprogram leadership standardized letter of recommendation (SLOR), and having five or more publications or presentations showed a significant association with residency performance. We identified several predictors of top performers in EM residency: an honors grade for an EM rotation, USMLE Step 1 score, AOA designation, interview score, high SLOR rankings from nonprogram leadership, and completion of five or more presentations and publications. EM program directors may consider utilizing these variables during the match process to choose applicants who have the highest chance of top performance during residency. Copyright © 2015 Elsevier Inc. All rights reserved.

Association rule mining in the US Vaccine Adverse Event Reporting System (VAERS).

PubMed

Wei, Lai; Scott, John

2015-09-01

Spontaneous adverse event reporting systems are critical tools for monitoring the safety of licensed medical products. Commonly used signal detection algorithms identify disproportionate product-adverse event pairs and may not be sensitive to more complex potential signals. We sought to develop a computationally tractable multivariate data-mining approach to identify product-multiple adverse event associations. We describe an application of stepwise association rule mining (Step-ARM) to detect potential vaccine-symptom group associations in the US Vaccine Adverse Event Reporting System. Step-ARM identifies strong associations between one vaccine and one or more adverse events. To reduce the number of redundant association rules found by Step-ARM, we also propose a clustering method for the post-processing of association rules. In sample applications to a trivalent intradermal inactivated influenza virus vaccine and to measles, mumps, rubella, and varicella (MMRV) vaccine and in simulation studies, we find that Step-ARM can detect a variety of medically coherent potential vaccine-symptom group signals efficiently. In the MMRV example, Step-ARM appears to outperform univariate methods in detecting a known safety signal. Our approach is sensitive to potentially complex signals, which may be particularly important when monitoring novel medical countermeasure products such as pandemic influenza vaccines. The post-processing clustering algorithm improves the applicability of the approach as a screening method to identify patterns that may merit further investigation. Copyright © 2015 John Wiley & Sons, Ltd.

Retailer licensing and tobacco display compliance: are some retailers more likely to flout regulations?

PubMed

Fry, Rae; Burton, Suzan; Williams, Kelly; Walsberger, Scott; Tang, Anita; Chapman, Kathy; Egger, Sam

2017-03-01

To assess retailer compliance with a licensing scheme requiring tobacco retailers to list their business details with the government, to examine whether listed retailers are more likely to comply with a point-of-sale (POS) display ban and other in-store retailing laws and to explore variations in compliance between different retailer types and locations. An audit of 1739 retailers in New South Wales, Australia, was used to assess compliance with tobacco retailing legislation. Auditors actively searched for and audited unlisted retailers and all listed retailers in 122 metropolitan and regional postcodes. Multivariate generalised linear regression models were used to examine associations between compliance and retailer type, remoteness and demographic characteristics (socioeconomic level, proportion of population under 18 years and proportion born in Australia). One unlisted tobacco retailer was identified for every 12.6 listed tobacco retailers. Unlisted retailers were significantly more likely than listed retailers to breach in-store retailing laws (p<0.001). Compliance with the POS display ban was observed in 91.3% of tobacco retailers, but compliance with all retailing laws was only 73.4%. Retailers in socioeconomically disadvantaged areas had lower compliance than those in high socioeconomic areas. Some tobacco retailers did not list their business details with the government as required, even though there was no financial cost to do so. Unlisted retailers were more likely to violate in-store regulations. The results suggest licensing schemes can be useful for providing a list of retailers, thus facilitating enforcement, but require a system to search for, and respond to, unlisted/unlicensed retailers. 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/.