[Manpower requirements for medical doctors in psychiatric departments of community hospitals--bottom-up calculation for the psychiatric department of Donauspital in Vienna].

PubMed

Fischer, Peter; Hanak, Sören; Wally, Beate; Aigner, Martin

2016-03-01

Clinical psychiatry changed dramatically in the past 30 years. Clinical challenges are very different from those in old mental hospitals. Psychotherapy and sociotherapy are effective but very time-consuming parts of treatments of nearly every psychiatric disorder. Planning of staff resources based on the German "Psychiatrie Personalverordnung" does not match with modern quality requirements. As a result, the standards of evidence-based treatment cannot be offered to severely mentally ill inpatients. We carried out a buttom-up calculation of medical staffing for the concrete patients considering diagnosis, and length of stay of the psychiatric department of the Danube hospital in Vienna 2013 and 2014. This is an 80 bed unit responsible for an area of 250,000 inhabitants, providing about 1100 admissions each year. The calculated yearly sum of working hours for medical doctors in the particular department was 39,527. When considering a net working-time of 80%, the actual number of medical staff should be at least doubled to allow psychiatric treatment according to current guidelines. Severely ill psychiatric patients seem to be undertreated because of low staffing of psychiatric departments.

Peer Facilitated Writing Groups: A Programmatic Approach to Doctoral Student Writing

ERIC Educational Resources Information Center

Kumar, Vijay; Aitchison, Claire

2018-01-01

Very few empirical studies have investigated programmes in which doctoral students act as peer facilitators in faculty writing groups. We report on the development of a centrally delivered doctoral student writing programme in which twenty student participants were mentored and provided with the resources to initiate their own faculty-based…

The experience of international nursing students studying for a PhD in the U.K: A qualitative study.

PubMed

Evans, Catrin; Stevenson, Keith

2011-06-13

Educating nurses to doctoral level is an important means of developing nursing capacity globally. There is an international shortage of doctoral nursing programmes, hence many nurses seek their doctorates overseas. The UK is a key provider of doctoral education for international nursing students, however, very little is known about international doctoral nursing students' learning experiences during their doctoral study. This paper reports on a national study that sought to investigate the learning expectations and experiences of overseas doctoral nursing students in the UK. Semi-structured qualitative interviews were conducted in 2008/09 with 17 international doctoral nursing students representing 9 different countries from 6 different UK universities. Data were analysed thematically. All 17 interviewees were enrolled on 'traditional' 3 year PhD programmes and the majority (15/17) planned to work in higher education institutions back in their home country upon graduation. Studying for a UK PhD involved a number of significant transitions, including adjusting to a new country/culture, to new pedagogical approaches and, in some cases, to learning in a second language. Many students had expected a more structured programme of study, with a stronger emphasis on professional nursing issues as well as research - akin to the professional doctorate. Students did not always feel well integrated into their department's wider research environment, and wanted more opportunities to network with their UK peers. A good supervision relationship was perceived as the most critical element of support in a doctoral programme, but good relationships were sometimes difficult to attain due to differences in student/supervisor expectations and in approaches to supervision. The PhD was perceived as a difficult and stressful journey, but those nearing the end reflected positively on it as a life changing experience in which they had developed key professional and personal skills. Doctoral programmes need to ensure that structures are in place to support international students at different stages of their doctoral journey, and to support greater local-international student networking. Further research is needed to investigate good supervision practice and the suitability of the PhD vis a vis other doctoral models (e.g. the professional doctorate) for international nursing students.

``Heavy-water Lattice and Heavy-Quark''

NASA Astrophysics Data System (ADS)

Maksoed, Ssi, Wh-

Refer to Birgitt Roettger-Roessler: ``Feelings at the Margins'', 2014 retrieved the Vienna, 2006 UNIDO Research Programme: Combating Marginalization and Poverty through Industrial Development/COMPID. Also from Vienna, on Feb 18-22, 1963 reported Technical Report Series 20 about ``Heavy Water Lattice''. Failed to relates scale-invariant properties of public-Debt growth to convergence in perturbation theory, sought JH Field: ``Convergence & Gauge Dependence Properties:..''. Furthers, in GP Lepage: ``On the Viabilities of Lattice Perturbation Theory'', 1992 stated: ``in terms of physical quantities, like the heavy-quark potential, greatly enhanced the predictive power of lattice perturbation theory''. Acknowledgements to HE. Mr. H. TUK SETYOHADI, Jl. Sriwijaya Raya 3, South-Jakarta, INDONESIA.

Perceived tutor benefits of teaching near peers: insights from two near peer teaching programmes in South East Scotland.

PubMed

Qureshi, Z U; Gibson, K R; Ross, M T; Maxwell, S

2013-08-01

There is little evidence about the benefits to junior doctors of participating in teaching, or how to train doctors as teachers. We explore (through South East Scotland based teaching programmes): (a) How prepared do junior doctors feel to teach? (b) What junior doctors consider to be the main challenges of teaching? (c) What motivates the junior doctors to continue teaching, and what is the perceived impact of teaching on their professional development? 'Questionnaire 1', distributed at 'tutor training days', explored (i) attitudes towards teaching and (ii) tutors' preparedness to teach. 'Questionnaire 2', distributed after completion of a teaching programme, evaluated the tutor experience of teaching. Seventy-six per cent of tutors reported no previous teacher training; 10% were able to teach during allocated work hours. The strongest motivation for teaching was to help students with their learning and to develop teaching skills. Ninety one per cent of tutors felt more prepared to teach by the end of the programme. Tutors also improved their clinical skills from teaching. There is a body of junior doctors, who see teaching as an important part of their career, developing both teaching and clinical skills in the tutor. If teaching is expected of foundation doctors, rotas ought to be more flexible to facilitate both teaching and teacher training.

The experience of international nursing students studying for a PhD in the U.K: A qualitative study

PubMed Central

2011-01-01

Background Educating nurses to doctoral level is an important means of developing nursing capacity globally. There is an international shortage of doctoral nursing programmes, hence many nurses seek their doctorates overseas. The UK is a key provider of doctoral education for international nursing students, however, very little is known about international doctoral nursing students' learning experiences during their doctoral study. This paper reports on a national study that sought to investigate the learning expectations and experiences of overseas doctoral nursing students in the UK. Methods Semi-structured qualitative interviews were conducted in 2008/09 with 17 international doctoral nursing students representing 9 different countries from 6 different UK universities. Data were analysed thematically. All 17 interviewees were enrolled on 'traditional' 3 year PhD programmes and the majority (15/17) planned to work in higher education institutions back in their home country upon graduation. Results Studying for a UK PhD involved a number of significant transitions, including adjusting to a new country/culture, to new pedagogical approaches and, in some cases, to learning in a second language. Many students had expected a more structured programme of study, with a stronger emphasis on professional nursing issues as well as research - akin to the professional doctorate. Students did not always feel well integrated into their department's wider research environment, and wanted more opportunities to network with their UK peers. A good supervision relationship was perceived as the most critical element of support in a doctoral programme, but good relationships were sometimes difficult to attain due to differences in student/supervisor expectations and in approaches to supervision. The PhD was perceived as a difficult and stressful journey, but those nearing the end reflected positively on it as a life changing experience in which they had developed key professional and personal skills. Conclusions Doctoral programmes need to ensure that structures are in place to support international students at different stages of their doctoral journey, and to support greater local-international student networking. Further research is needed to investigate good supervision practice and the suitability of the PhD vis a vis other doctoral models (e.g. the professional doctorate) for international nursing students. PMID:21668951

The benefits of working abroad for British General Practice trainee doctors: the London deanery out of programme experience in South Africa.

PubMed

Reardon, Candice; George, Gavin; Enigbokan, Oluwatobi

2015-10-14

The value of international health experience for doctors from developed nations is well recognised. Provisions have been made for medical staff in the United Kingdom to embark on work experiences abroad during their careers in the National Health Service. The London Deanery and Africa Health Placements provide an Out of Programme Experience for British General Practice trainee doctors wanting to work for a year in rural hospitals in South Africa. A qualitative study was conducted among fifteen British General Practice trainees who participated in the programme. The research aim was to understand the perceived benefit and value of their experience and their opinions about the structure of the programme. The data was analysed using thematic analysis. Their experience provided an accelerated year of learning and development that contributed to their professional and personal development. In addition to their general development, their improved ability to work in resource limited settings, enhancement of soft skills, a greater appreciation for the National Health Service and a better understanding of working within foreign health care systems were important gains. The timing of the experience, the security of re-employment on their return, assistance with administrative requirements of destination countries and the opportunity to gain varied, hands-on experience were highly valued components of the Out of Programme Experience. The value and benefits derived from the doctors' experience in South Africa are discussed in relation to another evaluation of the Out of Programme Experience, as well as issues of transferability of skills and competencies and future impacts on career decisions. This study provides evidence to suggest programmes such as the OOPE have the potential to create substantial benefits for trainee doctors, both in terms of their medical skills and competencies and through the development of softer skills. This programme, through the supply of scarce skills, further benefits the host country and specifically the health facilities and communities served by these trainee doctors.

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

PubMed

Nigenda, G

1997-02-01

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

West Nile virus lineage 2 infection in a blood donor from Vienna, Austria, August 2014.

PubMed

Jungbauer, C; Hourfar, M K; Stiasny, K; Aberle, S W; Cadar, D; Schmidt-Chanasit, J; Mayr, W R

2015-03-01

Eastern Austria is neighbouring regions with ongoing West Nile virus (WNV) transmissions. Three human WNV infections had been diagnosed during the past decade in Austria. The Austrian Red Cross Blood Service (ARC-BS) started a first voluntary screening for WNV in blood donors from Eastern Austria by Nucleic Acid Testing (NAT) in June 2014. This is also the most extensive WNV surveillance programme in humans in Austria so far. In August 2014, one autochthonous WNV infection was detected in a blood donor from Vienna. By now, one in 67,800 whole blood donations was found to be positive for WNV RNA. Copyright © 2015 Elsevier B.V. All rights reserved.

What supervisors and universities can do to enhance doctoral student experience (and how they can help themselves).

PubMed

Duke, Dawn C; Denicolo, Pam M

2017-05-01

Over the past two decades, there has been a flurry of government papers and policy reports worldwide calling for increased number and diversity of doctoral researchers and a broadening of the curriculum to meet the developing needs of respective national 'knowledge-driven' economies. This has been followed by position papers and best practice examples of employability skills development in boundary-crossing doctoral programmes, especially in response to these initiatives. However, there is a disassociation between this ample literature expounding the new doctorate with its broader remit, inclusivity and production of 'industry-ready' graduates and the comparatively sparse literature on the doctoral candidates' experiences of their programmes and career readiness. Within this review, we briefly outline international government initiatives and examples of the responses by Life Science and Biomedical doctoral programmes to address these various challenges. Furthermore, we explore the recent literature on the lived experience of doctoral researchers by examining their perception of the recent changes to the research context to make recommendations for universities and supervisors on how to better support an ever more diverse doctoral population for a wide range of career opportunities. Examples of how doctoral researchers themselves can make the best of currently available opportunities are also provided. © FEMS 2017.

What supervisors and universities can do to enhance doctoral student experience (and how they can help themselves)

PubMed Central

Denicolo, Pam M.

2017-01-01

Abstract Over the past two decades, there has been a flurry of government papers and policy reports worldwide calling for increased number and diversity of doctoral researchers and a broadening of the curriculum to meet the developing needs of respective national ‘knowledge-driven’ economies. This has been followed by position papers and best practice examples of employability skills development in boundary-crossing doctoral programmes, especially in response to these initiatives. However, there is a disassociation between this ample literature expounding the new doctorate with its broader remit, inclusivity and production of ‘industry-ready’ graduates and the comparatively sparse literature on the doctoral candidates’ experiences of their programmes and career readiness. Within this review, we briefly outline international government initiatives and examples of the responses by Life Science and Biomedical doctoral programmes to address these various challenges. Furthermore, we explore the recent literature on the lived experience of doctoral researchers by examining their perception of the recent changes to the research context to make recommendations for universities and supervisors on how to better support an ever more diverse doctoral population for a wide range of career opportunities. Examples of how doctoral researchers themselves can make the best of currently available opportunities are also provided. PMID:28472431

Self-imposed evaluation of the Helmholtz Research School MICMoR as a tool for quality assurance and advancement of a structured graduate programme

NASA Astrophysics Data System (ADS)

Elija Bleher, Bärbel; Schmid, Hans Peter; Scholz, Beate

2015-04-01

The Helmholtz Research School MICMoR (Mechanisms and Interactions of Climate Change in Mountain Regions) offers a structured graduate programme for doctoral students in the field of climate change research. It is hosted by the Institute of Meteorology and Climate Research (KIT/IMK-IFU) in Garmisch-Partenkirchen, in collaboration with 7 Bavarian partner universities and research institutions. Hence, MICMoR brings together a considerably large network with currently 20 doctoral students and 55 scientists. MICMoR offers scientific and professional skills training, provides a state-of-the-art supervision concept, and fosters international exchange and interdisciplinary collaboration. In order to develop and advance its programme, MICMoR has committed itself to a self-imposed mid-term review in its third year, to monitor to which extent its original objectives have been reached, and to explore and identify where MICMoR has room for improvement. The evaluation especially focused on recruitment, supervision, training, networking and cooperation. Carried out by an external expert (Beate Scholz from scholz ctc), the evaluation was based on a mixed methods approach, i.e. combining a quantitative survey involving all doctoral candidates as well as their supervisors and focus groups with different MICMoR stakeholders. The evaluation has brought forward some highly interesting results, pinpointing challenges and opportunities of setting up a structured doctoral programme. Overall, the evaluation proved to be a useful tool for evidence-based programme and policy planning, and demonstrated a high level of satisfaction of supervisors and fellows. Supervision, with facets ranging from disciplinary feedback to career advice, is demanding and requires strong commitment and adequate human resources development by all parties involved. Thus, MICMoR plans to offer mentor coaching and calls on supervisors and mentors to form a community of learners with their doctoral students. To realize this vision, a long way lies ahead for all participants. Here, the evaluation provided useful suggestions on how to best use scarce time resources. Due to the fact that MICMoR's fellowships provide only supplemental funding for its fellows to participate in the programme, their base funding (salaries, stipends) needs to be secured independently, e.g. through project funds. However, this created a significant challenge as doctoral topics were determined more by the projects' research questions than by the research school's research focus. To improve this situation, MICMoR introduced some full stipends in its third year. We conclude that, in order to successfully run an interdisciplinary, multi-network research school, sufficient funds for its general framework, but also for doctoral stipends/salaries are needed to obtain a more accurate fit between the programme's research focus and the doctoral topics. Furthermore, a high level of commitment and identification with the programme of both, doctoral students and their supervisors, is required. Finally, regular review and programme assessment are essential for tailored programme development and strategy planning.

Habilitations as a bottleneck? A retrospective analysis of gender differences at the Medical University of Vienna.

PubMed

Steinböck, Sandra; Reichel, Eva; Pichler, Susanna; Gutiérrez-Lobos, Karin

2016-04-01

The share of female physicians who drop out of a university career increases disproportionately with every career step. In this project, we analysed careers at the Medical University of Vienna (formerly the Medical Faculty at the University of Vienna) in the time span from 1992 to 2012 to explore the particular role of habilitations as a potential obstacle for women striving to pursue a career in science. To gain both a macro- and micro-view of the phenomenon of habilitations, a descriptive analysis of the data found in the archive of the Medical University of Vienna was carried out as a first step. Building on these results, structured interviews with the female physicians who were involved in the habilitation procedures at that time were conducted. While hardly any gender-based differences or discrimination can be reported for the habilitation procedures themselves, the research clearly reveals that the disparity in habilitations by men and women is a manifestation of unequal access to informal networks, differences regarding integration in the scientific community and available time resources. It is unlikely that the rising number of women completing doctoral studies in the field of medicine will automatically lead to a harmonisation of habilitation numbers. The analysis of existing gender-based differences with regard to habilitations in the field of medicine shows that they result from multiple processes that are subtle and relatively resistant to change.

Take-home experience of overseas doctors at the end of their two years training placements in the International Doctors Training Programme in Obstetrics and Gynaecology in the United Kingdom: A questionnaire-based study.

PubMed

Hosni, Mohamed M; Rishard, Mohamed

2017-01-01

This was a questionnaire-based study of overseas doctors, who came to the United Kingdom through the International Doctors Training Programme (IDTP) of Obstetrics and Gynaecology during the period of 2009-2012. The study was conducted at the end of their two-years training placement to find out what went well, what did not go well, where problems were encountered, and how they could have been avoided. We traced 48 overseas doctors, 35 (73%) responded to our questionnaire. Only 30% (9) felt that less than 50% of their expectations were met during their training period, 73.3% (22) of them received adequate help and support from their supervisors and 83.3% (25) would recommend IDTP to their colleagues. In conclusion, identification of the educational needs of international trainees, establishing a framework for their effective supervision and streamlining their training programme, in collaboration with the Royal College, regional deaneries and hosting hospitals are essential pre-requisites for overseas doctors to get the most out of their training.

A qualitative evaluation of the Scottish Staff and Associate Specialist Development Programme.

PubMed

Cleland, Jennifer; Burr, Jacqueline; Johnston, Peter

2016-05-01

The continued professional development of staff and associate specialist doctors in the UK was ill served prior to the introduction of the new staff and associate specialist doctor's contract in 2008. The aim of this study was to independently evaluate NHS Education for Scotland's approach to improving professional development for staff and associate specialist doctors, the staff and associate specialist Professional Development Fund. Semi-structured telephone interviews with key stakeholders, framed by a realistic approach to evaluate what works, for whom and in how and under what circumstances. An inductive and data-driven thematic analysis was carried out and then the realist framework was applied to the data. We interviewed 22 key stakeholders: staff and associate specialist doctors, staff and associate specialist educational advisors, programme architects and clinical directors, between end February and May 2014. The resultant data indicated five broad themes: organisational barriers to continued professional development for staff and associate specialist doctors, the purpose of funding, gains from funding, the need for better communication about the staff and associate specialist Programme Development Fund, and the interplay between individual and systems factors. The staff and associate specialist Programme Development Fund has changed the opportunities available to staff and associate specialist doctors in Scotland and, in that sense, has changed the context for this group - or at least those who have realised the opportunities. © The Author(s) 2016.

The Chilean Rural Practitioner Programme: a multidimensional strategy to attract and retain doctors in rural areas

PubMed Central

Peña, Sebastian; Ramirez, Jorge; Becerra, Carlos; Carabantes, Jorge

2010-01-01

Abstract Developing countries currently face internal and external migration of their health workforce and interventions are needed to attract and retain health professionals in rural areas. Evidence of multidimensional interventions, however, is scarce. This study explores a long-standing strategy to attract and retain doctors to rural areas in Chile: the Rural Practitioner Programme. The main objective is to describe the programme, characterize its multidimensional set of incentives and appraise preliminary programme outcomes. Retrospective national data were employed to examine recruitment, retention and incentives provided to extend the length of stay and motivate non-clinical work. The programme has successfully recruited a large number of applicants, with acceptance rates close to 100%. Retention rates are nearly 100% (drop-outs are exceptional), but only 58% of participants stay for the maximum period. Areas with greater work difficulty are attracting the best-ranked applicants, but incentives to engage in community projects, management responsibilities, continuous medical education and research have achieved mixed results. Rural doctors are satisfied with their experience and 70% plan to practise as specialists in a referral hospital. The programme has successfully matched the interests of physicians in specialization with the country’s need for rural doctors. However, a gap might be forming between the demand for certain specialties and what the programme can offer. There is a need to conciliate both parties, which will require a more refined strategy than before. This should be grounded in robust knowledge based on programme outcomes and evidence of the interests and motivations of health professionals. PMID:20461139

The Emergence of Doctoral Programmes in the Colombian Higher Education System: Trends and Challenges

ERIC Educational Resources Information Center

Acosta, Orlando; Celis, Jorge

2014-01-01

The international literature contains few formal analyses of the state of Colombian higher education and its most critical issues. This article systematically and comparatively analyzes the emergence of Colombian doctoral programmes within a national and international context. It shows that, while Colombia has experienced a significant growth in…

How Six Sigma Methodology Improved Doctors' Performance

ERIC Educational Resources Information Center

Zafiropoulos, George

2015-01-01

Six Sigma methodology was used in a District General Hospital to assess the effect of the introduction of an educational programme to limit unnecessary admissions. The performance of the doctors involved in the programme was assessed. Ishikawa Fishbone and 5 S's were initially used and Pareto analysis of their findings was performed. The results…

"Views from the Nano Edge": Women on Doctoral Preparation Programmes in Selected African Contexts

ERIC Educational Resources Information Center

Williamson, Charmaine

2016-01-01

The study explored the conceptual views of "critical mass", alongside micro experiences, of women, at a practice level, on a doctoral preparation programme which was implemented within the South African Development Community (SADC) and Ethiopian contexts. At the strategising level of policies, insufficient attention has been paid to the…

Quality of nursing doctoral education in seven countries: survey of faculty and students/graduates.

PubMed

Kim, Mi Ja; Park, Chang Gi; McKenna, Hugh; Ketefian, Shake; Park, So Hyun; Klopper, Hester; Lee, Hyeonkyeong; Kunaviktikul, Wipada; Gregg, Misuzu F; Daly, John; Coetzee, Siedine; Juntasopeepun, Phanida; Murashima, Sachiyo; Keeney, Sinead; Khan, Shaheen

2015-05-01

This study aimed to compare the findings of the quality of nursing doctoral education survey across seven countries and discuss the strategic directions for improving quality. No comparative evaluation of global quality of nursing doctoral education has been reported to date despite the rapid increase in the number of nursing doctoral programmes. A descriptive, cross-country, comparative design was employed. Data were collected from 2007-2010 from nursing schools in seven countries: Australia, Japan, Korea, South Africa, Thailand, UK and USA. An online questionnaire was used to evaluate quality of nursing doctoral education except for Japan, where a paper version was used. Korea and South Africa used e-mails quality of nursing doctoral education was evaluated using four domains: Programme, Faculty (referring to academic staff), Resource and Evaluation. Descriptive statistics, correlational and ordinal logistic regression were employed. A total of 105 deans/schools, 414 faculty and 1149 students/graduates participated. The perceptions of faculty and students/graduates about the quality of nursing doctoral education across the seven countries were mostly favourable on all four domains. The faculty domain score had the largest estimated coefficient for relative importance. As the overall quality level of doctoral education rose from fair to good, the resource domain showed an increased effect. Both faculty and students/graduates groups rated the overall quality of nursing doctoral education favourably. The faculty domain had the greatest importance for quality, followed by the programme domain. However, the importance of the resource domain gained significance as the overall quality of nursing doctoral education increased, indicating the needs for more attention to resources if the quality of nursing doctoral education is to improve. © 2015 John Wiley & Sons Ltd.

Understanding Non-Traditional PhD Students Habitus--Implications for PhD Programmes

ERIC Educational Resources Information Center

Naidoo, Devika

2015-01-01

Against the background of vast changes in doctoral education and the emergence of non-traditional doctoral programmes, this paper investigates the habitus of non-traditional PhD students at a South African university. Bourdieu's conceptual tool of habitus informed the study. In-depth and open-ended interviews were conducted with 10 non-traditional…

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

ERIC Educational Resources Information Center

Miclea, Mircea

2008-01-01

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

Closing the natural cycles - using biowaste compost in organic farming in Vienna

NASA Astrophysics Data System (ADS)

Erhart, Eva; Rogalski, Wojciech; Maurer, Ludwig; Hartl, Wilfried

2014-05-01

One of the basic principles of organic farming - that organic management should fit the cycles and ecological balances in nature - is put into practice in Vienna on a large scale. In Vienna, compost produced from separately collected biowaste and greenwaste is used on more than 1000 ha of organic farmland. These municipally owned farms are managed organically, but are stockless, like the vast majority of farms in the region. The apparent need for a substitute for animal manure triggered the development of an innovative biowaste management. Together with the Municipal Department 48 responsible for waste management, which was keen for the reduction of residual waste, the Municipal Department 49 - Forestry Office and Urban Agriculture and Bio Forschung Austria developed Vienna's biowaste management model. Organic household wastes and greenwastes are source-separated by the urban population and collected in a closely monitored system to ensure high compost quality. A composting plant was constructed which today produces a total of 43000 t compost per year in a monitored open windrow process. The quality of the compost produced conforms to the EU regulation 834/2007. A large part of the compost is used as organic fertilizer on the organic farmland in Vienna, and the remainder is used in arable farming and in viticulture in the region around Vienna and for substrate production. Vienna`s biowaste management-model is operating successfully since the 1980s and has gained international recognition in form of the Best Practice-Award of the United Nations Development Programme. In order to assess the effects of biowaste compost fertilization on crop yield and on the environment, a field experiment was set up near Vienna in 1992, which is now one of the longest standing compost experiments in Europe. The results showed, that the yields increased for 7 - 10 % with compost fertilization compared to the unfertilized control and the nitrogen recovery by crops was between 4 and 6 % of the total nitrogen applied in the compost treatments. Phosphorus and potassium supply with compost fertilization was approximately as high as with mineral fertilization. The humus content of the soil increased in the compost treatments, indicating that organic carbon applied via compost was stored in the soil. Regarding total heavy metal contents and available heavy metal fractions in soil and heavy metal contents in crops, fertilization with biowaste compost at rates allowed by organic farming rules gave no cause for concern. Nitrogen leaching to the groundwater as determined using ceramic suction cups was not increased with compost fertilization as compared to mineral fertilization.

Scaling up family medicine training in Gezira, Sudan - a 2-year in-service master programme using modern information and communication technology: a survey study.

PubMed

Mohamed, Khalid G; Hunskaar, Steinar; Abdelrahman, Samira Hamid; Malik, Elfatih M

2014-01-21

In 2010 the Gezira Family Medicine Project (GFMP) was initiated in Gezira state, Sudan, designed as an in-service training model. The project is a collaboration project between the University of Gezira, which aims to provide a 2-year master's programme in family medicine for practicing doctors, and the Ministry of Health, which facilitates service provision and funds the training programme. This paper presents the programme, the teaching environment, and the first batch of candidates enrolled. In this study a self-administered questionnaire was used to collect baseline data at the start of the project from doctors who joined the programme. A checklist was also used to assess the health centres where they work. A total of 188 out of 207 doctors responded (91%), while data were gathered from all 158 health centres (100%) staffed by the programme candidates. The Gezira model of in-service family medicine training has succeeded in recruiting 207 candidates in its first batch, providing health services in 158 centres, of which 84 had never been served by a doctor before. The curriculum is community oriented. The mean age of doctors was 32.5 years, 57% were males, and 32% were graduates from the University of Gezira. Respondents stated high confidence in practicing some skills such as asthma management and post-abortion uterine evacuation. They were least confident in other skills such as managing depression or inserting an intrauterine device. The majority of health centres was poorly equipped for management of noncommunicable diseases, as only 10% had an electrocardiography machine (ECG), 5% had spirometer, and 1% had a defibrillator. The Gezira model has responded to local health system needs. Use of modern information and communication technology is used to facilitate both health service provision and training. The GFMP represents an example of a large-volume scaling-up programme of family medicine in Africa.

Scaling up family medicine training in Gezira, Sudan – a 2-year in-service master programme using modern information and communication technology: a survey study

PubMed Central

2014-01-01

Background In 2010 the Gezira Family Medicine Project (GFMP) was initiated in Gezira state, Sudan, designed as an in-service training model. The project is a collaboration project between the University of Gezira, which aims to provide a 2-year master’s programme in family medicine for practicing doctors, and the Ministry of Health, which facilitates service provision and funds the training programme. This paper presents the programme, the teaching environment, and the first batch of candidates enrolled. Methods In this study a self-administered questionnaire was used to collect baseline data at the start of the project from doctors who joined the programme. A checklist was also used to assess the health centres where they work. A total of 188 out of 207 doctors responded (91%), while data were gathered from all 158 health centres (100%) staffed by the programme candidates. Results The Gezira model of in-service family medicine training has succeeded in recruiting 207 candidates in its first batch, providing health services in 158 centres, of which 84 had never been served by a doctor before. The curriculum is community oriented. The mean age of doctors was 32.5 years, 57% were males, and 32% were graduates from the University of Gezira. Respondents stated high confidence in practicing some skills such as asthma management and post-abortion uterine evacuation. They were least confident in other skills such as managing depression or inserting an intrauterine device. The majority of health centres was poorly equipped for management of noncommunicable diseases, as only 10% had an electrocardiography machine (ECG), 5% had spirometer, and 1% had a defibrillator. Conclusions The Gezira model has responded to local health system needs. Use of modern information and communication technology is used to facilitate both health service provision and training. The GFMP represents an example of a large-volume scaling-up programme of family medicine in Africa. PMID:24443978

Perceptions and Impact of Mandatory eLearning for Foundation Trainee Doctors: A Qualitative Evaluation.

PubMed

Brooks, Hannah L; Pontefract, Sarah K; Vallance, Hannah K; Hirsch, Christine A; Hughes, Elizabeth; Ferner, Robin E; Marriott, John F; Coleman, Jamie J

2016-01-01

Junior doctors in the UK must complete various educational components during their two year Foundation training programme. It is important that mandatory learning is informative and engaging. The aim of this study was to evaluate trainee doctors' perceptions of a Technology Enhanced Learning (TEL) programme developed to improve prescribing competency. Focus groups and interviews were conducted at three hospital sites in the West Midlands. Codes, sub-themes and themes were determined using deductive and inductive thematic analysis. Data were collected from 38 Foundation trainee doctors. Results revealed major themes relating to prescribing education, the user experience and user engagement. Key findings included the positive impact of preparedness following undergraduate education on the user experience of the TEL programme at the postgraduate level; the impact of content, structure, and individual learning needs and styles on the user experience; and the impact of motivation and time on engagement. Most trainees engaged with the programme owing to its mandatory nature; however, some trainees also used the programme voluntarily, for example, to acquire knowledge prior to starting a new placement. It is important to ensure that learners are willing to engage with mandatory TEL, and that they have the time and motivation to do so. It is also important to ensure that learners have a positive user experience and that in designing TEL individual differences in learning styles and needs are taken into account. These findings have implications for educators and system developers in the construction and design of mandatory eLearning programmes.

Perceptions and Career Prospects of the Distance Doctor of Education Degree: Voices from the Mid-Career ELT Tertiary Practitioners

ERIC Educational Resources Information Center

Kung, Fan-Wei

2017-01-01

The advancement of computer technologies has brought a plethora of technological innovations in educational settings. It is no exception in teacher training and education programmes around the world as the growth of professionalism has made the distance doctoral programmes possible for mid-career English language teaching (ELT) practitioners. The…

De-Colonising International Collaboration: The University of Kwazulu-Natal-Mauritius Institute of Education Cohort PhD Programme

ERIC Educational Resources Information Center

Samuel, Michael Anthony; Mariaye, Hyleen

2014-01-01

This paper explores the setting up of the partnership across the Mauritian and South African higher education contexts with respect to the development of a postgraduate PhD doctoral studies programme. The Mauritian Institute of Education (MIE) aims to develop staffing capacities through engagement with doctoral studies, especially in the context…

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

ERIC Educational Resources Information Center

Geber, Hilary; Bentley, Alison

2012-01-01

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

Student Accounts of Action Learning on a DBA Programme: Learning Inaction

ERIC Educational Resources Information Center

Mendonça, Roger; Parker, Anthony; Udo, Uwem; Groves, Catherine

2015-01-01

This account of practice sets out the action learning experience of three doctoral students on the same Doctoral Programme in Business Administration at a UK university. It also include the sense-making of a fourth member of the set. It explores the tension between their area of work and their engagement in the action learning process and, in so…

The Transformation of an Online Learning Community from an Organised Facility to an Organic Fraternity

ERIC Educational Resources Information Center

Fields, Alison; Lai, Kwok-Wing; Gibbs, John; Kirk, Alex; Vermunt, Jenny

2016-01-01

An online community of learning within a distance doctoral programme was explored to determine if and how the community evolved and transformed over time. This part-time doctoral programme gathers students into cohorts and runs a structured community with students and faculty for 18 months before students confirm candidatures and begin individual…

Obstacles to Success--Doctoral Student Attrition in South Africa

ERIC Educational Resources Information Center

Herman, Chaya

2011-01-01

The article explores doctoral attrition in South Africa, investigating and comparing the attributions of attrition of doctoral students and PhD programme leaders. The article is based on secondary data analysis of two large studies on doctoral education in South Africa. The main point of the article is that the different understandings of the…

[Dr. Jovan Andrejević Jols, the first Serbian anatomist life, work and achievement].

PubMed

Sakač, Dejan; Sakač, Vladimir; Čabarkapa, Velibor; Bugarski, Vojislava

2011-01-01

Doctor Jovan Andrejević Joles was one of the most educated Serbs of the 19th century, a medical doctor, scientist, journalist and translator. He was born in 1883 in Novi Sad. Even as a student of medicine he was active in scientific work, which resulted in a paper entiteled "The fine structure of the liver," later published in one of the most eminent medical journals in Europe. He completed the study of medicine in Vienna. He did not accept the position at the Medical Faculty in Vienna, and returned to Novi Sad, where he quickly gained an excellent reputation as a physician. He participated in the founding of the Serbian National Theatre in 1861, he was also one of the most active contributors of Matica Srpska, wrote many articles, critics and reviews, and was also regarded as the founder of aesthetic romanticism in Serbs. With Laza Kostić, he was the first among the Serbs to translate Shakespeare. At that time, when he was only 30 years old, he wrote about a brand-new art - photography. He lived in a harmonious marriage with Jelena - Ilka Bajić, who after Joles' death remarried to a captain of the Serbian army, and after his murder, became famous for the assassination attempt of King Milan Obrenović (recorded in history textbooks as the "Rebellion of Ilka"). Dr. Jovan Andrejevć died prematurely of tuberculosis, at that time an incurable disease, in 1864 in Novi Sad.

A mixed method, multiperspective evaluation of a near peer teaching programme.

PubMed

Lydon, Sinéad; O'Connor, Paul; Mongan, Orla; Gorecka, Miroslawa; McVicker, Lyle; Stankard, Aiden; Byrne, Dara

2017-09-01

Peer teaching (PT) has become increasingly popular. PT may offer benefits for students, tutors and institutions. Although resistance to PT has been identified among faculty, research has typically focused on students' experiences and perceptions, rather than those of the peer tutors or senior doctors/medical faculty. The current study comprised of a comprehensive, multiperspective evaluation of a near PT programme delivered by interns to final-year medical students in the Republic of Ireland. This study employed a mixed methods design, using both interviews and questionnaires to assess students' (n=130), interns' (n=49) and medical faculty's or senior doctors' (n=29) perceptions of the programme. All three groups were emphatic about the programme's benefits, although senior doctors and faculty reported significantly more positive attitudes than the others. Mean ratings of the programme's value, out of 10, were 8.2 among students, 8.2 among interns and 9.1 among senior doctors and faculty. Challenges identified were largely organisational in nature. Perceived benefits for students included the informality of teaching sessions, increased opportunities in the clinical environment and improvements in exam preparedness. Perceived benefits for the interns included improvements in knowledge and teaching ability and experience as a role model. PT programmes have been posited as an 'easy fix' to growing numbers of students. However, it is apparent that PT has substantial value outside of this. Future research that conducts economic evaluations of such programmes and that collects objective data on teaching quality and student learning would be of much interest. 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/.

Games, civil war and mutiny: metaphors of conflict for the nurse-doctor relationship in medical television programmes.

PubMed

Weaver, Roslyn

2013-12-01

Metaphors of medicine are common, such as war, which is evident in much of our language about health-care where patients and healthcare professionals fight disease, or the game, which is one way to frame the nurse-doctor professional relationship. This study analyses six pilot episodes of American (Grey's Anatomy, Hawthorne, Mercy, Nurse Jackie) and Australian (All Saints, RAN) medical television programmes premiering between 1998 and 2009 to assess one way that our contemporary culture understands and constructs professional relationships between nurses and doctors. Analysis shows that these popular television programmes frequently depict conflict, with games, civil war and mutiny between nurses and doctors over patient safety rather than professionals working collaboratively in teams to deliver health-care. Although the benefit of this televised conflict is the implication that nurses are knowledgeable, skilled professionals, the negative connotations include a dysfunctional and dangerous healthcare system, and also ongoing power struggles. Given that popular culture can sometimes influence the public's understanding of real-life nursing practice, it is important to explore what these metaphors of conflict are communicating about the nurse-doctor relationship. © 2013 John Wiley & Sons Ltd.

Mais Médicos (More Doctors) Program: its contribution in view of WHO recommendations for provision of doctors.

PubMed

Carvalho, Viviane Karoline da Silva; Marques, Carla Pintas; Silva, Everton Nunes da

2016-09-01

In order to examine whether Brazil's Mais Médicos (More Doctors) Programme (PMM) reflected World Health Organisation (WHO) recommendations for improved attraction, retention and recruitment of health workers in remote and rural areas, this descriptive, qualitative study drew on document analysis in order to compare the WHO recommendations published in 2010 with Brazil's Law No. 12,871/13, which instituted the PMM. Of the 16 WHO recommendations systematised here, the PMM met 37.5%. Recommendations not incorporated into the PMM include career development programmes and public recognition strategies. Although reflecting WHO recommendations and already in place elsewhere in the SUS prior to announcement of the PMM, the National Retention Grant Programme and multi-professional teams (as in the Family Health Strategy) were not implemented by the PMM. The programme contains innovative components such as a new curriculum for medical schools and compulsory medical service. On the other hand, the PMM could have invested more in personal and professional support.

[The significance of hierarchy in postgraduate education].

PubMed

Rupprecht, H

1999-01-01

There are structures of hierarchy in the postgraduate education. The postgraduate education is organized as a programme the young doctor has to absolve. The instruction and the control of the implementation of that programme must be carried out by a competent and experienced older physician, who is responsible for the correctness of that, the young doctor has to learn in his postgraduate education. The older physician unequivocally is integrated in the hierarchy above the young doctor legitimated by his knowledge, his experience and his personality. The hierarchy demonstrates itself as an indication of the moral integrity of the community and of each only individual.

Teaching doctors to treat doctors: medical student peer counselling.

PubMed

Spiro, J H; Roenneburg, M; Maly, B J

1980-01-01

Physicians' emotional problems need to be recognized and treated. Intervention and prevention in this problem area have been attempted at the Medical College of Wisconsin through a programme of peer counselling designed to teach student physicians how to recognize and treat emotional difficulties faced by their peers. During the 18 months that the programme has been in operation, 20 peer counsellors reported a total 1,185 hours spent in counselling their peers, lending credence to the speculation that doctors will turn to their peers for help if, in medical school, there is acceptance of fallibility and responsiveness on the part of peers.

Mind the Gap: Developing the Roles, Expectations and Boundaries in the Doctoral Supervisor-Supervisee Relationship

ERIC Educational Resources Information Center

Parker-Jenkins, Marie

2018-01-01

Does one need really need boundaries between doctoral supervisor and supervisee when talking about mature learners? Drawing on reflection from her extensive experience, the author believes it is critical to maintain this divide. There is an increase in doctoral students, proliferation of doctoral programmes globally and practices which vary from…

Bridging the education-action gap: a near-peer case-based undergraduate ethics teaching programme.

PubMed

Kong, Wing May; Knight, Selena

2017-10-01

Undergraduate ethics teaching has made significant progress in the past decade, with evidence showing that students and trainee doctors feel more confident in identifying and analysing ethical issues. There is general consensus that ethics education should enable students and doctors to take ethically appropriate actions, and nurture moral integrity. However, the literature reports that doctors continue to find it difficult to take action when faced with perceived unethical behaviour. This has been evident in recent healthcare scandals, in which care has fallen below acceptable ethical standards, despite the presence of professional ethical guidelines and competencies. The National Foundation Training Programme forms the first 2 years of training for new UK doctors. We designed a Foundation Doctor (FD)-led teaching programme in which medical students were invited to bring cases and experiences from clinical placements for small group discussion facilitated by FDs. The aim was to enable students to act ethically in practice through developing moral sensitivity and moral identity, together with skills in ethical reasoning and tools to address barriers to taking ethical action. FDs were chosen as facilitators, based on the evidence that near-peer is an effective form of teaching in medicine and may provide positive role models for students. This article reviews the background rationale for the programme and its design. Important themes emerging from the case discussions are explored. Student and FD facilitator feedbacks are evaluated, and practical challenges to the implementation of this type of programme are discussed. 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/.

Teaching general practitioners and doctors-in-training to discuss advance care planning: evaluation of a brief multimodality education programme.

PubMed

Detering, Karen; Silvester, William; Corke, Charlie; Milnes, Sharyn; Fullam, Rachael; Lewis, Virginia; Renton, Jodie

2014-09-01

To develop and evaluate an interactive advance care planning (ACP) educational programme for general practitioners and doctors-in-training. Development of training materials was overseen by a committee; informed by literature and previous teaching experience. The evaluation assessed participant confidence, knowledge and attitude toward ACP before and after training. Training provided to metropolitan and rural settings in Victoria, Australia. 148 doctors participated in training. The majority were aged at least 40 years with more than 10 years work experience; 63% had not trained in Australia. The programme included prereading, a DVD, interactive patient e-simulation workshop and a training manual. All educational materials followed an evidence-based stepwise approach to ACP: Introducing the topic, exploring concepts, introducing solutions and summarising the conversation. The primary outcome was the change in doctors' self-reported confidence to undertake ACP conversations. Secondary measures included pretest/post-test scores in patient ACP e-simulation, change in ACP knowledge and attitude, and satisfaction with programme materials. 69 participants completed the preworkshop and postworkshop evaluation. Following education, there was a significant change in self-reported confidence in six of eight items (p=0.008 -0.08). There was a significant improvement (p<0.001) in median scores on the e-simulation (pre 7/80, post 60/80). There were no significant differences observed in ACP knowledge following training, and most participants were supportive of patient autonomy and ACP pretraining. Educational materials were rated highly. A short multimodal interactive education programme improves doctors' confidence with ACP and performance on an ACP patient e-simulation. 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.

The United Nations programme on space applications: priority thematic areas

NASA Astrophysics Data System (ADS)

Haubold, H.

The Third United Nations Conference on the Exploration and Peaceful Uses of Outer Space (UNISPACE III) was held in 1999 with efforts to identify world wide benefits of developing space science and technology, particularly in the developing nations. One of the main vehicles to implement recommendations of UNISPACE III is the United Nations Programme on Space Applications of the Office for Outer Space Affairs at UN Headquarters in Vienna. Following a process of prioritization by Member States, the Programme focus its activities on (i) knowledge-based themes as space law and basic space science, (ii) application-based themes as disaster management, natural resources management, environmental monitoring, tele-health, and (iii) enabling technologies such as remote sensing satellites, communications satellites, global navigation satellite systems, and small satellites. Current activities of the Programme will be reviewed. Further information available at http://www.oosa.unvienna.org/sapidx.html

[Medical ethics in prison medicine].

PubMed

Bernheim, J

1980-11-01

A series of situations and decisions involving medical ethics in a prison medical service are discussed. The doctor's independence is considered in relation to his contract with administrative authorities. In contrast with most private doctor-patient relationships, there is usually no possibility for prisoners to choose their doctor and vice-versa. Freedom of consent on the part of the patient may also imply a right to no-treatment. Medical care in prison is not easy to delineate, also because patients often try to involve the doctor in non-medical demands. A prison doctor should avoid taking part in decisions which ought to be made by the judiciary or by administrative authorities. Programmes involving preventive medicine and sociotherapy imply collaboration between therapeutic and security staff. The continuous interplay and readjustment between powers based on public authority, on the rights of each individual prisoner and on the medical programmes makes it possible for some sort of therapeutic freedom to exist in the prison.

Formal mentoring programmes for medical students and doctors--a review of the Medline literature.

PubMed

Buddeberg-Fischer, Barbara; Herta, Katja-Daniela

2006-05-01

Mentoring programmes have been implemented as a specific career-advancement tool in the training and further education of various groups in the medical profession. The main focus of our investigation was to examine what types of structured mentoring programmes exist for doctors as well as for medical students, what short- and long-term goals these projects pursue, and whether statements can be made on the effectiveness and efficiency of these programmes. A literature-search strategy was applied to Medline for 1966-2002 using the keyword combinations: (a) mentor* [AND] program* [AND] medical students, and (b) mentor* [AND] program* [AND] physicians. Although a total of 162 publications were identified, only 16 papers (nine for medical students and seven for doctors) met the selected methodological criteria. The majority of the programmes lack a concrete structure as well as a short- and long-term evaluation. Main goals are to increase professional competence in research and in further specialization and to build up a professional network for the mentees; no statements are to be found on the advantages for the mentors. Programme evaluation is for the most part presented descriptively in terms of great interest and high level of satisfaction. No publication contains statements on the effectiveness or the efficiency of the programme. Although the results of mentoring are promising, more formal programmes with clear setup goals and a short- and long-term evaluation of the individual successes of the participants as well as the cost-benefit analysis are needed.

Assessment Matters: Some Issues Concerning the Supervision and Assessment of Work-Based Doctorates

ERIC Educational Resources Information Center

Johnson, David

2005-01-01

Since 2000, I have been working towards a professional doctorate at Middlesex University, and I am also working to introduce a work-based doctorate at Coventry University. This paper looks at the issues of supervision and assessment for work-based doctorates, which, I believe, are key to the design of such a programme and affect both the output…

Structuralization of Doctoral Education in Germany: An Interdisciplinary Comparison

ERIC Educational Resources Information Center

Qin, Lin

2017-01-01

Taking the establishment of structured doctoral programmes in Germany as an example, this paper focuses on how knowledge production in certain academic fields reshapes their doctoral education in a widely changing policy context. Based on case studies of eight graduate schools in three research fields, namely economics, life sciences, and…

Helping doctors in training to STEP-UP: A leadership and quality improvement programme in the Belfast Health and Social Care Trust.

PubMed

Donaghy, Grainne; McKeever, Kris; Flanagan, Catherine; O'Kane, Donal; McQuillan, Bernie; Cash, Johnny; Jack, Cathy; Lundy, Claire

2018-05-01

Medical engagement in healthcare organisations can improve service development and patient experience. Doctors in training have limited opportunities to engage in service improvement work and develop leadership skills. We describe the Specialist Trainees Engaged in Leadership Programme (STEP) , a programme developed to introduce concepts of medical leadership and quality improvement skills in the Belfast Trust. STEP started in 2013 and over 140 trainees have now participated in the programme. Over 42 quality improvement projects have been completed with the support of the programme. Evaluation of STEP has demonstrated an improvement across all domains explored throughout the duration of the programme, with benefits for the individual trainee and the wider organisation. We describe the programme in detail. The STEP curriculum can easily be adapted to meet the needs of NHS trainees, allowing them to understand the objectives and strategy of their employers and improve their ability to plan and deliver safe, effective, patient-centred care.

Stick or twist? Career decision-making during contractual uncertainty for NHS junior doctors.

PubMed

Spooner, S; Gibson, Jon; Rigby, Dan; Sutton, Matt; Pearson, Emma; Checkland, Kath

2017-01-25

To examine the extent, and nature, of impact on junior doctors' career decisions, of a proposed new contract and the uncertainty surrounding it. Mixed methods. Online survey exploring: doctors' future training intentions; their preferred specialty training (ST) programmes; whether they intended to proceed immediately to ST; and other plans. Linked qualitative interviews to explore more fully how and why decisions were affected. Doctors (F2s) in second year of Foundation School (FS) Programmes in England. Invitations sent by FSs. Open to all F2s November 2015-February 2016. All FSs represented. Survey completed by 816 F2s. Sample characteristics broadly similar to national F2 cohort. Proportions of doctors intending to proceed to ST posts in the UK, to defer or to exit UK medicine. Proportion of doctors indicating changes in training and career plans as a result of the contract and/or resulting uncertainty. Distribution of changes across training programmes. Explanations of these intentions from interviews and free text comments. Among the responding junior doctors, 20% indicated that issues related to the contract had prompted them to switch specialty and a further 20% had become uncertain about switching specialty. Switching specialty choice was more prevalent among those now choosing a community-based, rather than hospital-based specialty. 30% selecting general practice had switched choice because of the new contract. Interview data suggests that doctors felt they had become less valued or appreciated in the National Health Service and in society more broadly. Doctors reported that contract-related issues have affected their career plans. The most notable effect is a move away from acute to community-based specialities, with the former perceived as more negatively affected by the proposed changes. It is concerning that young doctors feel undervalued, and this requires further investigation. 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/.

Stick or twist? Career decision-making during contractual uncertainty for NHS junior doctors

PubMed Central

Gibson, Jon; Rigby, Dan; Sutton, Matt; Pearson, Emma; Checkland, Kath

2017-01-01

Objectives To examine the extent, and nature, of impact on junior doctors' career decisions, of a proposed new contract and the uncertainty surrounding it. Design Mixed methods. Online survey exploring: doctors' future training intentions; their preferred specialty training (ST) programmes; whether they intended to proceed immediately to ST; and other plans. Linked qualitative interviews to explore more fully how and why decisions were affected. Setting Doctors (F2s) in second year of Foundation School (FS) Programmes in England. Participants Invitations sent by FSs. Open to all F2s November 2015–February 2016. All FSs represented. Survey completed by 816 F2s. Sample characteristics broadly similar to national F2 cohort. Main outcome measures Proportions of doctors intending to proceed to ST posts in the UK, to defer or to exit UK medicine. Proportion of doctors indicating changes in training and career plans as a result of the contract and/or resulting uncertainty. Distribution of changes across training programmes. Explanations of these intentions from interviews and free text comments. Results Among the responding junior doctors, 20% indicated that issues related to the contract had prompted them to switch specialty and a further 20% had become uncertain about switching specialty. Switching specialty choice was more prevalent among those now choosing a community-based, rather than hospital-based specialty. 30% selecting general practice had switched choice because of the new contract. Interview data suggests that doctors felt they had become less valued or appreciated in the National Health Service and in society more broadly. Conclusions Doctors reported that contract-related issues have affected their career plans. The most notable effect is a move away from acute to community-based specialities, with the former perceived as more negatively affected by the proposed changes. It is concerning that young doctors feel undervalued, and this requires further investigation. PMID:28122834

The transition from medical student to doctor: perceptions of final year students and preregistration house officers related to expected learning outcomes.

PubMed

Lempp, H; Seabrook, M; Cochrane, M; Rees, J

2005-03-01

In this prospective qualitative study over 12 months, we evaluated the educational and clinical effectiveness of a new final year undergraduate programme in a London medical school (Guy's, King's and St Thomas'). A stratified sample of 17/360 final year students were interviewed four times, and the content was assessed against 32 amalgamated learning outcomes identified in 1997 in The New Doctor. At the beginning of the preregistration year, eight of the learning outcomes were already met, 10 partly, eight remained to be attained and for six, insufficient evidence existed. Preregistration house officers who have been through the final year student house officer programme expressed competence in many of the outcomes of the General Medical Council's New Doctor. The study identified areas such as prescribing where further developments are needed and will help in planning the new foundation programme.

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

ERIC Educational Resources Information Center

Rainford, Jon

2016-01-01

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

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

PubMed

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

2017-10-25

This study draws on an in-depth investigation of factors that influenced the career decisions of junior doctors. Junior doctors in the UK can choose to enter specialty training (ST) programmes within 2 years of becoming doctors. Their specialty choices contribute to shaping the balance of the future medical workforce, with views on general practice (GP) careers of particular interest because of current recruitment difficulties. This paper examines how experiences of medical work and perceptions about specialty training shape junior doctors' career decisions. Twenty doctors in the second year of a Foundation Training Programme in England were recruited. Purposive sampling was used to achieve a diverse sample from respondents to an online survey. Narrative interviewing techniques encouraged doctors to reflect on how experiences during medical school and in medical workplaces had influenced their preferences and perceptions of different specialties. They also spoke about personal aspirations, work priorities and their wider future.Junior doctors' decisions were informed by knowledge about the requirements of ST programmes and direct observation of the pressures under which ST doctors worked. When they encountered negative attitudes towards a specialty they had intended to choose, some became defensive while others kept silent. Achievement of an acceptable work-life balance was a central objective that could override other preferences.Events linked with specific specialties influenced doctors' attitudes towards them. For example, findings confirmed that while early, positive experiences of GP work could increase its attractiveness, negative experiences in GP settings had the opposite effect. Junior doctors' preferences and perceptions about medical work are influenced by multiple intrinsic and extrinsic factors and experiences. This paper highlights the importance of understanding how perceptions are formed and preferences are developed, as a basis for generating learning and working environments that nurture students and motivate their professional careers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The importance of a supportive environment in clinical audit: a pilot study of doctors' engagement with the NHS National PET-CT audit programme.

PubMed

Ross, Peter; Hubert, Jane; Saunders, Mike; Wong, Wai Lup

2014-10-01

The NHS National PET-CT Audit Programme was launched in 2008 as part of a national NHS programme to widen patient access to PET-computed tomography (CT) imaging in England. However, to implement clinical audit effectively, healthcare professionals need to be fully engaged with the process. The purpose of the pilot study was to identify and explore the different factors that influence doctors' engagement with the National NHS PET-CT Audit Programme. A single embedded case study was undertaken, which centred on the NHS National PET-CT Audit Programme. Seven theoretical propositions drawn from a review of the literature were tested and their influence evaluated. A purposeful sample of 13 semistructured interviews with consultant doctors was taken from different hospitals over a 6-month period. The data were analysed using directed thematic content analysis, with the themes compared against the study's propositions. Doctors' perspectives of clinical audit changed in response to the way in which the audit was implemented. The main barriers to engagement were the lack of a common vision and poor communication, which contributed to poor interprofessional relationships and a perceived culture of blame. In contrast, factors that facilitated engagement centred on the adoption of a more supportive and collaborative approach, which in turn facilitated higher levels of trust between professionals. The dissemination of performance data was found to be a key influencing factor. The study makes use of a unique data set and to the best of our knowledge is one of the first studies to document how the dissemination of doctors' performance data positively influences engagement with clinical audit in England. In addition, the study also shows how, contrary to some studies in the literature, clinical audit can reduce professional anxiety by providing a validation of professional competence. The study supports the premise that clinical audit will be fully embraced by doctors only if they are sufficiently involved in the process so as to be able to redefine and clarify its purpose and meaning. The preliminary findings of this pilot study provide the theoretical underpinning for a national survey into reporter perspectives of the National PET-CT Audit Programme.

Get SET: aligning anatomy demonstrator programmes with Surgical Education and Training selection criteria.

PubMed

Rhodes, Danielle; Fogg, Quentin A; Lazarus, Michelle D

2018-05-01

Prevocational doctors aspiring to surgical careers are commonly recruited as anatomy demonstrators for undergraduate and graduate medical programmes. Entry into Surgical Education and Training (SET) is highly competitive and a unique opportunity exists to align anatomy demonstrator programmes with the selection criteria and core competencies of SET programmes. This study used a qualitative approach to (i) determine what criteria applicants for SET are assessed on and (ii) identify criteria that could be aligned with and enhanced by an anatomy demonstrator programme. The selection guidelines of all nine surgical specialties for the 2017 intake of SET trainees were analysed using qualitative content analysis methodology. The Royal Australasian College of Surgeons adopted a holistic approach to trainee selection that assessed both discipline-specific and discipline-independent skills. Qualitative content analysis identified eight categories of key selection criteria: medical expertise, scholarly activity, professional identity, interpersonal skills, integrity, self-management, insight and self-awareness and community involvement. The structured curriculum vitae was heavily weighted towards discipline-specific skills, such as medical expertise and scholarly activity. Insufficient information was available to determine the weighting of selection criteria assessed by the structured referee reports or interviews. Anatomy demonstrator programmes provide prevocational doctors with unique opportunities to develop surgical skills and competencies in a non-clinical setting. Constructively aligned anatomy demonstrator programmes may be particularly beneficial for prevocational doctors seeking to improve their anatomical knowledge, teaching skills or scholarly activity. © 2017 Royal Australasian College of Surgeons.

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

PubMed

Bracke, N; Moens, L

2010-01-01

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

Strengthening medical education in haematology and blood transfusion: postgraduate programmes in Tanzania

PubMed Central

Makani, Julie; Lyimo, Magdalena; Magesa, Pius; Roberts, David J.

2017-01-01

Summary Haematology and blood transfusion, as a clinical and laboratory discipline, has a far-reaching impact on healthcare both through direct patient care as well as provision of laboratory and transfusion services. Improvement of haematology and blood transfusion may therefore be significant in achieving advances in health in Africa. In 2005, Tanzania had one of the lowest distributions of doctors in the world, estimated at 2·3 doctors per 100 000 of population, with only one haematologist, a medical doctor with postgraduate medical education in haematology and blood transfusion. Here, we describe the establishment and impact of a postgraduate programme centred on Master of Medicine and Master of Science programmes to build the capacity of postgraduate training in haematology and blood transfusion. The programme was delivered through Muhimbili University of Health and Allied Sciences (MUHAS) with partnership from visiting medical and laboratory staff from the UK and complemented by short-term visits of trainees from Tanzania to Haematology Departments in the UK. The programme had a significant impact on the development of human resources in haematology and blood transfusion, successfully training 17 specialists with a significant influence on delivery of health services and research. This experience shows how a self-sustaining, specialist medical education programme can be developed at low cost within Lower and Middle Income Countries (LMICs) to rapidly enhance delivery of capacity to provide specialist services. PMID:28369755

Strengthening medical education in haematology and blood transfusion: postgraduate programmes in Tanzania.

PubMed

Makani, Julie; Lyimo, Magdalena; Magesa, Pius; Roberts, David J

2017-06-01

Haematology and blood transfusion, as a clinical and laboratory discipline, has a far-reaching impact on healthcare both through direct patient care as well as provision of laboratory and transfusion services. Improvement of haematology and blood transfusion may therefore be significant in achieving advances in health in Africa. In 2005, Tanzania had one of the lowest distributions of doctors in the world, estimated at 2·3 doctors per 100 000 of population, with only one haematologist, a medical doctor with postgraduate medical education in haematology and blood transfusion. Here, we describe the establishment and impact of a postgraduate programme centred on Master of Medicine and Master of Science programmes to build the capacity of postgraduate training in haematology and blood transfusion. The programme was delivered through Muhimbili University of Health and Allied Sciences (MUHAS) with partnership from visiting medical and laboratory staff from the UK and complemented by short-term visits of trainees from Tanzania to Haematology Departments in the UK. The programme had a significant impact on the development of human resources in haematology and blood transfusion, successfully training 17 specialists with a significant influence on delivery of health services and research. This experience shows how a self-sustaining, specialist medical education programme can be developed at low cost within Lower and Middle Income Countries (LMICs) to rapidly enhance delivery of capacity to provide specialist services. © 2017 John Wiley & Sons Ltd.

Critical Autobiography in the Professional Doctorate: Improving Students' Writing through the Device of Literature

ERIC Educational Resources Information Center

Eastman, Christine; Maguire, Kate

2016-01-01

This paper argues for a pedagogic practice to overcome the challenges that many professional practitioners face in undertaking a professional doctorate. Recent examination feedback on a professional doctoral programme of 300 candidates in the UK highlighted that a number of candidates often struggle to write persuasively, critically and…

Producing "Industry-Ready" Doctorates: Australian Cooperative Research Centre Approaches to Doctoral Education

ERIC Educational Resources Information Center

Harman, Kay M.

2004-01-01

How the experience of science-based Ph.D. students working in or funded by Australian Cooperative Research Centres (CRCs) compares with their peers in regular university science-based departments is the key focus of this article. CRC doctoral programmes that integrate industry needs with professional development offer an alternative to traditional…

Pedagogical Implications of Working with Doctoral Students at a Distance

ERIC Educational Resources Information Center

Wikeley, Felicity; Muschamp, Yolande

2004-01-01

This paper discusses the issues raised when delivering professional doctorate programmes to students at a distance. It explores the importance in doctoral study of engagement with a research community, what a "community of practice" might mean within the academic context and the problematic nature of working with students already operating within…

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

ERIC Educational Resources Information Center

Mawson, Kate; Abbott, Ian

2017-01-01

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

Collaborative Doctoral Education: University-Industry Partnerships for Enhancing Knowledge Exchange

ERIC Educational Resources Information Center

Borrell-Damian, Lidia; Brown, Timothy; Dearing, Andrew; Font, Josep; Hagen, Stephen; Metcalfe, Janet; Smith, John

2010-01-01

This paper summarises the findings of the first stage of a pan-European study of collaborative doctoral training, which has examined programmes involving private sector partners. While studying for a doctorate has traditionally been seen as preparation for a job in academic teaching and research, for many candidates today (currently around 50%)…

Doctoral Supervisors' and Supervisees' Responses to Co-Supervision

ERIC Educational Resources Information Center

Olmos-López, Pamela; Sunderland, Jane

2017-01-01

With the increasing demand for doctoral education, co-supervision, understood as the formally agreed supervision of a research student by two or more academics in doctoral programmes, has become common practice in postgraduate circles in the UK. If supervision with one supervisor is complex due to personal, academic, ethical and sometimes…

Fitting contraceptive diaphragms: can laywomen provide quality training for doctors?

PubMed

Pickard, S; Baraitser, P; Herns, M; Massil, H

2001-07-01

To test the feasibility of training laywomen as professional patients to teach doctors to fit the contraceptive diaphragm. Semi-structured interviews with instructing doctors and questionnaires to DFFP trainees. These documented current teaching practice and the acceptability of professional patients. The Delphi technique was used to establish a curriculum for the professional patients' training programme. The results show that there is currently a lack of standardisation in teaching methods and content with respect to diaphragm fitting. All instructing doctors and DFFP trainees involved had experienced difficulties in recruiting women for training, and the majority would be happy to work with professional patients. After three rounds of the Delphi procedure, consensus was reached and a curriculum developed. Five women were recruited on to a training programme, and four successfully completed it. Lack of standardisation and difficulty recruiting patients are current problems when training doctors to fit diaphragms. Our study shows that the use of professional patients would be acceptable to both DFFP trainees and instructing doctors, and that it is possible to recruit and train women for this purpose.

The Hydrological Open Air Laboratory (HOAL) in Petzenkirchen: a hypothesis-driven observatory

NASA Astrophysics Data System (ADS)

Blöschl, G.; Blaschke, A. P.; Broer, M.; Bucher, C.; Carr, G.; Chen, X.; Eder, A.; Exner-Kittridge, M.; Farnleitner, A.; Flores-Orozco, A.; Haas, P.; Hogan, P.; Kazemi Amiri, A.; Oismüller, M.; Parajka, J.; Silasari, R.; Stadler, P.; Strauss, P.; Vreugdenhil, M.; Wagner, W.; Zessner, M.

2016-01-01

Hydrological observatories bear a lot of resemblance to the more traditional research catchment concept, but tend to differ in providing more long-term facilities that transcend the lifetime of individual projects, are more strongly geared towards performing interdisciplinary research, and are often designed as networks to assist in performing collaborative science. This paper illustrates how the experimental and monitoring set-up of an observatory, the 66 ha Hydrological Open Air Laboratory (HOAL) in Petzenkirchen, Lower Austria, has been established in a way that allows meaningful hypothesis testing. The overarching science questions guided site selection, identification of dissertation topics and the base monitoring. The specific hypotheses guided the dedicated monitoring and sampling, individual experiments, and repeated experiments with controlled boundary conditions. The purpose of the HOAL is to advance the understanding of water-related flow and transport processes involving sediments, nutrients and microbes in small catchments. The HOAL catchment is ideally suited for this purpose, because it features a range of different runoff generation processes (surface runoff, springs, tile drains, wetlands), the nutrient inputs are known, and it is convenient from a logistic point of view as all instruments can be connected to the power grid and a high-speed glassfibre local area network (LAN). The multitude of runoff generation mechanisms in the catchment provides a genuine laboratory where hypotheses of flow and transport can be tested, either by controlled experiments or by contrasting sub-regions of different characteristics. This diversity also ensures that the HOAL is representative of a range of catchments around the world, and the specific process findings from the HOAL are applicable to a variety of agricultural catchment settings. The HOAL is operated jointly by the Vienna University of Technology and the Federal Agency for Water Management and takes advantage of the Vienna Doctoral Programme on Water Resource Systems funded by the Austrian Science Funds. The paper presents the science strategy of the set-up of the observatory, discusses the implementation of the HOAL, gives examples of the hypothesis testing and summarises the lessons learned. The paper concludes with an outlook on future developments.

The Hydrological Open Air Laboratory (HOAL) in Petzenkirchen: a hypotheses driven observatory

NASA Astrophysics Data System (ADS)

Blöschl, G.; Blaschke, A. P.; Broer, M.; Bucher, C.; Carr, G.; Chen, X.; Eder, A.; Exner-Kittridge, M.; Farnleitner, A.; Flores-Orozco, A.; Haas, P.; Hogan, P.; Kazemi Amiri, A.; Oismüller, M.; Parajka, J.; Silasari, R.; Stadler, P.; Strauß, P.; Vreugdenhil, M.; Wagner, W.; Zessner, M.

2015-07-01

Hydrological observatories bear a lot of resemblance to the more traditional research catchment concept but tend to differ in providing more long term facilities that transcend the lifetime of individual projects, are more strongly geared towards performing interdisciplinary research, and are often designed as networks to assist in performing collaborative science. This paper illustrates how the experimental and monitoring setup of an observatory, the 66 ha Hydrological Open Air Laboratory (HOAL) in Petzenkirchen, Lower Austria, has been established in a way that allows meaningful hypothesis testing. The overarching science questions guided site selection, identifying dissertation topics and the base monitoring. The specific hypotheses guided the dedicated monitoring and sampling, individual experiments, and repeated experiments with controlled boundary conditions. The purpose of the HOAL is to advance the understanding of water related flow and transport processes involving sediments, nutrients and microbes in small catchments. The HOAL catchment is ideally suited for this purpose, because it features a range of different runoff generation processes (surface runoff, springs, tile drains, wetlands), the nutrient inputs are known, and it is convenient from a logistic point of view as all instruments can be connected to the power grid and a high speed glassfibre Local Area Network. The multitude of runoff generation mechanisms in the catchment provide a genuine laboratory where hypotheses of flow and transport can be tested, either by controlled experiments or by contrasting sub-regions of different characteristics. This diversity also ensures that the HOAL is representative of a range of catchments around the world and the specific process findings from the HOAL are applicable to a variety of agricultural catchment settings. The HOAL is operated jointly by the Vienna University of Technology and the Federal Agency for Water Management and takes advantage of the Vienna Doctoral Programme on Water Resource Systems funded by the Austrian Science Funds. The paper presents the science strategy of the setup of the observatory, discusses the implementation of the HOAL, gives examples of the hypothesis testing and summarises the lessons learned. The paper concludes with an outlook on future developments.

A Different Kind of Animal: Liminal Experiences of Social Work Doctoral Students

ERIC Educational Resources Information Center

Adorno, Gail; Cronley, Courtney; Smith, Kenneth Scott

2015-01-01

Evidence suggests that social and academic integration is a vital factor in doctoral student retention. This paper describes findings from a qualitative study which explored the experiences of a cohort of social work doctoral students during the first year in their programme of study. We used the anthropological concept of liminality which…

Emergent Frameworks of Research Teaching and Learning in a Cohort-Based Doctoral Programme

ERIC Educational Resources Information Center

Samuel, Michael; Vithal, Renuka

2011-01-01

This article argues that alternate models of doctoral research teaching and learning pedagogy could address the challenge of under-productivity of doctoral graduands in the South African higher education system. Present literature tends not to focus on the models of research teaching and learning as a form of pedagogy. The article presents a case…

"He Just Told Me to Get on with It": Insights into Transforming Doctoral Writing Development

ERIC Educational Resources Information Center

Johnson, E. Marcia

2015-01-01

This paper reports on the results of a two-year study into threshold concepts (TCs) in doctoral writing. The findings informed the development of a thinking to write strategy (the 4x4) that has been implemented as part of a pan-university doctoral writing programme at a New Zealand university.

The doctor dilemma in interprofessional education and care: how and why will physicians collaborate?

PubMed

Whitehead, Cynthia

2007-10-01

Interprofessional educational (IPE) initiatives are seen as a means to engage health care professionals in collaborative patient-centred care. Given the hierarchical nature of many clinical settings, it is important to examine how the aims of formal IPE courses intersect with the socialisation of medical students into roles of responsibility and authority. This article aims to provide an overview of doctor barriers to collaboration and describe aspects of medical education and socialisation that may limit doctor engagement in the goals of interprofessional education. Additionally, the paper examines the nature of team function in the health care system, reviewing different conceptual models to propose a spectrum of collaborative possibilities. Finally, specific suggestions are offered to increase the impact of interprofessional education programmes in medical education. An acknowledgement of power differentials between health care providers is necessary in the development of models for shared responsibility between professions. Conceptual models of teamwork and collaboration must articulate the desired nature of interaction between professionals with different degrees of responsibility and authority. Educational programmes in areas such as professionalism and ethics have shown limited success when formal and informal curricula significantly diverge. The socialisation of medical students into the role of a responsible doctor must be balanced with training to share responsibility appropriately. Doctor collaborative capacity may be enhanced by programmes designed to develop particular skills for which there is evidence of improved patient outcomes.

Outcomes of a nurse-managed service for stable HIV-positive patients in a large South African public sector antiretroviral therapy programme.

PubMed

Grimsrud, Anna; Kaplan, Richard; Bekker, Linda-Gail; Myer, Landon

2014-09-01

Models of care utilizing task shifting and decentralization are needed to support growing ART programmes. We compared patient outcomes between a doctor-managed clinic and a nurse-managed down-referral site in Cape Town, South Africa. Analysis included all adults who initiated ART between 2002 and 2011 within a large public sector ART service. Stable patients were eligible for down-referral. Outcomes [mortality, loss to follow-up (LTFU), virologic failure] were compared under different models of care using proportional hazards models with time-dependent covariates. Five thousand seven hundred and forty-six patients initiated ART and over 5 years 41% (n = 2341) were down-referred; the median time on ART before down-referral was 1.6 years (interquartile range, 0.9-2.6). The nurse-managed down-referral site reported lower crude rates of mortality, LTFU and virologic failure compared with the doctor-managed clinic. After adjustment, there was no difference in the risk of mortality or virologic failure by model of care. However, patients who were down-referred were more likely to be LTFU than those retained at the doctor-managed site (adjusted hazard ratio, 1.36; 95% CI, 1.09-1.69). Increased levels of LTFU in the nurse-managed vs. doctor-managed service were observed in subgroups of male patients, those with advanced disease at initiation and those who started ART in the early years of the programme. Reorganization of ART maintenance by down-referral to nurse-managed services is associated with programme outcomes similar to those achieved using doctor-driven primary care services. Further research is necessary to identify optimal models of care to support long-term retention of patients on ART in resource-limited settings. © 2014 John Wiley & Sons Ltd.

Foundation Programme Impact on Junior Doctor Personality and Anxiety in Northern Ireland

PubMed Central

O’Donnell, Mark; Noad, Rebecca; Boohan, Mairead; Carragher, Angela

2012-01-01

Objectives The main objectives of this study were to assess personality traits and levels of anxiety in Foundation Year 2 (F2) doctors during the foundation doctor training programme in the Northern Ireland Deanery (NIMDTA). Methods A prospective survey-based study was conducted for all F2 doctors attending the mandatory generic skills programme at NIMDTA. Anxiety was measured using the State-Trait Anxiety Inventory (STAI) while personality was assessed using the IPIP-NEO questionnaire. These previously validated questionnaires were completed at the start and again at the end of the F2 year. Results 147 (M=65, F=82) and 106 (M=55, F=51) F2 doctors completed questionnaires at both time points. STAI scores suggested a moderate level of anxiety amongst both male and female doctors at baseline and at the end of the academic year. There was no difference between gender for either parameter (Baseline-State: 34.0 vs. 36.0, p=0.48 and Trait: 39.0 vs. 40.5, p=0.33) (End-State: 41.0 vs. 36.0, p=0.14 and Trait: 42.0 vs. 40.5, p=0.78). IPIP-NEO scores for F2 doctors were consistently higher in the Accommodation (93.9 & 92.3) and Consolidation (88.8 & 87.6) personality factors and lower in the Neuroticism factor (66.3 & 65.9) at both assessment time-points. Female F2 doctors scored significantly higher in the accommodation factor at the end of the academic year when compared to their male counterparts (88.0 vs. 94.0, p<0.001). There was no difference between the genders for the other personality factors at the end of the year (p>0.09). Conclusion This first cohort of F2 doctors were exposed to many emerging changes in their training which did not appear to have any detrimental effect on their anxiety levels or personality profiles and suggests that junior doctors may not be affected by external influences or changing educational environments. PMID:23539378

Towards an Analytical Framework for Understanding the Development of a Quality Assurance System in an International Joint Programme

ERIC Educational Resources Information Center

Zheng, Gaoming; Cai, Yuzhuo; Ma, Shaozhuang

2017-01-01

This paper intends to construct an analytical framework for understanding quality assurance in international joint programmes and to test it in a case analysis of a European--Chinese joint doctoral degree programme. The development of a quality assurance system for an international joint programme is understood as an institutionalization process…

Improving Doctoral Support through Group Supervision: Analysing Face-to-Face and Technology-Mediated Strategies for Nurturing and Sustaining Scholarship

ERIC Educational Resources Information Center

Hutchings, Maggie

2017-01-01

The challenges of the doctoral journey can create social and academic isolation. Student support is normally facilitated through the supervisory team and research training programmes. There is little empirical evidence on the role group supervision and peer learning can play in nurturing and sustaining doctoral scholarship. This article explores…

A Statistical Evaluation of the Effects of a Structured Postdoctoral Programme

ERIC Educational Resources Information Center

Bessudnov, Alexey; Guardiancich, Igor; Marimon, Ramon

2015-01-01

Postdoctoral programmes have recently become an important step leading from doctoral education to permanent academic careers in the social sciences. This paper investigates the effects of a large and structured postdoctoral programme in the social sciences on a number of academic and non-academic outcomes of fellows. Propensity score matching is…

A Nurse Prescribing Programme Incorporating e-Learning

ERIC Educational Resources Information Center

Burgess, Joan

2007-01-01

In order to become a UK Nurse Prescriber, a First Level Registered Nurse must undergo an approved University based educational programme, which consists of theory, and a period of practice supervised by doctors. The Nursing and Midwifery Council (NMC) requires nurses undertaking this programme to have some formal university attendance and to be…

Quality of doctoral nursing education in the United Kingdom: exploring the views of doctoral students and staff based on a cross-sectional questionnaire survey.

PubMed

McKenna, Hugh; Keeney, Sinead; Kim, Mi Ja; Park, Chang Gi

2014-07-01

To evaluate the quality of doctoral education in nursing in the United Kingdom. In recent decades, doctoral education programmes in nursing are increasing worldwide. There are many reasons for this and concerns have been raised regarding the quality of provision in and across countries. To date, the quality of doctoral education on a global level has not been reported in the literature. This United Kingdom study is part of a seven country investigation into the quality of doctoral education in nursing (Australia, Japan, Korea, South Africa, Thailand, United Kingdom and United States of America). A quantitative study using a cross-sectional comparative survey design. An online survey was administered to collect the views of doctoral students and staff members on four domains: programme, faculty/staff, resource and evaluation. The study was carried out between 2010-2012. In most cases, staff perceived these more positively than students and the differences in perception were often statistically significant. Interestingly, many students rated the quality of supervision as excellent, whereas no staff member rated supervision this highly. The crucial importance of resources was confirmed in the path analysis of the four Quality of Doctoral Nursing Education domains. This demonstrates that investment in resources is much more cost-effective than investment in the other domains in relation to improving the overall quality of doctoral education in nursing. This study has wide-ranging implications for how the quality of doctoral education is monitored and enhanced. © 2013 John Wiley & Sons Ltd.

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

PubMed

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

2008-08-01

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

The virtual continuity in learning programme: results.

PubMed

Wood, Eleanor; Tso, Simon

2012-08-01

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

Perceptions and Impact of Mandatory eLearning for Foundation Trainee Doctors: A Qualitative Evaluation

PubMed Central

Brooks, Hannah L.; Vallance, Hannah K.; Hirsch, Christine A.; Hughes, Elizabeth; Ferner, Robin E.; Marriott, John F.; Coleman, Jamie J.

2016-01-01

Background Junior doctors in the UK must complete various educational components during their two year Foundation training programme. It is important that mandatory learning is informative and engaging. The aim of this study was to evaluate trainee doctors’ perceptions of a Technology Enhanced Learning (TEL) programme developed to improve prescribing competency. Method Focus groups and interviews were conducted at three hospital sites in the West Midlands. Codes, sub-themes and themes were determined using deductive and inductive thematic analysis. Results Data were collected from 38 Foundation trainee doctors. Results revealed major themes relating to prescribing education, the user experience and user engagement. Key findings included the positive impact of preparedness following undergraduate education on the user experience of the TEL programme at the postgraduate level; the impact of content, structure, and individual learning needs and styles on the user experience; and the impact of motivation and time on engagement. Most trainees engaged with the programme owing to its mandatory nature; however, some trainees also used the programme voluntarily, for example, to acquire knowledge prior to starting a new placement. Conclusions It is important to ensure that learners are willing to engage with mandatory TEL, and that they have the time and motivation to do so. It is also important to ensure that learners have a positive user experience and that in designing TEL individual differences in learning styles and needs are taken into account. These findings have implications for educators and system developers in the construction and design of mandatory eLearning programmes. PMID:28005938

Contribution by primary health nurses and general practitioners to the Diabetes Annual Review (Get Checked) programme in Auckland, New Zealand.

PubMed

Daly, Barbara; Kenealy, Timothy; Arroll, Bruce; Sheridan, Nicolette; Scragg, Robert

2013-08-16

To describe primary health care (practice and specialist) nurses involvement in the government-funded annual diabetes review 'Get Checked' programme and the division of care between nurses and general practitioners in Auckland, New Zealand. Of the total 911 practice and specialist nurses identified and working in the greater Auckland region, 276 (30%) were randomly selected and invited to undertake a self-administered questionnaire and telephone interview in 2006-8. An 86% response rate was achieved. Over 60% of practice nurses and over half of specialist nurses participate in 'Get Checked' reviews. Of those nurses, 40% of practice and 70% specialist nurses, reported completing over half of the total number of 'Get Checked' reviews at their practice. Of the nurses sampled who work in general practice (n=198), 38% reported that 'nurses mostly complete' the reviews, 45% stated that 'nurses and doctors equally complete' them and 17% reported that only 'doctors' did so. For the nurses who reported that 'nurses and doctors equally complete' the reviews (n=89), most nurses undertake blood pressure measurements (90%), weigh patients (88%), give lifestyle advice (87%), examine patient's feet (73%), and 44% carried out the complete review of the patients they consult. These findings show the 'Get Checked' programme was successful in engaging practice and community-based specialist nurses in the community management of diabetes and has revealed positive relationships between nurses and doctors, extended roles for nurses and the importance of engaging nurses in the design of health care programmes.

Distributed Leadership and Research Degree Administration: Understanding the Role of a Good Programme Administrator for Professional Doctorate Programmes

ERIC Educational Resources Information Center

Hawkes, Denise; Johansson, Carol; McSweeney, Catherine

2017-01-01

Studies of the interaction between professional and academic staff in leadership in higher education institutions have focused on distributed leadership. Whilst such studies have considered the leadership of the whole university, aspects of this model also apply to the relationship between programme leaders and administrators. This paper aims to…

Development of family medicine in Ukraine.

PubMed

Kolesnyk, Pavlo; Švab, Igor

2013-12-01

This article includes a personal history of a family physician working in Ukraine. In June 2012, Pavlo Kolesnyk, Ukrainian Assistant Professor and a Family Doctor was awarded the second Montegute Scholar grant and had the chance to attend the Wonca Europe Conference 2012 in Vienna. In many developed countries, family medicine is already well established. In Ukraine, which has the legacy of a socialist health care system the implementation of the discipline started only at the end of the last century. The changes in the health care system were of greater importance in primary care and family medicine. It gave greater decentralization of the health care system and supported investment in primary care. This article describes the development of family medicine in undergraduate and postgraduate education. Whilst family medicine is officially a priority of health care policy, there is still a long process ahead. Family medicine needs financial support from the government and doctor's wages have to be increased, to prevent this branch of medicine being unpopular among graduating medical students.

Primary care reform: a pilot study to test the evaluative potential of the Patient Enablement Instrument in Poland.

PubMed

Pawlikowska, T R B; Nowak, P R; Szumilo-Grzesik, W; Walker, J J

2002-04-01

Primary health care reform is underpinned by a move towards patient-centred holistic care. This pilot study uses the Patient Enablement Instrument (PEI) to assess outcome at a fundamental level: that of the patient and their doctor at consultation. Our aim was to assess the evaluative potential of the PEI in relation to a reform programme in Poland by (i) comparing the outcomes of consultations (using the PEI) carried out by nine doctors (three diploma GPs who had participated in the training programme, three GPs who had not participated in the training programme and three polyclinic internists); and (ii) relating PEI scores to a proxy quality process measure (consultation length). A cross-sectional quantitative questionnaire survey was carried out using the PEI. The subjects were patients consulting with nine doctors distributed within a single region around Gdansk. The overall results with the PEI and consultation length reflected UK experience. In addition, there were significant differences between groups in this pilot study. Patients seen by diploma GPs achieved higher patient enablement scores (mean 4.33, 95% confidence interval 4.09-4.58) relative to GPs (mean 3.44, 3.21-3.67) and polyclinic doctors (mean 3.23, 2.99-3.47). However, there is evidence of appreciable between-doctor variation in PEI scores within groups. The difference in patient enablement between groups was not affected by patient case mix, in contrast to the duration of consultation, which was. Holistically trained diploma GPs spent longer with patients with psychological problems. Patients seen by diploma GPs received longer consultations (mean 12.65 min, 95% confidence interval 12.18-13.13) relative to their colleagues (the GPs' mean was 10.11, 9.82-10.41 min; that of the polyclinic internists was 10.16, 9.81-10.50 min). The duration of consultation was positively correlated with patient enablement. The results of such training courses should be examined from the perspective of both the patient and their doctor. Significant differences were found in both patient enablement and consultation length between patients attending groups of doctors delivering primary care, but working from different paradigms. This pilot shows promising results which, if repeated in a larger study, would provide an objective means of evaluating such reform programmes.

Reducing the blame culture through clinical audit in nuclear medicine: a mixed methods study.

PubMed

Ross, P; Hubert, J; Wong, W L

2017-02-01

To identify the barriers and facilitators of doctors' engagement with clinical audit and to explore how and why these factors influenced doctors' decisions to engage with the NHS National Clinical Audit Programme. A single-embedded case study. Mixed methods sequential approach with explorative pilot study and follow-up survey. Pilot study comprised 13 semi-structured interviews with purposefully selected consultant doctors over a six-month period. Interview data coded and analysed using directed thematic content analysis with themes compared against the study's propositions. Themes derived from the pilot study informed the online survey question items. Exploratory factor analysis using STATA and descriptive statistical methods applied to summarise findings. Data triangulation techniques used to corroborate and validate findings across the different methodological techniques. NHS National PET-CT Clinical Audit Programme. Doctors reporting on the Audit Programme. Extent of engagement with clinical audit, factors that influence engagement with clinical audit. Online survey: 58/59 doctors responded (98.3%). Audit was found to be initially threatening (79%); audit was reassuring (85%); audit helped validate professional competence (93%); participation in audit improved reporting skills (76%). Three key factors accounted for 97.6% of the variance in survey responses: (1) perception of audit's usefulness, (2) a common purpose, (3) a supportive blame free culture of trust. Factor 1 influenced medical engagement most. The study documents performance feedback as a key facilitator of medical engagement with clinical audit. It found that medical engagement with clinical audit was associated with reduced levels of professional anxiety and higher levels of perceived self-efficacy.

Developing Critical Reflection in Professional Focused Doctorates: A Facilitator's Perspective

ERIC Educational Resources Information Center

Sambrook, Sally; Stewart, Jim

2008-01-01

Purpose: This paper aims to explore the challenges and opportunities for expediting critical reflection in management education and development to highlight particularly how critical reflection has been facilitated within the context of a professionally focused doctoral programme. Design/methodology/approach: The paper draws on empirical research…

From Being a Nurse to Becoming a "Different" Doctor

ERIC Educational Resources Information Center

McLean, Michelle

2017-01-01

Using interpretative phenomenological analysis to make meaning of the experiences of three highly qualified registered nurses who had enrolled in an undergraduate medical programme, this study provides insight into their personal journeys of wanting to become "different" doctors. In so doing, they conceptualised their future selves as…

Reframing European Doctoral Training for the New ERA

ERIC Educational Resources Information Center

Repeckaite, Daiva

2016-01-01

In 2014 the institutionalization of European higher education and training, as well as research and innovation, policy entered a new phase: a number of financial instruments were simplified and merged. The Erasmus Mundus programme, wherein consortia of European and overseas universities built joint master's or doctoral degrees, was split into two…

How safe are HEMS-programmes in Germany? A retrospective analysis.

PubMed

Thies, Karl-Christian; Sep, Daan; Derksen, Remon

2006-03-01

Recent accidents with helicopter emergency medical service (HEMS) aircraft raise the question how safe HEMS in Germany is and how accidents could be prevented. We surveyed all German HEMS-programmes and reviewed the data of the German Aviation Authority regarding accidents with HEMS. An average German HEMS-programme encounters one accident leading to at least severe damage or loss of the helicopter in 26 operating years, one accident resulting in casualties in 65 operating years and one fatal accident in 111 operating years. The major causes of accidents were obstacle strikes during landing at the scene. Flying in bad weather conditions and lack of discipline were other factors contributing to HEMS-accidents. HEMS-safety could be improved by special training programmes for pilots and HEMS-crewmembers to address the factors listed above. Safety training for doctors is recommended but we did not find support for the notion of changing the doctor's legal position of a passenger to a HEMS-crewmember.

Appropriate training and retention of community doctors in rural areas: a case study from Mali.

PubMed

Van Dormael, Monique; Dugas, Sylvie; Kone, Yacouba; Coulibaly, Seydou; Sy, Mansour; Marchal, Bruno; Desplats, Dominique

2008-11-18

While attraction of doctors to rural settings is increasing in Mali, there is concern for their retention. An orientation course for young practicing rural doctors was set up in 2003 by a professional association and a NGO. The underlying assumption was that rurally relevant training would strengthen doctors' competences and self-confidence, improve job satisfaction, and consequently contribute to retention. Programme evaluation distinguished trainees' opinions, competences and behaviour. Data were collected through participant observation, group discussions, satisfaction questionnaires, a monitoring tool of learning progress, and follow up visits. Retention was assessed for all 65 trainees between 2003 and 2007. The programme consisted of four classroom modules--clinical skills, community health, practice management and communication skills--and a practicum supervised by an experienced rural doctor. Out of the 65 trained doctors between 2003 and 2007, 55 were still engaged in rural practice end of 2007, suggesting high retention for the Malian context. Participants viewed the training as crucial to face technical and social problems related to rural practice. Discussing professional experience with senior rural doctors contributed to socialisation to novel professional roles. Mechanisms underlying training effects on retention include increased self confidence, self esteem as rural doctor, and sense of belonging to a professional group sharing a common professional identity. Retention can however not be attributed solely to the training intervention, as rural doctors benefit from other incentives and support mechanisms (follow up visits, continuing training, mentoring...) affecting job satisfaction. Training increasing self confidence and self esteem of rural practitioners may contribute to retention of skilled professionals in rural areas. While reorientations of curricula in training institutions are necessary, other types of professional support are needed. This experience suggests that professional associations dedicated to strengthening quality of care can contribute significantly to rural practitioners' morale.

Doctor pharmaceutical utilization behaviour changed by the global budget programme strategies on hypertensive outpatient prescription.

PubMed

Wei, Ching-Kuo; Wang, Shun-Mu; Yeh, Ming-Kung

2012-04-01

This study was to examine changes in doctor pharmaceutical utilization behaviour in response to Taiwan's newly implemented National Health Insurance individual hospital global budget (GB) programme and the changes in health care costs and prescription trends for hypertensive (HT) patients. We analysed hospital outpatient prescription utilization with a pre-post individual hospital GB group and comparison group (the hospitals who did not join the programme) to evaluate the impact of GB strategies on hypertensive expenditure. Descriptive analyses were performed based on the average daily medication expenditure for each prescription, and average number of items per prescription. This study reviewed 16,770,057 outpatient records and prescription records of 213,568 hypertensive patients. The average total medication expense (+17.6%), HT medication expense (+8.8%), daily medication expense (+16.3%), and daily HT medication expense (+6.3%) significantly increased after the action. After the individual hospital GB action, hospital doctors participating in action switched their patients' prescription drugs to other less expensive drugs such as rennin-angiotensin-aldosterone system inhibitors (-1.1%). The increase in volume of medications prescribed for control group were significantly larger for both alfa- and beta-adrenergic blocking agents (1.5%), and calcium channel blocking agents (3.9%). The individual hospital GB programme slowed down the trend of prescription drug cost increasing rate and reduced the prescription drug volume in hospitals. © 2010 Blackwell Publishing Ltd.

Transcendence, religion and spirituality in medicine: Medical students' point of view.

PubMed

Rassoulian, Anahita; Seidman, Charles; Löffler-Stastka, Henriette

2016-09-01

To explore how medical students-the doctors of tomorrow-reflect upon meeting the spiritual needs of their patients, and whether they have reflected on their own religious or spiritual beliefs, or not. The study also investigates to what extent the students feel comfortable with addressing spiritual issues in their patient care, and whether they feel this is beyond their role as medical doctors.A self-administered questionnaire was developed. The survey was administered in teaching classes at the medical university of Vienna. One thousand four hundred (836 women and 564 men) students responded, laying the foundation for a thorough statistical analysis.59.5% of the students had reflected on their own belief concepts, 21.9% consider themselves religious, and 20.1% see themselves as spiritual individuals. 75.6% of the students agreed with the statement that religious conviction/spirituality might have an effect on how cancer patients cope. 85.9% would consider talking with their patients about religious/spiritual issues if patients wish to do so. 86.3% would involve chaplains if they feel it is necessary.The results of this study suggest that future doctors want to see the patient in a wider scope than the bio-psycho-social one, by including the meta-dimension of transcendence.

Ada Dual-Use Summary: Ada Dual-Use Workshop Held in Vienna, Virginia on October 19-20, 1993. Ada Dual-Use Committee Briefing, November 8, 1993

DTIC Science & Technology

1993-11-29

Certification: Initial Continuing Fund Experimentatlonal Research: Same Design , Implement In Ada, C, C++ Same Problem, Develop With Multiple Methodologies ...allowing analysts ( non programmers) to ’parit’ specifications for screens, reports, databases and etc 2) generating from design specifications 75% of...before the non -defense sector did and designed a tool to tackle the problem. DOD tested the tool and it worked. But DOD hasn’t put Ada to work in a

Developing and Implementing an Online Doctoral Programme

ERIC Educational Resources Information Center

Combe, Colin

2005-01-01

Purpose: This article is a critical reflection of the development and implementation of one of the first online doctoral programs in the UK set up at the University of Northumbria, Newcastle in 2000. Design/methodology/approach: The method adopted for analysis takes the form of a case study. Findings: Effective market research has to be undertaken…

From Student to Graduate: Four Learners' Perspectives of the Professional Doctorate Journey

ERIC Educational Resources Information Center

Goodall, Helen J.; Huggins, Valerie A.; Webber, Louise A.; Wickett, Karen L.

2017-01-01

This paper presents a consideration of the experiences and perspectives of four female academics who are the first graduates of a new Professional Doctorate programme at a university in the South West of England. The authors position themselves simultaneously as researchers and research participants, engaging in collaborative autoethnography to…

Learning through Inter- and Intradisciplinary Problem Solving: Using Cognitive Apprenticeship to Analyse Doctor-to-Doctor Consultation

ERIC Educational Resources Information Center

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

2012-01-01

Today's healthcare can be characterised by the increasing importance of specialisation that requires cooperation across disciplines and specialities. In view of the number of educational programmes for interdisciplinary cooperation, surprisingly little is known on how learning arises from interdisciplinary work. In order to analyse the learning…

Professional Doctorates: A Pathway to Legitimacy for Non-Academic HE Professionals?

ERIC Educational Resources Information Center

Moran, Eamonn; Misra, Debananda

2018-01-01

This article discusses the current challenges faced by the two authors--both participants on a professional doctorate (PD) programme in education at a leading UK university--in gaining legitimacy as higher education (HE) professionals. By: (1) reflecting upon their own professional experiences in HE and as PD students; (2) utilizing…

A Systematic Review of Research on Professional Doctorates

ERIC Educational Resources Information Center

Hawkes, Denise; Yerrabati, Sridevi

2018-01-01

Alongside the growing numbers of professional doctorate programmes being offered within universities in the past 20 years, there has been a growth in the academic literature associated with various aspects of these research degrees. This systematic literature review draws on the evidence of 193 academic papers to map out the existing academic…

Transdisciplinary Qualities in Practice Doctorates

ERIC Educational Resources Information Center

Costley, Carol; Pizzolato, Nicola

2018-01-01

Doctoral programmes in which candidates research their own practice can be characterised as having transdisciplinary (TD) qualities. While most of the emphasis in the literature and in policy on TD is on research in teams, we argue for an expansion of the scope in the conception and understanding of TD research to include the way it can be…

Teachers Pursuing a Doctoral Degree: Motivations and Perceived Impact

ERIC Educational Resources Information Center

Kowalczuk-Waledziak, Marta; Lopes, Amélia; Menezes, Isabel; Tormenta, Nuna

2017-01-01

Background and purpose: In recent years, there has been a growth in international studies about the impact of different types of professional development programmes for teachers. However, few studies have directly addressed the role of higher research degrees, such as a doctorate, as a strategy for teachers' professional development, and even…

Do higher salaries lower physician migration?

PubMed

Okeke, Edward N

2014-08-01

It is believed that low wages are an important reason why doctors and nurses in developing countries migrate, and this has led to a call for higher wages for health professionals in developing countries. In this paper, we provide some of the first estimates of the impact of raising health workers' salaries on migration. Using aggregate panel data on the stock of foreign doctors in 16 Organization for Economic Cooperation and Development countries, we explore the effect of a wage increase programme in Ghana on physician migration. We find evidence that 6 years after the implementation of this programme, the foreign stock of Ghanaian doctors abroad had fallen by approximately 10% relative to the estimated counterfactual. This result should be interpreted with caution, however, given the sensitivity of the results to changes in model specification. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

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

PubMed Central

Pearson, Emma; Gibson, Jonathan; Checkland, Kath

2017-01-01

Objectives This study draws on an in-depth investigation of factors that influenced the career decisions of junior doctors. Setting Junior doctors in the UK can choose to enter specialty training (ST) programmes within 2 years of becoming doctors. Their specialty choices contribute to shaping the balance of the future medical workforce, with views on general practice (GP) careers of particular interest because of current recruitment difficulties. This paper examines how experiences of medical work and perceptions about specialty training shape junior doctors’ career decisions. Participants Twenty doctors in the second year of a Foundation Training Programme in England were recruited. Purposive sampling was used to achieve a diverse sample from respondents to an online survey. Results Narrative interviewing techniques encouraged doctors to reflect on how experiences during medical school and in medical workplaces had influenced their preferences and perceptions of different specialties. They also spoke about personal aspirations, work priorities and their wider future. Junior doctors’ decisions were informed by knowledge about the requirements of ST programmes and direct observation of the pressures under which ST doctors worked. When they encountered negative attitudes towards a specialty they had intended to choose, some became defensive while others kept silent. Achievement of an acceptable work-life balance was a central objective that could override other preferences. Events linked with specific specialties influenced doctors’ attitudes towards them. For example, findings confirmed that while early, positive experiences of GP work could increase its attractiveness, negative experiences in GP settings had the opposite effect. Conclusions Junior doctors’ preferences and perceptions about medical work are influenced by multiple intrinsic and extrinsic factors and experiences. This paper highlights the importance of understanding how perceptions are formed and preferences are developed, as a basis for generating learning and working environments that nurture students and motivate their professional careers. PMID:29074517

The Southeast Scotland Foundation Doctor Teaching Programme--is "near-peer" teaching feasible, efficacious and sustainable on a regional scale?

PubMed

Rodrigues, Jeremy; Sengupta, Anshuman; Mitchell, Alana; Kane, Christopher; Kane, Clare; Maxwell, Simon; Cameron, Helen; Ross, Michael; Ford, Michael

2009-02-01

Peer-assisted learning has advantages for students and tutors. We aimed to establish a novel 'near-peer' teaching scheme delivered by junior doctors for final-year medical students in Southeast Scotland. We report feedback from students regarding the perceived utility of this scheme, the results of a randomized controlled trial (RCT) of its impact, and mechanisms for quality assurance and sustainability. The scheme was devised by newly qualified doctors. Following open recruitment and tutor training, junior doctor-led sessions were provided on clinical examination and practical prescribing in 2006-2008. Feedback was sought using anonymized questionnaires. An RCT was performed to assess the effect of attendance at a prescribing tutorial on performance in a mock assessment. Of 271 students in 2006-2007, 234 (86%) completed voluntary feedback and 233 (99%) expressed interest in attending more tutorials. In the RCT, students who received a tutorial made fewer dosing errors (9 vs. 22, p = 0.049). The majority of tutors attending the training symposium felt the experience was useful and helped prepare them for teaching. 'Near-peer' teaching is a popular adjunct to the undergraduate programme and may promote junior doctors' professional development. Such schemes can be devised and delivered by juniors in conjunction with university staff.

Understanding how appraisal of doctors produces its effects: a realist review protocol.

PubMed

Brennan, Nicola; Bryce, Marie; Pearson, Mark; Wong, Geoff; Cooper, Chris; Archer, Julian

2014-06-23

UK doctors are now required to participate in revalidation to maintain their licence to practise. Appraisal is a fundamental component of revalidation. However, objective evidence of appraisal changing doctors' behaviour and directly resulting in improved patient care is limited. In particular, it is not clear how the process of appraisal is supposed to change doctors' behaviour and improve clinical performance. The aim of this research is to understand how and why appraisal of doctors is supposed to produce its effect. Realist review is a theory-driven interpretive approach to evidence synthesis. It applies realist logic of inquiry to produce an explanatory analysis of an intervention that is, what works, for whom, in what circumstances, in what respects. Using a realist review approach, an initial programme theory of appraisal will be developed by consulting with key stakeholders in doctors' appraisal in expert panels (ethical approval is not required), and by searching the literature to identify relevant existing theories. The search strategy will have a number of phases including a combination of: (1) electronic database searching, for example, EMBASE, MEDLINE, the Cochrane Library, ASSIA, (2) 'cited by' articles search, (3) citation searching, (4) contacting authors and (5) grey literature searching. The search for evidence will be iteratively extended and refocused as the review progresses. Studies will be included based on their ability to provide data that enable testing of the programme theory. Data extraction will be conducted, for example, by note taking and annotation at different review stages as is consistent with the realist approach. The evidence will be synthesised using realist logic to interrogate the final programme theory of the impact of appraisal on doctors' performance. The synthesis results will be written up according to RAMESES guidelines and disseminated through peer-reviewed publication and presentations. The protocol is registered with PROSPERO 2014:CRD42014007092. 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.

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

ERIC Educational Resources Information Center

Walker, Jude; Yoon, EeSeul

2017-01-01

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

Faculty Best Practices to Support Students in the "Virtual Doctoral Land"

ERIC Educational Resources Information Center

Deshpande, Anant

2017-01-01

Online students face numerous challenges in successfully completing doctoral programmes. The aim of this article is to explore the best practices that can be employed by faculty to support students in achieving this. It also seeks to categorize and identify the best practices emerging from literature into themes. An exploratory research method was…

Becoming an Interdisciplinary Scientist: An Analysis of Students' Experiences in Three Computer Science Doctoral Programmes

ERIC Educational Resources Information Center

Calatrava Moreno, María del Carmen; Danowitz, Mary Ann

2016-01-01

The aim of this study was to identify how and why doctoral students do interdisciplinary research. A mixed-methods approach utilising bibliometric analysis of the publications of 195 students identified those who had published interdisciplinary research. This objective measurement of the interdisciplinarity, applying the Rao-Stirling index to Web…

Peer mentoring: evaluation of a novel programme in paediatrics

PubMed Central

Eisen, Sarah; Sukhani, Seema; Brightwell, Alex; Stoneham, Sara; Long, Andrew

2014-01-01

Background Mentoring is important for personal and professional development of doctors. Peer mentoring is a core skill in the UK paediatric postgraduate curriculum. However, there is a paucity of peer mentoring programmes aimed at postgraduate doctors in training (postgraduate trainees), and there are no such schemes within paediatrics described in the literature. We developed a regional peer mentoring programme for postgraduate trainees in paediatrics to assess demand and need for peer mentoring and to explore the benefits for both peer mentees and mentors. Programme design Junior postgraduate trainees, randomly selected from volunteers, received peer mentoring from more senior trainees for 1 year. Peer mentors were selected by competitive application and undertook tailored training followed by an experiential learning programme. The programme was evaluated using structured questionnaires. Results 90% (76/84) of first-year postgraduate trainees in paediatrics applied to participate, demonstrating high demand. 18 peer mentor–mentee pairs were matched. Peer mentors and mentees reported high satisfaction rates, acquisition of new and transferable skills and changed behaviours. All peer mentors intended to use the skills in their workplace and, later, as an educational supervisor. Conclusions Our programme represents a novel approach to meeting the demonstrated demand and the curriculum requirement for peer mentoring, and enabled peer mentors and mentees to develop a valuable and versatile skill set. To our knowledge, it is the first such programme in paediatrics and provides a feasibility model that may be adapted locally to allow education providers to offer this important experience to postgraduate trainees. PMID:24152570

The Work of Scholars: An Institutional Ethnography of a McNair Scholars' Class

ERIC Educational Resources Information Center

Vaughan, Terry, III

2017-01-01

The McNair Scholars Program continues to be pivotal towards increasing diversity within graduate schools in the USA, particularly within doctoral programmes. The programme provides underrepresented undergraduate students with opportunities to learn about research and applying to graduate schools, which otherwise might not be available for these…

Integrating mental health into primary care in Sverdlovsk

PubMed Central

2009-01-01

Introduction Mental disorders occur as frequently in Russia as elsewhere, but the common mental disorders, especially depression, have gone largely unrecognised and undiagnosed by policlinic staff and area doctors. Methods This paper describes the impact and sustainability of a multi-component programme to facilitate the integration of mental health into primary care, by situation appraisal, policy dialogue, development of educational materials, provision of a training programme and the publication of standards and good practice guidelines to improve the primary care of mental disorders in the Sverdlovsk region of the Russian Federation. Results The multi-component programme has resulted in sustainable training about common mental disorders, not only of family doctors but also of other cadres and levels of professionals, and it has been well integrated with Sverdlovsk's overall programme of health sector reforms. Conclusion It is possible to facilitate the sustainable integration of mental health into primary care within the Russian context. While careful adaptation will be needed, the approach adopted here may also hold useful lessons for policy makers seeking to integrate mental health within primary care in other contexts and settings. PMID:22477885

Pensive Professionalism: The Role of 'Required Reflection' on a Professional Doctorate

ERIC Educational Resources Information Center

Cunningham, Bryan

2018-01-01

This short paper examines the origins and nature of the reflective writing that is presently required on one part-taught doctorate in education (EdD) programme. It explores the various ways in which EdD candidates have engaged with self-reflection, using a number of extracts from writing submitted for formal assessments (including of the doctoral…

Intercultural PhD Supervision: Exploring the Hidden Curriculum in a Social Science Faculty Doctoral Programme

ERIC Educational Resources Information Center

Kidman, Joanna; Manathunga, Catherine; Cornforth, Sue

2017-01-01

International knowledge markets rely heavily on a ready supply of highly mobile doctoral students, many of whom are from the global South, to bring in revenue. The supervision of these PhD students, however, can reproduce neo-colonial knowledge relations, often in subtle ways. In settler nations, international PhD students may find that they are…

A model for integrating strategic planning and competence-based curriculum design in establishing a public health programme: the UNC Charlotte experience.

PubMed

Thompson, Michael E; Harver, Andrew; Eure, Marquis

2009-08-11

The University of North Carolina at Charlotte, a doctoral/research-intensive university, is the largest institution of higher education in the Charlotte region. The university currently offers 18 doctoral, 62 master's and 90 baccalaureate programmes. Fall 2008 enrolment exceeded 23,300 students, including more than 4900 graduate students. The university's Department of Health Behavior and Administration was established on 1 July 2002 as part of a transformed College of Health & Human Services. In 2003, the Department initiated a series of stakeholder activities as part of its strategic planning and programmatic realignment efforts. The Department followed an empirically derived top-down/bottom-up strategic planning process that fostered community engagement and coordination of efforts across institutional levels. This process culminated in a vision to transform the unit into a Council on Education for Public Health accredited programme in public health and, eventually, an accredited school of public health. To date, the Department has revised its Master of Science in health promotion into an Master of Science in Public Health programme, renamed itself the Department of Public Health Sciences, launched a Bachelor of Science in Public Health major, laid plans for a doctoral programme, and received accreditation from the Council on Education for Public Health as a public health programme. Furthermore, the campus has endorsed the programme's growth into a school of public health as one of its priorities. It is only through this rigorous and cyclical process of determining what society needs, designing a curriculum specifically to prepare graduates to meet those needs, ensuring that those graduates meet those needs, and reassessing society's needs that we can continue to advance the profession and ensure the public's health. Community stakeholders should be active contributors to programme innovation. Lessons learnt from this process include: being connected to your community and knowing its needs, being responsive to your community, remembering that process is as important as product, and preparing for success. The efforts reported here can be informative to other institutions by exemplifying an integrated top-down/bottom-up process of strategic planning that ensures that a department's degree programmes meet current needs and that students graduate with the competences to address those needs.

Peer mentoring: evaluation of a novel programme in paediatrics.

PubMed

Eisen, Sarah; Sukhani, Seema; Brightwell, Alex; Stoneham, Sara; Long, Andrew

2014-02-01

Mentoring is important for personal and professional development of doctors. Peer mentoring is a core skill in the UK paediatric postgraduate curriculum. However, there is a paucity of peer mentoring programmes aimed at postgraduate doctors in training (postgraduate trainees), and there are no such schemes within paediatrics described in the literature. We developed a regional peer mentoring programme for postgraduate trainees in paediatrics to assess demand and need for peer mentoring and to explore the benefits for both peer mentees and mentors. Junior postgraduate trainees, randomly selected from volunteers, received peer mentoring from more senior trainees for 1 year. Peer mentors were selected by competitive application and undertook tailored training followed by an experiential learning programme. The programme was evaluated using structured questionnaires. 90% (76/84) of first-year postgraduate trainees in paediatrics applied to participate, demonstrating high demand. 18 peer mentor-mentee pairs were matched. Peer mentors and mentees reported high satisfaction rates, acquisition of new and transferable skills and changed behaviours. All peer mentors intended to use the skills in their workplace and, later, as an educational supervisor. Our programme represents a novel approach to meeting the demonstrated demand and the curriculum requirement for peer mentoring, and enabled peer mentors and mentees to develop a valuable and versatile skill set. To our knowledge, it is the first such programme in paediatrics and provides a feasibility model that may be adapted locally to allow education providers to offer this important experience to postgraduate trainees.

How do national cultures influence lay people's preferences toward doctors' style of communication? A comparison of 35 focus groups from an European cross national research.

PubMed

Rimondini, Michela; Mazzi, Maria Angela; Deveugele, Myriam; Bensing, Jozien M

2015-12-14

The evidence that inspires and fosters communication skills, teaching programmes and clinical recommendations are often based on national studies which assume, implicitly, that patients' preferences towards doctors' communication style are not significantly affected by their cultural background. The cross-cultural validity of national results has been recognized as a potential limitation on how generally applicable they are in a wider context. Using 35 country-specific focus group discussions from four European countries, the aim of the present study is to test whether or not national cultures influence lay people's preferences towards doctors' style of communication. Lay people preferences on doctor's communication style have been collected in Belgium, the Netherlands, the United Kingdom and Italy. Each centre organized between eight and nine focus groups, where participants (n = 259) were asked to comment on a video of a simulated medical interview. The discussions were audiotaped, transcribed and coded using a common framework (Guliver Coding System) that allowed for the identification of different themes. The frequency distribution of the topics discussed highlights lay people's generally positive views towards most part of doctors interventions. The regression model applied to the Guliver categories highlighted slight national differences and the existence of a cross-cultural appreciation, in particular, of five types of intervention: Doctors attitudes (both Task-Oriented and Affective/Emotional), Summarizing, Structuring and Providing solution. Lay panels valued doctors' communication style in a similar manner in the countries selected. This highlights the existence of a common background, which in the process of internationalization of heath care, might foster the implementation of cross-national teaching programmes and clinical guidelines.

Leading the Flying Faculty: What Do Leaders of Doctoral Programmes Need to Know?

ERIC Educational Resources Information Center

Poultney, Val

2017-01-01

This article employs a reflexive methodology to critically examine the opportunities and challenges raised for a leader of a UK EdD programme when the home institution undertakes short periods of intensive teaching abroad--a model known as "flying faculty". The University of Derby had, until 2010-11, a large institutional partnership…

The Impact of Institutional Student Support on Graduation Rates in US Ph.D. Programmes

ERIC Educational Resources Information Center

Bolli, Thomas; Agasisti, Tommaso; Johnes, Geraint

2015-01-01

Using National Research Council data, we investigate the determinants of graduation rates in US Ph.D. programmes. We emphasise the impact that support and facilities offered to doctoral students have on completion rates. Significant, strong and positive effects are found for the provision of on-site graduate conferences and dedicated workspace,…

Medical implications of employee assistance programmes.

PubMed

Lloyd, G G; Doyle, Y; Grange, C

1999-04-01

The development of employee assistance programmes (EAPs) has significant implications for doctors, especially general practitioners and psychiatrists. This paper discusses the importance of training counsellors to detect serious psychological disorders among people who use an EAP service and the need for clinicians to accept referrals of those users who are identified as being in need of further medical treatment.

Impressions of Action and Critical Action Learning: Exploring the Leadership Development of Senior Doctors in an English Healthcare Organization

ERIC Educational Resources Information Center

McCray, Janet; Warwick, Rob; Palmer, Adam

2018-01-01

This paper aims to explore the influence of one cycle of a learning set experience in a postgraduate medical leadership development programme. It does so from two perspectives: first, from the self-reports of nine senior doctors working in leadership roles in England in the National Health Service; and second from a researcher perspective as we…

Effects of two educational programmes aimed at improving the utilization of non-opioid analgesics in family medicine clinics in Mexico.

PubMed

Doubova, Svetlana Vladislavovna; Mino-León, Dolores; Reyes-Morales, Hortensia; Flores-Hernandez, Sergio; Torres-Arreola, Laura del Pilar; Pérez-Cuevas, Ricardo

2010-08-01

To develop and test two educational programmes (interactive and passive) aimed at improving family doctors' (FD) prescribing practices and patient's knowledge and use of non-opioid analgesics (NOA). The educational programmes were conducted in two family medicine clinics by using a three-stage approach: baseline evaluation, design, and implementation of educational activities, and post-programme evaluation. An interactive educational programme (IEP) was compared with a passive educational programme (PEP); both were participated by FDs and patients. The IEP for FDs comprised of workshops, discussion groups, in-service training and guidelines, while for patients the IEP consisted of an interactive session with a video, leaflets and a discussion. The PEP consisted in delivering the guidelines to the FDs and the leaflets to patients. The effect of the programmes on the FDs was measured through the appropriateness of prescriptions and analysed using the differences-in-differences estimator (D-in-D), and on patients through changes in self-medication and in their knowledge about the proper use and adverse events by analysing the inter- and intra-group differences before and after the programmes. The IEP obtained better results to improve appropriate FDs prescription of NOA than PEP (D-in-D = 15%). Regarding the patients, the PEP group reached higher reduction of self-medication than the IEP group (13.4% vs. 9.1%); the knowledge of proper NOA use increased by 8.5% in both groups, whereas knowledge of NOA-related adverse events was better in the IEP (39.6%) than in the PEP group (9.2%). The IEP was better to improve the doctors' abilities to prescribe NOAs, and both programmes improved patients' knowledge.

Choose your doctorate.

PubMed

Jolley, Jeremy

2007-02-01

The development of education options for nurses has been inexorable and it is increasingly the case that senior nurses are considering a doctorate as the logical next step in their educational career. Such individuals need to make important decisions as to whether they should embark on a taught doctorate, professional doctorate or a traditional PhD. Each of these options will necessitate a considerable investment in time and money as well as the sacrifice of quality time and spare time over a significant number of years. A doctorate is not for everyone. Those still reading this text may be asking 'could this possibly be for me'? This paper will try to help the reader decide which if any option to take. It is suggested that nurses will now turn to the doctoral degree as their next adventure in academic study. It is argued that this development is not being controlled by management forces and indeed cannot be controlled by them. This last is chiefly because the move towards doctoral education is led by individuals who choose to study for a doctorate simply because they can. The paper considers what choices are available to nurses who wish to pursue a doctoral programme of study. In particular, this paper considers what new developments in doctoral courses are becoming available and what advantage there may be in studying for one of the newer professional doctorates rather than a traditional PhD. The material here is the result of a review of the literature on recent developments in doctoral education for nurses. The existing provision by UK and other universities was also reviewed, the data being collected by an informal review of universities' advertising material. It is inevitable that some nurses who are already qualified to degree and masters degree will take advantage of the doctoral degree opportunities which now newly present themselves. For nurses in practice, the advantages of the professional doctorate is that it is more structured, enables more peer and academic support and is more practice orientated. It is suggested that the move towards doctoral programmes for nurses will present one of the most important evolutionary changes in the practice of nursing. It is suggested that doctoral education for nurses will increase in prevalence and that this process of change is already underway. Doctoral education will provide practitioners with the experience and skills required to conduct research and further develop practice. For individual practitioners, doctoral education will enhance self-confidence in an increasingly technical and complex arena and in a practice discipline that is becoming ever more politically charged. The professional doctorate appears to be particularly suited to senior nurse practitioners. What remains is for us to accept this new challenge and to shape its development for the benefit of the practice of nursing.

A cross sectional study on the motivators for Asian women to attend opportunistic mammography screening in a private hospital in Malaysia: the MyMammo study.

PubMed

Hassan, Norhashimah; Ho, Weang Kee; Mariapun, Shivaani; Teo, Soo Hwang

2015-06-12

To date, because of limited budgets and lower incidence of breast cancer, the majority of Asian countries do not have population-based screening programmes, but instead offer opportunistic screening. However, there have been few studies which have assessed the motivators for women attending such programmes and the appropriateness of the programmes in terms of targeting women at risk. We conducted a prospective cross-sectional study of 1,619 women aged 40 to 74 years attending a subsidized opportunistic screening mammogram from October 2011 to October 2013 at a private hospital in Malaysia. Breast cancer risk was estimated using the Gail Model and two-step cluster analysis was used to examine the motivators of attending screening. Although Malaysia comprises 54.5% Malay, 24.5% Chinese and 7.3% Indian, the majority of women in the MyMammo Study were Chinese (70.1%) and 99.2% had a <2% ten-year risk of breast cancer. The most commonly cited barriers were the perception of not being at risk and fear of painful mammography. We found that highly educated women, cited doctors, family and friends as their main motivators. Of those with only secondary school education, their main motivators were doctors. Taken together, our results suggest the women attending opportunistic mammography screening in Asia are at low risk of breast cancer and this poses challenges to cost-effective and equitable strategies for cancer control. We propose that to improve uptake of screening mammography, awareness programmes should target both doctors and members of the public.

An evaluation of UK foundation trainee doctors' learning behaviours in a technology-enhanced learning environment.

PubMed

Brooks, Hannah L; Pontefract, Sarah K; Hodson, James; Blackwell, Nicholas; Hughes, Elizabeth; Marriott, John F; Coleman, Jamie J

2016-05-03

Technology-Enhanced Learning (TEL) can be used to educate Foundation Programme trainee (F1 and F2) doctors. Despite the advantages of TEL, learning behaviours may be exhibited that are not desired by system developers or educators. The aim of this evaluation was to investigate how learner behaviours (e.g. time spent on task) were affected by temporal (e.g. time of year), module (e.g. word count), and individual (e.g. knowledge) factors for 16 mandatory TEL modules related to prescribing and therapeutics. Data were extracted from the SCRIPT e-Learning platform for first year Foundation trainee (F1) doctors in the Health Education England's West Midland region from 1(st) August 2013 to 5(th) August 2014. Generalised Estimating Equation models were used to examine the relationship between time taken to complete modules, date modules were completed, pre- and post-test scores, and module factors. Over the time period examined, 688 F1 doctors interacted with the 16 compulsory modules 10,255 times. The geometric mean time taken to complete a module was 28.9 min (95% Confidence Interval: 28.4-29.5) and 1,075 (10.5%) modules were completed in less than 10 min. In February and June (prior to F1 progression reviews) peaks occurred in the number of modules completed and troughs in the time taken. Most modules were completed, and the greatest amount of time was spent on the learning on a Sunday. More time was taken by those doctors with greater pre-test scores and those with larger improvements in test scores. Foundation trainees are exhibiting unintended learning behaviours in this TEL environment, which may be attributed to several factors. These findings can help guide future developments of this TEL programme and the integration of other TEL programmes into curricula by raising awareness of potential behavioural issues that may arise.

Dedication to Professor Hannspeter Winter (1941 2006): Dedication to Professor Hannspeter Winter (1941 2006)

NASA Astrophysics Data System (ADS)

McCullough, Bob

2007-03-01

Professor H Winter. It was with great sadness that we learnt of the death of colleague and friend Professor Hannspeter Winter in Vienna on the 8 November 2006. In memory of him and the contribution he made both to our conference and to the field of the physics of highly charged ions we dedicate these proceedings. Hannspeter was one of our distinguished invited speakers at HCI2006 and gave a talk on the status of the ITER programme. His invited paper on the subject is included in these proceedings. Hannspeter will be particularly remembered for his pioneering work on ion-surface interactions that, together with his colleagues at the Vienna University of Technology (TUW), has stimulated a worldwide experimental and theoretical interest in this field. He was appointed Director of the Institut fuer Allgemeine Physik at TUW in 1987 and using both his scientific and management skills has made it one of the leading university physics laboratories in the world. His research publications, of which there are 270, have inspired many others to work in the field of atomic and plasma physics. He was also a great European playing a major role in the EURATOM fusion programme, the European Physical Society and the International Union of Pure and Applied Physics and was an evaluator and advisory board member for many national and international institutions. Hannspeter was also an interesting and friendly social companion with interests in current affairs, music and fine wines and will be greatly missed both on a scientific and social level. Our condolences go to his wife Renate, son Dorian and his relatives. R W McCullough Co-chair HCI2006

The learning environment in professional doctorate and postgraduate dental education: a qualitative study.

PubMed

Subramanian, J; Thomson, W M

2017-11-01

Currently, there is a lack of studies focusing on professional doctoral students' and graduates' perceptions of their learning environment, in particular, using a qualitative approach to elicit in-depth information. This article aims to contribute to the existing body of knowledge by systematically exploring, critically analysing and getting a deeper understanding of professional doctorate dental students' and graduates' insights into effective and ineffective clinical and physical learning environment characteristics. The study included a total of 20 participants. Participants included 16 final-year Doctor of Clinical Dentistry (DClinDent) students and four dental specialists (graduates of the DClinDent programme). Semi-structured, individual interviews were used. Participants were asked to reflect upon and describe in detail their effective and ineffective learning environment experiences. The critical incident technique was used to guide the data collection. Data were analysed using a general inductive qualitative approach. Learning environment characteristics which participants associated with effective learning included the following: sufficient opportunities for comprehensive treatment planning; introduction to a number of patient treatment philosophies; a sufficient number of complex cases; clinically oriented research and assignment topics; a focus on clinical training in the programme generally; a research topic of a realistic depth and breadth, suitable for their 'specialist training' degree; and a well-resourced and updated physical infrastructure. On the other hand, most participants indicated that the absence of an adequate number of clinical cases, an overemphasis on research (as opposed to clinical practice) in the DClinDent programme and an 'outdated' physical infrastructure in the dental school clinics could hamper effective clinical learning. These findings contribute to the meaningful advancement of the literature on learning environment strategies through the exploration of (and in-depth qualitative insights into) what facilitated effective learning by New Zealand professional doctorate candidates and graduates. These findings provide a starting point for reflection by international academic directors, educational developers, curriculum planners, programme managers and clinical teachers in respect of the further development of the learning environment. Although the findings from this study may not be directly transferable to all international contexts, they have the potential to contribute to the further development of theory in this area. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PREFACE: EUCAS '05: The 7th European Conference on Applied Superconductivity (Vienna University of Technology, Austria, 11 15 September 2005)

NASA Astrophysics Data System (ADS)

Donaldson, Gordon; Weber, Harald W.; Sauerzopf, Franz M.

2006-03-01

This issue of Superconductor Science and Technology contains the plenary and invited papers presented at the 7th European Conference on Applied Superconductivity (EUCAS '05) that was held at the Vienna University of Technology from 11-15 September 2005. All those contributed papers that were submitted to the Conference Proceedings will be published in the Journal of Physics: Conference Series. The scientific aims of EUCAS '05 followed the tradition established at the preceding conferences in Göttingen, Edinburgh, Eindhoven, Sitges (Barcelona), Lyngby (Copenhagen) and finally Sorrento (Napoli). The focus was placed on the interplay between the most recent developments in superconductor research and the positioning of applications of superconductivity in the marketplace. Although initially founded as an exchange forum mainly for European scientists, it has gradually developed into a truly international meeting with significant attendance from the Far East and the United States. The Vienna conference attracted 813 participants in the scientific programme and 90 accompanying persons. 59% of all participants came from Europe, 31% from the Far East, 6% from the United States and Canada as well as 4% from other nations worldwide. 27 companies presented their latest developments in the field. 32 plenary and invited lectures highlighted the state-of-the-art in the areas of materials, large-scale as well as small-scale applications; 625 contributed papers (among them 556 posters) demonstrated the broad range of exciting activities in all research areas of our field. EUCAS '05 spread a lot of optimism and enthusiasm for this fascinating field of research and for its well established technological potential, especially among the numerous young researchers attending this conference. We are grateful to all those who participated in the meeting and contributed to its success.

Influencing sceptical staff to become supporters of service improvement: a qualitative study of doctors' and managers' views

PubMed Central

Gollop, R; Whitby, E; Buchanan, D; Ketley, D

2004-01-01

Objective: To explore scepticism and resistance towards changes in working practice designed to achieve service improvement. Two principal questions were studied: (1) why some people are sceptical or resistant towards improvement programmes and (2) what influences them to change their minds. Methods: Semi-structured qualitative interviews were conducted with 19 clinicians and 19 managers who held national and regional roles in two national programmes of service improvement within the NHS involving systematic organisational changes in working practices: the National Booking Programme and the Cancer Services Collaborative (now the Cancer Services Collaborative Improvement Partnership). Results: Scepticism and resistance exist in all staff groups, especially among medical staff. Reasons include personal reluctance to change, misunderstanding of the aims of improvement programmes, and a dislike of the methods by which programmes have been promoted. Sceptical staff can be influenced to become involved in improvement, but this usually takes time. Newly won support may be fragile, requiring ongoing evidence of benefits to be maintained. Conclusions: The support of health service staff, particularly doctors, is crucial to the spread and sustainability of the modernisation agenda. Scepticism and resistance are seen to hamper progress. Leaders of improvement initiatives need to recognise the impact of scepticism and resistance, and to consider ways in which staff can become positively engaged in change. PMID:15069217

The Framework of a Generic DProf Programme--A Reflection on Its Design, the Relational Dimension for Candidates and Advisers and the Potential for Knowledge Co-Creation

ERIC Educational Resources Information Center

Fillery-Travis, Annette Jayne

2014-01-01

This paper critically engages with the pedagogical design of a generic professional doctorate programme as a framework for creation of actionable knowledge within the practice of both adviser and candidate. Within this exploration the relational dimensions of the adviser-candidate interaction are identified and their potential impact partially…

Evaluative Study of M.A. Education Programmes of Teacher Education at Higher Education Level in Pakistan

ERIC Educational Resources Information Center

Fatima, Jabeen; Naseer Ud Din, Muhammad

2010-01-01

The study was aimed at evaluating the MA Education Programme of teacher education in Pakistan. Post-graduate teacher's training institutes in Pakistan grant the Master of Education (MA/M.Ed.), Master of Philosophy (M.Phil) and Doctor of Philosophy (Ph.D) post-graduate degrees in the field of education to enhance the careers and accelerate the…

Twenty years of home-based palliative care in Malappuram, Kerala, India: a descriptive study of patients and their care-givers.

PubMed

Philip, Rekha Rachel; Philip, Sairu; Tripathy, Jaya Prasad; Manima, Abdulla; Venables, Emilie

2018-02-14

The well lauded community-based palliative care programme of Kerala, India provides medical and social support, through home-based care, for patients with terminal illness and diseases requiring long-term support. There is, however, limited information on patient characteristics, caregivers and programme performance. This study was carried out to describe: i) the patients enrolled in the programme from 1996 to 2016 and their diagnosis, and ii) the care-giver characteristics and palliative care support from nurses and doctors in a cohort of patients registered during 2013-2015. A descriptive study was conducted in the oldest community-based palliative clinic in Kerala. Data were collected from annual patient registers from 1996 to 2016 and patient case records during the period 2013-2015. While 91% of the patients registered in the clinic in 1996 had cancer, its relative proportion came down to 32% in 2016 with the inclusion of dementia-related illness (19%) cardiovascular accidents (17%) and severe mental illness (5%).Among patients registered during 2013-15, the median number of home visits from nurses and doctors in 12 months were five and one respectively. In the same cohort, twelve months' post-enrolment, 56% of patients died, 30% were in continuing in active care and 7% opted out. Those who opted out of care were likely to be aged < 60 years, received one or less visit annually from a doctor or have a serious mental illness. 96% of patients had a care-giver at home, 85% of these care-givers being female. The changing dynamics over a 20-year period of this palliative care programme in Kerala, India, highlights the need for similar programmes to remain flexible and adapt their services in response to a growing global burden of Non Communicable Diseases. While a high death rate is expected in this population, the high proportion of patients choosing to stay in the programme suggests that home-based care is valued within this particular group. A diverse range of clinical and psycho-social support skills are required to assist families and their caregivers when caring for a cohort such as this one.

Scholarly work products of the doctor of nursing practice: one approach to evaluating scholarship, rigour, impact and quality.

PubMed

Terhaar, Mary F; Sylvia, Martha

2016-01-01

The aim of this investigation was to evaluate, monitor and manage the quality of projects conducted and work produced as evidence of scholarship upon completion of Doctor of Nursing Practice education. The Doctor of Nursing Practice is a relatively new degree which prepares nurses for high impact careers in diverse practice settings around the globe. Considerable variation characterises curricula across schools preparing Doctors of Nursing Practice. Accreditation assures curricula are focused on attainment of the Doctor of Nursing Practice essentials, yet outcomes have not been reported to help educators engage in programme improvement. This work has implications for nursing globally because translating strong evidence into practice is key to improving outcomes in direct care, leadership, management and education. The Doctor of Nursing Practice student learns to accomplish translation through the conduct of projects. Evaluating the rigour and results of these projects is essential to improving the quality, safety and efficacy of translation, improvements in care and overall system performance. A descriptive study was conducted to evaluate the scholarly products of Doctor of Nursing Practice education in one programme across four graduating classes. A total of 80 projects, conducted across the USA and around the globe, are described using a modification of the Uncertainty, Pace, Complexity Model. The per cent of students considered to have produced high quality work in relation to target expectations as well as the per cent that conducted means testing increased over the four study years. Evaluation of scope, complexity and rigour of scholarly work products has driven improvements in the curriculum and informed the work of faculty and advisors. Methods, evaluation and outcomes conformed around a set of expectations for scholarship and rigour have resulted in measurable outcomes, and quality publications have increased over time. © 2015 John Wiley & Sons Ltd.

Clinical leadership and pre-registration nursing programmes: A model for clinical leadership and a prospective curriculum implementation and evaluation research strategy.

PubMed

Brown, Angela; Dewing, Jan; Crookes, Patrick

2016-07-01

To present for wider debate a conceptual model for clinical leadership development in pre-registration nursing programmes and a proposed implementation plan. Globally, leadership in nursing has become a significant issue. Whilst there is continued support for leadership preparation in pre-registration nursing programmes, there have been very few published accounts of curriculum content and/or pedagogical approaches that foster clinical leadership development in pre-registration nursing. A doctoral research study has resulted in the creation of an overarching model for clinical leadership. A multi-method research study using theoretical and empirical literature 1974-2015, a focus group, expert opinion and a national on-line survey. A conceptual model of clinical leadership development in pre-registration nursing programme is presented, including the infinity loop of clinical leadership, an integral curriculum thread and a conceptual model: a curriculum-pedagogy nexus for clinical leadership. In order to test out usability and evaluate effectiveness, a multi method programme of research in one school of nursing in Australia is outlined. Implementation of the proposed conceptual model for clinical leadership development in pre-registration nursing programmes and a programme of (post-doctoral) research will contribute to what is known about curriculum content and pedagogy for nurse academics. Importantly, for nursing students and the profession as a whole, there is a clearer expectation of what clinical leadership might look like in the novice registered nurse. For nurse academics a model is offered for consideration in curriculum design and implementation with an evaluation strategy that could be replicated. Copyright © 2016 Elsevier Ltd. All rights reserved.

Training future doctors to be patient-centred: efficacy of a communication skills training (CST) programme in a Malaysian medical institution.

PubMed

Lukman, H; Beevi, Z; Yeap, R

2009-03-01

This study evaluates the efficacy of the preclinical communication skills training (CST) programme at the International Medical University in Malaysia. Efficacy indicators include students' (1) perceived competency (2) attitude (3) conceptual knowledge, and (4) performance with regard to patient-centred communication. A longitudinal study with a before-after design tracked a preclinical cohort's progress on the aforementioned indicators as they advance through the training. Results indicate that following the CST, students perceived themselves to be more competent in interpersonal communication, had more positive attitude towards patient-centred communication, and developed a better conceptual knowledge of doctor-patient communication. In addition, those with good conceptual knowledge tend to demonstrate better communication skills performance at the Objective Structure Clinical Examination 12 months following the initial CST.

Investing in learning and training refugee doctors.

PubMed

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

2010-06-01

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

Working better together: joint leadership development for doctors and managers.

PubMed

Kelly, Nicola

2014-01-01

Traditionally, there have been tensions between frontline healthcare professionals and managers, with well-known stereotypes of difficult consultants and pen-pushing managers. Many junior doctors have limited management experience and have often never even met a manager prior to taking on a consultant role. Based on a successful programme pioneered by Dr Robert Klaber (Imperial, London) we have set-up an innovative scheme for Birmingham Children's Hospital, pairing junior doctors and managers to learn and work together. Our aim was to cultivate positive attitudes and understanding between the two groups, break down inter-professional barriers, and to provide practical leadership experience and education. We recruited 60 managers and doctors to participate in shadowing, conversation, and quality improvement projects. Thought-provoking online materials, blogs, socials, and popular monthly workshops consisting of patient-focused debate and discussion around key leadership themes, have helped to support learning and cement shared values. Formal evaluation has demonstrated an improvement in how participants perceive their knowledge and ability based on key NHS Leadership Framework competencies. Participant feedback has been extremely positive, and everyone plans to continue to incorporate Paired Learning into their continuing professional development. We are now embedding Paired Learning in the on-going educational programme offered at Birmingham Children's Hospital, whilst looking at extending the scheme to include different professional groups and other trusts across the region and nationally.

Helping the healer: population-informed workplace wellness recommendations for physician well-being.

PubMed

Brooks, E; Early, S R; Gendel, M H; Miller, L; Gundersen, D C

2018-05-23

The need to keep physicians healthy and in practice is critical as demand for doctors grows faster than the supply. Workplace wellness programmes can improve employee health and retain skilled workers. To broaden our understanding about ways to help doctors coping with mental health problems and to develop population-informed workplace wellness recommendations for physician populations. Researchers surveyed physicians to document potential warning signs and prevention strategies. A survey was issued to doctors who presented to a physician health programme with mental health complaints. The survey captured respondents' feedback about how to identify and prevent mental health problems. Data were analyzed using simple descriptive statistics. There were 185 participants. Half of respondents believed their problems could have been recognized sooner and 60% said they exhibited signs that could aid in earlier detection. Potential warnings included fluctuations in mood (67%), increased comments about stress/burnout (49%) and behavioural changes (32%). To improve detection, prevention and care-seeking for mental health problems, doctors endorsed multiple items related to the use of interpersonal supports, personal factors and organizational dynamics throughout the survey. The findings confirmed earlier work demonstrating the value of social and organizational support in maintaining physician health. It further indicated that earlier identification and/or prevention of mental health problems is not only possible, but that medical organizations are uniquely situated to carry out this work.

Make induction day more effective - add a few problems.

PubMed

Mitchell, H E; Laidlaw, J M

1999-06-01

Induction courses are important to introduce Pre-Registration House Officers (PRHOs) to their new place of work. Traditionally, such programmes employ lectures, small group discussion and demonstrations. They let PRHOs meet members of various hospital disciplines and services. Since 1991, an interactive induction programme has been held each August for new PRHOs in the Eastern Region of Scotland taking up posts in Dundee Teaching Hospitals NHS Trust. Feedback from participants allows the course to be refined each year. In 1995, three paper-based patient management problems (PMPs) were included in the induction programme. Response was favourable. Most of the participants (82%) suggested the PMPs should be used again, but that more time should be allocated to enable them to tackle the problems. By August 1996, we aimed to provide a relevant and interactive programme that encouraged PRHOs to make immediate use of hospital resources. Two PMPs, in print format described likely case histories, with tasks that mirrored the junior doctors' forthcoming responsibilities. Healthcare team members and laboratory staff provided support as did study boards displaying written sheets of relevant clinical information. In the subsequent evaluation, the PMP component was rated highly by participants. They effectively triggered PRHOs to interact with hospital staff. We conclude that PMPs provide a valuable learning experience for junior doctors and are a useful addition to an induction day programme. We plan to refine and increase the use of PMPs in undergraduate and postgraduate settings.

Implementation of a teaching programme to improve doctors' awareness of DVLA guidelines: a multicentre study.

PubMed

Maruthappu, Mahiben; Sykes, Mark; Green, Ben L; Watson, Robert; Gollop, Nicholas D; Shalhoub, Joseph; Ng, Ka Ying Bonnie

2017-02-01

Over half of the UK population holds a driver's licence. Driver and Vehicle Licensing Authority (DVLA) guidelines are available for conditions from most specialties. Despite this, no focused training occurs in the undergraduate or postgraduate setting. We evaluate the impact of a teaching programme to improve guideline awareness. A 25-point questionnaire was designed using the current DVLA guidelines. Five questions were included for the following fields: neurology, cardiology, drug and alcohol abuse, visual disorders and respiratory. This was distributed to doctors in training at five hospitals. Four weeks later, a single-session teaching programme was implemented. The questionnaire was redistributed. Preintervention and postintervention scores were compared using the Wilcoxon rank sum test. 139 preteaching and 144 post-teaching questionnaires were completed. Implementation of a single-session teaching programme significantly improved the knowledge of DVLA guidelines in all five areas explored. Median scores: neurology, preteaching 40%, post-teaching 100%, p<0.001; cardiology, 0%, 100%, p<0.001; drug and alcohol misuse, 0%, 100%, p<0.001; visual disorders, 40%, 100%, p<0.001; respiratory disorders, 20%, 100%, p<0.001; and overall, 28%, 92%, p<0.001. Knowledge of DVLA guidelines among our cohort was poor. Implementation of a single-session teaching programme can significantly improve guideline knowledge and awareness, serving as a cost-effective intervention. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Practitioner Health Programme: a free and confidential health service for doctors and dentists in London

PubMed Central

2008-01-01

This article describes a free and confidential service available to doctors and dentists living or working in the London area and who are suffering from mental health, addiction or physical health concerns that may be affecting their work. The service is led by an experienced general practitioner and includes free and timely access to specialist services. The service will begin to accept referrals from October 2008. Please consult the web site for details: www.php.nhs.uk PMID:25949562

First year doctors experience of work related wellbeing and implications for educational provision

PubMed Central

2014-01-01

Objectives: To explore factors which affect newly qualified doctors’ wellbeing and look at the implications for educational provision. Methods Data were collected by free association narrative interviews of nine Foundation doctors and analysed using a grounded theory approach. Two Foundation programme directors were interviewed to verify data validity. Results Two main themes emerged: newly qualified doctors’ wellbeing is affected by 1) personal experience and 2) work related factors. They start work feeling unprepared by medical school, work experience (“shadowing”) or induction programmes at the beginning of the post. Senior colleague support and feedback are much valued but often lacking with little discussion of critical incidents and difficult issues. Challenges include sick patients, prescribing, patient/relative communication and no consistent team structure. Working shift patterns affects personal and social life. Enjoyment and reward come from helping patients, feelings of making a difference or teaching medical students. Conclusions Whilst becoming familiar with their roles, newly qualified doctors search for identity and build up resilience. The support given during this process affects their wellbeing including coping with day to day challenges, whether posts are experienced as rewarding and how work influences their personal and social lives. PMID:25341219

Teaching fellowships for UK foundation doctors.

PubMed

Qureshi, Shaun

2015-01-01

Teaching Fellowships for junior doctors in their second post-graduate (FY2) year should be considered by medical students and junior doctors in UK. FY2 Teaching Fellowships are available in many foundation schools as part of the UK Academic Foundation Programme. Although programme structures differ between schools, they are designed to allow junior trainees to take time out from clinical practice to develop their teaching skills and gain insights into medication education careers. The advantages of an FY2 teaching fellowship include valuable experience of teaching and formal feedback not available to other trainees; the opportunity to further develop your portfolio; further development of the trainee's own knowledge and skills; the stimulation of working with students. Potential drawbacks to be considered are reduced direct clinical contact; reduced salary; difficulty carrying out education research in the allocated time frame; occasional difficulties establishing the teacher-student relationship while the trainee is at a relatively junior level. Experience of medical education as an FY2 trainee provides a helpful stepping stone whether or not the trainee further pursues education as a career, because the teaching skills are transferable to any specialty, and the unique experience enhances the trainee's confidence as a role model for junior colleagues.

The influence of an undergraduate scientific initiation programme on the professional profile of new physicians.

PubMed

Cyrillo, Raphael Joaquim Teles; Setúbal, Sérgio; da Silva, Cyro Teixeira; Velarde, Luis Guillermo Coca; de Mattos, Ana Carolina Musser Tavares; Cardoso, Renato Bergallo Bezerra; Cardoso, Gilberto Perez

2010-01-01

This paper studies the influence of a Scientific Initiation Programme (SIP) on the professional profile of new doctors from a Brazilian university. Evaluate fifty-two new doctors divided into two groups matched by sex, age and academic performance and differing only in participation in the SIP. Professional and socioeconomic data were collected, including schooling of parents; average income before, during and after the medical course; current professional situation; results of exams for civil servant recruitment; and titles and degrees obtained after graduation. Significant differences were found only in civil servant recruitment exam results (p = 0.0098) and in income after graduation (p = 0.02), which were both higher in the non-SIP group. Only one doctor got a M.Sc. degree after graduation, but many of them in both groups obtained technical titles, and had papers presented at congresses or published. Apparently, taking part in a SIP led to lower income and worse civil servant recruitment exam results. However, this may only reflect a transient phase in a long-term process. New research currently under way will answer this remaining question, now that more time has elapsed since graduation.

Evaluation of Quality Production Parameters and Mating Behavior of Novel Genetic Sexing Strains of the Mediterranean Fruit Fly Ceratitis capitata (Wiedemann) (Diptera: Tephritidae)

PubMed Central

Haq, Ihsan ul; Wornayporn, Viwat; Ahmad, Sohel; Sto Tomas, Ulysses; Dammalage, Thilakasiri; Gembinsky, Keke; Franz, Gerald; Cáceres, Carlos; Vreysen, Marc J. B.

2016-01-01

The Mediterranean fruit fly Ceratitis capitata (Wiedemann) (Diptera: Tephritidae) is one of the most important pest of fruits and vegetables in tropical and subtropical countries. The sterile insect technique (SIT) as a component of area-wide integrated pest management (AW-IPM) approaches is being used for the successful management of this pest. VIENNA 8 is a genetic sexing strain (GSS) that has a white pupae (wp) and temperature sensitive lethal (tsl) mutation, the latter killing all female embryos when eggs are exposed to high temperatures (34°C). The use of this GSS permits production and the release of only males which has increased the cost effectiveness of the SIT several fold for this pest. An efficient method of identification of recaptured sterile males can further increase the cost effectiveness of the SIT for this pest. Therefore, VIENNA 8-Sergeant2 (Sr2) strain and the transgenic strain VIENNA 8–1260 having visible markers were constructed. All three strains were evaluated for egg production, egg hatch, and egg sterility parameters under semi mass-rearing conditions and mating competitiveness in field cages. VIENNA 8–1260 females produced significantly fewer eggs as compared with the two other strains, which produced similar numbers of eggs. However, egg hatch of all strains was similar. Egg hatch of eggs produced by untreated females that had mated with adult males that had been irradiated with 100 Gy as pupae 2 days before emergence, was different for the three strains, i.e., egg hatch of 0.63%, 0.77%, 0.89% for VIENNA 8, VIENNA 8–1260, and VIENNA 8-Sr2, respectively. Differences in male mating competitiveness of the three strains against wild-type males were gradually reduced with successive generations under semi mass-rearing conditions. However, VIENNA 8 males adapted faster to laboratory conditions as compared with VIENNA 8-Sr2 and VIENNA 8–1260 males with respect to mating competitiveness. VIENNA 8 males of the F10 generation were equally competitive with wild-type males, whereas the mating competitiveness of VIENNA 8-Sr2 and VIENNA 8–1260 males was similar but lower as compared with wild-type males. Males from all three strains copulated earlier than wild-type males. Results are discussed in relation with the potential benefits of incorporating novel strains for more effective SIT application. PMID:27336737

Initial Results of the Master's Degree Programme in "Leadership in Medicine" – Impact on hospital-based follow-on training of doctors

PubMed Central

Wulfert, Chris-Henrik; Hoitz, Joachim; Senger, Ulrike

2017-01-01

Objective: This pilot project, which was jointly conducted by a hospital and a university, describes the development of the Master's Degree Programme in Leadership in Medicine, a course designed to supplement medical specialty training. The aim of the pilot project is to demonstrate how hospital-based projects on personnel and organisational development undertaken under academic supervision can be used to increase leadership responsibility among doctors whose duties include providing initial and follow-on training and to professionalise medical specialty training as a leadership task. This need arose from the nationwide requirements and an internal audit regarding follow-on training. The version of the degree programme described below aims to further the personnel development of the participants in the field of didactics. Method: Each of the nine modules is made up of two classroom-based phases and one distance learning phase. The distance learning phase involves undertaking hospital-based projects on personnel and organisational development under academic supervision. The pilot phase participants were hospital doctors who, as part of their duties, hold leadership responsibility or are involved in the follow-on training of doctors. Results: The 17 participants successfully implemented more than 30 hospital-based projects during the distance learning phases of the nine modules. These projects included the development of medical specialty curricula, relevant didactic methods and evaluation design and were subsequently presented and subjected to reflection in interdisciplinary groups. The project presentation together with the project report were regarded as proof of competency. Conclusion: In addition to enhancing participant competency, the degree model described, which interlinks theory and practice, promotes organisational development through the implementation of projects undertaken under academic supervision. This has a double impact on the quality of medical follow-on training at the hospital where the participant is based, for not only is the individual's didactic competency enhanced, but so is the "learning organisation" as a whole as a result of continuous project orientation. PMID:29226220

Initial Results of the Master's Degree Programme in "Leadership in Medicine" - Impact on hospital-based follow-on training of doctors.

PubMed

Wulfert, Chris-Henrik; Hoitz, Joachim; Senger, Ulrike

2017-01-01

Objective: This pilot project, which was jointly conducted by a hospital and a university, describes the development of the Master's Degree Programme in Leadership in Medicine, a course designed to supplement medical specialty training. The aim of the pilot project is to demonstrate how hospital-based projects on personnel and organisational development undertaken under academic supervision can be used to increase leadership responsibility among doctors whose duties include providing initial and follow-on training and to professionalise medical specialty training as a leadership task. This need arose from the nationwide requirements and an internal audit regarding follow-on training. The version of the degree programme described below aims to further the personnel development of the participants in the field of didactics. Method: Each of the nine modules is made up of two classroom-based phases and one distance learning phase. The distance learning phase involves undertaking hospital-based projects on personnel and organisational development under academic supervision. The pilot phase participants were hospital doctors who, as part of their duties, hold leadership responsibility or are involved in the follow-on training of doctors. Results: The 17 participants successfully implemented more than 30 hospital-based projects during the distance learning phases of the nine modules. These projects included the development of medical specialty curricula, relevant didactic methods and evaluation design and were subsequently presented and subjected to reflection in interdisciplinary groups. The project presentation together with the project report were regarded as proof of competency. Conclusion: In addition to enhancing participant competency, the degree model described, which interlinks theory and practice, promotes organisational development through the implementation of projects undertaken under academic supervision. This has a double impact on the quality of medical follow-on training at the hospital where the participant is based, for not only is the individual's didactic competency enhanced, but so is the "learning organisation" as a whole as a result of continuous project orientation.

Treatment of diarrhoea in infants by medical doctors in Balochistan, Pakistan.

PubMed

Kasi, M; Kausar, P; Naz, R; Miller, L C

1995-12-01

Diarrhoea is an important public health problem in Balochistan, the westernmost province of Pakistan. Although the use of oral rehydration solutions (ORS) has been widely promoted, no studies have been reported on the actual uses of ORS in treating infant diarrhoea by the medical doctors in this region. The medical practices of 30 doctors in Balochistan were surveyed. The surveyors posed as the mothers of infants with diarrhoea. The questions asked by the doctors, the physical examinations performed, and the treatments prescribed were noted. The histories and physical examinations were incomplete, as performed by most practitioners. In addition, 80% of the doctors prescribed drugs, usually kaolin preparations to treat diarrhoea. However, 18 of the 30 (60%) practitioners also prescribed ORS for treating diarrhoea and most of them gave some recommendations about ORS use. It is concluded that many medical practitioners have incorporated ORS treatment into their practices. Ongoing educational programmes and refresher courses would likely improve the use of ORS further in this region.

Clinical leadership training: an evaluation of the Welsh Fellowship programme.

PubMed

Phillips, Suzanne; Bullock, Alison

2018-05-08

Purpose UK fellowship schemes have been set up to address low-level engagement of doctors with leadership roles. Established in 2013, the Welsh Clinical Leadership Fellowship (WCLF) programme aims to recruit aspiring future clinical leaders and equip them with knowledge and skills to lead improvements in healthcare delivery. This paper aims to evaluate the 12-month WCLF programme in its first two years of operation. Design/methodology/approach Focused on the participants ( n = 8), the authors explored expectations of the programme, reactions to academic components (provided by Academi Wales) and learning from workplace projects and other opportunities. The authors adopted a qualitative approach, collecting data from four focus groups, 20 individual face-to-face or telephone interviews with fellows and project supervisors and observation of Academi Wales training days. Findings Although from diverse specialties and stages in training, all participants reported that the Fellowship met expectations. Fellows learned leadership theory, developing understanding of leadership and teamwork in complex organisations. Through workplace projects, they applied their knowledge, learning from both success and failure. The quality of communication with fellows distinguished the better supervisors and impacted on project success. Research limitations/implications Small participant numbers limit generalisability. The authors did not evaluate longer-term impact. Practical implications Doctors are required to be both clinically proficient and influence service delivery and improve patient care. The WCLF programme addresses both the need for leadership theory (through the Academi Wales training) and the application of learning through the performance of leadership roles in the projects. Originality/value This work represents an evaluation of the only leadership programme in Wales, and outcomes have led to improvements.

Understanding international postgraduate studies. Drivers from the supply and the demand side.

PubMed

Delgado-Serrano, M M; Gomez-Bruque, J L; Ambrosio-Albala, M J; Llamas-Moreno, B

2010-01-01

Changes in the global political and socioeconomic scenario are fostering the internationalization of master and doctoral programme as one of the current priorities for Universities. Changes in European higher education such as those stimulated by the Bologna process and the introduction of double, multiple or joint Master degree programmes together with the Erasmus Mundus programme are enhancing the competition of European universities in the global education market place. Universities compete to attract the best students, both national and international, to their postgraduate programmes. However, the design and launch of international masters or doctorates imply working with a different logic to the one used in national programmes. Complexity, diversity and differentiation are drivers of international education and as happens in complex systems the properties and features of the final products are different from the existing in the individual components. The aim of this paper is to understand international studies as complex systems and to analyze and identify factors affecting to the different components involved in the implementation of these programmes. The new approaches and the interrelations in aspects such as academic, administrative or economic management, quality assurance and marketing issues are examined and drivers, challenges and good practices where possible are identified. The analysis has been carried out considering the point of view of both Universities (supply-led approach) and students and employers (demand-led approach). From the analysis have emerged important questions that show the interrelation pattern and that can be useful when designing and implementing international postgraduate studies. Universities and students tend to agree about many issues however, some divergences have also been identified which make the results of the research more valuable.

Improving cultural competence education: the utility of an intersectional framework.

PubMed

Powell Sears, Karen

2012-06-01

Most US medical schools have instituted cultural competence education in the undergraduate curriculum. This training is intended to improve the quality of care that doctors, the majority of whom are White, deliver to ethnic and racial minority patients. Research into the outcomes of cultural competence training programmes reveals that they have been largely ineffective in improving doctors' skills. In varied curricular formats, programmes tend to teach group-specific cultural knowledge, despite the vast heterogeneity of racial and ethnic groups. This cultural essentialism diminishes training effectiveness. This paper proposes key curriculum content changes and suggests the inclusion of an intersectional framework in the cultural competence curriculum. This framework maintains that racial and ethnic minority groups hold multiple social statuses, called social locations, which interact with one another to uniquely shape the health views, needs and experiences of the individuals within the groups. Social locations include those defined by race, ethnicity, gender, social class and sexuality, which are experienced multiplicatively, not additively, within a particular social context. Cultural competence education must go beyond simplified cultural understandings to explore these more complex meanings. Doctors' ability to understand, communicate with and treat diverse groups can be vastly improved by applying an intersectional framework in academic research, self-awareness exercises and clinical training. Integrating an intersectional framework into cultural competency education can better prepare doctors for caring for racial and ethnic minority patients. This paper recommends curriculum elements for the classroom and clinical training that can improve doctor knowledge and skills for caring for diverse groups. Medical schools can use the proposed model to facilitate the development of new educational strategies and learning experiences. These improvements can lead to more equitable care and ultimately diminish disparities in health care. Although these recommendations are designed with US schools in mind, they may improve doctor understanding and care of marginal populations across the world. © Blackwell Publishing Ltd 2012.

Changes in healthcare workers' knowledge about tuberculosis following a tuberculosis training programme.

PubMed

Naidoo, S; Taylor, M; Esterhuizen, T M; Nordstrom, D L; Mohamed, O; Knight, S E; Jinabhai, C C

2011-08-01

In resource-limited countries, health policy makers and practitioners need to know whether healthcare workers have sufficient knowledge of tuberculosis and its management. We conducted a study to: (1) measure knowledge changes among healthcare workers who participated in a tuberculosis training programme; and (2) make recommendations about future tuberculosis training for healthcare workers in the KwaZulu-Natal Department of Health. A cross-sectional study conducted in 2007 measured changes in tuberculosis knowledge of doctors, nurses and other healthcare workers after a training programme based on World Health Organization tuberculosis training modules. Data were collected before and after training using a self-administered, 98-item questionnaire covering eight components. A total of 267 healthcare workers, mean age 40.7 years, answered both pre- and post-training questionnaires. Mean total knowledge scores were low despite significant changes (p<0.001) from a pre-training score of 59.5% to a post-training score of 66.5%. Nurses showed significant improvements in mean total knowledge scores (p<0.001) but had the lowest mean total knowledge score post-training, 63.2%. Doctors had significantly better pre-training (p<0.001) and post-training (p<0.001) mean total knowledge scores compared to nurses. Improvement in healthcare workers' overall knowledge of tuberculosis during a training programme was not clinically significant. Periodic field training and supervision should be considered to ensure tuberculosis knowledge improvements.

The training of a 'stone doctor'.

PubMed

Talati, Jamsheer J

2012-09-01

To propose alternative models of training for doctors treating patients with stones, and to identify their relative value, as such doctors are trained through urology programmes which sometimes cannot be expanded to meet the need, are short of teachers, too comprehensive and lengthy. This review explores new pathways for training to provide competence in the care of patients with stones. Previous reports were identified and existing training models collectively categorised as Model 1. Three alternative models were constructed and compared in the context of advantages, acceptability, feasibility, educational impact and applicability in different geosocio-political contexts. In Model 2, urological and stone training diverge as options after common basic courses and experience. In Model 3, individuals access training through a common educational matrix (EM) for nurses, physicians, etc., according to the match between their capacities, entry requirements, personal desires and willingness for further responsibility. Stone doctors with no urological background cannot fulfil other service and educational commitments, and might create unwelcome dependence on other colleagues for complex situations. Programmes involving a common EM affect professional boundaries and are not easily acceptable. There is a lack of clarity on methods for medical certification and re-certification. However, the lack of technically competent stone experts in developing worlds requires an exploration of alternative models of training and practice. The ability to provide exemplary care after abbreviated training makes alternative models attractive. Worldwide debate, further exploration and pilot implementation are required, perhaps first in the developing world, in which much of the 'stone belt' exists.

Implementation research: towards universal health coverage with more doctors in Brazil

PubMed Central

Oliveira, Aimê; Trindade, Josélia Souza; Barreto, Ivana CHC; Palmeira, Poliana Araújo; Comes, Yamila; Santos, Felipe OS; Santos, Wallace; Oliveira, João Paulo Alves; Pessoa, Vanira Matos; Shimizu, Helena Eri

2017-01-01

Abstract Objective To evaluate the implementation of a programme to provide primary care physicians for remote and deprived populations in Brazil. Methods The Mais Médicos (More Doctors) programme was launched in July 2013 with public calls to recruit physicians for priority areas. Other strategies were to increase primary care infrastructure investments and to provide more places at medical schools. We conducted a quasi-experimental, before-and-after evaluation of the implementation of the programme in 1708 municipalities with populations living in extreme poverty and in remote border areas. We compared physician density, primary care coverage and avoidable hospitalizations in municipalities enrolled (n = 1450) and not enrolled (n = 258) in the programme. Data extracted from health information systems and Ministry of Health publications were analysed. Findings By September 2015, 4917 physicians had been added to the 16 524 physicians already in place in municipalities with remote and deprived populations. The number of municipalities with ≥ 1.0 physician per 1000 inhabitants doubled from 163 in 2013 to 348 in 2015. Primary care coverage in enrolled municipalities (based on 3000 inhabitants per primary care team) increased from 77.9% in 2012 to 86.3% in 2015. Avoidable hospitalizations in enrolled municipalities decreased from 44.9% in 2012 to 41.2% in 2015, but remained unchanged in control municipalities. We also documented higher infrastructure investments in enrolled municipalities and an increase in the number of medical school places over the study period. Conclusion Other countries having shortages of physicians could benefit from the lessons of Brazil’s programme towards achieving universal right to health. PMID:28250510

Vienna FORTRAN: A FORTRAN language extension for distributed memory multiprocessors

NASA Technical Reports Server (NTRS)

Chapman, Barbara; Mehrotra, Piyush; Zima, Hans

1991-01-01

Exploiting the performance potential of distributed memory machines requires a careful distribution of data across the processors. Vienna FORTRAN is a language extension of FORTRAN which provides the user with a wide range of facilities for such mapping of data structures. However, programs in Vienna FORTRAN are written using global data references. Thus, the user has the advantage of a shared memory programming paradigm while explicitly controlling the placement of data. The basic features of Vienna FORTRAN are presented along with a set of examples illustrating the use of these features.

Programming in Vienna Fortran

NASA Technical Reports Server (NTRS)

Chapman, Barbara; Mehrotra, Piyush; Zima, Hans

1992-01-01

Exploiting the full performance potential of distributed memory machines requires a careful distribution of data across the processors. Vienna Fortran is a language extension of Fortran which provides the user with a wide range of facilities for such mapping of data structures. In contrast to current programming practice, programs in Vienna Fortran are written using global data references. Thus, the user has the advantages of a shared memory programming paradigm while explicitly controlling the data distribution. In this paper, we present the language features of Vienna Fortran for FORTRAN 77, together with examples illustrating the use of these features.

Vienna Contribution to ITRF2014

NASA Astrophysics Data System (ADS)

Böhm, Sigrid; Krásná, Hana; Bachmann, Sabine

2016-12-01

The next realization of the International Terrestrial Reference System, the ITRF2014, was released in the beginning of 2016. The VLBI input to ITRF2014 was provided by the International VLBI Service for Geodesy and Astrometry (IVS) and consists of a combination of all Analysis Center contributions. One of these single solutions was contributed by the Vienna Special Analysis Center of the Department of Geodesy and Geoinformation at TU Wien. In this paper we describe the characteristics of the Vienna contribution (calculated using the Vienna VLBI Software VieVS) to ITRF2014 and VTRF2014, respectively. We give a documentation of the included sessions and stations as well as some statistical information which shows the performance of the Vienna contribution compared to the other contributions in the IVS combination. In addition to that, a single TRF solution, VieTRF2014a, which is based on the Vienna input to ITRF2014, is presented and compared to previous TRF solutions. By and large the Vienna contribution does not exhibit any outstanding features when compared to the other submissions, except for the Earth rotation component dUT1, which shows large residuals with respect to the combined solution. The reason for this discrepancy is probably the different parameterization of EOP in VieVS as piecewise linear offsets, necessitating a transformation prior to the combination.

[Court-ordered therapy, a measure for preventing reoffending].

PubMed

Bouchard, Jean-Pierre; Brulin-Solignac, Diane; Lodetti, Célia

In France, court-ordered therapy is a measure applicable in the framework of socio-judicial supervision, created by the law of 17th June 1998 relating to the prevention and suppression of sex offences, as well as the protection of minors. Since its introduction, its indications have been extended to include other offences. By organising a triangulation of the relations between the legal and health care systems (doctors and psychologists) through the intermediary of the doctor-coordinator, this programme aims to prevent reoffending. Copyright © 2017. Published by Elsevier Masson SAS.

Tuberculosis among physicians in training.

PubMed

Rao, K G; Aggarwal, A N; Behera, D

2004-11-01

A total of 478 resident doctors working at our hospital were interviewed regarding development of tuberculosis after joining the hospital. Nine residents had developed tuberculosis, yielding an overall risk of 11.2 cases per 1000 person-years of exposure. Another 231 resident doctors newly admitted to the residency programme over a 1-year period were prospectively followed up over the next year. Four residents in this group developed tuberculosis within 1 year of joining the hospital, yielding an overall incidence of 17.3/1000. Physicians in training have a high risk of developing active tuberculosis after nosocomial transmission.

Self-determining medical leadership needs of occupational health physicians.

PubMed

Giri, Prosenjit; Aylott, Jill; Kilner, Karen

2017-10-02

Purpose The purpose of this study was to explore which factors motivate doctors to engage in leadership roles and to frame an inquiry of self-assessment within Self-Determination Theory (SDT) to identify the extent to which a group of occupational health physicians (OHPs) was able to self-determine their leadership needs, using a National Health Service (NHS) England competency approach promoted by the NHS England Leadership Academy as a self-assessment leadership diagnostic. Medical leadership is seen as crucial to the transformation of health-care services, yet leadership programmes are often designed with a top-down and centrally commissioned "one-size-fits-all" approach. In the UK, the Smith Review (2015) concluded that more decentralised and locally designed leadership development programmes were needed to meet the health-care challenges of the future. However, there is an absence of empirical research to inform the design of effective strategies that will engage and motivate doctors to take up leadership roles, while at the same time, health-care organisations continue to develop formal leadership roles as a way to secure medical leadership engagement. The problem is further compounded by a lack of validated leadership qualities assessment instruments which support researching this problem. Design/Methodology/approach The analysis draws on a sample of about 25 per cent of the total population size of the Faculty of Occupational Medicine ( n = 1,000). The questionnaire used was the Leadership Qualities Framework tool as a form of online self-assessment ( NHS Leadership Academy, 2012 ). The data were analysed using descriptive statistics and simple inferential methods. Findings OHPs are open about reporting their leadership strengths and leadership development needs and recognise leadership learning as an ongoing development need regardless of their level of personal competence. This study found that the single most important factor to affect a doctor's confidence in leadership is their experience in a management role. In multivariate regression, management experience accounted for the usefulness of leadership training, suggesting that doctors learn best through applied "leadership learning" as opposed to theory-driven programmes. Drawing on SDT ( Deci and Ryan, 1985 ; 2000 ; Ryan and Deci, 2000 ), this article provides a theoretical framework that helps to understand those doctors who are likely to engage in leadership and management activities in the organisation. More choice and self-determination of medical leadership programmes are likely to result in more relevant leadership learning that builds on doctors' previous experience in this area. Research limitations/implications While this study benefitted from a large sample size, it was limited to the use of purely quantitative methods. Future studies would benefit from the application of a mixed methodology to combine quantitative data with one-to-one interviews or a focus group. Practical implications This study suggests that doctors are able to determine their own learning needs reliably and that they are more likely to increase their confidence in leadership and management if they are exposed to leadership and management experience. Originality/value This is the first large-scale study of this kind with a large sample within a single medical specialty. The study is considered as insider research, as the first author is an OHP with knowledge of how to engage OHPs in this work.

The stress and underground environment

NASA Astrophysics Data System (ADS)

Chama, A.

2009-04-01

Currently,the program of prevention in occupational health needs mainly to identify occupational hazards and strategy of their prevention.Among these risks,the stress represents an important psycho-social hazard in mental health,which unfortunately does not spare no occupation.My Paper attempts to highlight and to develop this hazard in its different aspects even its regulatory side in underground environment as occupational environment.In the interest of better prevention ,we consider "the information" about the impact of stress as the second prevention efficient and no expensive to speleologists,hygienists and workers in the underground areas. In this occasion of this event in Vienna,we also highlight the scientific works on the stress of the famous viennese physician and endocrinologist Doctor Hans Selye (1907-1982),nicknamed "the father of stress" and note on relation between biological rhythms in this underground area and psychological troubles (temporal isolation) (Jurgen Aschoff’s works and experiences out-of time).

Fellowship Available: 2005 IIASA Young Scientists Summer Program

NASA Astrophysics Data System (ADS)

2004-12-01

The International Institute for Applied Systems Analysis (IIASA) near Vienna, Austria, will host its annual Young Scientists's Summer Program (YSSP) for a selected group of graduate students from around the world. These students, primarily doctoral, will work closely with IIASA's senior scientists on projects within the institute's theme areas: natural resources and environment (e.g., transboundary air pollution and greenhouse gas initiative), population and society (e.g., risk, modeling, and society, and sustainable rural development), and energy and technology (e.g., transitions to new technologies and dynamic systems). Applicants must be advanced graduate students at a U.S. university; have comparable experience with ongoing research at IIASA; students who would benefit from interactions with scientists worldwide; and be interested in investigating the policy implications of his/her work.The U.S. Committee for IIASA provides airfare and a living allowance for those selected to participate in the fellowship.

The Influence of an undergraduate scientific initiation programme onn the professional profile of new physicians.

PubMed

Joaquim Teles Cyrillo, Raphael; Setúbal, Sérgio; da Silva Júnior, Cyro Teixeira; Guillermo Coca Velarde, Luis; de Mattos, Ana Carolina Musser Tavares; Bezerra Cardoso, Renato Bergallo; Cardoso, Gilberto Perez

2010-01-01

This paper studies the influence of a Scientific Initiation Programme (SIP) on the professional profile of new doctors from a Brazilian university. Evaluate fifty-two new doctors divided into two groups matched by sex, age and academic performance and differing only in participation in the SIP. Professional and socioeconomic data were collected, including schooling of parents; average income before, during and after the medical course; current professional situation; results of exams for civil servant recruitment; and titles and degrees obtained after graduation. Significant differences were found only in civil servant recruitment exam results (p=0.0098) and in income after graduation (p=0.02), which were both higher in the non-SIP group. Only one doctor got a M.Sc. degree after graduation, but many of them in both groups obtained technical titles, and had papers presented at congresses or published. Apparently, taking part in a SIP led to lower income and worse civil servant recruitment exam results. However, this may only reflect a transient phase in a long-term process. New research currently under way will answer this remaining question, now that more time has elapsed since graduation. Rev Port Pneumol 2010; XVI (5): 797-808. © 2010 Sociedade Portuguesa de Pneumologia/SPP.

A national questionnaire survey of consultants and middle grade doctors' perception of foundation doctors in obstetrics and gynaecology in the United Kingdom.

PubMed

Ismail, Sharif I M F

2014-12-01

The aim of this study was to compare foundation doctors in obstetrics and gynaecology to the former grade of senior house officer, as perceived by their consultant and middle grade colleagues. A self-construct questionnaire was sent to College District Tutors in obstetrics and gynaecology in all hospitals in the United Kingdom, for circulation to all consultants and middle grade doctors in obstetrics and gynaecology in their departments. A total of 155 questionnaires were returned, 143 completed and 12 indicating not having foundation doctors. Whilst about 50 % of respondents ranked the competencies of foundation year doctors as similar to that of the former senior house officer grade, the ratings were down in areas specific to obstetrics and gynaecology, such as seeing new patients in antenatal clinic, and up in general terms such as communication. General comments highlighted differences in ability and role and suggested longer attachments and less frequent changes in training structure. The study highlighted the need to focus on teaching generic skills in shorter durations and reflection on whole-patient management, which are relevant to all specialities. It underlined the impact of more frequent change of doctors on service delivery and recommended having a further look at foundation training programme before making any future changes.

Using Argumentation Theory to Identify the Challenges of Shared Decision-Making when the Doctor and the Patient have a Difference of Opinion

PubMed Central

Zanini, Claudia A.; Rubinelli, Sara

2012-01-01

This paper aims to identify the challenges in the implementation of shared decision-making (SDM) when the doctor and the patient have a difference of opinion. It analyses the preconditions of the resolution of this difference of opinion by using an analytical and normative framework known in the field of argumentation theory as the ideal model of critical discussion. This analysis highlights the communication skills and attitudes that both doctors and patients must apply in a dispute resolution-oriented communication. Questions arise over the methods of empowerment of doctors and patients in these skills and attitudes as the preconditions of SDM. Overall, the paper highlights aspects in which research is needed to design appropriate programmes of training, education and support in order to equip doctors and patients with the means to successfully engage in shared decision-making. Acknowledgements the authors would like to thank the Swiss National Science Foundation for funding this project (project number: PDFMP1_132523. Enhancing doctor-patient argumentation through the International Classification of Functioning, Disability and Health (ICF). Insights from a study in the field of chronic pain). PMID:25170461

Factors influencing the recommendation of the Human Papillomavirus vaccine by South African doctors working in a tertiary hospital.

PubMed

Hoque, Muhammad Ehsanul

2016-06-01

In South Africa, HPV vaccination programme has been incorporated recently in the school health system. Since doctors are the most trusted people regarding health issues in general, their knowledge and attitudes regarding HPV infections and vaccination are very important for HPV vaccine program nationally. The objective of this study was to investigate factors contributing to recommendation of HPV vaccines to the patients. This was a quantitative cross-sectional study conducted among 320 doctors, using a self-administered anonymous questionnaire. All the doctors were aware of HPV and knew that HPV is transmitted sexually. Their overall level of knowledge regarding HPV infections and HPV vaccine was poor. But the majority intended to prescribe the vaccine to their patients. It was found that doctors who knew that HPV 6 and 11 are responsible for >90% of anogenital warts, their patients would comply with the counselling regarding HPV vaccination, and received sufficient information about HPV vaccination were 5.68, 4.91 and 4.46 times respectively more likely to recommend HPV vaccination to their patients, compared to their counterparts (p<0.05). There was a knowledge gap regarding HPV infection and HPV vaccine among the doctors.

Learning, education and satisfaction after compulsory rotating internship in Kathmandu University Medical School: a qualitative study of interns' response.

PubMed

Shrestha, D; Mishra, B

2008-01-01

Internship is an integral part of MBBS training programme and mandatory to all students. Kathmandu University Medical School has adopted a programme of compulsory one year rotating internship including 6 weeks community exposure in out reach clinics for the first batch of students. The purpose of the study is to evaluate interns' feedback concerning learning, education and satisfaction. A questionnaire with 47 items was administered to 30 interns who had finished one year rotating internship in Kathmandu University Medical School. Fourty-two responses were graded according in Likert scale and 5 open ended questions were analyzed for common themes. The mean age of the interns was 24.77+/-0.67 yrs with female: male ratio of 1.5:1. Confidence level of communication of interns with faculties was lesser than with junior doctors and patients. Junior doctors and colleagues contributed more in interns' learning than faculties. Community exposure for 6 weeks was considered lengthy and lacking of clear objectives. However, 53.3% interns agreed that achievement of objectives of community posting was high or very high. Of the interns, 50% perceived certain degree of physical or mental or sexual harassment during internship. Interns raised the issue of not involving them as a part of team during clinical posting. Clinical competencies for most of the skills were high or very high. Interns have learned clinical skills and patient care in one year internship programme but contribution of junior doctors and colleague are more than teachers. Clear objectives are needed before clinical and community postings. Process of providing regular feedback from interns and vice versa should be implemented to improve interns' learning, education and satisfaction.

Reducing the blame culture through clinical audit in nuclear medicine: a mixed methods study

PubMed Central

Ross, P; Hubert, J

2017-01-01

Objectives To identify the barriers and facilitators of doctors’ engagement with clinical audit and to explore how and why these factors influenced doctors’ decisions to engage with the NHS National Clinical Audit Programme. Design A single-embedded case study. Mixed methods sequential approach with explorative pilot study and follow-up survey. Pilot study comprised 13 semi-structured interviews with purposefully selected consultant doctors over a six-month period. Interview data coded and analysed using directed thematic content analysis with themes compared against the study’s propositions. Themes derived from the pilot study informed the online survey question items. Exploratory factor analysis using STATA and descriptive statistical methods applied to summarise findings. Data triangulation techniques used to corroborate and validate findings across the different methodological techniques. Setting NHS National PET-CT Clinical Audit Programme. Participants Doctors reporting on the Audit Programme. Main Outcome measures Extent of engagement with clinical audit, factors that influence engagement with clinical audit. Results Online survey: 58/59 doctors responded (98.3%). Audit was found to be initially threatening (79%); audit was reassuring (85%); audit helped validate professional competence (93%); participation in audit improved reporting skills (76%). Three key factors accounted for 97.6% of the variance in survey responses: (1) perception of audit’s usefulness, (2) a common purpose, (3) a supportive blame free culture of trust. Factor 1 influenced medical engagement most. Conclusions The study documents performance feedback as a key facilitator of medical engagement with clinical audit. It found that medical engagement with clinical audit was associated with reduced levels of professional anxiety and higher levels of perceived self-efficacy. PMID:28210493

The impact of an integrated medical leadership programme.

PubMed

Agius, Steven J; Brockbank, Amy; Baron, Rebecca; Farook, Saleem; Hayden, Jacky

2015-01-01

The purpose of this paper is to determine the impact of an integrated Medical Leadership Programme (MLP) on a cohort of participating specialty doctors and the NHS services with which they were engaged. This was a qualitative study designed to obtain rich textual data on a novel training intervention. Semi-structured interviews were conducted with participating MLP trainees at fixed points throughout the programme in order to capture their experiences. Resulting data were triangulated with data from extant documentation, including trainees' progress reports and summaries of achievements. Recurring discourses and themes were identified using a framework thematic analysis. Evidence of the positive impact upon trainees and NHS services was identified, along with challenges. Evidence of impact across all the domains within the national Medical Leadership Competency Framework was also identified, including demonstrating personal qualities, working with others, managing services, improving services and setting direction. Data were drawn from interviews with a small population of trainees undertaking a pilot MLP in a single deanery, so there are inevitable limitations for generalisability in the quantitative sense. Whilst the pilot trainees were a self-selected group, it was a group of mixed origin and ability. The study has provided valuable lessons for the design of future leadership programmes aimed at doctors in training. Identifying the effectiveness of an innovative model of delivery with regard to the Medical Leadership Curriculum may assist with medical staff engagement and support health service improvements to benefit patient care.

A Combined Approach to Measure Micropollutant Behaviour during Riverbank Filtration

NASA Astrophysics Data System (ADS)

van Driezum, Inge; Saracevic, Ernis; Derx, Julia; Kirschner, Alexander; Sommer, Regina; Farnleitner, Andreas; Blaschke, Alfred Paul

2016-04-01

Riverbank filtration (RBF) systems are widely used as natural treatment process. The advantages of RBF over surface water abstraction are the elimination of for example suspended solids, biodegradable compounds (like specific micropollutants), bacteria and viruses (Hiscock and Grischek, 2002). However, in contrast to its importance, remarkably less is known on the respective external (e.g. industrial or municipal sewage) and the internal (e.g. wildlife and agricultural influence) sources of contaminants, the environmental availability and fate of the various hazardous substances, and its potential transport during soil and aquifer passage. The goal of this study is to get an insight in the behaviour of various micropollutants and microbial indicators during riverbank filtration. Field measurements were combined with numerical modelling approaches. The study area comprises an alluvial backwater and floodplain area downstream of Vienna. The river is highly dynamic, with discharges ranging from 900 m3/s during low flow to 11000 m3/s during flood events. Samples were taken in several monitoring wells along a transect extending from the river towards a backwater river in the floodplain. Three of the piezometers were situated in the first 20 meters away from the river in order to obtain information about micropollutant behaviour close to the river. A total of 9 different micropollutants were analysed in grab samples taken under different river flow conditions (n=33). Following enrichment using SPE, analysis was performed using high performance liquid chromatography-tandem mass spectrometry. Faecal indicators (E. coli and enterococci) and bacterial spores were enumerated in sample volumes of 1 L each using cultivation based methods (ISO 16649-1, ISO 7899-2:2000 and ISO 6222). The analysis showed that some compounds, e.g. ibuprofen and diclofenac, were only found in the river. These compounds were already degraded in the first ten meters away from the river. Analysis of carbamazepine however showed just a slight decrease in concentrations from the river towards the backwater river. Indicator bacteria showed a clear decrease already along the first meters. In the samples taken from the monitoring groundwater wells and abstraction well, faecal indicators were not detected in sample volumes of 1 L each. A combined approach using field measurements and a 3D groundwater transport model proved to be a suitable method to determine the behaviour of various micropollutants and faecal indicators. References Hiscock, K. M. and Grischek, T. (2002) Attenuation of groundwater pollution by bank filtration. Journal of Hydrology, 266(3-4), 139-144. Acknowledgements This paper was supported by FWF (Vienna Doctoral Program on Water Resource Systems W1219-N22) and the GWRS project (Vienna Water) as part of the "(New) Danube-Lower Lobau Network Project" funded by the Government of Austria and Vienna, and the European Agricultural Fund for Rural Development (LE 07-13).

The Requirement for Vocational Skills in the Engineering Industry in the Areas of Modena and Vienna. Synthesis Report.

ERIC Educational Resources Information Center

Gatti, Mario; Mereu, Maria Grazia; Tagliaferro, Claudio; Markowitsch, Jorg; Neuberger, Robert

Requirements for vocational skills in the engineering industry in Modena, Italy, and Vienna, Austria, were studied. In Modena, employees of a representative sample of 90 small, medium, and large firms in the mechanical processing, agricultural machinery, and sports car manufacturing sectors were interviewed. In Vienna, data were collected through…

Experiences with maternal and perinatal death reviews in the UK--the MBRRACE-UK programme.

PubMed

Kurinczuk, J J; Draper, E S; Field, D J; Bevan, C; Brocklehurst, P; Gray, R; Kenyon, S; Manktelow, B N; Neilson, J P; Redshaw, M; Scott, J; Shakespeare, J; Smith, L K; Knight, M

2014-09-01

Established in 1952, the programme of surveillance and Confidential Enquiries into Maternal Deaths in the UK is the longest running such programme worldwide. Although more recently instituted, surveillance and confidential enquiries into perinatal deaths are also now well established nationally. Recent changes to funding and commissioning of the Enquiries have enabled both a reinvigoration of the processes and improvements to the methodology with an increased frequency of future reporting. Close engagement with stakeholders and a regulator requirement for doctors to participate have both supported the impetus for involvement of all professionals leading to greater potential for improved quality of care for women and babies. © 2014 Royal College of Obstetricians and Gynaecologists.

Objective Structured Professional Assessments for Trainee Educational Psychologists: An Evaluation

ERIC Educational Resources Information Center

Dunsmuir, Sandra; Atkinson, Cathy; Lang, Jane; Warhurst, Amy; Wright, Sarah

2017-01-01

Objective Structured Professional Assessments (OSPAs) were developed and evaluated at three universities in the United Kingdom, to supplement supervisor assessments of trainee educational psychologists' placement practice. Participating second year students on three educational psychology doctoral programmes (n = 31) and tutors (n = 12) were…

Professional Learning: Lessons for Supervision from Doctoral Examining

ERIC Educational Resources Information Center

Wisker, Gina; Kiley, Margaret

2014-01-01

Most research into research supervision practice focuses on functional, collegial or problematic power-related experiences. Work developing the supervisory role concentrates on new supervisors, and on taught development and support programmes. Most literature on academics' professional learning concentrates on learning to be a university teacher…

Digital Technologies Jump Start Telemedicine

ERIC Educational Resources Information Center

Pierce, Alan

2011-01-01

The technologists, research doctors, computer programmers, electrical engineers, and biomedical engineers who design and create new medical diagnostic equipment and medical treatments are now working on medical systems that use the computing power of personal computers and cell phones. For disease diagnosis, they are finding ways to shrink…

Programme Planning in University Continuing Education.

ERIC Educational Resources Information Center

Msimuko, Arthur K.

1980-01-01

Different approaches to program planning in the field of university continuing education are presented, including the purchase model, the doctor-patient model, and the process consultation model. The author adds another approach, the client approach, which represents the traditional relationship between the helper and the helped. (CT)

Developing future clinical leaders for quality improvement: experience from a London children's hospital.

PubMed

Runnacles, Jane; Moult, Beki; Lachman, Peter

2013-11-01

Medical training does not necessarily prepare graduates for the real world of healthcare in which continual improvement is required. Doctors in postgraduate training (DrPGT) rarely have the opportunity to develop skills to implement changes where they work. Paradoxically they are often best placed to identify safety and quality concerns and can innovate across organisational boundaries. In order to address this, educational programmes require a supportive educational environment and should include experiential learning on a safety and quality project, alongside teaching of quality improvement (QI) knowledge and systems theory. Enabling Doctors in Quality Improvement and Patient Safety (EQuIP) has been designed for DrPGT at a London children's hospital. The aim is to prepare trainees for the future of continual improvement to ensure safe and effective services are developed through effective clinical microsystems. This paper describes the rationale and design of EQuIP with evaluation built in the evolving programme. EQuIP supports DrPGTs through a QI project within their department, aligned to the Great Ormond Street NHS Foundation Trust's objectives. This changes the way DrPGTs view healthcare as they become quality champions for their department. A three-level approach to the programme is described. The innovation involves a peer-designed programme while being work-based, delivering organisational strategies. Results of the preprogramme and postprogramme evaluations demonstrate an improvement in knowledge, skills and attitudes. Benefits to both the DrPGTs and the organisation are emphasised and key factors to achieve success and barriers identified by the participants. The design and evaluation of EQuIP may inform similar educational programmes in other organisations. This capacity building is crucial to ensure that future clinical leaders have the skills and motivation to improve the effectiveness of clinical microsystems.

Growth of nurse prescribing competence: facilitators and barriers during education.

PubMed

Hopia, Hanna; Karhunen, Anne; Heikkilä, Johanna

2017-10-01

To describe facilitators and barriers in relation to the growth of nurse prescribing competence from the perspective of the nurses studying in a prescribing programme. The number of nurses enrolled in a nurse prescribing programme is rapidly increasing in Finland. However, few studies on nurse prescribing education are available and therefore research is needed, particularly from the point of view of nurses studying in the programme. The descriptive, qualitative study used the text of student online learning diaries as data during a 14-month prescribing programme. The sample consisted of 31 nurses, public health nurses or midwives enrolled in a prescribing programme at a university of applied sciences. The data were analysed using the inductive analysis method. The growth of nurses' prescribing competence was facilitated by learning clinical examination of the patient, networking with peers, receiving support from the workplace and supervisors, doctors' positive attitude towards nurse prescribing and being able to apply competencies directly to nursing practice. The barriers to the growth of nurses' prescribing competence were unclear job description, incomplete care plans and concerns about how consultation with doctors will be organised and realised. The results show that, for the purpose of developing the new role and position of nurse prescribers, educators and nursing managers must invest more in staff awareness of nurse prescribing education and also offer more support to nurse prescribers in their workplaces. The results of this study can be used especially in countries where nurse prescribing education is only in the process of being planned or has just been started. Heads of nursing and educators in prescribing education will benefit from the results when creating expanded job descriptions for nurses and supporting networking between students during the period of training. © 2016 John Wiley & Sons Ltd.

Enhancing the quality and safety of care through training generalist doctors: a longitudinal, mixed-methods study of a UK broad-based training programme.

PubMed

Bullock, Alison; Webb, Katie Louise; Muddiman, Esther; MacDonald, Janet; Allery, Lynne; Pugsley, Lesley

2018-04-12

Changing patient demographics make it ever more challenging to maintain the quality and safety of care. One approach to addressing this is the development of training for generalist doctors who can take a more holistic approach to care. The purpose of the work we report here is to consider whether a broad-based training programme prepares doctors for a changing health service. We adopted a longitudinal, mixed-methods approach, collecting questionnaire data from trainees on the broad-based training (BBT) programme in England (baseline n=62) and comparator trainees in the same regions (baseline n=90). We held 15 focus groups with BBT trainees and one-to-one telephone interviews with trainees post-BBT (n=21) and their Educational Supervisors (n=9). From questionnaire data, compared with comparator groups, BBT trainees were significantly more confident that their training would result in: wider perspectives, understanding specialty complementarity, ability to apply learning across specialties, manage complex patients and provide patient-focused care. Data from interviews and focus groups provided evidence of positive consequences for patient care from BBT trainees' ability to apply knowledge from other specialties. Specifically, insights from BBT enabled trainees to tailor referrals and consider patients' psychological as well as physical needs, thus adopting a more holistic approach to care. Unintended consequences were revealed in focus groups where BBT trainees expressed feelings of isolation. However, when we explored this sentiment on questionnaire surveys, we found that at least as many in the comparator groups sometimes felt isolated. Practitioners with an understanding of care across specialty boundaries can enhance patient care and reduce risks from poor inter-specialty communication. Internationally, there is growing recognition of the place of generalism in medical practice and the need to take a more person-centred approach. Broad-based approaches to training support the development of generalist doctors, which is well-suited to a changing health service. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Professional values and reported behaviours of doctors in the USA and UK: quantitative survey

PubMed Central

Rao, Sowmya R; Sibbald, Bonnie; Hann, Mark; Harrison, Stephen; Walter, Alex; Guthrie, Bruce; Desroches, Catherine; Ferris, Timothy G; Campbell, Eric G

2011-01-01

Background The authors aimed to determine US and UK doctors' professional values and reported behaviours, and the extent to which these vary with the context of care. Method 1891 US and 1078 UK doctors completed the survey (64.4% and 40.3% response rate respectively). Multivariate logistic regression was used to compare responses to identical questions in the two surveys. Results UK doctors were more likely to have developed practice guidelines (82.8% UK vs 49.6% US, p<0.001) and to have taken part in a formal medical error-reduction programme (70.9% UK vs 55.7% US, p<0.001). US doctors were more likely to agree about the need for periodic recertification (completely agree 23.4% UK vs 53.9% US, p<0.001). Nearly a fifth of doctors had direct experience of an impaired or incompetent colleague in the previous 3 years. Where the doctor had not reported the colleague to relevant authorities, reasons included thinking that someone else was taking care of the problem, believing that nothing would happen as a result, or fear of retribution. UK doctors were more likely than US doctors to agree that significant medical errors should always be disclosed to patients. More US doctors reported that they had not disclosed an error to a patient because they were afraid of being sued. Discussion The context of care may influence both how professional values are expressed and the extent to which behaviours are in line with stated values. Doctors have an important responsibility to develop their healthcare systems in ways which will support good professional behaviour. PMID:21383386

Career destinations of University of Ghana Medical School graduates of various year groups.

PubMed

Lassey, A T; Lassey, P D; Boamah, M

2013-06-01

To report on the current career destination of the University of Ghana Medical School (UGMS) qualified doctors in the year groups, 1998, 2000, 2003, 2005 and 2008. Interview of doctors from each year group currently working at the Korle-Bu Teaching Hospital corroborated by phone calls to the doctors. All Ghanaian doctors from each graduating year group. 1. Current location of employment in Ghana or abroad, 2. Gender ratios of the doctors retained in Ghana. Three hundred and seventy-two (372) UGMS doctors consisting of 353 Ghanaians and 19 foreign students graduated over the five year groups. Of the 353 Ghanaians, 113 emigrated, while all but one of the 240 living in Ghana, practice medicine. The retention rate improved from 54.2% in 1998 to 86.3% in 2008. The overall retention rate however is 68.0% while the retention rates for the male and female doctors were 69.3% and 64.6% respectively. Of the 177 doctors practicing in Ghana from the first 4 year-groups (i.e. 1998, 2000, 2003 and 2005,) 139 (i.e. 31, 31, 34 and 43 from the respective year groups) have either completed postgraduate training or are in the residency training programme. Thus 78.5% of these doctors working in Ghana have opted for postgraduate training. The establishment of the GCPS and to a lesser extent the introduction of the ADHA before it appear to have slowed down the medical brain drain as more and more doctors avail themselves of the local opportunities. The GCPS therefore needs supporting effectively in order to continue to be a strong incentive for the retention of doctors in Ghana, apart from helping to staff district general hospitals with specialists.

Professional values and reported behaviours of doctors in the USA and UK: quantitative survey.

PubMed

Roland, Martin; Rao, Sowmya R; Sibbald, Bonnie; Hann, Mark; Harrison, Stephen; Walter, Alex; Guthrie, Bruce; Desroches, Catherine; Ferris, Timothy G; Campbell, Eric G

2011-06-01

BACKGROUND The authors aimed to determine US and UK doctors' professional values and reported behaviours, and the extent to which these vary with the context of care. METHOD 1891 US and 1078 UK doctors completed the survey (64.4% and 40.3% response rate respectively). Multivariate logistic regression was used to compare responses to identical questions in the two surveys. RESULTS UK doctors were more likely to have developed practice guidelines (82.8% UK vs 49.6% US, p<0.001) and to have taken part in a formal medical error-reduction programme (70.9% UK vs 55.7% US, p<0.001). US doctors were more likely to agree about the need for periodic recertification (completely agree 23.4% UK vs 53.9% US, p<0.001). Nearly a fifth of doctors had direct experience of an impaired or incompetent colleague in the previous 3 years. Where the doctor had not reported the colleague to relevant authorities, reasons included thinking that someone else was taking care of the problem, believing that nothing would happen as a result, or fear of retribution. UK doctors were more likely than US doctors to agree that significant medical errors should always be disclosed to patients. More US doctors reported that they had not disclosed an error to a patient because they were afraid of being sued. DISCUSSION The context of care may influence both how professional values are expressed and the extent to which behaviours are in line with stated values. Doctors have an important responsibility to develop their healthcare systems in ways which will support good professional behaviour.

Validation of a new ENT emergencies course for first-on-call doctors.

PubMed

Swords, C; Smith, M E; Wasson, J D; Qayyum, A; Tysome, J R

2017-02-01

First-on-call ENT cover is often provided by junior doctors with limited ENT experience; yet, they may have to manage life-threatening emergencies. An intensive 1-day simulation course was developed to teach required skills to junior doctors. A prospective, single-blinded design was used. Thirty-seven participants rated their confidence before the course, immediately following the course and after a two-month interval. Blinded assessors scored participant performance in two video-recorded simulated scenarios before and after the course. Participant self-rated confidence was increased in the end-of-course survey (score of 27.5 vs 53.0; p < 0.0001), and this was maintained two to four months after the course (score of 50.5; p < 0.0001). Patient assessment and management in video-recorded emergency scenarios was significantly improved following course completion (score of 9.75 vs 18.75; p = 0.0093). This course represents an effective method of teaching ENT emergency management to junior doctors. ENT induction programmes benefit from the incorporation of a simulation component.

Vantage point - A private matter.

PubMed

McCrae, Niall

2015-12-01

IMAGINE THAT you have been struggling with depression and your doctor has referred you for cognitive behaviour therapy (CBT). Such treatment is provided on the NHS through the Improving Access to Psychological Therapies (IAPT) programme. But there is a catch; you have been placed on a three-month waiting list.

The evolution of global health teaching in undergraduate medical curricula.

PubMed

Rowson, Mike; Smith, Abi; Hughes, Rob; Johnson, Oliver; Maini, Arti; Martin, Sophie; Martineau, Fred; Miranda, J Jaime; Pollit, Vicki; Wake, Rae; Willott, Chris; Yudkin, John S

2012-11-13

Since the early 1990s there has been a burgeoning interest in global health teaching in undergraduate medical curricula. In this article we trace the evolution of this teaching and present recommendations for how the discipline might develop in future years. Undergraduate global health teaching has seen a marked growth over the past ten years, partly as a response to student demand and partly due to increasing globalization, cross-border movement of pathogens and international migration of health care workers. This teaching has many different strands and types in terms of topic focus, disciplinary background, the point in medical studies in which it is taught and whether it is compulsory or optional. We carried out a survey of medical schools across the world in an effort to analyse their teaching of global health. Results indicate that this teaching is rising in prominence, particularly through global health elective/exchange programmes and increasing teaching of subjects such as globalization and health and international comparison of health systems. Our findings indicate that global health teaching is moving away from its previous focus on tropical medicine towards issues of more global relevance. We suggest that there are three types of doctor who may wish to work in global health - the 'globalised doctor', 'humanitarian doctor' and 'policy doctor' - and that each of these three types will require different teaching in order to meet the required competencies. This teaching needs to be inserted into medical curricula in different ways, notably into core curricula, a special overseas doctor track, optional student selected components, elective programmes, optional intercalated degrees and postgraduate study. We argue that teaching of global health in undergraduate medical curricula must respond to changing understandings of the term global health. In particular it must be taught from the perspective of more disciplines than just biomedicine, in order to reflect the social, political and economic causes of ill health. In this way global health can provide valuable training for all doctors, whether they choose to remain in their countries of origin or work abroad.

Postgraduate career intentions of medical students and recent graduates in Malawi: a qualitative interview study.

PubMed

Bailey, Nicola; Mandeville, Kate L; Rhodes, Tim; Mipando, Mwapatsa; Muula, Adamson S

2012-09-14

In 2004, the Malawian Ministry of Health declared a human resource crisis and launched a six year Emergency Human Resources Programme. This included salary supplements for key health workers and a tripling of doctors in training. By 2010, the number of medical graduates had doubled and significantly more doctors were working in rural district hospitals. Yet there has been little research into the views of this next generation of doctors in Malawi, who are crucial to the continuing success of the programme. The aim of this study was to explore the factors influencing the career plans of medical students and recent graduates with regard to four policy-relevant aspects: emigration outside Malawi; working at district level; private sector employment and postgraduate specialisation. Twelve semi-structured interviews were conducted with fourth year medical students and first year graduates, recruited through purposive and snowball sampling. Key informant interviews were also carried out with medical school faculty. Recordings were transcribed and analysed using a framework approach. Opportunities for postgraduate training emerged as the most important factor in participants' career choices, with specialisation seen as vital to career progression. All participants intended to work in Malawi in the long term, after a period of time outside the country. For nearly all participants, this was in the pursuit of postgraduate study rather than higher salaries. In general, medical students and young doctors were enthusiastic about working at district level, although this is curtailed by their desire for specialist training and frustration with resource shortages. There is currently little intention to move into the private sector. Future resourcing of postgraduate training opportunities is crucial to preventing emigration as graduate numbers increase. The lesser importance put on salary by younger doctors may be an indicator of the success of salary supplements. In order to retain doctors at district levels for longer, consideration should be given to the introduction of general practice/family medicine as a specialty. Returning specialists should be encouraged to engage with younger colleagues as role models and mentors.

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

PubMed

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

2016-03-01

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

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2012-12-01

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

Doctors in space (ships): biomedical uncertainties and medical authority in imagined futures.

PubMed

Henderson, Lesley; Carter, Simon

2016-12-01

There has been considerable interest in images of medicine in popular science fiction and in representations of doctors in television fiction. Surprisingly little attention has been paid to doctors administering space medicine in science fiction. This article redresses this gap. We analyse the evolving figure of 'the doctor' in different popular science fiction television series. Building upon debates within Medical Sociology, Cultural Studies and Media Studies we argue that the figure of 'the doctor' is discursively deployed to act as the moral compass at the centre of the programme narrative. Our analysis highlights that the qualities, norms and ethics represented by doctors in space (ships) are intertwined with issues of gender equality, speciesism and posthuman ethics. We explore the signifying practices and political articulations that are played out through these cultural imaginaries. For example, the ways in which 'the simple country doctor' is deployed to help establish hegemonic formations concerning potentially destabilising technoscientific futures involving alternative sexualities, or military dystopia. Doctors mostly function to provide the ethical point of narrative stability within a world in flux, referencing a nostalgia for the traditional, attentive, humanistic family physician. The science fiction doctor facilitates the personalisation of technological change and thus becomes a useful conduit through which societal fears and anxieties concerning medicine, bioethics and morality in a 'post 9/11' world can be expressed and explored. 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/.

Encouraging formative assessments of leadership for foundation doctors.

PubMed

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

2015-08-01

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

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

PubMed

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

2015-12-01

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

Teaching mindfulness in medical school: where are we now and where are we going?

PubMed

Dobkin, Patricia L; Hutchinson, Tom A

2013-08-01

Mindfulness has the potential to prevent compassion fatigue and burnout in that the doctor who is self-aware is more likely to engage in self-care activities and to manage stress better. Moreover, well doctors are better equipped to foster wellness in their patients. Teaching mindfulness in medical school is gaining momentum; we examined the literature and related websites to determine the extent to which this work is carried out with medical students and residents. A literature search revealed that 14 medical schools teach mindfulness to medical and dental students and residents. A wide range of formats are used in teaching mindfulness. These include simple lectures, 1-day workshops and 8-10-week programmes in mindfulness-based stress reduction. Two medical schools stand out because they have integrated mindfulness into their curricula: the University of Rochester School of Medicine and Dentistry (USA) and Monash Medical School (Australia). Studies show that students who follow these programmes experience decreased psychological distress and an improved quality of life. Although the evidence points to the usefulness of teaching mindful practices, various issues remain to be considered. When is it best to teach mindfulness in the trajectory of a doctor's career? What format works best, when and for whom? How can what is learned be maintained over time? Should mindfulness training be integrated into the medical school core curriculum? © 2013 John Wiley & Sons Ltd.

Leadership theory: implications for developing dental surgeons in primary care?

PubMed

Willcocks, S

2011-02-12

The development of leadership in healthcare has been seen as important in recent years, particularly at the clinical level. There have been various specific initiatives focusing on the development of leadership for doctors, nurses and other health care professions: for example, a leadership competency framework for doctors, the LEO programme and the RCN clinical leadership programme for nurses. The NHS has set up a Leadership Council to coordinate further developments. However, there has not been the same focus in dentistry, although the recent review of NHS dental services (Steele review) has proposed a need for leadership initiatives in NHS dentistry as a medium-term action. Central to this will be a need to focus on the leadership role for dental surgeons. Leadership is all the more important in dentistry, given the change of government and the policy of retrenchment, major public sector reform, the emergence of new organisations such as new commissioning consortia, possible changes to the dental contract, new ways of working, and changes to the profession such as the requirements for the revalidation of dental surgeons. The question is: which leadership theory or approach is best for dental surgeons working in primary care? This paper builds on earlier work exploring this question in relation to doctors generally, and GPs, in particular, and planned work on nurses. It will seek to address this question in relation to dental surgeons working in primary care.

The ViennaRNA web services.

PubMed

Gruber, Andreas R; Bernhart, Stephan H; Lorenz, Ronny

2015-01-01

The ViennaRNA package is a widely used collection of programs for thermodynamic RNA secondary structure prediction. Over the years, many additional tools have been developed building on the core programs of the package to also address issues related to noncoding RNA detection, RNA folding kinetics, or efficient sequence design considering RNA-RNA hybridizations. The ViennaRNA web services provide easy and user-friendly web access to these tools. This chapter describes how to use this online platform to perform tasks such as prediction of minimum free energy structures, prediction of RNA-RNA hybrids, or noncoding RNA detection. The ViennaRNA web services can be used free of charge and can be accessed via http://rna.tbi.univie.ac.at.

Bridging the Gap between Community and Cardiologists

ERIC Educational Resources Information Center

Jamatia, Biplab

2015-01-01

Cardiovascular diseases are an emerging cause of morbidity and mortality in India. India produces less than 150 cardiologists annually, leading to a gap between the need and availability of trained professionals. A three-year cardiology-training programme is available for post-graduate doctors in the conventional medical education system. The…

Researching Research in Master's Degrees in Europe

ERIC Educational Resources Information Center

Sin, Cristina

2012-01-01

The research dimension of higher education programmes is usually discussed in association with doctoral studies. Against a background of scarce literature investigating research in a Master's degree, this article aims to analyse the place of research in Master's qualifications, first, as envisaged by official European and national documents acting…

[Realistic possibilities of utilization of a personal computer in the office of a general practitioner].

PubMed

Masopust, V

1991-04-01

In May 1990 work on the programme "Computer system of the health community doctor Mic DOKI was" completed which resolves more than 70 basic tasks pertaining to the keeping of health documentation by health community doctors; it resolves automatically the entire administrative work in the health community, makes it possible to evaluate the activity of doctors and nurses it will facilitate the work of control organs of future health insurance companies and contribute to investigations of the health status of the population. Despite some problems ensuing from the contemporary economic situation of the country, the validity of contemporary health regulations and minimal training of our health personnel in the use of personal computers computerization of the health community system can be considered an asset to the reform of the health services which is under way.

The research group, the conference programme and academic training in safety promotion - a report of the activities at Karolinska Institutet, Sweden.

PubMed

Hörte, Lars-Gunnar; Jansson, Bjarne; Svanström, Leif

2012-01-01

The research group was established in 1967 at Lund University and moved to Karolinska Institutet in 1980. Work began with epidemiological studies of all injuries in the local community in support of various experimental local interventions. An important element was the creation of 'surveillance systems' in healthcare. The work resulted in the establishment of a WHO Collaborating Centre and an international safety-building programme called 'Safe Communities'. In parallel, training at both master's and doctoral level and the building of a conference programme were embarked upon. The research group consists of three sections. Specific efforts are being made by some countries to address their own injury problems.

Circle of influence

NASA Astrophysics Data System (ADS)

Robinson, Andrew

2018-04-01

The founder of the Vienna Circle – a polymathic and influential group of intellectuals dedicated to the philosophy of science from the late 1920s until the Nazi takeover of Austria in 1938 – was German philosopher and physicist Moritz Schlick. Karl Sigmund's latest book – Exact Thinking in Demented Times: the Vienna Circle and the Epic Quest for the Foundations of Science – tells the story of the Vienna Circle's ideas and personalities.

MAX-DOAS measurements of NO2 column densities in Vienna

NASA Astrophysics Data System (ADS)

Schreier, Stefan; Weihs, Philipp; Peters, Enno; Richter, Andreas; Ostendorf, Mareike; Schönhardt, Anja; Burrows, John P.; Schmalwieser, Alois

2017-04-01

In the VINDOBONA (VIenna horizontal aNd vertical Distribution OBservations Of Nitrogen dioxide and Aerosols) project, two Multi AXis Differential Optical Absorption Spectroscopy (MAX-DOAS) systems will be set up at two different locations and altitudes in Vienna, Austria. After comparison measurements in Bremen, Germany, and Cabauw, The Netherlands, the first of the two MAX-DOAS instruments was set up at the University of Veterinary Medicine in the northeastern part of Vienna in December 2016. The instrument performs spectral measurements of visible scattered sunlight at defined horizontal and vertical viewing directions. From these measurements, column densities of NO2 and aerosols are derived by applying the DOAS analysis. First preliminary results are presented. The second MAX-DOAS instrument will be set up in April/May 2017 at the University of Natural Resources and Life Sciences in the northwestern part of Vienna. Once these two instruments are measuring simultaneously, small campaigns including car DOAS zenith-sky and tower DOAS off-axis measurements are planned. The main emphasis of this project will be on the installation and operation of two MAX-DOAS instruments, the improvement of tropospheric NO2 and aerosol retrieval, and the characterization of the horizontal, vertical, and temporal variations of tropospheric NO2 and aerosols in Vienna, Austria.

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

PubMed

Offiah, Gozie; Doherty, Eva

2018-03-01

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

Foundation observation of teaching project--a developmental model of peer observation of teaching.

PubMed

Pattison, Andrew Timothy; Sherwood, Morgan; Lumsden, Colin James; Gale, Alison; Markides, Maria

2012-01-01

Peer observation of teaching is important in the development of educators. The foundation curriculum specifies teaching competencies that must be attained. We created a developmental model of peer observation of teaching to help our foundation doctors achieve these competencies and develop as educators. A process for peer observation was created based on key features of faculty development. The project consisted of a pre-observation meeting, the observation, a post-observation debrief, writing of reflective reports and group feedback sessions. The project was evaluated by completion of questionnaires and focus groups held with both foundation doctors and the students they taught to achieve triangulation. Twenty-one foundation doctors took part. All completed reflective reports on their teaching. Participants described the process as useful in their development as educators, citing specific examples of changes to their teaching practice. Medical students rated the sessions as better or much better quality as their usual teaching. The study highlights the benefits of the project to individual foundation doctors, undergraduate medical students and faculty. It acknowledges potential anxieties involved in having teaching observed. A structured programme of observation of teaching can deliver specific teaching competencies required by foundation doctors and provides additional benefits.

Why do primary care doctors undertake postgraduate diploma studies in a mixed private/public Asian setting?

PubMed

Lam, T P; Lam, K F; Tse, E Y Y

2006-06-01

The aim of this study was to examine the reasons why primary care doctors undertake postgraduate diploma studies in a mixed private/public Asian setting. Twenty four past or current postgraduate diploma students of the family medicine unit (FMU) of the University of Hong Kong participated in three focus group interviews. A structured questionnaire was constructed based on the qualitative data collected and was sent to 328 former applicants of postgraduate diploma studies at FMU. "Upgrading medical knowledge and skills" and "improving quality of practice" were two of the factors that most of the respondents considered to be significant in motivating them to undertake postgraduate diploma studies. "Time constraint" and "workload in practice" were however the most significant demotivating factors. Financial issues were more seriously considered by the junior than the senior doctors. To be able to "expand patient base and/or number" was considered to be a significant factor by the private doctors who were also keen to "improve communication and relationship with patients". These findings suggest that there are mixed reasons for primary care doctors to undertake postgraduate diploma studies. Course organisers should take into consideration these various reasons in planning their programmes.

Conflicting accountabilities: Doctor's dilemma in TB control in rural India.

PubMed

Fochsen, Grethe; Deshpande, Kirti; Ringsberg, Karin C; Thorson, Anna

2009-02-01

The aim of this study was to analyse how the implementation strategy of direct observed treatment short course (DOTS) has shaped and influenced patient-provider encounters in a district tuberculosis centre (DTC) in a rural district of India. Qualitative methods, combining observations and interviews, were carried out in a DTC focusing on the medical encounters between a TB doctor and his patients. The findings showed that the TB doctor seemed to be working with a dilemma, defined as conflicting accountabilities, in the medical encounters. In an organization perceived as inefficient and resource-constrained, the doctor struggled to find a balance between meeting the obligations of the DOTS programme and meeting the needs and expectations of the patients. Strategies to deal with these conflicting accountabilities were identified as limiting patients' involvement, struggling to maintain authority, and transferring responsibility. Professional involvement and patient participation were seen as part of a linked process in this study, and the importance of empowering doctors and health care workers who are implementing DOTS is emphasized. The development of DOTS guidelines needs to be based on the actual process of health care delivery, and staff empowering efforts should also include strengthening of public health care infrastructure.

Plasma Physics Network Newsletter, no. 5

NASA Astrophysics Data System (ADS)

1992-08-01

The fifth Plasma Physics Network Newsletter (IAEA, Vienna, Aug. 1992) includes the following topics: (1) the availability of a list of the members of the Third World Plasma Research Network (TWPRN); (2) the announcement of the fourteenth IAEA International Conference on Plasma Physics and Controlled Nuclear Fusion Research to be held in Wuerzburg, Germany, from 30 Sep. to 7 Oct. 1992; (3) the announcement of a Technical Committee Meeting on research using small tokamaks, organized by the IAEA as a satellite meeting to the aforementioned fusion conference; (4) IAEA Fellowships and Scientific Visits for the use of workers in developing member states, and for which plasma researchers are encouraged to apply through Dr. D. Banner, Head, Physics Section, IAEA, P.O. Box 100, A-1400 Vienna, Austria; (5) the initiation in 1993 of a new Coordinated Research Programme (CRP) on 'Development of Software for Numerical Simulation and Data Processing in Fusion Energy Research', as well as a proposed CRP on 'Fusion Research in Developing Countries using Middle- and Small-Scale Plasma Devices'; (6) support from the International Centre for Theoretical Physics (ICTP) for meetings held in Third World countries; (7) a report by W. Usada on Fusion Research in Indonesia; (8) News on ITER; (9) the Technical Committee Meeting planned 8-12 Sep. 1992, Canada, on Tokamak Plasma Biasing; (10) software made available for the study of tokamak transport; (11) the electronic mail address of the TWPRN; (12) the FAX, e-mail, and postal address for contributions to this plasma physics network newsletter.

MATSIM -The Development and Validation of a Numerical Voxel Model based on the MATROSHKA Phantom

NASA Astrophysics Data System (ADS)

Beck, Peter; Rollet, Sofia; Berger, Thomas; Bergmann, Robert; Hajek, Michael; Latocha, Marcin; Vana, Norbert; Zechner, Andrea; Reitz, Guenther

The AIT Austrian Institute of Technology coordinates the project MATSIM (MATROSHKA Simulation) in collaboration with the Vienna University of Technology and the German Aerospace Center. The aim of the project is to develop a voxel-based model of the MATROSHKA anthro-pomorphic torso used at the International Space Station (ISS) as foundation to perform Monte Carlo high-energy particle transport simulations for different irradiation conditions. Funded by the Austrian Space Applications Programme (ASAP), MATSIM is a co-investigation with the European Space Agency (ESA) ELIPS project MATROSHKA, an international collaboration of more than 18 research institutes and space agencies from all over the world, under the science and project lead of the German Aerospace Center. The MATROSHKA facility is designed to determine the radiation exposure of an astronaut onboard ISS and especially during an ex-travehicular activity. The numerical model developed in the frame of MATSIM is validated by reference measurements. In this report we give on overview of the model development and compare photon and neutron irradiations of the detector-equipped phantom torso with Monte Carlo simulations using FLUKA. Exposure to Co-60 photons was realized in the standard ir-radiation laboratory at Seibersdorf, while investigations with neutrons were performed at the thermal column of the Vienna TRIGA Mark-II reactor. The phantom was loaded with passive thermoluminescence dosimeters. In addition, first results of the calculated dose distribution within the torso are presented for a simulated exposure in low-Earth orbit.

Using QMRAcatch - a stochastic hydrological water quality and infection risk model - to identify sustainable management options for long term drinking water resource planning

NASA Astrophysics Data System (ADS)

Derx, J.; Demeter, K.; Schijven, J. F.; Sommer, R.; Zoufal-Hruza, C. M.; Kromp, H.; Farnleitner, A.; Blaschke, A. P.

2017-12-01

River water resources in urban environments play a critical role in sustaining human health and ecosystem services, as they are used for drinking water production, bathing and irrigation. In this study the hydrological water quality model QMRAcatch was used combined with measured concentrations of human enterovirus and human-associated genetic fecal markers. The study area is located at a river/floodplain area along the Danube which is used for drinking water production by river bank filtration and further disinfection. QMRAcatch was previously developed to support long term planning of water resources in accordance with a public infection protection target (Schijven et al., 2015). Derx et al. 2016 previously used QMRAcatch for evaluating the microbiological quality and required virus-reduction targets at the study area for the current and robust future "crisis" scenarios, i.e. for the complete failure of wastewater treatment plants and infection outbreaks. In contrast, the aim of this study was to elaborate future scenarios based on projected climate and population changes in collaboration with urban water managers. The identified scenarios until 2050 include increased wastewater discharge rates due to the projected urban population growth and more frequent storm and overflow events of urban sewer systems following forecasted changes in climate and hydrology. Based on the simulation results for the developed scenarios sustainable requirements of the drinking water treatment system for virus reductions were re-evaluated to achieve the health risk target. The model outcomes are used to guide practical and scientifically sound management options for long term water resource planning. This paper was supported by FWF (Vienna Doctoral Program on Water Resource Systems W1219-N22) and the GWRS project (Vienna Water) as part of the "(New) Danube-Lower Lobau Network Project" funded by the Government of Austria and Vienna, and the European Agricultural Fund for Rural Development (LE 07-13). ReferencesDerx, J. et al. (2016) QMRAcatch: Human-Associated Fecal Pollution and Infection Risk Modeling for a River/Floodplain Environment. J Env Qual 45(4), 1205-1214 Schijven, J., et al. (2015) QMRAcatch: Microbial Quality Simulation of Water Resources including Infection Risk Assessment. J Env Qual 44(5), 1491-1502

[The Image of Doctors in Europe: A Comparison of Countries].

PubMed

Heinz, Andreas; Décieux, Jean Philippe

2018-04-01

Patients expect a lot from doctors. They expect doctors to be trustworthy and competent, to discuss all treatment options with them, to inform them about mistakes made during the treatment and to put their interests before their own interests. This paper examines how the population of Europe assesses doctors in this respect and whether there are countries where the assessments are similar. In the "International Social Survey Programme - ISSP" the population in 32 countries was asked to assess the doctors in their respective countries. For this paper, data of 27,772 respondents from 18 European countries were analysed. The respondents were asked to rate 5 statements about doctors on a 5-point scale, with 1 indicating a positive assessment and 5 indicating a negative assessment. For each country, the mean values for the statements were calculated and grouped using cluster analysis to identify countries with similar assessments. "Doctors can be trusted" is the statement with the highest approval across all countries, with means ranging from 2.0 in Denmark to 2.7 in Russia. In most countries, the means of the following statements were close to each other: "Doctors discuss all treatment options with their patients", "The medical skills of doctors are as good as they should be", and "Doctors do not care more about their earnings than about their patients." In almost all countries, respondents were particularly skeptical about the statement "Doctors would tell their patients if they had made a mistake during treatment". Four clusters were identified, but there was no cluster that rated among the best for all five statements. With regard to trust, the discussion of treatment options and the pursuit of self-serving interests, doctors in Germany were not rated particularly well or particularly badly. In Germany, the population was more likely to think that doctors would not inform their patients about mistakes during the treatment. Trust in doctors seems to reflect the general level of trust in a country. The question arises why trust in doctors is high across countries if the respondents are much more skeptical regarding the other statements. © Georg Thieme Verlag KG Stuttgart · New York.

Use of Compound-Specific Stable Isotope Analysis to Distinguish Between Vapor Intrusion and Indoor Sources of VOCs - CSIA Protocol for Vapor Intrusion Investigations

DTIC Science & Technology

2014-07-01

Analyzer TCE Trichloroethene USEPA U.S. Environmental Protection Agency V- PDB Vienna - Pee Dee Belemnite V-SMOW Vienna – Standard Mean Ocean Water ... PDB ) for carbon, Standard Mean Ocean Chloride (SMOC) for chlorine, and Vienna-Standard Mean Ocean Water (V-SMOW) for hydrogen. CSIA Protocol for...7 3.3 INDOOR AIR SAMPLING LOCATIONS ............................................................ 8 3.4 COLLECTION OF WATER SAMPLES

Preface

NASA Astrophysics Data System (ADS)

Schuh, S.; Handler, G.

2009-03-01

The Joint European and National Astronomy Meeting 2008 (JENAM 2008) was held from September 8-12, 2008 in Vienna, Austria, as the joint meeting of the Austrian Society of Astronomy and Astrophysics (ÖGAA), the Astronomische Gesellschaft (AG), and the European Astronomical Society (EAS). It hosted nine symposia under the overall topic ''New Challenges To European Astronomy''. This special volume of Communications in Asteroseismology holds the proceedings of the JENAM 2008 Symposium No 4: ''Asteroseismology and Stellar Evolution''. The Asteroseismology and Stellar Evolution Symposium has been generously sponsored by the ÖGAA, by the HELAS Forum (an activity of the European Helio- and Asteroseismology Network, initiative funded by the European Commission since April 1st, 2006, as a Co-ordination Action under its Sixth Framework Programme, FP6), and by the Kulturabteilung der Stadt Wien (Magistratsabteilung 7). The Symposium program was put together by the Scientific Organizing Committee consisting of Conny Aerts (University of Leuven, Belgium), Annie Baglin (Observatoire de Paris, France), Wolfgang Glatzel (University of Göttingen, Germany), Gerald Handler (University of Vienna, Austria, Co-convener), Uli Heber (University of Erlangen-Nürnberg, Germany), Katrien Kolenberg (University of Vienna, Austria), Suzanna Randall (European Southern Observatory) and Sonja Schuh (University of Göttingen, Germany, Convener). Out of a total of 60 oral and poster contributions, 15 contributed talks were selected for presentation during the three half-day session program, with ample time for questions and discussion. There also was an opportunity to introduce the poster contributions during 2-min oral presentations. The scientific topics covered diverse object classes divided into Stochastically excited pulsators (main sequence, red giants, AGB supergiants), Heat-driven pulsators along the main sequence, and Compact pulsators, as well as additional topics that we have summarized as contributions on Eruptive variable and binary stars, and contributions presenting Methods and tools. The three session topics were introduced by two invited review speakers per field. In the first session, Jadwiga Daszynska-Daszkiewicz summarized current ''Challenges for stellar pulsation and evolution theory'', and Konstanze Zwintz reported ''A preliminary glimpse on CoRoT results and expectations'' (for Eric Michel), together giving an overview of the observational and theoretical status of the field. Anne Thoul and Oleg Kochukhov presented the state of the art in ''Asteroseismology of B stars'' and ''Asteroseismology of chemically peculiar stars'', respectively, in the second session, highlighting the hot issues in understanding and interpreting the pulsational behaviour of these groups. The stellar evolution aspect was given special consideration in ''Asteroseismology and Evolution of EHB stars'' by Roy Østensen and ''Asteroseismology and evolution of GW Vir stars'' by Pierre-Oliver Quirion in the concluding third session. A dedicated audience (on average 45 participants in each session), the excellent speakers, and our colleague Patrick Lenz who acted as the friendly and competent technician made this Symposium a highly interesting, enjoyable and successful event. We would like to thank all speakers, poster authors, and participants for coming to Vienna, the SOC and the referees for their work, the local organizers at Vienna for providing all the necessary infrastructure, and all sponsors for having made possible this event and the proceedings at hand.

National allergy programme had little impact on parent-reported food allergies in children aged 6-7 years.

PubMed

Palmu, Sauli; Heikkilä, Paula; Uski, Virpi; Niitty, Siina; Kurikka, Sari; Korppi, Matti

2018-01-01

The ten-year Finnish national allergy programme was launched in 2008 to lessen the disease and psychological burden of allergy. This study assessed the prevalence of parent-reported food allergies requiring avoidance diets at primary school in children aged six and seven years. The cohort comprised 1937 children (51% boys) who started primary school in Tampere, Finland, in August 2016. School health nurses charted parent-reported, doctor-diagnosed food allergies requiring avoidance diets as part of the routine health examination. We found that 127 (6.6%) children had parent-reported, doctor-diagnosed allergies to at least one food and 37 (1.9%) were allergic to basic foods, namely cows' milk, wheat and one other grain. All required an avoidance diet. The figure did not differ significantly from the 2.7% and 2.5% found by studies of this age group in 2009 and 2013, respectively. Allergies to fresh fruit and vegetables decreased from 5.8% in 2009 to 3.6% in 2016. We studied the national allergy programme that started in 2008 and found that there was a nonsignificant overall decrease in the number of children aged six to seven years on avoidance diets for allergies between 2009 and 2016. The only allergies that showed significant decreases were fresh fruit and vegetables. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Evaluation of training programme uptake in an attempt to reduce obstetric anal sphincter injuries: the SUPPORT programme.

PubMed

Rahman, Nadia; Vinayakarao, Latha; Pathak, Sangeeta; Minden, Dawn; Melson, Louise; Vitue, Ella; Pradhan, A

2017-03-01

The objective was to assess the feedback from a quality improvement training programme to reduce obstetric anal sphincter injuries (OASIS). Training sessions were organised that included evidence-based information on OASIS risk factors and training on models to measure perineal body length (PBL), perform episiotomies with standard and 60° fixed angle scissors (EPISCISSORS-60®), and measure post-delivery episiotomy suture angles with protractor transparencies. Feedback forms using a Likert scale (1-4) were completed and analysed. The setting was an evidence-based quality improvement programme (Strategy for Using Practical aids for Prevention of OASIS, Recording episiotomies and clinician Training [SUPPORT]) at two National Health Service (NHS) Hospitals in the UK. The participants were midwives and doctors attending the SUPPORT training programme RESULTS: All of the participants (100 %) would recommend the training programme to a friend or colleague. 92 % felt that the training session improved their knowledge of the impact of PBL and perineal distension and their knowledge of the relationship between episiotomy angle and OASIS "a lot" or "somewhat". Based on this feedback, we recommend the addition of the knowledge content of the SUPPORT programme to other centres providing perineal assessment and repair courses.

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

PubMed Central

Smith, Fay; Goldacre, Michael J

2015-01-01

Objectives Doctors who graduated in the UK after 2005 have followed a restructured postgraduate training programme (Modernising Medical Careers) and have experienced the introduction of the European Working Time Regulation and e-portfolios. In this paper, we report the views of doctors who graduated in 2008 three years after graduation and compare these views with those expressed in year 1. Design Questionnaires about career intentions, destinations and views sent in 2011 to all medical graduates of 2008. Participants 3228 UK medical graduates. Main outcome measures Comments on work, education and training. Results Response was 49% (3228/6538); 885 doctors wrote comments. Of these, 21.8% were unhappy with the standard of their training; 8.4% were positive. Doctors made positive comments about levels of supervision, support, morale and job satisfaction. Many doctors commented on poor arrangements for rotas, cover and leave, which had an adverse effect on work-life balance, relationships, morale and health. Some doctors felt pressured into choosing their future specialty too early, with inadequate career advice. Themes raised in year 3 that were seldom raised in year 1 included arrangements for flexible working and maternity leave, obtaining posts in desired locations and having to pay for courses, exams and conferences. Conclusions Many doctors felt training was available, but that European Working Time Regulation, rotas and cover arrangements made it difficult to attend. Three years after graduation, doctors raised similar concerns to those they had raised two years earlier, but the pressures of career decision making, family life and job seeking were new issues. PMID:26664735

Occupational factors for mood and anxiety disorders among junior medical doctors.

PubMed

Pougnet, R; Di Costanzo, Laurence Pougnet; Kerrien, Margaux; Jousset, D; Loddé, B; Dewitte, J D; Garlantézec, R

2015-09-09

Junior doctors are exposed to multiple occupational risks. The aim of this study was to assess the risk factors and protective factors for mood and anxiety disorders among junior doctors. We conducted a cross-sectional study via an anonymous online questionnaire between October 2011 and June 2012. All the junior doctors in our faculty were included. The questionnaire inquired about demographic and health data. It contained four validated scales: the Center for Epidemiologic Studies Depression Scale (CES-D), the Spielberger anxiety questionnaire, the WHO quality of life (WHO - QOL) questionnaire and the Job Content Questionnaire. Finally, it sought to clarify the conditions of professional practice and the interactions between university programmes and junior doctorate students (change of specialty, pregnancy, leave of absence, etc.). 192 juniors doctors participated in the study, 68.2% of whom were women. Out of the group, 13.0% presented a depressive syndrome, while 28.7% presented an anxiety disorder, 32.8% were experiencing Job Strain and 29.7% Iso Strain. The risk factor for anxiety was competition between junior doctors: OR=4.23 (1.06 ‒ 16.82). The protective factors for mood disorders were the help provided by senior physicians and the respect shown by patients: OR=0.21 (0.06-0.74) and 0.20 (0.06-0.75), respectively. This study demonstrated the impact of the relationships with senior physicians and patients on junior doctors' health at work. Consequently, prevention should not be focused uniquely on work organization, but should increase physicians' awareness of the importance of this relationship.

Learning leadership skills in practice through quality improvement.

PubMed

Gamble, James; Vaux, Emma

2014-02-01

The development of leadership skills in doctors in training is essential to support both their professional development and the future supply of clinical leaders the NHS so desperately needs. There is, however, limited opportunity in current training programmes for trainees to learn and develop these skills, and what opportunity there is has often focused on management rather than leadership skills. Involvement in trainee-led supported quality improvement projects can teach these skills. We summarise the current limitations in leadership training and discuss how the College's 'Learning To Make a Difference' programme, and others like it, are helping to teach leadership.

Malnutrition in the Field. Nigerian Civil War 1968-9

PubMed Central

Hughes, S. P. F.

1969-01-01

A short-term, large-scale medical and feeding programme has been provided for a population of 150,000 in the bush area near Udi in eastern Nigeria (Biafra). By January 1969 8,000 patients were receiving medical treatment each week for varying degrees of protein malnutrition (including kwashiorkor), vitamin deficiency, and dehydration; while 100,000 received weekly rations of a protein-supplemented diet. Close cooperation between the medical team—which consisted of one doctor, four nurses, and two relief workers—and the local Ibo people contributed to the success of the relief programme. PMID:5781491

Decolonial Pedagogies Walking and Asking. Notes to Paulo Freire from Abyayala

ERIC Educational Resources Information Center

Walsh, Catherine E.

2015-01-01

Catherine Walsh is senior professor and director of the doctoral programme in Latin American Cultural Studies at the Universidad Andina Simon Bolivar in Ecuador. Her present work is focused on the political, epistemic and ethical project of critical interculturality, and on concerns of decoloniality, taking as key the themes of knowledge,…

Work-Based Research Degrees: Systematic Cultivation through a University-Industry Network Space

ERIC Educational Resources Information Center

Sense, Andrew J.

2016-01-01

The purpose of this paper is to expound on an innovative approach to cultivating work-based Doctorates and Masters of Philosophy degrees, which involves close collaboration between industry organisations and a tertiary institution. This paper also reports on an examination of the programme's structural ability to help develop the learning…

Investigating Uses and Perceptions of an Online Collaborative Workspace for the Dissertation Process

ERIC Educational Resources Information Center

Rockinson-Szapkiw, Amanda J.

2012-01-01

The intent of this study was to investigate 93 doctoral candidates' perceptions and use of an online collaboration workspace and content management server, Microsoft Office SharePoint, for dissertation process. All candidates were enrolled in an Ed.D. programme in the United States. Descriptive statistics demonstrate that candidates frequently use…

PhD Students, Interculturality, Reflexivity, Community and Internationalisation

ERIC Educational Resources Information Center

Holliday, Adrian

2017-01-01

Interviews with a small group of doctoral students at a British university indicate that the students feel that the programme provides an environment within which they develop interculturality through reflexive engagement with the PhD community and in some cases with the participants in their research. Significant here is that they are…

The UCL EdD: An Apprenticeship for the Future Educational Professional?

ERIC Educational Resources Information Center

Taylor, Susan

2018-01-01

In 2001, the Institute of Education (now the UCL Institute of Education (UCL IOE)) became one of only three internationally accredited centres for the training of Reading Recovery trainers. To achieve accreditation, the training programme was required by the International Reading Recovery Trainers Organization to be linked to the IOE doctor of…

Postgraduate Research Supervision at a Distance: A Review of Challenges and Strategies

ERIC Educational Resources Information Center

Nasiri, Fuzhan; Mafakheri, Fereshteh

2015-01-01

This article reviews the literature on supervisory elements in distance postgraduate research programmes leading to a master's or doctoral degree. The authors first identify and review the main supervisory challenges from the perspectives of both supervisor and supervisee. This paves the path to investigate and categorise the strategies that have…

Fostering Connections between Graduate Students and Strengthening Professional Identity through Co-Mentoring

ERIC Educational Resources Information Center

Murdock, Jennifer L.; Stipanovic, Natalie; Lucas, Kyle

2013-01-01

For counsellors and counsellor educators, developing a sound sense of professional identity is a necessity in preserving and advancing the counselling field. In an effort to promote professional identity development in a group of counsellors in training, a co-mentoring programme was developed that paired master's level and doctoral level…

Reflections of a "Late-Career" Early-Career Researcher: An Account of Practice

ERIC Educational Resources Information Center

Groves, Catherine J.

2016-01-01

This account of practice describes the journey of an "accidental academic" through the Doctoral programme in Business Administration (DBA). It reflects on her experience of action learning and lessons learned to better embed action learning in future DBA teaching and assessment. The account is told from the perspective of a mature…

Decision technologies and the independent professional: the future's challenge to learning and leadership

PubMed Central

Dowie, J.

2001-01-01

Most references to "leadership" and "learning" as sources of quality improvement in medical care reflect an implicit commitment to the decision technology of "clinical judgement". All attempts to sustain this waning decision technology by clinical guidelines, care pathways, "evidence based practice", problem based curricula, and other stratagems only increase the gap between what is expected of doctors in today's clinical situation and what is humanly possible, hence the morale, stress, and health problems they are increasingly experiencing. Clinical guidance programmes based on decision analysis represent the coming decision technology, and proactive adaptation will produce independent doctors who can deliver excellent evidence based and preference driven care while concentrating on the human aspects of the therapeutic relation, having been relieved of the unbearable burdens of knowledge and information processing currently laid on them. History is full of examples of the incumbents of dominant technologies preferring to die than to adapt, and medicine needs both learning and leadership if it is to avoid repeating this mistake. Key Words: decision technology; clinical guidance programmes; decision analysis PMID:11700381

Specialty differences in the association between health care climate and patient trust.

PubMed

Weng, Hui-Ching; Chen, Yaw-Sen; Lin, Chia-Shiang; Tu, Yuan-Kun; Lin, Hsi-Hsun; Yu, Shang-Won

2011-09-01

Previous studies have suggested that there is a positive correlation between doctors' emotional intelligence (EI) and patients' trust in their attending physicians; however, there is only limited evidence of specialty differences between internists and surgeons for such an association. This study examined the association of nursing director assessments of doctors' EI, outside observer assessments of doctors' health care climate (HCC) in the examining room and patient-rated trust in internists and surgeons. Health care climate refers to a key component in communication and reflects the extent to which patients perceive their health care providers as supporting patient autonomy rather than controlling the provision of treatment. In this observational study, 2702 patients seen by 110 internists and 2642 patients seen by 101 surgeons were surveyed in face-to-face interviews by trained nurses in two teaching hospitals in Taiwan. Using hierarchical linear modelling, we examined the association between EI and HCC as well as patient trust in doctors working in the specialties of internal medicine and surgery. We found a significantly positive correlation between doctor EI and patient trust for all patients (p<0.01). In addition, although HCC was positively associated with patient trust for internists (p<0.01), it was not so for surgeons. We conclude that doctors might benefit from training programmes aimed at improving EI and that differences in patient expectations might be considered when hospitals attempt to evaluate doctors in different specialties. © Blackwell Publishing Ltd 2011.

Antirationalist critique or fifth column of scientism? Challenges from Doctor Who to the mad scientist trope.

PubMed

Orthia, Lindy A

2011-07-01

Much of the public understanding of science literature dealing with fictional scientists claims that scientist villains by their nature embody an antiscience critique. I characterize this claim and its founding assumptions as the "mad scientist" trope. I show how scientist villain characters from the science fiction television series Doctor Who undermine the trope via the programme's use of rhetorical strategies similar to Gilbert and Mulkay's empiricist and contingent repertoires, which define and patrol the boundaries between "science" and "non-science." I discuss three such strategies, including the literal framing of scientist villains as "mad." All three strategies exclude the characters from science, relieve science of responsibility for their villainy, and overtly or covertly contribute to the delivery of pro-science messages consistent with rationalist scientism. I focus on scientist villains from the most popular era of Doctor Who, the mid 1970s, when the show embraced the gothic horror genre.

Vienna-Chicago: the cultural transformation of the model system of the un-opposed molar.

PubMed

Luan, Xianghong; Diekwisch, Thomas G H

2007-08-01

The discussion over the roles of genes and environment on the phenotypical specification of organisms has held a central role in science philosophy since the late 19(th) century and has re-emerged in today's debate over genetic determinism and developmental plasticity. In fin-de-siecle Vienna, this debate coincided with a philosophical debate over empiricism/materialism versus idealism/vitalism. Turn-of-the-century Vienna's highly interdisciplinary environment was also the birthplace for the model system of the un-opposed molar. The un-opposed molar system features new tissue formation at the roots of teeth and tooth drift once opposing teeth are lost. The un-opposed molar model system was revived by a group of Viennese scientists who left Vienna during the Nazi period to address Vienna's questions about evolution and heredity and about genes and environment in Chicago's post-WWII scientific exile community. Here we are using the colorful history of the un-opposed molar to investigate the role of culture and method in the scientific evolution of a model system. (c) 2007 Wiley Periodicals, Inc.

Interview with Heribert Hirt.

PubMed

Hirt, Heribert

2016-01-01

As a son of an engineer who traveled widely during his career, Heribert Hirt began his life in the exotic country of Iran, before receiving his high-school education in Germany and then studying biochemistry at the University of Cape Town and then later at the University of Vienna, from where he received his PhD in 1987. He then worked as a postdoctoral fellow in Vienna, Oxford, and Wageningen, before starting his own group at the University of Vienna in 1993. It was also in Vienna that he became professor of genetics in 1997, followed by vice-director of the Gregor Mendel Institute of Plant Molecular Biology, and later head of the Plant Molecular Biology Department of the University of Vienna. In 2007, he decided that it was time for new challenges and accepted an appointment in France to direct the Paris-based INRA-CNRS Plant Genomics Institute for the following 7 years. In 2014, Heribert embarked on yet another challenge by accepting the role to head up the Center for Desert Agriculture at King Abdullah University of Sciences and Technology (KAUST) in Saudi Arabia. Copyright © 2015 Elsevier Ltd. All rights reserved.

Nesting doctoral students in collaborative North-South partnerships for health systems research.

PubMed

Loukanova, Svetla; Prytherch, Helen; Blank, Antje; Duysburgh, Els; Tomson, Göran; Gustafsson, Lars L; Sié, Ali; Williams, John; Leshabari, Melkizedeck; Haefeli, Walter E; Sauerborn, Rainer; Fonn, Sharon

2014-01-01

The European Union (EU) supports North-South Partnerships and collaborative research projects through its Framework Programmes and Horizon 2020. There is limited research on how such projects can be harnessed to provide a structured platform for doctoral level studies as a way of strengthening health system research capacity in sub-Saharan Africa (SSA). The aim of this study was to explore the challenges of, and facilitating factors for, 'nesting' doctoral students in North-South collaborative research projects. The term nesting refers to the embedding of the processes of recruiting, supervising, and coordinating doctoral students in the overall research plan and processes. This cross-sectional qualitative study was undertaken by the EU-funded QUALMAT Project. A questionnaire was implemented with doctoral students, supervisors, and country principal investigators (PIs), and content analysis was undertaken. Completed questionnaires were received from nine doctoral students, six supervisors, and three country PIs (86% responses rate). The doctoral students from SSA described high expectations about the input they would receive (administrative support, equipment, training, supervision). This contrasted with the expectations of the supervisors for proactivity and self-management on the part of the students. The rationale for candidate selection, and understandings of the purpose of the doctoral students in the project were areas of considerable divergence. There were some challenges associated with the use of the country PIs as co-supervisors. Doctoral student progress was at times impeded by delays in the release of funding instalments from the EU. The paper provides a checklist of essential requirements and a set of recommendations for effective nesting of doctoral students in joint North-South projects. There are considerable challenges to the effective nesting of doctoral students within major collaborative research projects. However, ways can be found to overcome them. The nesting process ultimately helped the institutions involved in this example to take better advantage of the opportunities that collaborative projects offer to foster North-South partnerships as a contribution to the strengthening of local research capacity.

Introducing a New Junior Doctor Electronic Weekend Handover on an Orthopaedic Ward.

PubMed

Maroo, Siddharth; Raj, Dipak

2017-01-01

Junior Doctors working on the Orthopaedic wards at a district general hospital identified the lack of a formal weekend handover. The Royal Colleges,GMC and Foundation Programme curriculum all emphasise the importance of a safe and effective handover. Doctors found that the current system of using a written, paper-based handover was unreliable, un-legible, and inefficient. Baseline measurements were sought in the form of a questionnaire which allowed us to obtain the limitations to the current handover. After this and a focus group, a new electronic, 'Microsoft Word' based handover was created and a repeat surgery issued in 2 weeks. Further PDSA cycles over the course of 8 weeks helped to improve and implement the new handover. The overall rating, out of 10, of the new handover increased from 3.4 to 8. Doctors felt the new handover was safer for patients and could be used as a tool for reviewing or referring patients. This project describes the use of a simple, cost-effective intervention that helped to improve patient safety and staff satisfaction.

Should we use philosophy to teach clinical communication skills?

PubMed

Gerber, Berna

2016-11-16

Effective communication between the doctor and patient is crucial for good quality health care. Yet, this form of communication is often problematic, which may lead to several negative consequences for both patients and doctors. Clinical communication skills have become important components of medical training programmes. The traditional approach is to teach students particular communication skills, such as listening to patients and asking open-ended questions. Despite their importance, such training approaches do not seem to be enough to deliver medical practitioners who are able and committed to communicate effectively with patients. This might be due to the pervasive negative influence of the medical profession's (mistaken) understanding of itself as a natural science on doctor-patient communication. Doctors who have been trained according to a positivist framework may consider their only responsibility to be the physical treatment of physical disorders. They may thus have little regard for the patient's psychological and social world and by extension for communication with the patient and/or their caregivers. To address this problem, I propose a curriculum, based on the academic field of philosophy, for teaching clinical communication.

Doctors in space (ships): biomedical uncertainties and medical authority in imagined futures

PubMed Central

Henderson, Lesley; Carter, Simon

2016-01-01

There has been considerable interest in images of medicine in popular science fiction and in representations of doctors in television fiction. Surprisingly little attention has been paid to doctors administering space medicine in science fiction. This article redresses this gap. We analyse the evolving figure of ‘the doctor’ in different popular science fiction television series. Building upon debates within Medical Sociology, Cultural Studies and Media Studies we argue that the figure of ‘the doctor’ is discursively deployed to act as the moral compass at the centre of the programme narrative. Our analysis highlights that the qualities, norms and ethics represented by doctors in space (ships) are intertwined with issues of gender equality, speciesism and posthuman ethics. We explore the signifying practices and political articulations that are played out through these cultural imaginaries. For example, the ways in which ‘the simple country doctor’ is deployed to help establish hegemonic formations concerning potentially destabilising technoscientific futures involving alternative sexualities, or military dystopia. Doctors mostly function to provide the ethical point of narrative stability within a world in flux, referencing a nostalgia for the traditional, attentive, humanistic family physician. The science fiction doctor facilitates the personalisation of technological change and thus becomes a useful conduit through which societal fears and anxieties concerning medicine, bioethics and morality in a ‘post 9/11’ world can be expressed and explored. PMID:27694600

Understanding how appraisal of doctors produces its effects: a realist review protocol

PubMed Central

Brennan, Nicola; Bryce, Marie; Pearson, Mark; Wong, Geoff; Cooper, Chris; Archer, Julian

2014-01-01

Introduction UK doctors are now required to participate in revalidation to maintain their licence to practise. Appraisal is a fundamental component of revalidation. However, objective evidence of appraisal changing doctors’ behaviour and directly resulting in improved patient care is limited. In particular, it is not clear how the process of appraisal is supposed to change doctors’ behaviour and improve clinical performance. The aim of this research is to understand how and why appraisal of doctors is supposed to produce its effect. Methods and analysis Realist review is a theory-driven interpretive approach to evidence synthesis. It applies realist logic of inquiry to produce an explanatory analysis of an intervention that is, what works, for whom, in what circumstances, in what respects. Using a realist review approach, an initial programme theory of appraisal will be developed by consulting with key stakeholders in doctors’ appraisal in expert panels (ethical approval is not required), and by searching the literature to identify relevant existing theories. The search strategy will have a number of phases including a combination of: (1) electronic database searching, for example, EMBASE, MEDLINE, the Cochrane Library, ASSIA, (2) ‘cited by’ articles search, (3) citation searching, (4) contacting authors and (5) grey literature searching. The search for evidence will be iteratively extended and refocused as the review progresses. Studies will be included based on their ability to provide data that enable testing of the programme theory. Data extraction will be conducted, for example, by note taking and annotation at different review stages as is consistent with the realist approach. The evidence will be synthesised using realist logic to interrogate the final programme theory of the impact of appraisal on doctors’ performance. The synthesis results will be written up according to RAMESES guidelines and disseminated through peer-reviewed publication and presentations. Trial registration number The protocol is registered with PROSPERO 2014:CRD42014007092. PMID:24958211

Doctor and Hobby Astronomer in Stormy Times: The Book Legacy of Dr. Johannes Häringshauser (1603-1642)

NASA Astrophysics Data System (ADS)

Davison, G.

2011-06-01

Johannes Häringshauser (1603-1941) was born in Vienna and graduated at Padua in the faculty of medicine in 1626. He became a Hofmedicus at the court and in the field of the Thirty Years War in 1627-1630 and then a Viertelmedicus at Mistelbach in Niederoesterreich in 1630 until 1641. His purchase of books had initially concentrated on medical topics but from 1636 to 1640 he bought some ten books on astronomy, including two by Johannes Kepler and one by Michael Mästlin, Kepler's tutor at Tübingen. The fact that he acquired the books by Mästlin and Kepler so soon after Galileo's trial shows him to have been a courageous independently minded thinker with wide ranging professional and intellectual interests. In his professional medical activities he sought to balance the medical practises of Galen and Paracelsus, and in his astronomy hobby he investigated the the new arguments of Mästlin, Kepler, and Galileo.

Contributions to the History of Astronomy, Vol. 8 (German Title: Beiträge zur Astronomiegeschichte, Band 8)

NASA Astrophysics Data System (ADS)

Dick, Wolfgang R.; Hamel, Jürgen

The contributions span a time interval of more than 450 years. There are biographical investigations on Georg Joachim Rheticus, C.W.A. von Wahl and K.F. Heym, investigation on a reprint of a chapter of the principal work of Nicolaus Copernicus, on Christoph Scheiner and the "camera obscura", and, with respect to the history of timekeeping, on the "big Nuremberg clock". 19th century topics are: a contribution on the honorary doctorate of Joseph Fraunhofer, and on the construction of a lunar globe by Wilhelmine Witte, while the report on Friedrich Wilhelm Bessel and the cholera pandemia in Königsberg in the year 1831 gives a view into everyday life of scientists. 20th century topics are: the contributions on Bruno Thüring in Vienna and his relations with national socialism, as well as on Arthur Beer, Albert Einstein and the Warburg library. The book concludes by short communications, obituaries and book reviews.

The physicians and surgeons of Koper from the 14th to the 17th century.

PubMed

Uran, Lejla Peternelj

2011-03-01

Koper stands out among Istrian towns of the nordeastern Adriatic coast for its highly advanced medicine. Communal service developed between the 13th and 15th century. Beside the hospital, almshouse and a quarantine, the city also boasted highly trained physicians, surgeons and barbers. Trade, crafts and navigation prospered and numerous town intellectuals established an academy whose most active members were medical doctors. The aim of this article is to give a chronological presentation of physicians related to Koper by their birth or work and of other scientists who contributed to the development of local medicine. These includes (about forty names) S. Santorio, Ser Benvenuto, P P. Vergerio, G. Nuzio, E Nuzio, P de Castaldi, I. de Albertis, L. Zarotti, B. Petronio, I. Bratti, Z. Zarotti, A.Valdera, G. Vergerio and C. Zarotti of whom some are well known. The author wishes to systematisize the bibliography, fill the gaps and show ways for further research in the archives and museums of Istria, Triest, Venice and Vienna.

Vienna Special Analysis Center Annual Report 2012

NASA Technical Reports Server (NTRS)

Boehm, Johannes; Boehm, Sigrid; Krasna, Hana; Madzak, Matthias; Nilsson, Tobias; Plank, Lucia; Raposo, Virginia; Schuh, Harald; Soja, Benedikt; Sun Jing;

The future of postgraduate training.

PubMed

Walsh, Kieran

2014-01-01

Improvements to postgraduate training have included newly designed postgraduate curricula, new forms of delivery of learning, more valid and reliable assessments, and more rigorous evaluation of training programmes. All these changes have been necessary and have now started to settle in. Now therefore is an appropriate time to look to the future of postgraduate training. Predicting the future is difficult in any course of life-however an examination of recent trends is often a good place to start. In this regard the recent trend to start to produce more doctors and healthcare professionals of the type that the population needs is likely to continue for some time to come. Medical education will also need to be more flexible in the future. The more flexible that training programmes are, the more likely that we will have experts that are sufficiently flexible to meet a range of different challenges throughout the rest of their careers. Medical education will also become more seamless in the future (at present there are probably too many major milestones and transitions in medical education). In the future educators will make much more use of technology enhanced learning, e-learning and simulation in postgraduate medical education. There will also be more pressure on postgraduate training programmes to offer value for money and to be able to demonstrate such value for money. Postgraduate medical education of the future will also be a more personalised and adaptive experience. It will be far more based on learners' individual needs and will be more responsive to those needs. Lastly postgraduate education will be much more closely supervised than it has been in the past. A common theme running through these changes will be patient centredness. This will mean safer training programmes that produce the type of doctors that patients and populations need.

Surgical capacity building in Timor-Leste: a review of the first 15 years of the Royal Australasian College of Surgeons-led Australian Aid programme.

PubMed

Guest, Glenn D; Scott, David F; Xavier, Joao P; Martins, Nelson; Vreede, Eric; Chennal, Antony; Moss, Daliah; Watters, David A

2017-06-01

Timor-Leste suffered a destructive withdrawal by the Indonesian military in 1999, leaving only 20 Timorese-based doctors and no practising specialists for a population of 700 000 that has now grown to 1.2 million. This article assesses the outcomes and impact of Royal Australasian College of Surgeons (RACS) specialist medical support from 2001 to 2015. Three programmes were designed collaboratively with the Timor-Leste Ministry of Health and Australian Aid. The RACS team began to provide 24/7 resident surgical and anaesthesia services in the capital, Dili, from July 2001. The arrival of the Chinese and Cuban Medical Teams provided a medical workforce, and the Cubans initiated undergraduate medical training for about 1000 nationals both in Cuba and in Timor-Leste, whilst RACS focused on specialist medical training. Australian Aid provided AUD$20 million through three continuous programmes over 15 years. In the first 10 years over 10 000 operations were performed. Initially only 10% of operations were done by trainees but this reached 77% by 2010. Twenty-one nurse anaesthetists were trained in-country, sufficient to cover the needs of each hospital. Seven Timorese doctors gained specialist qualifications (five surgery, one ophthalmology and one anaesthesia) from regional medical schools in Papua New Guinea, Fiji, Indonesia and Malaysia. They introduced local specialist and family medicine diploma programmes for the Cuban graduates. Timor-Leste has developed increasing levels of surgical and anaesthetic self-sufficiency through multi-level collaboration between the Ministry of Health, Universidade Nacional de Timor Lorosa'e, and sustained, consistent support from external donors including Australian Aid, Cuba and RACS. © 2016 Royal Australasian College of Surgeons.

Status and Plans for the Vienna VLBI and Satellite Software (VieVS 3.0)

NASA Astrophysics Data System (ADS)

Gruber, Jakob; Böhm, Johannes; Böhm, Sigrid; Girdiuk, Anastasiia; Hellerschmied, Andreas; Hofmeister, Armin; Krásná, Hana; Kwak, Younghee; Landskron, Daniel; Madzak, Matthias; Mayer, David; McCallum, Jamie; Plank, Lucia; Schartner, Matthias; Shabala, Stas; Teke, Kamil; Sun, Jing

2017-04-01

The Vienna VLBI and Satellite Software (VieVS) is a geodetic analysis software developed and maintained at Technische Universität Wien (TU Wien) with contributions from groups all over the world. It is used for both academic purposes in university courses as well as for providing Very Long Baseline Interferometry (VLBI) analysis results to the geodetic community. Written in a modular structure in Matlab, VieVS offers easy access to the source code and the possibility to adapt the programs for particular purposes. The new version 3.0, released in early 2017, includes several new features, e.g., improved scheduling capabilities for observing quasars and satellites. This poster gives an overview of all VLBI-related activities in Vienna and provides an outlook to future plans concerning the Vienna VLBI and Satellite Software (VieVS).

Considerations of private sector obstetricians on participation in the state led "Chiranjeevi Yojana" scheme to promote institutional delivery in Gujarat, India: a qualitative study.

PubMed

Ganguly, Parthasarathi; Jehan, Kate; de Costa, Ayesha; Mavalankar, Dileep; Smith, Helen

2014-11-05

In India a lack of access to emergency obstetric care contributes to maternal deaths. In 2005 Gujarat state launched a public-private partnership (PPP) programme, Chiranjeevi Yojana (CY), under which the state pays accredited private obstetricians a fixed fee for providing free intrapartum care to poor and tribal women. A million women have delivered under CY so far. The participation of private obstetricians in the partnership is central to the programme's effectiveness. We explored with private obstetricians the reasons and experiences that influenced their decisions to participate in the CY programme. In this qualitative study we interviewed 24 purposefully selected private obstetricians in Gujarat. We explored their views on the scheme, the reasons and experiences leading up to decisions to participate, not participate or withdraw from the CY, as well as their opinions about the scheme's impact. We analysed data using the Framework approach. Participants expressed a tension between doing public good and making a profit. Bureaucratic procedures and perceptions of programme misuse seemed to influence providers to withdraw from the programme or not participate at all. Providers feared that participating in CY would lower the status of their practices and some were deterred by the likelihood of more clinically difficult cases among eligible CY beneficiaries. Some providers resented taking on what they saw as a state responsibility to provide safe maternity services to poor women. Younger obstetricians in the process of establishing private practices, and those in more remote, 'less competitive' areas, were more willing to participate in CY. Some doctors had reservations over the quality of care that doctors could provide given the financial constraints of the scheme. While some private obstetricians willingly participate in CY and are satisfied with its functioning, a larger number shared concerns about participation. Operational difficulties and a trust deficit between the public and private health sectors affect retention of private providers in the scheme. Further refinement of the scheme, in consultation with private partners, and trust building initiatives could strengthen the programme. These findings offer lessons to those developing public-private partnerships to widen access to health services for underprivileged groups.

Re-Thinking Professional Development and Accountability: Towards a More Educational Training Practice

ERIC Educational Resources Information Center

Emmett, Yvonne

2015-01-01

In this article, I discuss the contribution of theoretical resources to the transformation in my thinking about professional development and accountability, within an action research self-study of practice as a civil servant, in the context of participation on the Doctor in Education (Leadership) programme at Dublin City University (DCU) in the…

The Role of Research Education Coordinators in Building Research Cultures in Doctoral Education

ERIC Educational Resources Information Center

Brew, Angela; Boud, David; Malfroy, Janne

2017-01-01

The development of cultures of support has become important in programmes for the preparation of research students. The paper draws on in-depth interviews with 21 research education coordinators from Australian and United Kingdom institutions to identify the strategies that they use to build research cultures and integrate research students into…

How Can Visual Arts Help Doctors Develop Medical Insight?

ERIC Educational Resources Information Center

Edmonds, Kathleen; Hammond, Margaret F.

2012-01-01

This research project examines how using the visual arts can develop medical insight, as part of a pilot programme for two groups of medical students. It was a UK study; a collaboration between Liverpool and Glyndw University's and Tate Liverpool's learning team. Tate Liverpool is the home of the National Collection of Modern Arts in the North of…

Multimodal Identity Texts as Mediational Spaces in Researching Ph.D. Students' Critical Teacher-Researcher Selves

ERIC Educational Resources Information Center

Valencia, Marlon; Herath, Sreemali

2015-01-01

This paper analyses how two Ph.D. students used multimodal identity texts (MMITs) to document their research journeys as they engaged in their doctoral studies. Drawing on qualitative data collected from multiple pre-service teacher preparation programmes in Chile and Sri Lanka, two bi-national researchers (a Colombian-Canadian and a Sri…

Help wanted.

PubMed

1999-09-01

Anthony McGrath , Senior Lecturer at Middle-sex University, is undertaking a doctorate to examine 'To what extent does masters degree education affect clinical prac-tice'. He would like to hear from anyone who has undertaken such a degree programme and remains in clinical practice to discuss their perceptions of the value of the educational and clinical benefits of their masters degree education.

The Advance of Research and Evaluation Skills by EPs: Implications for Training and Professional Development

ERIC Educational Resources Information Center

Eodanable, Miranda; Lauchlan, Fraser

2009-01-01

Research and evaluation has become increasingly important in many professions, including educational psychology, particularly as the profession moves to becoming more evidence-based in its practice. The recent move to a three year doctoral programme in England, Wales and Northern Ireland may be viewed as a positive one in developing research…

"Adam Smith Meets Walt Disney": School Image on the World Wide Web

ERIC Educational Resources Information Center

Smith, Alison

2007-01-01

This article describes a small-scale research project undertaken as part of the coursework in a Doctor of Education programme. The project investigated the organisational images or identities portrayed by ten secondary schools in Auckland, New Zealand on their school websites. The recent proliferation of school websites has provided schools with a…

The Economic Contribution of PhDs

ERIC Educational Resources Information Center

Casey, Bernard H.

2009-01-01

This paper looks at what the value of a doctorate is, both to employers in particular and to society and the economy at large. Given the emphasis many universities and funding agencies/governments are putting upon the development of PhD programmes, this is an issue deserving attention. The paper tries to show how two separate but interrelated…

Qvo Vadis Magister Artium? Policy Implications of Executive Master's Programmes in an Israeli Research University

ERIC Educational Resources Information Center

Yogev, Abraham

2010-01-01

During recent decades master's studies have mainly become professional, but in some countries, like Israel, they still are a stepping stone toward doctorate studies. Changes in that respect may however occur due to recent university marketization processes. Using Tel Aviv University as a case study, we focus on the executive master's programmes…

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

PubMed

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

2001-02-01

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

[Education of surgeons at the Medical School of the University of Pest between 1825 and 1848].

PubMed

Simon, Katalin

2009-01-01

From the 1820's a great number of surgeons attended the Faculty of Medicine in Pest. The increasing number of the students was resulted by several circumstances. After the Napoleonic wars peregrination from Hapsburg lands was prohibited. The Faculty of Medicine in Pest however offerred a diploma for its students valid for the whole territory of the Hapsburg Empire. The lectures were held in Hungarian or German, in contrary to the exclusively Latin lectures for medical students. A shorter preliminary education was needed. After three years the student could get his degree Chirurgiae Magister or Chirurgus civilis--the length of studies depended on the pleriminary studies of the surgeon. The Faculty started only two courses, so the surgeons mostly repeated the second or both courses. Although these degrees proved to be inferior to the titles Doctor Medicinae or Doctor Chirurgiae, many students wanted to get it. In the beginning of this period, in 1825/1825 117 persons attended the first semesters of the German, and 59 of the Hungarian course. This growth reached its peak in the years of the cholera. In 1832/1833 255 person matriculated to the first class of the German and 148 to the Hungarian course. This new contagion damaged not only human lifes, but the popularity of the surgical education as well. The number of students began slowly decrease. Another reason for this decrease was the new possibility for peregrination from the 1830's. In 1846/1847 48 persons matriculated to the first German course, and 49 to the Hungarian, while in the second one their number was only 10 and 20. As we can see, the German course was more popular, here came students from the other parts of the Hapsburg Empire, especially Jews: from Moravia (160; 110 of them was Jew), Bohemia (134) or Galicia (178; 124 of them was Jew). Between 1825 and 1846 2618 surgeons matriculated to the Faculty of Pest, many of them however left it with or without doing their exams. 1854 students took every exam, but only 259 got his degree as Chirurgiae Magister in Pest, and 1049 as Chirurgiae Civilis. Presumably many students carried on their studies in Vienna. Although the Faculty of Medicine in Pest was less renowned, than the medical faculty of Vienna or Prague, it definitely played a remarkable role in the contemporary medical and surgical education of the Hapsburg Empire.

'A bridge to the hospice': the impact of a Community Volunteer Programme in Uganda.

PubMed

Jack, Barbara A; Kirton, J; Birakurataki, J; Merriman, A

2011-10-01

In Africa, the need for palliative care provision is escalating with an increasing number of people living with HIV/AIDS, coupled with rising cancer and AIDS-related cancer diagnoses. In Uganda there is a shortage of doctors, particularly in rural areas. To address this Hospice Africa Uganda developed a Community Volunteer Programme to train volunteers to help by providing support to patients in their own homes. The aim of this qualitative study was to evaluate the impact of the Community Volunteer Programme. Sixty-four interviews, with patients (21), community volunteer workers (CVWs) (32), and the hospice clinical teams (11) were conducted, using semi-structured digitally recorded individual, group and focus group interviews, at the Hospice Africa Uganda sites. The results reported the value of the Community Volunteer Programme, including the impact on patients and families, and how the CVWs acted as a 'bridge to the hospice' in identifying patients. Developing financial challenges that are emerging which could potentially impact on the programme were reported. The Community Volunteer Programme appears to be having a positive impact on patients, families and the hospice team, and is a model worthy of consideration by other developing countries to allow the expansion of palliative care.

Night emergency cover for ENT in England: a national survey.

PubMed

Biswas, D; Rafferty, A; Jassar, P

2009-08-01

To evaluate the quality of out-of-hours ENT on-call cover by junior doctors, in view of the European Working Time Directive and the recent changes in the National Health Service workforce due to the 'Modernising Medical Careers' initiative, in England. We performed a national survey of first-on-call doctors for ENT, using a telephone questionnaire. Hospital contact details were sourced from the National Health Service website. The inclusion criterion was hospitals providing acute ENT facilities overnight in England. One hundred and nineteen hospitals were contacted; 91 were eligible, and 83 interviews were conducted. The grade of the first-on-call ENT doctor ranged from foundation year two (19 per cent) to registrar level or above (13 per cent). Forty-nine respondents (68 per cent) reported having no previous ENT experience. Fifty-three respondents (74 per cent) covered more than one speciality at night, with seven (10 per cent) covering four or more specialities. The second-on-call doctor was non-resident in 63 cases (88 per cent). Thirty respondents (42 per cent) stated that they did not feel comfortable managing common ENT emergencies as the first doctor on call. Otorhinolaryngology induction courses were offered in 37 of the respondents' hospitals (51 per cent), these courses were of varying duration. Night-time ENT care is often provided by junior doctors with little experience of the speciality, who are often also responsible for covering multiple specialities. Many reported not feeling comfortable managing common ENT emergencies. Structured induction programmes would help to provide basic knowledge and should be mandatory for all doctors covering ENT.

Dynamic data distributions in Vienna Fortran

NASA Technical Reports Server (NTRS)

Chapman, Barbara; Mehrotra, Piyush; Moritsch, Hans; Zima, Hans

1993-01-01

Vienna Fortran is a machine-independent language extension of Fortran, which is based upon the Single-Program-Multiple-Data (SPMD) paradigm and allows the user to write programs for distributed-memory systems using global addresses. The language features focus mainly on the issue of distributing data across virtual processor structures. Those features of Vienna Fortran that allow the data distributions of arrays to change dynamically, depending on runtime conditions are discussed. The relevant language features are discussed, their implementation is outlined, and how they may be used in applications is described.

[Rokitansky and the Vienna Medical School--from the philosophy of nature to natural science].

PubMed

Sedivy, Roland

2004-10-01

On February 19th 2004 we celebrated the 200th anniversary of Carl Rokitansky's birth. Together with Morgagni and Virchow, Rokitansky paved the way for the development of modern pathology. In addition, he was the co-founder of the so-called Second Vienna Medical School. Rokitansky represents a personality on the threshold of the change in medicine from a phenomenological-dominated philosophy to an evidence-based science. This jubilee essay aims at outlining this development particularly with regard to the Vienna Medical School before and after Rokitansky.

[Albert Reder Ritter von Schellmann (1826-1904)].

PubMed

Schmidt, G; Holubar, K

1990-01-01

Albert Reder von Schellmann (1826-1904) was an important syphilidologist of the Vienna Medical School in the second half of the nineteenth century. He went in for the dualistic concept of the origin of syphilis and ulcer caused by soft chancre. In 1870 - Reder became head of a third dermato-syphilidologic department in the "Josephinum" in Vienna, where military surgeons got their medical education. At the same time the two full professorships of dermatosyphilidology in the Vienna General Hospital were held by Ferdinand von Hebra (1816-1880) and Carl Ludwig Sigmund von Ilanor (1810-1883).

Translating the family medicine vision into educational programmes in Singapore.

PubMed

Wong, Teck Yee; Cheong, Seng Kwing; Koh, Gerald Ch; Goh, Lee Gan

2008-05-01

The core of the Family Medicine (FM) vision is patient-centred care, requiring specific education and vocational training. We traced how FM education started and what have been achieved. FM training began in 1971 with the formation of the College of General Practitioners Singapore. Previously, training consisted of self-directed learning, lunchtime talks and examination preparation courses run by hospital specialists. Formal FM vocational training programmes in the United Kingdom and Australia provided the model for a 3-year programme in 1988. The tripartite relationship between the local university, College of Family Physicians and Ministry of Health, together with a structured training programme, contributed to its success. To date, more than 240 Family Physicians in Singapore have been awarded the Masters in Medicine (FM) degree. The Graduate Diploma in Family Medicine programme (GDFM) was introduced in 2000 for Family Physicians who wished to practice at an enhanced level. This programme has trained 194 doctors since then. Behind the scenes, the following were important developments: counterculture with a difference, tripartite stake-holding, training the trainers and learning from others. For the FM undergraduate programme, our aim is to develop the knowledge base, core values and roles of the Family Physician. Sustaining the value of Family Medicine as a career choice is the enduring vision.

When and why do doctors decide to become general practitioners? Implications for recruitment into UK general practice specialty training.

PubMed

Irish, Bill; Lake, Jonathan

2011-01-01

All applicants to round 1 of national recruitment into the general practice specialty recruitment process were surveyed as to the reasons for, and the timing of their career choices. Most applicants reported decision making after completing undergraduate training citing variety, continuity of care and work-life balance as their main drivers for a career in general practice. Applicants were statistically more likely to have undertaken a Foundation placement in general practice than their peers on a Foundation programme. Reasons for choice of deanery were largely related to location and social ties, rather than to the educational 'reputation' of its programmes.

Compulsory service programmes for recruiting health workers in remote and rural areas: do they work?

PubMed Central

Mullan, Fitzhugh; Payne, Perry W; Ross, Heather

2010-01-01

Abstract Compulsory service programmes have been used worldwide as a way to deploy and retain a professional health workforce within countries. Other names for these programmes include ”obligatory”, ”mandatory”, ”required” and ”requisite.” All these different programme names refer to a country’s law or policy that governs the mandatory deployment and retention of a heath worker in the underserved and/or rural areas of the country for a certain period of time. This study identified three different types of compulsory service programmes in 70 countries. These programmes are all governed by some type of regulation, ranging from a parliamentary law to a policy within the ministry of health. Depending on the country, doctors, nurses, midwives and all types of professional allied health workers are required to participate in the programme. Some of the compliance-enforcement measures include withholding full registration until obligations are completed, withholding degree and salary, or imposing large fines. This paper aims to explain these programmes more clearly, to identify countries that have or had such programmes, to develop a typology for the different kinds and to discuss the programmes in the light of important issues that are related to policy concepts and implementation. As governments consider the cost of investment in health professionals’ education, the loss of health professionals to emigration and the lack of health workers in many geographic areas, they are using compulsory service requirements as a way to deploy and retain the health workforce. PMID:20461136

Screening for abdominal aortic aneurysm--a pilot study in six medical schemes.

PubMed

Rothberg, Alan D; McLeod, Heather; Walters, Laubi; Veller, Martin

2007-01-01

A pilot study to assess the feasibility and affordability of a targeted screening programme for abdominal aortic aneurysms in a group of employer-based medical schemes. Administrative database review and data extraction. Member enrolment by mail. Analysis using simple descriptive statistics. Review of international experience. Screening uptake and findings, type and cost of interventions recommended by providers. Database review identified 2187 age-eligible subjects (males between 60 and 65 years) who were advised to consult with their doctor/s if they had a history of smoking/and or cardiovascular disease. Two hundred and seven were referred for abdominal ultrasound screening, and aneurysms > or = 3.0 cm were found in 11 (5.3%). Only 1 subject had an aneurysm of sufficient size to justify early surgical intervention, and which resulted in the patient's death. Total cost of this pilot study approached R1 million. Analysis indicated that the sampling rate would have to be increased if such a programme were to be introduced as a routine medical benefit. International experience has been that screening for abdominal aortic aneurysms reduces morbidity and mortality but at a significant cost. Opinion of the researchers and trustees of the participating medical schemes was that this cost would be beyond the means of schemes at this time. Screening programmes, particularly those that increase health care costs in the early phases by identifying subjects for costly interventions, are unlikely to enjoy support as long as the health funding environment maintains its focus on short-term costs and benefits.

Life support course for nurses in Singapore.

PubMed

Heng, W J K; Seow, E; Tham, K Y

2011-08-01

Nurses are usually the first caregivers for cardiac arrest patients in an in-hospital environment, and subsequently partner with doctors in the further resuscitation of patients. The skills of basic life support are crucial for their practice. The Advanced Cardiac Life Support programme is traditionally geared toward training of medical staff in advanced resuscitation skills. The need for a bridging course that focuses on the knowledge and skills required by nurses to become effective members of the resuscitation team has resulted in the creation of the Life Support Course for Nurses (LSCN) in Singapore. The components of the LSCN programme have evolved over the years, taking into consideration the modifications to resuscitation guidelines. The LSCN programme is gradually including a larger proportion of nurses in the emergency and critical care environments as well as those in the general ward.

Advanced Critical Care Practitioners - Practical experience of implementing the Advanced Critical Care Practitioner Faculty of Intensive Care Medicine Curriculum in a London Critical Care Unit.

PubMed

Lee, Geraldine; Gilroy, Jo-Anne; Ritchie, Alistair; Grover, Vimal; Gull, Keetje; Gruber, Pascale

2018-05-01

With a chronic shortage of doctors in intensive care, alternative roles are being explored. One of these is the role of the Advanced Critical Care Practitioner. The Advanced Critical Care Practitioner Curriculum was developed by the Faculty of Intensive Care Medicine and is used to provide a structured programme of training. The Advanced Critical Care Practitioner programme consists of an academic and clinical component. This article outlines a practical approach of how the programme was developed and is currently being delivered at a single institution. This new advanced practice role offers opportunities to fill gaps in the medical workforce, improve continuity of patient care, provide mentoring and training for less experienced staff as well as offering a rewarding clinical role.

[Doctor-Patient Communication Training in Simulated Situations: Emotions and Perceptions of Simulated Patients during Patient-Centered Conversations].

PubMed

Butollo, Maria Asisa; Holzinger, Anita; Wagner-Menghin, Michaela

2018-04-13

The use of simulated patients (SPs) for doctor-patient communication training has been established in medical curricula as an important didactic method. The study addresses the question, if patients' emotions and perceptions are represented adequately in patient-centered communication. 22 of 37 SPs of the Medical University of Vienna (12 women, 10 men) were asked openly about their feelings after having acted as an SP in a semi-structured interview, which employed the Critical Incident Technique. The interviews were recorded, transcribed, separated into situational analysis units und analyzed deductively; we used the evidence based qualities of patient-centered communication and the "Nationaler Kompetenzbasierter Lernzielkatalog Medizin" as a guideline. Out of 192 analysis units, 67 were evaluated as positive and 125 as negative. The SPs reported positive feelings, such as perceiving "stability and trust in relationships" (22%), perception of congruence (15%), acceptance (27%) and empathy (36%). As to negative feelings, SPs reported "perceiving instability" (18%), "incongruence" (11%), "lack of acceptance" (40%) and "lack of empathy" (30%). Additionally, 50% of SPs were positively affected when observing students' learning success. When SPs perceived patient-centered communication, they reported positive emotions. A lack of patient centeredness, on the contrary, provoked negative emotions. An empathic attitude, as well as a "lack of acceptance" with contrary effects had the strongest influence on the SPs' mental state. The reaction of SPs to patient centeredness is sufficiently authentic to reach learning objectives, however it is also affected by reactions of SPs to the learning success of students, which is irrelevant for the real-life doctor-patient interaction. SP reactions are affected by students' attitudes. Students should therefore be prepared well before interacting with SPs in a roleplay setting. While SPs' behavior is authentic in patient-centered communication in general, SPs should be trained to hide their positive emotions concerning students' learning success during roleplay. © Georg Thieme Verlag KG Stuttgart · New York.

Comparison of atmospheric new particle formation events in three Central European cities

NASA Astrophysics Data System (ADS)

Németh, Zoltán; Rosati, Bernadette; Zíková, Naděžda; Salma, Imre; Bozó, László; Dameto de España, Carmen; Schwarz, Jaroslav; Ždímal, Vladimír; Wonaschütz, Anna

2018-04-01

Simultaneous particle number size distribution measurements were performed in the urban environment of Budapest, Vienna, and Prague, three Central European cities located within 450 km of each other. The measurement days from the continuous, 2-year long campaign were classified for new particle formation (NPF) events using an adapted classification scheme for urban sites. The total numbers of NPF event days were 152 for Budapest, 69 for Vienna, and 143 for Prague. There were 12 days when new particle formation took place at all three sites; 11 out of these 12 days were in spring and in summer. There were only 2 (Budapest-Vienna), 19 (Budapest-Prague), and 19 (Vienna-Prague) nucleation days, when NPF did not occur on the third site. The main difference was related to source and sink terms of gas-phase sulphuric acid. Air mass origin and back-trajectories did not show any substantial influence on the atmospheric nucleation phenomena. The relative contribution of particles from NPF with respect to regional aerosol to the particles originating from all sources was expressed as nucleation strength factor. The overall mean nucleation strength factors were 1.58, 1.54, and 2.01 for Budapest, Vienna, and Prague, respectively, and showed diurnal and seasonal variations. The monthly mean NSF varied from 1.2 to 3.2 in Budapest, from 0.7 to 1.9 in Vienna, and from 1.0 to 2.3 in Prague. This implies that the new particle formation in cities is a significant source of ultrafine (UF) particles, and the amount of them is comparable to the directly emitted UF particles.

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

PubMed

Pagaiya, Nonglak; Kongkam, Lalitaya; Sriratana, Sanya

2015-03-01

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

Competencies necessary for becoming a leader in the field of community medicine: a Japanese qualitative interview study.

PubMed

Kainuma, Mosaburo; Kikukawa, Makoto; Nagata, Masaharu; Yoshida, Motofumi

2018-04-17

To clarify competencies for inclusion in our curriculum that focuses on developing leaders in community medicine. Qualitative interview study. All six regions of Japan, including urban and rural areas. Nineteen doctors (male: 18, female: 1) who play an important leadership role in their communities participated in semistructured interviews (mean age 48.3 years, range 34-59; mean years of clinical experience 23.1 years, range 9-31). Semistructured interviews were held and transcripts were independently analysed and coded by the first two authors. The third and fourth authors discussed and agreed or disagreed with the results to give a consensus agreement. Doctors were recruited by maximum variation sampling until thematic saturation was achieved. Six themes emerged: (1)'Medical ability': includes psychological issues and difficult cases in addition to basic medical problems. High medical ability gives confidence to other medical professionals. (2)'Long term perspective': the ability to develop a long-term, comprehensive vision and to continuously work to achieve the vision. Cultivation of future generations of doctors is included. (3) 'Team building':the ability to drive forward programmes that include residents and local government workers, to elucidate a vision, to communicate and to accept other medical professionals. (4)'Ability to negotiate': the ability to negotiate with others to ensure that programmes and visions progress smoothly (5) 'Management ability': the ability to run a clinic, medical unit or medical association. (6) 'Enjoying oneself': doctors need to feel an attraction to community medicine, that it be fun and challenging for them. We found six competencies that are needed by leaders in the field of community medicine. The results of this study will contribute to designing a curriculum that develops such leaders. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Josephinism in medicine: the General Hospital in Vienna and the "Narrenturm" (insane asylum)].

PubMed

Sablik, K

1991-01-01

The spirit of enlightened absolutism was realized through the personal engagement of Emperor Joseph II in the foundation of the Vienna General Hospital, the asylum for the insane called "Narrenturm" and the maternity home.

Fuzzy Arden Syntax: A fuzzy programming language for medicine.

PubMed

Vetterlein, Thomas; Mandl, Harald; Adlassnig, Klaus-Peter

2010-05-01

The programming language Arden Syntax has been optimised for use in clinical decision support systems. We describe an extension of this language named Fuzzy Arden Syntax, whose original version was introduced in S. Tiffe's dissertation on "Fuzzy Arden Syntax: Representation and Interpretation of Vague Medical Knowledge by Fuzzified Arden Syntax" (Vienna University of Technology, 2003). The primary aim is to provide an easy means of processing vague or uncertain data, which frequently appears in medicine. For both propositional and number data types, fuzzy equivalents have been added to Arden Syntax. The Boolean data type was generalised to represent any truth degree between the two extremes 0 (falsity) and 1 (truth); fuzzy data types were introduced to represent fuzzy sets. The operations on truth values and real numbers were generalised accordingly. As the conditions to decide whether a certain programme unit is executed or not may be indeterminate, a Fuzzy Arden Syntax programme may split. The data in the different branches may be optionally aggregated subsequently. Fuzzy Arden Syntax offers the possibility to formulate conveniently Medical Logic Modules (MLMs) based on the principle of a continuously graded applicability of statements. Furthermore, ad hoc decisions about sharp value boundaries can be avoided. As an illustrative example shows, an MLM making use of the features of Fuzzy Arden Syntax is not significantly more complex than its Arden Syntax equivalent; in the ideal case, a programme handling crisp data remains practically unchanged when compared to its fuzzified version. In the latter case, the output data, which can be a set of weighted alternatives, typically depends continuously from the input data. In typical applications an Arden Syntax MLM can produce a different output after only slight changes of the input; discontinuities are in fact unavoidable when the input varies continuously but the output is taken from a discrete set of possibilities. This inconvenience can, however, be attenuated by means of certain mechanisms on which the programme flow under Fuzzy Arden Syntax is based. To write a programme making use of these possibilities is not significantly more difficult than to write a programme according to the usual practice. 2010 Elsevier B.V. All rights reserved.

Academic Superheroes? A Critical Analysis of Academic Job Descriptions

ERIC Educational Resources Information Center

Pitt, Rachael; Mewburn, Inger

2016-01-01

For over a decade, debate has raged about the nature and purpose of the PhD, including its role as preparation for working in academia. Academic work has changed a great deal in the last 60 years, yet our doctoral curriculum has remained relatively static. While there is increasing interest in matching PhD programmes to "real world"…

Rising to the Challenge: Acute Stress Appraisals and Selection Centre Performance in Applicants to Postgraduate Specialty Training in Anaesthesia

ERIC Educational Resources Information Center

Roberts, Martin J.; Gale, Thomas C. E.; McGrath, John S.; Wilson, Mark R.

2016-01-01

The ability to work under pressure is a vital non-technical skill for doctors working in acute medical specialties. Individuals who evaluate potentially stressful situations as challenging rather than threatening may perform better under pressure and be more resilient to stress and burnout. Training programme recruitment processes provide an…

Gender and Doctoral Studies: The Perceptions of Ph.D. Students in an American University

ERIC Educational Resources Information Center

Kurtz-Costes, Beth; Helmke, Laura Andrews; Ulku-Steiner, Beril

2006-01-01

Twenty students enrolled in Ph.D. programmes were interviewed to examine the role of gender in their academic experiences. Gender was examined in three ways: gender of the student, gender of the student's faculty supervisor and gender make-up of the faculty within the student's department or academic unit. All students reported the importance of…

Being a Good Course-Taker Is Not Enough: A Theoretical Perspective on the Transition to Independent Research

ERIC Educational Resources Information Center

Lovitts, Barbara E.

2005-01-01

Students are typically admitted into doctoral programmes because they have been good course-takers. Yet, the PhD is awarded for doing independent research and making an "original contribution" to knowledge. Graduate faculty acknowledge that the transition to independent research is hard for many students, and that they cannot predict who will…

Being Written: Thinking the Normative in the EdD

ERIC Educational Resources Information Center

Chua, S. M. J.

2018-01-01

In this paper, I give various reasons why the doctorate in education (EdD) programme helpfully heightens our normative senses. The writing of a thesis in time, and hence the realization that the same time--that window of opportunity--to do other things and enjoy other experiences is traded off, comports the student in a manner that heightens his…

Searching for "A Third Space": A Creative Pathway towards International PhD Students' Academic Acculturation

ERIC Educational Resources Information Center

Elliot, Dely Lazarte; Baumfield, Vivienne; Reid, Kate

2016-01-01

Undertaking a PhD is a challenging endeavour. Pursuing a doctoral education in a "foreign" context tends to increase the demands of this intellectual venture. The nature of research-based PhD programmes, often characterised by a lack of formal curricula where academic supervision lasts several years, may add another layer of complexity.…

"You're Facing That Machine but There's a Human Being behind It": Students' Affective Experiences on an Online Doctoral Programme

ERIC Educational Resources Information Center

Kennedy, Eileen; Gray, Morag

2016-01-01

Online students use highly emotional language to describe their experiences, indicating that learners do feel a great deal online. This paper draws on Wetherell's exploration of affective practice to theorise learners' responses to the pedagogical and technological online environment. Findings of a research project that focused on two cohorts of…

The non specialist paediatric training registrar in the healthcare system.

PubMed

O'Neill, M B; Kumar, A

2012-01-01

This study evaluated the experiences of non Specialist Paediatric Training Registrars (nonSPTR) in the Irish Healthcare system. The survey explored their adaptation to the healthcare system, skill development, perceptions of training and career development inclusive of working conditions. Thirty nine (53%) doctors responded. The time spent in Paediatrics ranged from 3 to 19 years with a mean of 8.9 years. Nineteen (49%) had only worked in non regional hospitals and for 20 (51%) the mean time spent in regional hospitals was 2.6 years. The very positives experiences (likert scores 5/6) included journal appraisal for 19 (49%), clinical skill development for 17 (44%) and consultant feedback for 11 (28%).The very negative experiences were difficulty obtaining desired clinical posts for 16 (43%) doctors and only 5 (13%) were happy with their career progression. Thirty one (79.5%) cited specific barriers to career progression, with only 10 (25%) making an application to the Specialist Paediatrics Registrar (SPR) training programme. Solutions for the non SPTR difficulties include the expansion of the SPR programme and the utilization of a criterion based portfolio system to integrate the nonSPTR into formal training.

Sign language in dental education-A new nexus.

PubMed

Jones, T; Cumberbatch, K

2017-08-14

The introduction of the landmark mandatory teaching of sign language to undergraduate dental students at the University of the West Indies (UWI), Mona Campus in Kingston, Jamaica, to bridge the communication gap between dentists and their patients is reviewed. A review of over 90 Doctor of Dental Surgery and Doctor of Dental Medicine curricula in North America, the United Kingdom, parts of Europe and Australia showed no inclusion of sign language in those curricula as a mandatory component. In Jamaica, the government's training school for dental auxiliaries served as the forerunner to the UWI's introduction of formal training of sign language in 2012. Outside of the UWI, a couple of dental schools have sign language courses, but none have a mandatory programme as the one at the UWI. Dentists the world over have had to rely on interpreters to sign with their deaf patients. The deaf in Jamaica have not appreciated the fact that dentists cannot sign and they have felt insulted and only go to the dentist in emergency situations. The mandatory inclusion of sign language in the Undergraduate Dental Programme curriculum at The University of the West Indies, Mona Campus, sought to establish a direct communication channel to formally bridge this gap. The programme of two sign language courses and a direct clinical competency requirement was developed during the second year of the first cohort of the newly introduced undergraduate dental programme through a collaborating partnership between two faculties on the Mona Campus. The programme was introduced in 2012 in the third year of the 5-year undergraduate dental programme. To date, two cohorts have completed the programme, and the preliminary findings from an ongoing clinical study have shown a positive impact on dental care access and dental treatment for deaf patients at the UWI Mona Dental Polyclinic. The development of a direct communication channel between dental students and the deaf that has led to increased dental access and treatment for the deaf can be extended to dentists and to other dental students globally. The vision is that similar courses will be introduced in other health training programmes at the UWI, and conceivably, in other institutions. The small sample size allows for informative, but not definitive, conclusions to be drawn. The mandatory inclusion of sign language and Deaf culture in the dental curricula has not just removed a communication barrier, but has assisted in the empathetic and ethical development of the dental student. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The impact of mentoring during postgraduate training on doctors' career success.

PubMed

Stamm, Martina; Buddeberg-Fischer, Barbara

2011-05-01

Although mentoring is perceived as key to a successful and satisfying career in medicine, there is a lack of methodologically sound studies to support this view. This study made use of a longitudinal design to investigate the impact of mentoring during postgraduate specialist training on the career success of doctors. We analysed data pertaining to 326 doctors (172 women, 52.8%; 154 men, 47.2%) from a cohort of medical school graduates participating in the prospective SwissMedCareer Study, assessing personal characteristics, the possession of a mentor, mentoring support provided by the development network, and career success. The impact of personal characteristics on having a mentor was investigated using multiple linear regression analysis. The impacts of having a mentor and of having development network mentoring support on career success were analysed using hierarchical multiple regression analysis. Up to 50% of doctors reported having a mentor. A significant gender difference was found, with fewer female than male doctors having a mentor (40.7% versus 60.4% at the fifth assessment; p ≤ 0.001). Apart from gender, significant predictors of having a mentor were instrumentality (β = 0.24, p ≤ 0.01) and extraprofessional concerns (β = -0.15, p ≤ 0.05). Both having a mentor and having career support from the development network were significant predictors of both objective (β = 0.15, p ≤ 0.01; β = 0.17, p ≤ 0.01) and subjective (β = 0.17, p ≤ 0.01; β = 0.14, p ≤ 0.05) career success, but not of career satisfaction. This study confirmed the positive impact of mentoring on career success in a cohort of Swiss doctors in a longitudinal design. However, female doctors, who are mentored less frequently than male doctors, appear to be disadvantaged in this respect. Formal mentoring programmes could reduce barriers to mentorship and promote the career advancement of female doctors in particular. © Blackwell Publishing Ltd 2011.

Nesting doctoral students in collaborative North–South partnerships for health systems research

PubMed Central

Loukanova, Svetla; Prytherch, Helen; Blank, Antje; Duysburgh, Els; Tomson, Göran; Gustafsson, Lars L.; Sié, Ali; Williams, John; Leshabari, Melkizedeck; Haefeli, Walter E.; Sauerborn, Rainer; Fonn, Sharon

2014-01-01

Background The European Union (EU) supports North–South Partnerships and collaborative research projects through its Framework Programmes and Horizon 2020. There is limited research on how such projects can be harnessed to provide a structured platform for doctoral level studies as a way of strengthening health system research capacity in sub-Saharan Africa (SSA). Objective The aim of this study was to explore the challenges of, and facilitating factors for, ‘nesting’ doctoral students in North–South collaborative research projects. The term nesting refers to the embedding of the processes of recruiting, supervising, and coordinating doctoral students in the overall research plan and processes. Design This cross-sectional qualitative study was undertaken by the EU-funded QUALMAT Project. A questionnaire was implemented with doctoral students, supervisors, and country principal investigators (PIs), and content analysis was undertaken. Results Completed questionnaires were received from nine doctoral students, six supervisors, and three country PIs (86% responses rate). The doctoral students from SSA described high expectations about the input they would receive (administrative support, equipment, training, supervision). This contrasted with the expectations of the supervisors for proactivity and self-management on the part of the students. The rationale for candidate selection, and understandings of the purpose of the doctoral students in the project were areas of considerable divergence. There were some challenges associated with the use of the country PIs as co-supervisors. Doctoral student progress was at times impeded by delays in the release of funding instalments from the EU. The paper provides a checklist of essential requirements and a set of recommendations for effective nesting of doctoral students in joint North–South projects. Conclusion There are considerable challenges to the effective nesting of doctoral students within major collaborative research projects. However, ways can be found to overcome them. The nesting process ultimately helped the institutions involved in this example to take better advantage of the opportunities that collaborative projects offer to foster North–South partnerships as a contribution to the strengthening of local research capacity. PMID:25030216

Local anaesthesia through the action of cocaine, the oral mucosa and the Vienna group.

PubMed

López-Valverde, A; de Vicente, J; Martínez-Domínguez, L; de Diego, R Gómez

2014-07-11

Local anaesthesia through the action of cocaine was introduced in Europe by the Vienna group, which includeed Freud, Koller and Königstein. Before using the alkaloid in animal or human experimentation all these scientists tested it on their oral mucosa - so-called self-experimentation. Some of them with different pathologies (that is, in the case of Freud), eventually became addicted to the alkaloid. Here we attempt to describe the people forming the so-called 'Vienna group', their social milieu, their experiences and internal disputes within the setting of a revolutionary discovery of the times.

[Suicide and suicide prevention in Vienna from 1938 to 1945].

PubMed

Sonneck, Gernot; Hirnsperger, Hans; Mundschütz, Reinhard

2012-01-01

Beginning with the inception of suicide prevention in interwar Vienna, the paper illustrates how the high number of counselling centres contrasted with a discourse of selection. Despite the fact that suicide rates proved extremely high, suicide prevention declined in importance between 1934 and 1945. Suicide was increasingly attributed to the weak and the inferior. The massive threat to Vienna's Jewish population and the high suicide rates among Viennese Jews are also outlined. The paper concludes with a synopsis of V. E. Frankl's activities in the field of suicide prevention at the Rothschild Hospital as well as the concentration camp in Theresienstadt.

[The First School of Vienna and Samuel Hahnemann's pharmaceutical techniques].

PubMed

Gantenbein, U L

2000-01-01

The First or Elder Vienna School of Medicine was initiated by Gerard van Swieten, the famous pupil of Herman Boerhaave. The aim of this school was to put medicine on new scientific foundations-promoting unprejudiced clinical observation, botanical and chemical research, and the introduction of simple but powerful remedies. One of the products of this school was Anton Störck (1731-1803), appointed Director of Austrian public health and medical education by Empress Maria Theresia. Following the tradition of the Vienna School, Störck was the first scientist to systematically test the effects of so-called poisonous plants (e.g., hemlock, henbane, meadow saffron). Discovering new therapeutic properties in previously dreaded plants, Störck used himself as a subject in experiments to determine tolerable dose levels. As a result of his investigations, Störck was able to successfully treat his patients using the drugs he discovered. Samuel Hahnemann's later writings, including his "Organon", show that he was considerably influenced by Störck's ideas. In fact, Hahnemann's clinical teacher at Vienna was a follower of Störck, Joseph Quarin. Hahnemann's elaborate system of validating homeopath material can be seen as a development and refinement of the techniques he learned in Vienna.

Obesity prevalence and nutritional habits among Indian women: a comparison between Punjabi women living in India and Punjabi migrants in Vienna, Austria.

PubMed

Singh, Maryam; Kirchengast, Sylvia

2011-01-01

The current study aimed to determine the prevalence of obesity and overweight among Indian women living in Punjab, India and in Vienna, Austria. A series of 115 women ageing between 17 and 80 years (x = 38.7 yrs; +/- 14.5) was enrolled in the present study. 65 women lived in the district of Jalandhar in Punjab, 50 Punjabi women lived in as migrants in Vienna Austria. Data collection comprised an anthropometric analysis including stature height, body weight and the body mass index (BMI). For classification of the weight status the Indian BMI cutoffs defined by the WHO for Asian Indians were used. Data concerning dietary patterns and lifestyle parameters were collected by structured interviews using a standardized questionnaire. Among both subgroups overweight and obesity were highly prevalent. Underweight (18.5%) was significantly more prevalent in Punjab than in Vienna (6.0 %), while overweight and obesity were more frequently found among Punjabi women in Vienna (26.0%; 54.0%) than among Punjabi women in India (9.2%; 24.6 %). Analysing lifestyle and dietary patterns it turned out that energy dense meals were preferred and fat and sugar were used frequently among both subsamples. A statistically significant relationship between dietary habits and weight status could not be proved.

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

PubMed

Scharfenberg, Janna; Schaper, Katharina; Krummenauer, Frank

2014-01-01

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

The Fischa-Dagnitz spring, Southern Vienna Basin: a multi tracer time series study re-assessing earlier conceptual assumptions.

NASA Astrophysics Data System (ADS)

Suckow, Axel; Gerber, Christoph; Kralik, Martin; Sültenfuss, Jürgen; Purtschert, Roland

2013-04-01

The gravel aquifer of the Southern Vienna Basin is a very important backup drinking water resource for the city of Vienna. A discharge location, the Fischa-Dagnitz spring in the Southern Vienna Basin, Austria, was re-investigated in 2011, five years after the gas exchange tracer test published in (Stolp et al., 2010), and sampled for stable isotopes 18O/2H, tritium, 3He, SF6 and 85Kr (Gerber et al., 2012). Additionally, new tritium time series data (Davis et al., 1967), previously not considered in Stolp et al. (2010), were included. These show a higher and earlier tritium peak of >300 TU in 1965 in the discharge of the Fischa-Dagnitz spring as compared to 221 TU in 1972 considered in Stolp et al. (2010). The new 3He, SF6 and 85Kr gas tracer data from 2011 confirm the earlier finding for 3He of Stolp et al. (2010) and indicate a more recent equilibration with the atmosphere than the water bound tracers 18O, 2H and tritium. A new modelling attempt using the Lumpy code (Suckow, 2012) confirmed the discrepancy between the tritium data and the gaseous tracers 3He, SF6 and 85Kr. No steady-state combination of local recharge (represented by an exponential model) and Schwarza river infiltration flowing through the gravel aquifer (represented by a parallel dispersion model) can equally well explain both the tritium time series and the gas tracer results. A revised conceptual model proposes that a pinching of the aquifer at unconformities in the gravel body or a fault zone known in the gravel body forces groundwater along the flow path closer to the surface and exposes it to the atmosphere. This would tend to reset the "dating" clock for the gaseous tracers 3He, SF6 and 85Kr, which can equilibrate quickly with the atmosphere, but not for tritium, which marks the transport behaviour of the water itself. These findings are of importance also for other multi-tracer assessments of groundwater movement in phreatic aquifer systems. References: Davis, G.H., Payne, B.R., Dincer, T., Florkowski, T., Gattinger, T., 1967. Seasonal Variations in the Tritium Content of Groundwaters of the Vienna Basin, Austria, Isotope Hydrology 1967. IAEA, Vienna, Austria, IAEA, Vienna, Austria, pp. 451-473. Gerber, C., Purtschert, R., Kralik, M., Humer, F., Sültenfuss, J., Darling, G.W., Gooddy, D., 2012. Suitability and potential of environmental tracers for base-flow determination in streams: EGU2012-14066, EGU 12. European Geosciences Union, Vienna Stolp, B.J., Solomon, D.K., Suckow, A., Vitvar, T., Rank, D., Aggarwal, P.K., Han, L.-F., 2010. Age dating base flow at springs and gaining streams using helium-3 and tritium: Fischa-Dagnitz system, southern Vienna Basin, Austria. Water Resources Research 46. Suckow, A., 2012. Lumpy - an interactive Lumped Parameter Modeling code based on MS Access and MS Excel., EGU 12. European Geosciences Union, Vienna

Retaining doctors in rural Timor-Leste: a critical appraisal of the opportunities and challenges.

PubMed

Asante, Augustine D; Martins, Nelson; Otim, Michael E; Dewdney, John

2014-04-01

Timor-Leste is in the process of addressing a key issue for the country's health sector: a medical workforce that is too small to provide adequate care. In theory, a bilateral programme of medical cooperation with Cuba created in 2003 could solve this problem. By the end of 2013, nearly 700 new doctors trained in Cuba had been added to Timor-Leste's medical workforce and by 2017 a further 328 doctors should have been trained in the country by Cuban and local health professionals. A few more doctors who have been trained in Indonesia and elsewhere will also soon enter the workforce. It is expected that the number of physicians in Timor-Leste in 2017 will be more than three times the number present in the country in 2003. Most of the new physicians are expected to work in rural communities and support the national government's goal of improving health outcomes for the rural majority. Although the massive growth in the medical workforce could change the way health care is delivered and substantially improve health outcomes throughout the country, there are challenges that must be overcome if Timor-Leste is to derive the maximum benefit from such growth. It appears crucial that most of the new doctors be deployed in rural communities and managed carefully to optimize their rural retention.

Mandatory communication skills training for cancer and palliative care staff: does one size fit all?

PubMed

Turner, Mary; Payne, Sheila; O'Brien, Terri

2011-12-01

There is increasing recognition of the importance of good communication between healthcare professionals and patients facing cancer or end of life. In England, a new national 3-day training programme called 'Connected' has been developed and is now mandatory for all cancer and palliative care professionals. This study aimed to explore the attitudes of staff in one region to undertaking this training. A survey questionnaire was developed through a series of discussions with experts and semi-structured interviews with five healthcare professionals. The questionnaire was distributed to 200 cancer and palliative care staff; 109 were completed and returned. There were significant differences between doctors' and nurses' attitudes to communication skills training, with doctors demonstrating more negative attitudes. More nurses than doctors felt that communication skills training should be mandatory for cancer and palliative care professionals (p ≤ 0.001), whilst more doctors felt that these staff should already be skilled communicators and not require further training (p ≤ 0.001). Nurses also self-rated their communication skills more highly than doctors. The current 'one size fits all' approach being taken nationally to advanced communication skills training does not meet the training preferences of all healthcare professionals, and it is recommended that tailoring courses to individuals' needs should be considered. Copyright © 2010 Elsevier Ltd. All rights reserved.

The social negotiation of fitness for work: tensions in doctor-patient relationships over medical certification of chronic pain.

PubMed

Wainwright, Elaine; Wainwright, David; Keogh, Edmund; Eccleston, Christopher

2015-01-01

The UK government is promoting the health benefits of work, in order to change doctors' and patients' behaviour and reduce sickness absence. The rationale is that many people 'off sick' would have better outcomes by staying at work; but reducing the costs of health care and benefits is also an imperative. Replacement of the 'sick note' with the 'fit note' and a national educational programme are intended to reduce sickness-certification rates, but how will these initiatives impact on doctor-patient relationships and the existing tension between the doctor as patient advocate and gate-keeper to services and benefits? This tension is particularly acute for problems like chronic pain where diagnosis, prognosis and work capacity can be unclear. We interviewed 13 doctors and 30 chronic pain patients about their experiences of negotiating medical certification for work absence and their views of the new policies. Our findings highlight the limitations of naïve rationalist approaches to judgements of work absence and fitness for work for people with chronic pain. Moral, socio-cultural and practical factors are invoked by doctors and patients to contest decisions, and although both groups support the fit note's focus on capacity, they doubt it will overcome tensions in the consultation. Doctors value tacit skills of persuasion and negotiation that can change how patients conceptualise their illness and respond to it. Policy-makers increasingly recognise the role of this tacit knowledge and we conclude that sick-listing can be improved by further developing these skills and acknowledging the structural context within which protagonists negotiate sick-listing. © The Author(s) 2014.

Prevalence differences of patients in vegetative state in The Netherlands and Vienna, Austria: a comparison of values and ethics.

PubMed

Beljaars, Daniëlle E A; Valckx, Wilhelmina J A R M; Stepan, Christoph; Donis, Johann; Lavrijsen, Jan C M

2015-01-01

Little is known about prevalence of persistent vegetative state/unresponsive wakefulness syndrome and comparisons between countries. The aim of this column was to explore reasons for the comparable count of patients in vegetative state found in prevalence studies in nursing homes in 1 European country (Netherlands) compared with a single European city (Vienna, Austria). The column is based on a literature review of vegetative state in The Netherlands and Vienna in the period 2007-2008, in the context of professional interactions with families and physicians of patients in vegetative state. In addition, in both countries, families and physicians were interviewed to illustrate views. Comparable between the 2 settings are the population characteristics and the definition of, and criteria, for vegetative state. A difference can be found in the development of authoritative policy guidelines in the Netherlands, after public debates and jurisdiction, which did not exist in Vienna at the time. There also seem to be different societal values concerning rehabilitation and end-of-life decisions for patients in vegetative state. The most important explanation for the vegetative state prevalence differences between the Netherlands and Vienna can be found in the different societal values about patients in vegetative state and their treatment and rehabilitation. In the Netherlands, life prolonging medical treatment, including artificial nutrition and hydration, is considered futile and can be withdrawn if there is no prospect of recovery. In Vienna, however, patients in vegetative state are regarded as severely disabled and in need of long-term rehabilitation and social reintegration. There is no end-of-life discussion in this context.

[The forgotten capitulation of evidence-based medicine].

PubMed

Schoemaker, Casper G; Smulders, Yvo M

2015-01-01

In 1992, the Canadian physician Gordon Guyatt wrote an article that is generally regarded as the starting point of evidence-based medicine (EBM). He described the ideas behind the McMaster residency programme for 'evidence-based practitioners', founded by David Sackett. Eight years later, in 2000, Guyatt concluded that this programme was too ambitious. In a new publication he described most doctors as 'evidence-users'. This editorial marks the transition from an individual to a collective form of EBM, emphasizing the use of evidence-based guidelines. The starting point of this collective form of EBM is not the well-known 1992 paper, but the forgotten editorial in 2000, which was described by Guyatt's colleagues as the capitulation of EBM.

Italy-Japan agreement and discrepancies in diagnosis of superficial gastric lesions.

PubMed

Vindigni, Carla; Marini, Mario; Cevenini, Gabriele; Raffaella Ambrosio, Maria; Onorati, Monica; Frosini, Giorgio; Gotoda, Takuji; Taniguchi, Hirokazu; Tosi, Piero

2010-01-01

The agreement between Italian and Japanese endoscopists and pathologists on endoscopic and histopathological diagnoses of superficial gastric lesions is verified with the use of Paris and Vienna classifications. The correlations between Paris endoscopic types and Vienna histopathological categories is high in both the independent Italian and Japanese evaluations. However, the agreement between Italian and Japanese endoscopists is moderate due to the difficult evaluation of the height of the lesions, in particular when they are mixed. The agreement on the size of the lesions is fairly good. The probability of the same allocation to the Vienna categories of a single case is 87 per cent, disagreements remaining in dysplasia grading, between dysplasia, not only high-grade but also low-grade, and in situ carcinoma, and on cancer invasion of the lamina propria. The results indicate that use of the Paris and Vienna classifications has reduced the discrepancies between Western and Japanese endoscopists and pathologists in the diagnosis of these lesions.

There are calls for a national screening programme for prostate cancer: what is the evidence to justify such a national screening programme?

PubMed

Green, A; Tait, C; Aboumarzouk, O; Somani, B K; Cohen, N P

2013-05-01

Prostate cancer is the commonest cancer in men and a major health issue worldwide. Screening for early disease has been available for many years, but there is still no national screening programme established in the United Kingdom. To assess the latest evidence regarding prostate cancer screening and whether it meets the necessary requirements to be established as a national programme for all men. Electronic databases and library catalogues were searched electronically and manual retrieval was performed. Only primary research results were used for the analysis. In recent years, several important randomised controlled trials have produced varied outcomes. In Europe the largest study thus far concluded that screening reduced prostate cancer mortality by 20%. On the contrary, a large American trial found no reduction in mortality after 7-10 years follow-up. Most studies comment on the adverse effects of screening - principally those of overdiagnosis and subsequent overtreatment. Further information about the natural history of prostate cancer and accuracy of screening is needed before a screening programme can be truly justified. In the interim, doctors and patients should discuss the risks, benefits and sequelae of taking part in voluntary screening for prostate cancer.

Vienna University Observatory and Bruno Thüring (German Title: Die Wiener Universitätssternwarte und Bruno Thüring )

NASA Astrophysics Data System (ADS)

Kerschbaum, Franz; Posch, Thomas; Lackner, Karin

We investigate Bruno Thüring's political attitude during the time of National Socialism, based on material from the Vienna Observatory archive, and on statements by his contemporaries. The contribution focuses on the filling of astronomy positions in Vienna, and also on the expulsion of Kasimir Graff. A central role is played by Wilhelm Führer, Obersturmführer der Waffen-SS (Senior Storm Leader of the Armed Protection Squad) and chief civil servant in the Reich science ministry. The transcription of an original letter of 1939 by Führer, addressed to Thüring, is given.

Arpad Gerster and Max Thorek contributions to American surgery.

PubMed

Langer, Robert M

2009-01-01

The legacy and the influence on American surgery is discussed of two Hungarian born surgeons: Arpad Gerster (1848-1923) and Max Thorek (1880-1960). Both of them were born in Northern Hungary, then part of the Austro-Hungarian Monarchy, today Slovakia. Gerster got his medical education in Vienna The influence of Theodor Billroth left everlasting impressions in him. In 1874 he arrived in New York and became the first doctor in town who practiced exclusively surgery. He became an attending surgeon in The German Hospital and later at Mount Sinai Hospital. Gerster modernized the hospital's functions and services, introducing the rotation system, and also made the original observation that dissemination of cancer may be caused by surgery. His aseptic methods were revolutionary at the time. Max Thorek arrived in Chicago in 1897. With a fantastic endurance he overwhelmed all barriers and became a doctor. He started his practice in one of Chicago's poor immigrant neighborhoods, but stepwise he could excel and in 1911 he co-founded The American Hospital. His ideas of modernizing surgery became reality. Thorek is one of the first who practiced plastic surgery, and his contribution by writing about surgical errors and safeguards became a great success. He founded the International College of Surgeons, a result of his widespread relations among surgeons all over the world. The parallels in the lives of these great surgeons: solid education, knowledge of languages, talent for music, literature, and arts, creative thinking combined with hard work, good humor, as well as a social conscience led them to make groundbreaking contributions to American and international surgery.

31 CFR Appendix N to Subpart C of... - Financial Crimes Enforcement Network

Code of Federal Regulations, 2013 CFR

2013-07-01

..., Post Office Box 39, Vienna, VA 22183. 3. Requests for amendments of records. Initial determinations... Request, Financial Crimes Enforcement Network, Post Office Box 39, Vienna, VA 22183. 4. Verification of... an accounting of disclosures, must satisfy one of the following identification requirements before...

Global Fund grant programmes: an analysis of evaluation scores.

PubMed

Radelet, Steven; Siddiqi, Bilal

2007-05-26

The Global Fund to Fight AIDS, Tuberculosis and Malaria evaluates programme performance after 2 years to help decide whether to continue funding. We aimed to identify the correlation between programme evaluation scores and characteristics of the programme, the health sector, and the recipient country. We obtained data on the first 140 Global Fund grants evaluated in 2006, and analysed 134 of these. We used an ordered probit multivariate analysis to link evaluation scores to different characteristics, allowing us to record the association between changes in those characteristics and the probability of a programme receiving a particular evaluation score. Programmes that had government agencies as principal recipients, had a large amount of funding, were focused on malaria, had weak initial proposals, or were evaluated by the accounting firm KPMG, scored lowest. Countries with a high number of doctors per head, high measles immunisation rates, few health-sector donors, and high disease-prevalence rates had higher evaluation scores. Poor countries, those with small government budget deficits, and those that have or have had socialist governments also received higher scores. Our results show associations, not causality, and they focus on evaluation scores rather than actual performance of the programmes. Yet they provide some early indications of characteristics that can help the Global Fund identify and monitor programmes that might be at risk. The results should not be used to influence the distribution of funding, but rather to allocate resources for oversight and risk management.

Doctor Referral of Overweight People to a Low-Energy Treatment (DROPLET) in primary care using total diet replacement products: a protocol for a randomised controlled trial.

PubMed

Jebb, Susan A; Astbury, Nerys M; Tearne, Sarah; Nickless, Alecia; Aveyard, Paul

2017-08-04

The global prevalence of obesity has risen significantly in recent decades. There is a pressing need to identify effective interventions to treat established obesity that can be delivered at scale. The aim of the Doctor Referral of Overweight People to a Low-Energy Treatment (DROPLET) study is to determine the clinical effectiveness, feasibility and acceptability of referral to a low-energy total diet replacement programme compared with usual weight management interventions in primary care. The DROPLET trial is a randomised controlled trial comparing a low-energy total diet replacement programme with usual weight management interventions delivered in primary care. Eligible patients will be recruited through primary care registers and randomised to receive a behavioural support programme delivered by their practice nurse or a referral to a commercial provider offering an initial 810 kcal/d low-energy total diet replacement programme for 8 weeks, followed by gradual food reintroduction, along with weekly behavioural support for 24 weeks. The primary outcome is weight change at 12 months. The secondary outcomes are weight change at 3 and 6 months, the proportion of participants achieving 5% and 10% weight loss at 12 months, and change in fat mass, haemoglobin A1c, low-density lipoprotein cholesterol and systolic and diastolic blood pressure at 12 months. Data will be analysed on the basis of intention to treat. Qualitative interviews on a subsample of patients and healthcare providers will assess their experiences of the weight loss programmes and identify factors affecting acceptability and adherence. This study has been reviewed and approved by the National Health ServiceHealth Research Authority (HRA)Research Ethics Committee (Ref: SC/15/0337). The trial findings will be disseminated to academic and health professionals through presentations at meetings and peer-reviewed journals and to the public through the media. If the intervention is effective, the results will be communicated to policymakers and commissioners of weight management services. ISRCTN75092026. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Young hospital doctors after night duty: their task-specific cognitive status and emotional condition.

PubMed

Lingenfelser, T; Kaschel, R; Weber, A; Zaiser-Kaschel, H; Jakober, B; Küper, J

1994-11-01

Sleep deprivation is an unpleasant burden of young hospital doctors during their medical training. It may disrupt the balance between coping strategies available to them and the professional demands encountered. Impaired medical care offered by sleep-deprived juniors may be a consequence. Valid research work on this subject is rare and surprisingly contradictory. Therefore, we evaluated the task-specific cognitive status and emotional condition of 40 young hospital doctors (27 men and 13 women, 29.9 +/- 2.9 years of age) at the University of Tuebingen, all of whom were in the beginning of their academic career. Subjects were tested twice acting as their own control, once at 8.00 am after a night off duty (OD) (at least 6 hours of uninterrupted sleep), and once at a similar time after a night on call (OC) being in the hospital for 24 hours. Standardized and reliable psychometric tests thought to represent daily routine medical function were performed. On-call activities were recorded by means of a sleep diary, whereas a questionnaire interrogated aspects of private and professional life. Neuropsychological function deteriorated significantly: number connection test (per cent of norms +/- SD, 103.2 +/- 9.8 OC vs 107.8 +/- 10.5 OD, F = 27.7, P < 0.001), things-to-do list (correct items +/- SD, 6.7 +/- 1.2 OC vs 7.4 +/- 1.5 OD, F = 12.7, P < 0.01), Vienna reaction timer (per cent of norms +/- SD, 95.6 +/- 9.0 OC vs 97.7 +/- 10.4 OD, F = 4.8, P < 0.05), Stroop test (T-values +/- SD, 59.7 +/- 6.3 OC vs 64.6 +/- 7.1 OD, F = 37.1, P < 0.001), ECG test (correct responses +/- SD, 38.3 +/- 7.3 OC vs 43.4 +/- 6.5 OD, F = 45.2, P < 0.001) and status of mood (T-value +/- SD, 60.3 +/- 9.0 OC vs 54.0 +/- 6.6 OD, F = 19.6, P < 0.001). Cognitive function and mood status of young hospital doctors after a night on call decrease considerably. In view of the special vulnerability of medical trainees to occupational stress all efforts are warranted to reduce sleep deprivation in the medical profession.

Gynaecologists and industry: ain't no sunshine.

PubMed

Farquhar, Cynthia M; Vercellini, Paolo; Marjoribanks, Jane

2017-08-01

The field of reproductive medicine is known for its innovations, and where there is innovation there is marketing and engagement with the doctors who are potential prescribers and users of those innovations. Financial connections between drug and device manufacturers with doctors have been extensively debated over the past decade. On one hand, relationships between doctors and industry could be considered synergistic by allowing the development of improved treatments. On the other hand, payment (and other benefits) from industry to doctors may subtly shift the main objective of the collaboration from patients' health to mutual benefits for both doctors and industry. Fertility patients can be considered 'vulnerable' as they face the multiple challenges of seeking to be parents, understanding complex and expensive fertility treatments that are by no means universally successful, and at the same time are under pressure because of their ever-increasing age. They are entitled to receive the most cost-effective treatments. We suggest that specialists in the field of reproductive medicine should be transparent about the receipt of financial benefits, including funding from industry, as it may be influencing both research outcomes and treatments that patients are offered. We also recommend that payments arising from industry-sponsored research should be centralized in institutional funds and not paid directly to researchers. And there should be transparency about the source and the purpose of the payment. Industry sponsorship of medical societies and their educational events should be kept to a minimum and declared quantitatively in societies' websites and scientific programme brochures. Industry sponsorship of scientific meetings should not include the right to host educational symposia or speakers within the programme. All speakers should declare their conflicts of interest (COIs) at their meetings. Guideline groups should require all members to declare their financial COIs before meeting and exclude or limit those members with COI. Governmental authorities should not allow continuing medical education credits to those educational events not complying with the above policies. The crucial role of medical journals as 'gatekeepers' for identifying 'science' must be reaffirmed. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Associations between perceived institutional support, job enjoyment, and intentions to work in the United Kingdom: national questionnaire survey of first year doctors.

PubMed

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

2016-05-23

Identifying factors that improve job satisfaction of new doctors and ease the difficult transition from student to doctor is of great interest to public health agencies. Studies to date have focused primarily on the value of changes to medical school curricula and induction processes in this regard, but have overlooked the extent to which institutional support can influence new doctors' enjoyment of and attitude to work. Here, we examine variation in the perceived level of support received by new medical graduates in the United Kingdom (UK) from their employer and whether this influences enjoyment of and attitudes to the first postgraduate year, and whether doctors who perceived a lower level of support were less inclined to intend a long term career in medicine in the UK. All UK medical graduates of 2012 were surveyed in 2013 in a cross-sectional study, towards the end of their first post-graduate year (the 'F1' year of the 2-year Foundation Training Programme for new UK doctors). We used linear regression to assess whether the level of support doctors reported receiving from their employing Trust (Very Good, Good, Adequate, Poor, or Very Poor) was associated with the extent to which they enjoyed their F1 year. Similarly, we assessed the strength of associations between self-reported level of Trust support and doctors' responses to 12 statements about fundamental aspects of their working lives, each assessed on a 5-point scale of agreement. Using χ (2) tests we examined whether doctors' intentions to practise medicine in the UK varied with the level of support they reported receiving from their Trust. The response rate was 45 % (2324/5171). Of 2324 responding junior doctors, 63.8 % reported receiving 'Very Good' (23.6 %) or 'Good' (40.2 %) initial support from their Trust, while a further 27.4 % stated they received 'Adequate' support. 'Poor' support was reported by 5.8 % and 'Very Poor' support by 2.2 %. We found very strong positive associations between the institutional support doctors reported receiving and their enjoyment of the F1 year and their self-expressed attitudes to aspects of their first year of work. Crucially, doctors who reported receiving lower levels of support ('Poor' or 'Very Poor') were significantly less likely to express intentions to continue practising medicine in the UK. The provision of effective institutional support for graduate doctors may promote workplace satisfaction and could help safeguard the long-term retention of junior doctors.

Enumerating Pathogenic Microorganism Surrogates for Groundwater Experiments Using Solid-Phase Cytometry

NASA Astrophysics Data System (ADS)

Stevenson, M. E.; Blaschke, A. P.; Kirschner, A.

2010-12-01

Regulators need a dependable method that would enable them to calculate with confidence the setback distance of a drinking water well from a potential point of contamination. Since it is not permissible to perform field tests using pathogenic microorganisms, it is necessary to predict the transport of dangerous microbes in a different way, using surrogates. One such surrogate method involves using bacteriophages, which are viruses that are pathogenic to bacteria, but are not dangerous to humans. Another possible surrogate to model the potential travel time of microbial contamination is the use of synthetic microspheres; we will test microspheres ranging in size from 0.025 to 1 µm. The constraining factor for comparing the transport of microspheres and bacteriophages is the detection limit of the measuring apparatus. Appropriate measuring techniques are mandatory for a comparison. Traditionally, bacteriophages are measured using plaque forming analysis, the detection limit being one plaque forming unit per petri dish. In our study, the use of solid-phase cytometry for enumerating microspheres for wellhead protection projects is being investigated, as the detection limit using this technology is one cell per filter. To the best of our knowledge, there is no other technique available that enables a comparable detection limit. The solid-phase cytometer used for this study is a ChemScan RDI (Chemunex, France). For comparison, epifluorescence microscopy will also be used. The ChemScan RDI device automatically drives an epifluorescent microscope to the site of each cell detected, in order to confirm the validity of the reading. In this way, it is possible to observe whether clumping together of microspheres is a problem or if non-target cells were labelled. Keywords: Microspheres, Solid-phase cytometry, ChemScan, Drinking water protection Acknowledgements: We would like to thank the Austrian Science Fund (FWF) for financial support as part of the Doctoral Program on Water Resource Systems (DK Plus W1219-N22) and the Vienna Waterworks (MA 31) as part of the GWRS-Vienna project.

Revisiting current “barefoot doctors” in border areas of China: system of services, financial issue and clinical practice prior to introducing integrated management of childhood illness (IMCI)

PubMed Central

2012-01-01

Background Under-5-years child mortality remains high in rural China. Integrated management of childhood illness (IMCI) was introduced to China in 1998, but only a few rural areas have been included. This study aimed at assessing the current situation of the health system of rural health care and evaluating the clinical competency of village doctors in management of childhood illnesses prior to implementing IMCI programme in remote border rural areas. Methods The study was carried out in the border areas of Puer prefecture of Yunnan province. There were 182 village doctors in the list of the health bureau in these border areas. Of these, 154 (84.6%) were recruited into the study. The local health system components were investigated using a qualitative approach and analyzed with triangulation of information from different sources. The clinical component was assessed objectively and quantitatively presented using descriptive statistics. Results The study found that the New Rural Cooperative Medical Scheme (NRCMS) coordinated the health insurance system and the provider service through 3 tiers: village doctor, township and county hospitals. The 30 RMB per person per year premium did not cover the referral cost, and thereby decreased the number of referrals. In contrast to available treatment facilities and drug supply, the level of basic medical education of village doctors and township doctors was low. Discontent among village doctors was common, especially concerning low rates of return from the service, exceptions being procedures such as injections, which in fact may create moral hazards to the patients. Direct observation on the assessment and management of paediatric patients by village doctors revealed inadequate history taking and physical examination, inability to detect potentially serious complications, overprescription of injection and antibiotics, and underprescription of oral rehydration salts and poor quality of counseling. Conclusion There is a need to improve health finance and clinical competency of the village doctors in the study area. PMID:22871045

What factors are critical to attracting NHS foundation doctors into specialty or core training? A discrete choice experiment

PubMed Central

Cleland, Jennifer; Johnston, Peter; Walker, Kim; Krucien, Nicolas; Skåtun, Diane

2018-01-01

Objectives Multiple personal and work-related factors influence medical trainees’ career decision-making. The relative value of these diverse factors is under-researched, yet this intelligence is crucially important for informing medical workforce planning and retention and recruitment policies. Our aim was to investigate the relative value of UK doctors’ preferences for different training post characteristics during the time period when they either apply for specialty or core training or take time out. Methods We developed a discrete choice experiment (DCE) specifically for this population. The DCE was distributed to all Foundation Programme Year 2 (F2) doctors across Scotland as part of the National Career Destination Survey in June 2016. The main outcome measure was the monetary value of training post characteristics, based on willingness to forgo additional potential income and willingness to accept extra income for a change in each job characteristic calculated from regression coefficients. Results 677/798 F2 doctors provided usable DCE responses. Location was the most influential characteristic of a training position, followed closely by supportive culture and then working conditions. F2 doctors would need to be compensated by an additional 45.75% above potential earnings to move from a post in a desirable location to one in an undesirable location. Doctors who applied for a training post placed less value on supportive culture and excellent working conditions than those who did not apply. Male F2s valued location and a supportive culture less than female F2s. Conclusion This is the first study focusing on the career decision-making of UK doctors at a critical careers decision-making point. Both location and specific job-related attributes are highly valued by F2 doctors when deciding their future. This intelligence can inform workforce policy to focus their efforts in terms of making training posts attractive to this group of doctors to enhance recruitment and retention. PMID:29530910

22 CFR 4.1 - General.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false General. 4.1 Section 4.1 Foreign Relations DEPARTMENT OF STATE GENERAL NOTIFICATION OF FOREIGN OFFICIAL STATUS § 4.1 General. In accordance with Article 10 of the Vienna Convention on Diplomatic Relations and Article 24 of the Vienna Convention on...

European Association of Echocardiography: Research Grant Programme.

PubMed

Gargani, Luna; Muraru, Denisa; Badano, Luigi P; Lancellotti, Patrizio; Sicari, Rosa

2012-01-01

The European Society of Cardiology (ESC) offers a variety of grants/fellowships to help young professionals in the field of cardiological training or research activities throughout Europe. The number of grants has significantly increased in recent years with contributions from the Associations, Working Groups and Councils of the ESC. The European Association of Echocardiography (EAE) is a registered branch of the ESC and actively takes part in this initiative. One of the aims of EAE is to promote excellence in research in cardiovascular ultrasound and other imaging modalities in Europe. Therefore, since 2008, the EAE offers a Research Grant Programme to help young doctors to obtain research experience in a high standard academic centre (or similar institution oriented to clinical or pre-clinical research) in an ESC member country other than their own. This programme can be considered as a valorization of the geographical mobility as well as cultural exchanges and professional practice in the field of cardiovascular imaging. The programme has been very successful so far, therefore in 2012 the EAE has increased its offer to two grants of 25,000 euros per annum each.

[Big differences in leadership and management training within health care services. Leadership and issues concerning cooperation should be more emphasized in basic medical education].

PubMed

Hauptig, S; Collste, L; Hammar, M; Calltorp, J; Frischer, J; Haase, H; Lindquist, I; Andersson, C

1999-12-08

A recent survey of medical management programmes at universities across the country showed manifest national differences to exist, both quantitative and qualitative. Using a questionnaire, the Swedish Society of Medical Management examined the programmes for physiotherapists, occupational therapists, social workers, nurses and physicians, with respect to such issues as leadership, self-awareness and communication, health economics, and administration. It was concluded that knowledge acquired differs between fields; that physiotherapy programmes tend to have a very didactic approach; that nurses are taught the importance of participation in developmental processes; that doctors are exposed to somewhat the same approach but to a large extent on a voluntary basis; and that social workers obtain good insight into the administrative skills necessary to their work. In the article it is concluded that students would benefit from orientation in the diverse approaches used in the other fields than their own, and that pooling of resources among different programmes might be a more economic alternative to current practice.

Encouragers and discouragers affecting medical graduates' choice of regional and rural practice locations.

PubMed

McKillop, Ann; Webster, Craig; Bennett, Win; O'Connor, Barbara; Bagg, Warwick

2017-12-01

Access to health care as near to where people live as possible is desirable. However, not enough medical graduates choose to work in rural and regional areas, especially in general practice. The career decisions of recent medical graduates are known to be affected by a variety of professional, societal and personal factors. Internationally, medical programmes have exposed students to regional and rural experiences partly to encourage them to seek employment in these areas after graduation. As such, the Pūkawakawa Programme is a year-long regional and rural experience for selected Year 5 students from the University of Auckland‘s Medical Programme in New Zealand in partnership with the Northland District Health Board and two Primary Health Organisations. A lack of clarity about the drivers of rural and regional career decisions underpinned this study, which aimed to explore the barriers and encouragers for students of the programme to return as resident medical officers to the regional hospital where they had gained clinical experience. A mixed-method, descriptive design was used, including a short survey, followed by participation in a focus-group discussion or a one-on-one interview. Survey data were summarised in tabular form and inductive, thematic analysis was applied to transcripts of focus groups and interviews. Nineteen doctors in their first or second year following graduation participated: 15 who had returned to the hospital where they had clinical experience in the programme and four who were employed elsewhere. 'A match of personal goals and intended career intentions' was the reason most frequently selected for junior doctors’ choice of early career employment. Other frequently selected reasons were lifestyle, friends and family close by, and the reputation and experience of the Pūkawakawa Programme. Qualitative data revealed that the learning experience, the unique design of the curriculum and associated support from clinicians were identified as important factors in encouraging students to work in regional and rural environments. However, discouraging factors included separation from friends and families, geographical isolation and the lack of opportunities for partners to find work. This study has confirmed the value of the Pūkawakawa Programme as an important contributor to the regional and rural workforce of the Northland District, New Zealand. The value of an academic‑clinical partnership has been shown to support a regional and rural clinical learning environment. Evidence is provided of one way of having overcome barriers to building regional and rural workforce capacity in this district.

Should trainee doctors use the developing world to gain clinical experience? The annual Varsity Medical Debate – London, Friday 20th January, 2012

PubMed Central

2013-01-01

The 2012 Varsity Medical Debate between Oxford University and Cambridge University provided a stage for representatives from these famous institutions to debate the motion “This house believes that trainee doctors should be able to use the developing world to gain clinical experience.” This article brings together many of the arguments put forward during the debate, centring around three major points of contention: the potential intrinsic wrong of ‘using’ patients in developing countries; the effects on the elective participant; and the effects on the host community. The article goes on to critically appraise overseas elective programmes, offering a number of solutions that would help optimise their effectiveness in the developing world. PMID:23433035

International variation in programmes for assessment of children's neurodevelopment in the community: Understanding disparate approaches to evaluation of motor, social, emotional, behavioural and cognitive function.

PubMed

Wilson, Philip; Wood, Rachael; Lykke, Kirsten; Hauskov Graungaard, Anette; Ertmann, Ruth Kirk; Andersen, Merethe Kirstine; Haavet, Ole Rikard; Lagerløv, Per; Abildsnes, Eirik; Dahli, Mina P; Mäkelä, Marjukka; Varinen, Aleksi; Hietanen, Merja

2018-05-01

Few areas of medicine demonstrate such international divergence as child development screening and surveillance. Many countries have nationally mandated surveillance policies, but the content of programmes and mechanisms for delivery vary enormously. The cost of programmes is substantial but no economic evaluations have been carried out. We have critically examined the history, underlying philosophy, content and delivery of programmes for child development assessment in five countries with comprehensive publicly funded health services (Denmark, Finland, Norway, Scotland and Sweden). The specific focus of this article is on motor, social, emotional, behavioural and global cognitive functioning including language. Variations in developmental surveillance programmes are substantially explained by historical factors and gradual evolution although Scotland has undergone radical changes in approach. No elements of universal developmental assessment programmes meet World Health Organization screening criteria, although some assessments are configured as screening activities. The roles of doctors and nurses vary greatly by country as do the timing, content and likely costs of programmes. Inter-professional communication presents challenges to all the studied health services. No programme has evidence for improved health outcomes or cost effectiveness. Developmental surveillance programmes vary greatly and their structure appears to be driven by historical factors as much as by evidence. Consensus should be reached about which surveillance activities constitute screening, and the predictive validity of these components needs to be established and judged against World Health Organization screening criteria. Costs and consequences of specific programmes should be assessed, and the issue of inter-professional communication about children at remediable developmental risk should be prioritised.

Medical education in Sweden.

PubMed

Lindgren, Stefan; Brännström, Thomas; Hanse, Eric; Ledin, Torbjörn; Nilsson, Gunnar; Sandler, Stellan; Tidefelt, Ulf; Donnér, Jakob

2011-01-01

Undergraduate medical education in Sweden has moved from nationally regulated, subject-based courses to programmes integrated either around organ systems or physiological and patho-physiological processes, or organised around basic medical science in conjunction with clinical specialities, with individual profiles at the seven medical schools. The national regulations are restricted to overall academic and professional outcomes. The 5½ year long university undergraduate curriculum is followed by a mandatory 18 months internship, delivered by the County Councils. While quality control and accreditation for the university curriculum is provided by the Swedish National Agency for Higher Education, no such formal control exists for the internship; undergraduate medical education is therefore in conflict with EU directives from 2005. The Government is expected to move towards 6 years long university undergraduate programmes, leading to licence, which will facilitate international mobility of both Swedish and foreign medical students and doctors. Ongoing academic development of undergraduate education is strengthened by the Bologna process. It includes outcome (competence)-based curricula, university Masters level complying with international standards, progression of competence throughout the curriculum, student directed learning, active participation and roles in practical clinical education and a national assessment model to assure professional competence. In the near future, the dimensioning of Swedish undergraduate education is likely to be decided more by international demands and aspects of quality than by national demands for doctors.

[Adverse reactions to drugs reported by the primary care physicians of Andalusia. Analysis of underreporting].

PubMed

Torelló Iserte, J; Castillo Ferrando, J R; Laínez, M M; García Morillas, M; Arias González, A

1994-04-15

To discover the sort of adverse reactions to medication (ARM) notified by Primary Care doctors and identify the under-notification of those cases having special clinical-epidemiological interest. Retrospective study in which 2,597 ARM corresponding to 1,467 Yellow Cards (YC) were analysed. These were notified by Primary Care doctors to the Centro Andaluz de Farmacovigilancia (Andalusian Drug-watch centre) during the period from 1/6/90 to 31/12/92. To assess the seriousness of the ARM, their terminological classification and imputability, the criteria used in the WHO's international "Yellow Card" programme of spontaneous notification were followed. 77.2% of all notifications were from Primary Care, of which 7.4% were of special interest due to their serious or novel character. However an undernotification of serious and well-known ARM was detected, such as digestive haemorrhages (1.07/10(6) inhibitants per year), anaphylactic shock (0.34/10(6) inhab/year), agranulocytosis (0.23/10(6) inhab/year) and aplastic anaemia (0.05/10(6) inhab/year), among others. Most of the main under-notified ARM are generated in the community but treated in hospital Casualty departments. Therefore it would be useful to develop specific Drug-watch programmes in the hospitals themselves.

Development of village doctors in China: financial compensation and health system support.

PubMed

Hu, Dan; Zhu, Weiming; Fu, Yaqun; Zhang, Minmin; Zhao, Yang; Hanson, Kara; Martinez-Alvarez, Melisa; Liu, Xiaoyun

2017-07-01

Since 1968, China has trained about 1.5 million barefoot doctors in a few years' time to provide basic health services to 0.8 billion rural population. China's Ministry of Health stopped using the term of barefoot doctor in 1985, and changed policy to develop village doctors. Since then, village doctors have kept on playing an irreplaceable role in China's rural health, even though the number of village doctors has fluctuated over the years and they face serious challenges. United Nations declared Sustainable Development Goals in 2015 to achieve universal health coverage by 2030. Under this context, development of Community Health workers (CHWs) has become an emerging policy priority in many resource-poor developing countries. China's experiences and lessons learnt in developing and maintaining village doctors may be useful for these developing countries. This paper aims to synthesis lessons learnt from the Chinese CHW experiences. It summarizes China's experiences in exploring and using strategic partnership between the community and the formal health system to develop CHWs in the two stages, the barefoot doctor stage (1968 -1985) and the village doctor stage (1985-now). Chinese and English literature were searched from PubMed, CNKI and Wanfang. The information extracted from the selected articles were synthesized according to the four partnership strategies for communities and health system to support CHW development, namely 1) joint ownership and design of CHW programmes; 2) collaborative supervision and constructive feedback; 3) a balanced package of incentives, both financial and non-financial; and 4) a practical monitoring system incorporating data from the health system and community. The study found that the townships and villages provided an institutional basis for barefoot doctor policy, while the formal health system, including urban hospitals, county health schools, township health centers, and mobile medical teams provided training to the barefoot doctors. But After 1985, the formal health system played a more dominant role in the CHW system including both selection and training of village doctors. China applied various mechanisms to compensate village doctors in different stages. During 1960s and 1970s, the main income source of barefoot doctors was from their villages' collective economy. After 1985 when the rural collective economy collapsed and barefoot doctors were transformed to village doctors, they depended on user fees, especially from drug sale revenues. In the new century, especially after the new round of health system reform in 2009, government subsidy has become an increasing source of village doctors' income. The barefoot doctor policy has played a significant role in providing basic human resources for health and basic health services to rural populations when rural area had great shortages of health resources. The key experiences for this great achievement are the intersection between the community and the formal health system, and sustained and stable financial compensation to the community health workers.

76 FR 6650 - Culturally Significant Objects Imported for Exhibition Determinations: “Birth of the Modern...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-07

... DEPARTMENT OF STATE [Public Notice 7317] Culturally Significant Objects Imported for Exhibition Determinations: ``Birth of the Modern: Style and Identity in Vienna 1900'' SUMMARY: Notice is hereby given of the... that the objects to be included in the exhibition ``Birth of the Modern: Style and Identity in Vienna...

The Vienna Frailty Questionnaire for Persons with Intellectual Disabilities--Revised

ERIC Educational Resources Information Center

Brehmer-Rinderer, Barbara; Zeilinger, Elisabeth Lucia; Radaljevic, Ana; Weber, Germain

2013-01-01

Frailty is a theoretical concept used to track individual age-related declines. Persons with intellectual disabilities (ID) often present with pre-existing deficits that would be considered frailty markers in the general population. The previously developed Vienna Frailty Questionnaire for Persons with ID (VFQ-ID) was aimed at assessing frailty in…

9 CFR 319.180 - Frankfurter, frank, furter, hotdog, weiner, vienna, bologna, garlic bologna, knockwurst, and...

Code of Federal Regulations, 2012 CFR

2012-01-01

...) Frankfurter, frank, furter, hot-dog, wiener, vienna, bologna, garlic bologna, knockwurst and similar cooked... poultry meat and/or Mechanically Separated (Kind of Poultry) without skin and without kidneys and sex... accordance with the provisions of § 381.118 of this chapter. (b) Frankfurter, frank, furter, hot-dog, wiener...

9 CFR 319.180 - Frankfurter, frank, furter, hotdog, weiner, vienna, bologna, garlic bologna, knockwurst, and...

Code of Federal Regulations, 2014 CFR

2014-01-01

...) Frankfurter, frank, furter, hot-dog, wiener, vienna, bologna, garlic bologna, knockwurst and similar cooked... poultry meat and/or Mechanically Separated (Kind of Poultry) without skin and without kidneys and sex... accordance with the provisions of § 381.118 of this chapter. (b) Frankfurter, frank, furter, hot-dog, wiener...

9 CFR 319.180 - Frankfurter, frank, furter, hotdog, weiner, vienna, bologna, garlic bologna, knockwurst, and...

Code of Federal Regulations, 2013 CFR

2013-01-01

...) Frankfurter, frank, furter, hot-dog, wiener, vienna, bologna, garlic bologna, knockwurst and similar cooked... poultry meat and/or Mechanically Separated (Kind of Poultry) without skin and without kidneys and sex... accordance with the provisions of § 381.118 of this chapter. (b) Frankfurter, frank, furter, hot-dog, wiener...

Evaluation of the Vienna APL corrections using reprocessed GNSS series

NASA Astrophysics Data System (ADS)

Steigenberger, P.; Dach, R.

2011-12-01

The Institute of Geodesy and Geophysics of the Vienna University of Technology recently started an operational service to provide non-tidal atmospheric pressure loading (APL) corrections. As the series is based on European Centre for Medium-Range Weather Forecasts (ECMWF) pressure data, it is fully consistent with the Vienna Mapping Function 1 (VMF1) atmospheric delay correction model for microwave measurements. Whereas VMF1 is widely used for, e.g., observations of Global Navigation Satellite Systems (GNSS), applying APL corrections is not yet a standard nowadays. The Center for Orbit Determination in Europe (CODE) - a joint venture between the Astronomical Institute of the University of Bern (AIUB, Bern, Switzerland), the Federal Office of Topography (swisstopo, Wabern, Switzerland), the Federal Office for Cartography and Geodesy (BKG, Frankfurt am Main, Germany), and the Insitute for Astronomical and Physical Geodesy, TU Muenchen (IAPG, Munich, Germany) - uses a recently generated series of reprocessed multi-GNSS data (considering GPS and GLONASS) to evaluate the APL corrections provided by the Vienna group. The results are also used to investigate the propagation of the APL effect in GNSS-derived results if no corrections are applied.

Status and plans for the future of the Vienna VLBI Software

NASA Astrophysics Data System (ADS)

Madzak, Matthias; Böhm, Johannes; Böhm, Sigrid; Girdiuk, Anastasiia; Hellerschmied, Andreas; Hofmeister, Armin; Krasna, Hana; Kwak, Younghee; Landskron, Daniel; Mayer, David; McCallum, Jamie; Plank, Lucia; Schönberger, Caroline; Shabala, Stanislav; Sun, Jing; Teke, Kamil

2016-04-01

The Vienna VLBI Software (VieVS) is a VLBI analysis software developed and maintained at Technische Universität Wien (TU Wien) since 2008 with contributions from groups all over the world. It is used for both academic purposes in university courses as well as for providing VLBI analysis results to the geodetic community. Written in a modular structure in Matlab, VieVS offers easy access to the source code and the possibility to adapt the programs for particular purposes. The new version 2.3, released in December 2015, includes several new parameters to be estimated in the global solution, such as tidal ERP variation coefficients. The graphical user interface was slightly modified for an improved user functionality and, e.g., the possibility of deriving baseline length repeatabilities. The scheduling of satellite observations was refined, the simulator newly includes the effect of source structure which can also be corrected for in the analysis. This poster gives an overview of all VLBI-related activities in Vienna and provides an outlook to future plans concerning the Vienna VLBI Software.

Estimation of the sustainable geothermal potential of Vienna

NASA Astrophysics Data System (ADS)

Tissen, Carolin; Benz, Susanne A.; Keck, Christiane A.; Bayer, Peter; Blum, Philipp

2017-04-01

Regarding the limited availability of fossil fuels and the absolute necessity to reduce CO2 emissions in order to mitigate the worldwide climate change, renewable resources and new energy systems are required to provide sustainable energy for the future. Shallow geothermal energy holds a huge untapped potential especially for heating and hot water, which represent up to 50% of the global energy demand. Previous studies quantified the capacity of shallow geothermal energy for closed and open systems in cities such as Vienna, London (Westminster) and Ludwigsburg in Germany. In the present study, these approaches are combined and also include the anthropogenic heat input by the urban heat island (UHI) effect. The objective of the present study is therefore to estimate the sustainable geothermal potential of Vienna. Furthermore, the amount of energy demand for heating and hot water that can be supplied by open and closed geothermal systems will be determined. The UHI effect in Vienna is reflected in higher ground water temperatures within the city centre (14 ˚ C to 18 ˚ C) in comparison to lower ones in rural areas (10 ˚ C to 13 ˚ C). A preliminary estimation of the anthropogenic heat flow into the ground water caused by elevated basement temperatures and land surface temperatures is 3,5 × 108 kWh/a. This additional heat flow leads to a total geothermal potential which is 2.5 times larger than the estimated annual energy demand for heating and hot water in Vienna.

What factors are critical to attracting NHS foundation doctors into specialty or core training? A discrete choice experiment.

PubMed

Scanlan, Gillian Marion; Cleland, Jennifer; Johnston, Peter; Walker, Kim; Krucien, Nicolas; Skåtun, Diane

2018-03-12

Multiple personal and work-related factors influence medical trainees' career decision-making. The relative value of these diverse factors is under-researched, yet this intelligence is crucially important for informing medical workforce planning and retention and recruitment policies. Our aim was to investigate the relative value of UK doctors' preferences for different training post characteristics during the time period when they either apply for specialty or core training or take time out. We developed a discrete choice experiment (DCE) specifically for this population. The DCE was distributed to all Foundation Programme Year 2 (F2) doctors across Scotland as part of the National Career Destination Survey in June 2016. The main outcome measure was the monetary value of training post characteristics, based on willingness to forgo additional potential income and willingness to accept extra income for a change in each job characteristic calculated from regression coefficients. 677/798 F2 doctors provided usable DCE responses. Location was the most influential characteristic of a training position, followed closely by supportive culture and then working conditions. F2 doctors would need to be compensated by an additional 45.75% above potential earnings to move from a post in a desirable location to one in an undesirable location. Doctors who applied for a training post placed less value on supportive culture and excellent working conditions than those who did not apply. Male F2s valued location and a supportive culture less than female F2s. This is the first study focusing on the career decision-making of UK doctors at a critical careers decision-making point. Both location and specific job-related attributes are highly valued by F2 doctors when deciding their future. This intelligence can inform workforce policy to focus their efforts in terms of making training posts attractive to this group of doctors to enhance recruitment and retention. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

An Analytical Comparison of the Opinions of Physicians Working in Emergency and Trauma Surgery Departments at Tabriz and Vienna Medical Universities Regarding Family Presence during Resuscitation.

PubMed

Soleimanpour, Hassan; Behringer, Wilhelm; Tabrizi, Jafar Sadegh; Sarahrudi, Kambiz; Golzari, Samad E J; Hajdu, Stefan; Rasouli, Maryam; Nikakhtar, Mehdi; Mehdizadeh Esfanjani, Robab

2015-01-01

The present study evaluated the opinions of physicians working in the emergency and trauma surgery departments of Vienna Medical University, in Austria, and Tabriz Medical University, in Iran, regarding the presence of patients' relatives during resuscitation. In a descriptive-analytical study, the data obtained from questionnaires that had been distributed randomly to 40 specialists and residents at each of the participating universities were analyzed. The questionnaire consisted of two sections aimed at capturing the participants' demographic data, the participants' opinions regarding their support for the family's presence during resuscitation, and the multiple potential factors affecting the participants' attitudes, including health beliefs, triggers that could facilitate the procedure, self-efficacy, intellectual norms, and perceived behavioral control. The questionnaire also included a direct question (Question 16) on whether the participants approved of family presence. Each question could be answered using a Likert-type scale. The results showed that the mean scores for Question 16 were 4.31 ± 0.64 and 3.57 ± 1.31 for participants at Vienna and Tabriz universities, respectively. Moreover, physicians at Vienna University disapproved of the presence of patients' families during resuscitation to a higher extent than did those at Tabriz University (P = 0.018). Of the studied prognostic factors affecting the perspectives of Vienna Medical University's physicians, health beliefs (P = 0.000; B = 1.146), triggers (P = 0.000; B = 1.050), and norms (P = 0.000; B = 0.714) were found to be significant. Moreover, of the studied prognostic factors affecting the perspectives of Tabriz Medical University's physicians, health beliefs (P = 0.000; B = 0.875), triggers (P = 0.000; B = 1.11), self-efficacy (P = 0.001; B = 0.5), and perceived behavioral control (P = 0.03; B = 0.713) were significant. Most physicians at Vienna and Tabriz Medical universities were not open towards family members' presence during resuscitation.

Medical professionalism on television: student perceptions and pedagogical implications.

PubMed

Weaver, Roslyn; Wilson, Ian; Langendyk, Vicki

2014-11-01

Previous research has pointed to the role television can play in informing health practices and beliefs. Within the academic setting in particular, some educators have raised concerns about the influence of medical dramas on students. Less research, however, draws on the perspectives of students, and this study therefore explores medical students' perceptions of medical practice and professionalism in popular medical television programmes. Qualitative data from surveys of Australian undergraduate medical students showed that students perceived professionalism in dichotomous ways, with three main themes: cure-care, where a doctor's skill is either technical or interpersonal; work-leisure, where a doctor is either dedicated to work or personal life; and clinical-administration, where work is either direct patient care or administration. There continue to be imagined divisions between curing and caring for students, who express concerns about balancing work and leisure, and expectations that doctors should have little administrative work. Given students were able to identify these important contemporary issues around professionalism on television, there is pedagogical value in using popular images of the medical world in medical education. © The Author(s) 2014.

Should we use philosophy to teach clinical communication skills?

PubMed Central

2016-01-01

Effective communication between the doctor and patient is crucial for good quality health care. Yet, this form of communication is often problematic, which may lead to several negative consequences for both patients and doctors. Clinical communication skills have become important components of medical training programmes. The traditional approach is to teach students particular communication skills, such as listening to patients and asking open-ended questions. Despite their importance, such training approaches do not seem to be enough to deliver medical practitioners who are able and committed to communicate effectively with patients. This might be due to the pervasive negative influence of the medical profession’s (mistaken) understanding of itself as a natural science on doctor–patient communication. Doctors who have been trained according to a positivist framework may consider their only responsibility to be the physical treatment of physical disorders. They may thus have little regard for the patient’s psychological and social world and by extension for communication with the patient and/or their caregivers. To address this problem, I propose a curriculum, based on the academic field of philosophy, for teaching clinical communication. PMID:28155325

Medical graduates' early career choices of specialty and their eventual specialty destinations: UK prospective cohort studies.

PubMed

Goldacre, Michael J; Laxton, L; Lambert, T W

2010-07-06

To report on doctors' early choices of specialty at selected intervals after qualification, and eventual career destinations. Questionnaire surveys. United Kingdom. Total of 15 759 doctors who qualified in 1974, 1977, 1983, 1993, and 1996, and their career destinations 10 years after graduation. 15 759 doctors were surveyed one and three years after graduation and 12 108 five years after graduation. Career preferences at years 1, 3, and 5, and destinations at 10 years, were known for, respectively, 64% (n=10 154), 62% (n=9702), and 61% (n=7429) of the survey population. In the 1993 and 1996 cohorts, career destinations matched with year 1 choices for 54% (1890/3508) of doctors in year 1, 70% (2494/3579) in year 3, and 83% (2916/3524) in year 5. Corresponding results for the earlier cohorts (1974-83) were similar: 53% (3310/6264), 74% (4233/5752), and 82% (2976/3646). The match rates varied by specialty; for example, the rates were consistently high for surgery. Career destinations matched with year 1 choices for 74% (722/982) of doctors who specified a definite (rather than probable or uncertain) specialty choice in their first postgraduate year. About half of those who chose a hospital specialty but did not eventually work in it were working in general practice by year 10. Ten years after qualification about a quarter of doctors were working in a specialty that was different from the one chosen in their third year after graduation. This stayed reasonably constant across graduation cohorts despite the changes in training programmes over time. Subject to the availability of training posts, postgraduate training should permit those who have made early, definite choices to progress quickly into their chosen specialty, while recognising the need for flexibility for those who choose later.

Junior doctor-led ‘near-peer’ prescribing education for medical students

PubMed Central

Gibson, Kyle R; Qureshi, Zeshan U; Ross, Michael T; Maxwell, Simon R

2014-01-01

Aims Prescribing errors are common and inadequate preparation of prescribers appears to contribute. A junior doctor-led prescribing tutorial programme has been developed for Edinburgh final year medical students to increase exposure to common prescribing tasks. The aim of this study was to assess the impact of these tutorials on students and tutors. Methods One hundred and ninety-six tutorials were delivered to 183 students during 2010–2011. Each student completed a questionnaire after tutorial attendance which explored their previous prescribing experiences and the perceived benefits of tutorial attendance. Tutors completed a questionnaire which evaluated their teaching experiences and the impact on their prescribing practice. Student tutorial attendance was compared with end-of-year examination performance using linear regression analysis. Results The students reported increased confidence in their prescribing knowledge and skills after attending tutorials. Students who attended more tutorials also tended to perform better in end-of-year examinations (Drug prescribing: r = 0.16, P = 0.015; Fluid prescribing: r = 0.18, P = 0.007). Tutors considered that participation enhanced their own prescribing knowledge and skills. Although they were occasionally unable to address student uncertainties, 80% of tutors reported frequently correcting misconceptions and deficits in student knowledge. Ninety-five percent of students expressed a preference for prescribing training delivered by junior doctors over more senior doctors. Conclusions A ‘near-peer’ junior doctor-led approach to delivering prescribing training to medical students was highly valued by both students and tutors. Although junior doctors have relatively less clinical experience of prescribing, we believe that this can be addressed by training and academic supervision and is outweighed by the benefits of these tutorials. PMID:23617320

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

PubMed Central

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

2017-01-01

Abstract Background Antimicrobial resistance has led to widespread implementation of interventions for appropriate prescribing. However, such interventions are often adopted without an adequate understanding of the challenges facing doctors-in-training as key prescribers. Methods The review followed a realist, theory-driven approach to synthesizing qualitative, quantitative and mixed-methods literature. Consistent with realist review quality standards, articles retrieved from electronic databases were systematically screened and analysed to elicit explanations of antimicrobial prescribing behaviours. These explanations were consolidated into a programme theory drawing on social science and learning theory, and shaped though input from patients and practitioners. Results By synthesizing data from 131 articles, the review highlights the complex social and professional dynamics underlying antimicrobial prescribing decisions of doctors-in-training. The analysis shows how doctors-in-training often operate within challenging contexts (hierarchical relationships, powerful prescribing norms, unclear roles and responsibilities, implicit expectations about knowledge levels, uncertainty about application of knowledge in practice) where they prioritize particular responses (fear of criticism and individual responsibility, managing one’s reputation and position in the team, appearing competent). These complex dynamics explain how and why doctors-in-training decide to: (i) follow senior clinicians’ prescribing habits; (ii) take (or not) into account prescribing aids, advice from other health professionals or patient expectations; and (iii) ask questions or challenge decisions. This increased understanding allows for targeted tailoring, design and implementation of antimicrobial prescribing interventions. Conclusions This review contributes to a better understanding of how antimicrobial prescribing interventions for doctors-in-training can be embedded more successfully in the hierarchical and inter-professional dynamics of different healthcare settings. PMID:28859445

Comparative attitude and plans of the medical students and young Nepalese doctors.

PubMed

Lakhey, M; Lakhey, S; Niraula, S R; Jha, D; Pant, R

2009-01-01

Many doctors are leaving Nepal to work abroad. To understand this problem better, we decided to study the attitude and plans of young doctors and medical students. This cross-sectional study was conducted at Kathmandu Medical College involving 65 first year medical students, 100 interns and 100 house officers. The data collected was entered in Microsoft excel and analysed by SPSS (Statistical Package for Social Sciences) programme. Chi-square test was used to compare two proportions. Significance level was set at 5%. Only 2% house officers said that their job prospects were excellent as compared to 22.4% of students, whereas 20% house officers as compared to 9% students thought job prospects in Nepal were poor (p= 0.003). Eighty two percent of students thought that a doctor's service to his country was very important as compared to 51% of interns (p= 0.001) and 58% of house officers. Forty percent of students, 58% of interns and 48% of house officers (no statistical significance between the three groups) planned to migrate to a developed country after graduation. Eighty eight percent of students, 89% interns and 74% of house officers (no statistical significant differences between the three groups) were of the opinion that improving career opportunities or working environment of the doctor could make the profession more attractive. Although majority of students, interns and house officers were of the opinion that a doctor's service to his community/country was very important, almost half of them still planned to migrate to a developed country after graduation. Improving the chances of professional advancement and professional working environment can make the profession more attractive, and therefore, may decrease this tendency for brain drain from our country.

Integrated School of Ocean Sciences: Doctoral Education in Marine Sciences in Kiel

NASA Astrophysics Data System (ADS)

Bergmann, Nina; Basse, Wiebke; Prigge, Enno; Schelten, Christiane; Antia, Avan

2016-04-01

Marine research is a dynamic thematic focus in Kiel, Germany, uniting natural scientists, economists, lawyers, philosophers, artists and computing and medical scientists in frontier research on the scientific, economic and legal aspects of the seas. The contributing institutions are Kiel University, GEOMAR Helmholtz Centre for Ocean Research Kiel, Kiel Institute for the World Economy and Muthesius University in Kiel. Marine science education in Kiel trains young scientists to investigate the role of the oceans in global change, risks arising from ocean usage and sustainable management of living and non-living marine resources. Basic fundamental research is supplemented with applied science in an international framework including partners from industry and public life. The Integrated School of Ocean Sciences (ISOS) established through the Cluster of Excellence "The Future Ocean", funded within the German Excellence Initiative, provides PhD candidates in marine sciences with interdisciplinary education outside of curricular courses. It supports the doctoral candidates through supplementary training, a framework of supervision, mentoring and mobility, the advisors through transparency and support of doctoral training in their research proposals and the contributing institutions by ensuring quality, innovation and excellence in marine doctoral education. All PhD candidates financed by the Helmholtz Research School for Ocean System Science and Technology (HOSST) and the Collaborative Research Centre 754 "Climate-biogeochemical interactions in the tropical ocean" (SFB 754) are enrolled at the ISOS and are integrated into the larger peer community. Over 150 PhD candidate members from 6 faculties form a large interdisciplinary network. At the ISOS, they sharpen their scientific profile, are challenged to think beyond their discipline and equip themselves for life after a PhD through early exposure to topics beyond research (e.g. social responsibility, public communication, global sustainability etc.). The primary advisor and at least one co-advisor form an advisory committee, committing to support the candidate in two mandatory meetings per year. Contrasting to other PhD programmes, ISOS emphasises on an open policy with voluntary participation for all other aspects of the programme, creating a unique environment that lives upon personal involvement and maximises tangible benefits for individual PhD candidates.

‘He's going to be a doctor in August’: a narrative interview study of medical students' and their educators' experiences of aligned and misaligned assistantships

PubMed Central

Jones, Owen Meurig; Okeke, Chiemeka; Bullock, Alison; Wells, Stephanie E; Monrouxe, Lynn V

2016-01-01

Objective To explore final-year students’ and clinical supervisors’ experiences of alignment and misalignment with future Foundation Year 1 (F1) posts in an assistantship programme in the UK. Setting Assistantships are clinical placements in which students assist junior doctors by undertaking similar duties under supervision. Models of assistantship programmes vary across curricula. Some actively seek to align with students’ initial postgraduate F1 post. To date, no research has examined the implications of this association for teaching and learning. Qualitative individual and group narrative interviews were conducted with students and supervisors of 2 Welsh medical schools to address: RQ1: How do students and supervisors understand the purpose of the longitudinal assistantship? RQ2: Does alignment/misalignment of the assistantship with students’ initial F1 post influence students’ and supervisors’ teaching and learning experiences? Audio-recordings of interviews were transcribed, participants anonymised and framework analysis was used. Participants A convenience sample of 4 participant groups comprised (1) final-year medical students whose assistantship and F1 post were aligned (n=27), (2) final-year medical students whose assistantship and F1 post were misaligned (n=18) and (3) supervisors (n=10, junior doctors; n=11, consultants). Results All participant groups highlighted increased student confidence in undertaking the duties of an F1 doctor arising from their assistantship period. Learning transferable skills was also highlighted. Many students considered themselves to be team members, ‘learning the trade’ as they shadowed their F1. Opportunities for caring for acutely unwell patients were scarce. The evidence shows enhanced engagement for students aligned to their first F1 post with greater opportunities for workplace acclimatisation. Those who were misaligned were perceived as being disadvantaged. Conclusions Our findings suggest that alignment with students’ first F1 post enhances the assistantship experience. Further longitudinal assessment is required to examine whether and how this translates into improvements in functioning and reductions in stress and anxiety during this transitional period. PMID:27288387

General practitioners and mental health staff sharing patient care: working model.

PubMed

Horner, Deborah; Asher, Kim

2005-06-01

The paper describes a shared care programme developed by mental health services and general practitioners for shifting patients with chronic psychiatric disorders to the care of a general practitioner. The programme is characterized by: (i) a dedicated mental health service general practitioner liaison position to manage the programme and provide support to both patients and doctors; (ii) a multidisciplinary care planning meeting that includes mental health staff, the patient, the general practitioner and a carer; and (iii) a jointly developed individual management plan that specifies patient issues, strategies to deal with these issues, persons responsible for monitoring and a review date. The shared care protocol, the results of a review of patient mental health indicators and general practitioner satisfaction with the programme are described. Outcomes to date suggest that patients' mental health is not compromised and may be enhanced by transfer to general practitioners within the shared care model. Indicators of mental health outcomes (Health of the Nation Outcome Scale and Life Skills Profile scores) show improved patient symptomatology and functioning in most cases. The programme fits the model of recovery-based mental health services and complies with current local, state and Commonwealth policies that encourage integrated and collaborative approaches by mental health services and general practitioners in delivering mental health care to persons with chronic mental illness.

Building workforce capacity to detect and respond to child abuse and neglect cases: A training intervention for staff working in emergency settings in Vietnam.

PubMed

Flemington, Tara; Fraser, Jennifer

2017-09-01

Too many children are brought to hospital emergency departments on numerous occasions before they are recognised as victims of child abuse and neglect. For this reason, improving knowledge and response behaviors of emergency staff at all levels is likely to have a significant impact on better outcomes. An Australian based training programme was the first of its kind to address this issue in a Vietnamese Emergency Department. Titled 'Safe Children Vietnam', the programme aimed to improve knowledge, attitudes and reporting behaviors concerning child abuse in the emergency setting. A pre-post test design was used to evaluate the impact of 'Safe Children Vietnam' on emergency staff knowledge, attitudes and intentions to report child abuse and neglect. Emergency staff including doctors, nurses and healthcare staff (n=116) participated in the clinical training programme. Linear Mixed Model analyses showed that on programme completion, they were more likely to recognise serious cases of all types of abuse. The 'Safe Children Vietnam' programme was effective at improving emergency staff knowledge of child abuse and neglect. A systems wide approach may be necessary to impact on emergency staff attitudes towards reporting cases of abuse. Copyright © 2017 Elsevier Ltd. All rights reserved.

Fitness to practice of medical graduates: one programme's approach.

PubMed

Braatvedt, Claire; Poole, Phillippa; Merry, Alan; Gorman, Des; Reid, Papaarangi; Bagg, Warwick

2014-11-07

Doctors must ensure they are fit to practise medicine. There is a relationship between unprofessional behaviour at medical school and in subsequent medical practice. This study describes one programme's Fitness to Practice (FtP) policy and outcomes since inception in 2005. FtP notifications were classified into: health or personal; professional attitudes, or external issues. Seriousness was classified as non-critical, critical or extraordinarily critical. Anonymous data were extracted and analysed from a confidential FtP database. There were 157 FtP notifications involving 132 (5.5%) students. 87.2% were for issues with professional attitudes and 80.3% were non-critical. 17 students received more than one FtP notification. Students in clinical years were over-represented (p<0.0001) as were males (57% vs. 43%: p=0.0286). 96% of students continued the programme after remedial action. Two students were excluded from the programme on FtP grounds. The national regulatory body was notified of nine individual students with the potential for on- going FtP concerns. Over 9 years, 5.5% of medical students received a FtP notification, with most of these isolated non-critical incidents of a professional nature. A small subset of students had repeated or serious concerns, underscoring the need for a FtP policy in any medical programme.

[The rearrangement of the medical faculty and the teaching of the medicine in the era of the reforms. The plan of the medical studies in the "restored" university of Cagliari and Sassari (1764-1766)].

PubMed

Tognotti, Eugenia

2004-01-01

In the same decade during which Vienna government was proceeding to the rearrangement of the Medical Faculty of the University of Pavia, Savoy government started the reform of Cagliari and Sassari Universities. The programme of medical studies to be introduced in the "restored" Universities aroused an important debate which involved the government of Turin, the local authorities and the Magistrature. The main points concerned the teachings to be started, the programmes and the texts to be adopted, the methods and contents of teaching. The range of ideas aiming to conform island medical Faculties to the progress of science, gave life to the critique of a teaching model, still ruled by the Galenic authority and by metaphysical etiological explanations, which ignored the physiological and pathological reality revealed by the anatomical study methodically on performed corpses. The new programme of studies admitted the teaching of surgery, which had completely disappeared in the university ruled by Jesuites, and increased the value of anatomy teaching, that will be chosen as a subject for the speech made during the solemn opening of the medical Faculty of Sassari in 1765. The need for an empirical testing which had to follow theorical studies in wards, where teachers had to give lessons at patients' bedside, was considered of such importance that it was codified in the Regulations of the reformed University. It was the very first step towards the welding between medical-surgical studies and nosocomial practice which was about to revolutionize the teaching framework of medical studies.

Vienna in the Early Twentieth Century: The Cultural Response to Modernization. Curriculum Units, NEH Institute, Summer 1993.

ERIC Educational Resources Information Center

Oregon Univ., Eugene.

These curriculum units were developed by participants in the National Endowment for the Humanities seminar at the University of Oregon in 1993. The lessons include: (1) "Schule, Freunde, Liebe: Wien um die Jahrhundertwende (School, Friends, Love: Vienna at the Turn of the Century)" (Linda Hansen; Glenn Tetterton-Opheim); (2) "Kultur…

Tree of Life: Gustav with Gusto

ERIC Educational Resources Information Center

Sterling, Joan

2010-01-01

Gustav Klimt was born in Vienna in 1862. At age 14, he received a scholarship to the Vienna Public Art School. After graduating, he painted realistic portraits and later began to paint landscapes. Klimt was best known for creating a style known as Art Nouveau, in answer to the Industrial Revolution of the early 20th century. Art Nouveau was a…

The Relationships between Paranormal Belief, Creationism, Intelligent Design and Evolution at Secondary Schools in Vienna (Austria)

ERIC Educational Resources Information Center

Eder, Erich; Turic, Katharina; Milasowszky, Norbert; Van Adzin, Katherine; Hergovich, Andreas

2011-01-01

The present study is the first to investigate the relationships between a multiple set of paranormal beliefs and the acceptance of evolution, creationism, and intelligent design, respectively, in Europe. Using a questionnaire, 2,129 students at secondary schools in Vienna (Austria) answered the 26 statements of the Revised Paranormal Belief Scale…

Family medicine training in sub-Saharan Africa: South–South cooperation in the Primafamed project as strategy for development

PubMed Central

Flinkenflögel, Maaike; Essuman, Akye; Chege, Patrick; Ayankogbe, Olayinka; De Maeseneer, Jan

2014-01-01

Background. Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. Objective. To explore the extent to which the Primafamed South–South cooperative project contributed to the development of family medicine in sub-Saharan Africa. Methods. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. Results. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. Conclusions. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The South–South cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels. PMID:24857843

The Correspondence of Bruno Bettelheim and Rudolf Ekstein.

PubMed

Fisher, David James

2006-01-01

This paper provides the historical, cultural, and clinical context for the relationship between Bruno Bettelheim (1903-1990) and Rudolf Ekstein (1912-2005). Both were Viennese-born and trained intellectuals who received doctorates in the human sciences from the University of Vienna in 1937. Both were deeply identified with lay analysis, emphasizing that for psychoanalysis to perpetuate itself it needed to promote serious and rigorous forms of research. Because Bettelheim was the better known of the two, this introduction focuses on Ekstein's family history, with special emphasis on his experience of loss and trauma and his capacity to recover from personal and educational obstacles. It argues that Ekstein was a representative product of Austro-Marxism in the period between the wars, embracing the ethical brand of democratic socialism and group solidarity that was integral to the theory and practice of Austrian Social Democracy. It discusses Ekstein's training with Moritz Schlick in philosophy and his immersion in the Vienna Circle of logical positivism. From Schlick, Ekstein evolved into a philosophical thinker who learned how to think his own thoughts. Ekstein joined the circle of psychoanalytic pedagogues who clustered around the Vienna Psychoanalytic Society, under the tutelage of Willi Hoffer, August Aichhorn and, above all, Anna Freud. The clinical component of psychoanalysis emanated from his commitment to understanding the inner world of the child. Bettelheim and Ekstein first became aware of each other from reading the analytic literature and finally met in America in the 1950s. They shared a professional interest in conducting research and doing clinical work on severely disturbed children and adolescents, including those with psychotic, borderline and autistic diagnoses. They debated the value of milieu therapy versus psychoanalytically oriented psychotherapy on such children. As their relationship evolved, the two collaborated and began a fascinating correspondence that gradually evolved into an intimate friendship. They both engaged in a polemic with Bernard Rimland, who was massively critical of their clinical work and a hostile critic of psychoanalytic approaches to the treatment of disturbed children. Rimland was an advocate of a neurological approach to mental illness, with an emphasis on biology and psychopharmacology. The 22 letters that constitute the Bettelheim-Ekstein exchange began with clinical concerns, including the varieties of solitude, isolation and countertransference disruptions that may trouble the psychoanalytic researcher and clinician in dealing with primitively disordered children. It moves to other issues, including mutual support during the Rimland Affair. As the two became more friendly, a pattern of good-natured competition and envy appeared. The two engaged in a heated exchange on the question of whether contemporary Vienna remained as anti-Semitic as it had been in their respective youths: Bettelheim, the concentration camp survivor, argued that nothing had changed and that most Austrians remained viscerally anti-Semitic; Ekstein, the Austro-Marxist, contended that one could not blame a generation born after World War II, holding that in his experience many Austrians had examined their consciences and held distinctly different options from their parents or grandparents. Toward the end of their correspondence, we encounter Ekstein's tender sensitivity to Bettelheim's descent into depression as a result of the death of his wife, Trude, leading eventually to recurrent episodes of suicidal ideation and plans for his own suicide. The letters testify to a unique friendship with a somewhat old-world quality.

The International Max Planck Research Schools for Molecular Biology and Neurosciences in Gttingen (Germany) as Examples for Joint Doctoral Training by a German University and Its Non-University Partners

ERIC Educational Resources Information Center

Burkhardt, Steffen; Neher, Erwin

2008-01-01

New concepts of higher education have recently been implemented through the MSc/PhD programmes in Molecular Biology and Neurosciences in the International Max Planck Research Schools, due to close cooperation between the University of Gttingen, three Max Planck Institutes and the German Primate Centre. The novel measures include a three stage…

A Partnership across the Ocean between the University of the Western Cape and the University of Missouri-St. Louis: Facilitating a Global Research Programme for Doctoral Students

ERIC Educational Resources Information Center

Boyer, Patricia G.; Holtman, Lorna; Murphy, Carole H.; Thaver, Beverley

2014-01-01

The downturn of the global economy requires universities worldwide to do more with fewer resources. These conditions have presented an opportunity for two universities, the University of the Western Cape and the University of Missouri-St. Louis, to collaborate on a research course offered to postgraduate students. The purpose of this article is to…

Restricted working hours in Austrian residency programs : Survey results.

PubMed

Bergmeister, Konstantin D; Aman, Martin; Podesser, Bruno K

2018-04-27

New regulations for working hours of medical doctors have been implemented in Austria based on the European directive 2003/88/EG, limiting on-duty working hours to 48 h per week. Clinical work is, therefore, substantially reduced compared to previous decades, and little is known on physician and students' opinions on this matter. We illustrate survey results concerning on-job training, its difficulties, and implications for restricted working hours. We conducted an internal survey among M.D. and Ph.D. students and medical staff members at the Medical University of Vienna using the MedCampus system (CAMPUSOnline, Graz, Austria) and SPSS (V.21, IBM Corp, Armonk, NY, USA). Participants were 36.5% staff members and 63.5% students. Students rated continuous education of physicians high at 9.19 ± 1.76 and staff members at 8.90 ± 2.48 on a 1-10 (1 unimportant, 10 most important) scale. Students rated limited time resources, while staff considered financial resources as the greatest challenge for in-hospital education. Overall, 28.85% thought that restricted working hours can positively influence education, while 19.04% thought the opposite and 52.11% were undecided. Considering the limited available time and financial resources, education of tomorrow's medical doctors remains an important but difficult task. While participants of our survey rated education as very important despite its many challenges, the opinions towards limited working hours were not as clear. Given that over 50% are still undecided whether reduced work hours may also positively influence medical education, it clearly presents an opportunity to include the next generations of physicians in this undertaking.

Using 3D computer simulations to enhance ophthalmic training.

PubMed

Glittenberg, C; Binder, S

2006-01-01

To develop more effective methods of demonstrating and teaching complex topics in ophthalmology with the use of computer aided three-dimensional (3D) animation and interactive multimedia technologies. We created 3D animations and interactive computer programmes demonstrating the neuroophthalmological nature of the oculomotor system, including the anatomy, physiology and pathophysiology of the extra-ocular eye muscles and the oculomotor cranial nerves, as well as pupillary symptoms of neurological diseases. At the University of Vienna we compared their teaching effectiveness to conventional teaching methods in a comparative study involving 100 medical students, a multiple choice exam and a survey. The comparative study showed that our students achieved significantly better test results (80%) than the control group (63%) (diff. = 17 +/- 5%, p = 0.004). The survey showed a positive reaction to the software and a strong preference to have more subjects and techniques demonstrated in this fashion. Three-dimensional computer animation technology can significantly increase the quality and efficiency of the education and demonstration of complex topics in ophthalmology.

Austrian Teachers and Their Education since 1945. Bulletin, 1957, No. 2

ERIC Educational Resources Information Center

Lahey, Helen C.

1954-01-01

During the academic year 1955-1956 Dr. Helen C. Lahey, Professor of Education at City College of the City of New York, New York, served as Fulbright guest professor at the Pedagogical Seminar in the Faculty of Philosophy of the University of Vienna, Austria. While in Vienna Dr. Lahey was granted permission for research in the archives and library…

Mineral Resources in Mobile Phones: A Case Study of Boston and Vienna Teachers and Students

ERIC Educational Resources Information Center

Bookhagen, Britta; Koeberl, Christian; Juang, Linda; DeRosa, Donald A.

2017-01-01

As part of an outreach initiative by the Natural History Museum in Vienna, Austria, an interdisciplinary educational module was developed to teach students about sustainability through the lens of mineral resources used to produce mobile phones. The overall goal of the module is to provide teachers of different subjects with a multifaceted tool to…

Viktor Lowenfeld: Portrait of a Young Art Teacher in Vienna in the 1930s

ERIC Educational Resources Information Center

Leshnoff, Susan K.

2013-01-01

Viktor Lowenfeld (1903-1960), one of the most influential art educators of the 20th century and author of "Creative and Mental Growth" (1947, 1952, 1957), barely talked or wrote about his early teaching experiences at the Chajes Realgymnasium, a secondary school for Jewish youth in Vienna, where he taught art and math for 14 years before…

Does Pukawakawa (the regional-rural programme at the University of Auckland) influence workforce choice?

PubMed

Matthews, Christina; Bagg, Warwick; Yielder, Jill; Mogol, Vernon; Poole, Phillippa

2015-02-20

Relative shortages of rural doctors persist. In 2008 the University of Auckland medical programme introduced a Year 5 regional and rural immersion programme, Pukawakawa, based in Northland, New Zealand (NZ). This study evaluates the early workforce outcomes of graduates of this programme. During 2013 we surveyed Auckland medical graduates who were in the 2008-2011 Pukawakawa cohorts. Questions were asked regarding recent and current place of work, future intentions for place of work, and career preference with reasons why. Qualitative analysis was undertaken to analyse free text responses about experiences of Pukawakawa on this choice. Of the 72 Pukawakawa participants, 45 completed the survey, for a response rate of 63%. In 2013, 62% were working in rural or regional areas, with 31% in the Northland DHB. The great majority intend to work rurally or regionally, with 35.6% intending to return to Northland DHB. Of the respondents, 68% listed general practice in their top three future career intentions. In the early postgraduate years, medical graduates who participated in Pukawakawa are very likely to be working in rural and regional areas. These graduates also show an intention to work in general practice and rural medicine.

A new tool to evaluate postgraduate training posts: the Job Evaluation Survey Tool (JEST).

PubMed

Wall, David; Goodyear, Helen; Singh, Baldev; Whitehouse, Andrew; Hughes, Elizabeth; Howes, Jonathan

2014-10-02

Three reports in 2013 about healthcare and patient safety in the UK, namely Berwick, Francis and Keogh have highlighted the need for junior doctors' views about their training experience to be heard. In the UK, the General Medical Council (GMC) quality assures medical training programmes and requires postgraduate deaneries to undertake quality management and monitoring of all training posts in their area. The aim of this study was to develop a simple trainee questionnaire for evaluation of postgraduate training posts based on the GMC, UK standards and to look at the reliability and validity including comparison with a well-established and internationally validated tool, the Postgraduate Hospital Educational Environment Measure (PHEEM). The Job Evaluation Survey Tool (JEST), a fifteen item job evaluation questionnaire was drawn up in 2006, piloted with Foundation doctors (2007), field tested with specialist paediatric registrars (2008) and used over a three year period (2008-11) by Foundation Doctors. Statistical analyses including descriptives, reliability, correlation and factor analysis were undertaken and JEST compared with PHEEM. The JEST had a reliability of 0.91 in the pilot study of 76 Foundation doctors, 0.88 in field testing of 173 Paediatric specialist registrars and 0.91 in three years of general use in foundation training with 3367 doctors completing JEST. Correlation of JEST with PHEEM was 0.80 (p < 0.001). Factor analysis showed two factors, a teaching factor and a social and lifestyle one. The JEST has proved to be a simple, valid and reliable evaluation tool in the monitoring and evaluation of postgraduate hospital training posts.

ViennaNGS: A toolbox for building efficient next- generation sequencing analysis pipelines

PubMed Central

Wolfinger, Michael T.; Fallmann, Jörg; Eggenhofer, Florian; Amman, Fabian

2015-01-01

Recent achievements in next-generation sequencing (NGS) technologies lead to a high demand for reuseable software components to easily compile customized analysis workflows for big genomics data. We present ViennaNGS, an integrated collection of Perl modules focused on building efficient pipelines for NGS data processing. It comes with functionality for extracting and converting features from common NGS file formats, computation and evaluation of read mapping statistics, as well as normalization of RNA abundance. Moreover, ViennaNGS provides software components for identification and characterization of splice junctions from RNA-seq data, parsing and condensing sequence motif data, automated construction of Assembly and Track Hubs for the UCSC genome browser, as well as wrapper routines for a set of commonly used NGS command line tools. PMID:26236465

Third cycle university studies in Europe in the field of agricultural engineering and in the emerging discipline of biosystems engineering.

PubMed

Ayuga, F; Briassoulis, D; Aguado, P; Farkas, I; Griepentrog, H; Lorencowicz, E

2010-01-01

The main objectives of European Thematic Network entitled 'Education and Research in Agricultural for Biosystems Engineering in Europe (ERABEE-TN)' is to initiate and contribute to the structural development and the assurance of the quality assessment of the emerging discipline of Biosystems Engineering in Europe. ERABEE is co-financed by the European Community in the framework of the LLP Programme. The partnership consists of 35 participants from 27 Erasmus countries, out of which 33 are Higher Education Area Institutions (EDU) and 2 are Student Associations (ASS). 13 Erasmus participants (e.g. Thematic Networks, Professional Associations, and Institutions from Brazil, Croatia, Russia and Serbia) are also involved in the Thematic Network through synergies. To date, very few Biosystems Engineering programs exist in Europe and those that are initiated are at a very primitive stage of development. The innovative and novel goal of the Thematic Network is to promote this critical transition, which requires major restructuring in Europe, exploiting along this direction the outcomes accomplished by its predecessor; the USAEE-TN (University Studies in Agricultural Engineering in Europe). It also aims at enhancing the compatibility among the new programmes of Biosystems Engineering, aiding their recognition and accreditation at European and International level and facilitating greater mobility of skilled personnel, researchers and students. One of the technical objectives of ERABEE is dealing with mapping and promoting the third cycle studies (including European PhDs) and supporting the integration of research at the 1st and 2nd cycle regarding European Biosystems Engineering university studies. During the winter 2008 - spring 2009 period, members of ERABEE conducted a survey on the contemporary status of doctoral studies in Europe, and on a possible scheme for promotion of cooperation and synergies in the framework of the third cycle of studies and the European Doctorate in Biosystems Engineering in Europe. This paper presents the results of the survey. The legal regulations and their extent on the different countries concerning the third cycle are presented, along with the current structure of third cycle studies. The evolution and adaptation to the new EHEA in each country is also considered. Information was also gathered on the emerging topics of the Biosystems Engineering field and how these topics could be addressed by the new doctoral programmes at the European level.

Highly Productive Application Development with ViennaCL for Accelerators

NASA Astrophysics Data System (ADS)

Rupp, K.; Weinbub, J.; Rudolf, F.

2012-12-01

The use of graphics processing units (GPUs) for the acceleration of general purpose computations has become very attractive over the last years, and accelerators based on many integrated CPU cores are about to hit the market. However, there are discussions about the benefit of GPU computing when comparing the reduction of execution times with the increased development effort [1]. To counter these concerns, our open-source linear algebra library ViennaCL [2,3] uses modern programming techniques such as generic programming in order to provide a convenient access layer for accelerator and GPU computing. Other GPU-accelerated libraries are primarily tuned for performance, but less tailored to productivity and portability: MAGMA [4] provides dense linear algebra operations via a LAPACK-comparable interface, but no dedicated matrix and vector types. Cusp [5] is closest in functionality to ViennaCL for sparse matrices, but is based on CUDA and thus restricted to devices from NVIDIA. However, no convenience layer for dense linear algebra is provided with Cusp. ViennaCL is written in C++ and uses OpenCL to access the resources of accelerators, GPUs and multi-core CPUs in a unified way. On the one hand, the library provides iterative solvers from the family of Krylov methods, including various preconditioners, for the solution of linear systems typically obtained from the discretization of partial differential equations. On the other hand, dense linear algebra operations are supported, including algorithms such as QR factorization and singular value decomposition. The user application interface of ViennaCL is compatible to uBLAS [6], which is part of the peer-reviewed Boost C++ libraries [7]. This allows to port existing applications based on uBLAS with a minimum of effort to ViennaCL. Conversely, the interface compatibility allows to use the iterative solvers from ViennaCL with uBLAS types directly, thus enabling code reuse beyond CPU-GPU boundaries. Out-of-the-box support for types from the Eigen library [8] and MTL 4 [9] are provided as well, enabling a seamless transition from single-core CPU to GPU and multi-core CPU computations. Case studies from the numerical solution of PDEs are given and isolated performance benchmarks are discussed. Also, pitfalls in scientific computing with GPUs and accelerators are addressed, allowing for a first evaluation of whether these novel devices can be mapped well to certain applications. References: [1] R. Bordawekar et al., Technical Report, IBM, 2010 [2] ViennaCL library. Online: http://viennacl.sourceforge.net/ [3] K. Rupp et al., GPUScA, 2010 [4] MAGMA library. Online: http://icl.cs.utk.edu/magma/ [5] Cusp library. Online: http://code.google.com/p/cusp-library/ [6] uBLAS library. Online: http://www.boost.org/libs/numeric/ublas/ [7] Boost C++ Libraries. Online: http://www.boost.org/ [8] Eigen library. Online: http://eigen.tuxfamily.org/ [9] MTL 4 Library. Online: http://www.mtl4.org/

Single Particle Analysis by Combined Chemical Imaging to Study Episodic Air Pollution Events in Vienna

NASA Astrophysics Data System (ADS)

Ofner, Johannes; Eitenberger, Elisabeth; Friedbacher, Gernot; Brenner, Florian; Hutter, Herbert; Schauer, Gerhard; Kistler, Magdalena; Greilinger, Marion; Lohninger, Hans; Lendl, Bernhard; Kasper-Giebl, Anne

2017-04-01

The aerosol composition of a city like Vienna is characterized by a complex interaction of local emissions and atmospheric input on a regional and continental scale. The identification of major aerosol constituents for basic source appointment and air quality issues needs a high analytical effort. Exceptional episodic air pollution events strongly change the typical aerosol composition of a city like Vienna on a time-scale of few hours to several days. Analyzing the chemistry of particulate matter from these events is often hampered by the sampling time and related sample amount necessary to apply the full range of bulk analytical methods needed for chemical characterization. Additionally, morphological and single particle features are hardly accessible. Chemical Imaging evolved to a powerful tool for image-based chemical analysis of complex samples. As a complementary technique to bulk analytical methods, chemical imaging can address a new access to study air pollution events by obtaining major aerosol constituents with single particle features at high temporal resolutions and small sample volumes. The analysis of the chemical imaging datasets is assisted by multivariate statistics with the benefit of image-based chemical structure determination for direct aerosol source appointment. A novel approach in chemical imaging is combined chemical imaging or so-called multisensor hyperspectral imaging, involving elemental imaging (electron microscopy-based energy dispersive X-ray imaging), vibrational imaging (Raman micro-spectroscopy) and mass spectrometric imaging (Time-of-Flight Secondary Ion Mass Spectrometry) with subsequent combined multivariate analytics. Combined chemical imaging of precipitated aerosol particles will be demonstrated by the following examples of air pollution events in Vienna: Exceptional episodic events like the transformation of Saharan dust by the impact of the city of Vienna will be discussed and compared to samples obtained at a high alpine background site (Sonnblick Observatory, Saharan Dust Event from April 2016). Further, chemical imaging of biological aerosol constituents of an autumnal pollen breakout in Vienna, with background samples from nearby locations from November 2016 will demonstrate the advantages of the chemical imaging approach. Additionally, the chemical fingerprint of an exceptional air pollution event from a local emission source, caused by the pull down process of a building in Vienna will unravel the needs for multisensor imaging, especially the combinational access. Obtained chemical images will be correlated to bulk analytical results. Benefits of the overall methodical access by combining bulk analytics and combined chemical imaging of exceptional episodic air pollution events will be discussed.

Perceived Effects of the Malaysian National Tobacco Control Programme on Adolescent Smoking Cessation: A Qualitative Study

PubMed Central

Hizlinda, Tohid; Noriah, Mohd Ishak; Noor Azimah, Muhammad; Farah Naaz, Momtaz Ahmad; Anis Ezdiana, Abdul Aziz; Khairani, Omar

2012-01-01

Background: The prevalence of teenage smoking has decreased over the past decade following the implementation of the national tobacco control programme. However, the effect of the programme on smoking cessation in teenagers has not been determined. Methods: Twenty-eight participants (12 teenagers, 8 teachers, and 8 doctors) were interviewed using 5 in-depth interviews and 3 group discussions. Social cognitive theory (SCT) was applied as the theoretical framework. Semi-structured interview protocols were used, and thematic analysis and analytic generalisation utilising SCT were performed. Results: The current national tobacco control programme was found to be ineffective in promoting smoking cessation among teenagers. The participants attributed the ineffective campaign to the followings: inadequacy of message content, lack of exposure to the programme, and poor presentation and execution. In addition, the participants perceived the developed tobacco control policies to be a failure based on poor law enforcement, failure of retailers to comply with the law, social availability of cigarettes to teenagers, and easy availability of cheap, smuggled cigarettes. This study highlighted that the programme-related problems (environmental factors) were not the only factors contributing to its perceived ineffectiveness. The cunning behaviour of the teenagers (personal factor) and poor self-efficacy to overcome nicotine addiction (behavioural factor) were also found to hinder cessation. Conclusion: Tobacco control programmes should include strategies beyond educating teenagers about smoking and restricting their access to cigarettes. Strategies to manage the cunning behaviour of teenagers and strategies to improve their self-efficacy should also be implemented. These comprehensive programmes should have a foundation in SCT, as this theory demonstrates the complex interactions among the environmental, personal, and behavioural factors that influence teenage smoking. PMID:22973136

Perceived effects of the Malaysian National Tobacco Control Programme on adolescent smoking cessation: a qualitative study.

PubMed

Tohid, Hizlinda; Ishak, Noriah Mohd; Muhammad, Noor Azimah; Ahmad, Farah Naaz Momtaz; Aziz, Abdul Anis Ezdiana; Omar, Khairani

2012-04-01

The prevalence of teenage smoking has decreased over the past decade following the implementation of the national tobacco control programme. However, the effect of the programme on smoking cessation in teenagers has not been determined. Twenty-eight participants (12 teenagers, 8 teachers, and 8 doctors) were interviewed using 5 in-depth interviews and 3 group discussions. Social cognitive theory (SCT) was applied as the theoretical framework. Semi-structured interview protocols were used, and thematic analysis and analytic generalisation utilising SCT were performed. The current national tobacco control programme was found to be ineffective in promoting smoking cessation among teenagers. The participants attributed the ineffective campaign to the followings: inadequacy of message content, lack of exposure to the programme, and poor presentation and execution. In addition, the participants perceived the developed tobacco control policies to be a failure based on poor law enforcement, failure of retailers to comply with the law, social availability of cigarettes to teenagers, and easy availability of cheap, smuggled cigarettes. This study highlighted that the programme-related problems (environmental factors) were not the only factors contributing to its perceived ineffectiveness. The cunning behaviour of the teenagers (personal factor) and poor self-efficacy to overcome nicotine addiction (behavioural factor) were also found to hinder cessation. Tobacco control programmes should include strategies beyond educating teenagers about smoking and restricting their access to cigarettes. Strategies to manage the cunning behaviour of teenagers and strategies to improve their self-efficacy should also be implemented. These comprehensive programmes should have a foundation in SCT, as this theory demonstrates the complex interactions among the environmental, personal, and behavioural factors that influence teenage smoking.

What do doctors and nurses think about development of clinical leadership?

PubMed

Lo, David; Till, Alex; McKimm, Judy

2017-09-02

Leadership development for health-care professionals is a priority within the NHS. Training is generally targeted at individual staff groups in isolation, even though contemporary leadership thinking recognizes the benefits of collaborative leadership between different clinical disciplines. Focussing on the attitudes and perceived training needs of undergraduate and qualified medical and nursing professionals, this article highlights the similarities and differences and will help to inform the design of existing and future leadership programmes.

Investigating the effect of distance between the teacher and learner on the student perception of a neuroanatomical near-peer teaching programme.

PubMed

Stephens, Jonny R; Hall, Samuel; Andrade, Matheus Gesteira; Border, Scott

2016-12-01

Near-peer teaching (NPT) is a highly valuable resource for the education of medical undergraduates with benefits to the students, teachers themselves, and the faculty. To maximise the effectiveness of such teaching programmes, the aim of this study was to determine how the student learning experience, and underpinning social and cognitive congruencies changes as the learner-teacher distance increases. Second-year medical students at the University of Southampton participated in a series of neuroanatomy, extra-curricular revision sessions taught by the third-, fourth-, and fifth-year medical students and junior doctors. The students completed a validated questionnaire after the session rating various aspects of the teaching. Although all teachers delivered sessions that we rated highly with a mean perceived gain in knowledge of 18 % amongst all students, it was found that the third- and fourth-year medical students delivered a session that was rated significantly better than the fifth-year students and junior doctors across all, but one areas of feedback. We believe that these findings may be explained by the diminishing social and cognitive congruencies shared between learner and teacher with increasing distance. From our results, we hypothesise that graduation is an important threshold, where there is a significant drop in congruencies between the learner and teacher, therefore, having a significant impact on the perception of the NPT session.

Inpatient care of mentally ill people in prison: results of a year's programme of semistructured inspections

PubMed Central

Reed, John L; Lyne, Maggi

2000-01-01

Objective To investigate the facilities for inpatient care of mentally disordered people in prison. Design Semistructured inspections conducted by doctor and nurse. Expected standards were based on healthcare quality standards published by the Prison Service or the NHS. Setting 13 prisons with inpatient beds in England and Wales subject to the prison inspectorate's routine inspection programme during 1997-8. Main outcomes measures Appraisals of quality of care against published standards. Results The 13 prisons had 348 beds, 20% of all beds in prisons. Inpatient units had between 3 and 75 beds. No doctor in charge of inpatients had completed specialist psychiatric training. 24% of nursing staff had mental health training; 32% were non-nursing trained healthcare officers. Only one prison had occupational therapy input; two had input from a clinical psychologist. Most patients were unlocked for about 3.5 hours a day and none for more than nine hours a day. Four prisons provided statistics on the use of seclusion. The average length of an episode of seclusion was 50 hours. Conclusion The quality of services for mentally ill prisoners fell far below the standards in the NHS. Patients' lives were unacceptably restricted and therapy limited. The present policy dividing inpatient care of mentally disordered prisoners between the prison service and the NHS needs reconsideration. PMID:10764360

Effectiveness of a regional self-study perinatal education programme: a successful adaptation in Yucatan, Mexico.

PubMed

Osorno, Lorenzo R; Campos, Miriam C; Cook, Lynn J; Vela, Gabriela R; Dávila, Jorge R

2006-08-01

To evaluate the effectiveness of the Perinatal Continuing Education Programme (PCEP) in a Latin American country. We carried out a study within secondary and tertiary care, and rural Mexican Institute of Social Security (IMSS) hospitals on the Yucatan Peninsula. Participants were doctors, nurses and nursing assistants working with pregnant women and newborns at each hospital. The PCEP was translated into Spanish and then implemented between January 1998 and December 2001. Two nurses at each hospital were trained to co-ordinate the programme and the personnel were invited to participate. Participation involved purchasing the self-teaching books, study outside work hours and participation in skills demonstration and practice sessions. Evaluation included the percentage of personnel who participated in and those who completed the programme, an opinion survey of the programme, level of pre- and post-intervention knowledge, and the quality of neonatal care according to expert-recommended routines. Results were analysed with chi-square and Student's t-tests. A total of 65.3% of the 1421 people in the study population began the programme and 72% of those completed it. Improvement was observed in 14 of 23 (P<0.05) evaluated neonatal care practices. Participants rated the written material as very clear and useful in daily practice. The PCEP is an effective strategy for improving the level of knowledge and perinatal care in all regional hospitals on the Yucatan Peninsula, Mexico. This initial application of the PCEP in a Spanish-speaking country was successful.

Evaluating the implementation of a quality improvement process in General Practice using a realist evaluation framework.

PubMed

Moule, Pam; Clompus, Susan; Fieldhouse, Jon; Ellis-Jones, Julie; Barker, Jacqueline

2018-05-25

Underuse of anticoagulants in atrial fibrillation is known to increase the risk of stroke and is an international problem. The National Institute for Health Care and Excellence guidance CG180 seeks to reduce atrial fibrillation related strokes through prescriptions of Non-vitamin K antagonist Oral Anticoagulants. A quality improvement programme was established by the West of England Academic Health Science Network (West of England AHSN) to implement this guidance into General Practice. A realist evaluation identified whether the quality improvement programme worked, determining how and in what circumstances. Six General Practices in 1 region, became the case study sites. Quality improvement team, doctor, and pharmacist meetings within each of the General Practices were recorded at 3 stages: initial planning, review, and final. Additionally, 15 interviews conducted with the practice leads explored experiences of the quality improvement process. Observation and interview data were analysed and compared against the initial programme theory. The quality improvement resources available were used variably, with the training being valued by all. The initial programme theories were refined. In particular, local workload pressures and individual General Practitioner experiences and pre-conceived ideas were acknowledged. Where key motivators were in place, such as prior experience, the programme achieved optimal outcomes and secured a lasting quality improvement legacy. The employment of a quality improvement programme can deliver practice change and improvement legacy outcomes when particular mechanisms are employed and in contexts where there is a commitment to improve service. © 2018 John Wiley & Sons, Ltd.

Evaluating the impact of a partnership for creating change in substance misuse practice in St. Petersburg, Russia.

PubMed

Green, Anita J; Holloway, David G

2005-11-01

This paper reports on an evaluation of an innovative education and training programme for nurses and narcologists in St. Petersburg, Russia. The aims of the evaluation were: first, to evaluate the effect of the education and training programme on the clinical practice of doctors and nurses who have had direct contact with the programme and, second, to evaluate the influence of the education and training programme on city-wide drug and alcohol policy and practice. Brief contextual information regarding the programme is provided prior to an account of the qualitative methodology. Particular attention was paid to the work of Patton [Utilisation-focused evaluation, second ed., Sage, London, 1986; Qualitative research and evaluation methods, third ed., Sage, London, 2002] for the theoretical framework and to Hantais and Mangen [Cross-national research methods in the social sciences, Pinter, London, 1996] regarding the methodological issues that surround international and cross-cultural research projects. Data collection was carried out in St. Petersburg and in the United Kingdom, which involved key participants in the programme. The data analysis followed Miles and Huberman [Qualitative data analysis. An expanded sourcebook, second ed. Sage, Thousand Oaks, 1994] which yielded six major themes: rehabilitation, the role and continuing professional development of the trained nurse; the status of the nurse training-college and the staff, small scale projects and their significance; sharing experiences/networking/face-to-face meetings; and, lack of resistance. The findings are discussed and recommendations for further involvement are identified.

The Vienna Stroke Registry--objectives and methodology. The Vienna Stroke Study Group.

PubMed

2001-02-15

The Vienna Stroke Registry (VSR) comprises nine neurological departments of Vienna and was established in 1998. This article describes the objectives and methodology of the VSR. The goals of the VSR are as follows: (1) to document the quality (structure, process, outcome) of medical services and to construct a database which can be used for future adjustment of medical services in Vienna (early stroke intervention, concept of stroke units, rehabilitation services); (2) to guide educational programs; (3) to adjust or establish algorithms for clinical decision making and to analyze predictors of outcome; (4) to document changes in diagnostic and therapeutic strategies over time; (5) to formulate hypotheses about the etiology, pathophysiology, clinical course, and outcome of stroke. Since October 1998 all patients with the presumed diagnosis of a transitory ischemic attack (TIA) or stroke who had been admitted to one of the participating centers within 72 hours of the onset of symptoms were included in the VSR. All patients are prospectively documented according to standardized detailed protocols. The collected data refer to demographic parameters; medical, particularly, vascular history; vascular risk factors; laboratory and technical investigations (including cerebrovascular, cardiological, and neuroradiological findings); details of pharmacological and non-pharmacological treatment; factors influencing the time from the onset of symptoms to hospital admission and the start of therapy; clinical and etiological classification according to pre-specified criteria; neurological and functional impairment at specified time points; structured follow-up investigations at 3, 12, and 24 months after the event. Until September 2000, 2300 patients had been included in the VSR. The target number of 3500 patients will be achieved in the second half of 2001. A baseline description of the VSR population will be given separately.

Additive homeopathy in cancer patients: Retrospective survival data from a homeopathic outpatient unit at the Medical University of Vienna.

PubMed

Gaertner, Katharina; Müllner, Michael; Friehs, Helmut; Schuster, Ernst; Marosi, Christine; Muchitsch, Ilse; Frass, Michael; Kaye, Alan David

2014-04-01

Current literature suggests a positive influence of additive classical homeopathy on global health and well-being in cancer patients. Besides encouraging case reports, there is little if any research on long-term survival of patients who obtain homeopathic care during cancer treatment. Data from cancer patients who had undergone homeopathic treatment complementary to conventional anti-cancer treatment at the Outpatient Unit for Homeopathy in Malignant Diseases, Medical University Vienna, Department of Medicine I, Vienna, Austria, were collected, described and a retrospective subgroup-analysis with regard to survival time was performed. Patient inclusion criteria were at least three homeopathic consultations, fatal prognosis of disease, quantitative and qualitative description of patient characteristics, and survival time. In four years, a total of 538 patients were recorded to have visited the Outpatient Unit Homeopathy in Malignant Diseases, Medical University Vienna, Department of Medicine I, Vienna, Austria. 62.8% of them were women, and nearly 20% had breast cancer. From the 53.7% (n=287) who had undergone at least three homeopathic consultations within four years, 18.7% (n=54) fulfilled inclusion criteria for survival analysis. The surveyed neoplasms were glioblastoma, lung, cholangiocellular and pancreatic carcinomas, metastasized sarcoma, and renal cell carcinoma. Median overall survival was compared to expert expectations of survival outcomes by specific cancer type and was prolonged across observed cancer entities (p<0.001). Extended survival time in this sample of cancer patients with fatal prognosis but additive homeopathic treatment is interesting. However, findings are based on a small sample, and with only limited data available about patient and treatment characteristics. The relationship between homeopathic treatment and survival time requires prospective investigation in larger samples possibly using matched-pair control analysis or randomized trials. Copyright © 2014 Elsevier Ltd. All rights reserved.

Survey on the knowledge and expectations of Psychiatry of Intellectual Disability (ID) in Junior Doctors joining a NHS Mental Health Trust.

PubMed

Thalitaya, Madhusudan Deepak; Reynolds, Claire

2017-09-01

Nationally, there is a drive to rotate more Foundation and GP Trainee Doctors through Psychiatry posts. In East London Foundation Trust (ELFT) in Bedfordshire, doctors from Core Psychiatry, Foundation and GP training programmes come to train in Psychiatry. Many will not have worked in Psychiatry before and have little experience of patients with ID. The prevalence of people with ID is increasing with improved life expectancy. They are a complex and vulnerable group with considerable wider legal, ethical and social issues. Recent national reports including the Confidential Inquiry in to Premature Deaths in People with Learning Disability 3 and Transforming Care 4 have recommended increased training and awareness of the roles and responsibilities for all health staff who provide care to people with ID. To survey the knowledge level and expectations of junior doctors on Psychiatry placements in Bedfordshire in relation to ID and local logistical arrangements of services and on call duties. The local ID governance committee together with the Postgraduate Medical Education Department created a questionnaire which was circulated to new trainee Doctors on placements with ELFT. The questionnaire was distributed to new trainees after 3 different inductions throughout the year. This combined self-rating questions using Likert scales, multiple choice answers and others allowing for expanded free text answers. The results show the self-rated knowledge levels of ID psychiatry in general and with regard to local services and on call arrangements amongst new trainees was low. The majority of trainees indicated they would have liked to have received information on the suggested areas at the start of the placement. When given the option of themes of information the psychiatric and medical presentation was most sought, although general and on call specific information was also indicated to be useful. The most popular delivery of information was found to be oral presentation and hand out at induction, followed by an electronic document. 8 trainees were interested in attending clinical sessions in ID and most felt it would be feasible in their posts to get to these. This survey shows that Junior Doctors from different training programmes rate their knowledge of ID psychiatry to be low. This has implications during their rotation in a mental health trust as they are expected to cover an ID ward whilst on call, but also going forward in their careers as all specialties will encounter patients with ID. It is known that awareness of patients with ID is lacking in many healthcare professionals and we know that people with ID are living longer, however continue to have worse health than the general population. The results show trainees would like more education on ID and would be interested in attending clinical sessions in ID psychiatry. The results will enable clinicians in ID services how best to improve the local induction experience for trainees. It also will guide how to educate colleagues outside of the specialty to improve their practice with people with ID, which will improve standards in the quality of care people with ID receive from doctors who treat them.

Quality assessment and improvement of post graduate family medicine training in the USA.

PubMed

Hoekzema, Grant S; Maxwell, Lisa; Gravel, Joseph W; Mills, Walter W; Geiger, William; Honeycutt, J David

2016-09-01

In 2013, the World Organisation of Family Doctors published training standards for post-graduate medical education (GME) in Family Medicine/General Practice (FP/GP). GME quality has not been well-defined, other than meeting accreditation standards. In 2009, the Association of Family Medicine Residency Directors (AFMRD) developed a tool that would aid in raising the quality of family medicine residency training in the USA. We describe the development of this quality improvement tool, which we called the residency performance index (RPI), and its first three years of use by US family medicine residency (FMR) programmes. The RPI uses metrics specific to family medicine training in the USA to help programmes identify strengths and areas for improvement in their educational activities. Our review of three years of experience with the RPI revealed difficulties with collecting data, and lack of information on graduates' scope of practice. It also showed the potential usefulness of the tool as a programme improvement mechanism. The RPI is a nationwide, standardised, programme quality improvement tool for family medicine residency programmes in the USA, which was successfully launched as part of AFMRD's strategic plan. Although some initial challenges need to be addressed, it has the promise to aid family medicine residencies in their internal improvement efforts. This model could be adapted in other post-graduate training settings in FM/GP around the world.

Inter-professional work based learning within an MSc in Advanced Practice: lessons from one UK higher education programme.

PubMed

Gaskell, Lynne; Beaton, Susan

2010-09-01

This paper will describe the implementation of inter-professional work based education (IPE) in one postgraduate Advanced Practitioner programme in the UK. The concept of Advanced Practice has developed as a response of a number of drivers including change in junior doctor training; government policy and increasing demands on the central government funded UK health service (the NHS). The programme was commissioned by the then greater Manchester Strategic Health Authority (now NHS North West) to meet service needs. The educational philosophy underpinning the MSc Advanced Practice (health and social care) provided by the University of Salford is IPE linked to work based learning. The process of work based learning (WBL) and inter-professional learning underpinning the programme will be discussed in relation to feedback from university staff, Advanced Practitioner (AP) students and employer feedback taken from programme and module evaluations. We argue that IPE at this level facilitates a greater understanding of the connectivity between professionals working in the health care system in the UK; a better understanding of the skills and knowledge base of colleagues; more inter-professional working and appropriate referrals in the work place. This has raised the profile of Advanced Practice (AP) in the region and ultimately resulted in better patient care with more effective and efficient use of resources (Acton Shapiro, 2006, 2008). (c) 2009 Elsevier Ltd. All rights reserved.

Band 3 nullVIENNA , a novel homozygous SLC4A1 p.Ser477X variant causing severe hemolytic anemia, dyserythropoiesis and complete distal renal tubular acidosis.

PubMed

Kager, Leo; Bruce, Lesley J; Zeitlhofer, Petra; Flatt, Joanna F; Maia, Tabita M; Ribeiro, M Leticia; Fahrner, Bernhard; Fritsch, Gerhard; Boztug, Kaan; Haas, Oskar A

2017-03-01

We describe the second patient with anionic exchanger 1/band 3 null phenotype (band 3 null VIENNA ), which was caused by a novel nonsense mutation c.1430C>A (p.Ser477X) in exon 12 of SLC4A1. We also update on the previous band 3 null COIMBRA patient, thereby elucidating the physiological implications of total loss of AE1/band 3. Besides transfusion-dependent severe hemolytic anemia and complete distal renal tubular acidosis, dyserythropoiesis was identified in the band 3 null VIENNA patient, suggesting a role for band 3 in erythropoiesis. Moreover, we also, for the first time, report that long-term survival is possible in band 3 null patients. © 2016 Wiley Periodicals, Inc.

Stereotyping at the undergraduate level revealed during interprofessional learning between future doctors and biomedical scientists.

PubMed

Lewitt, Moira S; Ehrenborg, Ewa; Scheja, Max; Brauner, Annelie

2010-01-01

Interprofessional education (IPE) involving undergraduate health professionals is expected to promote collaboration in their later careers. The role of IPE between doctors and biomedical scientists has not been explored at the undergraduate level. Our aim was to introduce IPE sessions for medical and biomedical students in order to identify the benefits and barriers to these groups learning together. Medical and biomedical students together discussed laboratory results, relevant literature, and ideas for developing new diagnostic tools. The programme was evaluated with questionnaires and interviews. While there was general support for the idea of IPE, medical and biomedical students responded differently. Biomedical students were more critical, wanted more explicit learning objectives and felt that their professional role was often misunderstood. The medical students were more enthusiastic but regarded the way the biomedical students communicated concerns about their perceived role as a barrier to effective interprofessional learning. We conclude that stereotyping, which can impede effective collaborations between doctors and biomedical scientists, is already present at the undergraduate level and may be a barrier to IPE. Effective learning opportunities should be supported at the curriculum level and be designed to specifically enable a broad appreciation of each other's future professional roles.

A descriptive study on emergency department doctors' and nurses' knowledge and attitudes concerning substance use and substance users.

PubMed

Kelleher, Sean; Cotter, Patrick

2009-01-01

The aim of this study was to determine emergency department doctors' and nurses' knowledge and attitudes regarding problematic substance use and substance users. Data were collected using an adapted survey questionnaire and the Substance Abuse Attitude Survey (SAAS). By means of convenience/opportunistic sampling all emergency department doctors and nurses (N=145) working in three university teaching hospitals in Ireland were asked to fill out the knowledge and attitudes questionnaire. A response rate of 46%, N=66 was achieved. Results indicate that participants' current level of knowledge about alcohol and drug misuse in general, is satisfactory. A particular knowledge deficit in relation to intervention strategies, and other substances was identified. The majority of participants have never received any specific training regarding substance use and this suggests that substance using patients are managed inadequately. The SAAS results indicate that participants exhibited near-optimal attitudes for constructive working with substance using patients. There is an urgent need for further in-service training programmes and the development of standard protocols/guidelines for the identification and management of substance using patients who present in the emergency department.

A catalogue of the type and figured fossil decapod crustaceans in the collections of the Geological Survey of Austria in Vienna

PubMed Central

Hyžný, Matúš; Zorn, Irene

2017-01-01

The present catalogue lists and figures the type and figured material of fossil decapod crustaceans housed in the collections of the Geological Survey of Austria in Vienna. Specimens previously believed to be lost were relocated. Lectotypes and paralectotypes are chosen herein for 11 species. Taxonomic affinity of taxa originally described in open nomenclature is discussed. PMID:28255177

Implementation and Research on the Operational Use of the Mesoscale Prediction Model COAMPS in Poland

DTIC Science & Technology

2008-09-30

participated in EGU General Assembly , Vienna Austria 13-18 April 2008, giving a poster presentation. Bogumil Jakubiak, University of Warsaw...participated in EGU General Assembly , Vienna Austria 13-18 April 2008, giving two posters presentation. Mikolaj Sierzega, University of Warwick – participated...model forecast to generate background error statistics. This helps us to identify and understand the uncertainties in high-resolution NWP forecasts

"Eurotrain for Training." Proceedings of a European Congress on Continuing Education and Training (4th, Berlin, Germany; Warsaw, Poland; Prague, Czechoslovakia; Budapest, Hungary; Vienna, Austria, October 5-9, 1992).

ERIC Educational Resources Information Center

Wisser, Ulrike, Ed.; Grootings, Peter, Ed.

1992-01-01

A "travelling" congress was conducted in five European cities (Berlin, Warsaw, Prague, Budapest, and Vienna) to promote a mutual exchange of views between east and west. The participants stressed the growing European Community interest in current examples of cooperation with neighbors in central and eastern Europe. In addition to…

USSR Report. International Affairs.

DTIC Science & Technology

1987-05-13

ORGANIZATION OF INDUSTRIAL PRODUCTION (UEO) THE WORKING CLASS § THE CONTEMPORARY WORLD (UWC) PEOPLES OF ASIA & AFRICA (UAA) MILITARY HISTORY JOURNAL...and beyond. He said that the documents from the European Conference in Helsinki and the Madrid meeting have given an important stimulus to the work ...commission’s activity with the work of the Vienna meeting deserved all-round support, he said. "It is important that the Vienna followup meeting make

Multiscale Dynamics and Information in Data Collection and Assimilation for Environmental Applications

DTIC Science & Technology

2015-07-30

elsewhere such as: prepared in cooperation with; translation of; report supersedes; old edition number, etc. 14. ABSTRACT. A brief (approximately 200...involves the derivative of a stochastic path, which is obtained using Malliavin calculus . 4 DISTRIBUTION A: Distribution approved for public release...predictability, 8th European Nonlinear Oscillations Conference, The Vienna University of Technology, Vienna, Austria, July 06 – 11, 2014. [11] Lingala N

An integrative concept for visitor monitoring in a heavily used conservation area in the vicinity of a large city: the Danube Floodplains National Park, Vienna

Treesearch

Arne Amberger; Christiane Brandenburg; Andreas Muhar

2002-01-01

The Danube Floodplains National Park, Vienna, Austria is used predominantly by the Viennese population for daily recreation purposes. Different methods were applied for the monitoring of visitor activities in the National Park (long-term video monitoring, short-term visitor observation, interviews and route registration). The results show that only a combination of...

Attitudes towards suicide among medical students: comparison between Madras (India) and Vienna (Austria).

PubMed

Etzersdorfer, E; Vijayakumar, L; Schöny, W; Grausgruber, A; Sonneck, G

1998-03-01

Attitudes towards suicide among medical students in Madras (India) and Vienna (Austria) were compared using the SUIATT questionnaire by Diekstra and Kerkhof (1989). Results show a very restrictive attitude in Madras, rejecting the right to commit suicide, nearly always judging suicide as a cowardly act, and rejecting the idea of assisted suicide. On the other hand, in Vienna a more permissive attitude was found. It is interpreted that the Indian pattern comes close to a "medical" or "disease model", with stronger emphasis on mental illness, impulsiveness and emotional aspects, whereas the Viennese pattern reflects a "theoretical", "rational model", concentrating on cognitive factors and minimizing the influence of mental illness, emotional difficulties and restrictions related to suicidal behaviour. This pattern may be influenced by the public discussion on assisted suicide and the right to die in Europe in the last decade. Possible relations to the risk for actual suicidal behaviour are discussed using respective answers concerning previous suicidal ideation and suicide attempts. The answers concerning suicidal ideation seem to be strongly influenced by the different attitude patterns: only 16.8% reported previous suicidal ideation in Madras, compared to 51.5% in Vienna, whereas the percentage of reported suicide attempts is equal in both centres (5.9%:4.9%).

Prevalence of HBsAg, knowledge, and vaccination practice against viral hepatitis B infection among doctors and nurses in a secondary health care facility in Lagos state, South-western Nigeria.

PubMed

Abiola, Abdul-Hakeem Olatunji; Agunbiade, Adebukola Bola; Badmos, Kabir Bolarinwa; Lesi, Adenike Olufunmilayo; Lawal, Abdulrazzaq Oluwagbemiga; Alli, Quadri Olatunji

2016-01-01

Hepatitis B Virus, a highly infectious blood-borne virus poses a major threat to public health globally due to its high prevalence rate and grave consequence in causing liver cirrhosis and hepatocelullar carcinoma, the third cause of cancer death worldwide. The aim is determine the prevalence of HBsAg, knowledge, and vaccination practices against viral hepatitis B infection among doctors and nurses in a health care facility. Study design was a descriptive cross-sectional study among all the doctors and nurses in the health care facility. Data was collected using pre-tested, structured, self-administered questionnaire and blood samples were taken from respondents and tested using commercial enzyme-linked immunosorbent assay (ELIZA) test kit to determine prevalence of hepatitis B surface antigen after informed consent. Ethical approval was obtained from Health Research and Ethics Committee of the Lagos University Teaching Hospital. Responses of the respondents to the knowledge and vaccination practices against viral hepatitis B infection were scored and graded as poor (<50%), fair (50-74%) and good (≥75%). The study was carried out in January, 2014. A total of 134 out of the 143 recruited respondents participated in the study. Prevalence of HBsAg was 1.5%. Among the respondents, 56.7% had good knowledge and 94.8% reported poor practice of vaccination against viral hepatitis B infection. Mean knowledge and vaccination practices scores (%) were 72.54+7.60 and 29.44+14.37 respectively. Only 29% of the respondents did post vaccination testing for anti HBsAg. Prevalence of HBsAg was low. Knowledge of viral hepatitis B was fair, and practice of post hepatitis B vaccination testing was poor. It is therefore recommended that the state ministry of health should organise further health education programme, institute compulsory occupational hepatitis B vaccination programme and post vaccination anti-HBS testing to ensure adequate antibody level in this adult population.

[Execution and quality of attention paid to medical doctoral theses at the faculty of medicine at the University of Würzburg as seen by the doctoral candidates in their 5th and 6th year of study].

PubMed

Diez, C; Arkenau, C; Meyer-Wentrup, F

2002-07-01

The significance of a doctoral thesis in medicine has been discussed controversially among medical students and faculty members. We examined in a brief but comprehensive study how medical students evaluate their research activities and whether or not alternative thesis models should be implemented. A questionnaire comprising 50 questions was evaluated from 160 5th and 6th year medical students at the University of Wuerzburg. Almost two-thirds of our interviewees started working on a thesis project at the beginning of the 4th year of study. 59 % of our participants reported to have neglected the regular study and 56 % said to have prolonged the regular study due to the work on a thesis. Despite considerable variation, the median time spent weekly on a thesis project was 10 hours, independent of where the students worked. The median grade of satisfaction during the whole thesis was rated at 6.5 as assessed on an analogous scale from 1-10 (very satisfied). The research results from 94 students contributed to 164 articles (already published or in press) and the results of 110 students were presented at scientific meetings. Only 50 % of our interviewees were pleased with their published output and the importance of student research activities for the overall German biomedical research was rated 4.4 as assessed on an analogous scale from 1-10 (very important). 70 % of our interviewees preferred defined research periods and 47 % would apply for dual-degree research programmes. The scientific significance of a MD thesis in comparison to a PhD thesis was rated at 2.1 on an analogous scale from 1-5 (5 = equally significant). The current German research model might be modified and defined research periods and dual-degree research programmes as a one possible alternative should be considered.

An audit of the complications of intercostal chest drain insertion in a high volume trauma service in South Africa

PubMed Central

Oosthuizen, GV; Sartorius, B; Keene, C; Clarke, DL

2014-01-01

Introduction Intercostal chest drain (ICD) insertion is a commonly performed procedure in trauma and may be associated with significant morbidity. Methods This was a retrospective review of ICD complications in a major trauma service in South Africa over a four-year period from January 2010 to December 2013. Results A total of 1,050 ICDs were inserted in 1,006 patients, of which 91% were male. The median patient age was 24 years (interquartile range [IQR]: 20–29 years). There were 962 patients with unilateral ICDs and 44 with bilateral ICDs. Seventy-five per cent (758/1,006) sustained penetrating trauma and the remaining 25% (248/1006) sustained blunt trauma. Indications for ICD insertion were: haemopneumothorax (n=338), haemothorax (n=314), simple pneumothorax (n=265), tension pneumothorax (n=79) and open pneumothorax (n=54). Overall, 203 ICDs (19%) were associated with complications: 18% (36/203) were kinked, 18% (36/203) were inserted subcutaneously, 13% (27/203) were too shallow and in 7% (14/203) there was inadequate fixation resulting in dislodgement. Four patients (2%) sustained visceral injuries and two sustained vascular injuries. Forty-one per cent (83/203) were inserted outside the ‘triangle of safety’ but without visceral or vascular injuries. One patient had the ICD inserted on the wrong side. Junior doctors inserted 798 ICDs (76%) while senior doctors inserted 252 (24%). Junior doctors had a significantly higher complication rate (24%) compared with senior doctors (5%) (p<0.001). There was no mortality as a direct result of ICD insertion. Conclusions ICD insertion is associated with a high rate of complications. These complications are significantly higher when junior doctors perform the procedure. A multifaceted quality improvement programme is needed to improve the situation. PMID:25350185

An audit of the complications of intercostal chest drain insertion in a high volume trauma service in South Africa.

PubMed

Kong, V Y; Oosthuizen, G V; Sartorius, B; Keene, C; Clarke, D L

2014-11-01

Intercostal chest drain (ICD) insertion is a commonly performed procedure in trauma and may be associated with significant morbidity. This was a retrospective review of ICD complications in a major trauma service in South Africa over a four-year period from January 2010 to December 2013. A total of 1,050 ICDs were inserted in 1,006 patients, of which 91% were male. The median patient age was 24 years (interquartile range [IQR]: 20-29 years). There were 962 patients with unilateral ICDs and 44 with bilateral ICDs. Seventy-five per cent (758/1,006) sustained penetrating trauma and the remaining 25% (248/1006) sustained blunt trauma. Indications for ICD insertion were: haemopneumothorax (n=338), haemothorax (n=314), simple pneumothorax (n=265), tension pneumothorax (n=79) and open pneumothorax (n=54). Overall, 203 ICDs (19%) were associated with complications: 18% (36/203) were kinked, 18% (36/203) were inserted subcutaneously, 13% (27/203) were too shallow and in 7% (14/203) there was inadequate fixation resulting in dislodgement. Four patients (2%) sustained visceral injuries and two sustained vascular injuries. Forty-one per cent (83/203) were inserted outside the 'triangle of safety' but without visceral or vascular injuries. One patient had the ICD inserted on the wrong side. Junior doctors inserted 798 ICDs (76%) while senior doctors inserted 252 (24%). Junior doctors had a significantly higher complication rate (24%) compared with senior doctors (5%) (p<0.001). There was no mortality as a direct result of ICD insertion. Conclusions ICD insertion is associated with a high rate of complications. These complications are significantly higher when junior doctors perform the procedure. A multifaceted quality improvement programme is needed to improve the situation.

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

PubMed

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

2015-01-01

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

Medical ethics and ethical dilemmas.

PubMed

Iyalomhe, G B S

2009-01-01

Ethical problems routinely arise in the hospital and outpatient practice settings and times of dilemma do occur such that practitioners and patients are at cross-roads where choice and decision making become difficult in terms of ethics. This paper attempts a synopsis of the basic principles of medical ethics, identifies some ethical dilemmas that doctors often encounter and discusses some strategies to address them as well as emphasizes the need for enhanced ethics education both for physicians and patients particularly in Nigeria. Literature and computer programmes (Medline and PsychoInfo databases) were searched for relevant information. The search showed that the fundamental principles suggested by ethicists to assist doctors to evaluate the ethics of a situation while making a decision include respect for autonomy, beneficence, non-maleficence and justice. Although the above principles do not give answers as to how to handle a particular situation, they serve as a guide to doctors on what principles ought to apply to actual circumstances. The principles sometimes conflict with each other leading to ethical dilemmas when applied to issues such as abortion, contraception, euthanasia, professional misconduct, confidentiality truth telling, professional relationship with relatives, religion, traditional medicine and business concerns. Resolution of dilemmas demand the best of the doctor's knowledge of relevant laws and ethics, his training and experience, his religious conviction and moral principles as well as his readiness to benefit from ethics consultation and the advice of his colleagues. Ethics education should begin from the impressionable age in homes, continued in the medical schools and after graduation to ensure that doctors develop good ethical practices and acquire the ability to effectively handle ethical dilemmas. Also, education of patients and sanction of unethical behaviour will reduce ethical dilemmas.

Barriers to education of overseas doctors in paediatrics: a qualitative study in South Yorkshire.

PubMed

Mahajan, J; Stark, P

2007-03-01

To explore the factors that may influence the progress of doctors who come from the Indian subcontinent to train in paediatrics in the UK. Overseas doctors training in paediatrics in Rotherham, Sheffield and Doncaster participated in the study. Focus groups were used to collect data; two focus groups, each with 4-5 participants, were conducted at 6-week intervals. Semistructured, one-to-one interviews were conducted to add more understanding and depth to issues highlighted in the focus groups. The focus groups and interviews were audiotaped; the tapes were transcribed and data were analysed using the Grounded Theory; open codes were formed and concepts identified using microanalysis, and initial theories were built. Lack of information about the National Health Service (NHS)/Royal Colleges, inappropriate communication skills, difficulties in team working, difficulties in preparing for Royal College examinations, visa and job hunting, and social and cultural isolation were identified as major barriers. Problems arose not only from difficulties with language but also from use of local and colloquial words, different accents and difficulty in communicating sensitive issues. Lack of understanding of role in teams and difficulties in working in multiprofessional setting all contributed to the problems. Cultural differences inside and outside the workplace, and social isolation were also highlighted. Induction programmes, mentoring, awareness of the issues within the teams, and courses in communication specifically directed at overseas doctors were identified as means to overcome these barriers. Several intercultural factors were identified that could act as barriers to the progress of overseas doctors training in paediatrics in the UK. Increased awareness of these factors within the teams would be the first step in resolving some of the issues.

The INQUA Loess Commission as a Central European Enterprise

NASA Astrophysics Data System (ADS)

Smalley, Ian J.; Markovic, Slobodan B.; O'Hara-Dhand, Ken

2010-03-01

The International Union of Quaternary Research (INQUA) organized the study and consideration of the Quaternary Period (the last 2.6 million years in Earth's history) via a set of commissions, sub-commissions, working groups, projects and programmes. One of the most successful and best records was the Loess Commission (LC) which functioned assub-commission and then commission from 1961 to 2003, resulting in 40 years of useful activity. The history of the LC can be divided into three phases: 1, from 1961-1977 when the President was Julius Fink; 2, from 1977-1991, with President Marton Pecsi; 3, from 1991-2003 with Presidents An Zhi-Sheng and Ian Smalley. Fink, from Vienna, and Pecsi, from Budapest, gave the LC a distinctly Central European aspect. The nature of loess in Central Europe influenced the nature of the LC but the settings for phases 1 and 2 were quite distinct. Phase 1 was a small scale academic operation, carried out in German. As phase 2 began in 1977 the scope expanded and Central Europe became a base for worldwide loess studies. where the LC language changed to English. Phase 2 was run from a National Geographical Institute and demonstrated a different approach to loess research, although the basic programmes of continent-wide mapping and stratigraphy remained the same. The Commission benefited from this change of style and emphasis. In phase 3 the administration moved away from Central Europe but the Finkian ethos remained solid.

Control of Aedes aegypti larvae in household water containers by Chinese cat fish.

PubMed

Wu, N; Wang, S S; Han, G X; Xu, R M; Tang, G K; Qian, C

1987-01-01

In 1980-81 an outbreak of dengue fever occurred in Guangdong province and in Guangxi-Zhuang autonomous region in the central-southern part of China. Subsequently, a nationwide survey indicated that the vector of the disease, Aedes aegypti, was confined to the coastal strip of Guangdong and Guangxi-Zhuang. Since the first case in the outbreak occurred in Guangxi-Zhuang, a community-based programme to control A. aegypti was set up in eight fishing villages of this region where the mosquito was breeding in household water containers. The principal method of control was use of the indigenous edible fish Clarias fuscus (Chinese cat fish), which is highly larvivorous and tolerant of harsh environmental conditions. Each container was stocked with a young fish, which could survive there for periods of up to a year. A team of primary medical personnel (barefoot doctors) made sure that the programme was correctly implemented. The programme was monitored from 1981 to 1985 in three of the villages, and the results indicated that the Breteau index remained at a low level throughout this period.

Control of Aedes aegypti larvae in household water containers by Chinese cat fish

PubMed Central

Neng, Wu; Shusen, Wang; Guangxin, Han; Rongman, Xu; Guangkun, Tang; Chen, Qian

1987-01-01

In 1980-81 an outbreak of dengue fever occurred in Guangdong province and in Guangxi-Zhuang autonomous region in the central-southern part of China. Subsequently, a nationwide survey indicated that the vector of the disease, Aedes aegypti, was confined to the coastal strip of Guangdong and Guangxi-Zhuang. Since the first case in the outbreak occurred in Guangxi-Zhuang, a community-based programme to control A. aegypti was set up in eight fishing villages of this region where the mosquito was breeding in household water containers. The principal method of control was use of the indigenous edible fish Clarias fuscus (Chinese cat fish), which is highly larvivorous and tolerant of harsh environmental conditions. Each container was stocked with a young fish, which could survive there for periods of up to a year. A team of primary medical personnel (barefoot doctors) made sure that the programme was correctly implemented. The programme was monitored from 1981 to 1985 in three of the villages, and the results indicated that the Breteau index remained at a low level throughout this period. PMID:3500803

First observations of fertilized eggs and preleptocephalus larvae of Rhinomuraena quaesita in the Vienna Zoo.

PubMed

Preininger, D; Halbauer, R; Bartsch, V; Weissenbacher, A

2015-01-01

For the first time worldwide, fertilized eggs of ribbon eels (Rhinomuraena quaesita) hatched into feeding preleptocephali and could be kept alive for a period of seven days in the Vienna Zoo. The study reports on husbandry, behavioral observations and dimensions of eggs and preleptocephalus larvae. Furthermore, body color variations of ribbon eels in captivity do not reflect its sex or sexual maturity. © 2014 Wiley Periodicals, Inc.

Karl Schwarzschild's investigations of `out-of-focus photometry' between 1897 and 1899 at Kuffner Observatory in Vienna

NASA Astrophysics Data System (ADS)

Habison, Peter

From 1897 to 1899 Karl Schwarzschild worked at the Kuffner Observatory in Vienna. During these years he developed new measuring techniques in the field of photographic photometry, where he studied particularly the quantitative determination of the departure from the reciprocity law during photographic exposure. This paper concentrates on Schwarzschild's early work in this field and gives an overview of his important Viennese years.

Ethnic cartography and politics in Vienna, 1918-1945.

PubMed

Svatek, Petra

2018-03-01

In Vienna, the close of the First World War and the period of the peace negotiations in Paris saw an enormous boom of ethnic-geographic research approaches and ethnic map-making. This process continued with the appointment of the Viennese geographer Hugo Hassinger (1877-1952) to the chair of human geography at the University of Vienna in 1931 and intensified with the establishment of the South East German Research Association and the National Socialist takeover in March 1938. But did the initiatives to create ethnic maps originate with politicians and authorities, or did they come from the scientists themselves? This article argues that scientists embarked upon ethnic geographies on their own initiative. Although political institutions used scientists and their resources for their own, political ends (ethnographic maps served as an important source for the National Socialists in their operations for ethnic consolidation), scientists also mobilized resources from the political sphere for career and disciplinary purposes.

The pre-Anschluss Vienna School of Medicine - the physicians: Sigmund Freud (1856-1939), Julius Wagner-Jauregg (1857-1940) and Karel Wenckebach (1864-1940).

PubMed

Shaw, Lily Bzl; Shaw, Robert A

2016-05-01

Three physicians are discussed. Sigmund Freud, probably the best-known member of the Vienna School of Medicine, was the path-breaking pioneer in psychoanalysis and psychotherapy. Julius Wagner-Jauregg was a psychiatrist who discovered the link between iodine deficiency and goitre and also developed malaria therapy to treat progressive paralysis caused by syphilis for which he was awarded the Nobel Prize. Karel Wenckebach, the pioneering Dutch cardiologist, is best known for the Wenckebach block. After the Anschluss, fate dealt very different hands to these three physicians. Freud fled to London where he soon died. Wagner-Jauregg, who had some pan-Germanic sympathies as well as views on eugenics, left a controversial legacy. The Dutch cardiologist Wenckebach died in Vienna shortly after his homeland had been invaded in 1940 by that of his hosts. © IMechE 2014.

Can we still stop the migration of physicians from Austria? : An evaluation of clinical internships by students of the Medical University of Vienna.

PubMed

Seitz, Tamara; Turk, Bela R; Löffler-Stastka, Henriette

2017-01-01

The increasing emigration of graduates of the Medical University of Vienna presents a serious problem. This study examined students' evaluation of clinical rotations, their self-rated performance, and where they felt the most deficits exist. Medical students answered an online questionnaire surveying the following aspects: an evaluation of their internship; supervision; integration in the team and improvement of field-specific knowledge; the qualities of taking a patient's medical history by empathy; patient-centeredness; structure; target orientation; and the ability to integrate field-specific knowledge into anamnesis. The data collected indicate that rotations in Austria, especially in Vienna, were evaluated significantly worse than those abroad. Particularly the lack of supervision and integration in the team were criticized. These data stress a dire need for the reform of curricular structures during clinical rotation in the latter years of medical education.

Gender, politics, and radioactivity research in interwar Vienna: the case of the Institute for Radium Research.

PubMed

Rentetzi, Maria

2004-09-01

This essay explores the significance of political and ideological context as well as experimental culture for the participation of women in radioactivity research. It argues that the politics of Red Vienna and the culture of radioactivity research specific to the Viennese setting encouraged exceptional gender politics within the Institute for Radium Research in the interwar years. The essay further attempts to provide an alternative approach to narratives that concentrate on personal dispositions and stereotypical images of women in science to explain the disproportionately large number of women in radioactivity research. Instead, the emphasis here is on the institutional context in which women involved themselves in radioactivity in interwar Vienna. This approach places greater importance on contingencies of time and place and highlights the significance of the cultural and political context in a historical study while at the same time shedding light on the interrelation between scientific practices and gender.

A sustainable city implantation for Vienna, Austria

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

Levine, R.S.; Radmard, T.; Dumreicher, H.

1995-11-01

This paper presents a prototype of the Sustainable City Implantation of the future, which the city of Vienna, Austria is interested in considering as a solution to a long standing urban problem. Developed conceptually through numerous architectural design studio projects and field studies the Sustainable City Implantation is inspired by the historic medieval Italian hilltown. This city-as-a-hill prototype, rendered through sophisticated and flexible computer models, offers the promise of overcoming many of the puzzles and conundrums plaguing urban designers and social ecologists in their efforts to find the proper form and scale for charting the pathway to sustainability in naturemore » and the built environment. The new holistic, people centered, urban model has been developed to be able to synthesize new urban concepts with technological means to develop humane, sustainable cities. This preliminary study develops and verifies this model together with its process for a significant urban site in the city of Vienna.« less

Terrestrial reference frame solution with the Vienna VLBI Software VieVS and implication of tropospheric gradient estimation

NASA Astrophysics Data System (ADS)

Spicakova, H.; Plank, L.; Nilsson, T.; Böhm, J.; Schuh, H.

2011-07-01

The Vienna VLBI Software (VieVS) has been developed at the Institute of Geodesy and Geophysics at TU Vienna since 2008. In this presentation, we present the module Vie_glob which is the part of VieVS that allows the parameter estimation from multiple VLBI sessions in a so-called global solution. We focus on the determination of the terrestrial reference frame (TRF) using all suitable VLBI sessions since 1984. We compare different analysis options like the choice of loading corrections or of one of the models for the tropospheric delays. The effect of atmosphere loading corrections on station heights if neglected at observation level will be shown. Time series of station positions (using a previously determined TRF as a priori values) are presented and compared to other estimates of site positions from individual IVS (International VLBI Service for Geodesy and Astrometry) Analysis Centers.

A RCT of three training and support strategies to encourage implementation of screening and brief alcohol intervention by general practitioners.

PubMed

Kaner, E F; Lock, C A; McAvoy, B R; Heather, N; Gilvarry, E

1999-09-01

Providing doctors with new research findings or clinical guidelines is rarely sufficient to promote changes in clinical practice. An implementation strategy is required to provide clinicians with the skills and encouragement needed to alter established routines. To evaluate the effectiveness and cost-effectiveness of different training and support strategies in promoting implementation of screening and brief alcohol intervention (SBI) by general practitioners (GPs). Subjects were 128 GPs, one per practice, from the former Northern and Yorkshire Regional Health Authority, who agreed to use the 'Drink-Less' SBI programme in an earlier dissemination trial. GPs were stratified by previous marketing conditions and randomly allocated to three intensities of training and support: controls (n = 43) received the programme with written guidelines only, trained GPs (n = 43) received the programme plus practice-based training in programme usage, trained and supported GPs (n = 42) received the programme plus practice-based training and a support telephone call every two weeks. GPs were requested to use the programme for three months. Outcome measures included proportions of GPs implementing the programme and numbers of patients screened and intervened with. Seventy-three (57%) GPs implemented the programme and screened 11,007 patients for risk drinking. Trained and supported GPs were significantly more likely to implement the programme (71%) than controls (44%) or trained GPs (56%); they also screened, and intervened with, significantly more patients. Costs per patient screened were: trained and supported GPs, 1.05 Pounds; trained GPs, 1.08 Pounds; and controls, 1.47 Pounds. Costs per patient intervened with were: trained and supported GPs, 5.43 Pounds; trained GPs, 6.02 Pounds; and controls, 8.19 Pounds. Practice-based training plus support telephone calls was the most effective and cost-effective strategy to encourage implementation of SBI by GPs.

Patient safety and communication: a new assessment for doctors trained in countries where language differs from that of the host country: results of a pilot using a domain-based assessment.

PubMed

Cushing, Annie M; Ker, Jean S; Kinnersley, Paul; McKeown, Pascal; Silverman, Jonathan; Patterson, John; Westwood, Olwyn M R

2014-06-01

Global migration of healthcare workers places responsibility on employers to comply with legal employment rights whilst ensuring patient safety remains the central goal. We describe the pilot of a communication assessment designed for doctors who trained and communicated with patients and colleagues in a different language from that of the host country. It is unique in assessing clinical communication without assessing knowledge. A 14-station OSCE was developed using a domain-based marking scheme, covering professional communication and English language skills (speaking, listening, reading and writing) in routine, acute and emotionally challenging contexts, with patients, carers and healthcare teams. Candidates (n=43), non-UK trained volunteers applying to the UK Foundation Programme, were provided with relevant station information prior to the exam. The criteria for passing the test included achieving the pass score and passing 10 or more of the 14 stations. Of the 43 candidates, nine failed on the station criteria. Two failed the pass score and also the station criteria. The Cronbach's alpha coefficient was 0.866. This pilot tested 'proof of concept' of a new domain-based communication assessment for non-UK trained doctors. The test would enable employers and regulators to verify communication competence and safety in clinical contexts, independent of clinical knowledge, for doctors who trained in a language different from that of the host country. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The European Society for Medical Oncology Magnitude of Clinical Benefit Scale in daily practice: a single institution, real-life experience at the Medical University of Vienna.

PubMed

Kiesewetter, Barbara; Raderer, Markus; Steger, Günther G; Bartsch, Rupert; Pirker, Robert; Zöchbauer-Müller, Sabine; Prager, Gerald; Krainer, Michael; Preusser, Matthias; Schmidinger, Manuela; Zielinski, Christoph C

2016-01-01

The European Society for Medical Oncology (ESMO) Magnitude of Clinical Benefit Scale (MCBS) has been designed to stratify the therapeutic benefit of a certain drug registered for the treatment of cancer. However, though internally validated, this tool has not yet been evaluated for its feasibility in the daily practice of a major center of medical oncology. The practicability of the MCBS for advanced oncological diseases at the Clinical Division of Oncology, Medical University of Vienna, which constitutes one of the largest oncological centres in Europe, was analysed in a three-step approach. First, retrospectively collected data were analysed to gain an overview of treatments in regular use. Second, data were scored by using the MCBS. Third, the ensuing results were evaluated within corresponding programme directorships to assess feasibility in a real-life clinical context. In the majority of tumour entities, the MCBS results reported earlier are consistent with daily clinical practice. Thus, in metastatic breast cancer or advanced lung cancer, there was a high level of clinical benefit for first-line treatment standards, and these results reflected well real-life experience. However, analyses based on the first version of the MCBS are limited if it comes to salvage treatment in tumour entities in which optimal sequencing of potential treatment options is of major importance, as in metastatic colorectal or renal cell cancer. In contrast to this, it is remarkable that certain novel therapies such as nivolumab assessed for heavily pretreated advanced renal cancer reached the highest level of clinical benefit due to prolongation in survival and a favourable toxicity profile. The MCBS clearly underlines the potential benefit of these compounds. The MCBS is an excellent tool for daily clinical practice of a tertiary referral centre. It supports treatment decisions based on the clinical benefit to be expected from a novel approach such as immunotherapy in as yet untested indications.

What does it mean to be a mentor in medical education?

PubMed

Stenfors-Hayes, Terese; Hult, Håkan; Dahlgren, Lars Owe

2011-01-01

Mentor programmes are becoming increasingly common in undergraduate education. However, the meaning attached to being a mentor varies significantly. The aim of this study is to explore how teachers in medical and dental education understand their role as mentors. Twenty mentors in two different mentor programmes for undergraduate medical and dental students were interviewed. The transcripts were analysed using a phenomenographic approach. The findings comprise three qualitatively different ways of understanding what it means to be a mentor, which are described as: (1) a mentor is someone who can answer questions and give advice, (2) a mentor is someone who shares what it means to be a doctor/dentist, and (3) a mentor is someone who listens and stimulates reflection. The way the mentors understood their role also affected what they did as mentors, their relationships with their mentees and their perceived benefits as mentors. Being a mentor can be perceived in qualitatively different ways also within the same mentor programme. This understanding affects the mentors' actions, their relationships with their mentees and their perceived benefits of being a mentor. Awareness of one's own understanding is important in improving practices and the findings of this study can be used by mentors, teachers and educational developers to facilitate improved effectiveness in mentor programmes, both for mentors and mentees.

The UK's National Programme for IT: Why was it dismantled?

PubMed

Justinia, Taghreed

2017-02-01

This paper discusses the UK's National Programme for IT (NPfIT), which was an ambitious programme launched in 2002 with an initial budget of some £6.2 billion. It attempted to implement a top-down digitization of healthcare in England's National Health Service (NHS). The core aim of the NPfIT was to bring the NHS' use of information technology into the 21st century, through the introduction of an integrated electronic patient record systems, and reforming the way that the NHS uses information, and hence to improve services and the quality of patient care. The initiative was not trusted by doctors and appeared to have no impact on patient safety. The project was marred by resistance due to the inappropriateness of a centralized authority making top-down decisions on behalf of local organizations. The NPfIT was officially dismantled in September 2011. Deemed the world's largest civil IT programme, its failure and ultimate demise sparked a lot of interest as to the reasons why. This paper summarises the underlying causes that lead to dismantling the NPfIT. At the forefront of those circumstances were the lack of adequate end user engagement, the absence of a phased change management approach, and underestimating the scale of the project.

RNTCP 2007: looking ahead to future challenges.

PubMed

Chauhan, L S

2007-04-01

The largest TB control programme in terms of patients treated is India's Revised National Tuberculosis Control Programme (RNTCP). The treatment success of new smear positive TB cases under RNTCP has exceeded the global benchmark of 85%. Also there are some challenges in TB control programme eg, addressing TB in HIV-infected persons and accurate diagnosis and management of multidrug resistant TB (MDR-TB). Diagnosis of MDR-TB requires sophisticated laboratories. If MDR-TB is not managed effectively, then there is possibility to emerge drug-resistant TB which is virtually untreatable. The Public-Private mix initiatives of RNTCP attempt to make quality assured treatment for TB for all patients, regardless of healthcare providers they choose. The International Standards of TB Care (ISTC) is an international effort which has articulated the diagnostic, treatment and public health standards which all providers should hold themselves and their peers accountable to. For providers the path to practise the ISTC is to diagnose and treat patients in collaboration with RNTCP. The IMA has taken up the cause of TB control in India very seriously. This organisation of the doctors (IMA) deserves recognition for becoming the first professional association to endorse the ISTC in India. All health providers should work with and support the RNTCP, so that the programme can be made into a genuine mass movement to fight TB.

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

PubMed

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

2017-07-17

Occupational stress and burnout are highly prevalent among medical doctors and can have adverse effects on patient, doctor, and organisational outcomes. The purpose of the current study was to review and evaluate evidence on psychosocial interventions aimed at reducing occupational stress and burnout among medical doctors. A systematic review was conducted for original research articles reporting on psychosocial interventions targeting occupational stress or burnout among medical doctors, published in the English language, and with data collected at a minimum of two time points. Searches were conducted across five electronic databases, as well as by manual search of Google Scholar. Data was extracted relating to study characteristics and outcomes, quality and rigour, as well as modes of delivery and engagement. Studies were appraised using the Strength of Recommendation Taxonomy (SORT) and Critical Appraisal Skills Programme (CASP). Twenty-three articles were reviewed, which reported on interventions utilising cognitive-behavioural, relaxation, and supportive discussion strategies. Only 12 studies allowed estimation of pre- to post-intervention effects. Cognitive behavioural interventions demonstrated the strongest evidence, particularly for reducing stress. Some evidence was identified to support the efficacy of relaxation-based approaches, but no such evidence was found for the efficacy of discussion-based interventions, such as Balint groups. There was a lack of quality among reviewed studies, with no studies receiving a quality rating of 1, and the overall body of evidence being rated as level B, according to the SORT. Effect sizes were not pooled due to a lack of quality among the study sample. This review found that despite increased scientific attention, the quality of research examining the benefits of psychosocial/behavioural interventions for occupational stress and burnout in medical doctors remains low. Despite this, interventions focused on cognitive and behavioural principles appear to show promise in reducing doctor stress and burnout. Limitations of the current review include a lack of risk of bias assessment or pooling of analyses. Recommendations for improving the quality of research in this area, as well as implications of the current body of evidence are discussed. PROSPERO CRD42016032595.

Junior doctors' experiences of managing patients with medically unexplained symptoms: a qualitative study.

PubMed

Yon, Katherine; Nettleton, Sarah; Walters, Kate; Lamahewa, Kethakie; Buszewicz, Marta

2015-12-01

To explore junior doctors' knowledge about and experiences of managing patients with medically unexplained symptoms (MUS) and to seek their recommendations for improved future training on this important topic about which they currently receive little education. Qualitative study using in-depth interviews analysed using the framework method. Participants were recruited from three North Thames London hospitals within the UK. Twenty-two junior doctors undertaking the UK foundation two-year training programme (FY1/FY2). The junior doctors interviewed identified a significant gap in their training on the topic of MUS, particularly in relation to their awareness of the topic, the appropriate level of investigations, possible psychological comorbidities, the formulation of suitable explanations for patients' symptoms and longer term management strategies. Many junior doctors expressed feelings of anxiety, frustration and a self-perceived lack of competency in this area, and spoke of over-investigating patients or avoiding patient contact altogether due to the challenging nature of MUS and a difficulty in managing the accompanying uncertainty. They also identified the negative attitudes of some senior clinicians and potential role models towards patients with MUS as a factor contributing to their own attitudes and management choices. Most reported a need for more training during the foundation years, and recommended interactive case-based group discussions with a focus on providing meaningful explanations to patients for their symptoms. There is an urgent need to improve postgraduate training about the topics of MUS and avoiding over-investigation, as current training does not equip junior doctors with the necessary knowledge and skills to effectively and confidently manage patients in these areas. Training needs to focus on practical skill development to increase clinical knowledge in areas such as delivering suitable explanations, and to incorporate individual management strategies to help junior doctors tolerate the uncertainty associated with MUS. 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/

Perceptions of medical students and their mentors in a specialised programme designed to provide insight into non-traditional career paths

PubMed Central

Josephson, Anna; Stenfors-Hayes, Terese

2011-01-01

Objectives This pilot study explores the perceptions of medical students and their individual mentors who advised them in a specialised programme where students gained insight into non-tradition career paths. Methods Twelve medical students in years 3-6 at Karolinska Institutet, Sweden were recruited to the Prominentia mentor programme where they were individually paired with mentors who met with them to discuss and advise them on non-traditional career paths. Application letters of students to join the programme as well as electronically distributed questionnaires and semi-structured interviews were used to assess the perceptions of mentors and students to the programme. Both the questionnaire and the interview transcripts were thematised using content analysis. Results In terms of expectations and requests, the application letters showed that all students specified their career goals and the type of mentor they desired. Whereas mentors in general had fewer requests and some had no specific demands. In light of perceived effects, all mentors felt they discussed future careers with their students and the majority of students responded the same way, with some interesting deviations. Most discussed topics during meetings were: future career, medical education, combinations of private life and work, and work environment. Conclusions This pilot study revealed that students appreciated receiving inspiration and seeing career path opportunities outside academic medicine as well as receiving support in personal and professional development and guidance about the students’ role as a doctor. However, discrepancies were found regarding how mentors and students respectively perceived the mentor programme.

A novel Internet-based blended learning programme providing core competency in clinical research.

PubMed

Tsugihashi, Yukio; Kakudate, Naoki; Yokoyama, Yoko; Yamamoto, Yosuke; Mishina, Hiroki; Fukumori, Norio; Nakamura, Fumiaki; Takegami, Misa; Ohno, Shinya; Wakita, Takafumi; Watanabe, Kazuhiro; Yamaguchi, Takuhiro; Fukuhara, Shunichi

2013-04-01

We developed a novel Internet-based blended learning programme that allows busy health care professionals to attain core competency in clinical research. This study details the educational strategies and learning outcomes of the programme. This study was conducted at Kyoto University and seven satellite campuses from September 2009 to March 2010. A total of 176 health care professionals who had never attempted to attain core competency in clinical research were enrolled. The participants were supplied with a novel programme comprising the following four strategies: online live lectures at seven satellite campuses, short examinations after each lecture, an Internet-based feedback system and an end-of-course examination. We assessed the proportion of attendance at the lectures as the main outcome. In addition, we evaluated interaction via the feedback system and scores for end-of-course examination. Of the 176 participants, 134 (76%) reported working more than 40 hours per week. The mean proportion of attendance over all 23 lectures was 82%. A total of 156 (89%) participants attended more than 60% of all lectures and were eligible for the end-of-course examination. A total of the participants accessed the feedback system 3564 times and asked 284 questions. No statistically significant differences were noted in the end-of-course scores among medical doctors, pharmacists, registered nurses and other occupations. We developed an Internet-based blended learning programme providing core competency in clinical research. Most busy health care professionals completed the programme successfully. In addition, the participants could attain the core competency effectively, regardless of their occupation. © 2011 Blackwell Publishing Ltd.

Education for nurses working in cardiovascular care: a European survey.

PubMed

2014-12-01

Nurses represent the largest sector of the workforce caring for people with cardiovascular disease in Europe. Little is known about the post-registration education provided to nurses working within this specialty. The aim of this descriptive cross sectional survey was to describe the structure, content, teaching, learning, assessment and evaluation methods used in post-registration cardiovascular nurse education programmes in Europe. A 24-item researcher generated electronic questionnaire was sent to nurse representatives from 23 European countries. Items included questions about cardiovascular registered nurse education programmes. Forty-nine respondents from 17 European countries completed questionnaires. Respondents were typically female (74%) and educated at Masters (50%) or doctoral (39%) level. Fifty-one percent of the cardiovascular nursing education programmes were offered by universities either at bachelor or masters level. The most frequently reported programme content included cardiac arrhythmias (93%), heart failure (85%) and ischaemic heart disease (83%). The most common teaching mode was face-to-face lectures (85%) and/or seminars (77%). A variety of assessment methods were used with an exam or knowledge test being the most frequent. Programme evaluation was typically conducted through student feedback (95%). There is variability in the content, teaching, learning and evaluation methods in post-registration cardiovascular nurse education programmes in Europe. Cardiovascular nurse education would be strengthened with a stronger focus upon content that reflects current health challenges faced in Europe. A broader view of cardiovascular disease to include stroke and peripheral vascular disease is recommended with greater emphasis on prevention, rehabilitation and the impact of health inequalities. © The European Society of Cardiology 2013.

A rapid assessment of a community health worker pilot programme to improve the management of hypertension and diabetes in Emfuleni sub-district of Gauteng Province, South Africa.

PubMed

Ndou, Tshipfuralo; van Zyl, Greer; Hlahane, Salamina; Goudge, Jane

2013-01-24

Non-communicable diseases (NCD) and infectious chronic illnesses are recognised as significant contributing factors to the burden of disease globally, specifically in South Africa, yet clinical management is often poor. The involvement of community health workers (CHWs) in TB and HIV care in South Africa, and other low- and middle-income settings, suggests that they could make an important contribution in the management of NCDs. Using a rapid assessment, this study examines the outcomes of a pilot CHW programme to improve the management of hypertension and diabetes in Gauteng province, South Africa. A record review compared outcomes of patients receiving home visits (n56) with a control group (n168) attending the clinic, matched, as far as possible, on age, gender, and condition. Focus group discussions and semi-structured interviews with CHWs, patients, district, clinic, and NGO staff were used to obtain descriptions of the functioning of the programme and patient experiences. Despite the greater age and co-morbidity among those in the pilot programme, the findings suggest that control of hypertension was improved by CHW home visits in comparison to usual clinic care. However, too few doctor visits, insufficient monitoring of patient outcomes by clinic staff, and a poor procurement process for supplies required by the CHWs hampered the programme's activities. The role of CHWs in the management of hypertension should be given greater consideration, with larger studies being conducted to provide more robust evidence. Adequate training, supervision, and operational support will be required to ensure success of any CHW programme.

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

PubMed

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

2007-08-28

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

Modelling reduction of urban heat load in Vienna by modifying surface properties of roofs

NASA Astrophysics Data System (ADS)

Žuvela-Aloise, Maja; Andre, Konrad; Schwaiger, Hannes; Bird, David Neil; Gallaun, Heinz

2018-02-01

The study examines the potential of urban roofs to reduce the urban heat island (UHI) effect by changing their reflectivity and implementing vegetation (green roofs) using the example of the City of Vienna. The urban modelling simulations are performed based on high-resolution orography and land use data, climatological observations, surface albedo values from satellite imagery and registry of the green roof potential in Vienna. The modelling results show that a moderate increase in reflectivity of roofs (up to 0.45) reduces the mean summer temperatures in the densely built-up environment by approximately 0.25 °C. Applying high reflectivity materials (roof albedo up to 0.7) leads to average cooling in densely built-up area of approximately 0.5 °C. The green roofs yield a heat load reduction in similar order of magnitude as the high reflectivity materials. However, only 45 % of roof area in Vienna is suitable for greening and the green roof potential mostly applies to industrial areas in city outskirts and is therefore not sufficient for substantial reduction of the UHI effect, particularly in the city centre which has the highest heat load. The strongest cooling effect can be achieved by combining the green roofs with high reflectivity materials. In this case, using 50 or 100 % of the green roof potential and applying high reflectivity materials on the remaining surfaces have a similar cooling effect.

Psychiatry and political-institutional abuse from the historical perspective: the ethical lessons of the Nuremberg Trial on their 60th anniversary.

PubMed

López-Muñoz, Francisco; Alamo, Cecilio; Dudley, Michael; Rubio, Gabriel; García-García, Pilar; Molina, Juan D; Okasha, Ahmed

2007-05-09

Sixty years ago at the Nuremberg Trials, 23 Nazi leaders were tried as war criminals, in what was known as "The Doctors' Trial". This trial exposed a perverse system of the criminal use of medicine in the fields of public health and human research. These practices, in which racial hygiene constituted one of the fundamental principles and euthanasia programmes were the most obvious consequence, violated the majority of known bioethical principles. Psychiatry played a central role in these programmes, and the mentally ill were the principal victims. The aim of the present work is to review, from the historical perspective, the antecedents of the shameful euthanasia programmes for the mentally ill, the procedures involved in their implementation and the use of mentally ill people as research material. The Nuremberg Code, a direct consequence of the Doctors' Trial, is considered to be the first international code of ethics for research with human beings, and represented an attempt to prevent any repeat of the tragedy that occurred under Nazism. Nevertheless, the last 60 years have seen continued government-endorsed psychiatric abuse and illegitimate use of psychoactive drugs in countries such as the Soviet Union or China, and even in some with a long democratic tradition, such as the United States. Even today, the improper use of psychiatry on behalf of governments is seen to be occurring in numerous parts of the globe: religious repression in China, enforced hospitalization in Russia, administration of psychoactive drugs in immigrant detention centres in Australia, and the application of the death penalty by lethal injection and psychiatric participation in coercive interrogation at military prisons, in relation to the USA. The Declaration of Madrid in 1996 constituted the most recent attempt to eradicate, from the ethical point of view, these horrendous practices. Various strategies can be used to combat such abuses, though it is uncertain how effective they are in preventing them.

Family medicine training in sub-Saharan Africa: South-South cooperation in the Primafamed project as strategy for development.

PubMed

Flinkenflögel, Maaike; Essuman, Akye; Chege, Patrick; Ayankogbe, Olayinka; De Maeseneer, Jan

2014-08-01

Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. To explore the extent to which the Primafamed South-South cooperative project contributed to the development of family medicine in sub-Saharan Africa. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The South-South cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels. © The Author 2014. Published by Oxford University Press.

Creating a blended learning module in an online master study programme in oncology.

PubMed

Mayer, Benjamin; Ring, Christina; Muche, Rainer; Rothenbacher, Dietrich; Schmidt-Strassburger, Uta

2015-01-01

The medical faculty of Ulm University has launched the postgraduate master online study programme Advanced Oncology (AO) in 2010. We describe the challenges in developing an e-learning module using the example of a medical biometry course, focusing the implementation of the course material and our single-loop learning experience after the first students have finished and evaluated the lecture. Programme participants are qualified medical doctors and researchers in biomedical areas related to the field of oncology. The study programme provides the majority of lectures online via didactic videos accompanied by one-week attendance seminars. Supplementary learning materials include review articles, supportive reading material, multiple choice questions, and exercises for each unit. Lecture evaluations based on specific questions concerning learning environment and information learned, each measured on a five-point Likert scale. Lecture videos were implemented following the classical triad of the didactic process, using oncological examples from practice to teach. The online tutorial support offered to students was hardly used, thus we enhanced faculty presence during the face-to-face seminars. Lecture evaluations improved after revising the learning material on the basis of the first AO student cohort's comments. Developing and implementing an online study programme is challenging with respect of maximizing the information students learn due to limited opportunities for personal contact between lecturers and students. A more direct interaction of lecturers and students in a blended learning setting outperforms a mere web-based contact in terms of learning advantage and students' satisfaction, especially for complex methodological content.

Mosquitoes (Diptera: Culicidae) and their relevance as disease vectors in the city of Vienna, Austria.

PubMed

Lebl, Karin; Zittra, Carina; Silbermayr, Katja; Obwaller, Adelheid; Berer, Dominik; Brugger, Katharina; Walter, Melanie; Pinior, Beate; Fuehrer, Hans-Peter; Rubel, Franz

2015-02-01

Mosquitoes (Diptera: Culicidae) are important vectors for a wide range of pathogenic organisms. As large parts of the human population in developed countries live in cities, the occurrence of vector-borne diseases in urban areas is of particular interest for epidemiologists and public health authorities. In this study, we investigated the mosquito occurrence in the city of Vienna, Austria, in order to estimate the risk of transmission of mosquito-borne diseases. Mosquitoes were captured using different sampling techniques at 17 sites in the city of Vienna. Species belonging to the Culex pipiens complex (78.8 %) were most abundant, followed by Coquillettidia richiardii (10.2 %), Anopheles plumbeus (5.4 %), Aedes vexans (3.8 %), and Ochlerotatus sticticus (0.7 %). Individuals of the Cx. pipiens complex were found at 80.2 % of the trap sites, while 58.8 % of the trap sites were positive for Cq. richiardii and Ae. vexans. Oc. sticticus was captured at 35.3 % of the sites, and An. plumbeus only at 23.5 % of the trap sites. Cx. pipiens complex is known to be a potent vector and pathogens like West Nile virus (WNV), Usutu virus (USUV), Tahyna virus (TAHV), Sindbis virus (SINV), Plasmodium sp., and Dirofilaria repens can be transmitted by this species. Cq. richiardii is a known vector species for Batai virus (BATV), SINV, TAHV, and WNV, while Ae. vexans can transmit TAHV, USUV, WNV, and Dirofilaria repens. An. plumbeus and Oc. sticticus seem to play only a minor role in the transmission of vector-borne diseases in Vienna. WNV, which is already wide-spread in Europe, is likely to be the highest threat in Vienna as it can be transmitted by several of the most common species, has already been shown to pose a higher risk in cities, and has the possibility to cause severe illness.

[Johann van Beethoven (1776-1848)].

PubMed

Eikermann, Erika

2012-01-01

The article about the life and achievements of the apothecary Johann van Beethoven, the younger brother of the composer Ludwig van Beethoven, depicts a vivid picture of life in the 18th, 19t century. Research on archived original documents in Bonn, Vienna and Linz on the Danube made it possible to reveal details about the relationship inside this famous family and describes the hurdles of life of a successful apothecary. In 1776 Johann van Beethoven was born as the fourth child of the Beethoven family, a family of Bonner musicians. In 1790 he began his apprenticeship to become an apothecary at the Bonner "Hofapotheke". Towards the end of 1795 he moved to join his older brothers Ludwig and Karl in Vienna. During his time there he worked as a "subject" in various Viennese pharmacies. However in 1808 he purchased the pharmacy "Zur Goldenen Krone" in Linz on the Danube. His new pharmacy flourished, supplying first the Napoleonic occupation troops, and later the Austrian Military with medicines and field dressing/bandage materials. When in 1812 he married his Housekeeper, his Brother Ludwig opposed harshly, on reasons of social status and on moral grounds. Four years later, in 1816 Johann sold the pharmacy in Linz and founded a new pharmacy in Urfahr, on the opposite bank of the Danube. In 1819 he became a squire (or landowner), when he purchased a manor estate in Gneixendorf, near Krems on the Danube. In spite of his numerous duties as an apothecary and squire, Johann was frequently resident in Vienna, supporting his brother both emotionally and pharmaceutically. At the end of his life Johann sold both his pharmacy and the Gneixendorf estate, and spent his last years as a private gentleman living a dazzling lifestyle in Vienna. He died on January 12th 1848 and was buried in Vienna's "Waldmüllerpark".

Problems of postgraduate medical training in Nigeria.

PubMed

Ike, S O

2004-01-01

Postgraduate medical training in Nigeria has been in dire straits for about two decades now. That it has continued to survive, is a tribute to the average resident doctor who has become immunized, and who has grown a thick skin of armour, as well the spirit of altruism of the medical teachers--consultants (young and old), who despite odds, have kept their focus clear, above the murky waters of national distraction and daunting socio economic challenges. A review of relevant literature on medical education in Nigeria was undertaken by manual library search. This paper x-rays the strong points that have still prevailed to hold the rudiments and ideals of postgraduate medical training in a viable position up to date. It discusses the weaknesses and threats--potential and real--to the training programme. This paper attempts to search, and actually hopes, for silver lining in the Nigerian sky as possible solution lifelines that may yet re-engineer the programme.

Physical therapy as a profession and its educational development in Pakistan.

PubMed

Memon, Aamir Raoof; Sahibzada, Nasir Mansoor; Azim, Muhammad Ehab; Siddiqui, Furqan Ahmed

2016-11-01

Physical therapists work in different medical and related settings and serve to maintain and restore functional capability. Pakistan has a disability rate of 2.65% with a total of around 5.035 million disabled people. Physical therapy as a profession started in 1956 at the Jinnah Postgraduate Medical Centre with a 2-year diploma, later on 4 years bachelors programme was also started. In 2008, doctor of physical therapy programme was initiated. The representative body "Pakistan Physical Therapy Association" was also established in 2008 which then joined the World Confederation for Physical Therapy in 2011. There is plenty of work being done in the field and it has seen a rapid growth in the past decade compared to the last 50 years. Currently, there are 69 institutions in Pakistan offering various physical therapy courses. The profession currently requires an autonomous regulatory body to control its educational curriculum and development as well as safeguard its interests.

Summative assessment of undergraduates' communication competence in challenging doctor-patient encounters. Evaluation of the Düsseldorf CoMeD-OSCE.

PubMed

Mortsiefer, Achim; Immecke, Janine; Rotthoff, Thomas; Karger, André; Schmelzer, Regine; Raski, Bianca; Schmitten, Jürgen In der; Altiner, Attila; Pentzek, Michael

2014-06-01

To evaluate the summative assessment (OSCE) of a communication training programme for dealing with challenging doctor-patient encounters in the 4th study year. Our OSCE consists of 4 stations (breaking bad news, guilt and shame, aggressive patients, shared decision making), using a 4-item global rating (GR) instrument. We calculated reliability coefficients for different levels, discriminability of single items and interrater reliability. Validity was estimated by gender differences and accordance between GR and a checklist. In a pooled sample of 456 students in 3 OSCEs over 3 terms, total reliability was α=0.64, reliability coefficients for single stations were >0.80, and discriminability in 3 of 4 stations was within the range of 0.4-0.7. Except for one station, interrater reliability was moderate to strong. Reliability on item level was poor and pointed to some problems with the use of the GR. The application of the GR on regular undergraduate medical education shows moderate reliability in need of improvement and some traits of validity. Ongoing development and evaluation is needed with particular regard to the training of the examiners. Our CoMeD-OSCE proved suitable for the summative assessment of communication skills in challenging doctor-patient encounters. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[The directional axes in the reform of medical teaching. A strategic proposal].

PubMed

Martins e Silva, J

1993-10-01

The circumstances preceding the future revision of the medical curriculum are analysed, main internal and external stimuli are described, and sources of resistance to changes in medical training require new educational philosophy, privileging oriented training during undergraduation, as a preliminary phase of medical education. The definition and accompaniment of the general and specific objectives, the strategy and programme used, the design and adequacy of the available support, and the related engagement of all political, academic and socially responsible persons and institutions, are fundamental factors for successful change. The education and training of polyvalent medical doctors requires methodological modifications, namely the definition of a core curriculum, made dynamic through the teaching of interdependent subjects and earlier contact with common clinical problems. Learning through interconnected basic and clinical matters will benefit the technical and psychosocial education of future doctors. The education resulting from a renewal in undergraduate medical education will be mostly determined by organizational and institutional frameworks, teaching methods and the evaluation process used, as well as by teacher commitment, pedagogic and scientific capacities. Professional competence should be the end product of efficient training. Otherwise, undergraduate medical education would not prepare the professional development of the young doctors, thus diminishing the quality of medical training in the future.

Training a medical workforce to meet the needs of diverse minority communities.

PubMed

Sopoaga, Faafetai; Zaharic, Tony; Kokaua, Jesse; Covello, Sahra

2017-01-21

The growing demand for a competent health workforce to meet the needs of increasingly diverse societies has been widely acknowledged. One medical school in New Zealand explored the integration of the commonly used patient-centred model approach, with an intersectional framework in the development of a cultural competency training programme. In the Pacific Immersion Programme, medical students in their fourth year of training are given the opportunity to learn about different factors that influence the health and health care of a minority community through immersion in that community. The programme objectives include enabling students to learn through experience living within the local community context, and supporting them to re-evaluate their own personal beliefs, assumptions and/or prior prejudices. This study evaluates the usefulness of this programme in the training of medical students to work in diverse communities. Two analytical approaches were used for evaluation. Deductive and inductive analyses were conducted on 235 reflective essays completed by three cohorts of students from 2011 to 2013 to ascertain the value of the programme for student learning. In addition, one cohort was invited to complete a pre and post-programme questionnaire. Overall, the students found the programme to be a valued learning environment. They found living within a Pacific family environment to be an eye opening experience. It increased students comfort level in cross cultural engagement and emphasised the importance of patient's perspectives in health care provision. Students' self-reported knowledge about Pacific cultural values, protocols, traditional beliefs and the main health challenges increased significantly after the programme. They appreciated learning directly from community members, and through observations about how culture, beliefs and the socio-economic environment influence peoples' health and wellbeing. Medical schools are required to train a competent health workforce to meet the needs of diverse communities. The Pacific Immersion Programme provides a unique learning environment which can improve the training of doctors to work in diverse communities. The key to its success is enabling students to be engaged learners from "the inside" rather than an "outsider looking in". The Programme enables experiential learning in a sensitive and meaningful way and can be useful for training in other institutions.

Critical appraisal of the Vienna consensus: performance indicators for assisted reproductive technology laboratories.

PubMed

Lopez-Regalado, María Luisa; Martínez-Granados, Luis; González-Utor, Antonio; Ortiz, Nereyda; Iglesias, Miriam; Ardoy, Manuel; Castilla, Jose A

2018-05-24

The Vienna consensus, based on the recommendations of an expert panel, has identified 19 performance indicators for assisted reproductive technology (ART) laboratories. Two levels of reference values are established for these performance indicators: competence and benchmark. For over 10 years, the Spanish embryology association (ASEBIR) has participated in the definition and design of ART performance indicators, seeking to establish specific guidelines for ART laboratories to enhance quality, safety and patient welfare. Four years ago, ASEBIR took part in an initiative by AENOR, the Spanish Association for Standardization and Certification, to develop a national standard in this field (UNE 17900:2013 System of quality management for assisted reproduction laboratories), extending the former requirements, based on ISO 9001, to include performance indicators. Considering the experience acquired, we discuss various aspects of the Vienna consensus and consider certain discrepancies in performance indicators between the consensus and UNE 179007:2013, and analyse the definitions, methodology and reference values used. Copyright © 2018. Published by Elsevier Ltd.

European Physical Society Conference on High Energy Physics

NASA Astrophysics Data System (ADS)

The European Physical Society Conference on High Energy Physics, organized by the High Energy and Particle Physics Division of the European Physical Society, is a major international conference that reviews biennially since 1971 the state of our knowledge of the fundamental constituents of matter and their interactions. The latest conferences in this series were held in Stockholm, Grenoble, Krakow, Manchester, Lisbon, and Aachen. Jointly organized by the Institute of High Energy Physics of the Austrian Academy of Sciences, the University of Vienna, the Vienna University of Technology, and the Stefan Meyer Institute for Subatomic Physics of the Austrian Academy of Sciences, the 23rd edition of this conference took place in Vienna, Austria. Among the topics covered were Accelerators, Astroparticle Physics, Cosmology and Gravitation, Detector R&D and Data Handling, Education and Outreach, Flavour Physics and Fundamental Symmetries, Heavy Ion Physics, Higgs and New Physics, Neutrino Physics, Non-Perturbative Field Theory and String Theory, QCD and Hadronic Physics, as well as Top and Electroweak Physics.

Vienna - Chicago

PubMed Central

Luan, Xianghong; Diekwisch, Thomas G.H.

2009-01-01

The discussion over the roles of genes and environment on the phenotypical specification of organisms has held a central role in science philosophy since the late 19th century and has re-emerged in today’s debate over genetic determinism and developmental plasticity. In fin-de-siecle Vienna, this debate coincided with a philosophical debate over empiricism/materialism versus idealism/vitalism. Turn-of-the-century Vienna’s highly interdisciplinary environment was also the birthplace for the model system of the unopposed molar. The un-opposed molar system features new tissue formation at the roots of teeth and tooth drift once opposing teeth are lost. The un-opposed molar model system was revived by a group of Viennese scientists that left Vienna during the Nazi period to address Vienna’s questions about evolution and heredity and about genes and environment in Chicago’s post-WWII scientific exile community. Here we are using the colorful history of the un-opposed molar to investigate the role of culture and method in the scientific evolution of a model system. PMID:17621674

Is it time for integration of surgical skills simulation into the United Kingdom undergraduate medical curriculum? A perspective from King's College London School of Medicine.

PubMed

Hamaoui, Karim; Sadideen, Hazim; Saadeddin, Munir; Onida, Sarah; Hoey, Andrew W; Rees, John

2013-01-01

Changes in undergraduate medical curricula, combined with reforms in postgraduate education, have training implications for surgical skills acquisition in a climate of reduced clinical exposure. Confidence and prior experience influences the educational impact of learning. Currently there is no basic surgical skills (BSS) programme integrated into undergraduate curricula in the United Kingdom. We explored the role of a dedicated BSS programme for undergraduates in improving confidence and influencing careers in King's College London School of Medicine, and the programme was evaluated. A programme was designed in-line with the established Royal College of Surgeons course. Undergraduates were taught four key skills over four weeks: knot-tying, basic-suturing, tying-at-depth and chest-drain insertion, using low-fidelity bench-top models. A Likert-style questionnaire was designed to determine educational value and influence on career choice. Qualitative data was collected. Only 29% and 42% of students had undertaken previous practice in knot-tying and basic suturing, respectively. 96% agreed that skills exposure prior to starting surgical rotations was essential and felt a dedicated course would augment undergraduate training. There was a significant increase in confidence in the practice and knowledge of all skills taught (p<0.01), with a greater motivation to be actively involved in the surgical firm and theatres. A simple, structured BSS programme can increase the confidence and motivation of students. Early surgical skills targeting is valuable for students entering surgical, related allied, and even traditionally non-surgical specialties such as general practice. Such experience can increase the confidence of future junior doctors and trainees. We advocate the introduction of a BSS programme into United Kingdom undergraduate curricula.

Is it time for integration of surgical skills simulation into the United Kingdom undergraduate medical curriculum? A perspective from King’s College London School of Medicine

PubMed Central

2013-01-01

Purpose: Changes in undergraduate medical curricula, combined with reforms in postgraduate education, have training implications for surgical skills acquisition in a climate of reduced clinical exposure. Confidence and prior experience influences the educational impact of learning. Currently there is no basic surgical skills (BSS) programme integrated into undergraduate curricula in the United Kingdom. We explored the role of a dedicated BSS programme for undergraduates in improving confidence and influencing careers in King’s College London School of Medicine, and the programme was evaluated. Methods: A programme was designed in-line with the established Royal College of Surgeons course. Undergraduates were taught four key skills over four weeks: knot-tying, basic-suturing, tying-at-depth and chest-drain insertion, using low-fidelity bench-top models. A Likert-style questionnaire was designed to determine educational value and influence on career choice. Qualitative data was collected. Results: Only 29% and 42% of students had undertaken previous practice in knot-tying and basic suturing, respectively. 96% agreed that skills exposure prior to starting surgical rotations was essential and felt a dedicated course would augment undergraduate training. There was a significant increase in confidence in the practice and knowledge of all skills taught (p<0.01), with a greater motivation to be actively involved in the surgical firm and theatres. Conclusion: A simple, structured BSS programme can increase the confidence and motivation of students. Early surgical skills targeting is valuable for students entering surgical, related allied, and even traditionally non-surgical specialties such as general practice. Such experience can increase the confidence of future junior doctors and trainees. We advocate the introduction of a BSS programme into United Kingdom undergraduate curricula. PMID:24498471

Antimicrobial stewardship education in US colleges and schools of pharmacy.

PubMed

Kufel, Wesley D; Jeffres, Meghan N; MacDougall, Conan; Cho, Jonathan C; Marx, Ashley H; Williams, Dennis M

2018-05-28

Pharmacists are key members of antimicrobial stewardship (AS) teams. It is unknown if and how US colleges and schools of pharmacy incorporate AS into their Doctor of Pharmacy (PharmD) curricula. This study was a cross-sectional, multicentre, electronic survey distributed to infectious diseases faculty or department chairs of 137 accredited and candidate-status PharmD programmes. One hundred and sixteen programmes participated, representing an 84.7% response rate. AS education was integrated into the required didactic, elective didactic and experiential education components of the curricula in 79 (68.1%), 43 (37.1%) and 97 (83.6%) PharmD programmes, respectively. The most common AS topics in required and elective didactic curricula were AS definitions, principles and purpose (98.7% and 86.0%) and the pharmacist's role in AS (93.7% and 83.7%). In the required and elective didactic curricula, lecture (93.7% and 86.0%) and case-based instruction (57.0% and 83.7%) were the most common instructional methods. For experiential education, the pharmacist's role in AS (96.9%), de-escalation of antimicrobials (96.9%) and antimicrobial dose optimization (95.9%) were the most common AS topics. PharmD programmes employing a faculty member who specializes in AS were more likely to offer AS experiential education than programmes without AS faculty (88.1% versus 71.9%, P = 0.049). Integration of AS education in US PharmD curricula is variable and there are considerable differences in the AS activities and topics delivered. PharmD programmes should attempt to expose students to AS education to prepare future pharmacists for AS practice. Efforts should be made to incorporate interprofessional collaboration into AS education.

A qualitative evaluation of a comprehensive self-management programme for COPD patients: effectiveness from the patients' perspective.

PubMed

Monninkhof, Evelyn; van der Aa, Maaike; van der Valk, Paul; van der Palen, Job; Zielhuis, Gerhard; Koning, Karen; Pieterse, Marcel

2004-11-01

The COPE self-management programme, including a self-management education course, self-treatment of exacerbations and a fitness programme, appeared to have no significant effect on health related quality of life (HRQoL) as measured by the St. George's Respiratory Questionnaire (SGRQ). This is in contrast to our hypothesis and despite expressions of satisfaction of patients to healthcare workers. To understand this discrepancy, a qualitative study was performed. A purposive sample of 20 participants of the COPE self-management programme were interviewed at home using in-depth, semi-structured interviews. Interviews were audio taped and transcribed verbatim and analysed according grounded theory. The fitness programme was most positively evaluated by patients due to the perceived increase of exercise capacity and the social aspect of the group training. Major effects gained by the self-management education course reported by patients were the skills to evenly distribute their energy and to listen to their body signals. Most patients thought favourable about self-treatment of exacerbations. The possibility to start early, not having to call a doctor and autonomy were raised as important advantages. Furthermore, several patients reported increased self-confidence and coping behaviour as important effects of the COPE programme. Finally, many patients reported feeling safe due to the frequent follow-up visits and 24h access to the hospital, and this aspect elicited to be very important. In this study, the qualitative interviews suggest that the SGRQ and possibly other existing HRQoL instruments might fail to capture the full experience of patients in self-management studies. The need for more elaborate qualitative research on this subject is indicated.

The "Health Coaching" programme: a new patient-centred and visually supported approach for health behaviour change in primary care.

PubMed

Neuner-Jehle, Stefan; Schmid, Margareta; Grüninger, Ueli

2013-07-17

Health related behaviour is an important determinant of chronic disease, with a high impact on public health. Motivating and assisting people to change their unfavourable health behaviour is thus a major challenge for health professionals. The objective of the study was to develop a structured programme of counselling in primary care practice, and to test its feasibility and acceptance among general practitioners (GPs) and their patients. Our new concept integrates change of roles, shared responsibility, patient-centredness, and modern communication techniques-such as motivational interviewing. A new colour-coded visual communication tool is used for the purpose of leading through the 4-step counselling process. As doctors' communication skills are crucial, communication training is a mandatory part of the programme. We tested the feasibility and acceptance of the "Health Coaching" programme with 20 GPs and 1045 patients, using questionnaires and semistructured interviewing techniques. The main outcomes were participation rates; the duration of counselling; patients' self-rated behavioural change in their areas of choice; and ratings of motivational, conceptual, acceptance, and feasibility issues. In total, 37% (n=350) of the patients enrolled in step 1 completed the entire 4-Step counselling process, with each step taking 8-22 minutes. 50% of ratings (n=303) improved by one or two categories in the three-colour circle, and the proportion of favourable health behaviour ratings increased from 9% to 39%. The ratings for motivation, concept, acceptance, and feasibility of the "Health Coaching" programme were consistently high. Our innovative, patient-centred counselling programme for health behaviour change was well accepted and feasible among patients and physicians in a primary care setting. Randomised controlled studies will have to establish cost-effectiveness and promote dissemination.

Changes in performance: a 5-year longitudinal study of participants in a multi-source feedback programme.

PubMed

Violato, Claudio; Lockyer, Jocelyn M; Fidler, Herta

2008-10-01

Multi-source feedback (MSF) enables performance data to be provided to doctors from patients, co-workers and medical colleagues. This study examined the evidence for the validity of MSF instruments for general practice, investigated changes in performance for doctors who participated twice, 5 years apart, and determined the association between change in performance and initial assessment and socio-demographic characteristics. Data for 250 doctors included three datasets per doctor from, respectively, 25 patients, eight co-workers and eight medical colleagues, collected on two occasions. There was high internal consistency (alpha > 0.90) and adequate generalisability (Ep(2) > 0.70). D study results indicate adequate generalisability coefficients for groups of eight assessors (medical colleagues, co-workers) and 25 patient surveys. Confirmatory factor analyses provided evidence for the validity of factors that were theoretically expected, meaningful and cohesive. Comparative fit indices were 0.91 for medical colleague data, 0.87 for co-worker data and 0.81 for patient data. Paired t-test analysis showed significant change between the two assessments from medical colleagues and co-workers, but not between the two patient surveys. Multiple linear regressions explained 2.1% of the variance at time 2 for medical colleagues, 21.4% of the variance for co-workers and 16.35% of the variance for patient assessments, with professionalism a key variable in all regressions. There is evidence for the construct validity of the instruments and for their stability over time. Upward changes in performance will occur, although their effect size is likely to be small to moderate.

Middle and late Badenian palaeoenvironments in the northern Vienna Basin and their potential link to the Badenian Salinity Crisis

NASA Astrophysics Data System (ADS)

Harzhauser, Mathias; Grunert, Patrick; Mandic, Oleg; Lukeneder, Petra; Gallardo, Ángela García; Neubauer, Thomas A.; Carnevale, Giorgio; Landau, Bernard M.; Sauer, Roman; Strauss, Philipp

2018-04-01

Hydrocarbon exploration in the Bernhardsthal and Bernhardsthal-Sued oil fields documents an up to 2000 m thick succession of middle and upper Badenian deposits in this part of the northern Vienna Basin (Austria). Based on palaeontological analyses of core-samples, well-log data and seismic surveys we propose an integrated stratigraphy and describe the depositional environments. As the middle/late Badenian boundary is correlated with the Langhian/Serravallian boundary, the cores capture the crucial phase of the Middle Miocene Climate Transition. The middle Badenian starts with a major transgression leading to outer neritic to upper bathyal conditions in the northern Vienna Basin, indicated by Bathysiphon-assemblages and glass-sponges. A strong palaeo-relief and rapid synsedimentary subsidence accentuated sedimentation during this phase. The middle/late Badenian boundary coincides with a major drop of relative sea level by about 200 m, resulting in a rapid shift from deeper marine depositional environments to coastal and freshwater swamps. In coeval marine settings, a more than 100 m thick unit of anhydrite-bearing clay formed. This is the first evidence of evaporite precipitation during the Badenian Salinity Crisis in the Vienna Basin. Shallow lagoonal environments with diverse and fully marine mollusc and fish assemblages were established during the subsequent late Badenian re-flooding. In composition, the mollusc fauna differs considerably from older ones and is characterized by the sudden appearance of species with eastern Paratethyan affinities.

Stranded in Vienna: Wilhelm Ebert (1871-1916) (German Title: Gestrandet in Wien: Wilhelm Ebert (1871-1916))

NASA Astrophysics Data System (ADS)

Schnell, Anneliese

2011-08-01

Wilhelm Ebert, born 1871 in Leipzig, did study astronomy for a short time in Geneva and afterwards in Munich where he finished his PhD. He spent most of his scientific life in France, working on problems of latitude determination and celestial mechanics, mostly at the Bureau des Longitudes in Paris. He was member of the Astronomische Gesellschaft. Probably he used some of the regular meetings of the AG to introduce his work to German astronomers - for a rather short time he worked at the observatories of Kiel, Straßburg and Greifswald. In Greifswald he qualified for giving university lectures and he started to collect astronomical instruments to establish an observatory. M. Loewy, at that time director of Paris observatory, asked him to come back to France, first he had a position at Nice Observatory and shortly afterwards in Paris again. In 1909 he decided to live in Vienna, once more he applied for the qualification of giving university lectures; this time the procedure was easy going. He announced quite a lot of courses but nobody knows if they really took place. From February 1915 until his death in November 1916 he stayed in a psychiatric hospital in Vienna suffering from a disease which was uncurable at that time. His wife tried to get some information about his death in 1937. Already at that time he was unknown to the members of Vienna Observatory.

Extraterrestrial vestibular research, a new partial field of medical research into the human vestibular apparatus.

PubMed

Pichler, H J

1967-01-01

The first otologic professorial chair in the world was established by Politzer in Vienna as long ago as 1861. In 1914 an assistant of the 1st Vienna Ear Clinic with Politzer as its head, Barany, was awarded the Nobel Prize for Medicine for his fundamental investigations into the organ of equilibration and for his discovery of the caloric sensitivity of the semicircular canals. Since that time Barany is regarded as the founder of the physiology of the vestibular apparatus. During the period 1959 to 1963 a new conception of fundamental research into the vestibule was demanded and elaborated in Vienna with the postulate that, in all theoretical deliberations and practical experience, one should take into consideration that our experiments into the vestibule do not take place on a static platform but rather on a diversely moving one, namely the surface of the earth. This led to new findings in the field of research into the otolith apparatus. In 1962 it was discovered that the gravitation of the sun at the distance of earth-sun represents a supraliminal stimulus, namely both in the aphelion as well as in the perihelion position of the earth. In 1965 it was suggested in Vienna that a new branch of research into the vestibule should be established on an international level, the so-called extraterrestrial vestibular research. The importance of this new branch of research is discussed for all problems of orientation of human beings in space.

[Different philosophical traditions for knowledge development in nursing sciences].

PubMed

Ballard, Ariane; Khadra, Christelle; Le May, Sylvie; Gendron, Sylvie

2016-03-01

doctoral studies in nursing engage a critical reflections about philosophical traditions inherent to knowledge development. critical realism, hermeneutics, postmodernism and poststructuralism refer to philosophical traditions that are generally less explored in nursing, although they are attracting greater attention. this paper offers an introductory presentation to these traditions as the authors also reflect upon their contribution to nursing knowledge development in. for each tradition, ontological and epistemological properties are presented to provide an overview of their main features. Contributions to nursing knowledge development are then discussed. ontology refers to stratified, fixed and changing, or multiple realities, depending on the philosophical tradition. Likewise, epistemology emphasizes the explanatory power of knowledge, intersubjectivity, or inherent power dynamics. the diversity of philosophical traditions represents an asset that can significantly contribute to the advancement of the nursing discipline. clarification of the philosophical dimensions that underlie knowledge development is essential for doctoral nursing students in the process of developing their research projects and future programmes of research.

Communication behaviours of skilled and less skilled oncologists: a validation study of the Medical Interaction Process System (MIPS).

PubMed

Ford, Sarah; Hall, Angela

2004-09-01

The Medical Interaction Process System (MIPS) was originally developed in order to create a reliable observation tool for analysing doctor-patient encounters in the oncology setting. This paper reports a series of analyses carried out to establish whether the behaviour categories of the MIPS can discriminate between skilled and less skilled communicators. This involved the use of MIPS coded cancer consultations to compare the MIPS indices of 10 clinicians evaluated by an independent professional as skilled communicators with 10 who were considered less skilled. Eleven out of the 15 MIPS variables tested were able to distinguish the skilled from the less skilled group. Although limitations to the study are discussed, the results indicate that the MIPS has satisfactory discriminatory power and the results provide validity data that meet key objectives for developing the system. There is an ever-increasing need for reliable methods of assessing doctors' communication skills and evaluating medical interview teaching programmes. Copyright 2004 Elsevier Ireland Ltd.

Addressing the key communication barriers between microbiology laboratories and clinical units: a qualitative study.

PubMed

Skodvin, Brita; Aase, Karina; Brekken, Anita Løvås; Charani, Esmita; Lindemann, Paul Christoffer; Smith, Ingrid

2017-09-01

Many countries are on the brink of establishing antibiotic stewardship programmes in hospitals nationwide. In a previous study we found that communication between microbiology laboratories and clinical units is a barrier to implementing efficient antibiotic stewardship programmes in Norway. We have now addressed the key communication barriers between microbiology laboratories and clinical units from a laboratory point of view. Qualitative semi-structured interviews were conducted with 18 employees (managers, doctors and technicians) from six diverse Norwegian microbiological laboratories, representing all four regional health authorities. Interviews were recorded and transcribed verbatim. Thematic analysis was applied, identifying emergent themes, subthemes and corresponding descriptions. The main barrier to communication is disruption involving specimen logistics, information on request forms, verbal reporting of test results and information transfer between poorly integrated IT systems. Furthermore, communication is challenged by lack of insight into each other's area of expertise and limited provision of laboratory services, leading to prolonged turnaround time, limited advisory services and restricted opening hours. Communication between microbiology laboratories and clinical units can be improved by a review of testing processes, educational programmes to increase insights into the other's area of expertise, an evaluation of work tasks and expansion of rapid and point-of-care test services. Antibiotic stewardship programmes may serve as a valuable framework to establish these measures. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

Addressing the key communication barriers between microbiology laboratories and clinical units: a qualitative study

PubMed Central

Skodvin, Brita; Aase, Karina; Brekken, Anita Løvås; Charani, Esmita; Lindemann, Paul Christoffer; Smith, Ingrid

2017-01-01

Abstract Background Many countries are on the brink of establishing antibiotic stewardship programmes in hospitals nationwide. In a previous study we found that communication between microbiology laboratories and clinical units is a barrier to implementing efficient antibiotic stewardship programmes in Norway. We have now addressed the key communication barriers between microbiology laboratories and clinical units from a laboratory point of view. Methods Qualitative semi-structured interviews were conducted with 18 employees (managers, doctors and technicians) from six diverse Norwegian microbiological laboratories, representing all four regional health authorities. Interviews were recorded and transcribed verbatim. Thematic analysis was applied, identifying emergent themes, subthemes and corresponding descriptions. Results The main barrier to communication is disruption involving specimen logistics, information on request forms, verbal reporting of test results and information transfer between poorly integrated IT systems. Furthermore, communication is challenged by lack of insight into each other’s area of expertise and limited provision of laboratory services, leading to prolonged turnaround time, limited advisory services and restricted opening hours. Conclusions Communication between microbiology laboratories and clinical units can be improved by a review of testing processes, educational programmes to increase insights into the other’s area of expertise, an evaluation of work tasks and expansion of rapid and point-of-care test services. Antibiotic stewardship programmes may serve as a valuable framework to establish these measures. PMID:28633405

The Lightwave programme and roadshow: an overview and update

NASA Astrophysics Data System (ADS)

Wong, Nicholas H. L.; Posner, Matthew T.; John, Pearl V.

2015-10-01

While optics and photonics are exciting disciplines with much research, industrial, and economic potential in the 21st century, this appreciation is only shared by a limited number of science, technology, engineering, and mathematics (STEM) experts, and there is a recognized STEM skills shortage. To widen the pool of talent, it is essential to expose students to optics and photonics throughout their education and particularly starting at a young age. The Lightwave programme, consisting of an interactive collection of photonics demonstrations and experiments targeted for primary school students, was thus created to facilitate this endeavor. The programme is run by doctoral students forming a team of "Lightwave ambassadors". All the demonstrations that comprise Lightwave can be easily integrated into a physics curriculum, enabling educators to generate more student interest and enhance the image of science through an interactive pedagogy. We provide a description of the programme at its initial inception, and report on the recent additions and updates that have brought about its success, moving from a purely outreach driven focus to engaging pupils with our own research. We also discuss our approach to ensuring that our team of ambassadors are from diverse backgrounds and use both male and female students as role models. Finally, we reflect on how evaluation methods to obtain feedback from our activities are key to Lightwave's sustainability and in improving the perception of optics and photonics.

Examination of anonymous canine faecal samples provides data on endoparasite prevalence rates in dogs for comparative studies.

PubMed

Hinney, Barbara; Gottwald, Michaela; Moser, Jasmine; Reicher, Bianca; Schäfer, Bhavapriya Jasmin; Schaper, Roland; Joachim, Anja; Künzel, Frank

2017-10-15

Several endoparasites of dogs cannot only be detrimental to their primary host but might also represent a threat to human health because of their zoonotic potential. Due to their high dog population densities, metropolitan areas can be highly endemic for such parasites. We aimed to estimate the prevalence of endoparasites in dogs in the Austrian capital of Vienna by examining a representative number of canine faecal samples and to compare the prevalences with two neighbouring peri-urban and rural regions. In addition we analysed whether the density of dog populations and cleanliness of dog zones correlated with parasite occurrence. We collected 1001 anonymous faecal samples from 55 dog zones from all 23 districts of the federal state of Vienna, as well as 480 faecal samples from the Mödling district and Wolkersdorf with a peri-urban and rural character, respectively. Faeces were examined by flotation and by Baermann technique. Additionally we evaluated 292 Viennese, 102 peri-urban and 50 rural samples for Giardia and Cryptosporidium by GiardiaFASTest ® and CryptoFASTest ® . Samples from "clean" dog zones were compared to samples from "dirty" zones. The infection rate of Toxocara was surprisingly low, ranging from 0.6% to 1.9%. Trichuris was the most frequent helminth (1.8-7.5%) and Giardia the most frequent protozoan (4.0-10.8%). Ancylostomatidae, Crenosoma, Capillaria, Taeniidae, Cystoisospora and Sarcocystis were found in 1.8-2.2%, 0-0.9%, 0-0.9%, 0-0.6%, 0.3-3.1% and 0-0.6% of the samples, respectively. Samples from "dirty" dog zones in Vienna showed a significantly higher rate of parasites overall (p=0.003) and of Trichuris (p=0.048) compared to samples from "clean" dog zones. There were no statistically significant differences in densely vs. less densely populated areas of Vienna. Samples from the rural region of Wolkersdorf had significantly higher overall parasite, Trichuris and Cystoisospora prevalences than the peri-urban Mödling district and Vienna (p=0.000-0.039), while samples from the Mödling district had a significantly higher Giardia, Crenosoma and Capillaria prevalence than those from Vienna (p=0.002-0.047). Parasite excretion is dynamic and representative sampling and monitoring are necessary for parasite surveillance. Dog owners should be informed about the zoonotic risk and encouraged to remove dog faeces and dispose of them properly to reduce the infection risk for both other dogs and humans. Copyright © 2017 Elsevier B.V. All rights reserved.

A systematic review of leadership training for medical students.

PubMed

Lyons, Oscar; Su'a, Bruce; Locke, Michelle; Hill, Andrew

2018-01-19

Leadership is increasingly being recognised as an essential requirement for doctors. Many medical schools are in the process of developing formal leadership training programmes, but it remains to be elucidated what characteristics make such programmes effective, and to what extent current programmes are effective, beyond merely positive learner reactions. This review's objective was to investigate the effectiveness of undergraduate medical leadership curricula and to explore common features of effective curricula. A systematic literature search was conducted. Articles describing and evaluating undergraduate medical leadership curricula were included. Outcomes were stratified and analysed according to a modified Kirkpatrick's model for evaluating educational outcomes. Eleven studies met inclusion criteria. Leadership curricula evaluated were markedly heterogeneous in their duration and composition. The majority of studies utilised pre- and post- intervention questionnaires for evaluation. Two studies described randomised controlled trials with objective measures. Outcomes were broadly positive. Only one study reported neutral outcomes. A wide range of leadership curricula have shown subjective effectiveness, including short interventions. There is limited objective evidence however, and few studies have measured effectiveness at the system and patient levels. Further research is needed investigating objective and downstream outcomes, and use of standard frameworks for evaluation will facilitate effective comparison of initiatives.

Prescribing and formulating neonatal intravenous feeding solutions by microcomputer.

PubMed Central

MacMahon, P

1984-01-01

This paper describes a computer programme for a low cost microcomputer designed to assist in the task of administering total parenteral nutrition to neonates: no knowledge of computers is necessary to operate the system. The programme displays recommended values for each of the total parenteral nutrition constituents that must be prescribed, based on detailed analysis of all the pertinent variables. The recommended values may be rejected but they do provide a useful prompt, especially for the more junior doctors. The programme includes a number of safeguards that protect against entering potentially dangerous values. As soon as the operator has completed the procedure of entering total parenteral nutrition requirements the calculations necessary to formulate a solution containing these are automatically performed. The print out contains this data plus instructions on the infusion rate and an analysis of the formulation's calorific content. This system makes it easier to vary the quantity of individual total parenteral nutrition constituents and time has been saved which was previously wasted performing laborious calculations. One of the most important contributions has been the virtual elimination of errors in the complex task of prescribing and formulating total parenteral nutrition for sick neonates. PMID:6430246

Clinician-scientist MB/PhD training in the UK: a nationwide survey of medical school policy.

PubMed

Barnett-Vanes, Ashton; Ho, Guiyi; Cox, Timothy M

2015-12-30

This study surveyed all UK medical schools regarding their Bachelor of Medicine (MB), Doctor of Philosophy (PhD) (MB/PhD) training policy in order to map the current training landscape and to provide evidence for further research and policy development. Deans of all UK medical schools registered with the Medical Schools Council were invited to participate in this survey electronically. The number of medical schools that operate institutional MB/PhD programmes or permit self-directed student PhD intercalation. Medical school recruitment procedures and attitudes to policy guidance. 27 of 33 (81%) registered UK medical schools responded. Four (14%) offer an institutional MB/PhD programme. However, of those without institutional programmes, 17 (73%) permit study interruption and PhD intercalation: two do not (one of whom had discontinued their programme in 2013), three were unsure and one failed to answer the question. Regarding student eligibility, respondents cited high academic achievement in medical studies and a bachelor's or master's degree. Of the Medical schools without institutional MB/PhD programmes, 5 (21%) have intentions to establish a programme, 8 (34%) do not and 3 were unsure, seven did not answer. 19 medical schools (70%) considered national guidelines are needed for future MB/PhD programme development. We report the first national survey of MB/PhD training in the UK. Four medical schools have operational institutional MB/PhD programmes, with a further five intending to establish one. Most medical schools permit study interruption and PhD intercalation. The total number MB/PhD students yet to graduate from medical school could exceed 150, with 30 graduating per year. A majority of medical school respondents to this survey believe national guidelines are required for MB/PhD programme development and implementation. Further research should focus on the MB/PhD student experience. Discussion regarding local and national MB/PhD policies between medical schools and academic stakeholders are needed. 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/

[Uprising in the faculty. On the rhetorical function of 'therapeutic nihilism' in traditional medicine in Vienna].

PubMed

Wiesemann, C

1993-01-01

It has been a long tradition to quote from Joseph Dietl's 'manifesto' of therapeutic nihilism from 1845 to illustrate the perils of medical extremism. But Dietl's claim for medicine as a natural science cannot fully be understood without considering the social and political circumstances the developing New Vienna School had to face. The professionalization of Viennese academic medicine was opposed by the forces of restaurative absolutism and, in particular, the traditional preponderance of medical practitioners who played a major role in the medical faculty.

[From Comte to Carnap. Marcel Boll and the introduction of the Vienna Circle in France].

PubMed

Schöttler, Peter

2015-01-01

The issue of the introduction of viennese "scientific philosophy" in France appears to be resolved. However, the rediscovery of the positivist physicist Marcel Boll (1886-1971), who was the first-well before Louis Rougier-to draw the French public's attention to the works of Schlick, Frank, and Carnap, obliges us to rethink the passage from traditional positivism to neo-positivism during the 1920s and 1930s. The French reception of the Vienna circle can be dated earlier than accepted and is more profound than usualy assumed.

Proceedings of the European ISTVS Conference (6th) , OVK Symposium (4th), On ’Off Road Vehicles in Theory and Practice’ , Held at Vienna, Austria on 28-30 September 1994 in Vienna, Austria. Volume 1.

DTIC Science & Technology

1994-09-30

The Commander-in-Chief of the British troops, General Sir Peter de la Billiere, reported that each vehicle of the Tenth Transport Regiment covered 400...Simulation des Reifenprofileinflusses fuir die Gelaindebeweglichkeit von Fahrzeugen C. W. FERVERS IKK-University of German Armed Forces Hamburg, Germany...of the Process) 731 Experimentelle und theoretische Analyse kohaisiven Erdreichs beim Verschiebevorgang (Optimierung des Vorganges) A. JARZEBOWSKI, J

Experiences of a commercial weight-loss programme after primary care referral: a qualitative study.

PubMed

Allen, Jodie T; Cohn, Simon R; Ahern, Amy L

2015-04-01

Referral to a commercial weight-loss programme is a cost-effective intervention that is already used within the NHS. Qualitative research suggests this community-based, non-medical intervention accords with participants' view of weight management as a lifestyle issue. To examine the ways in which participants' attitudes and beliefs about accessing a commercial weight management programme via their doctor relate to their weight-loss experience, and to understand how these contextual factors influence motivation and adherence to the intervention. A qualitative study embedded in a randomised controlled trial evaluating primary care referral to a commercial weight-loss programme in adults who are overweight or obese in England. The study took place from June-September 2013. Twenty-nine participants (body mass index [BMI] ≥28 kg/m(2); age ≥18 years), who took part in the WRAP (Weight Loss Referrals for Adults in Primary Care) trial, were recruited at their 3-month assessment appointment to participate in a semi-structured interview about their experience of the intervention and weight management more generally. Interviews were audiorecorded, transcribed verbatim, and analysed inductively using a narrative approach. Although participants view the lifestyle-based, non-medical commercial programme as an appropriate intervention for weight management, the referral from the GP and subsequent clinical assessments frame their experience of the intervention as medically pertinent with clear health benefits. Referral by the GP and follow-up assessment appointments were integral to participant experiences of the intervention, and could be adapted for use in general practice potentially to augment treatment effects. © British Journal of General Practice 2015.

A systematic review of training programmes for recruiters to randomised controlled trials.

PubMed

Townsend, Daisy; Mills, Nicola; Savović, Jelena; Donovan, Jenny L

2015-09-28

Recruitment to randomised controlled trials (RCTs) is often difficult. Clinician related factors have been implicated as important reasons for low rates of recruitment. Clinicians (doctors and other health professionals) can experience discomfort with some underlying principles of RCTs and experience difficulties in conveying them positively to potential trial participants. Recruiter training has been suggested to address identified problems but a synthesis of this research is lacking. The aim of our study was to systematically review the available evidence on training interventions for recruiters to randomised trials. Studies that evaluated training programmes for trial recruiters were included. Those that provided only general communication training not linked to RCT recruitment were excluded. Data extraction and quality assessment were completed by two reviewers independently, with a third author where necessary. Seventeen studies of 9615 potentially eligible titles and abstracts were included in the review: three randomised controlled studies, two non-randomised controlled studies, nine uncontrolled pre-test/post-test studies, two qualitative studies, and a post-training questionnaire survey. Most studies were of moderate or weak quality. Training programmes were mostly set within cancer trials, and usually consisted of workshops with a mix of health professionals over one or two consecutive days covering generic and trial specific issues. Recruiter training programmes were well received and some increased recruiters' self-confidence in communicating key RCT concepts to patients. There was, however, little evidence that this training increased actual recruitment rates or patient understanding, satisfaction, or levels of informed consent. There is a need to develop recruiter training programmes that can lead to improved recruitment and informed consent in randomised trials.

Why a carefully designed, nurse-led intervention failed to meet expectations: the case of the Care Programme for Palliative Radiotherapy.

PubMed

Vahedi Nikbakht-Van de Sande, C V M; Braat, C; Visser, A Ph; Delnoij, D M J; van Staa, A L

2014-04-01

Implement and evaluate the Care Programme for Palliative Radiotherapy (CPPR) in the Outpatient Clinic of the Department of Radiotherapy, Erasmus MC-Cancer Institute, Rotterdam, The Netherlands. Participatory Action Research (PAR). Qualitative descriptive design: participatory observations, semi-structured interviews with patients and professionals and focus groups with professionals; content analysis of documents. Patients with impending paraplegia due to metastatic spinal cord compression, nurse practitioners (NPs), nurse manager, staff and ward nurses, radiographers, radiotherapists and medical doctors. After a shift from inpatient to outpatient radiotherapy treatment, patients and healthcare professionals perceived shortcomings in the oncological chain care. The CPPR was developed in a participative way giving a key role to the NP. Evaluation after implementation of the programme showed that patients and professionals were predominantly positive about its effects. However, implementation was not sustained due to lack of institutional and managerial support. The technological innovation far preceded the organisational changes needed to provide innovative, patient-centred care. Implementing this programme with a central role for the NP was seen as the solution to the problems identified. However, in spite of the systematic approach using PAR, the programme was not successful in bringing about sustained improvements. NPs fulfil a valuable role in the care and support of patients with palliative care needs but need institutional support. More attention should have paid to the organisational context. Involve all relevant actors; use a participatory approach to enhance commitment; ensure the support of management during the whole project. Copyright © 2013 Elsevier Ltd. All rights reserved.

An Irish Experience in Establishing and Evaluating an Intern Led Teaching Programme.

PubMed

Jenkinson, A; Kelleher, E; Moneley, D; Offiah, G

2017-03-10

Near-Peer Teaching is a relatively new and expanding area of medical education. The benefit to medical students has been demonstrated in numerous contexts around the world. Our aim was to establish a structured Intern-Led Teaching (ILT) programme in the context of an Irish Intern Training Network affiliated to an Irish Medical School. We then sought to evaluate the success of this programme. Seventy interns were enrolled in the ILT programme and completed a Train the Trainer course involving teaching methods and skills of effective feedback. Following this, the intern tutors delivered several one-hour teaching sessions in small groups to final year medical students on a weekly basis. At the end of each teaching block, a feedback questionnaire was distributed to participating students to evaluate their experiences of this new teaching modality. Tutorial topics were varied. They included clinical examination, history taking, prescribing, and emergencies. Eighty-one percent of students found the intern-led tutorials to be beneficial compared to tutorials run by more senior doctors. Additionally, students felt that with intern led tutorials they could ask questions they otherwise would not. There was a more comfortable environment, and information taught was considered more relevant. A significant number of students felt less nervous about the final medical examinations after the intern-led tutorials. The establishment of a structured intern-led teaching programme was well received by final year medical students. This project shows that interns are a valuable teaching resource in the medical school and should be included in medical schools' curricula.

Health literacy in a community with low levels of education: findings from Chakaria, a rural area of Bangladesh.

PubMed

Das, Susmita; Mia, Mohammad Nahid; Hanifi, Syed Manzoor Ahmed; Hoque, Shahidul; Bhuiya, Abbas

2017-02-16

Health literacy (HL) helps individuals to make effective use of available health services. In low-income countries such as Bangladesh, the less than optimum use of services could be due to low levels of HL. Bangladesh's health service delivery is pluralistic with a mix of public, private and informally trained healthcare providers. Emphasis on HL has been inadequate. Thus, it is important to assess the levels of HL and service utilization patterns. The findings from this study aim to bridge the knowledge gap. The data for this study came from a cross-sectional survey carried out in September 2014, in Chakaria, a rural area in Bangladesh. A total of 1500 respondents were randomly selected from the population of 80,000 living in the Chakaria study area of icddr, b (International Centre for Diarrhoeal Disease Research, Bangladesh). HL was assessed in terms of knowledge of existing health facilities and sources of information on health care, immunization, diabetes and hypertension. Descriptive and cross-tabular analyses were carried out. Chambers of the rural practitioners of allopathic medicine, commonly known as 'village doctors', were mentioned by 86% of the respondents as a known health service facility in their area, followed by two public sector community clinics (54.6%) and Union Health and Family Welfare Centres (28.6%). Major sources of information on childhood immunization were government health workers. Almost all of the respondents had heard about diabetes and hypertension (97.4% and 95.4%, respectively). The top three sources of information for diabetes were neighbours (85.7%), followed by relatives (27.9%) and MBBS (Bachelor of Medicine and Bachelor of Surgery) doctors (20.4%). For hypertension, the sources were neighbours (78.0%), followed by village doctors (38.2%), MBBS doctors (23.2%) and relatives (15%). The proportions of respondents who knew diabetes and hypertension control measures were 40.9% and 28.0%, respectively. More females knew about the control of diabetes (44.4% to 36.6%) and hypertension (31.1% to 24.2%) than males. A low level of HL in terms of modern health service facilities, diabetes and hypertension clearly indicated the need for a systematic HL programme. The relatively high levels of literacy concerning immunization show that it is possible to enhance HL in areas with low levels of education through systematic awareness-raising programmes, which could result in higher service coverage.

Graduates from vertically integrated curricula.

PubMed

Wijnen-Meijer, Marjo; ten Cate, Olle; van der Schaaf, Marieke; Harendza, Sigrid

2013-06-01

  Vertical integration (VI) has been recommended as an undergraduate medical curriculum structure that fosters the transition to postgraduate training. Our definition of VI includes: (1) the provision of early clinical experience; (2) the integration of biomedical sciences with clinical cases; (3) long clerkships during the final year; and (4) increasing levels of clinical responsibility for students. The aim of the current study is to support the hypothesis that medical graduates from VI programmes meet the expectations of postgraduate supervisors better than those from non-VI curricula.   A questionnaire study was carried out among supervisors of postgraduate training programmes run at Utrecht (the Netherlands, VI; n = 128) and Hamburg (Germany, non-VI; n = 114). The supervisors were asked about their medical graduates' preparedness for work, knowledge and capabilities to manage some specific parts of the work as a doctor. They evaluated their performances on a five-point Likert scale.   The two groups of supervisors did not differ in their judgment of their graduates' preparedness for work and level of knowledge. However, supervisors in Utrecht evaluated their graduates higher with respect to capability to work independently, solving medical problems, managing unfamiliar medical situations, prioritising tasks, collaborating with other people, estimating when they need to consult their supervisors and reflecting on their activities.   Graduates from VI medical curricula appeared to be more capable in several facets of a doctor's job. Research into the actual performance of graduates from VI and non-VI curricula is needed to further support a firm recommendation for VI curricula. © 2013 John Wiley & Sons Ltd.

What shape do UK trainees want their training to be? Results of a cross-sectional study

PubMed Central

Harries, Rhiannon L; Rashid, Mustafa; Smitham, Peter; Vesey, Alex; McGregor, Richard; Scheeres, Karl; Bailey, Jon; Sohaib, Syed Mohammed Afzal; Prior, Matthew; Frost, Jonathan; Al-Deeb, Walid; Kugathasan, Gana; Gokani, Vimal J

2016-01-01

Objectives The British Government is acting on recommendations to overhaul postgraduate training to meet the needs of the changing population, to produce generalist doctors undergoing shorter broad-based training (Greenaway Review). Only 45 doctors in training were involved in the consultation process. This study aims to obtain a focused perspective on the proposed reforms by doctors in training from across specialities. Design Prospective, questionnaire-based cross-sectional study. Setting/participants Following validation, a 31-item electronic questionnaire was distributed via trainee organisations and Postgraduate Local Education and Training Board (LETB) mailing lists. Throughout the 10-week study period, the survey was publicised on several social media platforms. Results Of the 3603 demographically representative respondents, 69% knew about proposed changes. Of the respondents, 73% expressed a desire to specialise, with 54% keen to provide general emergency cover. A small proportion (12%) stated that current training pathway length is too long, although 86% felt that it is impossible to achieve independent practitioner-level proficiency in a shorter period of time than is currently required. Opinions regarding credentialing were mixed, but tended towards disagreement. The vast majority (97%) felt credentialing should not be funded by doctors in training. Respondents preferred longer placement lengths with increasing career progression. Doctors in training value early generalised training (65%), with suggestions for further improvement. Conclusions This is the first large-scale cross-specialty study regarding the Shape of Training Review. Although there are recommendations which trainees support, it is clear that one size does not fit all. Most trainees are keen to provide a specialist service on an emergency generalist background. Credentialing is a contentious issue; however, we believe removing aspects from curricula into post-Certificate of Completion of Training (CCT) credentialing programmes with shortened specialty training routes only degrades the current consultant expertise, and does not serve the population. Educational needs, not political winds, should drive changes in postgraduate medical education and all stakeholders should be involved. PMID:27855084

Everyday ethics in internal medicine resident clinic: an opportunity to teach.

PubMed

Carrese, Joseph A; McDonald, Erin L; Moon, Margaret; Taylor, Holly A; Khaira, Kiran; Catherine Beach, Mary; Hughes, Mark T

2011-07-01

Being a good doctor requires competency in ethics. Accordingly, ethics education during residency training is important. We studied the everyday ethics-related issues (i.e. ordinary ethics issues commonly faced) that internal medical residents encounter in their out-patient clinic and determined whether teaching about these issues occurred during faculty preceptor-resident interactions. This study involved a multi-method qualitative research design combining observation of preceptor-resident discussions with preceptor interviews. The study was conducted in two different internal medicine training programme clinics over a 2-week period in June 2007. Fifty-three residents and 19 preceptors were observed, and 10 preceptors were interviewed. Transcripts of observer field notes and faculty interviews were carefully analysed. The analysis identified several themes of everyday ethics issues and determined whether preceptors identified and taught about these issues. Everyday ethics content was considered present in 109 (81%) of the 135 observed case presentations. Three major thematic domains and associated sub-themes related to everyday ethics issues were identified, concerning: (i) the Doctor-Patient Interaction (relationships; communication; shared decision making); (ii) the Resident as Learner (developmental issues; challenges and conflicts associated with training; relationships with colleagues and mentors; interactions with the preceptor), and; (iii) the Doctor-System Interaction (financial issues; doctor-system issues; external influences; doctor frustration related to system issues). Everyday ethics issues were explicitly identified by preceptors (without teaching) in 18 of 109 cases (17%); explicit identification and teaching occurred in only 13 cases (12%). In this study a variety of everyday ethics issues were frequently encountered as residents cared for patients. Yet, faculty preceptors infrequently explicitly identified or taught these issues during their interactions with residents. Ethics education is important and residents may regard teaching about the ethics-related issues they actually encounter to be highly relevant. A better understanding of the barriers to teaching is needed in order to promote education about everyday ethics in the out-patient setting. © Blackwell Publishing Ltd 2011.

Closing the theory to practice gap for newly qualified doctors: evaluation of a peer-delivered practical skills training course for newly qualified doctors in preparation for clinical practice.

PubMed

Beane, A; Padeniya, A; De Silva, A P; Stephens, T; De Alwis, S; Mahipala, P G; Sigera, P C; Munasinghe, S; Weeratunga, P; Ranasinghe, D; Deshani, E M; Weerasinghe, T; Thilakasiri, K; Jayasinghe, Kas; Dondorp, A M; Haniffa, R

2017-10-01

The Good Intern Programme (GIP) in Sri Lanka has been implemented to bridge the 'theory to practice gap' of doctors preparing for their internship. This paper evaluates the impact of a 2-day peer-delivered Acute Care Skills Training (ACST) course as part of the GIP. The ACST course was developed by an interprofessional faculty, including newly graduated doctors awaiting internship (pre-intern), focusing on the recognition and management of common medical and surgical emergencies. Course delivery was entirely by pre-intern doctors to their peers. Knowledge was evaluated by a pre- and post-course multiple choice test. Participants' confidence (post-course) and 12 acute care skills (pre- and post-course) were assessed using Likert scale-based questions. A subset of participants provided feedback on the peer learning experience. Seventeen courses were delivered by a faculty consisting of eight peer trainers over 4 months, training 320 participants. The mean (SD) multiple choice questionnaire score was 71.03 (13.19) pre-course compared with 77.98 (7.7) post-course (p<0.05). Increased overall confidence in managing ward emergencies was reported by 97.2% (n=283) of respondents. Participants rated their post-course skills to be significantly higher (p<0.05) than pre-course in all 12 assessed skills. Extended feedback on the peer learning experience was overwhelmingly positive and 96.5% would recommend the course to a colleague. A peer-delivered ACST course was extremely well received and can improve newly qualified medical graduates' knowledge, skills and confidence in managing medical and surgical emergencies. This peer-based model may have utility beyond pre-interns and beyond Sri Lanka. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

What do UK doctors in training value in a post? A discrete choice experiment.

PubMed

Cleland, Jennifer; Johnston, Peter; Watson, Verity; Krucien, Nicolas; Skåtun, Diane

2016-02-01

Many individual and job-related factors are known to influence medical careers decision making. Medical trainees' (residents) views of which characteristics of a training post are important to them have been extensively studied but how they trade-off these characteristics is under-researched. Such information is crucial for the development of effective policies to enhance recruitment and retention. Our aim was to investigate the strength of UK foundation doctors' and trainees' preferences for training post characteristics in terms of monetary value. We used an online questionnaire study incorporating a discrete choice experiment (DCE), distributed to foundation programme doctors and doctors in training across all specialty groups within three UK regions, in August-October 2013. The main outcome measures were monetary values for training-post characteristics, based on willingness to forgo and willingness to accept extra income for a change in each job characteristic, calculated from regression coefficients. The questionnaire was answered by 1323 trainees. Good working conditions were the most influential characteristics of a training position. Trainee doctors would need to be compensated by an additional 49.8% above the average earnings within their specialty to move from a post with good working conditions to one with poor working conditions. A training post with limited rather than good opportunities for one's spouse or partner would require compensation of 38.4% above the average earnings within their specialty. Trainees would require compensation of 30.8% above the average earnings within their specialty to move from a desirable to a less desirable locality. These preferences varied only to a limited extent according to individual characteristics. Trainees place most value on good working conditions, good opportunities for their partners and desirable geographical location when making career-related decisions. This intelligence can be used to develop alternative models of workforce planning or to develop information about job opportunities that address trainees' values. © 2016 John Wiley & Sons Ltd.

PREFACE: International Conference on the Applications of the Mössbauer Effect (ICAME 2009)

NASA Astrophysics Data System (ADS)

Müller, Herbert; Reissner, Michael; Steiner, Walter; Wiesinger, Günter

2010-04-01

The International Conference on the Applications of the Mössbauer Effect (ICAME2009) was held for the first time in Austria, at the Vienna University of Technology on 19-24 July 2009. This largest conference of the Mössbauer community attracted much interest, nearly 500 colleagues announced their intention to participate. Unfortunately, due to the world-wide finance crisis, in the end many could not manage to come. Nevertheless 380 abstracts were submitted. More than 300 participants from 38 countries were present at the conference. The programme contained 20 invited talks, selected by the international advisory board. 49 contributions were selected for oral presentation. Following the advice of the IBAME board, no parallel sessions were organized. Therefore most of the work was presented as posters, attached for the whole week, giving thus the opportunity for intense discussions outside of the poster sessions. A special tutorial session, dedicated to Mössbauer spectroscopy with synchrotron radiation, organized by R Rüffer was held on the first day. It was included in the conference programme giving all participants the opportunity to attend this meeting. Although lasting until late in the evening, the audience was always well occupied. New developments in the field of iron-containing superconductors were discussed in a micro symposium. The scientific level of the whole conference was high. After thorough peer-reviewing, 147 papers were accepted by the referees and are presented in this volume. ICAME2009 was possible due to the efforts of many people, in the organizing committee, the programme committee and the editorial board and to the students who took care of the participants during the conference and all social activities. ICAME2009 was in several ways a special conference. It was the 30th in the series of ICAME meetings, and the first after the celebration of 50 years of the Mössbauer Effect. In 2009 Rudolf Mössbauer also celebrated his 80th birthday. The positive atmosphere, the high attendance in the sessions and the lively discussions made the conference a great success and a memorable event. It was pointed out, that Mössbauer spectroscopy is still an interesting and powerful method with great opportunities in the future. Herbert Müller (Secretary) Michael Reissner (Chairman) This book is dedicated to our colleagues Nicol Malcom, who could not come, because he suddenly died a few weeks in advance to the conference and Hercilio Rechenberg, who died on his way home from Vienna. Conference photograph Conference Organisation Local Organizing Committee Reissner Michael (Chairman)Müller Herbert (Conference Secretary) Amthauer Georg Lottermoser WernerSteiner Walter Bauer Ernst Michor Herwig Vogl Gero Bühler-Paschen Silke Müller Martin Waas Monika Grodzicki Michael Redhammer Günther Wiesinger Günter Grössinger Roland Sassik Herbert Hilscher Gerfried Sepiol Bogdan International Programme Committee Amthauer Georg Gütlich Philipp Steiner Walter Baggio-Saitovich Elisa Litterst Fred Jochen Trautwein Alfred Xaver Berry Frank Long Gary Vogl Gero Felner Israel Nagy Denes Lajos Yoshida Yutaka Greneche Jean-Marc Rüffer Rudolf International Advisory Board Alp E ErcanGénin Jean-Marie Baggio-Saitovitch Elisa Greneche Jean-Marc Miglierini Marcel Balogh Judit Grodzicki Michael Musić Svetozar Bender Koch Christian Gütlich Philipp Nagy Dénes Lajos Berry Frank Häggström Lennart Nishida Tetsuaki Brown Dennis Hanzel Darko Pérez Alcázar German Campbell Stewart Hassaan Mohamed Yousri Rüffer Rudolf Carbucicchio Massimo Jumas Jean-Claude Ryan Dominic H Croci Simonetta Kadyrzhanov Kariat Sanchez Francisco Di Naili Katila Toivo Schünemann Volker Elzain Mohamed Kim Chul Sung Stanek Jan Fabris José Domingos Klingelhöfer Göstar Stevens John Felner Israel Langouche Guido Suzdalev Igor P Fern George R Lyubutin Igor S Szymanski Krzysztof Forder Sue D Marco Jose F Waanders Frans Gajbhiye Nandeo Mašlaň Miroslav Yoshida Yutaka

Isochron burial dating of the Haslau terrace of the Danube (Vienna Basin) and interlaboratory comparison of sample preparation in Vienna and Budapest

NASA Astrophysics Data System (ADS)

Ruszkiczay-Rüdiger, Zsófia; Neuhuber, Stephanie; Decker, Kurt; Braucher, Régis; Fiebig, Marcus; Braun, Mihály; Lachner, Johannes; Aster Team

2017-04-01

In the Vienna Basin, terraces to the South of the Danube form a staircase with altitudes ranging between 25 and 130 m above current water level. The terrace system has been strongly dissected by faults related to the sinistral movement of the Vienna Basin Transform Fault System [1, 2]. Although each fault block displays a slightly different succession of terraces, fault-related vertical displacements south of the Danube have not yet been quantified. To better understand the Quaternary terrace sequence and its displacement along a fault segment south of the Danube, the isochron burial dating method [3] based on the 26Al and 10Be cosmogenic nuclide pair has been used on a terrace at Haslau an der Donau (˜40 m above river level). This terrace is locally the lowest of a staircase of a total of 6 different levels. Based on geomorphological mapping, its age was considered to be Middle Pleistocene [4]. The sample set consisted of several quartzite cobbles taken from two sedimentary units (5.5 m and 11.8 m depth) separated by an erosional hiatus of unknown duration. Six cobbles were selected for inter-laboratory comparison and processed at both the Cosmogenic Nuclide Sample Preparation Laboratory at Vienna and at Budapest [5]. AMS measurements were performed at the French national facility ASTER (CEREGE, Aix-en-Provence) and at the Vienna Environmental Research Accelerator (VERA). Initially, the obtained results show that the 10Be and 26Al concentrations calculated from the subsamples processed independently using different extraction schemes at both laboratories overlap within error for all subsamples but one, whose 26Al concentrations were significantly different. The low 26Al concentration measured in one Budapest sample probably resulted from Al having been trapped within the insoluble residues observed after evaporation to dryness. A modification of the sample processing allows overcoming this difficulty while treating for the following sample set. The results demonstrate that the laboratory background is safe for in-situ produced cosmogenic 10Be and 26Al extraction at both Vienna and Budapest laboratories and that the different geochemical digestion and purification schemes applied by the two laboratories for the extraction of 10Be and 26Al lead to similar results. A preliminary (not corrected) isochron burial age of ˜2.4 Ma was calculated for the higher sedimentary unit of the Haslau terrace on the basis of the slope of the isochron. This age is significantly older than the Middle Pleistocene age previously estimated. Further age determinations are nevertheless necessary to decide whether this preliminary age is accurate or not. Thanks to OTKA PD83610, OMAA 90öu17; LP2012-27/2012. INSU/CNRS, the ANR through the program "EQUIPEX Investissement d'Avenir" and IRD. References: [1] Decker et al., 2005. QSR 24, 307-322. [2] Salcher et al., 2012. Tectonics 31, 1-20. [3] Balco and Rovey, 2008. AJS 908, 1083-1114 [4] Fuchs and Grill, 1984. Geologische Karte von Wien und Umgebung (1:200.000) [5] http://www.geochem.hu/kozmogen/Lab_en.html

Water: from the source to the treatment plan

NASA Astrophysics Data System (ADS)

Baude, I.; Marquet, V.

2012-04-01

Isabelle BAUDE isa.baude@free.fr Lycee français de Vienne Liechtensteinstrasse 37AVienna As a physics and chemistry teacher, I have worked on water from the source to the treatment plant with 27 pupils between 14 and 15 years old enrolled in the option "Science and laboratory". The objectives of this option are to interest students in science, to introduce them to practical methods of laboratory analyses, and let them use computer technology. Teaching takes place every two weeks and lasts 1.5 hours. The theme of water is a common project with the biology and geology teacher, Mrs. Virginie Marquet. Lesson 1: Introduction: The water in Vienna The pupils have to consider why the water is so important in Vienna (history, economy etc.) and where tap water comes from. Activities: Brainstorming about where and why we use water every day and why the water is different in Vienna. Lesson 2: Objectives of the session: What are the differences between mineral waters? Activities: Compare water from different origins (France: Evian, Vittel, Contrex. Austria: Vöslauer, Juvina, Gasteiner and tap water from Vienna) by tasting and finding the main ions they contain. Testing ions: Calcium, magnesium, sulphate, chloride, sodium, and potassium Lesson 3: Objectives of the session: Build a hydrometer Activities: Producing a range of calibration solutions, build and calibrate the hydrometer with different salt-water solutions. Measure the density of the Dead Sea's water and other mineral waters. Lesson 4: Objectives of the session: How does a fountain work? Activities: Construction of a fountain as Heron of Alexandria with simple equipment and try to understand the hydrostatic principles. Lesson 5: Objectives of the session: Study of the physical processes of water treatment (decantation, filtration, screening) Activities: Build a natural filter with sand, stone, carbon, and cotton wool. Retrieve the filtered water to test it during lesson 7. Lesson 6: Visit of the biggest treatment plant of Europe in Vienna. Lesson 7: Objectives of the session: Water Quality Monitoring: Biochemical Oxygen Demand (chemical analysis) in common with my colleague.

A comparison of large 18th-century floods on Danube: Vienna - Bratislava - Budapest

NASA Astrophysics Data System (ADS)

Kiss, Andrea; Parajka, Juraj

2013-04-01

The documentation of historic floods can help in better understanding of factors that might cause and contribute to large and extreme flood events. In particular, the analysis of historic floods provides information about flood seasonality, its changes and anthropogenic impacts on river flood regime which in some cases strongly influenced flood behaviour. The main objective of the present contribution is to document large and medium size flood events on Danube in Vienna, Bratislava and Budapest in the 18th century. In the present study, based on contemporary documentary evidence, for each of the three towns a five-scaled flood index series is developed to describe the magnitude and intensity of flood events. According to this classification, the 100-year flood event was characterised by the index value 5, while great destructive floods - depending on their extension, destructivity and further impacts - received the values 4 and 3, respectively. Less significant but still harmful flood events were classified as No. 2, and floods without further specification remained in the lowest category (No. 1). Beside classification issues, seasonality and flood frequency differences between the three towns are as well discussed. The results indicate that a greater number of flood events took place in the last decades of the century, but only a few flood events of the same magnitude are documented simultaneously in all three towns. And whereas in 1775 no winter flood event was reported in Vienna, an important ice jam flood was documented in Bratislava, and a catastrophic ice jam flood event, greatest of the century, occurred in Budapest. In 1787 autumn the greatest flood event of the century occurred in Vienna, while hardly any flood waves were observed at Budapest. While in Vienna, summer (and partly autumn) floods had great importance, in Budapest a large number of ice jam floods were documented. In some cases the differences are likely caused by different hydrometeorological and morphological conditions, but the importance of human impact (e.g. different types and levels of flood protection in the towns, large-scale changes of land use in the catchment area) have to be as well emphasised.

Van Swieten and the renaissance of the Vienna Medical School.

PubMed

Kidd, M; Modlin, I M

2001-04-01

The period until 1745 found the Viennese medical system languishing far behind advances made in other major European centers. This chaotic situation was reversed by the foresight and breadth of vision of the Empress Maria Theresa, who initiated considerable reform in Austria by actively recruiting the best minds of the time to reduce the intellectual and technologic differences. Her ability to entice one of Boerhaave's most eminent pupils, Gerard van Swieten, to leave Leiden for Vienna, particularly benefited the Vienna Medical School. In 1745 van Swieten assumed responsibility for reconfiguration of the patronage and nepotism-ridden medical system of the Austro-Hungarian Empire. As a first task, he swiftly expunged the influence of the Jesuits and other religious orders from medicine and established formal training and examinations, transforming the medical discipline into a meritocracy. Excelling as a physician and an innovative teacher, he also established a close personal relationship with the Empress and became her medical confidante. To a large part, the success of this first great Viennese medical school was owed to de Haen, who left Leiden to implement Boerhaave's method of clinical teaching. As a result of these innovations and with considerable support from the Empress, the University of Vienna, particularly its medical school, within a few decades achieved recognition throughout Europe as a seat of learning and scholarship. Van Swieten would not be remembered today if his contribution had been only scholarly or scientific achievements. He propelled Austrian medicine to a level commensurate with that of other European states of the day by 27 years of dedicated and industrious service.

Optimizing antibiotic usage in hospitals: a qualitative study of the perspectives of hospital managers.

PubMed

Broom, A; Gibson, A F; Broom, J; Kirby, E; Yarwood, T; Post, J J

2016-11-01

Antibiotic optimization in hospitals is an increasingly critical priority in the context of proliferating resistance. Despite the emphasis on doctors, optimizing antibiotic use within hospitals requires an understanding of how different stakeholders, including non-prescribers, influence practice and practice change. This study was designed to understand Australian hospital managers' perspectives on antimicrobial resistance, managing antibiotic governance, and negotiating clinical vis-à-vis managerial priorities. Twenty-three managers in three hospitals participated in qualitative semi-structured interviews in Australia in 2014 and 2015. Data were systematically coded and thematically analysed. The findings demonstrate, from a managerial perspective: (1) competing demands that can hinder the prioritization of antibiotic governance; (2) ineffectiveness of audit and monitoring methods that limit rationalization for change; (3) limited clinical education and feedback to doctors; and (4) management-directed change processes are constrained by the perceived absence of a 'culture of accountability' for antimicrobial use amongst doctors. Hospital managers report considerable structural and interprofessional challenges to actualizing antibiotic optimization and governance. These challenges place optimization as a lower priority vis-à-vis other issues that management are confronted with in hospital settings, and emphasize the importance of antimicrobial stewardship (AMS) programmes that engage management in understanding and addressing the barriers to change. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Implications of the Vienna Integrated Model of Art Perception for art-based interventions in clinical populations: Comment on "Move me, astonish me... delight my eyes and brain: The Vienna Integrated Model of top-down and bottom-up processes in Art Perception (VIMAP) and corresponding affective, evaluative, and neurophysiological correlates" by Matthew Pelowski et al.

NASA Astrophysics Data System (ADS)

Taruffi, Liila; Koelsch, Stefan

2017-07-01

Pelowski et al. present a holistic framework within which the multiple processes underlying art viewing can be systematically organized [1]. The proposed model integrates a broad range of dynamic mechanisms, which can effectively account for empirical as well as humanistic perspectives on art perception. Particularly challenging is the final section of the article, where the authors draw a correspondence between behavioral and cognitive components and brain structures (as well as networks). Here, we comment on the implications of the Vienna Integrated Model of Art Perception for art therapy in clinical populations, particularly focusing on (1) expanding Pelowski et al.'s considerations of the Default Mode Network (DMN) into discussion of its relevance to mental diseases, and (2) elaborating on empathic resonance in aesthetic contexts and the capacity of art to build up empathic skills.

Exploring the physical layer frontiers of cellular uplink: The Vienna LTE-A Uplink Simulator.

PubMed

Zöchmann, Erich; Schwarz, Stefan; Pratschner, Stefan; Nagel, Lukas; Lerch, Martin; Rupp, Markus

Communication systems in practice are subject to many technical/technological constraints and restrictions. Multiple input, multiple output (MIMO) processing in current wireless communications, as an example, mostly employs codebook-based pre-coding to save computational complexity at the transmitters and receivers. In such cases, closed form expressions for capacity or bit-error probability are often unattainable; effects of realistic signal processing algorithms on the performance of practical communication systems rather have to be studied in simulation environments. The Vienna LTE-A Uplink Simulator is a 3GPP LTE-A standard compliant MATLAB-based link level simulator that is publicly available under an academic use license, facilitating reproducible evaluations of signal processing algorithms and transceiver designs in wireless communications. This paper reviews research results that have been obtained by means of the Vienna LTE-A Uplink Simulator, highlights the effects of single-carrier frequency-division multiplexing (as the distinguishing feature to LTE-A downlink), extends known link adaptation concepts to uplink transmission, shows the implications of the uplink pilot pattern for gathering channel state information at the receiver and completes with possible future research directions.

Doctor of physical therapy students' attitudes towards people with disabilities: a descriptive study.

PubMed

Yorke, Amy M; Ruediger, Thomas; Voltenburg, Nicole

2017-01-01

Purpose To describe attitudes of doctoral physical therapy (DPT) students towards people with disability and examine predictive ability of demographic variables on those attitudes. Methods Two established surveys, Attitudes Towards Disabled Persons-Form O (ATDP-O) and Disability Attitudes in Health Care (DAHC) were completed by first (Y1) and third year (Y3) students in a DPT programme. Demographics and information about students' contact experience with people with disabilities were collected through a brief questionnaire. Multiple linear regression models were constructed from predictor variables. Results Scores on the ATDP-O and the DAHC were not significantly different between the Y1 and Y3 DPT students. There was a modest correlation (r = 0.342, p < 0.001) between the ATDP-O and the DAHC. Being female and having work contact with people with disabilities both explained about 9% of the variance in the DAHC; while having a close family member explains about 4% of the variance in the ATDP-O. Conclusion Attitudes of DPT students over the course of their education did not change. The DAHC is a more recently developed tool and should continue to be investigated for its usefulness in healthcare professional students. Faculty should consider measuring attitudes and developing specific educational strategies to improve attitudes with the goal to improve patient care. Implications for Rehabilitation Attitudes towards people with disability can impact their health care. Physical therapy students, in general, express positive attitudes towards people with disabilities and no differences in attitudes were determined in a group of Year 1 and Year 3 doctoral physical therapy students. Opportunities exist to intentionally thread educational strategies throughout a professional curriculum to facilitate further development of positive attitudes in doctoral physical therapy students.

Randomised trial of three approaches for marketing smoking cessation programmes to Australian general practitioners.

PubMed

Cockburn, J; Ruth, D; Silagy, C; Dobbin, M; Reid, Y; Scollo, M; Naccarella, L

1992-03-14

To compare three approaches for marketing a quit smoking intervention kit to general practitioners. Randomised trial of (a) personal delivery and presentation by an educational facilitator with a follow up visit six weeks later; (b) delivery to the receptionist by a friendly volunteer courier with a follow up phone call six weeks later, or (c) postal delivery with a follow up letter six weeks later. Melbourne, Australia. 264 randomly selected general practitioners. A research assistant visited each doctor four months after delivery and measured use of components of the kit. A questionnaire measuring perceptions of aspects of the kit and its delivery was completed by doctors. Costs of each approach were calculated. Doctors receiving the educational facilitator approach were significantly more likely than those receiving the other two approaches to have seen the kit, to rate the method of delivery as engendering motivation to try the kit, to have used one of the "intensive intervention" components from the kit, to report that they found the kit less complicated, and to report greater knowledge of how to use the kit. There were no significant differences in use of "minimal intervention" components of the kit, ratings of overall acceptability of delivery, perceptions of cultural and structural barriers to using the kit, and ratings of the overall acceptability of the kit. The cost of the educational facilitator approach ($A142/doctor) was 24 times that of the mailed approach. The volunteer courier approach ($A14) was twice the cost of the mailed approach. Educational facilitators and volunteer couriers do not seem to be cost effective strategies for distributing smoking interventions.

Peer counselling for doctors in Norway: A qualitative study of the relationship between support and surveillance.

PubMed

Isaksson Rø, Karin; Veggeland, Frode; Aasland, Olaf G

2016-08-01

Peer support can entail collegial responsibility for counselling and support as well as reactions to academic or ethical failure. These considerations can be complementary, but also conflicting. This article focuses on how the peer support programme in Norway addresses these considerations. Focus group interviews held with Norwegian peer counsellors from August 2011 to June 2012 were analysed by a stepwise deductive-inductive method. Based on organisational theory, two "ideal types" of counsellors were identified from the data, and these were then used to reanalyse the text. We found that the organisational framework is associated with the peer counsellors' role conception and thereby the relationship between the counsellor and the help-seeking doctor. The relationship between informal frameworks like collegiality, confidence and discretion, and more formalized incentive-driven frameworks, appear to influence the accessibility to peer support, the mandate to provide relevant help and the understanding of what peer support represents. The study showed the need for a continuous awareness of a balance between the informal and the more formalized elements in the framework for peer support. This is of importance for how the service can contribute to better health among doctors and to secure quality and safety in the treatment of patients. The analysis can also be used to demonstrate the consequences of how the peer support program is designed - such as the degree of formalisation and the balance between "hard" and "soft" ways to regulate the interaction between peer counsellors and doctors - for the ability to achieve the stated objectives of the service. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Mary Wakefield: Health Resources and Services Administrator. Interview.

PubMed

Wakefield, Mary

2014-06-01

Dr. Mary Wakefield is the administrator of the Health Resources and Services Administration. She came from the University of North Dakota, where she directed the Center for Rural Health. She has served as director of the Center for Health Policy, Research and Ethics at George Mason University and has worked with the World Health Organization's Global Programme on AIDS in Geneva, Switzerland. She is a fellow in the American Academy of Nursing and was elected to the Institute of Medicine of the National Academies. A native of North Dakota, Wakefield holds a doctoral degree in nursing from the University of Texas.

[Nationwide Evaluation of the "Parental Folder" and its Utility Value--Insights into the Health and Information Behaviour of Parents].

PubMed

Pawils, S; Busche, W; Schwinn, A; Fillinger, U; Koch, U

2015-09-01

The "parental folder" is meant as a primary prevention programme for children starting at birth with the aim to give access to relevant health knowledge to all parents and to strengthen the parental competence in doctor-parent communication. In a sample of N=1,634 families the effects of the folder were examined in a randomized controlled study in the federal states Rhineland-Palatinate and Saxony. In addition N=103 experts were asked for their valuation of the folder. © Georg Thieme Verlag KG Stuttgart · New York.

[Between individuality and "evidence-based medicine"--the role of the general practitioner within the scope of disease management programs].

PubMed

Szecsenyi, Joachim; Schneider, Antonius

2003-06-01

In Germany, the change from the "traditional", experience-based general practitioner (GP) to the evidence-based practising co-ordinator may be accelerated by the introduction of disease management programmes. Here, we will discuss some tools that can help to meet this challenge. Also, a set of requirements will be defined that the health care system will have to provide in support of GPs. Maintaining the relationship between doctor and patient and also allowing for individual care on the basis of evidence-based medicine will remain a challenge.

Evolution of the concept of Capacity-building, results achieved during the past years and the future

NASA Astrophysics Data System (ADS)

Laffaiteur, M.; Camacho, S.

Capacity-building is one of the key elements for the implementation of space applications programmes, particularly in developing countries. As early as 1982, the work programme of the United Nations Programme on Space Applications was expanded in order to promote education and training by organizing seminars, training courses and workshops in various areas, such as astronomy, telecommunications and Earth observation. In the framework of this Programme, the Office for Outer Space Affairs undertook the initiative, at the beginning of the 1990's, aimed at establishing regional centres for space science and technology education, affiliated to the United Nations and located in developing countries. These centres have started their activities between 1995 and 2000 in Africa, Asia and the Pacific, and Latin America and the Caribbean. The centres are based on the concept that by pooling material and human resources, developing countries can have education and training centres, of an international-level quality. A considerable impetus has been given to capacity-building after the UNISPACE III Conference, in particular in the "Vienna Declaration on Space and Human Development". The necessity to enhance capacity-building through the development of human and budgetary resources, the training of teachers, the exchange of teaching methods, materials and experience and the development of infrastructure and policy regulatories. In the process of the implementation of the recommendations of UNISPACE III, Action Teams led by Governments were established. One of them was exclusively dealing with capacity-building. Its proposals have been reviewed last June by the Committee on the Peaceful Uses of Outer Space (COPUOS) and will be examined, among other reports of Action Teams, by the General Assembly in next October. A lot of work has been done during the past years and have produced very important results. But there is still an important gap in capacity-building between space-faring countries and developing countries. A strategy has been presented by the Action Team in order to implement a strategy aimed at increasing again the impact of the various initiatives already going on. The promotion of the sharing of educational materials and information could be facilitated by a network of bodies in UN Member States, dedicated organizations and UN regional centres. This presentation will aim to show the current status of this issue and to present results already achieved and the way forward.

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

PubMed

Berhan, Yifru

2008-01-01

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

Circulatory Shock. Volume 34. Number 1. May 1991. International Conference on Shock (2nd), Meeting of European Shock Society (5th), Annual Meeting of the Shock Society (USA) (14th), Vienna Shock Form (3rd) Held in Vienna, Austria on 2-6 June 1991

DTIC Science & Technology

1991-06-06

OCTADECENOATE, AS A BURN TOXIN Takayuki Ozawa, Mika Hayakawa, Kazuhiro Kosaka, Satoru Sugiyama, Kazuhisa Yokoo, Hisashi Aoyama, and Yohei Izawa Department...shock. 41 CARDIOPULMONARY HEMODYNAMIC AND PERIPHERAL CIRCULATORY RESPONSES IN SHOCK T. Muteki, N. Kaku. T. Fukushige, I. Kohno and T. Hiraki Department...Tadashi, 242 Machleidt, Werner, 213 Ozawa, Takayuki , 11 Kawarada, Yoshifumi, 442 Mackie, D.P., 348 Ozawa, Kazue, 268 Keser, Claudia, 380 Maitra, Subir R

Elucidating the effects of river fluctuation on microbial removal during riverbank filtration

NASA Astrophysics Data System (ADS)

Derx, J.; Sommer, R.; Farnleitner, A. H.; Blaschke, A. P.

2010-12-01

The transfer of microbial pathogens from surface or waste water can have adverse effects on groundwater quality at riverbank filtration sites. Previous studies on groundwater protection in sandy unconfined aquifers with the focus on virus transport and health based water quality targets, such as done in the Netherlands, revealed larger protection zones than zones limited by 60 days of groundwater travel time. The 60 days of travel time are the design criterion in Austria for drinking water protection. However, in gravel aquifers, microbial transport processes differ significantly to those in sandy aquifers. Preferential flow and aquifer heterogeneities dominate microbial transport in sandy gravels and gravel aquifers. Microbial mass transfer and dual domain transport models were used previously to reproduce these effects. Furthermore, microbial transport has mainly been studied in the field during steady state groundwater flow situations. Hence, previous microbial transport models have seldom accounted for transient groundwater flow conditions. These dynamic flow conditions could have immense effects on the fate of microorganisms because of the variations in flow velocities, which are dominating microbial transport. In the current study, we used a variably saturated, three-dimensional groundwater flow and transport model coupled to a hydrodynamic surface water model at a riverbank filtration site. With this model, we estimated the required groundwater protection zones based on 8 log10 viral reductions and compared them to the 60 days travel time zones. The 8 log10 removal steps were based on a preliminary microbial risk assessment scheme for enteroviruses at the riverbank infiltration sites. The groundwater protection zones were estimated for a set of well withdrawal rates, river fluctuation ranges and frequencies, river gradients and bank slopes. The river flow dynamics and the morphology of the riverbed and banks are potentially important factors affecting microbial transport processes during riverbank filtration, which were previously not accounted for. Acknowledgments We would like to thank the Austrian Science Funds FWF for financial support as part of the Doctoral program DK-plus W1219-N22 on Water Resource Systems and the Vienna Waterworks (MA31) as part of the GWRS-Vienna project. We would also like to thank the MA39 (IFUM) for helping at the preliminary risk assessment.

Growing Physics and Astronomy Public Outreach in Montreal

NASA Astrophysics Data System (ADS)

Simard, Gabrielle; Lepo, Kelly

2017-01-01

AstroMcGill was founded in 2011 by an enthusiastic group of undergraduate students, graduate students and post-doctoral fellows. It serves as the education and public outreach (EPO) branch of the astronomy group within the Physics Department at McGill University in Montreal, Quebec. Over the last five years, AstroMcGill has grown from organizing sporadic visits in a couple primary schools to running a successful inquiry-based outreach programme for grade 4-6 students, the McGill Space Explorers. During the same time span, the attendance at public AstroNight lectures ramped up from attracting a few dozen people to over 500 people each month. We will highlight the recent successes of the programme and our best guesses for the reasons behind this success. We will also discuss the challenges of working in a bilingual city as we juggle our majority anglophone volunteers, a mandatory french science curriculum for primary school children and the (somewhat) overlapping English- and French-speaking communities in the city.

Building mental health workforce capacity through training and retention of psychiatrists in Zimbabwe.

PubMed

Abas, Melanie A; Nhiwatiwa, Sekai M; Mangezi, Walter; Jack, Helen; Piette, Angharad; Cowan, Frances M; Barley, Elizabeth; Chingono, Alfred; Iversen, Amy; Chibanda, Dixon

2014-08-01

Despite the need to improve the quantity and quality of psychiatry training in sub-Saharan Africa (SSA), very little is known about the experiences of psychiatric trainees in the region. This is the first study examining psychiatric trainees in a low-income country in SSA. It was carried out as part of the needs assessment for a unique Medical Education Partnership Initiative (MEPI) programme to find African solutions for medical shortages in Africa. We approached all doctors who had trained in post-graduate psychiatry in Zimbabwe in 2010 and conducted in-depth qualitative interviews with all except one (n = 6). We analysed the data using constant comparison and thematic analysis. Trainees described the apprenticeship model as the programme's primary strength, through providing clinical exposure and role models. Programme weaknesses included shortages in information sources, trainee salaries, trainers, public health education, and in the mental health service. Most respondents were, however, eager to continue practising psychiatry in Zimbabwe, motivated by family ties, national commitment and helping vulnerable, stigmatized individuals. Respondents called for sub-speciality training and for infrastructure and training to do research. Resources need to be made available for psychiatric trainees in more SSA settings to develop public health competencies. However, investment in psychiatry training programmes must balance service provision with trainees' educational needs. Directing investment towards needs identified by trainees may be a cost-effective, context-sensitive way to increase retention and learning outcomes.

Seventeen years' experience of a voluntarily based drug rationalisation programme in hospital.

PubMed Central

Baker, J. A.; Lant, A. F.; Sutters, C. A.

1988-01-01

A study was carried out analysing the operation of a drug rationalisation programme in a central London teaching district that had evolved from experience over 17 years. Creation of a limited list of about 700 drugs had been achieved by local consensus. Drug selection was based on appraisal of efficacy, safety, and cost and was undertaken by means of collaborative participation of most consultant specialists in the district. Educative and other non-restrictive strategies for reinforcing the rationalisation policy had achieved a consistently high rate of compliance in prescribing recommended drugs. The concept of selectivity in drug use and its continuous local reappraisal had a beneficial impact on the prescribing habits of doctors at all levels of seniority as well as on the training of medical undergraduates and nurses in the therapeutic use of medicines. Peer review and self audit were encouraged by use of an extensive monitoring system which incorporated continuous "facilitative" dialogue between ward pharmacists and prescribers. Two models of drug rationalisation programme were studied, the second of which together with other local initiatives had been associated with substantial and sustained reductions in drug spending each year over nine years since 1978. It is concluded that the second drug rationalisation programme model substantially improves the cost effective use of drugs in hospital and furthermore has the potential of being extended to general practice, especially in types of prescribing that are common to both forms of patient care. PMID:3139150

Sparkling Geomagnetic Field: Involving Schools in Geomagnetic Research

NASA Astrophysics Data System (ADS)

Bailey, Rachel; Leonhardt, Roman; Leichter, Barbara

2014-05-01

Solar activity will be reaching a maximum in 2013/2014 as the sun reaches the end of its cycle, bringing with it an opportunity to study in greater detail the effect of solar wind or "space weather" on our planet's magnetic field. Heightened solar activity leads to a larger amount of clouds of energetic particles bombarding the Earth. Although the Earth's magnetic field shields us from most of these particles, the field becomes distorted and compacted by the solar wind, which leads to magnetic storms that we detect from the surface. These storms cause aurorae at higher latitudes and can lead to widespread disruption of communication and navigation equipment all over the Earth when sufficiently strong. This project, "Sparkling Geomagnetic Field," is a part of Austria's Sparkling Science programme, which aims to involve schools in active scientific research to encourage interest in science from a young age. Researchers from the Central Institute for Meteorology and Geodynamics (ZAMG) in Vienna have worked hand-in-hand with three schools across Austria to set up regional geomagnetic stations consisting of state-of-the-art scalar and vector magnetometers to monitor the effects of the solar wind on the geomagnetic field. The students have been an active part of the research team from the beginning, first searching for a suitable location to set up the stations as well as later overseeing the continued running of the equipment and analysing the data output. Through this project the students will gain experience in contemporary scientific methods: data processing and analysis, field work, as well as equipment setup and upkeep. A total of three stations have been established with schools in Innsbruck, Tamsweg and Graz at roughly equal distances across Austria to run alongside the already active station in the Conrad Observatory near Vienna. Data acquisition runs through a data logger and software developed to deliver data in near realtime. This network allows for evaluation of both the spatial and temporal development of magnetic storms across the longitudes. Currently the stations are running in a test phase as the last system wrinkles are ironed out. The geomagnetic network will be running and delivering continuous data by spring 2014.

The effect of functional insulin therapy on glycaemic parameters in children with diabetes mellitus type 1.

PubMed

Štimjanin-Koldžo, Diana; Alajbegović, Salem; Štimjanin, Ena; Mehinagić, Jasmina

2017-08-01

Aim The aim of the study is to evaluate the effect of a prospectively conducted interactive 5-day education programme based on Düsseldorf model on glycated haemoglobin (A1C), and total daily dose of insulin in type 1 diabetes patients. Methods A total of 67 type 1 diabetes patients was analysed; mean age of 11±0.68 years, 43 females and 24 males. The programme was led by a trained team of diabetes specialist doctors and nurses. All subjects and their parents completed a knowledge test about diabetes at beginning, and at the end of education, and after 12 months (30 questions). Subjects were evaluated for total daily insulin, and HbA1c at baseline, as well as 3, 6, 9 and 12 months after the end of the education programme. Results Results of the knowledge test after the education have shown higher knowledge at baseline. At the end of the education programme an average of total daily insulin dose was significantly lower. There was a 3.17% reduction in HbA1c values over 9 months, and 1.8% over 12 months in the comparison to the baseline values (p<0.001). Conclusions Structured education programme of functional insulin therapy was associated with improved glycaemic control in type 1 diabetes patients and their parents. It motivated patients and parents to improve glycaemic control. One year after the follow up, glycaemic control was worsening, due to lack of patients' motivation, therefore, there is a need for yearly re-education. Copyright© by the Medical Assotiation of Zenica-Doboj Canton.

Does the Committee Peer Review Select the Best Applicants for Funding? An Investigation of the Selection Process for Two European Molecular Biology Organization Programmes

PubMed Central

Bornmann, Lutz; Wallon, Gerlind; Ledin, Anna

2008-01-01

Does peer review fulfill its declared objective of identifying the best science and the best scientists? In order to answer this question we analyzed the Long-Term Fellowship and the Young Investigator programmes of the European Molecular Biology Organization. Both programmes aim to identify and support the best post doctoral fellows and young group leaders in the life sciences. We checked the association between the selection decisions and the scientific performance of the applicants. Our study involved publication and citation data for 668 applicants to the Long-Term Fellowship programme from the year 1998 (130 approved, 538 rejected) and 297 applicants to the Young Investigator programme (39 approved and 258 rejected applicants) from the years 2001 and 2002. If quantity and impact of research publications are used as a criterion for scientific achievement, the results of (zero-truncated) negative binomial models show that the peer review process indeed selects scientists who perform on a higher level than the rejected ones subsequent to application. We determined the extent of errors due to over-estimation (type I errors) and under-estimation (type 2 errors) of future scientific performance. Our statistical analyses point out that between 26% and 48% of the decisions made to award or reject an application show one of both error types. Even though for a part of the applicants, the selection committee did not correctly estimate the applicant's future performance, the results show a statistically significant association between selection decisions and the applicants' scientific achievements, if quantity and impact of research publications are used as a criterion for scientific achievement. PMID:18941530

Innovation for the future of Irish MedTech industry: retrospective qualitative review of impact of BioInnovate Ireland’s clinical fellows

PubMed Central

McGloughlin, Elizabeth Kate; Anglim, Paul; Keogh, Ivan; Sharif, Faisal

2018-01-01

Clinicians have historically been integral in innovating and developing technology in medicine and surgery. In recent years, however, in an increasingly complex healthcare system, a doctor with innovative ideas is often left behind. Transition from idea to bedside now entails significant hurdles, which often go unrecognised at the outset, particularly for first-time innovators. The BioInnnovate Ireland process, based on the Stanford Biodesign Programme (Identify, Invent and Implement), aims to streamline the process of innovation within the MedTech sector. These programmes focus on needs-based innovation and enable multidisciplinary teams to innovate and collaborate more succinctly. In this preliminary study, the authors aimed to examine the impact of BioInnovate Ireland has had on the clinicians involved and validate the collaborative process. To date, 13 fellows with backgrounds in clinical medicine have participated in the BioInnovate programme. Ten of these clinicians remain involved in clinical innovation projects with four of these working on Enterprise Ireland funded commercialisation grants and one working as chief executive officer of a service-led start-up, Strive. Of these, five also remain engaged in clinical practice on a full or part-time basis. The clinicians who have returned to full-time clinical practice have used the process and learning of the programme to influence their individual clinical areas and actively seek innovative solutions to meet clinical challenges. Clinicians, in particular, describe gaining value from the BioInnovate programme in areas of ‘Understanding Entrepreneurship’ and ‘Business Strategy’. Further study is needed into the quantitative impact on the ecosystem and impact to other stakeholders. PMID:29599999

Innovation for the future of Irish MedTech industry: retrospective qualitative review of impact of BioInnovate Ireland's clinical fellows.

PubMed

McGloughlin, Elizabeth Kate; Anglim, Paul; Keogh, Ivan; Sharif, Faisal

2018-01-01

Clinicians have historically been integral in innovating and developing technology in medicine and surgery. In recent years, however, in an increasingly complex healthcare system, a doctor with innovative ideas is often left behind. Transition from idea to bedside now entails significant hurdles, which often go unrecognised at the outset, particularly for first-time innovators. The BioInnnovate Ireland process, based on the Stanford Biodesign Programme (Identify, Invent and Implement), aims to streamline the process of innovation within the MedTech sector. These programmes focus on needs-based innovation and enable multidisciplinary teams to innovate and collaborate more succinctly. In this preliminary study, the authors aimed to examine the impact of BioInnovate Ireland has had on the clinicians involved and validate the collaborative process. To date, 13 fellows with backgrounds in clinical medicine have participated in the BioInnovate programme. Ten of these clinicians remain involved in clinical innovation projects with four of these working on Enterprise Ireland funded commercialisation grants and one working as chief executive officer of a service-led start-up, Strive. Of these, five also remain engaged in clinical practice on a full or part-time basis. The clinicians who have returned to full-time clinical practice have used the process and learning of the programme to influence their individual clinical areas and actively seek innovative solutions to meet clinical challenges. Clinicians, in particular, describe gaining value from the BioInnovate programme in areas of 'Understanding Entrepreneurship' and 'Business Strategy'. Further study is needed into the quantitative impact on the ecosystem and impact to other stakeholders.

Mini-Med School: promoting awareness of medicine as a career for suburban and rural high-school students.

PubMed

Shaikh, Faisal M; Babar, Mahwash; Cross, K Simon

2013-06-01

There is a global shortage of medical manpower. One approach to resolve such deficiencies is to effectively promote health careers to high-school students. Summer programmes held by medical faculties provide ideal opportunities for pre-medical students to examine the possible career opportunities in medicine. The Royal College of Surgeons in Ireland has recently launched a 'Mini-Medical School' (MMS) programme for suburban and rural high-school students in the South Eastern Region of Ireland. This paper illustrates the MMS project and describes the participants' reaction and evaluation of the programme and the factors influencing their desire to practise medicine in future. A total of 90 students completed the online survey (response rate 75%). Eighty-two per cent of the students indicated definitive and strong desire to study medicine after secondary school. There was no difference in interest between male and female students (P-value 0.665). The main factors influencing this interest were personal. Forty-four per cent of participants attributed this to the opportunity to help others while 30% to the intellectual challenge, whereas family, friends and other factors accounted for the rest of influential factors to study medicine. The majority agreed (60%) that the programme was quite accessible and easy to have a place. Opinions about the content of the programme focussed mainly on the interactive sessions. Forty-seven per cent liked the live patient-doctor interaction session the most, and 43% found the live video session very informative. The MMS is a highly effective platform for both the medical specialties and the high-school students. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Cryopreservation of Embryos of the Mediterranean Fruit Fly Ceratitis capitata Vienna 8 Genetic Sexing Strain

PubMed Central

Augustinos, Antonios A.; Rajamohan, Arun; Kyritsis, Georgios A.; Zacharopoulou, Antigone; Haq, Ihsan ul; Targovska, Asya; Caceres, Carlos; Bourtzis, Kostas; Abd-Alla, Adly M. M.

2016-01-01

The Mediterranean fruit fly, Ceratitis capitata, is one of the most serious pests of fruit crops world-wide. During the last decades, area-wide pest management (AW-IPM) approaches with a sterile insect technique (SIT) component have been used to control populations of this pest in an effective and environment-friendly manner. The development of genetic sexing strains (GSS), such as the Vienna 8 strain, has been played a major role in increasing the efficacy and reducing the cost of SIT programs. However, mass rearing, extensive inbreeding, possible bottleneck phenomena and hitch-hiking effects might pose major risks for deterioration and loss of important genetic characteristics of domesticated insect. In the present study, we present a modified procedure to cryopreserve the embryos of the medfly Vienna 8 GSS based on vitrification and used this strain as insect model to assess the impact of the cryopreservation process on the genetic structure of the cryopreserved insects. Forty-eight hours old embryos, incubated at 24°C, were found to be the most suitable developmental stage for cryopreservation treatment for high production of acceptable hatch rate (38%). Our data suggest the absence of any negative impact of the cryopreservation process on egg hatch rate, pupation rates, adult emergence rates and stability of the temperature sensitive lethal (tsl) character on two established cryopreserved lines (flies emerged from cryopreserved embryos), named V8-118 and V8-228. Taken together, our study provides an optimized procedure to cryopreserve the medfly Vienna 8 GSS and documents the absence of any negative impact on the genetic structure and quality of the strain. Benefits and sceneries for utilization of this technology to support operational SIT projects are discussed in this paper. PMID:27537351