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Sample records for flying doctor service

  1. Web Services Integration on the Fly

    National Research Council Canada - National Science Library

    Leong, Hoe W

    2008-01-01

    .... Given data, software agents and supporting software infrastructure, web services integration on the fly means that human coding is not required to integrate web services into a Web Service Architecture...

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

    Science.gov (United States)

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

    2007-01-01

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

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

    Science.gov (United States)

    Umefjord, Göran; Petersson, Göran; Hamberg, Katarina

    2003-10-22

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

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

    OpenAIRE

    Umefjord, Göran; Petersson, Göran; Hamberg, Katarina

    2003-01-01

    Background In 1998 the Swedish noncommercial public health service Infomedica opened an Ask the Doctor service on its Internet portal. At no charge, anyone with Internet access can use this service to ask questions about personal health-related and disease-related matters. Objective To study why individuals choose to consult previously-unknown doctors on the Internet. Methods Between November 1, 2001, and January 31, 2002 a Web survey of the 3622 Ask the Doctor service users, 1036 men (29%) a...

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

    Directory of Open Access Journals (Sweden)

    von der Tann Matthias

    2007-08-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusion Doctors displayed high levels of distress as reflected in the significant proportion of those who were at some risk of

  6. Is Fly in/Fly out (FIFO) a viable interim solution to address remote medical workforce shortages?

    Science.gov (United States)

    Margolis, Stephen A

    2012-01-01

    Geographically remote regions of Australia experience a higher degree of socioeconomic inequality and health inequity, amid poor resourcing and extreme climatic conditions, when compared with their more urban counterparts. Doctors with the knowledge, skills and interest in remote work remain a scarce resource, with only 58 practitioners per 100,000 people versus 196/100,000 in metropolitan areas. Pending the arrival of the full complement of long-term remote medical workforce, an alternative solution that has so far received little attention but could provide near equivalence to resident doctors is the 'fly in/fly out' (FIFO) model. Specifically, where one doctor has a continuous relationship with one town or community, albeit spending their rostered time off away from this location, rather than continuity of service with different doctors each time. In this model, doctors spend a fixed number of days at work geographically remote from their home and families, with logistical support (eg housing, transport) provided, followed by a fixed number of days back at home not working. This provides a the doctor with the benefits of remote clinical work plus guaranteed time off at home, a more acceptable roster than in many remote locations at present. This also avoids the complex issue of experienced doctors having to leave remote areas mid-career for the well-documented reasons of spouse employment and children's education, as well as providing easier access to professional development activities. The author followed this path and remains a FIFO doctor after 7 years of continuous service. For FIFO to be effective, there needs to be a commitment from the sponsoring organisation for short, balanced, flexible, family friendly rosters and a positive organizational structure with effective communication between management and front line staff. Evidence shows that families and children with healthy family functioning, who are able to balance separateness and togetherness and

  7. Factors influencing the provision of public health services by village doctors in Hubei and Jiangxi provinces, China.

    Science.gov (United States)

    Ding, Yan; Smith, Helen J; Fei, Yang; Xu, Biao; Nie, Shaofa; Yan, Weirong; Diwan, Vinod K; Sauerborn, Rainer; Dong, Hengjin

    2013-01-01

    The Chinese central government launched the Health System Reform Plan in 2009 to strengthen disease control and health promotion and provide a package of basic public health services. Village doctors receive a modest subsidy for providing public health services associated with the package. Their beliefs about this subsidy and providing public health services could influence the quality and effectiveness of preventive health services and disease surveillance. To understand village doctors' perspectives on the subsidy and their experiences of delivering public health services, we performed 10 focus group discussions with village doctors, 12 in-depth interviews with directors of township health centres and 4 in-depth interviews with directors of county-level Centers for Disease Control and Prevention. The study was conducted in four counties in central China, two in Hubei province and two in Jiangxi province. Village doctors prioritize medical services but they do their best to manage their time to include public health services. The willingness of township health centre directors and village doctors to provide public health services has improved since the introduction of the package and a minimum subsidy, but village doctors do not find the subsidy to be sufficient remuneration for their efforts. Improving the delivery of public health services by village doctors is likely to require an increase in the subsidy, improvement in the supervisory relationship between village clinics and township health centres and the creation of a government pension for village doctors.

  8. 42 CFR 410.24 - Limitations on services of a doctor of dental surgery or dental medicine.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Limitations on services of a doctor of dental surgery or dental medicine. 410.24 Section 410.24 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Medical and Other Health Services § 410.24 Limitations on services of a doctor of dental surgery or dental...

  9. Reasons why specialist doctors undertake rural outreach services: an Australian cross-sectional study.

    Science.gov (United States)

    O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

    2017-01-07

    The purpose of the study is to explore the reasons why specialist doctors travel to provide regular rural outreach services, and whether reasons relate to (1) salaried or private fee-for-service practice and (2) providing rural outreach services in more remote locations. A national cross-sectional study of specialist doctors from the Medicine in Australia: Balancing Employment and Life (MABEL) survey in 2014 was implemented. Specialists providing rural outreach services self-reported on a 5-point scale their level of agreement with five reasons for participating. Chi-squared analysis tested association between agreement and variables of interest. Of 567 specialists undertaking rural outreach services, reasons for participating include to grow the practice (54%), maintain a regional connection (26%), provide complex healthcare (18%), healthcare for disadvantaged people (12%) and support rural staff (6%). Salaried specialists more commonly participated to grow the practice compared with specialists in fee-for-service practice (68 vs 49%). This reason was also related to travelling further and providing outreach services in outer regional/remote locations. Private fee-for-service specialists more commonly undertook outreach services to provide complex healthcare (22 vs 14%). Specialist doctors undertake rural outreach services for a range of reasons, mainly to complement the growth and diversity of their main practice or maintain a regional connection. Structuring rural outreach around the specialist's main practice is likely to support participation and improve service distribution.

  10. Evaluation of aggression in Australian after-hours doctor home-visit services.

    Science.gov (United States)

    Ifediora, Chris O

    2018-04-01

    Minimizing the risks and distress arising from aggression in after-hours house call (AHHC) services will help improve service quality in the industry. Unfortunately, no national study has ever evaluated this in Australian AHHCs. Apart from reducing this gap, findings from this work will have global relevance given the rising popularity of the AHHC industry worldwide. A survey of all 300 doctors employed by the National Home Doctor Service, Australia's largest AHHC service provider. A validated electronic questionnaire was used to examine the doctors' experiences over a 12-month period. There were 168 valid responses (56% response rate). Aggression prevalence was 47.1%, and just over half (51.8%) of the cases came from the patients. "Verbal aggression" was the commonest (48.3%). Others are "threats" (26.6%), "vexatious complaints" (13.3%), "property damage" (4.2%), "physical violence" (4.2%), "sexual harassment" (2.8%), and "stalking" (0.7%). Majority of the respondents were concerned (90.2%) and apprehensive (75.2%) regarding the risks. Doctors who have experienced aggression were more likely to express apprehension (OR = 3.99; CI = 1.54-10.31; P = 0.004), while those that have attained Postgraduate Fellowships (Vocationally Registered) were less likely to report experiences of aggression (OR = 0.28; CI = 0.09-0.84; P = 0.02). Even though a higher proportion of females were concerned (92.3% vs 89.6%) and apprehensive (82.1% vs 73.6%) compared with males, these differences were not statistically significant (Fisher's Exact Tests: P = 1.000 and 0.469, respectively). Aggression in Australian AHHC affects nearly 1-in-2 practitioners, with high levels of concern and apprehension being expressed. Concerned companies should do more to ensure that their doctors attain PG fellowships, as this is linked to lower reports of aggression. Where possible, family and friends need to be involved in patient care, as nearly half of the reported aggressions come from

  11. The perspectives of eThekwini public service anaesthetic doctors on ...

    African Journals Online (AJOL)

    ... public service anaesthetic doctors on the informed consent process for anaesthesia. ... in four main areas: the preanaesthetic interview, optimisation of the process, ... the recording of written consent on a specific anaesthetic consent form.

  12. Exploring the safety measures by doctors on after-hours house call services.

    Science.gov (United States)

    Ifediora, Chris

    2015-01-01

    Aggression against doctors involved in after-hours house calls (AHHC) is widely perceived to be high. It is, however, unclear how doctors who perform this service manage the risk of aggressive patients during home visits. The aim of this paper is to explore if and how doctors manage the risk of violence against them during AHHC. A survey was designed and administered to all 300 Australian-based doctors engaged in AHHC under the National Home Doctor Service (NHDS). The survey was conducted from September 2014 to November 2014. There were 172 responses (57.3 per cent). Only 43 per cent of respondents adopted personal protective measures. The remaining 57 per cent had none; of those 6 per cent had never considered protective measures, and 31.8 per cent were aware of the risk of violence, but were unsure of what to do. Measures adopted include the use of chaperones/security personnel (34.1 per cent), dependence on surgery policies (31.2 per cent), de-escalation techniques (15.2 per cent), panic buttons (7.2 per cent), personal alarms (6.1 per cent), and others (6.5 per cent). Females were more likely to adopt personal protective measures than males (OR 4.94; pdoctors were less likely to do so relative to overseas-trained doctors (OR 0.35; p=0.04; CI 0.12-0.99). Just over half of the doctors involved in AHHC took no precautions against aggressive attacks while on duty, and nearly one-third relied on the policies of their employing surgeries.

  13. [Supplementary services used as marketing tools in the competition among private practice doctors].

    Science.gov (United States)

    Meurers, Horst

    2009-01-01

    What is the relation between additional healthcare services, marketing and competition among office-based physicians? The best and truly effective marketing strategy is a satisfied patient recommending his doctor's services to others. Hence, good marketing starts with a convincing service concept, not just with advertising. More and more frequently patients ask for supplementary health service offerings. Additional services tailored to individual practices--e.g., in the field of nutrition, sports, fitness, wellness, aesthetics--meet the patients' demands, but at the same time they provide a competitive advantage over the ordinary medical practice. And what is more, these additional healthcare services have a nice side effect: they earn an additional income which is not unwelcome in times of decreasing revenues from the public healthcare system. The much sought-after potential for additional services and income can be achieved by offering commercial medical services, e.g., the sale of healthcare products. The coexistence of the doctor's commercial and non-commercial medical services is admissible as long as certain rules of professional conduct and tax laws are followed.

  14. [External workplace violence against doctors in hospital services in Lima Metropolitana, Peru 2014].

    Science.gov (United States)

    Tuya-Figueroa, Ximena; Mezones-Holguin, Edward; Monge, Eduardo; Arones, Ricardo; Mier, Milagros; Saravia, Mercedes; Torres, Jose; Mayta-Tristán, Percy

    2016-01-01

    . To calculate the frequency and factors associated with external workplace violence (EWV) against doctors in health inpatient services in the metropolitan area of Lima (Spanish: Lima Metropolitana), Peru. . A cross-sectional analytic study, which included doctors from the Ministry of Health (MINSA), Social Security (EsSalud), and the private subsector, was carried out. The frequency of EWV was measured throughout the entire professional practice during the previous 12 months and during the last month. Variables related to the doctor, assailant, and health service were measured. Raw and adjusted prevalence ratios (PR) were calculated by means of a Poisson-family generalized linear model with non-parametric bootstrapping. . A total of 406 doctors participated; 31.5% were victims of EWV at least once during their professional practice, with 19.9% over the past 12 months and 7.6% during the last month. The chances of being threatened in the last 12 months increased if the doctor was male (adjusted PR [aPR]: 1.7; 95% confidence interval [CI] = 1.1- 2.8), had graduated from a Peruvian university outside of the metropolitan area of Lima (aPR: 1.5; 95% CI = 1.1-2.4), worked at MINSA (aPR: 7.9; 95% CI = 2.24-50.73) or EsSalud (RR: 8.68; 95% CI = 2.26-56.17), and worked in the emergency (aPR: 1.9; 95% CI = 1.2-3.6) or operating room (aPR: 1.6; 95% CI = 1.1-2.3). Age, years of professional practice, or being a medical resident were not associated with EWV. . In the hospitals studied, a large number of doctors have been victims of EWV. Working in public services increases the possibility of violence. Implementation of support, identification, and primary prevention strategies in hospitals is recommended.

  15. Are doctors and nurses associated with coverage of essential health services in developing countries? A cross-sectional study

    Directory of Open Access Journals (Sweden)

    de Pinho Helen

    2009-03-01

    Full Text Available Abstract Background There is broad policy consensus that a shortage of doctors and nurses is a key constraint to increasing utilization of essential health services important for achieving the health Millennium Development Goals. However there is limited research on the quantitative links between health workers and service coverage rates. We examined the relationship between doctor and nurse concentrations and utilization rates of five essential health services in developing countries. Methods We performed cross-national analyses of low- and middle-income countries by means of ordinary least squares regression with coverage rates of antenatal care, attended delivery, caesarean section, measles immunization, tuberculosis case diagnosis and care for acute respiratory infection as outcomes. Doctor, nurse and aggregate health worker (sum of doctors and nurses concentrations were the main explanatory variables. Results Nurses were associated with utilization of skilled birth attendants (P = 0.02 and doctors were associated with measles immunization rates (P = 0.01 in separate adjusted analyses. Aggregate health workers were associated with the utilization of skilled birth attendants (P Conclusion A range of health system and population-level factors aside from health workers influences coverage of health services in developing countries. However, it is also plausible that health workers who are neither doctors nor nurses, such as clinical officers and community health workers, may be providing a substantial proportion of health services. The human resources for health research agenda should be expanded beyond doctors and nurses.

  16. The determinants and engagement patterns of chaperones and chauffeurs by Australian doctors in after-hours house-call services.

    Science.gov (United States)

    Ifediora, Chris Onyebuchi

    2017-01-01

    The use of escorts (chauffeurs and chaperones) while on duty in after-hours-house-call (AHHC) is one key protective option available to doctors in the service, and has been linked to low burnout and increased satisfaction in AHHC. This study aims to explore the patterns of engagement of escorts in Australian AHHC. This is a questionnaire-based, electronic survey of all 300 doctors involved in AHHC through the National Home Doctor Service (NHDS), Australia's largest providers of the service. The survey explored the doctor's experiences over the 12-month period from October 2013 to September 2014. This survey received a total of 168 valid responses, giving a response rate of 56%. Nearly 61% of the doctors involved in AHHC engaged escorts (chauffeurs and chaperones). Of those doctors that engage chauffeurs, three-quarters do so "all or most times", while only one-quarter engaged chaperones to the same degree of frequency. Hiring escorts is very popular among Brisbane (91.7%) and Sydney-based (88.2%) practitioners, but is unpopular in the City of Gold Coast (26.1%). There were moderate patronages in Adelaide (52.9%) and Melbourne Area (46.4%). Compared to males, females were less likely to drive themselves without escorts (OR 0.20; P  doctors involved in the Australian AHHC, particularly given their proven benefits in the service. Future studies may be needed to fully explore the real reasons behind the significant associations identified in this study.

  17. Evaluation of patient and doctor perception toward the use of telemedicine in Apollo Tele Health Services, India

    Directory of Open Access Journals (Sweden)

    Rajesh V Acharya

    2016-01-01

    Full Text Available Introduction: Telemedicine incorporates electronic information and medical technology. It connects healthcare through vast distances which would benefit both patients and doctors. The aim of this questionnaire study was to evaluate the effects of telemedicine on patients and medical specialists. Methods: A cross-sectional study was conducted among 122 participants (71 patients and 51 doctors on satisfaction in quality of service, cost-effectiveness, and problems encountered in healthcare provided by the telemedicine in Apollo Tele Health Services, Hyderabad, Telangana, India. The data for each group were calculated and compared. Results: About 80% patients and all the doctors reported their satisfaction on the quality of treatment given through telemedicine. Approximately, 90% of the participants found telemedicine cost-effective and 61% of the doctors found an increase in patient's inflow apart for their regular practice. Problems encountered in telemedicine were 47% in technical issues and 39% in time scheduling by doctors and 31% of patients were uncomfortable to face the camera, and 24% had technical issues. Conclusions: The results of the present study showed that telemedicine in healthcare could prove to be useful to patients in distant regions and to rural doctors in India. In the near future, telemedicine can be considered as an alternate to face to face patient care.

  18. The Fly-in Fly-out and Drive-in Drive-out model of health care service provision for rural and remote Australia: benefits and disadvantages.

    Science.gov (United States)

    Hussain, Rafat; Maple, Myfanwy; Hunter, Sally V; Mapedzahama, Virginia; Reddy, Prasuna

    2015-01-01

    Rural Australians experience poorer health and poorer access to health care services than their urban counterparts, and there is a chronic shortage of health professionals in rural and remote Australia. Strategies designed to reduce this rural-urban divide include fly-in fly-out (FIFO) and drive-in drive-out (DIDO) services. The aim of this article is to examine the opportunities and challenges involved in these forms of service delivery. This article reviews recent literature relating to FIFO and DIDO healthcare services and discusses their benefits and potential disadvantages for rural Australia, and for health practitioners. FIFO and DIDO have short-term benefits for rural Australians seeking healthcare services in terms of increasing equity and accessibility to services and reducing the need to travel long distances for health care. However, significant disadvantages need to be considered in the longer term. There is a potential for burnout among health professionals who travel long distances and work long hours, often without adequate peer support or supervision, in order to deliver these services. A further disadvantage, particularly in the use of visiting medical practitioners to provide generalist services, is the lack of development of a sufficiently well-resourced local primary healthcare system in small rural communities. Given the potential negative consequences for both health professionals and rural Australians, the authors caution against the increasing use of FIFO and DIDO services, without the concurrent development of well-resourced, funded and staffed primary healthcare services in rural and remote communities.

  19. [Psychiatric patients at the police station in the southern South Holland region: assessment by the District Health Service forensic doctor].

    Science.gov (United States)

    Aardoom, H A; Huisman-Wolfs, M M; Nijs, H G T

    2002-09-21

    To describe the epidemiological characteristics of ambulant psychiatric patients who were either brought to the police station or who came by themselves, but who were not kept in a cell, as a basis for the development of a reception protocol. Descriptive. The data from the medical records from 2000 kept by the forensic doctors employed by the district health services for the Southern South Holland region were inventoried. On request by the police, the forensic doctors examined 203 clients. The majority of these were middle-aged men who did have a place of residence. The reason for police involvement was bizarre or confused behaviour in public. Half of the patients had received or were receiving some form of psychiatric treatment from the mental health service. In approximately half of the cases the forensic doctor found a solution together with the police. In the other half of the cases the forensic doctor asked the crisis intervention team at the mental health service for an evaluation. Two thirds of these patients were hospitalised and one third was sent away. Because examination by both the forensic doctor and the mental health service psychiatrist and other procedures were lengthy (up to 6 hours), patients had to spend a long time in a holding cell at the police station that was not designed for stays of this length of time, and often lacked toilet facilities. The forensic doctor treated about half the clients without the need of assistance from the crisis intervention psychiatrist. The temporary accommodation for these confused clients was inadequate.

  20. The determinants and engagement patterns of chaperones and chauffeurs by Australian doctors in after-hours house-call services

    Directory of Open Access Journals (Sweden)

    Chris Onyebuchi Ifediora

    2017-04-01

    Full Text Available Objectives The use of escorts (chauffeurs and chaperones while on duty in after-hours-house-call (AHHC is one key protective option available to doctors in the service, and has been linked to low burnout and increased satisfaction in AHHC. This study aims to explore the patterns of engagement of escorts in Australian AHHC. Method This is a questionnaire-based, electronic survey of all 300 doctors involved in AHHC through the National Home Doctor Service (NHDS, Australia’s largest providers of the service. The survey explored the doctor’s experiences over the 12-month period from October 2013 to September 2014. Results This survey received a total of 168 valid responses, giving a response rate of 56%. Nearly 61% of the doctors involved in AHHC engaged escorts (chauffeurs and chaperones. Of those doctors that engage chauffeurs, three-quarters do so “all or most times”, while only one-quarter engaged chaperones to the same degree of frequency. Hiring escorts is very popular among Brisbane (91.7% and Sydney-based (88.2% practitioners, but is unpopular in the City of Gold Coast (26.1%. There were moderate patronages in Adelaide (52.9% and Melbourne Area (46.4%. Compared to males, females were less likely to drive themselves without escorts (OR 0.20; P < 0.01; CI [0.07–0.57], but more likely to engage chauffeurs (OR 5.87; P = 0.03; CI [1.16–29.77]. Practitioners who were apprehensive were three times more likely to either engage escorts as chauffeurs (OR 3.10; P = 0.04; CI [1.05–9.15] or as an accompanying chaperone if they self-drive (OR 3.03; P = 0.02; CI [1.16–7.89]. Conclusion More needs to be done to increase the engagement of escorts by doctors involved in the Australian AHHC, particularly given their proven benefits in the service. Future studies may be needed to fully explore the real reasons behind the significant associations identified in this study.

  1. Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example.

    Science.gov (United States)

    Li, Tongtong; Lei, Trudy; Xie, Zheng; Zhang, Tuohong

    2016-02-04

    To ensure equity and accessibility of public health care in rural areas, the Chinese central government has launched a series of policies to motivate village doctors to provide basic public health services. Using chronic disease management and prevention as an example, this study aims to identify factors associated with village doctors' basic public health services provision and to formulate targeted interventions in rural China. Data was obtained from a survey of village doctors in three provinces in China in 2014. Using a multistage sampling process, data was collected through the self-administered questionnaire. The data was then analyzed using multilevel logistic regression models. The high-level basic public health services for chronic diseases (BPHS) provision rate was 85.2% among the 1149 village doctors whom were included in the analysis. Among individual level variables, more education, more training opportunities, receiving more public health care subsidy (OR = 3.856, 95 % CI: 1.937-7.678, and OR = 4.027, 95% CI: 1.722-9.420), being under integrated management (OR = 1.978, 95% CI: 1.132-3.458), and being a New Cooperative Medical Scheme insurance program-contracted provider (OR = 2.099, 95% CI: 1.187-3.712) were associated with the higher BPHS provision by village doctors. Among county level factors, Foreign Direct Investment Index showed a significant negative correlation with BPHS provision, while the government funding for BPHS showed no correlation (P > 0.100). Increasing public health care subsidies received by individual village doctors, availability and attendance of training opportunities, and integrated management and NCMS contracting of village clinics are important factors in increasing BPHS provision in rural areas.

  2. Update on the Health Services Research Doctoral Core Competencies.

    Science.gov (United States)

    Burgess, James F; Menachemi, Nir; Maciejewski, Matthew L

    2018-03-13

    To present revised core competencies for doctoral programs in health services research (HSR), modalities to deliver these competencies, and suggested methods for assessing mastery of these competencies. Core competencies were originally developed in 2005, updated (but unpublished) in 2008, modestly updated for a 2016 HSR workforce conference, and revised based on feedback from attendees. Additional feedback was obtained from doctoral program directors, employer/workforce experts and attendees of presentation on these competencies at the AcademyHealth's June 2017 Annual Research Meeting. The current version (V2.1) competencies include the ethical conduct of research, conceptual models, development of research questions, study designs, data measurement and collection methods, statistical methods for analyzing data, professional collaboration, and knowledge dissemination. These competencies represent a core that defines what HSR researchers should master in order to address the complexities of microsystem to macro-system research that HSR entails. There are opportunities to conduct formal evaluation of newer delivery modalities (e.g., flipped classrooms) and to integrate new Learning Health System Researcher Core Competencies, developed by AHRQ, into the HSR core competencies. Core competencies in HSR are a continually evolving work in progress because new research questions arise, new methods are developed, and the trans-disciplinary nature of the field leads to new multidisciplinary and team building needs. © Health Research and Educational Trust.

  3. Mercury release from fly ashes and hydrated fly ash cement pastes

    Science.gov (United States)

    Du, Wen; Zhang, Chao-yang; Kong, Xiang-ming; Zhuo, Yu-qun; Zhu, Zhen-wu

    2018-04-01

    The large-scale usage of fly ash in cement and concrete introduces mercury (Hg) into concrete structures and a risk of secondary emission of Hg from the structures during long-term service was evaluated. Three fly ashes were collected from coal-fired power plants and three blend cements were prepared by mixing Ordinary Portland cement (OPC) with the same amount of fly ash. The releasing behaviors of Hg0 from the fly ash and the powdered hydrated cement pastes (HCP) were measured by a self-developed Hg measurement system, where an air-blowing part and Hg collection part were involved. The Hg release of fly ashes at room temperature varied from 25.84 to 39.69 ng/g fly ash during 90-days period of air-blowing experiment. In contrast, the Hg release of the HCPs were in a range of 8.51-18.48 ng/g HCP. It is found that the Hg release ratios of HCPs were almost the same as those of the pure fly ashes, suggesting that the hydration products of the HCP have little immobilization effect on Hg0. Increasing temperature and moisture content markedly promote the Hg release.

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

    Science.gov (United States)

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

    2014-01-01

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

  5. OpenFlyData: an exemplar data web integrating gene expression data on the fruit fly Drosophila melanogaster.

    Science.gov (United States)

    Miles, Alistair; Zhao, Jun; Klyne, Graham; White-Cooper, Helen; Shotton, David

    2010-10-01

    Integrating heterogeneous data across distributed sources is a major requirement for in silico bioinformatics supporting translational research. For example, genome-scale data on patterns of gene expression in the fruit fly Drosophila melanogaster are widely used in functional genomic studies in many organisms to inform candidate gene selection and validate experimental results. However, current data integration solutions tend to be heavy weight, and require significant initial and ongoing investment of effort. Development of a common Web-based data integration infrastructure (a.k.a. data web), using Semantic Web standards, promises to alleviate these difficulties, but little is known about the feasibility, costs, risks or practical means of migrating to such an infrastructure. We describe the development of OpenFlyData, a proof-of-concept system integrating gene expression data on D. melanogaster, combining Semantic Web standards with light-weight approaches to Web programming based on Web 2.0 design patterns. To support researchers designing and validating functional genomic studies, OpenFlyData includes user-facing search applications providing intuitive access to and comparison of gene expression data from FlyAtlas, the BDGP in situ database, and FlyTED, using data from FlyBase to expand and disambiguate gene names. OpenFlyData's services are also openly accessible, and are available for reuse by other bioinformaticians and application developers. Semi-automated methods and tools were developed to support labour- and knowledge-intensive tasks involved in deploying SPARQL services. These include methods for generating ontologies and relational-to-RDF mappings for relational databases, which we illustrate using the FlyBase Chado database schema; and methods for mapping gene identifiers between databases. The advantages of using Semantic Web standards for biomedical data integration are discussed, as are open issues. In particular, although the performance of open

  6. URGENT NEED OF A DOCTOR

    CERN Multimedia

    Medical Service

    2001-01-01

    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGAD 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European EmergencyCall 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors will...

  7. State Level Review of Doctoral Programs in Texas.

    Science.gov (United States)

    Whittington, Nil

    Review of doctoral degree programs in Texas public colleges and universities is discussed. Attention is directed to review procedures and strengths and weaknesses in the state's doctoral programs in educational psychology, counseling and guidance, and student personnel services. Doctoral programs were reviewed because of their high cost and a…

  8. Talking With Your Doctor: MedlinePlus Health Topic

    Science.gov (United States)

    ... Doctor (For Teens) (Nemours Foundation) Also in Spanish Working with doctors and nurses (Department of Health and Human Services, Office on Women's Health) Seniors Living with Multiple Health Problems: What Older Adults ...

  9. IN URGENT NEED OF A DOCTOR

    CERN Multimedia

    Medical Service

    2001-01-01

    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors ...

  10. Assessment of hepatitis B vaccination status in doctors of Services hospital, Lahore

    International Nuclear Information System (INIS)

    Usmani, R.A.; Rana, M.S.; Sarwer, H.; Fazli, H.; Ali Pervaiz, M.A.; Tahir, I.; Sajjad, R.; Muhammad Saleem Wazir, M.S.

    2010-01-01

    Background: Hepatitis B is the most common serious infection of the liver and can lead to premature death from liver cancer or liver failure. Of the two billion people who have been infected with Hepatitis B virus, more than 350 million have chronic infection. The objectives of this study were to assess the Hepatitis B vaccination status, reasons for non-compliance and the risk of exposure to doctors at a tertiary care hospital. Methods: Three hundred and twenty-two doctors were selected from the various departments of the hospital by simple random sampling. They were given a self-administered questionnaire after taking verbal consent. Some doctors refused to fill-in the questionnaire while some others were on leave during the time of study and the remaining 215 doctors responded to the questionnaire. Results: A total of 215 doctors, (age range 22-59 years) responded to the questionnaire. Amongst them 11.6% had not received even a single dose of Hepatitis B vaccine while 14.4% had not completed the required course of vaccination. Most common reason cited by doctors for non immunisation was that they had not thought about it. Consultants were more likely of the other doctors to have received completed vaccination (83.9% versus 69.9%) (p<0.05). They were also significantly more likely to know their antibody titre after completing vaccination. Needle stick injuries were common. One hundred and forty-five doctors in the study admitted having received at least one needle prick/sharp injury. Of them, 51.6% had received a needle prick/sharp injury more than once. Conclusion: Despite the availability of an effective vaccine in the market doctors continue to remain non-vaccinated. It is the lack of awareness and carelessness on part of doctors coupled with the negligence of the risk that has led them being incompletely vaccinated. There is a need to ensure that every doctor is completely vaccinated against Hepatitis B before he/she enters professional practice. (author)

  11. 'What makes an excellent mental health doctor?' A response integrating the experiences and views of service users with critical reflections of psychiatrists.

    Science.gov (United States)

    Gunasekara, Imani; Patterson, Sue; Scott, James G

    2017-11-01

    While therapeutic relationships are appropriately recognised as the foundation of mental health service, service users commonly report suboptimal experiences. With shared understanding critical to improvement in practice, we explored service users' experiences and expectations of psychiatrists and consultations, engaging psychiatrists throughout the process. Using an iterative qualitative approach we co-produced a response to the question 'what makes an excellent mental health doctor?' Experiences and expectations of psychiatrists were explored in interviews with 22 service users. Data collection, analysis and interpretation were informed by consultation with peer workers. Findings were contextualised in formal consultations with psychiatrists. As 'masters of their craft', excellent mental health doctors engage authentically with service users as people (not diagnoses). They listen, validate experiences and empathise affectively and cognitively. They demonstrate phronesis, applying clinical knowledge compassionately. Psychiatrists share service users' aspiration of equitable partnership but competing demands and 'professional boundaries' constrain engagement. Consistent delivery of the person-centred, recovery-oriented care promoted by policy and sought by service users will require substantial revision of the structure and priorities of mental health services. The insights and experiences of service users must be integral to medical education, and systems must provide robust support to psychiatrists. © 2017 John Wiley & Sons Ltd.

  12. Area-Wide Suppression of the Mediterranean Fruit Fly, Ceratitis capitata, and the Oriental Fruit Fly, Bactrocera dorsalis, in Kamuela, Hawaii

    OpenAIRE

    Vargas, Roger I.; Pi?ero, Jaime C.; Mau, Ronald F. L.; Jang, Eric B.; Klungness, Lester M.; McInnis, Donald O.; Harris, Ernest B.; McQuate, Grant T.; Bautista, Renato C.; Wong, Lyle

    2010-01-01

    The United States Department of Agriculture's Agricultural Research Service initiated an area-wide fruit fly management program in Hawaii in 2000. The first demonstration site was established in Kamuela, Hawaii, USA. This paper documents suppression of the Mediterranean fruit fly, Ceratitis capitata (Wiedemann), and the oriental fruit fly, Bactrocera dorsalis (Hendel) (Diptera: Tephritidae), in a 40 km2 area containing urban, rural and agricultural zones during a 6 year period. The suppressio...

  13. [Corruption risks in relations between doctor and patient ].

    Science.gov (United States)

    Kolwitz, Marcin; Gąsiorowski, Jakub

    2014-01-01

    The article describes the problem of corruption occurring in the relationship between doctor and patient. The doctor-patient relationship, including the provision of health services, is one of several potential areas of corruption in the health care system. Among the reasons for the existence of corruption in these relationships are the need to obtain better healthcare for the patient, and higher earnings in the case of a doctor. Indications of corruption are utilitarian (action for personal advantage without ethical aspects), but may also be (actually or in the patient's opinion) the only way to obtain services and save health and even life. Corruption between the doctor and the patient can be limited by better organization of the health care system, including the financing of benefits and education of medical personnel and patients, as well as traditional legal measures, such as prevention or the application of criminal sanctions.

  14. Talking to Your Doctor

    Medline Plus

    Full Text Available ... Lines Health Services Locator HealthCare.gov NIH Clinical Research Trials and You Talking to Your Doctor Science ... More » Quick Links NIH News in Health NIH Research Matters NIH Record Research & Training Medical Research Initiatives ...

  15. Talking to Your Doctor

    Medline Plus

    Full Text Available ... Info Lines Health Services Locator HealthCare.gov NIH Clinical Research Trials and You Talking to Your Doctor Science ... Labs & Clinics Training Opportunities Library Resources Research Resources Clinical Research Resources Safety, Regulation and Guidance More » Quick Links ...

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

    Science.gov (United States)

    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…

  17. Talking to Your Doctor

    Medline Plus

    Full Text Available ... Staff Directory En Español Site Menu Home Health Information Health Info Lines Health Services Locator HealthCare.gov NIH Clinical Research Trials and You Talking to Your Doctor Science Education Resources Community Resources Clear Health A–Z ...

  18. IN URGENT NEED OF A DOCTOR

    CERN Multimedia

    Medical Service

    2002-01-01

    GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors will come to your home. Cal...

  19. Talking to Your Doctor

    Medline Plus

    Full Text Available ... Lines Health Services Locator HealthCare.gov NIH Clinical Research Trials and You Talking to Your Doctor Science Education Resources Community Resources Clear Health A–Z Publications List More » Search Health Topics Quick Links MedlinePlus Health Info NIH News in ...

  20. [Doctor-patient relationship in the context of a changing society].

    Science.gov (United States)

    Siebzehner, Miriam Ines; Balik, Chaya; Matalon, Andre

    2008-12-01

    During the 20th century doctors gained a special status in the medical system, which is about to change as a consequence of a change in the doctor-patient relationship and in the characteristics of the labor market in health care. Some changes correspond with the adoption of business terms within the medical system. The doctor is represented as a supplier of services, while the patient is a consumer. From patient-centered care, the doctor-patient relationship changed to a costumer-supplier of services, as is the case in other fields of the consumer society. This article analyzes the changes in the patterns of the doctor-patient interactions in the light of the changes in society over the last decades such as: the creation of regulations and laws on patients' rights; the establishment of organizations that represent the sick, the distribution of knowledge and information by means of mass communication, changes in the status of the doctors, the academization of other health professionals and changes in the management of health care to a more financially viable approach to the costs of health.

  1. Attracting and retaining doctors in rural Nepal.

    Science.gov (United States)

    Shankar, P R

    2010-01-01

    In Nepal, a number of private sector medical schools have opened recently; although sufficient numbers of doctors are graduating there continues to be a doctor shortage in rural areas. This article analysed the rural doctor shortage in Nepal and reviewed the international literature for strategies that may be suitable for use in Nepal. Original research articles, reviews, magazine articles and project reports dealing with Nepal and other developing countries during the period 1995 to 2010 were sourced via Google, Google Scholar and Pubmed. Full text access was obtained via WHO's HINARI database. The health workforce in Nepal is unevenly distributed resulting in doctor shortages in rural areas. The recent introduction of mandatory rural service for scholarship students was aimed to reduce the loss of medical graduates to developed nations. High tuition fees in private medical schools and low Government wages prevent recent graduates from taking up rural positions, and those who do face many challenges. Potential corrective strategies include community-based medical education, selecting rural-background medical students, and providing a partial or complete tuition fee waiver for medical students who commit to rural service. Traditional healers and paramedical staff can also be trained for and authorized to provide rural health care. A range of strategies developed elsewhere could be used in Nepal, especially community-oriented medical education that involves rural doctors in training medical students. The reimbursement of tuition fees, assistance with relocation, and provision of opportunities for academic and professional advancement for rural doctors should also be considered. Government investment in improving working conditions in rural Nepal would assist rural communities to attract and retain doctors.

  2. Through doctors' eyes: A qualitative study of hospital doctor perspectives on their working conditions.

    LENUS (Irish Health Repository)

    McGowan, Yvonne

    2013-03-11

    BACKGROUND: Hospital doctors face significant challenges in the current health care environment, working with staff shortages and cutbacks to health care expenditure, alongside increased demand for health care and increased public expectations. OBJECTIVE: This article analyses challenges faced by junior hospital doctors, providing insight into the experiences of these frontline staff in delivering health services in recessionary times. DESIGN: A qualitative methodology was chosen. METHODS: Semi-structured in-depth interviews were conducted with 20 doctors from urban Irish hospitals. Interviews were recorded via note taking. Full transcripts were analysed thematically using NVivo software. RESULTS: Dominant themes included the following: (1) unrealistic workloads: characterised by staff shortages, extended working hours, irregular and frequently interrupted breaks; (2) fatigue and its impact: the quality of care provided to patients while doctors were sleep-deprived was questioned; however, little reflection was given to any impact this may have had on junior doctors own health; (3) undervalued and disillusioned: insufficient training, intensive workloads and a perceived lack of power to influence change resulted in a sense of detachment among junior doctors. They appeared immune to their surroundings. CONCLUSION: Respondents ascribed little importance to the impact of current working conditions on their own health. They felt their roles were underappreciated and undervalued by policy makers and hospital management. Respondents were concerned with the lack of time and opportunity for training. This study highlighted several \\'red flags\\

  3. Talking to Your Doctor

    Science.gov (United States)

    ... or risks? Will I need more tests later? Understanding your doctor's responses is essential to good communication. Here are a few more tips: If you ... is maintained by the NEI Office of Science Communications, Public Liaison, and ... and Human Services | The National Institutes of Health | USA.gov ...

  4. Patient perception of smartphone usage by doctors

    Directory of Open Access Journals (Sweden)

    Kerry G

    2017-03-01

    Full Text Available Georgina Kerry,1 Shyam Gokani,2 Dara Rasasingam,2 Alexander Zargaran,3 Javier Ash,2 Aaina Mittal2 1College of Medical and Dental Sciences, University of Birmingham, Birmingham, 2Faculty of Medicine, Imperial College London, London, 3Faculty of Medicine, St George’s University of London, London, UK Abstract: Technological advancements have revolutionized modern medicine and smartphones are now ubiquitous among health care professionals. The ability to look up information promptly is invaluable to doctors and medical students alike, but there is an additional contiguous benefit to patients. Queries can be answered more accurately through fingertip access to evidence-based medicine, and physicians have instant access to emergency care protocols. However, is consideration always extended to the patient’s perception of the use of smartphones by doctors? Do patients know why we use smartphones to assist us in their care? What do they think when they see a doctor using a smartphone?An independent question, conducted within a wider service evaluation (ethical approval not required, full verbal and written electronic consent provided by all patients at St. Mary’s Hospital, London, indicated that although the majority (91.0% of patients owned a smartphone, many (61.6% did not agree that the use of smartphones at work by doctors is professional. This highlights the potential for damage to the doctor–patient relationship. There is a risk that these patients will disconnect with care services with possible detriment to their health. Additionally, it is notable that a larger proportion of those patients aged >70 years found the use of smartphones by doctors at work unprofessional, compared with patients aged <70 years.Adequate communication between the doctor and patient is critical in ensuring that doctors can make use of modern technology to provide the best possible care and that patients are comfortable with this and do not feel isolated or

  5. Associations of stress and burnout among Australian-based doctors involved in after-hours home visits.

    Science.gov (United States)

    Ifediora, Chris

    2015-01-01

    The after-hours house call (AHHC) service in Australia is growing, but studies have never explored the doctor variables associated with burnout and stress within the service. This study fills this knowledge gap. To determine the doctor variables associated with burnout and stress among doctors involved in AHHC. A quantitative, questionnaire-based survey of all 300 doctors engaged in AHHC through the National Home Doctor Service (NHDS), Australia's largest home visiting doctor-service provider. The Maslach Burnout Inventory (MBI) was used to assess burnout over a 12-month period from October 2013 to September 2014. Ordinal logistics regression was used to identify significant associations. There were 168 valid responses received, giving a 56 per cent response rate. The most significant factor associated with reduced stress and burnout is the adoption of self-protection measures while on the job. Such measures include the use of chaperones, the use of panic alarms or buttons, adopting de-escalation techniques, and reliance on relevant surgery policies. Other associations with reduced stress include the attainment of postgraduate fellowships (vocational registration), working less than 24 hours per week, being in legally recognised partnerships, and being male. Conversely, having general practice as a career, being under 40 years of age, and obtaining primary medical degrees from Australia (as opposed to overseas) are all associated with increased burnout for doctors involved in AHHC. A number of doctor variables have been found to significantly reduce burnout in AHHC Among these, the adoption of self-protective measures and the attainment postgraduate fellowships, where possible, should be encouraged among practitioners involved in the service.

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

    Science.gov (United States)

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

    2016-07-07

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

  7. Doctors' and nurses' perceptions of a ward-based pharmacist in rural northern Sweden.

    Science.gov (United States)

    Sjölander, Maria; Gustafsson, Maria; Gallego, Gisselle

    2017-08-01

    Background This project is part of the prospective quasi experimental proof-of-concept investigation of clinical pharmacist intervention study to reduce drug-related problems among people admitted to a ward in a rural hospital in northern Sweden. Objective To explore doctors' and nurses' perceptions and expectations of having a ward-based pharmacist providing clinical pharmacy services. Setting Medical ward in a rural hospital in northern Sweden. Method Eighteen face-to-face semi-structured interviews were conducted with a purposive sample of doctors and nurses working on the ward where the clinical pharmacy service was due to be implemented. Semi-structured interviews were digitally recorded, transcribed and analysed using thematic analysis. Main outcome measure Perceptions and expectations of nurses and doctors. Results Doctors and nurses had limited experience of working with pharmacists. Most had a vague idea of what pharmacists can contribute within a ward setting. Participants, mainly nurses, suggested inventory and drug distribution roles, but few were aware of the pharmacists' skills and clinical competence. Different views were expressed on whether the new clinical pharmacy service would have an impact on workload. However, most participants took a positive view of having a ward-based pharmacist. Conclusion This study provided an opportunity to explore doctors' and nurses' expectations of the role of clinical pharmacists before a clinical pharmacy service was implemented. To successfully implement a clinical pharmacy service, roles, clinical competence and responsibilities should be clearly described. Furthermore, it is important to focus on collaborative working relationships between doctors, nurses and pharmacists.

  8. Suicide in doctors and wives of doctors.

    Science.gov (United States)

    Sakinofsky, I

    1980-06-01

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

  9. Should a doctor stop rendering medical services? Principles of conduct towards patients attempting to commit suicide. Part 1 -- the Polish perspective.

    Science.gov (United States)

    Zajdel, Justyna; Zajdel, Radoslaw; Krakowiak, Anna

    2013-01-01

    According to the general idea a doctor can start the medical management process in an adult and not legally incapacitated patient after the patient has given consent to initiate such a process. The patient's refusal makes rendering medical services impossible, irrespective of their scope and kind. It should be emphasized that such a refusal is respected if it is expressed fully, clearly and consciously. Cases in which such a refusal is expressed by an intoxicated suicidal patient, remaining under the influence of narcotics, drugs or medicaments which characterize with a similar activity should be particularly analysed. Although such a person is able to verbally declare his objection, his ability to process the information given by the doctor before initiating medical procedures is limited, or even non-existant. The refusal therefore cannot be regarded as reliable, which results in rendering medical services to the patient. An analysis was made of Acts of Law and the opinions of the judiciar by comparing and excluding contradictory and incoherent elements. Despite the lack of clear regulations of a patient rejecting procedures aimed at saving the patient's life, or the prevention of serious health impairment or sustaining injury, it should be assumed that the objection expressed by the patient who does not demonstrate the ability to process the information provided by the doctor is not reliable, and the doctor is therefore still obliged to render medical services. External factors, such as consumption of alcohol, narcotics and drugs, which characterize with a similar activity impair perception and make the taking of a conscious decision impossible. Not providing medical help and introducing direct compulsion would mean neglecting provision of due diligence in the process of treatment and, as a consequence, placing the patient's health at risk, and suffering from negative implications for the patient's life and/or health in the future. Current provisions should

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

    Science.gov (United States)

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

    2017-04-01

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

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

    Science.gov (United States)

    Himmelstein, Mary S; Sanchez, Diana T

    2016-03-01

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

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

    Science.gov (United States)

    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.

  13. [RELATIONSHIP BETWEEN JUNIOR AND SENIOR DOCTORS: A BUBERIAN MODEL].

    Science.gov (United States)

    Pougnet, Richard; Pougnet, Laurence

    2016-01-01

    Doctors in training work in services under the supervision of senior doctors. These professional relationships may lead to frustrations, or ill-being at work. Indeed doctors are often very busy with care and can hardly communicate. The purpose of this article is to propose ways to think in its ethical dimension this relationship, by learning from Martin Buber's ideas. He thought a philosophy of relationship in two word pairs: I-Thou and I-It. This thought can be useful in the context of the médical relationship and mentorship. Indeed we can see our colleague as a person or only as a caregiver. We offer a relationship model according to buberian thought, between junior and senior doctor caring about the same patients.

  14. Towards a Marketing Communication Recruitment Plan for the Rowan University Educational Leadership Doctoral Program

    Science.gov (United States)

    Kanyi, Titus Kamau

    2009-01-01

    Doctoral studies are at the apex of the education system. Attracting, recruiting, enrolling, and graduating the best suited students in doctoral education is, therefore, critical in ensuring the highest academic standards and service to society. Focusing on Rowan University's Doctor of Education (Ed.D.) in Educational Leadership program, this…

  15. Protest of doctors: a basic human right or an ethical dilemma.

    Science.gov (United States)

    Abbasi, Imran Naeem

    2014-03-10

    Peaceful protests and strikes are a basic human right as stated in the United Nations' universal declaration on human rights. But for doctors, their proximity to life and death and the social contract between a doctor and a patient are stated as the reasons why doctors are valued more than the ordinary beings. In Pakistan, strikes by doctors were carried out to protest against lack of service structure, security and low pay. This paper discusses the moral and ethical concerns pertaining to the strikes by medical doctors in the context of Pakistan. The author has carefully tried to balance the discussion about moral repercussions of strikes on patients versus the circumstances of doctors working in public sector hospitals of a developing country that may lead to strikes. Doctors are envisaged as highly respectable due to their direct link with human lives. Under Hippocrates oath, care of the patient is a contractual obligation for the doctors and is superior to all other responsibilities. From utilitarian perspective, doctors' strikes are justifiable only if there is evidence of long term benefits to the doctors, patients and an improvement in service delivery. Despite that, it is hard to justify such benefits against the risks to the patients. Harms that may incur to the patients include: prolongation of sufferings, irreversible damage to health, delay in treatment, death, loss of work and waste of financial resources.In a system of socialized medicine, government owing to greater control over resources and important managerial decisions should assume greater responsibility and do justice to all stakeholders including doctors as well as patients. If a doctor is underpaid, has limited options for career growth and is forced to work excessively, then not only quality of medical care and ability to act in the best interests of patients is adversely affected, it may also lead to brain drain. There is no single best answer against or in favor of doctors' industrial

  16. Resources for Developing Country Researchers

    International Development Research Centre (IDRC) Digital Library (Canada)

    Melanie Brunet

    fields of physics and mathematics. The service requires individual registration: http://ejds.ictp.it/ejds/faces/register.xhtml Language: Primarily English. Free Medical Journals (http://www.freemedicaljournals.com/) and Free Books4 Doctors · (http://www.freebooks4doctors.com/) Established by Flying Publishers, these two sites ...

  17. Economics of Corruption in Doctoral Education: The Dissertations Market

    Science.gov (United States)

    Osipian, Ararat L.

    2012-01-01

    This paper addresses the issue of "dissertations for sale" in Russia. The tasks of this anthropological study include establishing the problem of corruption in doctoral education, identification of the dissertations suppliers, study of the specific services they offer, analysis of their prices on different services, and generalizations…

  18. The path of patient loyalty and the role of doctor reputation.

    Science.gov (United States)

    Torres, Eduardo; Vasquez-Parraga, Arturo Z; Barra, Cristobal

    2009-01-01

    Patient loyalty to doctors is relevant to medical services in which doctor-patient relationships are central and for which competition has increased in recent years. This study aims at understanding the process whereby patients develop loyalty to their doctor and doctor reputation has a moderating role. Based on a randomization of subjects, the study offers and tests an explanation chain representing key variables determining patient loyalty: patient commitment, trust and satisfaction, and doctor reputation. Primary data was collected using a structured questionnaire from a quota sample of regular patients in a large city in South America. The patients most committed to their doctor are more loyal to them. In turn, commitment is determined by patient trust, which is determined by patient satisfaction. Doctor reputation positively influences both patient trust and satisfaction. The explanation chain not only gives an account of how patient loyalty is formed; it also identifies a path health professionals can follow to secure patient loyalty.

  19. The industrial doctor and radiation hygiene at ECN

    International Nuclear Information System (INIS)

    Carpaij, W.J.M.

    1982-01-01

    The organisation of the health service department of the Netherlands Energy Research Centre where a nuclear reactor is maintained in operation, is divided in three working groups: (1) the occupational health service, (2) the radiation inspection service, and (3) the safety control service. Next to these, there are three groups which also render services to outsiders, viz. the analytical, the instrumentation, and the biological control services. The task and place of each of these is elucidated. The industrial doctor's main task is the supervision of the medical surveillance of all personnel members, counseling of the radiological workers, and treatment of radiation accidents. (Auth.)

  20. Recyclability of Concrete Pavement Incorporating High Volume of Fly Ash

    Science.gov (United States)

    Yoshitake, Isamu; Ishida, Takeo; Fukumoto, Sunao

    2015-01-01

    Recyclable concrete pavement was made from fly ash and crushed limestone sand and gravel as aggregates so that the concrete pavement could be recycled to raw materials for cement production. With the aim to use as much fly ash as possible for the sustainable development of society, while achieving adequate strength development, pavement concrete having a cement-replacement ratio of 40% by mass was experimentally investigated, focusing on the strength development at an early age. Limestone powder was added to improve the early strength; flexural strength at two days reached 3.5 MPa, the minimum strength for traffic service in Japan. The matured fly ash concrete made with a cement content of 200 kg/m3 achieved a flexural strength almost equal to that of the control concrete without fly ash. Additionally, Portland cement made from the tested fly ash concrete was tested to confirm recyclability, with the cement quality meeting the Japanese classification of ordinary Portland cement. Limestone-based recyclable fly ash concrete pavement is, thus, a preferred material in terms of sustainability. PMID:28793518

  1. Recyclability of Concrete Pavement Incorporating High Volume of Fly Ash.

    Science.gov (United States)

    Yoshitake, Isamu; Ishida, Takeo; Fukumoto, Sunao

    2015-08-21

    Recyclable concrete pavement was made from fly ash and crushed limestone sand and gravel as aggregates so that the concrete pavement could be recycled to raw materials for cement production. With the aim to use as much fly ash as possible for the sustainable development of society, while achieving adequate strength development, pavement concrete having a cement-replacement ratio of 40% by mass was experimentally investigated, focusing on the strength development at an early age. Limestone powder was added to improve the early strength; flexural strength at two days reached 3.5 MPa, the minimum strength for traffic service in Japan. The matured fly ash concrete made with a cement content of 200 kg/m3 achieved a flexural strength almost equal to that of the control concrete without fly ash. Additionally, Portland cement made from the tested fly ash concrete was tested to confirm recyclability, with the cement quality meeting the Japanese classification of ordinary Portland cement. Limestone-based recyclable fly ash concrete pavement is, thus, a preferred material in terms of sustainability.

  2. Modeling Medical Services with Mobile Health Applications

    Directory of Open Access Journals (Sweden)

    Zhenfei Wang

    2018-01-01

    Full Text Available The rapid development of mobile health technology (m-Health provides unprecedented opportunities for improving health services. As the bridge between doctors and patients, mobile health applications enable patients to communicate with doctors through their smartphones, which is becoming more and more popular among people. To evaluate the influence of m-Health applications on the medical service market, we propose a medical service equilibrium model. The model can balance the supply of doctors and demand of patients and reflect possible options for both doctors and patients with or without m-Health applications in the medical service market. In the meantime, we analyze the behavior of patients and the activities of doctors to minimize patients’ full costs of healthcare and doctors’ futility. Then, we provide a resolution algorithm through mathematical reasoning. Lastly, based on artificially generated dataset, experiments are conducted to evaluate the medical services of m-Health applications.

  3. Doctors on display: the evolution of television's doctors.

    Science.gov (United States)

    Tapper, Elliot B

    2010-10-01

    Doctors have been portrayed on television for over 50 years. In that time, their character has undergone significant changes, evolving from caring but infallible supermen with smoldering good looks and impeccable bedside manners to drug-addicted, sex-obsessed antiheroes. This article summarizes the major programs of the genre and explains the pattern of the TV doctors' character changes. Articulated over time in the many permutations of the doctor character is a complex, constant conversation between viewer and viewed representing public attitudes towards doctors, medicine, and science.

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

    Science.gov (United States)

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

    2009-04-18

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

  5. Survey of Doctors' Experience of Patients Using the Internet

    OpenAIRE

    Potts, Henry W. W; Wyatt, Jeremy C

    2002-01-01

    Background There have been many studies showing the variable quality of Internet health information and it has often been assumed that patients will blindly follow this and frequently come to harm. There have also been reports of problems for doctors and health services following patient Internet use, but their frequency has not been quantified. However, there have been no large, rigorous surveys of the perceptions of Internet-aware doctors about the actual benefits and harms to their patient...

  6. Protest of doctors: a basic human right or an ethical dilemma

    Science.gov (United States)

    2014-01-01

    Background Peaceful protests and strikes are a basic human right as stated in the United Nations’ universal declaration on human rights. But for doctors, their proximity to life and death and the social contract between a doctor and a patient are stated as the reasons why doctors are valued more than the ordinary beings. In Pakistan, strikes by doctors were carried out to protest against lack of service structure, security and low pay. This paper discusses the moral and ethical concerns pertaining to the strikes by medical doctors in the context of Pakistan. The author has carefully tried to balance the discussion about moral repercussions of strikes on patients versus the circumstances of doctors working in public sector hospitals of a developing country that may lead to strikes. Discussion Doctors are envisaged as highly respectable due to their direct link with human lives. Under Hippocrates oath, care of the patient is a contractual obligation for the doctors and is superior to all other responsibilities. From utilitarian perspective, doctors’ strikes are justifiable only if there is evidence of long term benefits to the doctors, patients and an improvement in service delivery. Despite that, it is hard to justify such benefits against the risks to the patients. Harms that may incur to the patients include: prolongation of sufferings, irreversible damage to health, delay in treatment, death, loss of work and waste of financial resources. In a system of socialized medicine, government owing to greater control over resources and important managerial decisions should assume greater responsibility and do justice to all stakeholders including doctors as well as patients. If a doctor is underpaid, has limited options for career growth and is forced to work excessively, then not only quality of medical care and ability to act in the best interests of patients is adversely affected, it may also lead to brain drain. Summary There is no single best answer against or

  7. From a dream to a resounding reality: The inception of a doctors ...

    African Journals Online (AJOL)

    After two grueling years of determination and resilience, the Kenyan doctors have formed a doctors' union. The Kenya Medical Practitioners, Pharmacists and Dentists Union(KMPDU)not only aims at agitating for better terms of service for its members, it also aims to influence the running of the Kenyan health sector and ...

  8. Microstructure Development and Transport Properties of Portland Cement-fly Ash Binary Systems : In view of service life predictions

    NARCIS (Netherlands)

    Yu, Z.

    2015-01-01

    Fly ash is a by-product of burning coal in electric power generating plants. It is commonly known that owing to its pozzolanic properties fly ash is widely used as a partial replacement for Portland cement in concrete. The use of fly ash in concrete not only reduces the landfill costs of fly ash,

  9. the inception of a doctors union in Kenya

    African Journals Online (AJOL)

    raoul

    2012-01-25

    Jan 25, 2012 ... of the Kenyan health sector and improve health services in Kenya. ... that up to three quarters of doctors will have left the government payroll three .... dispensation in Kenya which brought along a strong bill of rights, giving ...

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

    Science.gov (United States)

    Strauman, Elena C; Goodier, Bethany C

    2011-03-01

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

  11. Barriers to healthy eating by National Health Service (NHS hospital doctors in the hospital setting: results of a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Wilson Sue

    2008-08-01

    Full Text Available Abstract Background With high levels of obesity and related illness, improving the health of the nation is a major public health concern. This study aimed to identify factors that prevent healthy eating among doctors, and that are associated with satisfaction with catering services. Findings Methods: Cross-sectional survey of 328 NHS doctors working in two NHS Trusts with on-site hospital canteen. Questionnaire to establish perceived barriers to healthy eating, weekly use and satisfaction with the hospital canteen, lifestyle and dietary habits, gender, age, height, weight, job details, and affect. Results: 70% of doctors reported using their hospital canteen each week, with 2 visits per week on average. Canteen opening times, lack of selection and lack of breaks were the most commonly perceived barriers to healthy eating. Availability of healthy options caused the most dissatisfaction. Only 12% felt the NHS was supportive of healthy eating. 74% did not feel their canteen advocated healthy eating. Canteen use is associated with younger age (r = -0.254, p Conclusion Interventions to encourage regular meal breaks, eating breakfast and drinking more water each day need developing. Improved canteen accessibility and availability of healthy options at evenings and weekends may be beneficial.

  12. Seasonal use of red-cockaded woodpecker cavities by southern flying squirrels.

    Energy Technology Data Exchange (ETDEWEB)

    Loeb, Susan C; Ruth, Deanna L

    2004-12-31

    Loeb, Susan C., and Deanna L. Ruth. 2004. Seasonal use of red-cockaded woodpecker cavities by southern flying squirrels. In: Red-cockaded woodpecker; Road to Recovery. Proceedings of the 4th Red-cockaded woodpecker Symposium. Ralph Costa and Susan J. Daniels, eds. Savannah, Georgia. January, 2003. Chapter 8. Cavities, Cavity Trees, and Cavity Communities. Pp 501-502. Abstract: Southern flying squirrels can significantly impact red-cockaded woodpecker reproductive success (Laves and Loeb 1999). Thus exclusion or removal of flying squirrels from red-cockaded woodpecker cavities and clusters may be warranted in small woodpecker populations (U.S. Fish and Wildlife Service 2003). However, development of effective and efficient protocols for southern flying squirrel control requires an understanding of the seasonal dynamics of southern flying squirrel cavity use. Most studies of southern flying squirrel use of red-cockaded woodpecker cavities have been conducted during spring (e.g., Harlow and Lennartz 1983, Rudolph et al. 1990a, Loeb 1993) and no studies have examined the effects of long term flying squirrel control on subsequent cavity use. The objectives of this study were to determine: (1) whether flying squirrel use of red-cockaded woodpecker cavities varies with season or cavity type, and (2) the long term effect of continuous squirrel removal.

  13. mHealth: Knowledge and use among doctors and nurses in public secondary health-care facilities of Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Bukola Samuel Owolabi

    2018-01-01

    Full Text Available Objectives: Mobile health (mHealth is gaining importance worldwide, changing and improving the way healthcare and services are provided, but its role is just emerging in Nigeria. This study aimed to assess the knowledge and use of mHealth among health workers and the provisions for its use in public secondary health-care facilities of Lagos State, Nigeria. Methods: The study was a descriptive cross-sectional study carried out among 65 doctors and 135 nurses selected using a two-staged sampling method. Data were collected with pretested self-administered questionnaires and analyzed with EpiInfo™ 7. Results: Majority (doctors 84.6%, nurses 91.1% had not heard of the term “mHealth,” but most (doctors 96.9%, nurses 87.4% were aware of the use of mobile phones in health-care delivery. Only three (27.3% (health call centers/health-care telephone helpline, appointment reminders, and mobile telemedicine out of 11 mHealth components listed were mostly known. Most doctors simply used patient monitoring/surveillance and mobile telemedicine, while nurses mainly used treatment compliance and appointment reminder services. Majority were willing to use more mHealth services if available in their hospital. All the doctors and 97% of nurses had mobile phones. However, only about one-quarter (27.5% had smartphones with applications used for mHealth purposes. Conclusions: Knowledge, awareness, and use of mHealth services were low. Doctors and nurses should be enlightened and trained on ways to use mHealth services to improve health-care delivery, mHealth services should be made available in the hospitals, and use of smartphones encouraged as they portend better adaptability for mHealth use.

  14. Epistaxis management: current understanding amongst junior doctors.

    Science.gov (United States)

    Fox, R; Nash, R; Liu, Z-W; Singh, A

    2016-03-01

    Epistaxis is a common and potentially life-threatening emergency. This survey assesses understanding and confidence in epistaxis management amongst current junior doctors. A cross-sectional study was conducted of foundation year one and two doctors based at three National Health Service trusts within a single region of the UK, assessing basic understanding and procedural confidence. A total of 111 foundation doctors completed this survey. The average duration of undergraduate exposure to otolaryngology was 8.1 days. Forty-one per cent of respondents stated that they would apply pressure to the nasal bones to control epistaxis. Seventy-five per cent lacked confidence in their ability to manage epistaxis. Those with two weeks or more of undergraduate exposure to otolaryngology were more confident than those with one week or less of exposure (p epistaxis management, with patient safety implications. Confidence is associated with the duration of undergraduate exposure to otolaryngology. A minimum emergency safe competency should be a priority during foundation training if not achieved in UK medical schools.

  15. FliO Regulation of FliP in the Formation of the Salmonella enterica Flagellum

    Science.gov (United States)

    Barker, Clive S.; Meshcheryakova, Irina V.; Kostyukova, Alla S.; Samatey, Fadel A.

    2010-01-01

    The type III secretion system of the Salmonella flagellum consists of 6 integral membrane proteins: FlhA, FlhB, FliO, FliP, FliQ, and FliR. However, in some other type III secretion systems, a homologue of FliO is apparently absent, suggesting it has a specialized role. Deleting the fliO gene from the chromosome of a motile strain of Salmonella resulted in a drastic decrease of motility. Incubation of the ΔfliO mutant strain in motility agar, gave rise to pseudorevertants containing extragenic bypass mutations in FliP at positions R143H or F190L. Using membrane topology prediction programs, and alkaline phosphatase or GFPuv chimeric protein fusions into the FliO protein, we demonstrated that FliO is bitopic with its N-terminus in the periplasm and C-terminus in the cytoplasm. Truncation analysis of FliO demonstrated that overexpression of FliO43–125 or FliO1–95 was able to rescue motility of the ΔfliO mutant. Further, residue leucine 91 in the cytoplasmic domain was identified to be important for function. Based on secondary structure prediction, the cytoplasmic domain, FliO43–125, should contain beta-structure and alpha-helices. FliO43–125-Ala was purified and studied using circular dichroism spectroscopy; however, this domain was disordered, and its structure was a mixture of beta-sheet and random coil. Coexpression of full-length FliO with FliP increased expression levels of FliP, but coexpression with the cytoplasmic domain of FliO did not enhance FliP expression levels. Overexpression of the cytoplasmic domain of FliO further rescued motility of strains deleted for the fliO gene expressing bypass mutations in FliP. These results suggest FliO maintains FliP stability through transmembrane domain interaction. The results also demonstrate that the cytoplasmic domain of FliO has functionality, and it presumably becomes structured while interacting with its binding partners. PMID:20941389

  16. FliO regulation of FliP in the formation of the Salmonella enterica flagellum.

    Directory of Open Access Journals (Sweden)

    Clive S Barker

    2010-09-01

    Full Text Available The type III secretion system of the Salmonella flagellum consists of 6 integral membrane proteins: FlhA, FlhB, FliO, FliP, FliQ, and FliR. However, in some other type III secretion systems, a homologue of FliO is apparently absent, suggesting it has a specialized role. Deleting the fliO gene from the chromosome of a motile strain of Salmonella resulted in a drastic decrease of motility. Incubation of the ΔfliO mutant strain in motility agar, gave rise to pseudorevertants containing extragenic bypass mutations in FliP at positions R143H or F190L. Using membrane topology prediction programs, and alkaline phosphatase or GFPuv chimeric protein fusions into the FliO protein, we demonstrated that FliO is bitopic with its N-terminus in the periplasm and C-terminus in the cytoplasm. Truncation analysis of FliO demonstrated that overexpression of FliO₄₃-₁₂₅ or FliO₁-₉₅ was able to rescue motility of the ΔfliO mutant. Further, residue leucine 91 in the cytoplasmic domain was identified to be important for function. Based on secondary structure prediction, the cytoplasmic domain, FliO₄₃-₁₂₅, should contain beta-structure and alpha-helices. FliO₄₃-₁₂₅-Ala was purified and studied using circular dichroism spectroscopy; however, this domain was disordered, and its structure was a mixture of beta-sheet and random coil. Coexpression of full-length FliO with FliP increased expression levels of FliP, but coexpression with the cytoplasmic domain of FliO did not enhance FliP expression levels. Overexpression of the cytoplasmic domain of FliO further rescued motility of strains deleted for the fliO gene expressing bypass mutations in FliP. These results suggest FliO maintains FliP stability through transmembrane domain interaction. The results also demonstrate that the cytoplasmic domain of FliO has functionality, and it presumably becomes structured while interacting with its binding partners.

  17. The effect of the doctor's sex on the doctor-patient relationship

    OpenAIRE

    Gray, Judith

    1982-01-01

    The differences between male and female doctors are investigated, and what patients expect from their doctors is examined. Some conclusions are drawn from the preferences which patients express for male and female doctors and from the different outcomes of male and female doctor-patient interactions.

  18. Building doctoral ecologies

    DEFF Research Database (Denmark)

    Bengtsen, Søren Smedegaard

    2018-01-01

    heavily from the support from informal and extra-curricular researcher communities and non-formal support systems even beyond the institution in the private and societal lifeworlds. The chapter describes and analyses such forms of organizational and existential darkness within doctoral education...... and professionalization of doctoral education, with Graduate schools increasing in size and organizational complexity. Paradoxically, we see in contemporary research into doctoral students’ learning experiences that the students do not favour the formalized support systems and supervision, but on the contrary draw most......, and discusses how institutions and doctoral programmes could use such sprawling spaces for learning to build doctoral ecologies and to strengthening existentially based pedagogies within doctoral education....

  19. Why doctors consider leaving UK medicine: qualitative analysis of comments from questionnaire surveys three years after graduation.

    Science.gov (United States)

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

    2018-01-01

    Objective To report the reasons why doctors are considering leaving medicine or the UK. Design Questionnaire survey. Setting UK. Participants Questionnaires were sent three years after graduation to all UK medical graduates of 2008 and 2012. Main outcome measures Comments from doctors about their main reasons for considering leaving medicine or the UK (or both). Results The response rate was 46.2% (5291/11,461). Among the 60% of respondents who were not definitely intent on remaining in UK medicine, 50% were considering working in medicine outside the UK and 10% were considering leaving medicine. Among those considering working in medicine outside the UK, the most commonly cited reasons were to gain wider experience, that things would be 'better' elsewhere and a negative view of the National Health Service and its culture, state and politics. Other reasons included better training or job opportunities, better pay and conditions, family reasons and higher expectations. Three years after graduation, doctors surveyed in 2015 were significantly more likely than doctors surveyed in 2011 to cite factors related to the National Health Service, to pay and conditions, to their expectations and to effects on work-life balance and patient care. Among those considering leaving medicine, the dominant reason for leaving medicine was a negative view of the National Health Service (mentioned by half of those in this group who commented). Three years after graduation, doctors surveyed in 2015 were more likely than doctors surveyed in 2011 to cite this reason, as well as excessive hours and workload, and financial reasons. Conclusions An increasingly negative view is held by many doctors of many aspects of the experience of being a junior doctor in the National Health Service, and the difficulty of delivering high-quality patient care within what many see as an under-funded system. Policy changes designed to encourage more doctors to remain should be motivated by a desire to address

  20. Automatisierte Artikelbestellverwaltung: Doctor-Doc – ein bibliothekarisches Verwaltungswerkzeug / Automation in Interlibrary Loan: Doctor-Doc – a tool for librarians

    Directory of Open Access Journals (Sweden)

    Fischer, Markus

    2010-05-01

    Full Text Available Interlibrary loan has always been an important service to supplement own library holdings.To organize and standardize the order process of journal articles for 6 hospitals, we did create an online tool for the Solothurner Spitäler AG. The resulting application is available for libraries free of charge under http://www.doctor-doc.com/. The application is maintained and will be further developed by an association founded specially for this purpose. Doctor-Doc is not a supplier of articles, but rather a platform to organize orders at existing suppliers like Subito, British Library or any other supplying libraries. Doctor-Doc is OpenURL compliant and is able to resolve identifiers like PMIDs. In combination with an existing account from the german EZB, libraries can use the application as a linkresolver.The application has become an essential tool to efficiently manage interlibrary loan for the Solothurner Spitäler AG. The tool is also used by many libraries in Germany and Switzerland.

  1. Choose your doctorate.

    Science.gov (United States)

    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

  2. A National Study of Wellbeing of Hospital Doctors in Ireland

    OpenAIRE

    Hayes, Blanaid

    2016-01-01

    The working environment for hospital doctors in Ireland has undergone radical change in recent years with hospital posts becoming unattractive to doctors in training and to consultants. For young medical graduates, the tensions between training requirements and service demands have contributed to a ‘brain drain’ with over half leaving to work abroad after graduation. Many consultant posts are vacant or are filled on a temporary basis, impacting on the quality of patient care. This study se...

  3. Doctors on display: the evolution of television's doctors

    OpenAIRE

    Tapper, Elliot B.

    2010-01-01

    Doctors have been portrayed on television for over 50 years. In that time, their character has undergone significant changes, evolving from caring but infallible supermen with smoldering good looks and impeccable bedside manners to drug-addicted, sex-obsessed antiheroes. This article summarizes the major programs of the genre and explains the pattern of the TV doctors' character changes. Articulated over time in the many permutations of the doctor character is a complex, constant conversation...

  4. Radiographers as doctors: A profile of UK doctoral achievement

    International Nuclear Information System (INIS)

    Snaith, B.; Harris, M.A.; Harris, R.

    2016-01-01

    Introduction: Radiography aspires to be a research active profession, but there is limited information regarding the number of individuals with, or studying for, a doctoral award. This study aims to profile UK doctoral radiographers; including their chosen award, approach and employment status. Method: This was a prospective cohort study utilising an electronic survey. No formal database of doctoral radiographers existed therefore a snowball sampling method was adopted. The study sample was radiographers (diagnostic and therapeutic) based in the UK who were registered with the Health and Care Professions Council (HCPC) and who held, or were studying for, a doctoral award. Results: A total of 90 unique responses were received within the timescale. The respondents comprised 58 females (64.4%) and the majority were diagnostic radiographers (n = 71/90; 78.9%). The traditional PhD was the most common award, although increasing numbers were pursuing Education or Professional Doctorates. An overall increase in doctoral studies is observed over time, but was greatest amongst those working in academic institutions, with 63.3% of respondents (n = 57/90) working solely within a university, and a further 10% employed in a clinical–academic role (n = 9/90). Conclusion: This study has demonstrated that radiography is emerging as a research active profession, with increasing numbers of radiographers engaged in study at a doctoral level. This should provide a platform for the future development of academic and clinical research. - Highlights: • 90 radiographers were identified as holding, or studying for, a doctoral award. • The PhD is the most common award. • EdD and professional doctorates are increasing in popularity. • Academic staff were more likely to pursue such research training.

  5. Doctors' views about training and future careers expressed one year after graduation by UK-trained doctors: questionnaire surveys undertaken in 2009 and 2010.

    Science.gov (United States)

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

    2014-12-21

    The UK medical graduates of 2008 and 2009 were among the first to experience a fully implemented, new, UK training programme, called the Foundation Training Programme, for junior doctors. We report doctors' views of the first Foundation year, based on comments made as part of a questionnaire survey covering career choices, plans, and experiences. Postal and email based questionnaires about career intentions, destinations and views were sent in 2009 and 2010 to all UK medical graduates of 2008 and 2009. This paper is a qualitative study of 'free-text' comments made by first-year doctors when invited to comment, if they wished, on any aspect of their work, education, training, and future. The response rate to the surveys was 48% (6220/12952); and 1616 doctors volunteered comments. Of these, 61% wrote about their first year of training, 35% about the working conditions they had experienced, 33% about how well their medical school had prepared them for work, 29% about their future career, 25% about support from peers and colleagues, 22% about working in medicine, and 15% about lifestyle issues. When concerns were expressed, they were commonly about the balance between service provision, administrative work, and training and education, with the latter often suffering when it conflicted with the needs of medical service provision. They also wrote that the quality of a training post often depended on the commitment of an individual senior doctor. Service support from seniors was variable and some respondents complained of a lack of team work and team ethic. Excessive hours and the lack of time for reflection and career planning before choices about the future had to be made were also mentioned. Some doctors wrote that their views were not sought by their hospital and that NHS management structures did not lend themselves to efficiency. UK graduates from non-UK homes felt insecure about their future career prospects in the UK. There were positive comments about

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

    Science.gov (United States)

    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

  7. Enhancing Doctoral Research Education through the Institution of Graduate Writing Courses in Ghanaian Universities

    Directory of Open Access Journals (Sweden)

    Joseph B. A. Afful

    2017-10-01

    Full Text Available A key support service in doctoral research that has increasingly gained attention is academic writing courses. This position paper argues for the institutionalization of graduate writing courses in universities in Ghana in order to acquaint doctoral students with the theoretical, procedural, and practical aspects of the writing of high stakes academic genres. An overview (including evaluation of existing courses on research- related writing in some universities is proffered. The study consequently presents arguments to support a proposal for institutional graduate writing courses in Ghanaian universities, followed by a discussion of other pertinent issues such as the curriculum, staffing, and funding. It is hoped that the institutionalization of such a writing support service will ultimately improve the quality of doctoral research education in Ghana

  8. Doctor-patient dialogue--basic aspect of medical consultation.

    Science.gov (United States)

    Murariu-Brujbu, Isabella Cristina; Macovei, Luana Andreea

    2013-01-01

    Family medicine is the specialty that provides ongoing primary medical care and improves the health status of the individual, of the family and of the community through preventive, educational, therapeutic and rehabilitation measures. The family doctor often makes the interdisciplinary synthesis, in a flexible manner, either alone or in most cases with interdisciplinary consultation. In the latter case, the family doctor initiates the team work and makes the final evaluation by using the longitudinal follow-up of the disease. The doctor-patient encounter represents the "confrontation" with the greatest moral weight, due to the complexity of the values involved, the status of the doctor in a society, and patient's involvement in decision making. The patient is a person who should be treated with respect, honesty, professionalism and loyalty, whatever the clinical status, severity of illness, mental competence or incompetence. A focus, on an international scale, is represented by the characteristics of a good doctor, family physician included, as the latter is the first link in the network of health services. Each model of consultation varies in a more or less subtle way in priorities assignment, and suggests slight differences regarding the role played by doctor and patient in their collaboration. The qualities of a good family physician include not only the strictly professional competences, that also apply to other medical specialties, but also duties, such as, clearly explaining to patients issues concerning their health, informing them about all the possible preventive measures of diseases, making a diagnosis, initiating and supervising a therapy. Medical responsibility lies at the crossroads between medical science and the conscience of the doctor.

  9. A design study for a simple-to-fly, constant attitude light aircraft

    Science.gov (United States)

    Smetana, F. O.; Humphreys, D. E.; Montoya, R. J.; Rickard, W. W.; Wilkinson, I. E.

    1973-01-01

    The activities during a four-year study by doctoral students to evolve in detail a design for a simple-to-fly, constant attitude light airplane are described. The study indicated that such aircraft could materially reduce the hazards to light airplane occupants which arise from the high pilot work load and poor visibility that occur during landing. Preliminary cost studies indicate that in volume production this system would increase the cost of the aircraft in roughly the same fashion that automatic transmission, power steering, power brakes, and cruise control increase the cost of a compact car.

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

    Science.gov (United States)

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

    2011-04-01

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

  11. Cementing Efficiency of Low Calcium Fly Ash in Fly Ash Concretes

    OpenAIRE

    T. D. Gunneswara Rao; Mudimby Andal

    2014-01-01

    Research on the utilization of fly ash will no longer refer the fly ash as a waste material of thermal power plants. Use of fly ash in concrete making, makes the concrete economical as well as durable. The fly ash is being added to the concrete in three ways namely, as partial replacement to cement, as partial replacement to fine aggregates and as admixture. Addition of fly ash to the concrete in any one of the form mentioned above, makes the concrete more workable and durable than the conven...

  12. A Bridging Approach to Boost Doctoral Enrollment in a HBCU: An Exploratory Qualitative Study

    Science.gov (United States)

    Birore, Charles M. S.; Wu, Liyun

    2017-01-01

    A declining enrollment in doctoral social work programs not only affects the sustainability of the programs, but also impacts the knowledge-based economy in the long run. The shortage of doctoral-prepared faculty, interwoven with the current national shortage of social workers, will limit effective service delivery, and generation of knowledge…

  13. FlySec: a risk-based airport security management system based on security as a service concept

    Science.gov (United States)

    Kyriazanos, Dimitris M.; Segou, Olga E.; Zalonis, Andreas; Thomopoulos, Stelios C. A.

    2016-05-01

    Complementing the ACI/IATA efforts, the FLYSEC European H2020 Research and Innovation project (http://www.fly-sec.eu/) aims to develop and demonstrate an innovative, integrated and end-to-end airport security process for passengers, enabling a guided and streamlined procedure from the landside to airside and into the boarding gates, and offering for an operationally validated innovative concept for end-to-end aviation security. FLYSEC ambition turns through a well-structured work plan into: (i) innovative processes facilitating risk-based screening; (ii) deployment and integration of new technologies and repurposing existing solutions towards a risk-based Security paradigm shift; (iii) improvement of passenger facilitation and customer service, bringing security as a real service in the airport of tomorrow;(iv) achievement of measurable throughput improvement and a whole new level of Quality of Service; and (v) validation of the results through advanced "in-vitro" simulation and "in-vivo" pilots. On the technical side, FLYSEC achieves its ambitious goals by integrating new technologies on video surveillance, intelligent remote image processing and biometrics combined with big data analysis, open-source intelligence and crowdsourcing. Repurposing existing technologies is also in the FLYSEC objectives, such as mobile application technologies for improved passenger experience and positive boarding applications (i.e. services to facilitate boarding and landside/airside way finding) as well as RFID for carry-on luggage tracking and quick unattended luggage handling. In this paper, the authors will describe the risk based airport security management system which powers FLYSEC intelligence and serves as the backend on top of which FLYSEC's front end technologies reside for security services management, behaviour and risk analysis.

  14. Doctoral Women: Managing Emotions, Managing Doctoral Studies

    Science.gov (United States)

    Aitchison, Claire; Mowbray, Susan

    2013-01-01

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

  15. Impact of doctors' resistance on success of drug utilization review system.

    Science.gov (United States)

    Choi, Jong Soo; Yun, Seong Hyeon; Kim, Dongsoo; Park, Seung Woo

    2014-04-01

    The drug utilization review (DUR) system, which checks any conflict event of medications, contributes to improve patient safety. One of the important barriers in its adoption is doctors' resistance. This study aimed to analyze the impacts of doctors' resistance on the success of the DUR system. This study adopted an augmented the DeLone and McLean Information System (D&M IS) Success Model (2003), which used doctors' resistance as a socio-technological measure. This study framework is the same as that of the D&M IS Success Model in that it is based on qualities, such as system, information, and services. The major difference is that this study excluded the variable 'use' because it was not statistically significant for mandatory systems. A survey of doctors who used computers to enter prescriptions was conducted at a Korean tertiary hospital in February 2012. This study is very meaningful in that it is the first study to explore the success factors of the DUR system associated with doctors' resistance. Doctors' resistance to the DUR system was not statistically associated with user usefulness, whereas it affected user satisfaction. The results indicate that doctors still complain of discomfort in using the DUR system in the outpatient clinical setting, even though they admit that it contributes to patient safety. To mitigate doctors' resistance and raise user satisfaction, more opinions from doctors regarding the DUR system have to be considered and have to be reflected in the system.

  16. Doctors' attitudes and practices regarding smoking cessation during ...

    African Journals Online (AJOL)

    Abstract. Objective. To investigate the current smoking cessation practices and attitudes of doctors working in the public antenatal services, as well as their perceived barriers to addressing the issue in the context of routine care. Study design. The study was qualitative, consisting of 14 semistructured, one-to-one interviews ...

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

    Science.gov (United States)

    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

  18. Can E. coli fly?

    DEFF Research Database (Denmark)

    Lindeberg, Yrja Lisa; Egedal, Karen; Hossain, Zenat Zebin

    2018-01-01

    , and the numbers of flies landing on the exposed rice were counted. Following exposure, the surface of the rice was microbiologically and molecularly analysed for the presence of E. coli and genes of diarrheagenic E. coli and Shigella strains. RESULTS: Rice was at greater risk (p ... with E. coli if flies landed on the rice than if no flies landed on the rice (odds ratio 5·4 (p ...-landings, the average CFU per fly-landing was > 0·6 x 103 CFU. Genes of diarrheagenic E. coli and Shigella species were detected in 39 of 60 (65%) of exposed rice samples. Two fly species were identified; the common housefly (Musca domestica) and the oriental latrine fly (Chrysomya megacephala). CONCLUSION: Flies may...

  19. Doctors in Balzac's work.

    Science.gov (United States)

    Moulin, Thierry

    2013-01-01

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

  20. Chiropractic Health Care: A National Study of Cost of Education, Service Utilization, Number of Practicing Doctors of Chiropractic, and Other Key Policy Issues. Volumes I-II.

    Science.gov (United States)

    von Kuster, Thomas, Jr.

    Results from the first federally sponsored study of the chiropractic health care profession are presented, and a broad range of facts and issues of concern to policy-makers, the profession, and the public are described. The two-year project included three national surveys of: service providers (doctors of chiropractic in practice more than two…

  1. Fly ash carbon passivation

    Science.gov (United States)

    La Count, Robert B; Baltrus, John P; Kern, Douglas G

    2013-05-14

    A thermal method to passivate the carbon and/or other components in fly ash significantly decreases adsorption. The passivated carbon remains in the fly ash. Heating the fly ash to about 500 and 800 degrees C. under inert gas conditions sharply decreases the amount of surfactant adsorbed by the fly ash recovered after thermal treatment despite the fact that the carbon content remains in the fly ash. Using oxygen and inert gas mixtures, the present invention shows that a thermal treatment to about 500 degrees C. also sharply decreases the surfactant adsorption of the recovered fly ash even though most of the carbon remains intact. Also, thermal treatment to about 800 degrees C. under these same oxidative conditions shows a sharp decrease in surfactant adsorption of the recovered fly ash due to the fact that the carbon has been removed. This experiment simulates the various "carbon burnout" methods and is not a claim in this method. The present invention provides a thermal method of deactivating high carbon fly ash toward adsorption of AEAs while retaining the fly ash carbon. The fly ash can be used, for example, as a partial Portland cement replacement in air-entrained concrete, in conductive and other concretes, and for other applications.

  2. A Closer Look at the Junior Doctor Crisis in the United Kingdom's National Health Services: Is Emigration Justifiable?

    Science.gov (United States)

    Teo, Wendy Zi Wei

    2018-07-01

    This article attempts to tackle the ethically and morally troubling issue of emigration of physicians from the United Kingdom, and whether it can be justified. Unlike most research that has already been undertaken in this field, which looks at migration from developing countries to developed countries, this article takes an in-depth look at the migration of physicians between developed countries, in particular from the United Kingdom (UK) to other developed countries such as Canada, Australia, New Zealand, and the United States (US). This examination was written in response to a current and critical crisis in the National Health Service (NHS), where impending contract changes may bring about a potential exodus of junior doctors.

  3. Doctor-assisted suicide: What is the present legal position in South Africa?

    Science.gov (United States)

    McQuoid-Mason, David J

    2015-09-21

    In the recent case of Stransham-Ford v. the Minister of Justice and Correctional Services, the North Gauteng High Court held that a terminally ill patient who was experiencing intractable suffering was entitled to commit suicide with the assistance of his doctor and that the doctor's conduct would not be unlawful. The court was careful to state that it was not making a general rule about doctor-assisted suicide. The latter should be left to the Parliament, the Constitutional Court and 'future courts'. The judge dealt specifically with the facts of the case at hand. In order to understand the basis of the decision it is necessary to consider: (i) the facts of the case; (ii) the question of causation; (iii) the paradox of 'passive' and 'active' euthanasia; (iv) the test for unlawfulness in euthanasia cases; and (v) the meaning of doctor-assisted suicide. It is also necessary to clarify the present legal position regarding doctor-assisted suicide.

  4. FliO Regulation of FliP in the Formation of the Salmonella enterica Flagellum

    OpenAIRE

    Barker, Clive S.; Meshcheryakova, Irina V.; Kostyukova, Alla S.; Samatey, Fadel A.

    2010-01-01

    The type III secretion system of the Salmonella flagellum consists of 6 integral membrane proteins: FlhA, FlhB, FliO, FliP, FliQ, and FliR. However, in some other type III secretion systems, a homologue of FliO is apparently absent, suggesting it has a specialized role. Deleting the fliO gene from the chromosome of a motile strain of Salmonella resulted in a drastic decrease of motility. Incubation of the ΔfliO mutant strain in motility agar, gave rise to pseudorevertants containing extrageni...

  5. McDonaldization or commercial re-stratification: corporatization and the multimodal organisation of English doctors.

    Science.gov (United States)

    Waring, Justin; Bishop, Simon

    2013-04-01

    This paper investigates transitions in the social organisation of medicine found in the extended opportunities for private corporations to own, manage and deliver public healthcare services in the English National Health Service. It follows recent calls to explain the reconstruction of medical work without reducing analysis to either the structures of organisational control or the strategic resistance of doctors. Accordingly, the paper considers how doctors interact, mediate and co-create new organisational environments. Central to our analysis are the variable sources of power that influence whether doctors acquiesce, resist or re-create change. Drawing on ethnographic research carried out between 2006 and 2010 in two Independent Sector Treatment Centres - private providers of public healthcare - the paper shows how doctors' responses to bureaucratic and commercial structures reflect their own structured forms of power, which have variable value within this new commercial environment. These include clinical experience and specialist knowledge, but also social and economic influence. Building on established sociological debates, these divergent sources of power explain how for some doctors the expansion of private healthcare might involve more extreme forms of McDonaldization, while for others it might involve opportunities for Commercial Re-stratification. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Malaysian primary care doctors' views on men's health: an unresolved jigsaw puzzle.

    Science.gov (United States)

    Tong, Seng Fah; Low, Wah Yun; Ismail, Shaiful Bahari; Trevena, Lyndal; Willcock, Simon

    2011-05-12

    Men have been noted to utilise health care services less readily then women. Primary care settings provide an opportunity to engage men in health care activities because of close proximity to the target group (men in the community). Understanding attitudes towards men's health among Malaysian primary care doctors is important for the effective delivery of health services to men. We aimed to explore the opinions and attitudes of primary care doctors (PCDs) relating to men's health and help-seeking behaviour. A qualitative approach to explore the opinions of 52 PCDs was employed, using fourteen in-depth interviews and eight focus group discussions in public and private settings. Purposive sampling of PCDs was done to ensure maximum variation in the PCD sample. Interviews were recorded and transcribed verbatim for analysis. Open coding with thematic analysis was used to identify key issues raised in the interview. The understanding of the concept of men's health among PCDs was fragmented. Although many PCDs were already managing health conditions relevant and common to men, they were not viewed by PCDs as "men's health". Less attention was paid to men's help-seeking behaviour and their gender roles as a potential determinant of the poor health status of men. There were opposing views about whether men's health should focus on men's overall health or a more focused approach to sexual health. There was also disagreement about whether special attention was warranted for men's health services. Some doctors would prioritise more common conditions such as hypertension, diabetes and hypercholesterolaemia. The concept of men's health was new to PCDs in Malaysia. There was wide variation in understanding and opposing attitudes towards men's health among primary care doctors. Creating awareness and having a systematic approach would facilitate PCDs in delivering health service to men.

  7. Malaysian primary care doctors' views on men's health: an unresolved jigsaw puzzle

    Directory of Open Access Journals (Sweden)

    Ismail Shaiful

    2011-05-01

    Full Text Available Abstract Background Men have been noted to utilise health care services less readily then women. Primary care settings provide an opportunity to engage men in health care activities because of close proximity to the target group (men in the community. Understanding attitudes towards men's health among Malaysian primary care doctors is important for the effective delivery of health services to men. We aimed to explore the opinions and attitudes of primary care doctors (PCDs relating to men's health and help-seeking behaviour. Methods A qualitative approach to explore the opinions of 52 PCDs was employed, using fourteen in-depth interviews and eight focus group discussions in public and private settings. Purposive sampling of PCDs was done to ensure maximum variation in the PCD sample. Interviews were recorded and transcribed verbatim for analysis. Open coding with thematic analysis was used to identify key issues raised in the interview. Results The understanding of the concept of men's health among PCDs was fragmented. Although many PCDs were already managing health conditions relevant and common to men, they were not viewed by PCDs as "men's health". Less attention was paid to men's help-seeking behaviour and their gender roles as a potential determinant of the poor health status of men. There were opposing views about whether men's health should focus on men's overall health or a more focused approach to sexual health. There was also disagreement about whether special attention was warranted for men's health services. Some doctors would prioritise more common conditions such as hypertension, diabetes and hypercholesterolaemia. Conclusions The concept of men's health was new to PCDs in Malaysia. There was wide variation in understanding and opposing attitudes towards men's health among primary care doctors. Creating awareness and having a systematic approach would facilitate PCDs in delivering health service to men.

  8. Doctors Today

    LENUS (Irish Health Repository)

    Murphy, JFA

    2012-03-01

    Doctors’ relationship with patients and their role in society is changing. Until the 1960s doctors concentrated on the welfare of patients with less emphasis placed on patients’ rights1. Over recent decades there has been increasing empowerment of the individual across all facets of society including health care. Doctors continue to be perceived as having expertise and authority over medical science. Patients, however, now hold sway over questions of values or preferences. We all must be aware of this change in the doctor- patient interaction. We need to be more aware of the outcomes that patients view as important. The concept of shared decision-making with the patient is now widely appreciated. The process involves a change in mind set particularly for doctors who trained in an earlier era.

  9. Cost incentives for doctors

    DEFF Research Database (Denmark)

    Schottmüller, Christoph

    2013-01-01

    If doctors take the costs of treatment into account when prescribing medication, their objectives differ from their patients' objectives because the patients are insured. This misalignment of interests hampers communication between patient and doctor. Giving cost incentives to doctors increases...... welfare if (i) the doctor's examination technology is sufficiently good or (ii) (marginal) costs of treatment are high enough. If the planner can costlessly choose the extent to which doctors take costs into account, he will opt for less than 100%. Optimal health care systems should implement different...... degrees of cost incentives depending on type of disease and/or doctor....

  10. Analytical model for erosion behaviour of impacted fly-ash particles ...

    Indian Academy of Sciences (India)

    Mathematical model; erosion rate; boiler components; fly ash ... sion, together with the processes of blocking, fouling and corrosion, shortens the service-life of boiler ..... Jun Y D, Tabakoff W 1994 Numerical simulation of a dilute particulate flow ...

  11. Providing healthcare services on-the-fly using multi-player cooperation game theory in Internet of Vehicles (IoV environment

    Directory of Open Access Journals (Sweden)

    Neeraj Kumar

    2015-08-01

    Full Text Available Internet of Vehicles (IoV is a leading technology of the present era. It has gained huge attention with respect to its implementation in wide variety of domains ranging from traffic safety to infotainment applications. However, IoV can also be extended to healthcare domain, where the patients can be provided healthcare services on-the-fly. We extend this novel concept in this paper and refer it as “Healthcare services on-the-fly”. The concept of game theory has been used among the vehicles to access the healthcare services while traveling. The vehicles act as players in the game and tend to form and split coalitions to access these services. Learning automata (LA act as the players for interaction with the environment and take appropriate actions based on reward and penalty. Apart from this, Virtual Machine (VM scheduling algorithm for efficient utilization of resources at cloud level has also been formulated. A stochastic reward net (SRN-based model is used to represent the coalition formation and splitting with respect to availability of resources at cloud level. The performance of the proposed scheme is evaluated using various performance evaluation metrics. The results obtained prove the effectiveness of the proposed scheme in comparison to the best, first, and random fit schemes.

  12. Fly ash aggregates. Vliegaskunstgrind

    Energy Technology Data Exchange (ETDEWEB)

    1983-03-01

    A study has been carried out into artificial aggregates made from fly ash, 'fly ash aggregates'. Attention has been drawn to the production of fly ash aggregates in the Netherlands as a way to obviate the need of disposal of fly ash. Typical process steps for the manufacturing of fly ash aggregates are the agglomeration and the bonding of fly ash particles. Agglomeration techniques are subdivided into agitation and compaction, bonding methods into sintering, hydrothermal and 'cold' bonding. In sintering no bonding agent is used. The fly ash particles are more or less welded together. Sintering in general is performed at a temperature higher than 900 deg C. In hydrothermal processes lime reacts with fly ash to a crystalline hydrate at temperatures between 100 and 250 deg C at saturated steam pressure. As a lime source not only lime as such, but also portland cement can be used. Cold bonding processes rely on reaction of fly ash with lime or cement at temperatures between 0 and 100 deg C. The pozzolanic properties of fly ash are used. Where cement is applied, this bonding agent itself contributes also to the strength development of the artificial aggregate. Besides the use of lime and cement, several processes are known which make use of lime containing wastes such as spray dry absorption desulfurization residues or fluid bed coal combustion residues. (In Dutch)

  13. Hydration of fly ash cement and microstructure of fly ash cement pastes

    Energy Technology Data Exchange (ETDEWEB)

    Shiyuan, H.

    1981-01-01

    The strength development and hydration of fly ash cement and the influence of addition of gypsum on those were studied at normal and elevated temperatures. It was found that an addition of a proper amount of gypsum to fly ash cement could accelerate the pozzolanic reaction between CH and fly ash, and as a result, increase the strength of fly ash cement pastes after 28 days.

  14. Asthma management in pregnancy: young female doctors knowledge and practice

    International Nuclear Information System (INIS)

    Younis, M.; Anwar, S.; Aneela, I.; Saeed, M.S.

    2012-01-01

    Background: Optimal asthma control in pregnant women is very much essential for the good health of both mother and the fetus. Maternal and fetal complications occur due to poor control of asthma. There are concerns that management of bronchial asthma in pregnant women should be optimal by the health professionals. Objective: The aim of the study was to evaluate the knowledge and practices of young female doctors about the bronchial asthma management in pregnancy. Study Design: Randomized evidence based. Study Setting: Punjab Public Service Commission (PPSC) interviews for women medical officers and female doctors working in different medical units and chest unit of Mayo Hospital a tertiary care hospital affiliated with King Edward Medical University, Lahore. Materials and Methods: A questionnaire based survey of knowledge and practices of one hundred and one female doctors in the management of bronchial asthma was made. Amongst these, 32 doctors were FCPS 1 in medicine and gynecology. Remaining 69 doctors were in the pipeline and they have completed one year house job in different specialties. The case scenario was Asthma management approach during pregnancy in a stable patient of moderate severity. Inclusion Criteria 1. All those female doctors who have completed one year house job. 2. Female doctors working in gynecology, medicine, surgery and allied specialties. Results: Overall 14 (13.6%) doctors (5 (35.7%) PGs and 9 (64.3%) Non PGs) have the standard prescription of inhaled corticosteroids with long acting inhaled B2 agonists and montelukast as controller medication and short acting inhaled B2 agonist as needed as reliever medication according to the standard guidelines. Conclusion: The majority of young female doctors had the suboptimal knowledge and practice of asthma management in pregnancy. We suggest initiating the training programs to optimize their knowledge and practices. (author)

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

    Science.gov (United States)

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

    2010-03-01

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

  16. Exporting doctoral education: experience of a state-supported university.

    Science.gov (United States)

    Stoskopf, Carleen H; Xirasagar, Sudha; Han, Whiejong M; Snowdon, Sonja

    2007-01-01

    There is a demand for non-traditional doctoral education in healthcare management and policy among many countries in support of their health system reform efforts. Healthcare professionals need retooling to provide stewardship to complex new health financing systems. Most health service leaders are mid career professionals and cannot transplant themselves to study on American university campuses. They demand high quality programs, designed to enable most coursework to be completed overseas. Aided by recent distance education technology, the University of South Carolina's Department of Health Services Policy and Management developed and provides doctoral programs for working professionals in Taiwan and South Korea with a minimal and convenient campus attendance requirement. This paper presents the experience of setting up the programs, management, quality control, and benefits for both students overseas and for our Department's mission and on-campus programs. Our experience is that there are many challenges, but it is also rewarding from academic, scholarly, and financial perspectives.

  17. Re-Imagining Doctoral Education: Professional Doctorates and beyond

    Science.gov (United States)

    Lee, Alison; Brennan, Marie; Green, Bill

    2009-01-01

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

  18. Dynamics between doctors and managers in the Italian National Health Care System.

    Science.gov (United States)

    Vicarelli, Giovanna M; Pavolini, Emmanuele

    2017-11-01

    This article focuses on the changes in the Italian NHS by concentrating on patterns in the managerialisation of doctors. It addresses a series of shortcomings in studies on the response by doctors to managerialisation. The first is a shortcoming of theoretical and analytical nature. It is necessary to adopt a broader perspective whereby analysis considers not only the interaction between doctors and managers, but also the public control and regulation agencies that operate in that field. The second shortcoming is a methodological one. The literature on managerialisation is more theoretical than applied. It is necessary to adopt a strategy based on a plurality of methodologies and sources in order to focus attention on a national case (Italy in the present study), discussing the changes over time (from the beginning of managerialisation until today) and considering different groups within the medical profession. The outcome is a complex picture of the dynamics between doctors and managers which foregrounds the managerial co-optation processes of a small group of national health service doctors, the transition from strategic adaptation to forms of resistance against managerialisation by the majority of Italian NHS doctors, and the emergence of restratification processes among self-employed doctors working with the NHS. © 2017 Foundation for the Sociology of Health & Illness.

  19. The "doctor-customer" relationship: Hippocrates in the modern marketplace.

    Science.gov (United States)

    Mulhall, Kevin J; Ahmed, Aftab; Masterson, Eric

    2002-01-01

    We performed a consecutive survey of 100 people presenting to a hospital injury clinic to ascertain their attitude to terminology currently used to describe them in our own institution and in the international literature. The results of this demonstrated that the subjects significantly preferred the traditional assignation "patient" rather than terms such as client or customer. This finding reflects the need to remember peoples' attitudes and expectations from their consultation with their doctor. Although business models undoubtedly help in the provision of an efficient health care service, remaining at the centre of this encounter is a doctor-patient relationship that involves a more complex interaction than simply a market transaction.

  20. Corrosion Measurements in Reinforced Fly Ash Concrete Containing Steel Fibres Using Strain Gauge Technique

    Directory of Open Access Journals (Sweden)

    V. M. Sounthararajan

    2013-01-01

    Full Text Available Corrosion of steel bars in concrete is a serious problem leading to phenomenal volume expansion and thereby leading to cover concrete spalling. It is well known that the reinforced concrete structures subjected to chloride attack during its service life cause these detrimental effects. The early detection of this damage potential can extend the service life of concrete. This study reports the comprehensive experimental studies conducted on the identification of corrosion mechanism in different types of reinforced concrete containing class-F fly ash and hooked steel fibres. Fly ash replaced concrete mixes were prepared with 25% and 50% fly ash containing steel fibres at 0.5%, 1.0%, and 1.5% by volume fraction. Corrosion process was investigated in an embedded steel bar (8 mm diameter reinforced in concrete by passing an impressed current in sodium chloride solution. Strain gauge attached to the rebars was monitored for electrical measurements using strain conditioner. Strain gauge readings observed during the corrosion process exhibited the volume changes of the reinforcement embedded inside the concrete. The corrosion potential of different steel fibre reinforced concrete mixes with fly ash addition showed higher resistance towards the corrosion initiation.

  1. Doctors and pharmaceutical industry.

    Science.gov (United States)

    Beran, Roy G

    2009-09-01

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

  2. Ommatidia of blow fly, house fly, and flesh fly: implication of their vision efficiency.

    Science.gov (United States)

    Sukontason, Kabkaew L; Chaiwong, Tarinee; Piangjai, Somsak; Upakut, Sorawit; Moophayak, Kittikhun; Sukontason, Kom

    2008-06-01

    This work aims to elucidate the number of ommatidia or facets (the outwardly visible units of each ommatidium) for compound eyes in blow flies [Chrysomya megacephala (F.), Chrysomya rufifacies (Macquart), Chrysomya nigripes (Aubertin), Lucilia cuprina (Wiedemann)], house flies (Musca domestica L.), and flesh flies (Liosarcophaga dux Thomson) by manual counts of the corneal spreads. The head of the fly in each species was soaked in 20% potassium hydroxide solution at room temperature for 7 days, and the clear compound eye was dissected into six small parts, each of which was placed onto a slide and flattened using a coverslip. Images of each part were obtained using a microscope connected to a computer. The printed images of each part were magnified, and the total number of ommatidia per eye was manually counted. For males, the mean number of ommatidia was statistically different among all flies examined: L. dux (6,032) > C. rufifacies (5,356) > C. nigripes (4,798) > C. megacephala (4,376) > L. cuprina (3,665) > M. domestica (3,484). Likewise, the mean number of facets in females was statistically different: L. dux (6,086) > C. megacephala (5,641) > C. rufifacies (5,208) > C. nigripes (4,774) > L. cuprina (3,608) > M. domestica (3433). Scanning electron microscopy analysis of adult flies revealed the sexual dimorphism in the compound eye. Male C. megacephala had large ommatidia in the upper two thirds part and small ommatidia in the lower one third part, whereas only small ommatidia were detected in females. Dense postulate appearance was detected in the external surface of the corneal lens of the ommatidia of C. megacephala, C. rufifacies, and C. nigripes, while a mix of dense postulate appearance and variable groove array length was detected in L. cuprina and M. domestica. The probable functions of ommatidia are discussed with reference to other literature.

  3. Doctors and romance: not only of interest to Mills and Boon readers.

    Science.gov (United States)

    Callister, Paul; Badkar, Juthika; Didham, Robert

    2009-06-01

    Internationally there is a growing demand for health services. Skilled health workers, including doctors, have a high degree of international mobility and New Zealand (NZ) stands out internationally in terms of the significant flows of doctors in and out of the country. Through changes in training of doctors in NZ and migration flows, there have been major shifts in the composition of the medical workforce in NZ since the mid-1980s. Studies of the changing nature of the medical workforce often focus on gender and migration separately as well as only considering doctors as individuals. The aim of this exploratory study is to examine the living arrangements of doctors, the composition of migrant doctors who are coming to NZ, and to understand the educational and employment status of the partners of doctors. This study is a descriptive analysis primarily using census data from 1986 through to 2006 and immigration data collected by the Department of Labour. Half of the female medical doctors approved for residence through the Skilled/Business stream migrated independently, while for male doctors less than athird came to NZ independently. Male migrant doctors were more likely to be partnered. Census data showed that people with medical backgrounds tend to partner with each other. However, these relationships are changing, as more women become doctors. In 1986 about 14% of male doctors had a nurse or midwife as a partner and nearly 9% had a doctor partner. By 2006 the proportion of partners of male doctors who were also doctors had risen to 16%, higher than the 9% who were nurses. For female doctors the changes are more dramatic. In 1986, 42% of female doctors in relationships had a doctor as a partner. By 2006, female doctors had increased substantially, but the percentage with a doctor partner had dropped to under athird. Well-qualified couples where one or both are doctors, have a greater propensityto live in main urban areas. Through official reports and extensive

  4. The Fly Printer - Extended

    DEFF Research Database (Denmark)

    Beloff, Laura; Klaus, Malena

    2016-01-01

    Artist talk / Work-in-progress What is the purpose of a machine or an artifact, like the Fly Printer, that is dislocated, that produces images that have no meaning, no instrumentality, that depict nothing in the world? The biological and the cultural are reunited in this apparatus as a possibility...... to break through a common way of depicting the world, trying to find different surfaces and using strange apparatus to insist in the interstice of visibility. The Fly Printer is a printing apparatus in a form of a closed environment that contains a flock of fruit flies. The flies eat special food...... that is prepared for them that is mixed with laser jet printer inks. The flies digest the food and gradually print different color dots onto the paper that is placed under the fly habitat. In the Fly Printer biological organisms are used for replacing a standard part of our common printer technology. The work...

  5. Wanted--doctors who care.

    Science.gov (United States)

    Lovdal, L T; Pearson, R

    1989-03-01

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

  6. Australian doctors and the visual arts. Part 3. Doctor-artists in Victoria.

    Science.gov (United States)

    Hamilton, D G

    1986-06-09

    The contribution of doctors to the visual arts is being discussed in a series of six articles. The first two articles dealt with doctors and the visual arts in New South Wales. In this, the third, doctor-artists in Victoria are discussed.

  7. [Patients' rights--doctors' duties].

    Science.gov (United States)

    Jaeger, L; Bertram, E; Grate, S; Mischkowsky, T; Paul, D; Probst, J; Scala, E; Wbllenweber, H D

    2015-06-01

    On 26 February 2013 the new "Law on Patients' Rights" (hereinafter also the "Law") became effective. This Law strengthens patients' rights vis-à-vis the insurdnce company and also regulates patients' rights regarding their relation to the doctor. This has consequences for the laws on medical liability all doctors must consider. The doctor's performance is and remains a service and such service does not hold any guarantee of success. Nevertheless, this Law primarily reads as a "law on the duties of physicians". To duly take into account these duties and to avoid mistakes and misinterpretation of the Law, the Ethics Committee of the Consortium of Osteosynthesis Trauma Germany (AOTRAUMA-D) has drafted comments on the Law. Brief summaries of its effects are to be found at the end of the respective comment under the heading "Consequences for Practice". The text of the law was influenced particularly by case law, as continuously developed by the German Federal Court of Justice ("BGH"). The implementation of the Law on Patients' Rights was effected by the newly inserted sections 630a to 630h of the German Civil Code (the "BGB"), which are analysed below. The following comments are addressed to physicians only and do not deal with the specific requirements and particularities of the other medical professions such as physiotherapy, midwifery and others so on. Special attention should be paid to the comments on the newly inserted Duty to inform, which has to be fullfilled prior to any diagnostic or therapeutic procedure (sec. 630c para 2 sentence 1 BGB). Under certain conditions the doctor also has to inform the patient about the circumstances that lead to the presumed occurance of a therapeutic or diagnostic malpractice (sec. 630c para. 2 sentence 2 BGB), based on the manifestation of an undesired event or an undesired outcome. As before, the patient's valid consent to any procedure (sec. 630d BGB) is directly linked to the comprehensive and timely provision of information

  8. Views of senior UK doctors about working in medicine: questionnaire survey.

    Science.gov (United States)

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

    2014-11-01

    We surveyed the UK medical qualifiers of 1993. We asked closed questions about their careers; and invited them to give us comments, if they wished, about any aspect of their work. Our aim in this paper is to report on the topics that this senior cohort of UK-trained doctors who work in UK medicine raised with us. Questionnaire survey. 3479 contactable UK-trained medical graduates of 1993. UK. Comments made by doctors about their work, and their views about medical careers and training in the UK. Postal and email questionnaires. Response rate was 72% (2507); 2252 were working in UK medicine, 816 (36%) of whom provided comments. Positive comments outweighed negative in the areas of their own job satisfaction and satisfaction with their training. However, 23% of doctors who commented expressed dissatisfaction with aspects of junior doctors' training, the impact of working time regulations, and with the requirement for doctors to make earlier career decisions than in the past about their choice of specialty. Some doctors were concerned about government health service policy; others were dissatisfied with the availability of family-friendly/part-time work, and we are concerned about attitudes to gender and work-life balance. Though satisfied with their own training and their current position, many senior doctors felt that changes to working hours and postgraduate training had reduced the level of experience gained by newer graduates. They were also concerned about government policy interventions.

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

    Science.gov (United States)

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

    2012-06-01

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

  10. Doctors' enjoyment of their work and satisfaction with time available for leisure: UK time trend questionnaire-based study.

    Science.gov (United States)

    Surman, Geraldine; Lambert, Trevor W; Goldacre, Michael

    2016-04-01

    Doctors' job satisfaction is important to the health service to ensure commitment, effective training, service provision and retention. Job satisfaction matters to doctors for their personal happiness, fulfilment, service to patients and duty to employers. Monitoring job satisfaction trends informs workforce planning. We surveyed UK-trained doctors up to 5 years after graduation for six graduation year cohorts: 1996, 1999, 2002, 2005, 2008, 2012. Doctors scored their job enjoyment (Enjoyment) and satisfaction with time outside work (Leisure) on a scale from 1 (lowest enjoyment/satisfaction) to 10 (highest). Overall, 47% had a high level of Enjoyment (scores 8-10) 1 year after graduation and 56% after 5 years. For Leisure, the corresponding figures were 19% and 37% at 1 and 5 years, respectively. For Leisure at 1 year, high scores were given by about 10% in the 1990s, rising to about 25% in the mid-2000s. Low scores (1-3) for Enjoyment were given by 15% of qualifiers of 1996, falling to 5% by 2008; corresponding figures for Leisure were 42% and 19%. At 5 years, the corresponding figures were 6% and 4%, and 23% and 17%. Enjoyment and Leisure were scored higher by general practitioners than doctors in other specialties. Both measures varied little by sex, ethnicity or medical school attended. Scores for Enjoyment were generally high; those for Leisure were lower. Policy initiatives should address why this aspect of satisfaction is low, particularly in the first year after graduation but also among hospital doctors 5 years after graduation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Non-EEA-doctors in EEA-countries: doctors or cleaners?

    NARCIS (Netherlands)

    Herfs, Paul; Kater, L.; Haalboom, J.R.E.

    2007-01-01

    Background: Migration of non-EEA doctors to EEA-countries has become a common phenomenon. As coordination within the EEA has not yet been established, every EEA-country is re-inventing the wheel of assessment of foreign medical degrees and developing additional programmes for non-EEA doctors. There

  12. The onion fly

    International Nuclear Information System (INIS)

    Loosjes, M.

    1990-01-01

    This paper describes the origin, practical application, problems in application and prospects of control of the onion fly, Delia antiqua (Diptera: Anthomyiidae), in the Netherlands by the Sterile Insect Technique (SIT). The larva of the onion fly is a severe pest in onions in temperate regions. Development of resistance of the onion fly against insecticides caused research on the SIT to be started by the Dutch Government in 1965. This research was on mass-rearing, long-term storage of pupae, sterilization, and release and ratio assessment techniques. By 1979 sufficient information had been turned over to any interested private company. In the case of the onion fly the SIT can be applied like a control treatment instead of chemical control to individual onion fields. This is due to the limited dispersal activity of the flies and the scattered distribution of onion fields in the Netherlands, with 5-10% of the onion growing areas planted with onions

  13. Soluble components of the flagellar export apparatus, FliI, FliJ, and FliH, do not deliver flagellin, the major filament protein, from the cytosol to the export gate.

    Science.gov (United States)

    Sajó, Ráchel; Liliom, Károly; Muskotál, Adél; Klein, Agnes; Závodszky, Péter; Vonderviszt, Ferenc; Dobó, József

    2014-11-01

    Flagella, the locomotion organelles of bacteria, extend from the cytoplasm to the cell exterior. External flagellar proteins are synthesized in the cytoplasm and exported by the flagellar type III secretion system. Soluble components of the flagellar export apparatus, FliI, FliH, and FliJ, have been implicated to carry late export substrates in complex with their cognate chaperones from the cytoplasm to the export gate. The importance of the soluble components in the delivery of the three minor late substrates FlgK, FlgL (hook-filament junction) and FliD (filament-cap) has been convincingly demonstrated, but their role in the transport of the major filament component flagellin (FliC) is still unclear. We have used continuous ATPase activity measurements and quartz crystal microbalance (QCM) studies to characterize interactions between the soluble export components and flagellin or the FliC:FliS substrate-chaperone complex. As controls, interactions between soluble export component pairs were characterized providing Kd values. FliC or FliC:FliS did not influence the ATPase activity of FliI alone or in complex with FliH and/or FliJ suggesting lack of interaction in solution. Immobilized FliI, FliH, or FliJ did not interact with FliC or FliC:FliS detected by QCM. The lack of interaction in the fluid phase between FliC or FliC:FliS and the soluble export components, in particular with the ATPase FliI, suggests that cells use different mechanisms for the export of late minor substrates, and the major substrate, FliC. It seems that the abundantly produced flagellin does not require the assistance of the soluble export components to efficiently reach the export gate. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. A study of the relationship between resilience, burnout and coping strategies in doctors.

    Science.gov (United States)

    McCain, R Scott; McKinley, Nicola; Dempster, Martin; Campbell, W Jeffrey; Kirk, Stephen J

    2017-08-09

    The aim of this study was to measure resilience, coping and professional quality of life in doctors. A cross-sectional study using an online questionnaire in a single National Health Service trust, including both primary and secondary care doctors. 283 doctors were included. Mean resilience was 68.9, higher than population norms. 100 (37%) doctors had high burnout, 194 (72%) doctors had high secondary traumatic stress and 64 (24%) had low compassion satisfaction. Burnout was positively associated with low resilience, low compassion satisfaction, high secondary traumatic stress and more frequent use of maladaptive coping mechanisms, including self-blame, behavioural disengagement and substance use. Non-clinical issues in the workplace were the main factor perceived to cause low resilience in doctors. Despite high levels of resilience, doctors had high levels of burnout and secondary traumatic stress. Doctors suffering from burnout were more likely to use maladaptive coping mechanisms. As doctors already have high resilience, improving personal resilience further may not offer much benefit to professional quality of life. A national study of professional Quality of Life, Coping And REsilience, which we are proposing to undertake, will for the first time assess the UK and Ireland medical workforce in this regard and guide future targeted interventions to improve professional quality of life. © 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.

  15. Talking to Your Doctor

    Medline Plus

    Full Text Available ... to Your Doctor , National Eye Institute (NEI) Español Aging Planning Your Doctor Visit , NIHSeniorHealth.gov Videos: Talking ... A Guide for Older People , National Institute on Aging (NIA) Talking With Your Doctor Presentation Toolkit , National ...

  16. 9 CFR 355.16 - Control of flies, rats, mice, etc.

    Science.gov (United States)

    2010-01-01

    ... INSPECTION AND CERTIFICATION CERTIFIED PRODUCTS FOR DOGS, CATS, AND OTHER CARNIVORA; INSPECTION... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Control of flies, rats, mice, etc. 355.16 Section 355.16 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF...

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

    Science.gov (United States)

    Baylor Coll. of Medicine, Houston, TX.

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

  18. Lifestyle Medicine: Lifestyle Profile of Resident Doctors in a Nigerian ...

    African Journals Online (AJOL)

    Lifestyle behavours of Physicians are becoming increasingly important because of the dual benefits of safeguarding the physicians' health and promotion of good patient health outcome. Resident doctors at tertiary institutions provide the bulk of service to patients hence the need to identify their lifestyle behaviours and ...

  19. Gender differences in job quality and job satisfaction among doctors in rural western China.

    Science.gov (United States)

    Miao, Yang; Li, Lingui; Bian, Ying

    2017-12-28

    Few studies about gender differences in job quality and job satisfaction among medical professionals have been carried out in China. So the objectives of this study were to examine whether and to what extent gender differences existed in job quality and job satisfaction of doctors in rural western China. From 2009 to 2011, a total of 1472 doctors from 103 selected county-level health care facilities in rural western China were recruited into the study. Information about the doctors' demographic characteristics, job quality, and job satisfaction was collected through a designed questionnaire. Besides examining gender differences in single dimensions of job quality and job satisfaction, principal component analysis was used to construct a composite job quality index to measure the differences in the comprehensive job quality, and exploratory factor analysis was applied to evaluate the differences in the overall job satisfaction. Chi-square test was used to calculate differences between proportions, and t-test was used to compare differences between means. Among the doctors, there were 705 males and 767 females (ratio 1:1.09). Male doctors had significantly higher monthly salaries, longer working hours, more times of night shifts per month, longer continuous working hours, and longer years of service at current facilities, and marginally significantly higher hourly wage and longer years of service in current professions. However, female doctors showed greater overall job qualities. Significant and marginally significant gender differences were only found in satisfaction with remuneration compared to workload, the chance of promotion and working environment. But female showed greater satisfaction in the overall job satisfaction and the factor including sub-aspects of working environment, remuneration compared to workload, the chance of promotion, utilization of subjective initiative, and sense of achievement. Gender differences in job quality and job satisfaction did

  20. Temperature Effects on Olive Fruit Fly Infestation in the FlySim Cellular Automata Model

    Science.gov (United States)

    Bruno, Vincenzo; Baldacchini, Valerio; di Gregorio, Salvatore

    FlySim is a Cellular Automata model developed for simulating infestation of olive fruit flies (Bactrocera Oleae) on olive (Olea europaea) groves. The flies move into the groves looking for mature olives where eggs are spawn. This serious agricultural problem is mainly tackled by using chemical agents at the first signs of the infestation, but organic productions with no or few chemicals are strongly requested by the market. Oil made with infested olives is poor in quality, nor olives are suitable for selling in stores. The FlySim model simulates the diffusion of flies looking for mature olives and the growing of flies due to atmospheric conditions. Foreseeing an infestation is the best way to prevent it and to reduce the need of chemicals in agriculture. In this work we investigated the effects of temperature on olive fruit flies and resulting infestation during late spring and summer.

  1. Doctoral e-Theses; experiences in harvesting on a national and European level

    CERN Multimedia

    CERN. Geneva

    2007-01-01

    In many countries in Europe doctoral e-theses are an integrated part of institutional repositories, which have been set up in recent years. In some countries they have been harvested on a national level, like in the Netherlands with the ‘Promise of Science’ portal (http://www.darenet.nl/promiseofscience) . In October 2006 SURFfoundation (The Netherlands), JISC (UK) and DIVA (funded through BIBSAM in Sweden) started a common project to harvest repositories with e-theses on an international scale and to set up a freely accessible European portal and test in practice the interoperability. The project, which aims at creating a value added service for doctoral e-Theses, will finish in June 2007. In the presentation we will show some lessons learned and the first results of the Demonstrator, an interoperable portal of European doctoral e-theses in five countries: Denmark, Germany, the Netherlands, Sweden and the UK. Furthermore, we will present the developments regarding the European coordination of doctoral...

  2. Flying insects and Campylobacter

    DEFF Research Database (Denmark)

    Hald, Birthe; Sommer, Helle Mølgaard; Skovgård, Henrik

    Campylobacter in flies Flies of the Muscidae family forage on all kind of faeces – various fly species have different preferences. M domestica prefer pigs, horses and cattle faeces, animals which are all known to frequently excrete Campylobacter. As a result, the insects pick up pathogenic micro...

  3. Workplace violence against resident doctors in a tertiary care hospital in Delhi.

    Science.gov (United States)

    Anand, Tanu; Grover, Shekhar; Kumar, Rajesh; Kumar, Madhan; Ingle, Gopal Krishna

    2016-01-01

    Healthcare workers particularly doctors are at high risk of being victims of verbal and physical violence perpetrated by patients or their relatives. There is a paucity of studies on work-related violence against doctors in India. We aimed to assess the exposure of workplace violence among doctors, its consequences among those who experienced it and its perceived risk factors. This study was done among doctors working in a tertiary care hospital in Delhi. Data were collected by using a self-administered questionnaire containing items for assessment of workplace violence against doctors, its consequences among those who were assaulted, reporting mechanisms and perceived risk factors. Of the 169 respondents, 104 (61.4%) were men. The mean (SD) age of the study group was 28.6 (4.2) years. Sixty-nine doctors (40.8%) reported being exposed to violence at their workplace in the past 12 months. However, there was no gender-wise difference in the exposure to violence (p=0.86). The point of delivery of emergency services was reported as the most common place for experiencing violence. Verbal abuse was the most common form of violence reported (n=52; 75.4%). Anger, frustration and irritability were the most common symptoms experienced by the doctors who were subjected to violence at the workplace. Only 44.2% of doctors reported the event to the authorities. 'Poor communication skills' was considered to be the most common physician factor responsible for workplace violence against doctors. A large proportion of doctors are victims of violence by their patients or relatives. Violence is being under-reported. There is a need to encourage reporting of violence and prepare healthcare facilities to tackle this emerging issue for the safety of physicians.

  4. Nursing doctoral education in Turkey.

    Science.gov (United States)

    Yavuz, Meryem

    2004-10-01

    Quality health care is an issue of concern worldwide, and nursing can and must play a major and global role in transforming the healthcare environment. Doctorally prepared nurses are very much needed in the discipline to further develop and expand the science, as well as to prepare its future educators, scholars, leaders, and policy makers. In 1968, the Master of Science in Nursing Program was initiated in Turkey, followed by the Nursing Doctoral Education Program in 1972. Six University Schools of Nursing provide nursing doctoral education. By the graduating year of 2001, 154 students had graduated with the Doctor of Philosophy in Nursing (Ph.D.), and 206 students were enrolled in related courses. Many countries in the world are systematically building various collaborative models in their nursing doctoral education programs. Turkey would like to play an active role in creating collaborative nursing doctoral education programs with other countries. This paper centres on the structure and model of doctoral education for nurses in Turkey. It touches on doctoral programs around the world; describes in detail nursing doctoral education in Turkey, including its program structure, admission process, course units, assessment strategies and dissertation procedure; and discusses efforts to promote Turkey as a potential partner in international initiatives to improve nursing doctoral education.

  5. [When state authorisation was introduced for medical doctors in Norway].

    Science.gov (United States)

    Haave, Per

    2007-12-13

    In 1927, a law was implemented in Norway that for the first time required medical students to be state authorised before they could practice medicine and use the title medical doctor. The question of authorisation split the professional elite, both the Norwegian Medical Association and the Medical Faculty at the University of Oslo. Those very few members of the professional elite that advocated authorisation did, however, convince the government as well as the parliament that authorisation should be given and recalled by the state. State authorisation was first of all aimed at protecting the medical profession against "unfit" members; it was not a question of monopolising medical work or preventing other groups from working within the healthcare services. To put this into context, one should know that there had been a transition from a bureaucratic to a free labour market and most doctors were no longer engaged by the State, but had to practise in a private market. One feared that this would undermine the doctors' authority and status. In this situation, authorisation by the state was considered necessary to safeguard the public's confidence in doctors and their work.

  6. Identifying poor performance among doctors in NHS organizations.

    Science.gov (United States)

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

    2013-10-01

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

  7. Choosing, Changing or Adhering to a Registered Doctor in a ...

    African Journals Online (AJOL)

    Background: The phenomenon of doctor shopping has not yet attracted the attention of managers in the South African healthcare sector. Satisfaction with services is known to be mediated by the personal connection inherent in interpersonal continuity with the provider. Such a connection hinges on the fulfilment of ...

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

    Science.gov (United States)

    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/.

  9. Keeping the doctor in the loop: Ayurvedic pharmaceuticals in Kerala.

    Science.gov (United States)

    Kudlu, Chithprabha

    2016-12-01

    Ethnographic inquiry into Ayurvedic commodification in Kerala revealed the prevalence of a distinct regional pharmaceutical market dominated by physician-manufacturers, oriented towards supplying classical medicines to Ayurvedic doctors. This stands in sharp contrast to mainstream Ayurveda that is observed to have undergone biomedicalization and pharmaceuticalization. This paper argues that Kerala's classical-medicine-centric pharmaceutical market constitutes an alternative modernity because it provided Kerala Ayurveda with a different route to modernization impervious to the biomedical regime, as well as endowing it with the institutional power to safeguard its regional identity. Although physician-entrepreneurs are its key architects, it is sustained by value regimes shaped by a unique regional medico-cultural milieu. Even when industrially produced, classical medicines remain embedded within Ayurveda's socio-technical network; unlike proprietary drugs sold as individual product-identities through non-Ayurvedic channels, they travel together as a pharmacopeia, distributed through exclusive doctor-mediated agencies. This clinic-centric distribution format is best conceptualized as an open-source business model as it made low-margin generics viable by packaging them with therapies and services. Besides ensuring better access and affordability, it provided resistance to pharmaceuticalization and intellectual property concentration. By keeping the doctor in the loop, it prevented medicines from degenerating into de-contextualized commodities; the service component of Ayurveda therein preserved went on become the unique selling point in the health-tourism market. The tourism-inspired proliferation of Brand Kerala eventually triggered a paradigm shift in mainstream Ayurveda - shifting focus from 'pharmaceuticals' to 'services' and from 'illness' to 'wellness'. Furthermore, interacting with hybrid Ayurvedas in transnational markets, Kerala Ayurveda co-produces new

  10. Effects of eucalyptol on house fly (Diptera: Muscidae and blow fly (Diptera: Calliphoridae

    Directory of Open Access Journals (Sweden)

    Sukontason Kabkaew L.

    2004-01-01

    Full Text Available The effects of eucalyptol were evaluated against the house fly, Musca domestica L., and blow fly, Chrysomya megacephala (F.. The bioassay of adults, using topical application, indicated that M. domestica males were more susceptible than females, with the LD50 being 118 and 177 mg/fly, respectively. A higher LD50 of C. megacephala was obtained; 197 mg/fly for males and 221 mg/fly for females. Living flies of both species yielded a shorter life span after being treated with eucalyptol. The bioassay of larvae, using the dipping method on the third instar, showed that M. domestica was more susceptible than C. megacephala, with their LC50 being 101 and 642 mg/ml, respectively. The emergence of adults, which had been treated with eucalyptol in larvae, decreased only in M. domestica. Having the volatile property, fumigation or impregnated paper test of eucalyptol or the efficacy of repellence or attractiveness merits further investigations to enhance bio-insecticidal efficacy.

  11. WAYS OF ACQUIRING FLYING PHOBIA.

    Science.gov (United States)

    Schindler, Bettina; Vriends, Noortje; Margraf, Jürgen; Stieglitz, Rolf-Dieter

    2016-02-01

    The few studies that have explored how flying phobia is acquired have produced contradictory results. We hypothesized that classical conditioning plays a role in acquiring flying phobia and investigated if vicarious (model) learning, informational learning through media, and experiencing stressful life events at the time of onset of phobia also play a role. Thirty patients with flying phobia and thirty healthy controls matched on age, sex, and education were interviewed with the Mini-DIPS, the short German version of the Anxiety Disorders Interview Schedule (DSM-IV diagnostic criteria) and the Fear-of-Flying History Interview. Fifty Percent of patients with flying phobia and 53% of healthy controls reported frightening events in the air. There was no significant difference between the two samples. Thus there were not more classical conditioning events for patients with flying phobia. There also was no significant difference between the two samples for vicarious (model) learning: 37% of flying phobia patients and 23% of healthy controls felt influenced by model learning. The influence of informational learning through media was significantly higher for the clinical sample (70%) than for the control group (37%). Patients with flying phobia experienced significantly more stressful life events in the period of their frightening flight experience (60%) than healthy controls (19%). Frightening experiences while flying are quite common, but not everybody develops a flying phobia. Stressful life events and other factors might enhance conditionability. Informational learning through negative media reports probably reinforces the development of flying phobia. Clinical implications are discussed. © 2015 Wiley Periodicals, Inc.

  12. 78 FR 9907 - TGP Development Company, LLC; TGP Flying Cloud Holdings, LLC; WEC TX Company, LLC v. Arizona...

    Science.gov (United States)

    2013-02-12

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL13-45-000] TGP Development Company, LLC; TGP Flying Cloud Holdings, LLC; WEC TX Company, LLC v. Arizona Public Service Company... section 206 of the Federal Power Act, 16 U.S.C. 824(e) (2006), TGP Development Company, LLC, TGP Flying...

  13. Doctoral education in the nuclear sector; La formacion de doctores en el sector nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Minguez, E.

    2013-03-01

    Doctoral aducation is a major priority for European universities. In the context of the Bologna Process the importance of doctoral education as the third cycle of higher education and the first stage of a young researchers career, and thus in linking the European Higher Education and Research Areas, was first highlighted in the 2003 Berlin Report. The core component of doctoral training is the advancement of knowledge through original research. considering the need for structured doctoral programs and the need for transparent supervision and assessment, we note that the normal workload of the third cycle in most countries would correspond 3-4 years full time. This is spirit of the new Spanish Doctoral Law. Then, universities should ensure that their doctoral programmes promote interdisciplinary training and the development of transferable skills, thus meeting the needs of the wider employment market. We need to achieve and overall increase in the numbers of doctoral candidates taking up research careers as early stage researchers and also increase the employability as a normal way as it is the case of other advance countries. In Spain, universities with doctoral nuclear programmes and the CIEMAT, with the sponsorship of the nuclear sector, a doctoral school in nuclear science and engineering should be created to enhance the research careers of Young students for the future of nuclear activities in Spain. (Author)

  14. Why Doctors Do Not Answer Referral Letters | Smith | South African ...

    African Journals Online (AJOL)

    Background: Healthcare workers at primary healthcare (PHC) clinics are frustrated by the fact that they do not receive replies to their referral letters to doctors. Referral letters act as permission slips to allow patients easy access to treatment by specialists at secondary and tertiary service levels and communicate reasons for ...

  15. Importance of Campylobacter jejuni FliS and FliW in Flagella Biogenesis and Flagellin Secretion

    Directory of Open Access Journals (Sweden)

    Katarzyna A. Radomska

    2017-06-01

    Full Text Available Flagella-driven motility enables bacteria to reach their favorable niche within the host. The human foodborne pathogen Campylobacter jejuni produces two heavily glycosylated structural flagellins (FlaA and FlaB that form the flagellar filament. It also encodes the non-structural FlaC flagellin which is secreted through the flagellum and has been implicated in host cell invasion. The mechanisms that regulate C. jejuni flagellin biogenesis and guide the proteins to the export apparatus are different from those in most other enteropathogens and are not fully understood. This work demonstrates the importance of the putative flagellar protein FliS in C. jejuni flagella assembly. A constructed fliS knockout strain was non-motile, displayed reduced levels of FlaA/B and FlaC flagellin, and carried severely truncated flagella. Pull-down and Far Western blot assays showed direct interaction of FliS with all three C. jejuni flagellins (FlaA, FlaB, and FlaC. This is in contrast to, the sensor and regulator of intracellular flagellin levels, FliW, which bound to FlaA and FlaB but not to FlaC. The FliS protein but not FliW preferred binding to glycosylated C. jejuni flagellins rather than to their non-glycosylated recombinant counterparts. Mapping of the binding region of FliS and FliW using a set of flagellin fragments showed that the C-terminal subdomain of the flagellin was required for FliS binding, whereas the N-terminal subdomain was essential for FliW binding. The separate binding subdomains required for FliS and FliW, the different substrate specificity, and the differential preference for binding of glycosylated flagellins ensure optimal processing and assembly of the C. jejuni flagellins.

  16. Moral distress and professional freedom of speech among doctors.

    Science.gov (United States)

    Førde, Reidun; Aasland, Olaf Gjerløw

    2013-06-25

    Previous studies indicate that Norwegian doctors experience distress in their encounter with differing and partly contradictory ideals, such as the obligation to criticise unethical and inappropriate practices. The objective of this study was to investigate the perception of moral distress and professional freedom of speech among Norwegian doctors as of today, as well as identify changes that have occurred since the previous study undertaken in 2004. A total of 1,522 economically active doctors received a questionnaire listing various statements describing the perception of moral distress and professional freedom of speech. The responses were compared to responses to the 2004 study. Altogether 67% of the doctors responded to the questionnaire. The proportion who reported «fairly strong» or «strong» moral distress varied from 24% to 70% among the different statements. On the whole, the «rank and file» hospital doctors reported the highest degree of moral distress. Nevertheless, a decrease in the scores for moral distress could be observed from 2004 to 2010. During the same period, the perception of professional freedom of speech increased slightly. A reduced level of distress associated with ethical conflicts in working life may be due to improved methods for handling distressing situations, or because the consequences of the health services reorganisations are perceived as less threatening now than in 2004, immediately after the introduction of the hospital reform. However, the perceived lower distress level may also be due to professional and ethical resignation. These findings should be followed up by a qualitative study.

  17. [Job satisfaction among Norwegian doctors].

    Science.gov (United States)

    Nylenna, Magne; Aasland, Olaf Gjerløw

    2010-05-20

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

  18. The geographical mobility of recently graduated medical doctors

    DEFF Research Database (Denmark)

    Drejer, Ina; Holm, Jacob Rubæk; Petersen, Karin Dam

    specialize to become general practitioners (GPs). Access to medical services is included among the services important for ensuring the basics in a welfare society. The analysis is limited to general practitioners (GPs), although access to other types of medical professionals is also an important aspect......University graduates are not evenly distributed geographically, and attraction and retention of university graduates is high on the agenda in many regional development strategies. In this paper we study the geographical mobility of a particular type of university graduates: medical doctors who...... of local access to medical services. We have chosen GPs because they – except in cases of emergency – are the main entrance to medical services in Denmark. We study how different factors may influence where GPs choose to set up medical practice. We pay particular attention to the importance of local...

  19. Mass rearing methods for fruit fly

    International Nuclear Information System (INIS)

    Dominguez Gordillo, J.C.

    1999-01-01

    The most common rearing methods used for mass rearing of fruit flies, with emphasis on those of economic importance in Mexico such as Anastrepha ludens (the Mexican fruit fly). Anastrepha obliqua (the mango and plum fruit fly) and the exotic fruit fly Ceratitis capitata (the Mediterranean fruit fly) are described here. (author)

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    Deshpande, Anant

    2016-01-01

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

  2. Susceptibility of low-chill blueberry cultivars to oriental fruit fly, mediterranean fruit fly, and melon fly (Diptera: Tephritidae)

    Science.gov (United States)

    Forced infestation studies were conducted to determine if fruits of southern highbush blueberries (Vaccinium corymbosum L. hybrids) are hosts for three invasive tephritid fruit flies. Fruits of 17 blueberry cultivars were exposed to gravid female flies of Bactrocera dorsalis (Hendel) (oriental frui...

  3. Challenges to the Doctoral Journey: a Case of Female Doctoral Students from Ethiopia

    Directory of Open Access Journals (Sweden)

    Asamenew Demessie Bireda

    2015-11-01

    Full Text Available This study aimed to investigate some challenges female doctoral students experience in their doctoral journey. The study used a qualitative design and structured interviews. The theoretical framework that guided the study was that of Urie Bronfenbrenner’s ecosystemic theory. A purposely selected sample of five female doctoral students from the University of South Africa Ethiopia campus participated in the study. The results identified three major areas of concern such as: academic, psychosocial and home/work related. Specifically, female doctoral students reported concerns surrounding quality of supervision support, inadequate academic skill, nature or system of education, stress, motivation, isolation, balancing personal and professional life, relationship problems, home and work related concerns. Hence, universities must provide opportunities and resourceful strategies to meet the challenges posed by women scholars in the doctoral journey.

  4. [Street doctors warn of epidemic of uninsured homeless persons in the Netherlands].

    Science.gov (United States)

    Slockers, Marcel T; van Laere, Igor R A L; Smit, Ronald B J

    2015-01-01

    Over the past few years, the Netherlands Street Doctors Group, a national network of doctors and nurses providing outreach primary care to homeless people in the Netherlands, has observed a growing number of homeless patients who do not have health insurance resulting in their access to healthcare services and medication being limited. In this article we raise the alarm about the epidemic of uninsured Dutch homeless. We explain and comment on the reasons why people are no longer insured and elaborate on the regulations and obligations related to homelessness and the characteristics of consumers and providers of social and medical services. We describe how difficult it is for homeless people to become re-insured as in order to follow a complex set of requirements commitment and patience are necessary. For most homeless patients, the re-insurance process requires the personal guidance and support of a motivated case manager. Consequently, we suggest that policy makers and service providers should have a better understanding of factors contributing to being uninsured and more compassion for those who are.

  5. A marketing clinical doctorate programs.

    Science.gov (United States)

    Montoya, Isaac D; Kimball, Olive M

    2007-01-01

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

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

    Science.gov (United States)

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

    2014-03-04

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

  7. Awareness of cardiopulmonary resuscitation in medical-students and doctors in Rawalpindi-Islamabad, Pakistan

    International Nuclear Information System (INIS)

    Zamir, Q.; Nadeem, A.; Rizvi, A.H.

    2012-01-01

    Objective: To assess the level of awareness regarding basic and practical knowledge of cardiopulmonary resuscitation and its importance in the eyes of medical/dental students and doctors. Methods: The cross-sectional study was conducted in medical and dental colleges as well as hospitals of Rawalpindi and Islamabad, Pakistan, from June to September 2011. Non-probability convenience sampling was used and structured questionnaires on basic and practical knowledge of the procedure were distributed. The questionnaire had 26 items related to basic and advanced knowledge of the required skills. Doctors were divided into two groups based on their years of service and practice. Those with less than 5 years' experience were grouped as junior doctors, while rest as senior doctors. Descriptive statistics were employed to analyse the data using SPPS version 17 and Microsoft Excel. Percentages were worked out and the results were interpreted. Result: Of the 1000 questionnaires distributed, 646 (64.6%) were received duly filled and represented the study sample. Of the 646 participants, 34 (5.26%) were dentists, 424 (65.63%) were medical students, 92 (14.24%) were doctors and 96 (14.86%) were dental students. Basic knowledge of doctors was found to be better than that of dentists (n=96; 50% vs. n=8; 23%). Similarly, the advance knowledge of doctors was better than the dentists (n=53; 58% vs. n=11; 31%). The basic knowledge of junior doctors was found to be almost equal to the senior doctors (n=26; 44.75% vs. n=15; 45.5%). The advance knowledge of junior doctors was found to be better than the senior doctors (n=27; 45.37% vs. n=10; 29.48%). Among the students, 157 (37%) of the medical students had basic knowledge of CPR, while 36 (38%) dental students had basic knowledge of the topic. Medical students had more advanced knowledge (n=157; 37%) than dental students (n=34; 35%). Conclusion: The awareness of basic and advance knowledge of cardiopulmonary resuscitation skills in medical

  8. [Supervision of junior doctors and allocation of work tasks regarding admissions and further treatment of acute admitted patients.

    DEFF Research Database (Denmark)

    Folkestad, Lars; Brabrand, Mikkel; Hallas, Peter

    2010-01-01

    INTRODUCTION: It is being debated whether medical staff working at the emergency departments with acute admission services dealing with medical patients have the required professional competence level. It has not previously been documented which doctors see the acute admissions initially at emerg......INTRODUCTION: It is being debated whether medical staff working at the emergency departments with acute admission services dealing with medical patients have the required professional competence level. It has not previously been documented which doctors see the acute admissions initially...... for help from a senior colleague. Udgivelsesdato: 2010-May-31...

  9. Effect of Climate Change on Service Life of High Volume Fly Ash Concrete Subjected to Carbonation—A Korean Case Study

    Directory of Open Access Journals (Sweden)

    Ki-Bong Park

    2017-01-01

    Full Text Available The increase in CO2 concentrations and global warming will increase the carbonation depth of concrete. Furthermore, temperature rise will increase the rate of corrosion of steel rebar after carbonation. On the other hand, compared with normal concrete, high volume fly ash (HVFA concrete is more vulnerable to carbonation-induced corrosion. Carbonation durability design with climate change is crucial to the rational use of HVFA concrete. This study presents a probabilistic approach that predicts the service life of HVFA concrete structures subjected to carbonation-induced corrosion resulting from increasing CO2 concentrations and temperatures. First, in the corrosion initiation stage, a hydration-carbonation integration model is used to evaluate the contents of the carbonatable material, porosity, and carbonation depth of HVFA concrete. The Monte Carlo method is adopted to determine the probability of corrosion initiation. Second, in the corrosion propagation stage, an updated model is proposed to evaluate the rate of corrosion, degree of corrosion for cover cracking of concrete, and probability of corrosion cracking. Third, the whole service life is determined considering both corrosion initiation stage and corrosion propagation stage. The analysis results show that climate change creates a significant impact on the service life of durable concrete.

  10. What do they do? Interactions between village doctors and medical representatives in Chakaria, Bangladesh.

    Science.gov (United States)

    Rahman, M Hafizur; Agarwal, Smisha; Tuddenham, Susan; Peto, Heather; Iqbal, Mohammad; Bhuiya, Abbas; Peters, David H

    2015-07-01

    Informally trained village doctors supply the majority of healthcare services to the rural poor in many developing countries. This study describes the demographic and socio-economic differences between medical representatives (MRs) and village doctors in rural Bangladesh, and explores the nature of their interactions. This study was conducted in Chakaria, a rural sub-district of Bangladesh. Focus group discussions and in-depth interviews were conducted, along with a quantitative survey to understand practice perceptions. Data analysis was performed using grounded theory and bivariate statistical tests. We surveyed 43 MRs and 83 village doctors through 22 focus group discussions and 33 in-depth interviews. MRs have a higher average per capita monthly expenditure compared to village doctors. MRs are better educated with 98% having bachelor's degrees whereas 84% of village doctors have twelfth grade education or less (pmarkets require stricter regulations and educational initiatives for providers and MRs. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Spin doctoring

    OpenAIRE

    Vozková, Markéta

    2011-01-01

    1 ABSTRACT The aim of this text is to provide an analysis of the phenomenon of spin doctoring in the Euro-Atlantic area. Spin doctors are educated people in the fields of semiotics, cultural studies, public relations, political communication and especially familiar with the infrastructure and the functioning of the media industry. Critical reflection of manipulative communication techniques puts spin phenomenon in historical perspective and traces its practical use in today's social communica...

  12. Ascribing emotion to reasonable use in accelerated cancer services.

    Science.gov (United States)

    Obling, Anne Roelsgaard

    2013-01-01

    A recurrent theme in medical sociology has been the juxtaposition of emotion with scientific rationality in the delivery of health care services. However, apart from addressing this juxtaposition very little is said about the complex intertwinement of "emotional" and "rational" practices which makes up professionals' own day-to-day work experiences - and how these experiences are influenced by present ways of organising health care. This paper aims to explore the ways that hospital doctors relate emotions to their understanding of professional medical work and how they respond to recent organisational changes within the field. Drawing upon a small series of semi-structured interviews (n = 14) with doctors from a public teaching hospital in Denmark, the paper adopts a constructivist framework to analyse personal biographies of health professionals' working lives. The doctors represented rich accounts of professional medical work, which includes an understanding of what a doctor should feel and how he/she should make him/herself emotionally available to others. However, the impetus for making this appearance was not left unaffected by recent new public management reforms and attempts to accelerate the delivery of services. The organisation of cancer services into a work system, which consists of a set of tasks broken down into narrow jobs, underestimates the emotional components of patient-doctor encounters. This makes the creation and maintenance of a genuine patient-doctor relationship difficult and the result is feelings of a failed encounter on behalf of the doctor. The paper suggests that recent rearrangements of cancer services complicate doctors' ability to incorporate emotion into a stream of medical care in a "rational" way. This is shown to challenge their professional ethos and the forms emotional engagement takes in medical practice.

  13. Personal Health Practices of Doctors in a Teaching Hospital in Nigeria

    African Journals Online (AJOL)

    Healthy lifestyle and clinical preventive activities have been shown to improve health status of individuals. However routine health promotion and preventive services is limited in medical practice due to time and cost constraint. This study examines how physicians themselves try to promote their own health. Ninety doctors ...

  14. Job Satisfaction Analysis in Rural China: A Qualitative Study of Doctors in a Township Hospital

    OpenAIRE

    Chen, Qiwei; Yang, Lan; Feng, Qiming; Tighe, Scott S.

    2017-01-01

    Background. Township hospitals in China provide rural communities with basic but much needed critical health care services. The doctors working in these hospitals often feel unsatisfied when considering their work schedules and financial rewards. Method. To explore job satisfaction of health workers in a township hospital, a qualitative study was conducted of 39 doctors from five township hospitals in Guangxi Zhuang Autonomous Region. The goal was to understand the level of job satisfaction o...

  15. Working with doctors and nurses

    Science.gov (United States)

    ... with doctors and nurses Working with doctors and nurses Answering questions, filling out papers, getting poked and ... to pay? What questions will the doctor or nurse ask? top It’s a good idea to know ...

  16. The Doctoral Degree in Dental Hygiene: Creating New Oral Healthcare Paradigms.

    Science.gov (United States)

    Gurenlian, JoAnn R; Rogo, Ellen J; Spolarich, Ann Eshenaur

    2016-06-01

    Doctoral dental hygiene education would prepare scholars and leaders to improve population health through changes in oral health policy and delivery. Discussions about doctoral education in dental hygiene have centered on the need to create a cadre of dental hygiene researchers and scholars who will expand the body of knowledge for the profession. It has been proposed that scholars are needed to lead the development of theory and disseminate knowledge unique to the discipline of dental hygiene. Transformation to doctoral education is not a new trend as many other health care disciplines have already implemented curricular models, establishing the doctoral degree for entry level into practice. The Institute of Medicine has called for the exploration of new models for care delivery. Dental hygienists need to be prepared with leadership skills enabling them to participate and lead interprofessional teams and develop policies designed to improve the delivery of oral health care services to enhance population health. Current educational models do not adequately prepare dental hygienists to serve in this capacity. The purpose of this article is to present 2 models of doctoral education for dental hygiene that will illustrate how dental hygienists can be better prepared as scholars and leaders for the profession. These proposed models of doctoral education in dental hygiene present a paradigm shift in dental hygiene education. As with other disciplines that have evolved, both academically and professionally, dental hygiene will be positioned to achieve the hallmark of professional status with this terminal degree. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Fly ash quality and utilization

    Energy Technology Data Exchange (ETDEWEB)

    Barta, L.E.; Lachner, L.; Wenzel, G.B. [Inst. for Energy, Budapest (Hungary); Beer, M.J. [Massachusetts Inst. of Technology, Cambridge, MA (United States)

    1995-12-01

    The quality of fly ash is of considerable importance to fly ash utilizers. The fly ash puzzolanic activity is one of the most important properties that determines the role of fly ash as a binding agent in the cementing process. The puzzolanic activity, however is a function of fly ash particle size and chemical composition. These parameters are closely related to the process of fly ash formation in pulverized coal fired furnaces. In turn, it is essential to understand the transformation of mineral matter during coal combustion. Due to the particle-to-particle variation of coal properties and the random coalescence of mineral particles, the properties of fly ash particles e.g. size, SiO{sub 2} content, viscosity can change considerably from particle to particle. These variations can be described by the use of the probability theory. Since the mean values of these randomly changing parameters are not sufficient to describe the behavior of individual fly ash particles during the formation of concrete, therefore it is necessary to investigate the distribution of these variables. Examples of these variations were examined by the Computer Controlled Scanning Electron Microscopy (CCSEM) for particle size and chemical composition for Texas lignite and Eagel Butte mineral matter and fly ash. The effect of combustion on the variations of these properties for both the fly ash and mineral matter were studied by using a laminar flow reactor. It is shown in our paper, that there are significant variations (about 40-50% around the mean values) of the above-listed properties for both coal samples. By comparing the particle size and chemical composition distributions of the mineral matter and fly ash, it was possible to conclude that for the Texas lignite mineral matter, the combustion did not effect significantly the distribution of these properties, however, for the Eagel Butte coal the combustion had a major impact on these mineral matter parameters.

  18. Job Satisfaction Analysis in Rural China: A Qualitative Study of Doctors in a Township Hospital.

    Science.gov (United States)

    Chen, Qiwei; Yang, Lan; Feng, Qiming; Tighe, Scott S

    2017-01-01

    Background . Township hospitals in China provide rural communities with basic but much needed critical health care services. The doctors working in these hospitals often feel unsatisfied when considering their work schedules and financial rewards. Method . To explore job satisfaction of health workers in a township hospital, a qualitative study was conducted of 39 doctors from five township hospitals in Guangxi Zhuang Autonomous Region. The goal was to understand the level of job satisfaction of doctors and to make recommendations for improvements. Results . About 75% (28/39) of the doctors expressed negative attitudes related to their work conditions. Slightly more than half (22/39) mentioned they should receive greater compensation for their work and more than one were seriously considering other options. Many participants (35/39) showed their satisfaction about the achievement of serving as a doctor. Conclusion . Their main concerns related to job satisfaction included working conditions, financial rewards, and the doctor's relationships with patients. Increasing the incomes and fringe benefits of healthcare workers, improving their work conditions, and providing training and continuing education opportunities would help rural clinics retain doctors and eliminate the current unsatisfactory conditions. The findings also highlight the need for the government to increase financial support of township hospitals.

  19. Intolerance and Violence Against Doctors.

    Science.gov (United States)

    Singh, Meharban

    2017-10-01

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

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

    OpenAIRE

    Westerband, Yamissette

    2016-01-01

    Latinas are underrepresented within the professorate and within doctoral programs, particularly within Research Intensive Institutions. This dissertation explores how the doctoral socialization process impacts the pipeline from the Ph.D. to scholarly careers for Latinas in Research universities. Given the low numbers of representation and production at the doctoral level for Latinas, what happens when they do enter Ph.D. programs? Their doctoral experience must be marked in one way or anot...

  1. [The essence of doctor-patient relationship in creating image of a medical institution].

    Science.gov (United States)

    Dworzański, Wojciech; Dworzańska, Anna; Burdan, Franciszek

    2012-01-01

    Irrespective of changing standards and continuous reforms in health service, the patient should always remain the principal focus. The patient is a person who should be treated not only as a customer or a recipient of medical services but also as a person being in a situation which is difficult and often unacceptable. Among the factors affecting patients' satisfaction and contentment in the course of the disease it is profoundly important that he cooperates with his doctor. For years it has been attempted to create an ideal model of doctor-patient relationship which would be mutually beneficial and not violating privacy or welfare of any of them. These attempts focused on various theoretical models, among others paternalistic, informative and interpretive. However, special attention should be paid to adherence to principles which is based on respect for patient autonomy, harmlessness, charity and fairness.

  2. Self-reported and employer-recorded sickness absence in doctors.

    Science.gov (United States)

    Murphy, I J

    2014-09-01

    Doctors' sickness absence reduces the quality and continuity of patient care and is financially costly. Doctors have lower rates of sickness absence than other healthcare workers. To compare self-reported with recorded sickness absence in doctors in a UK National Health Service hospital trust. A retrospective questionnaire study. The main outcome measures were self-reported and trust-recorded sickness absence episodes of 4 days or more in two consecutive 6-month periods. The response rate was 82% (607/736). Self-reported sickness absence rates were 1.2% compared with a rate of 0.6% from trust-recorded data. There were 38 matched pairs of self-reported (mean duration: 18 days, standard deviation: 22 days) and trust-recorded (mean duration: 10 days, standard deviation: 17 days) sickness absence episodes of 4 days or more in the 12 months studied. A matched pairs t-test determined that the difference between the two means was significant (t = 2.57, P sickness absence was significantly under-recorded in this study population. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

    Science.gov (United States)

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

    2017-05-01

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

  4. MEDICAL SERVICE - URGENT CALLS

    CERN Multimedia

    Service Médical

    2000-01-01

    IN URGENT NEED OF A DOCTOR GENEVA: EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME: Open 24h/24h 748-49-50 AMG- Association Of Geneva Doctors: Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin 719-61-11 EMERGENCIES 719-61-11 CHILDREN'S EMERGENCIES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112   FRANCE: EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ...

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

    Science.gov (United States)

    Kanwar, R S

    2010-01-01

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

  6. Use of multimedia messaging system (MMS) by junior doctors for scan image transmission in neurosurgery.

    Science.gov (United States)

    Ling, Ji Min; Lim, Kim Zhuan; Ng, Wai Hoe

    2012-02-01

    Multimedia Messaging Service (MMS) is used by neurosurgical residents to transmit scan images to the attending neurosurgeon in conjunction with telephone consultation. This service has been well received by the attending neurosurgeons, who felt that after viewing scan images on their phones, they felt increased confidence in clinical decision making and that it reduced the need for recall to the hospital. The use of MMS can be extended to junior doctors making referrals from regional hospitals with no neurosurgical cover. This study aims to validate the competency of non-neurosurgically trained junior doctors in selecting optimal images to transmit via MMS to the attending neurosurgeon on call. Ten junior doctors with no formal neurosurgical training and five neurosurgical residents were interviewed. They were shown the full complement of images together with relevant clinical history and assessment. They were then asked to make the radiological diagnosis and then select two images for MMS transmission to the attending neurosurgeon that they thought would best aid the neurosurgeon in clinical decision making. The attending neurosurgeon was asked to comment, on each image, whether his management plan would differ if he was shown the entire series of the images. All the images chosen are deemed appropriate, and the decision made based on the MMS images would be similar if the entire series of images were available to the neurosurgeon. However, 7 of 10 junior doctors were unable to read magnetic resonance images of lumbar spine. There was no significant difference in the images chosen by the neurosurgical residents and the junior doctors. It is feasible and safe for junior doctors to utilize MMS to transmit computed tomographic images to a neurosurgeon while making an urgent referral. The images selected are representative of the disease pathology and facilitate clinical decision making. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Research support by doctoral-granting colleges/schools of nursing.

    Science.gov (United States)

    Yoon, Saun-Joo Lee; Wolfe, Sandra; Yucha, Carolyn B; Tsai, Peishan

    2002-01-01

    Colleges and schools of nursing with doctoral programs focus on developing quality research programs. One effective way of managing and nurturing a research program is through the implementation of a nursing research office or center. The purpose of this study is to describe the resources provided by the colleges/schools of nursing with doctoral programs for research development. A self-report questionnaire, developed by the research team, was mailed to all schools of nursing offering doctoral programs. The response rate was 79 per cent (65/82 schools). Results indicated that 56 schools (86.2 per cent) have designated research support offices. The main goals of nursing research offices are to increase the amount of extramural funding and to promote dissemination of scholarly work via publications and presentations. The majority of research offices provide assistance with grants and the research process and offer educational programs. Most doctoral-granting schools are providing some support for research activities. However, the degree of investment in research support varied widely among the responding schools. This study suggests that it takes both time and institutional commitment to build a successful research environment. Although necessary for research development, support services are not sufficient by themselves. Instead, they need to be considered in the light of individual (e.g., faculty interest and motivation) and group (e.g., culture of scholarship) factors within each school. Copyright 2002 by W.B. Saunders Company

  8. The relationship between satisfaction and knowledge about family-doctor program in Shahr-e-Kord

    Directory of Open Access Journals (Sweden)

    Masoumeh Alidoosti

    2011-11-01

    Full Text Available Background: Attention to the satisfaction of recipients of medical services is an important issue. This cross-sectional study was carried out to determine the relationship between satisfaction and awareness of villagers about family-doctor program. Materials and Method: In this study, 1100 persons who were covered with the family-doctor program in rural area in Shahr-e-Kord. We used a self-made questionnaire and multi-stage sampling method. Data analyzed using chi-squared and Spearman correlation coefficient tests and p-value less than 0.05 was considered significant.Results: Awareness to family-doctor program was weak in 37.6% of peoples and 48.1 percent of them were fairly satisfied. There was a significant correlation between the knowledge of people and their satisfaction (p= 0.04.Conclusion: Informing people about the main goals of family-doctor program will help to promote the quality of program and increase people satisfaction

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

    Science.gov (United States)

    Mulvey, James

    2003-01-01

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

  10. Coaching doctoral students

    DEFF Research Database (Denmark)

    Godskesen, Mirjam Irene; Kobayashi, Sofie

    2016-01-01

    In this paper we focus on individual coaching carried out by an external coach as a new pedagogical element that can impact doctoral students’ sense of progress in doctoral education. The study used a mixed methods approach in that we draw on quantitative and qualitative data from the evaluation...... impact the supervisor – student relationship in a positive way....

  11. Possibilities of utilizing power plant fly ashes

    Directory of Open Access Journals (Sweden)

    Mezencevová Andrea

    2003-09-01

    Full Text Available The burning of fossil fuels in industrial power stations plays a significant role in the production of thermal and electrical energy. Modern thermal power plants are producing large amounts of solid waste, mainly fly ashes. The disposal of power plant waste is a large environmental problem at the present time. In this paper, possibilities of utilization of power plant fly ashes in industry, especially in civil engineering, are presented. The fly ash is a heterogeneous material with various physical, chemical and mineralogical properties, depending on the mineralogical composition of burned coal and on the used combustion technology. The utilization of fly ashes is determined of their properties. The fineness, specific surface area, particle shape, density, hardness, freeze-thaw resistance, etc. are decisive. The building trade is a branch of industry, which employs fly ash in large quantities for several decades.The best utilization of fluid fly ashes is mainly in the production of cement and concrete, due to the excellent pozzolanic and cementitious properties of this waste. In the concrete processing, the fly ash is utilized as a replacement of the fine aggregate (fine filler or a partial replacement for cement (active admixture. In addition to economic and ecological benefits, the use of fly ash in concrete improves its workability and durability, increases compressive and flexural strength, reduces segregation, bleeding, shrinkage, heat evolution and permeability and enhances sulfate resistance of concrete.The aim of current research is to search for new technologies for the fly ash utilization. The very interesting are biotechnological methods to recovery useful components of fly ashes and unconventional methods of modification of fly ash properties such as hydrothermal zeolitization and mechanochemical modification of its properties. Mechanochemistry deals with physico - chemical transformations and chemical reactions of solids induced by

  12. Finding the Right Doctor

    Science.gov (United States)

    ... certified hospital Communicating with Healthcare Professionals for Caregivers Consumer Health Care • Home • Health Insurance Information • Your Healthcare Team Introduction Finding the Right Doctor Talking to Your Doctor Getting a Second ...

  13. Analysis list: FLI1 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available FLI1 Blood,Bone,Muscle + hg19 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/targe...t/FLI1.1.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/target/FLI1.5.tsv http://dbarchive.biosciencedb...c.jp/kyushu-u/hg19/target/FLI1.10.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/colo/FLI1.Blood.tsv,http://dbarchive.bioscience...dbc.jp/kyushu-u/hg19/colo/FLI1.Bone.tsv,http://dbarchive.bioscience...dbc.jp/kyushu-u/hg19/colo/FLI1.Muscle.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/colo/Bl

  14. Exploring newly qualified doctors' workplace stressors: an interview study from Australia

    Science.gov (United States)

    Tallentire, Victoria R; Smith, Samantha E; Facey, Adam D; Rotstein, Laila

    2017-01-01

    Purpose Postgraduate year 1 (PGY1) doctors suffer from high levels of psychological distress, yet the contributory factors are poorly understood. This study used an existing model of workplace stress to explore the elements most pertinent to PGY1 doctors. In turn, the data were used to amend and refine the conceptual model to better reflect the unique experiences of PGY1 doctors. Method Focus groups were undertaken with PGY1 doctors working at four different health services in Victoria, Australia. Transcripts were coded using Michie's model of workplace stress as the initial coding template. Remaining text was coded inductively and the supplementary codes were used to modify and amplify Michie's framework. Results There were 37 participants in total. Key themes included stressors intrinsic to the job, such as work overload and long hours, as well as those related to the context of work such as lack of role clarity and relationships with colleagues. The main modification to Michie's framework was the addition of the theme of uncertainty. This concept related to most of the pre-existing themes in complex ways, culminating in an overall sense of anxiety. Conclusions Michie's model of workplace stress can be effectively used to explore the stressors experienced by PGY1 doctors. Pervasive uncertainty may help to explain the high levels of psychological morbidity in this group. While some uncertainty will always remain, the medical education community must seek ways to improve role clarity and promote mutual respect. PMID:28801411

  15. Identifying glass compositions in fly ash

    Directory of Open Access Journals (Sweden)

    Katherine eAughenbaugh

    2016-01-01

    Full Text Available In this study, four Class F fly ashes were studied with a scanning electron microscope; the glassy phases were identified and their compositions quantified using point compositional analysis with k-means clustering and multispectral image analysis. The results showed that while the bulk oxide contents of the fly ashes were different, the four fly ashes had somewhat similar glassy phase compositions. Aluminosilicate glasses (AS, calcium aluminosilicate glasses (CAS, a mixed glass, and, in one case, a high iron glass were identified in the fly ashes. Quartz and iron crystalline phases were identified in each fly ash as well. The compositions of the three main glasses identified, AS, CAS, and mixed glass, were relatively similar in each ash. The amounts of each glass were varied by fly ash, with the highest calcium fly ash containing the most of calcium-containing glass. Some of the glasses were identified as intermixed in individual particles, particularly the calcium-containing glasses. Finally, the smallest particles in the fly ashes, with the most surface area available to react in alkaline solution, such as when mixed with portland cement or in alkali-activated fly ash, were not different in composition than the large particles, with each of the glasses represented. The method used in the study may be applied to a fly ash of interest for use as a cementing material in order to understand its potential for reactivity.

  16. Stress levels of critical care doctors in India: A national survey.

    Science.gov (United States)

    Amte, Rahul; Munta, Kartik; Gopal, Palepu B

    2015-05-01

    Doctors working in critical care units are prone to higher stress due to various factors such as higher mortality and morbidity, demanding service conditions and need for higher knowledge and technical skill. The aim was to evaluate the stress level and the causative stressors in doctors working in critical care units in India. A two modality questionnaire-based cross-sectional survey was conducted. In manual mode, randomly selected delegates attending the annual congress of Indian Society of Critical Care Medicine filled the questionnaire. In the electronic mode, the questionnaires were E-mailed to critical care doctors. These questionnaires were based on General Health Questionnaire-12 (GHQ-12). Completely filled 242 responses were utilized for comparative and correlation analysis. Prevalence of moderate to severe stress level was 40% with a mean score of 2 on GHQ-12 scale. Too much responsibility at times and managing VIP patients ranked as the top two stressors studied, while the difficult relationship with colleagues and sexual harassment were the least. Intensivists were spending longest hours in the Intensive Care Unit (ICU) followed by pulmonologists and anesthetists. The mean number of ICU bed critical care doctors entrusted with was 13.2 ± 6.3. Substance abuse to relieve stress was reported as alcohol (21%), anxiolytic or antidepressants (18%) and smoking (14%). Despite the higher workload, stress levels measured in our survey in Indian critical care doctors were lower compared to International data. Substantiation of this data through a wider study and broad-based measures to improve the quality of critical care units and quality of the lives of these doctors is the need of the hour.

  17. [DIFFERENCE IN THE PREVALENCE OF BURNOUT SYNDROME IN PRECLINICAL AND CLINICAL TEACHING DOCTORS OF MOSTAR SCHOOL OF MEDICINE].

    Science.gov (United States)

    Vukojevič, Mladenka; Antunovič, Andelka; Petrov, Božo

    2015-01-01

    The aim of this study was to determine the difference in the prevalence of burnout syndrome in preclinical and clinical teaching doctors of Mostar School of Medicine in the academic year 2011/2012. Special attention was also focused on finding out the possible difference between the syndrome incidence that was correlated to gender and years of service. The main hypothesis was that the probability of burnout syndrome incidence was higher in the group of female clinical teaching doctors having more years of service. The study involved 62 people with high academic education employed at Mostar School of Medicine who were surveyed during a randomly selected consecutive 3-month period (February to May) of the academic year 2011/2012. The data were prospectively collected through a standardized questionnaire survey. The studied parameters were gender, years of work experience and the engagement in preclinical or clinical departments of the Medical School. The survey showed that 43 out of 62 (69.4%) respondents did not suffer the burnout syndrome, while moderate syndrome was recodred in 19 (30.6%) of them. No person had serious symptoms of the syndrome. The difference between the respondents who suffered the syndrome and those who did not was not statistically significant (P=0.002). Considering the gender of respondents, statistically significant differences were not confirmed (P=0.444). Considering the years of service, the highest incidence of the syndrome was found in people with more work experience (in the group of 21-25 years), but the difference between the groups was not statistically significant (P=0.271). Observing the work in preclinical and clinical departments, because of the limited number of patients we could not confirm the hypothesis. The syndrome had affected 13 (21%) clinical teaching doctors and 6 (9,7%) preclinical doctors, while the differenece between them was not statistically significant (P=0.054). Considering the results of this research, it has

  18. Engineering properties of fly ash concrete

    International Nuclear Information System (INIS)

    Hilmi Mahmud

    1999-01-01

    This paper presents some of the engineering properties of Malaysian fly ash concrete. Workability, compressive, flexural, tensile splitting, drying shrinkage, elastic modulus and non destructive tests were performed on fly ash and control OPC concrete specimens. Data show that concrete containing 25% fly ash replacement of cement exhibit superior or similar engineering properties to that normal concrete without fly ash. These encouraging results demonstrated the technical merits of incorporating fly ash in concrete and should pave the way for wide scale use of this versatile material in the Malaysian construction industry. (author)

  19. Disease Risk Perception and Safety Practices: A Survey of Australian Flying Fox Rehabilitators.

    Directory of Open Access Journals (Sweden)

    Cecilia A Sánchez

    2016-02-01

    Full Text Available Interactions with flying foxes pose disease transmission risks to volunteer rehabilitators (carers who treat injured, ill, and orphaned bats. In particular, Australian bat lyssavirus (ABLV can be transmitted directly from flying foxes to humans in Australia. Personal protective equipment (PPE and rabies vaccination can be used to protect against lyssavirus infection. During May and June 2014, active Australian flying fox carers participated in an online survey (SOAR: Survey Of Australian flying fox Rehabilitators designed to gather demographic data, assess perceptions of disease risk, and explore safety practices. Responses to open-ended questions were analysed thematically. A logistic regression was performed to assess whether rehabilitators' gender, use of PPE, threat perception, and years of experience predicted variation in their odds of being bitten or scratched. Eligible responses were received from 122 rehabilitators located predominantly on the eastern coast of Australia. Eighty-four percent of respondents were female. Years of experience ranged from <1 to 30 years (median 5 years. Respondents were highly educated. All rehabilitators were vaccinated against rabies and 94% received a rabies titre check at least every two years. Sixty-three percent of carers did not perceive viruses in flying foxes as a potential threat to their health, yet 74% of carers reported using PPE when handling flying foxes. Eighty-three percent of rehabilitators had received a flying fox bite or scratch at some point during their career. Carers provide an important community service by rescuing and rehabilitating flying foxes. While rehabilitators in this study have many excellent safety practices, including a 100% vaccination rate against rabies, there is room for improvement in PPE use. We recommend 1 the establishment of an Australia-wide set of guidelines for safety when caring for bats and 2 that the responsible government agencies in Australia support

  20. Australian doctors and the visual arts. Part 1. Doctor-artists in New South Wales.

    Science.gov (United States)

    Hamilton, D G

    Since Europeans first settled in Australia their doctors have been interested in the visual arts. Some have been hobby painters and sculptors, a few with great distinction. Some have been gallery supporters and administrators. A few have written art books. Some have been outstanding photographers. Of the larger number of doctors who have collected art, only those are mentioned who have made their collections public or have made important donations to galleries. The subject of Australian doctors and the visual arts will be discussed in six articles in this and following issues of the journal. The first deals with doctor-artists in New South Wales.

  1. Treatment of fly ash for use in concrete

    Science.gov (United States)

    Boxley, Chett; Akash, Akash; Zhao, Qiang

    2013-01-08

    A process for treating fly ash to render it highly usable as a concrete additive. A quantity of fly ash is obtained that contains carbon and which is considered unusable fly ash for concrete based upon foam index testing. The fly ash is mixed with an activator solution sufficient to initiate a geopolymerization reaction and for a geopolymerized fly ash. The geopolymerized fly ash is granulated. The geopolymerized fly ash is considered usable fly ash for concrete according to foam index testing. The geopolymerized fly ash may have a foam index less than 35% of the foam index of the untreated fly ash, and in some cases less than 10% of the foam index of the untreated fly ash. The activator solution may contain an alkali metal hydroxide, carbonate, silicate, aluminate, or mixtures thereof.

  2. Factors influencing turnover intention among primary care doctors: a cross-sectional study in Chongqing, China.

    Science.gov (United States)

    Wen, Tong; Zhang, Yan; Wang, Xue; Tang, Guo

    2018-02-13

    The intention to leave a job, known as turnover intention, among primary care doctors has a significant impact on primary health care service delivery. We investigated primary care doctors' turnover intention and analysed associated factors involved in primary health facilities in Chongqing, China. A total of 440 doctors were interviewed, they were selected using a multi-stage stratified random sampling method. The survey instrument was a self-administered questionnaire which assessed socio-demographic and work-related characteristics, job satisfaction and turnover intention. The data were analysed using χ 2 test, one-way analysis of variance, exploratory factor analysis and linear regression analysis. Our study found that 42.3% of the primary care doctors we sampled in Chongqing, China, intended to resign. Location, age, job title, doctor's position level, work pressure and job satisfaction were associated with turnover intention. Job satisfaction included both employment-related job satisfaction (including "your chance of promotion", "your rate of pay" and two other items) and satisfaction with the job itself (including "the freedom to choose your own method of working", "your job safety" and two other items). Improving job satisfaction, in terms of salary, promotion and job safety, is crucial for reducing turnover intention among primary care doctors. Therefore, we suggest that the government increase its financial investment in primary care facilities, especially in less-developed areas, and reform incentive mechanisms to improve the job satisfaction of primary care doctors. The government should consider policies such as establishing a social pension programme for village-level doctors and providing more opportunities for job promotion among primary care doctors, especially township-level doctors. Attention should also be paid to the impact of rapid urbanization, which could lead to increased workload or increased opportunities for career development, thus

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

    Science.gov (United States)

    Wildy, Helen; Peden, Sanna; Chan, Karyn

    2015-01-01

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

  4. Healthy Doctors – Sick Medicine

    Directory of Open Access Journals (Sweden)

    Olaf Gjerløw Aasland

    2015-05-01

    Full Text Available Doctors are among the healthiest segments of the population in western countries. Nevertheless, they complain strongly of stress and burnout. Their own explanation is deprofessionalisation: The honourable art of doctoring has been replaced by standardised interventions and production lines; professional autonomy has withered. This view is shared by many medical sociologists who have identified a “golden age of medicine,” or “golden age of doctoring,” starting after World War II and declining around 1970. This article looks at some of the central sociological literature on deprofessionalisation, particularly in a perspective of countervailing powers. It also looks into another rise-and-fall model, proposed by the medical profession itself, where the fall in professional power was generated by the notion that there are no more white spots to explore on the map of medicine. Contemporary doctoring is a case of cognitive dissonance, where the traditional doctor role seems incompatible with modern health care.Keywords: deprofessionalisation, professional autonomy, cognitive dissonance, golden age of doctoring

  5. 42 CFR 485.635 - Condition of participation: Provision of services.

    Science.gov (United States)

    2010-10-01

    ... more doctors of medicine or osteopathy and one or more physician assistants, nurse practitioners, or... patients, including— (i) Inpatient hospital care; (ii) Services of doctors of medicine or osteopathy; and... supervision of a registered nurse, a doctor of medicine or osteopathy, or, where permitted by State law, a...

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

    Science.gov (United States)

    Hao, Haijing

    2015-06-01

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

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

    Science.gov (United States)

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

    2014-12-01

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

  8. Talking to Your Doctor

    Medline Plus

    Full Text Available ... for the doctor’s contact information and their preferred method of communication. Remember that nurses and pharmacists are also good sources of information. How to Talk to your Doctor Talking With Your Doctor , NIH ...

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

    Science.gov (United States)

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

    2016-07-01

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

  10. Talking to Your Doctor

    Medline Plus

    Full Text Available ... You Talking to Your Doctor Science Education Resources Community Resources Clear Health A–Z Publications List More » ... can play an active role in your health care by talking to your doctor. Clear and honest ...

  11. Barefoot Doctors and the "Health Care Revolution" in Rural China: A Study Centered on Shandong Province.

    Science.gov (United States)

    Xu, Sanchun; Hu, Danian

    2017-09-01

    Barefoot doctors were rural medical personnel trained en masse, whose emergence and development had a particular political, economic, social, and cultural background. Like the rural cooperative medical care system, the barefoot doctor was a well-known phenomenon in the Cultural Revolution. Complicated regional differences and a lack of reliable sources create much difficulty for the study of barefoot doctors and result in differing opinions of their status and importance. Some scholars greatly admire barefoot doctors, whereas others harshly criticize them. This paper explores the rise and development of barefoot doctors based on a case study of Shandong province. I argue that the promotion of barefoot doctors was a consequence of the medical education revolution and an implementation of the Cultural Revolution in rural public health care, which significantly influenced medical services and development in rural areas. First, barefoot doctors played a significant role in accomplishing the first rural health care revolution by providing primary health care to peasants and eliminating endemic and infectious illnesses. Second, barefoot doctors were the agents who integrated Western and Chinese medicines under the direction of the state. As an essential part of the rural cooperative medical system, barefoot doctor personnel grew in number with the system's implementation. After the Cultural Revolution ended, the cooperative medical system began to disintegrate-a process that accelerated in the 1980s until the system's collapse in the wake of the de-collectivization. As a result, the number of barefoot doctors also ran down steadily. In 1985, "barefoot doctor" as a job title was officially removed from Chinese medical profession, demonstrating that its practice was non-universal and unsustainable. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Talking to Your Doctor

    Medline Plus

    Full Text Available ... Impact of NIH Research Science, Health, and Public Trust You are here Home » Institutes at NIH » NIH ... Your Doctor Plain Language Science, Health, and Public Trust Talking to Your Doctor Part I: Preparing for ...

  13. Electrodialytic removal of heavy metals from fly ashes

    DEFF Research Database (Denmark)

    Pedersen, Anne Juul

    2002-01-01

    The aim of the Ph.D. work was to develop the electrodialytic remediation method for removal of heavy metals from fly ashes. The work was focused on two types of fly ashes: fly ashes from wood combustion and fly ashes from municipal solid waste incineration.......The aim of the Ph.D. work was to develop the electrodialytic remediation method for removal of heavy metals from fly ashes. The work was focused on two types of fly ashes: fly ashes from wood combustion and fly ashes from municipal solid waste incineration....

  14. Doctoral education in the nuclear sector

    International Nuclear Information System (INIS)

    Minguez, E.

    2013-01-01

    Doctoral education is a major priority for European universities. In the context of the Bologna Process the importance of doctoral education as the third cycle of higher education and the first stage of a young researchers career, and thus in linking the European Higher Education and Research Areas, was first highlighted in the 2003 Berlin Report. The core component of doctoral training is the advancement of knowledge through original research. considering the need for structured doctoral programs and the need for transparent supervision and assessment, we note that the normal workload of the third cycle in most countries would correspond 3-4 years full time. This is spirit of the new Spanish Doctoral Law. Then, universities should ensure that their doctoral programmes promote interdisciplinary training and the development of transferable skills, thus meeting the needs of the wider employment market. We need to achieve and overall increase in the numbers of doctoral candidates taking up research careers as early stage researchers and also increase the employability as a normal way as it is the case of other advance countries. In Spain, universities with doctoral nuclear programmes and the CIEMAT, with the sponsorship of the nuclear sector, a doctoral school in nuclear science and engineering should be created to enhance the research careers of Young students for the future of nuclear activities in Spain. (Author)

  15. Treatment of fly ash for use in concrete

    Science.gov (United States)

    Boxley, Chett [Park City, UT

    2012-05-15

    A process for treating fly ash to render it highly usable as a concrete additive. A quantity of fly ash is obtained that contains carbon and which is considered unusable fly ash for concrete based upon foam index testing. The fly ash is mixed with a quantity of spray dryer ash (SDA) and water to initiate a geopolymerization reaction and form a geopolymerized fly ash. The geopolymerized fly ash is granulated. The geopolymerized fly ash is considered usable fly ash for concrete according to foam index testing. The geopolymerized fly ash may have a foam index less than 40%, and in some cases less than 20%, of the foam index of the untreated fly ash. An optional alkaline activator may be mixed with the fly ash and SDA to facilitate the geopolymerization reaction. The alkaline activator may contain an alkali metal hydroxide, carbonate, silicate, aluminate, or mixtures thereof.

  16. Flying Cities

    DEFF Research Database (Denmark)

    Ciger, Jan

    2006-01-01

    The Flying Cities artistic installation brings to life imaginary cities made from the speech input of visitors. In this article we describe the original interactive process generating real time 3D graphics from spectators' vocal inputs. This example of cross-modal interaction has the nice property....... As the feedback we have received when presenting Flying Cities was very positive, our objective now is to cross the bridge between art and the potential applications to the rehabilitation of people with reduced mobility or for the treatment of language impairments....

  17. Flying Cities

    DEFF Research Database (Denmark)

    Herbelin, Bruno; Lasserre, Sebastien; Ciger, Jan

    2008-01-01

    Flying Cities is an artistic installation which generates imaginary cities from the speech of its visitors. Thanks to an original interactive process analyzing people's vocal input to create 3D graphics, a tangible correspondence between speech and visuals opens new possibilities of interaction....... This cross-modal interaction not only supports our artistic messages, but also aims at providing anyone with a pleasant and stimulating feedback from her/his speech activity. As the feedback we have received when presenting Flying Cities was very positive, our objective is now to cross the bridge between art...

  18. Studies on mating competition of irradiated melon flies

    International Nuclear Information System (INIS)

    Limohpasmanee, W.

    1994-01-01

    Mating competition is the key factor for fruit flies control by using sterile insect technique project. Mass rearing and irradiation can reduce the mating competition of fruit flies. This experiment has purpose to evaluate the mating competition of the irradiated melon fly. The results show that mating competition values of irradiated melon flies were 0.36 and 0.24 when they mated with normal and irradiated females. Both normal male and female can mate more frequency than irradiated flies. (Z=1.322, P<0.05; Z=1.851, P<0.05). The results show that quality of mass rearing and irradiated melon fly was lower than the normal flies. So that quality of irradiated fly must be improved and the number of released flies as less must be higher than natural flies 6 time

  19. Talking to Your Doctor

    Medline Plus

    Full Text Available ... NIH Website NIH Employee Intranet Staff Directory En Español Site Menu Home Health Information Health Info Lines ... Talking With Your Doctor , NIH News in Health Español Talking to Your Doctor , National Eye Institute (NEI) ...

  20. Talking to Your Doctor

    Medline Plus

    Full Text Available ... Communications & Public Liaison » Clear Communication Clear Communication Clear Communication Health Literacy Clear & Simple Clear Health from NIH Cultural Respect Language Access Talking to Your Doctor Plain Language Science, Health, and Public Trust Talking to Your Doctor ...

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

    Science.gov (United States)

    Godskesen, Mirjam; Kobayashi, Sofie

    2016-01-01

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

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

    Science.gov (United States)

    Gopaul, Bryan

    2015-01-01

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

  3. Job Satisfaction Analysis in Rural China: A Qualitative Study of Doctors in a Township Hospital

    Directory of Open Access Journals (Sweden)

    Qiwei Chen

    2017-01-01

    Full Text Available Background. Township hospitals in China provide rural communities with basic but much needed critical health care services. The doctors working in these hospitals often feel unsatisfied when considering their work schedules and financial rewards. Method. To explore job satisfaction of health workers in a township hospital, a qualitative study was conducted of 39 doctors from five township hospitals in Guangxi Zhuang Autonomous Region. The goal was to understand the level of job satisfaction of doctors and to make recommendations for improvements. Results. About 75% (28/39 of the doctors expressed negative attitudes related to their work conditions. Slightly more than half (22/39 mentioned they should receive greater compensation for their work and more than one were seriously considering other options. Many participants (35/39 showed their satisfaction about the achievement of serving as a doctor. Conclusion. Their main concerns related to job satisfaction included working conditions, financial rewards, and the doctor’s relationships with patients. Increasing the incomes and fringe benefits of healthcare workers, improving their work conditions, and providing training and continuing education opportunities would help rural clinics retain doctors and eliminate the current unsatisfactory conditions. The findings also highlight the need for the government to increase financial support of township hospitals.

  4. The entry-level occupational therapy clinical doctorate: advantages, challenges, and international issues to consider.

    Science.gov (United States)

    Brown, Ted; Crabtree, Jeffrey L; Mu, Keli; Wells, Joe

    2015-04-01

    Internationally, occupational therapy education has gone through several paradigm shifts during the last few decades, moving from certificate to diploma to bachelors to masters and now in some instances to clinical doctorate as the entry-level professional credential to practice. In the United States there is a recommendation under consideration by the American Occupational Therapy Association (AOTA) that by 2025, all occupational therapy university programs will move to the clinical doctorate level. It should be noted, however, that the AOTA Board can only make recommendations and it is the Accreditation Council for Occupational Therapy Education (ACOTE) who has regulatory authority to approve such a change. What are the potential implications for the profession, our clients, and funders of occupational therapy services? What are the primary drivers for the move towards the clinical doctorate being the educational entry point? Is the next step in the evolution of occupational therapy education globally a shift to the entry-level clinical doctorate? This article reviews current literature and discusses issues about the occupational therapy entry-level clinical doctorate. The published evidence available about the occupational therapy entry-level clinical doctorate is summarized and the perceived or frequently cited pros and cons of moving to the clinical doctorate as the singular entry point to occupational therapy practice are considered. The potential impacts of the introduction of the clinical doctorate as the entry-to-practice qualification across the United States on the occupational therapy community internationally will be briefly discussed. If the United States moves toward the entry-level clinical doctorate as the only educational starting point for the profession, will other jurisdictions follow suit? Further discourse and investigation of this issue both inside and outside of the United States is needed so that informed decisions can be made.

  5. Fly ash dynamics in soil-water systems

    International Nuclear Information System (INIS)

    Sharma, S.; Fulekar, M.H.; Jayalakshmi, C.P.

    1989-01-01

    Studies regarding the effluents and coal ashes (or fly ash) resulting from coal burning are numerous, but their disposal and interactions with the soil and water systems and their detailed environmental impact assessment with concrete status reports on a global scale are scanty. Fly ash dynamics in soil and water systems are reviewed. After detailing the physical composition of fly ash, physicochemical changes in soil properties due to fly ash amendment are summarized. Areas covered include texture and bulk density, moisture retention, change in chemical equilibria, and effects of fly ash on soil microorganisms. Plant growth in amended soils is discussed, as well as plant uptake and accumulation of trace elements. In order to analyze the effect of fly ash on the physicochemical properties of water, several factors must be considered, including surface morphology of fly ash, pH of the ash sluice water, pH adjustments, leachability and solubility, and suspended ash and settling. The dynamics of fly ash in water systems is important due to pollution of groundwater resources from toxic components such as trace metals. Other factors summarized are bioaccumulation and biomagnification, human health effects of contaminants, and the impact of radionuclides in fly ash. Future research needs should focus on reduction of the environmental impact of fly ash and increasing utilization of fly ash as a soil amendment. 110 refs., 2 figs., 10 tabs

  6. Dr Oen Boen Ing Patriot doctor, social activist, and doctor of the poor

    Directory of Open Access Journals (Sweden)

    Ravando Lie

    2017-05-01

    Full Text Available This article examines the efforts and achievements of Oen Boen Ing, a Tionghoa doctor, to improve the quality of health of the poorer inhabitants of Surakarta. Dr Oen played an important role in five different periods: Dutch colonialism, the Japanese occupation, the Indonesian revolution, Soekarno’s regime, and Suharto’s New Order. Known for being a benevolent doctor, activist, and patriot of the revolution during his life-time, Dr Oen also gave medical assistance to the needy, which famously earned him the accolade of “doctor of the poor”. During the Indonesian revolution, Dr Oen assisted the Student Soldiers (Tentara Pelajar and afterwards was appointed the member of Supreme Advisory Council (Dewan Pertimbangan Agung/DPA by Soekarno in 1949. As a benevolent doctor and activist, Dr Oen is remembered for founding the Panti Kosala Hospital which was renamed to perpetuate his name on 30 October 1983, exactly a year after his passing. When he died, thousands of peoples gathered to pay their final respects to the doctor. He was honoured with a ceremony conducted in the Mangkunegaran Palace. Dr Oen’s name will be eternally respected, especially in Surakarta.

  7. Formation and utilization of fly ash

    Energy Technology Data Exchange (ETDEWEB)

    Vargyai, J

    1974-01-01

    General problems of slag and fly ash formation and utilization are discussed. The ever-increasing energy demand, and the comeback of coal as an energy carrier in power plants call for efficient solutions to the problem of slag and fly ash. Slag and fly ash are used for concrete in which they partly replace cement. Other possible uses are the amelioration of acid soils, fireclay manufacture, road construction, and tiles. It is possible to recover metals, such as vanadium, iron, aluminum, and radioactive materials from certain types of fly ash and slag. The utilization of fly ash is essential also with respect to the abatement of entrainment from dumps.

  8. Analysis list: Fli1 [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Fli1 Blood,Embryo + mm9 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/target/Fli1....1.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/target/Fli1.5.tsv http://dbarchive.biosciencedbc.jp/kyu...shu-u/mm9/target/Fli1.10.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/colo/Fli1.Blood.tsv,http://dbarchive.bioscience...dbc.jp/kyushu-u/mm9/colo/Fli1.Embryo.tsv http://dbarchive.bioscience...dbc.jp/kyushu-u/mm9/colo/Blood.gml,http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/colo/Embryo.gml ...

  9. Investigation of Hong Kong Doctors' Current Knowledge, Beliefs, Attitudes, Confidence and Practices: Implications for the Treatment of Tobacco Dependency

    Directory of Open Access Journals (Sweden)

    Abu Saleh M. Abdullah

    2006-10-01

    Conclusion: The survey has shown that existing smoking cessation service provision in Hong Kong for patients who smoke is inadequate, and has identified a lack of smoking cessation skills among doctors. Action should be taken to train doctors in smoking cessation skills and encourage them to routinely establish the smoking status of their patients and to advise all smokers to quit smoking.

  10. Fee-for-Service Is Dead. Long Live Fee for Service?

    Science.gov (United States)

    Greene, Jan

    2017-09-01

    The move to a value-based payment system was supposed to end perverse incentives that pay doctors more for delivering often unnecessary services. But things are changing slowly and the market is still 95% fee for service. There's talk of reworking the Medicare fee schedule so docs are paid more for the things that work, and less for those that don't.

  11. Talking to Your Doctor

    Medline Plus

    Full Text Available ... Discovery Into Health ® Impact of NIH Research Science, Health, and Public Trust You are here Home » Institutes at NIH » ... Access Talking to Your Doctor Plain Language Science, Health, and Public Trust Talking to Your Doctor Part I: Preparing ...

  12. Dementia - what to ask your doctor

    Science.gov (United States)

    What to ask your doctor about dementia; Alzheimer disease - what to ask your doctor; Cognitive impairment - what to ask your doctor ... Alzheimer's Association. Dementia Care Practice Recommendations ... in a Home Setting. Updated 2009. Alz.org. www.alz.org/national/ ...

  13. [How to make regional medicine revive from the medical crisis or collapse due to the severe paucity of medical doctors: a plan with "the magnet hospital"].

    Science.gov (United States)

    Itoh, Tsunetoshi

    2009-01-01

    In 2002-2003, the practice of doctors lending their names to appear as "staff" of hospitals became known. Problems regarding funds from public hospitals were also revealed. Tohoku University asked regional societies how to improve the medical situation, and redefined its responsibilities. The Educational Development Center for Local Medicine and Department of Local Medical Service System were set up (2005-2008). A severe shortage of medical doctors prevails in Japan: the number of doctors per population is at the 4th lowest among OECD countries, and the number per hospital bed is the lowest. We have no nursing homes whose beds are not counted as hospital beds. The number of faculty staff in Japanese medical schools is 1/3 to those of Western countries. The reported number of doctors working in hospitals and offices surpasses that by census for medical doctors by >40,000. Japanese doctors work for >60 hours per week. I propose essential plans to improve Japanese situation for medical service: 1. Immediately increase the number of doctors by at least 50%. Based on our calculation, we need 450,000 doctors. 2. When the shortage of doctors is severe, establish a magnet hospital with c.a. 500 beds for every 200,000 population, capable of treating highly emergency patients and attracting doctors who need medical training. Hospitals should not belong to each city or town. 3. Establish a comprehensive organization to nurture doctors on a long-term basis. It should consist of a medical school, hospitals, and the prefectural government. It should help doctors to move between hospitals, and be responsible both for designing doctors' career paths and for allocating them appropriately.

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

    Science.gov (United States)

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

    2018-07-01

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

  15. [Murder of the doctor].

    Science.gov (United States)

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

    2015-01-01

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

  16. On Doctoral Student Development: Exploring Faculty Mentoring in the Shaping of African American Doctoral Student Success

    Science.gov (United States)

    Felder, Pamela

    2010-01-01

    This study examines the influence of faculty mentorship in the shaping of African American doctoral student success. A case analysis framework is used to investigate the belief systems that doctoral students held about their doctoral experience. Data collection involved a one-phase semi-structured interview protocol used to gather information…

  17. Geographical distribution and profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa.

    Science.gov (United States)

    Ntuli, Samuel T; Maboya, Edwin

    2017-09-27

    The shortage and unequal distribution of medical doctors in low- and middle-income countries continues to be a public health concern. To establish the geographical distribution and demographic profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa. The PERSAL system was used to obtain information on the number of medical doctors employed in public sector hospitals of the Limpopo Province. Data were exported from PERSAL's database and then analysed using STATA version 9.0. The mean age of the 887 medical doctors was 40.1 ± 11.2 years (range 24-79 years). Sixty per cent of the doctors were male, 66% were aged ≤ 45 years and 84% were African. Most of the doctors (86%) were medical officers, of which 55% had < 5 years working experience. Overall, the doctor-to-population ratio for the five districts in the province was 16.4/100 000, with Capricorn (33.7/100 000) and Waterberg (20.2/100 000) recording the highest ratios. A large proportion (43%) of medical officers are employed in the Capricorn District, of which 71% were practising at the tertiary hospital. This study demonstrated a shortage and maldistribution of medical doctors in the public sector hospitals of the Limpopo Province. This has a potentially negative effect on the delivery of an appropriate and efficient healthcare service to the population and requires urgent attention.

  18. [Patients, doctors and the internet].

    Science.gov (United States)

    Jeannot, Jean Gabriel; Bischoff, Thomas

    2015-05-13

    The majority of the Swiss population uses the internet to seek information about health. The objective is to be better informed, before or after the consultation. Doctors can advise their information-seeking patients about high quality websites, be it medical portals or websites dedicated to a specific pathology. Doctors should not see the internet as a threat but rather as an opportunity to strengthen the doctor-patient relationship.

  19. The effect of Health smart cards for Quality Health care services ( doctor martyr Beheshti medical research center in Qom

    Directory of Open Access Journals (Sweden)

    Saeed zarandi

    2016-03-01

    Full Text Available The main objective of this study was to investigate the effect of the use health smart card on the aspects quality of healthcare services in doctor martyr beheshti medical research center in qom . With regard to the measures taken in the context of the establishment of this card in Qom and the lack of previous experience in this province, one of the concerns of the authorities to investigate the performance and capabilities of the card and its effects on the quality of health services is affecting the present study is to respond to this concerns. This research method is descriptive and applied to the target population of physicians, nurses and medical record experts employed at the Medical Center have formed a martyr Beheshti Qom due to more awareness cognitive advantages associated with its use of smart cards have given. The population is equal to the number of 444 and 124 questionnaire for data analysis is used. The sampling method used in this research was stratified random sampling conducted in the respective classes. Spss software for data analysis & exploratory factor analysis & confirmed, Kolmogorov-Smirnov Test, Wilcoxon Test & matrix of factors were used. The analysis results showed that Health Smart Cards for quality of health care services positive and significant effects on Dimension quality of the reliability & Tangibles . Analysis of demographic variables that influence opinions about the quality of health care Health Smart Cards significantly related to gender and education level, and also no experience discussed the variables significantly associated with age.

  20. Fourth Doctoral Student Assembly

    CERN Multimedia

    Ingrid Haug

    2016-01-01

    On 10 May, over 130 PhD students and their supervisors, from both CERN and partner universities, gathered for the 4th Doctoral Student Assembly in the Council Chamber.   The assembly was followed by a poster session, at which eighteen doctoral students presented the outcome of their scientific work. The CERN Doctoral Student Programme currently hosts just over 200 students in applied physics, engineering, computing and science communication/education. The programme has been in place since 1985. It enables students to do their research at CERN for a maximum of three years and to work on a PhD thesis, which they defend at their University. The programme is steered by the TSC committee, which holds two selection committees per year, in June and December. The Doctoral Student Assembly was opened by the Director-General, Fabiola Gianotti, who stressed the importance of the programme in the scientific environment at CERN, emphasising that there is no more rewarding activity than lear...

  1. An analytical comparison of the patient-to-doctor policy and the doctor-to-patient policy in the outpatient clinic

    NARCIS (Netherlands)

    Hulshof, P.J.H.; Vanberkel, P.T.; Boucherie, Richardus J.; Hans, Elias W.; van Houdenhoven, Mark; van Ommeren, Jan C.W.

    Outpatient clinics traditionally organize processes such that the doctor remains in a consultation room, while patients visit for consultation, we call this the Patient-to-Doctor policy. A different approach is the Doctor-to-Patient policy, whereby the doctor travels between multiple consultation

  2. Penumbra: Doctoral support as drama

    DEFF Research Database (Denmark)

    Wisker, Gina; Robinson, Gill; Bengtsen, Søren Smedegaard

    2017-01-01

    Much international doctoral learning research focuses on personal, institutional and learning support provided by supervisors, managed relationships,‘nudging’ robust, conceptual, critical, creative work. Other work focuses on stresses experienced in supervisor-student relationships and doctoral...... journeys. Some considers formal and informal learning communities supporting students on research journeys, and roles played by families, friends and others, sometimes o ering encouragement and sometimes added stress. However, little has been explored concerning often uno cial, largely unrecognised...... sanctioned (‘lightside’), and less well recognised often unsanctioned (‘darkside’) on doctoral research and writing learning journey, instigating questions about doctoral student needs, and the range of support provided, both legitimate, well known, less legitimate. This work concentrates on the ‘darkside’....

  3. Fighting for business: the limits of professional cooperation among American doctors during the First World War.

    Science.gov (United States)

    Schafer, James A

    2015-04-01

    The American medical profession participated extensively in preparedness and mobilization for the First World War, with more than one in five doctors voluntarily enlisting in various branches of the Army and Navy Medical Corps. Medical officers were widely valorized for suspending their civilian careers and for sacrificing their professional income while in service. Because of the meager commissions that medical officers received by comparison with fees many doctors earned in established private medical practices, scores of county medical societies implemented organizational solutions to this business problem, with the hopes of removing a significant disincentive to enlistment. In these "practice protection plans," a civilian doctor promised to take care of the patients of a military doctor, to forward a portion of the fees collected thereby to the family of the military doctor, and to refer these patients to the military doctor upon his return. Despite initial enthusiasm and promotion, these plans ultimately failed to achieve their objectives, leading some medical officers to accuse civilian doctors of being opportunistic, unpatriotic "slackers." This episode reveals the limits of professional cooperation in American medicine at the time and the need to explain organizational failures in the grand narrative of professionalization during the "Golden Age" of American medicine. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Psychiatric Prescribers' Experiences With Doctor Shoppers.

    Science.gov (United States)

    Worley, Julie; Johnson, Mary; Karnik, Niranjan

    2015-01-01

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

  5. Agency doctorates

    International Nuclear Information System (INIS)

    1970-01-01

    Staff members of the Agency working at the Seibersdorf laboratory are continuing to achieve high academic distinction. Two more - both Austrian - have now been awarded the degree of Doctor of Agriculture. Joachim Kramer, who is 26, graduated from the Hochschule fur Bodenkultur in 1967 with the degree of Diplom-Ingenieur and then started work in the plant breeding and genetics section of the laboratory under the direction of Dr. Knut Mikaelsen. The results of the research work he carried out were accepted as the subject of a thesis for which he has now been granted his doctorate. The doctoral promotion took place on 30 June, at a ceremony attended by Dr. Andre Finkelstein, Deputy Director General for Research and Isotopes. The subject of Dr. Kramer's thesis was a comprehensive study of the mutagenic effects of fast neutrons and gamma rays, and the influence of various modifying factors such as water content, oxygen and metabolic state of seeds at the time of irradiation. This work has contributed significantly to the understanding of the mechanisms by which these two types of ionizing radiation produce mutations in seeds. The knowledge gained will be of great importance in the efficient use of ionizing radiation in practical plant breeding. Paul Wassermann, who is 33 years old, joined the Agency in 1965. He, too, graduated from the Hochschule fur Bodenkultur as Diplom-Ingenieur in agriculture, having graduated with honours previously from the agricultural secondary school at Raumberg, Austria, in 1958. Dr. Wassermann's own words may be used to explain how he came to gain his doctorate. 'In October, 1966, I completed my studies at the Hochschule,' he writes. 'I was employed at the Agency laboratories in Seibersdorf, working in the plant and soils group. Encouraged by the interesting research which was performed there, a thesis entitled 'the Fate of Nitrogen in Submerged Rice Soils' was started, which finally led to the doctor's degree in Agriculture in June this year

  6. The doctoral learning penumbra

    DEFF Research Database (Denmark)

    Bengtsen, Søren Smedegaard; Robinson, Gill; Wisker, Gina

    This paper presents our cross-national research into what we term the ‘doctoral learning penumbra’, which covers the diverse, unnoticed, and often unrecognised forms of help and support that doctoral students draw from during their PhD, and which are vital for completion. Our aim is to better...

  7. Headache - what to ask your doctor

    Science.gov (United States)

    ... Migraine - what to ask your doctor; Tension-type headache - what to ask your doctor; Cluster headache - what to ask your doctor ... How can I tell if the headache I am having is dangerous? What are ... headache ? A migraine headache ? A cluster headache ? What medical ...

  8. Australian doctors and the visual arts. Part 4. Doctors as supporters of art galleries and artists in Victoria.

    Science.gov (United States)

    Hamilton, D G

    1986-07-07

    The contribution of doctors to the visual arts is being discussed in a series of six articles. Doctor-artists in New South Wales and Victoria, and doctors as collectors, donors, gallery supporters and writers in New South Wales, have been discussed in earlier articles. This, the fourth article, deals with doctors as supporters of art galleries and artists in Victoria.

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

    Science.gov (United States)

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

    2018-01-01

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

  10. [Life conditions of Togolese doctors].

    Science.gov (United States)

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

    2010-09-01

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

  11. Reinventing The Doctor

    Directory of Open Access Journals (Sweden)

    Moyez Jiwa

    2011-07-01

    Full Text Available There has been a seismic shift in the lives of people because of technology. People are far better informed than they were in the 1980s and 1990s. Much of this information is available through the media but even more is available and archived on the internet. The forces pushing the internet into health and health care are strong and unstoppable, ensuring that the internet and the choices it offers must be part of the design of our future health care system. We are no longer content to wait in queues as we live at a faster pace than earlier generations — we don’t not have time to wait for appointments months, weeks or even days in advance. The internet offers the prospect of online consultations in the comfort of your own home. The physical examination will change as new devices are developed to allow the necessary sounds and signals emitted by our malfunctioning bodies to be recorded, interpreted and captured at a remote location. Meanwhile, for those who prefer to see a health care practitioner in person the options to consult practitioners other than doctors who can advise on our health is expanding. The reality is we can’t afford to train or pay for all the doctors we need under the current “doctor-knows-best” system of health care. Patients no longer believe the rhetoric and are already voting with their feet. Pharmacists, nurses and other allied health professionals are beginning to play a much greater role in offering relief from symptoms and monitoring of chronic diseases. Of course, the doctor of the future will still need to offer face-to-face consultations to some people most of the time or most people some of the time. The social role doctors play will continue to be important as humans will always need other humans to personally respond to their distress. As doctors reinvent themselves, the internet and the value of time with patients will be the driving forces that move us into a more sustainable future in health care.

  12. Rural outreach by specialist doctors in Australia: a national cross-sectional study of supply and distribution.

    Science.gov (United States)

    O'Sullivan, Belinda G; Joyce, Catherine M; McGrail, Matthew R

    2014-09-04

    Outreach has been endorsed as an important global strategy to promote universal access to health care but it depends on health workers who are willing to travel. In Australia, rural outreach is commonly provided by specialist doctors who periodically visit the same community over time. However information about the level of participation and the distribution of these services nationally is limited. This paper outlines the proportion of Australian specialist doctors who participate in rural outreach, describes their characteristics and assesses how these characteristics influence remote outreach provision. We used data from the Medicine in Australia: Balancing Employment and Life (MABEL) survey, collected between June and November 2008. Weighted logistic regression analyses examined the effect of covariates: sex, age, specialist residential location, rural background, practice arrangements and specialist group on rural outreach. A separate logistic regression analysis studied the effect of covariates on remote outreach compared with other rural outreach. Of 4,596 specialist doctors, 19% (n = 909) provided outreach; of which, 16% (n = 149) provided remote outreach. Most (75%) outreach providers were metropolitan specialists. In multivariate analysis, outreach was associated with being male (OR 1.38, 1.12 to 1.69), having a rural residence (both inner regional: OR 2.07, 1.68 to 2.54; and outer regional/remote: OR 3.40, 2.38 to 4.87) and working in private consulting rooms (OR 1.24, 1.01 to 1.53). Remote outreach was associated with increasing 5-year age (OR1.17, 1.05 to 1.31) and residing in an outer regional/remote location (OR 10.84, 5.82 to 20.19). Specialists based in inner regional areas were less likely than metropolitan-based specialists to provide remote outreach (OR 0.35, 0.17 to 0.70). There is a healthy level of interest in rural outreach work, but remote outreach is less common. Whilst most providers are metropolitan-based, rural doctors are more

  13. The Criminal Justice Doctorate: A Study of Doctoral Programs in the United States.

    Science.gov (United States)

    Felkenes, George T.

    Graduates of six institutions were surveyed in an effort to develop a profile of doctoral graduates from institutions that have traditionally offered doctoral programs oriented specifically toward the field of criminal justice. A second research objective was to develop an understanding of the attitudes, frustrations, and utilization patterns of…

  14. Flying car design and testing

    OpenAIRE

    Klein, S.; Smrcek, L.

    2009-01-01

    This paper is primarily concerned with the inverted design process and manufacture of a flying car prototype which can overcome the problem of traffic management in the world today. A possible solution to the problem of overcrowded roads would be to design a flying or hovering car. Given technological advances in aircraft construction, navigation and operation, flying cars or personal aircraft are now a feasible proposition. The viability of such a concept was investigated in terms of produci...

  15. Feasible utopias in doctoral education

    DEFF Research Database (Denmark)

    Elliot, Dely; Guccione, Kay; Bengtsen, Søren Smedegaard

    -Martek, Chen & McAlpine, 2011). PGRs’ motivation, creativity, resilience and momentum during their long and intense doctoral journey are often strongly sustained by unseen informal structures, social support systems and extra-curricular activities tacitly providing emotional, social, pastoral and academic......Part 1 Abstract Ongoing educational and psycho-social challenges in doctoral education (e.g. psychological distress, attrition and delay in completion) warrant a more comprehensive understanding of the expanded doctoral education context and how the different facets of doctoral support mechanisms......, 2016b; Bengtsen & Barnett, 2017; Bryan & Guccione, 2018; Elliot et al., 2016b, 2016c; Wisker et al., 2017). Yet, there remains a somewhat limited understanding not only of these multifaceted components but how they interact with already existing formal and informal support mechanisms offered...

  16. Are flying-foxes coming to town? Urbanisation of the spectacled flying-fox (Pteropus conspicillatus in Australia.

    Directory of Open Access Journals (Sweden)

    Jessica Tait

    Full Text Available Urbanisation of wildlife populations is a process with significant conservation and management implications. While urban areas can provide habitat for wildlife, some urbanised species eventually come into conflict with humans. Understanding the process and drivers of wildlife urbanisation is fundamental to developing effective management responses to this phenomenon. In Australia, flying-foxes (Pteropodidae are a common feature of urban environments, sometimes roosting in groups of tens of thousands of individuals. Flying-foxes appear to be becoming increasingly urbanised and are coming into increased contact and conflict with humans. Flying-fox management is now a highly contentious issue. In this study we used monitoring data collected over a 15 year period (1998-2012 to examine the spatial and temporal patterns of association of spectacled flying-fox (Pteropus conspicillatus roost sites (camps with urban areas. We asked whether spectacled flying-foxes are becoming more urbanised and test the hypothesis that such changes are associated with anthropogenic changes to landscape structure. Our results indicate that spectacled flying-foxes were more likely to roost near humans than might be expected by chance, that over the period of the study the proportion of the flying-foxes in urban-associated camps increased, as did the number of urban camps. Increased urbanisation of spectacled flying-foxes was not related to changes in landscape structure or to the encroachment of urban areas on camps. Overall, camps tended to be found in areas that were more fragmented, closer to human habitation and with more urban land cover than the surrounding landscape. This suggests that urbanisation is a behavioural response rather than driven by habitat loss.

  17. Does a self-referral counselling program reach doctors in need of help? A comparison with the general Norwegian doctor workforce

    Directory of Open Access Journals (Sweden)

    Gude Tore

    2007-03-01

    Full Text Available Abstract Background Doctors have a relatively high degree of emotional distress, but seek help to a lesser degree and at a later stage than other academic groups. This can be deleterious for themselves and for their patients. Prevention programs have therefore been developed but it is unclear to what extent they reach doctors in need of help. This study describes doctors who participated in a self-referrral, easily accessible, stress relieving, counselling program in Norway, and compares them with a nationwide sample of Norwegian doctors. Methods Two hundred and twenty seven (94% of the doctors, 117 women and 110 men, who came to the resort centre Villa Sana, Modum, Norway, between August 2003 and July 2005, agreed to participate in the study. Socio-demographic data, reasons for and ways of help-seeking, sick-leave, symptoms of depression and anxiety, job stress and burnout were assessed by self-reporting questionnaires. Results Forty-nine percent of the Sana doctors were emotionally exhausted (Maslach compared with 25% of all Norwegian doctors. However, they did not differ on empathy and working capacity, the other two dimensions in Maslach's burnout inventory. Seventy-three percent of the Sana doctors could be in need of treatment for depression or anxiety based on their symptom distress scores, compared with 14% of men and 18% of women doctors in Norway. Twenty-one percent of the Sana doctors had a history of suicidal thoughts, including how to commit the act, as compared to 10% of Norwegian doctors in general. Conclusion Sana doctors displayed a higher degree of emotional exhaustion, symptoms of depression and anxiety as well as job related stress, compared with all Norwegian doctors. This may indicate that the program at Villa Sana to a large extent reaches doctors in need of help. The counselling intervention can help doctors to evaluate their professional and private situation, and, when necessary, enhance motivation for seeking adequate

  18. Best practices in doctoral retention: Mentoring

    Directory of Open Access Journals (Sweden)

    Judie L. Brill

    2014-06-01

    Full Text Available  The aim of this critical literature review is to outline best practices in doctoral retention and the successful approach of one university to improve graduation success by providing effective mentorship for faculty and students alike. The focus of this literature review is on distance learning relationships between faculty and doctoral students, regarding retention, persistence, and mentoring models. Key phrases and words used in the search and focusing on mentoring resulted in over 20,000 sources. The search was narrowed to include only doctoral study and mentoring. Research questions of interest were: Why do high attrition rates exist for doctoral students? What are the barriers to retention? What are the benefits of doctoral mentoring? What programs do institutions have in place to reduce attrition? The researchers found a key factor influencing doctoral student retention and success is effective faculty mentorship. In particular, the design of a mentoring and faculty training program to increase retention and provide for success after graduation is important. This research represents a key area of interest in the retention literature, as institutions continue to search for ways to better support students during their doctoral programs and post-graduation. DOI: 10.18870/hlrc.v4i2.186

  19. EHR adoption among doctors who treat the elderly.

    Science.gov (United States)

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

    2010-12-01

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

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

    Science.gov (United States)

    Wegwarth, Odette; Gaissmaier, Wolfgang; Gigerenzer, Gerd

    2009-08-01

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

  1. Development of informational-communicative system, created to improve medical help for family medicine doctors.

    Science.gov (United States)

    Smiianov, Vladyslav A; Dryha, Natalia O; Smiianova, Olha I; Obodyak, Victor K; Zudina, Tatyana O

    2018-01-01

    Introduction: Today mobile health`s protection service has no concrete meaning. As an research object it was called mHealth and named by Global observatory of electronic health`s protection as "Doctor and social health practice that can be supported by any mobile units (mobile phones or smartphones), units for patient`s health control, personal computers and other units of non-wired communication". An active usage of SMS in programs for patients` cure regimen keeping was quiet predictable. Mobile and electronic units only begin their development in medical sphere. Thus, to solve all health`s protection system reformation problems a special memorandum about cooperation in creating E-Health system in Ukraine was signed. The aim: Development of ICS for monitoring and non-infection ill patients` informing system optimization as a first level of medical help. Materials and methods: During research, we used systematical approach, meta-analysis, informational-analytical systems` schemes projection, expositive modeling. Developing the backend (server part of the site), we used next technologies: 1) the Apache web server; 2) programming language PHP; 3) Yii 2 PHP Framework. In the frontend developing were used the following technologies (client part of the site): 1) Bootstrap 3; 2) Vue JS Framework. Results and conclusions: Created duo-channel system "doctor-patient" and "patient-doctor" will allow usual doctors of family medicine (DFM) take the interactive dispensary cure and avoid uncontrolled illness progress. Doctor will monitor basic physical data of patient`s health and curing process. The main goal is to create automatic system to allow doctor regularly write periodical or non-periodical notifications, get patients` questioning answers and spread information between doctor and patient; that will optimize work of DFMs.

  2. THE UNQUALIFIED MEDICAL PRACTITIONERS - Methods of Practice and Nexus with the Qualified Doctors

    OpenAIRE

    K.V. Narayana

    2006-01-01

    The private sector accounts for about 75 percent of outpatient as well as inpatient medical care in Andhra Pradesh. The presence of a large number of unqualified medical practitioners in the rural areas and urban slums indicate that they provide most of the outpatient services in the private sector. Given the huge quantum of services provided by the RMPs, the present study aims at identifying their number, characteristics and the nexus with the qualified doctors through a case study of one di...

  3. Telemedicine and primary health: The virtual doctor project Zambia

    OpenAIRE

    Mupela, Evans; Mustarde, Paul; Jones, Huw

    2011-01-01

    This paper is a commentary on a project application of telemedicine to alleviate primary health care problems in Lundazi district in the Eastern province of Zambia. The project dubbed 'The Virtual Doctor Project' will use hard body vehicles fitted with satellite communication devices and modern medical equipment to deliver primary health care services to some of the neediest areas of the country. The relevance and importance of the project lies in the fact that these areas are hard-to-reach d...

  4. The Trouble with Doctoral Aspiration Now

    Science.gov (United States)

    Burford, James

    2018-01-01

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

  5. Patient's Decision to Disclose the Use of Traditional and Complementary Medicine to Medical Doctor: A Descriptive Phenomenology Study

    Science.gov (United States)

    Kelak, Johny Anak; Safii, Razitasham

    2018-01-01

    Nondisclosure of traditional and complementary medicine (T&CM) use may cause individual to be at risk of undue harm. This study aimed to explore patient's experience and views on their decision to disclose the use of T&CM to the doctor. An exploratory qualitative study using in-depth interview involving 10 primary care clinics attendees in Kuching was conducted. The results indicated that disclosure of T&CM use will motivate them to get information, increase doctor's awareness, and get support from family and friends for disclosure. Fear of negative relationship and negative response from doctors was a barrier for disclosure. Doctor's interpersonal and communication skills of being involved, treating patients respectfully, listening attentively, respecting privacy, and taking time for the patient were a critical component for disclosure. Intrapersonal trust regarding doctor influences their satisfaction on healthcare. Women are more open and receptive to a health concern and expressing negative emotions and tend to share problems, whereas men always described themselves as healthy, tended to keep their own personal feeling to themselves, and tended to not share. The doctor should consider gender differences in disclosure, their attitude towards T&CM use, and gained patient's trust in the delivery of healthcare services. Good interpersonal and communication skills must be maintained between doctor and patients. PMID:29636778

  6. Composites Based on Fly Ash and Clay

    International Nuclear Information System (INIS)

    Fidancevska, E.; Jovanov, V.; Angusheva, B.; Srebrenkoska, V.

    2014-01-01

    Fly ash is a waste generated from the coal combustion during the production of electricity in the thermal power plants. It presents industrial by-product containing Technologically Enhanced Natural Occurring Radioactive Materials (TENORM) with the great potential for valorisation. Fly ash is successfully utilized in cement and concrete industry, also in ceramics industry as component for manufacturing bricks and tiles, and recently there are many investigations for production of glass-ceramics from fly ash. Although the utilization of fly ash in construction and civil engineering is dominant, the development of new alternative application for its further exploitation into new products is needed. This work presents the possibility for fly ash utilization for fabricating dense composites based on clay and fly ash with the potential to be used in construction industry

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

    Science.gov (United States)

    Duncan, Myanna; Haslam, Cheryl

    2015-01-01

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

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

    Science.gov (United States)

    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.

  9. Conceptualising Doctoral Writing as an Affective-political Practice

    Directory of Open Access Journals (Sweden)

    James Burford

    2017-03-01

    Full Text Available Aim/Purpose: This article offers a conceptual summary and critique of existing literature on doctoral writing and emotion. The article seeks to intervene in current debates about doctoral writing by re-positioning it as an affective-political practice Background: Over recent decades public interest in the doctorate has expanded as it has become re-framed as a key component of national success in the global knowledge economy. It is within this context that the practice of doctoral writing has crystallised as an object of interest. While researchers have examined the increased regulation, surveillance, and intensification of doctoral writing, often this work is motivated to develop pedagogies that support students to meet these new expectations. At this point, there has been limited attention to what broad changes to the meanings and practices of doctoral writing feel like for students. Methodology: The paper offers a conceptual review that examines the ways in which doctoral writing tends to be understood. A review of literature in the areas of doctoral writing, doctoral emotion, and critical studies of academic labour was undertaken in order to produce a more comprehensive understanding of the political and emotional dynamics of doctoral writing. Contribution: It is intended that this conceptual research paper help researchers attend to the emotional context of doctoral writing in the current university context. Critical studies of academic work and life are identified as a possible platform for the development of future doctoral education research, and the conceptual tool of “affective-politics” is advanced as a novel frame for approaching doctoral writing research.

  10. Exploring provision of Innovative Community Education Placements (ICEPs) for junior doctors in training: a qualitative study.

    Science.gov (United States)

    Griffin, Ann; Jones, Melvyn M; Khan, Nada; Park, Sophie; Rosenthal, Joe; Chrysikou, Vasiliki

    2016-02-09

    Medical education in community settings is an essential ingredient of doctors' training and a key factor in recruiting general practitioners (GP). Health Education England's report 'Broadening the Foundation' recommends foundation doctors complete 4-month community placements. While Foundation GP schemes exist; other community settings, are not yet used for postgraduate training. The objective of this study was to explore how community-based training of junior doctors might be expanded into possible 'innovative community education placements' (ICEPs), examining opportunities and barriers to these developments. A qualitative study where semistructured interviews were undertaken and themes were generated deductively from the research questions, and iteratively from transcripts. UK community healthcare. Stakeholders from UK Community healthcare providers and undergraduate GP and community educators. Nine participants were interviewed; those experienced in delivering community-based undergraduate education, and others working in community settings that had not previously trained doctors. Themes identified were practicalities such as 'finance and governance', 'communication and interaction', 'delivery of training' and 'perceptions of community'. ICEPs were willing to train Foundation doctors. However, concerns were raised that large numbers and inadequate resources could undermine the quality of educational opportunities, and even cause reputational damage. Organisation was seen as a challenge, which might be best met by placing some responsibility with trainees to manage their placements. ICEP providers agreed that defined service contribution by trainees was required to make placements sustainable, and enhance learning. ICEPs stated the need for positive articulation of the learning value of placements to learners and stakeholders. This study highlighted the opportunities for foundation doctors to gain specialist and generalist knowledge in ICEPs from diverse clinical

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

    Science.gov (United States)

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

    2012-12-01

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

  12. Flies without centrioles.

    Science.gov (United States)

    Basto, Renata; Lau, Joyce; Vinogradova, Tatiana; Gardiol, Alejandra; Woods, C Geoffrey; Khodjakov, Alexey; Raff, Jordan W

    2006-06-30

    Centrioles and centrosomes have an important role in animal cell organization, but it is uncertain to what extent they are essential for animal development. The Drosophila protein DSas-4 is related to the human microcephaly protein CenpJ and the C. elegans centriolar protein Sas-4. We show that DSas-4 is essential for centriole replication in flies. DSas-4 mutants start to lose centrioles during embryonic development, and, by third-instar larval stages, no centrioles or centrosomes are detectable. Mitotic spindle assembly is slow in mutant cells, and approximately 30% of the asymmetric divisions of larval neuroblasts are abnormal. Nevertheless, mutant flies develop with near normal timing into morphologically normal adults. These flies, however, have no cilia or flagella and die shortly after birth because their sensory neurons lack cilia. Thus, centrioles are essential for the formation of centrosomes, cilia, and flagella, but, remarkably, they are not essential for most aspects of Drosophila development.

  13. Work of female rural doctors.

    Science.gov (United States)

    Wainer, Jo

    2004-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Borde Theda

    2008-04-01

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

  15. Doctoral education in a successful ecological niche

    DEFF Research Database (Denmark)

    Christensen, Mette Krogh; Lund, Ole

    2014-01-01

    Scholarly communities are dependent on and often measured by their ability to attract and develop doctoral students. Recent literature suggests that most scholarly communities entail ecological niches in which the doctoral students learn the codes and practices of research. In this article, we...... successful doctoral education because it: 1) fleshes out the professional attitude that is necessary for becoming a successful researcher in the department, 2) shapes and adapts the doctoral students’ desires to grasp and identify with the department’s practices, and 3) provides the doctoral students...... explore the microclimate in an ecological niche of doctoral education. Based on a theoretical definition of microclimate as the emotional atmosphere that ties group members together and affects their actions, we conducted a case study that aimed to describe the key features of the microclimate...

  16. Note from the CERN Medical Service

    CERN Multimedia

    Medical Service

    2005-01-01

    FLU VACCINATION People working on the CERN site who wish to be vaccinated may go to the Medical Service (ground-floor, bldg. 57), without a prior appointment, but THEY MUST BRING THEIR VACCINE WITH THEM. Ideally, vaccination should take place between 1st October and 30th November 2006. CERN staff aged 50 or over are recommended to have the flu vaccination.  Vaccination is particularly important for those suffering from chronic lung, cardio-vascular or kidney problems, for diabetics and those convalescing from serious illness or after major surgery . The Medical Service will not administer vaccines for family members or retired staff members, who must contact their usual family doctor. The Medical Service will not administer vaccines for family members or retired staff members, who must contact their normal family doctor.

  17. Interspecific Mating between Wild and Sterile Fruit Flies of Oriental Fruit Fly, Bactrocera dorsalis (Hendel) with Guava Fruit Fly, Bactrocera correcta (Bezzi) in Cages

    International Nuclear Information System (INIS)

    Pransopon, Prapon; Sutantawong, Manon

    2003-06-01

    Copulation and sperm transfer were observed between wild flies and sterile flies of Bactrocera dorsalis (Hendel) and Bactrocera correcta (Bezzi) in cages. 8-day old pupae of B. dorsalis and B. correcta were irradiated with gamma rays at 90 and 80 gray respectively. Wild flies from infested fruits and sterile flies from artificial diet in the labolatory were used for testing. The experiments were conducted 3 treatments and 3 replications. The ratio of sterile male : wild male: wild female were 3:1:1 by using sterile male of B. dorsalis: wild male of B. correcta : wild female of B. correcta and sterile male of B. correcta: wild male of B. dorsalis: wild female of B. dorsalis as 60:20:20 flies respectively. The experiment found 69 pairs of copulation consisting of 3 mating pairs(4.3%) of wild male with wild female of B. dorsalis, 22 mating pairs (31.9%) of wild male with wild female of B. correcta, 2 mating pairs(2.9%) of sterile male of B dorsalis with wild female of B. correcta, 42 mating pairs(60.9%) of sterile male of B. correcta with wild female of B. dorsalis. The cages which ratio 1:1 consisted of wild B. dorsalis and wild B. correcta (male and female = 50:50 flies) were observed and found that 43 pairs of copulation such as 2 mating pairs (4.6%) of wild male with wild female of B. dorsalis, 26 mating pairs (60.5%) of wild male with wild female of B. correcta, 2 mating pairs(2.9%) of sterile male of B. dorsalis with wild female of B. correcta and 15 mating pairs(34.9%) of wild male of B. correcta with wild female of B. dorsalis. Mated female flies were separated from male flies. Egg hatch and sperm were checked. The hatchability of normal copulation of B. dorsalis and B. correcta were 81 and 90%. The average sperm level in spermathecae of normal copulation of B. dorsalis and B. correcta were 2.2 and 2.3 respectively but had no sperm in their spemathecae of females of interspecific copulations Mating behavior of both species began in the evening before sunset at

  18. Leaching of saltstones containing fly ash

    International Nuclear Information System (INIS)

    Barnes, M.W.; Roy, D.M.; Langton, C.A.

    1985-01-01

    Two types of fly ash were incorporated in saltstones designed for potential encapsulation of Savannah River Plant low level defense waste. These fly ashes have some cementitious properties while at the same time their presence in substitution for cement slows early hydration. Class C fly ash has a high calcium content and is considered cementitious; Class F fly ash has a low calcium content and is not classified as cementitious. Leach tests were performed and physical properties were measured for saltstones containing each class, to see the differences in the effect of the fly ashes. The four waste ions nitrate, nitrite, sodium and sulfate were shown to leach by diffusion. Effective diffusivities were determined for these ions. Data for nitrate, the most important species from the environmental point of view, are shown in Table A. Saltstones made with Class C fly ash have substantially lower leach rates than those made with Class F fly ash. The leach rates, and therefore the square roots of the effective diffusivities, have been found to be proportional to the pore surface area per unit volume (or the ratio of pore volume to pore radius), to the fraction of waste containing solution, and to the inverse of the fraction of calcium in the saltstone. Rates and diffusivities are not proportional to the water to cement ratio, because this number depends on whether the fly ash is counted as cementitious, as in Class C cement, or not cementitious, as in Class F cement. In fact the relatively small amount of calcium in Class F cement contributes to the cementitious properties overall, though not so much as Class C cement. 4 refs., 2 figs., 6 tabs

  19. «FLYING MEN - THE EYES OF THE ARMY»

    Directory of Open Access Journals (Sweden)

    Наталья Георгиевна Георгиева

    2014-12-01

    Full Text Available The purpose of this article is to give some information about the First World War and pay tribute to the memory of those who defended the honour of their country. The authors consider the written and oral (family stories sources devoted to one of those “flying men”, who were “the eyes of the army”. So the article deals with the history of participation of military aviator A.M. Cheremukhin [18 (30.05.1895, Moscow - 19.08.1958, Palanga, Lithuanian SSR, Soviet Union] in the First World War. He later became a Soviet scientist, designer of aircraft and helicopter, Doctor of Engineering (1937, Professor (1934, Lenin prizewinner (1957, twice Stalin prizewinner (1949, 1952, honored worker of science and technology of the Russian Federation (1947. He was awarded six orders of the Russian Empire (1916, 1917, «Croix de Guerre» of France (1917 and six Soviet orders (three orders of Lenin, two orders of the Red Banner of Labour and the order of the Red Star. The authors briefly describe the major milestones of his biography and measures to perpetuate his memory.

  20. Investigation of the relationship between convenient visits and doctors' fatigue using burnout and work engagement scales.

    Science.gov (United States)

    Matsumoto, Yuuki; Hoshiko, Michiko; Morimatsu, Yoshitaka; Mori, Mihoko; Kushino, Nanae; Ishitake, Tatsuya

    2015-01-01

    Fatigue caused by high workload is often responsible for the high attrition among doctors, and has contributed to a disruption in community medicine. In order to address this problem, institutional mechanisms at the hospital level are required. Previous studies have shown that systemic measures at the hospital level and a change in the mindset of patients can help manage the problem. "Convenient visits" refer to emergency visits for non-emergency problems. It is an avoidable cause of high workload on doctors. Convenient visits also refer to emergency consultation for non-emergency symptoms. As this is a new phenomenon, its relationship with doctors' fatigue needs further research. We investigated the relationship between convenient visits and doctors' fatigue using burnout and work engagement scales. We selected 44 hospitals, with >200 beds each, in provincial cities of prefectures with a doctor-population ratio lower than the national average. These cities were considered likely to manifest the phenomenon of 24-hour society and include overworked doctors. Ordinance-designated cities were excluded from this study owing to wide population variability. Three doctors from each hospital were randomly selected from among physicians, surgeons, and pediatricians. We distributed questionnaires (a questionnaire concerning convenient visits, Maslach Burnout Inventory-Human Services Survey, and Utrecht Work Engagement Scale) to 132 doctors. Forty-two doctors responded to the survey. The median proportion of convenient visits among emergency visits was 50%. Sixty percent of the doctors surveyed were annoyed by convenient visits. Other doctors indicated good collaboration between the hospitals and communities or that they were not currently annoyed by convenient visits, although they had been annoyed previously. The emotional exhaustion in doctors, who worked in hospitals that did not restrict convenient visits, was significantly higher than in those who worked in hospitals

  1. Doctors with dyslexia: strategies and support.

    Science.gov (United States)

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

    2017-10-01

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

  2. Epilepsy - what to ask your doctor - adult

    Science.gov (United States)

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

  3. Open notes: doctors and patients signing on.

    Science.gov (United States)

    Delbanco, Tom; Walker, Jan; Darer, Jonathan D; Elmore, Joann G; Feldman, Henry J; Leveille, Suzanne G; Ralston, James D; Ross, Stephen E; Vodicka, Elisabeth; Weber, Valerie D

    2010-07-20

    Few patients read their doctors' notes, despite having the legal right to do so. As information technology makes medical records more accessible and society calls for greater transparency, patients' interest in reading their doctors' notes may increase. Inviting patients to review these notes could improve understanding of their health, foster productive communication, stimulate shared decision making, and ultimately lead to better outcomes. Yet, easy access to doctors' notes could have negative consequences, such as confusing or worrying patients and complicating rather than improving patient-doctor communication. To gain evidence about the feasibility, benefits, and harms of providing patients ready access to electronic doctors' notes, a team of physicians and nurses have embarked on a demonstration and evaluation of a project called OpenNotes. The authors describe the intervention and share what they learned from conversations with doctors and patients during the planning stages. The team anticipates that "open notes" will spread and suggests that over time, if drafted collaboratively and signed by both doctors and patients, they might evolve to become contracts for care.

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

    Science.gov (United States)

    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.

  5. Effective doctor-patient communication: an updated examination.

    Science.gov (United States)

    Matusitz, Jonathan; Spear, Jennifer

    2014-01-01

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

  6. A new frontier of Okinawa's agriculture: An economic evaluation of the melon fly eradication project

    International Nuclear Information System (INIS)

    Kakazu, H.

    2006-01-01

    During the post-reversion period (1972-2002), Okinawa's GDP has grown on average by 6.40% annually. In the growth process, agricultural activities have been rapidly replaced by construction and services activities such as public works and tourism. Okinawa's agriculture has been diversifying from traditional sugarcane and pineapple cultivation to flowers, tropical fruits and various healthy foods such as bitter melon or ''goya'' and turmeric. This paper attempts to post-evaluate the area-wide melon fly eradication project in Okinawa which was successfully completed in 1993. The melon flies affected more than 40 important vegetables and fruits in Okinawa. The sterile insect technique (SIT), an environmentally friendly method, was adopted to eradicate the flies. Based on conventional cost-benefit analysis, the project produced net accumulated benefits after 6 years of the eradication. The study shows that the project is viable even on commercial basis

  7. Properties of Fly Ash Blocks Made from Adobe Mould

    Science.gov (United States)

    Chokhani, Alankrit; Divakar, B. S.; Jawalgi, Archana S.; Renukadevi, M. V.; Jagadish, K. S.

    2018-06-01

    Fly ash being one of the industrial waste products poses a serious disposal problem. This paper presents an experimental study of utilization of fly ash to produce blocks with varying proportions and mix combinations. Composition of fly ash blocks mainly consist of fly ash and sand, with cementitious product as either cement, lime or both, such as fly ash-sand-cement, fly ash-sand-lime and fly ash-sand-cement-lime are used. Four different proportions for each of the mix combinations are experimented. Compressive strength, water absorption, Initial rate of absorption, and dry density of fly ash blocks are studied. The influence of partial and complete replacement of cement by lime is examined.

  8. Properties of Fly Ash Blocks Made from Adobe Mould

    Science.gov (United States)

    Chokhani, Alankrit; Divakar, B. S.; Jawalgi, Archana S.; Renukadevi, M. V.; Jagadish, K. S.

    2018-02-01

    Fly ash being one of the industrial waste products poses a serious disposal problem. This paper presents an experimental study of utilization of fly ash to produce blocks with varying proportions and mix combinations. Composition of fly ash blocks mainly consist of fly ash and sand, with cementitious product as either cement, lime or both, such as fly ash-sand-cement, fly ash-sand-lime and fly ash-sand-cement-lime are used. Four different proportions for each of the mix combinations are experimented. Compressive strength, water absorption, Initial rate of absorption, and dry density of fly ash blocks are studied. The influence of partial and complete replacement of cement by lime is examined.

  9. Direct-to-consumer advertising: physicians' views of its effects on quality of care and the doctor-patient relationship.

    Science.gov (United States)

    Murray, Elizabeth; Lo, Bernard; Pollack, Lance; Donelan, Karen; Lee, Ken

    2003-01-01

    The objective of the study was to determine physicians' views of the effects of Direct-to-Consumer Advertising (DTCA) on health service utilization, quality of care, and the doctor-patient relationship. Cross-sectional survey of a nationally representative sample of US physicians to determine their perceptions of the effects of patients discussing information from DTCA on time efficiency; requests for specific interventions; health outcomes; and the doctor-patient relationship. Physicians reported that more than half (56%) of patients who discussed information from DTCA in a visit did so because they wanted a specific intervention, such as a test, change in medication, or specialist referral. The physician deemed 49% of these requests clinically inappropriate. Physicians filled 69% of requests they deemed clinically inappropriate; 39% of physicians perceived DTCA as damaging to the time efficiency of the visit, and 13% saw it as helpful. Thirty-three percent of physicians thought discussing DTCA had improved the doctor-patient relationship; 8% felt it had worsened it. The effect on the relationship was strongly associated with doing what the patient wanted. DTCA can have good and bad effects on quality of care, the doctor-patient relationship, and health service utilization. The benefits might be maximized, and the harms minimized, by increasing the accuracy of information in advertisements; enhancing physicians' communication and negotiation skills; and encouraging patients to respect physicians' clinical expertise.

  10. Understanding doctors' ethical challenges as role virtue conflicts.

    Science.gov (United States)

    McDougall, Rosalind

    2013-01-01

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

  11. Privacy, professionalism and Facebook: a dilemma for young doctors.

    Science.gov (United States)

    MacDonald, Joanna; Sohn, Sangsu; Ellis, Pete

    2010-08-01

    This study aimed to examine the nature and extent of use of the social networking service Facebook by young medical graduates, and their utilisation of privacy options. We carried out a cross-sectional survey of the use of Facebook by recent medical graduates, accessing material potentially available to a wider public. Data were then categorised and analysed. Survey subjects were 338 doctors who had graduated from the University of Otago in 2006 and 2007 and were registered with the Medical Council of New Zealand. Main outcome measures were Facebook membership, utilisation of privacy options, and the nature and extent of the material revealed. A total of 220 (65%) graduates had Facebook accounts; 138 (63%) of these had activated their privacy options, restricting their information to 'Friends'. Of the remaining 82 accounts that were more publicly available, 30 (37%) revealed users' sexual orientation, 13 (16%) revealed their religious views, 35 (43%) indicated their relationship status, 38 (46%) showed photographs of the users drinking alcohol, eight (10%) showed images of the users intoxicated and 37 (45%) showed photographs of the users engaged in healthy behaviours. A total of 54 (66%) members had used their accounts within the last week, indicating active use. Young doctors are active members of Facebook. A quarter of the doctors in our survey sample did not use the privacy options, rendering the information they revealed readily available to a wider public. This information, although it included some healthy behaviours, also revealed personal information that might cause distress to patients or alter the professional boundary between patient and practitioner, as well as information that could bring the profession into disrepute (e.g. belonging to groups like 'Perverts united'). Educators and regulators need to consider how best to advise students and doctors on societal changes in the concepts of what is public and what is private.

  12. Assessment of patient's satisfaction with healthcare services ...

    African Journals Online (AJOL)

    Assessment of patient's satisfaction with healthcare services obtained from a ... to identify deficiencies and improve on the quality of health services rendered. ... by the doctor or nurse (r = 0.315, p<0.001) and a significant negative correlation ...

  13. Courteous but not curious: how doctors' politeness masks their existential neglect. A qualitative study of video-recorded patient consultations.

    Science.gov (United States)

    Agledahl, Kari Milch; Gulbrandsen, Pål; Førde, Reidun; Wifstad, Åge

    2011-11-01

    To study how doctors care for their patients, both medically and as fellow humans, through observing their conduct in patient-doctor encounters. Qualitative study in which 101 videotaped consultations were observed and analysed using a Grounded Theory approach, generating explanatory categories through a hermeneutical analysis of the taped consultations. A 500-bed general teaching hospital in Norway. 71 doctors working in clinical non-psychiatric departments and their patients. The doctors were concerned about their patients' health and how their medical knowledge could be of service. This medical focus often over-rode other important aspects of the consultations, especially existential elements. The doctors actively directed the focus away from their patients' existential concerns onto medical facts and rarely addressed the personal aspects of a patient's condition, treating them in a biomechanical manner. At the same time, however, the doctors attended to their patients with courteousness, displaying a polite and friendly attitude and emphasising the relationship between them. The study suggests that the main failing of patient-doctor encounters is not a lack of courteous manners, but the moral offence patients experience when existential concerns are ignored. Improving doctors' social and communication skills cannot resolve this moral problem, which appears to be intrinsically bound to modern medical practice. Acknowledging this moral offence would, however, be the first step towards minimising the effects thereof.

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

    OpenAIRE

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

    2014-01-01

    Background Social networking sites such as Facebook have become immensely popular in recent years and present a unique opportunity for researchers to eavesdrop on the collective conversation of current societal issues. Objective We sought to explore doctor-related humor by examining doctor jokes posted on Facebook. Methods We performed a cross-sectional study of 33,326 monitored Facebook users, 263 (0.79%) of whom posted a joke that referenced doctors on their Facebook wall during a 6-month o...

  15. 42 CFR 418.202 - Covered services.

    Science.gov (United States)

    2010-10-01

    ... the services of the hospice medical director or the physician member of the interdisciplinary group must be performed by a doctor of medicine or osteopathy. (d) Counseling services provided to the.... Counseling, including dietary counseling, may be provided both for the purpose of training the individual's...

  16. Proceedings of Arcom Doctoral Workshop Research Methodology

    OpenAIRE

    Scott, Lloyd

    2018-01-01

    Editorial Editorial Welcome to this special doctoral workshop on Research Methodology which forms part of what is now a well-established support mechanism for researchers in the discipline of the Built Environment and more particularly construction management. The ARCOM doctoral series, around now for some seventeen years, has addressed many of the diverse research areas that PhD researchers in the discipline have chosen to focus on in their doctoral journey. This doctoral workshop has as ...

  17. Plant growth on 'fly ash'

    Energy Technology Data Exchange (ETDEWEB)

    Holliday, R; Hodgson, D R; Townsend, W N; Wood, J W

    1958-04-12

    Plants were grown in plot and pot experiments to assess the toxicity of the fly ash. It was found that plants grouped into three classes: tolerant, moderately tolerant, and sensitive. Boron was found to be a major compoent of the toxic principle of fly ash.

  18. Radon house doctor

    International Nuclear Information System (INIS)

    Nitschke, I.A.; Brennan, T.; Wadach, J.B.; O'Neil, R.

    1986-01-01

    The term house doctor may be generalized to include persons skilled in the use of instruments and procedures necessary to identify, diagnose, and correct indoor air quality problems as well as energy, infiltration, and structural problems in houses. A radon house doctor would then be a specialist in radon house problems. Valuable experience in the skills necessary to be developed by radon house doctors has recently been gained in an extensive radon monitoring and mitigation program in upstate New York sponsored by Niagara Mohawk Power Corporation and the New York State Energy Research and Development Authority. These skills, to be described in detail in this paper, include: (i) the use of appropriate instruments, (ii) the evaluation of the symptoms of a radon-sick house, (iii) the diagnostic procedures required to characterize radon sources in houses, (iv) the prescription procedures needed to specify treatment of the problem, (v) the supervision of the implementation of the treatment program, (vi) the check-up procedures required to insure the house cured of radon problems. 31 references, 3 tables

  19. Women who doctor shop for prescription drugs.

    Science.gov (United States)

    Worley, Julie; Thomas, Sandra P

    2014-04-01

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

  20. The interpretability of doctor identification badges in UK hospitals: a survey of nurses and patients.

    Science.gov (United States)

    Hickerton, Bethan C; Fitzgerald, Daniel John; Perry, Elizabeth; De Bolla, Alan R

    2014-07-01

    Hospital badges have multiple important purposes, but their essential role remains the clear identification of the bearer, including their professional status. The modernisation of medical careers in the National Health Service has changed terminology dramatically, resulting in a plethora of new job titles emerging among both doctors and nurses. To determine whether the new or old terminology allowed clearer identification of medical doctors by patients and nurses. We replicated 11 identification badges used in the Royal Cornwall Hospital and Wrexham Maelor Hospital, both current and before the introduction of new medical training terminology. Data were collected from 114 patients and 67 nurses, by asking them to (1) identify which name badges represented doctors and (2) rank them in order of seniority. Only 11% of patients and 60% of nurses identified a 'Foundation Year 1 Trainee' as a qualified medical doctor. Indeed, only 'General Practice Vocational Trainee' and 'Consultant' were both readily identifiable as qualified doctors to both patients and nurses. Ranking was also a problem, with only 19% of patients and 45% of nurses able to correctly grade medical doctors using the current terminology. The old terminology allowed more accurate identification by nurses, with over 80% successfully ranking and marking the title appropriately. Current terminology is a source of confusion to both patients and members of the immediate medical care team, with nurses unable to correctly identify medical doctors. Our study indicates that a review of terminology is necessary to ensure patients, and staff, are able to communicate effectively. 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.

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

    Science.gov (United States)

    Gopaul, Bryan

    2011-01-01

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

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

    Science.gov (United States)

    Karnow, Gerald F.

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

  3. The Cape doctor 1807-1910: perspectives.

    Science.gov (United States)

    Phillips, Howard

    2004-01-01

    This chapter contrasts the Cape doctor in 1807 and in 1910, and finds that, in a whole variety of ways, the differences between the two were not of degree but of kind. Underlying this sea-change was the germ revolution of the late Victorian era, which transformed the Cape doctor out of all recognition, thereby laying important foundations for the development of the twentieth-century South African doctor.

  4. Future fly ash marketing; Flugaschevermarktung in der Zukunft

    Energy Technology Data Exchange (ETDEWEB)

    Mauder, R.; Hugot, A. [Evonik Power Minerals GmbH, Dinslaken (Germany)

    2008-07-01

    It can be assumed that the fly ash production volumes will undergo a marked increase over the next few years. The conditions of fly ash production will improve as a result of modern and refurbished power plants, yielding a positive effect on the quality of fly ashes. Other vital parameters of future fly ash marketing are fly ash logistics and the infrastructure of power plants. Basically, economic utilisation of the increased production volumes is possible; however, new and long-term strategies are necessary. (orig.)

  5. Characteristics of hot spots of melon fly, Bactrocera (Dacus) cucurbitae Coquillett (Diptera: Tephritidae) in sterile fly release areas on Okinawa island [Japan

    International Nuclear Information System (INIS)

    Nakamori, H.; Shiga, M.; Kinjo, K.

    1993-01-01

    The spatio-temporal dynamics of populations of the melon fly, Bactrocera (Dacus) cucurbitae COQUILLETT, in the southern part of Okinawa Island where an eradication program using sterile flies has been conducted, were analyzed in relation to the seasonal succession and abundance of wild and cultivated host fruits. The study areas were classified into four major zones according to the seasonal abundance of flies caught by cue-lure traps and the availability of host fruits including Diplocyclos palmatus, Melothria liukiuensis and Momordica charantia var. pevel. Zone-I is characterized by the continuous presence of host fruits and a relatively-high population density of the melon fly indicated by the cue-lure trap catch of more than 1, 000 flies per 1, 000 traps per day throughout the year. Zone-II has a characteristic decline in both number of host fruits and fly density during the fall-winter period with an annual average of less than 1, 000 flies per 1, 000 traps per day. Zone-III includes areas where host fruits and flies (about 1 fly/trap/day) were relatively abundant only during the winter-spring period. Zone-IV is characterized by constantly low availability of host fruits and low fly density throughout the year. Hot spots, which are defined as areas where the ratio of sterile to wild flies hardly increases despite frequent and intensive release of sterile flies, were found in the Zone-I areas. Therefore, the continuous presence and abundance of host fruits appears to hot spots. For effective control of this species, it is essential to locate such areas and release sterile flies

  6. [French doctors working in Great Britain: a study of their characteristics and motivations for migration].

    Science.gov (United States)

    Duverne, A; Carnet, D; d'Athis, P; Quantin, C

    2008-10-01

    As member states in the European Union now recognize the national qualifications of other member states, doctors will be able to move more freely within Europe according to the opportunities on offer and the constraints imposed by the different health-care systems. The aim of this study is to understand the reasons why French doctors choose to work in Great Britain. A self-completed questionnaire was used to conduct a survey among French doctors registered with the British Medical Council in 2005 who had done their studies in France and for whom the address was correct. The response rate, which was difficult to assess (impossible to distinguish between incorrect addresses and absence of response), was about 37%. The results show that doctors move to Britain for various reasons. In most cases (59%), the decision to emigrate is made for both professional and personal reasons. The second most common profile (29%), including essentially women, comprises those who emigrate to join a spouse. The third profile (12%) concerns those who emigrate for purely professional reasons: this group is made up of men who, for the most part, are disappointed with conditions in the French-hospital system: lack of recognition, poor pay and limited career prospects. Doctors who are dissatisfied with working conditions and low revenues in France seem to find that the National Health Service provides a better environment. Whatever the original reasons for expatriation, doctors particularly appreciate the salaried status, organization of working hours and teamwork, as well as more recognition of the work done. Because of uncertainties in the representativity of the returned questionnaires, the results of our study cannot be generalized to the whole population of French doctors currently working in Britain, but it does bring to light the principal reasons for their move to Britain. Though few doctors emigrate, the trend testifies to the dissatisfaction felt by certain doctors in the French

  7. Quality characteristics of Greek fly ashes and potential uses

    Energy Technology Data Exchange (ETDEWEB)

    Skodras, G.; Grammelis, P.; Kakaras, E. [Institute for Solid Fuels Technology and Applications, Ptolemais (Greece); Karangelos, D.; Anagnostakis, M.; Hinis, E. [Nuclear Engineering Section, Mechanical Engineering Department, National Technical University of Athens, Athens (Greece)

    2007-01-15

    The main characteristics of fly ash from Greek coal-fired boilers are presented in this paper in relation to its exploitation potential. Both fuel and fly ash samples were collected and analyzed according to the ASTM Standards. Apart from the typical analyses (proximate, ultimate, ash analysis and calorific value), an ICP-AES spectrometer was used for the analysis of heavy metals in the ash. Experimental measurements in order to determine the radioactivity content of raw fuel and the fly ash were carried out as well. A representative fly ash sample from Ptolemais power plant was evaluated and tested as filler in Self-Compacting Concrete (SCC). Ashes from the Greek brown coal are classified in type C, most of the fly ash being produced in Ptolemais of Northern Greece, while the rest in Megalopolis. Ptolemais fly ash is rich in calcium compounds, while Megalopolis fly ash contains more pyrite. Increased heavy metal concentrations are observed in the fly ash samples of Greek coal. Greek fly ash appears to have not only pozzolanic but also hydraulic behaviour. Furthermore, Greek fly ash, depending on its origin, may have relatively high natural radioactivity content, reaching in the case of Megalopolis fly ash 1 kBq kg{sup -1} of {sup 226}Ra. The laboratory results showed that fly ashes can be a competitive substitute to conventional limestone filler material in SCC. Fly ash is mostly used in Greece in cement industry replacing cement clinker and aiming to the production of special types of Portland cements. However, a more aggressive utilisation strategy should be developed, since low quantities of the total produced fly ash are currently further utilised. (author)

  8. Are 'Village Doctors' in Bangladesh a curse or a blessing?

    Directory of Open Access Journals (Sweden)

    Wahed Tania

    2010-07-01

    Full Text Available Abstract Background Bangladesh is one of the health workforce crisis countries in the world. In the face of an acute shortage of trained professionals, ensuring healthcare for a population of 150 million remains a major challenge for the nation. To understand the issues related to shortage of health workforce and healthcare provision, this paper investigates the role of various healthcare providers in provision of health services in Chakaria, a remote rural area in Bangladesh. Methods Data were collected through a survey carried out during February 2007 among 1,000 randomly selected households from 8 unions of Chakaria Upazila. Information on health-seeking behaviour was collected from 1 randomly chosen member of a household from those who fell sick during 14 days preceding the survey. Results Around 44% of the villagers suffered from an illness during 14 days preceding the survey and of them 47% sought treatment for their ailment. 65% patients consulted Village Doctors and for 67% patients Village Doctors were the first line of care. Consultation with MBBS doctors was low at 14%. Given the morbidity level observed during the survey it was calculated that 250 physicians would be needed in Chakaria if the patients were to be attended by a qualified physician. Conclusions With the current shortage of physicians and level of production in the country it was asserted that it is very unlikely for Bangladesh to have adequate number of physicians in the near future. Thus, making use of existing healthcare providers, such as Village Doctors, could be considered a realistic option in dealing with the prevailing crisis.

  9. The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China.

    Science.gov (United States)

    Tang, Liyang

    2012-09-14

    Patient's satisfaction with medical service delivery/assessment of medical service/trust in health delivery system may have significant influence on patient's life satisfaction in China's health delivery system/in various kinds of hospitals.The aim of this study was to test whether and to what extent patient's satisfaction with medical service delivery/patient's assessments of various major aspects of medical service/various major aspects of patient's trust in health delivery system influenced patient's life satisfaction in China's health delivery system/in various kinds of hospitals. This study collaborated with National Bureau of Statistics of China to carry out a 2008 national urban resident household survey in 17 provinces, autonomous regions, and municipalities directly under the central government (N = 3,386), and specified ordered probit models were established to analyze dataset from this household survey. The key considerations in generating patient's life satisfaction involved patient's overall satisfaction with medical service delivery, assessment of doctor-patient communication, assessment of medical cost, assessment of medical treatment process, assessment of medical facility and hospital environment, assessment of waiting time for medical service, trust in prescription, trust in doctor, and trust in recommended medical examination. But the major considerations in generating patient's life satisfaction were different among low level public hospital, high level public hospital, and private hospital. The promotion of patient's overall satisfaction with medical service delivery, the improvement of doctor-patient communication, the reduction of medical cost, the improvement of medical treatment process, the promotion of medical facility and hospital environment, the reduction of waiting time for medical service, the promotion of patient's trust in prescription, the promotion of patient's trust in doctor, and the promotion of patient's trust in

  10. Doctoral Students’ Experiences of Feeling (or not Like an Academic

    Directory of Open Access Journals (Sweden)

    Esma Emmioglu Sarikaya

    2017-04-01

    Full Text Available Aim/Purpose: This paper examined the balance and meaning of two types of experiences in the day-to-day activity of doctoral students that draw them into academia and that move them away from academia: ‘feeling like an academic and belonging to an academic community;’ and ‘not feeling like an academic and feeling excluded from an academic community.’ Background: As students navigate doctoral work, they are learning what is entailed in being an academic by engaging with their peers and more experienced academics within their community. They are also personally and directly experiencing the rewards as well as the challenges related to doing academic work. Methodology\t: This study used a qualitative methodology; and daily activity logs as a data collection method. The data was collected from 57 PhD students in the social sciences and STEM (Science, Technology, Engineering, and Mathematics fields at two universities in the UK and two in Canada. Contribution: The current study moves beyond the earlier studies by elaborating on how academic activities contribute/hinder doctoral students’ sense of being an academic. Findings: The participants of the study generally focused on disciplinary/scholarly rather than institutional/service aspects of academic work, aside from teaching, and regarded a wide range of activities as having more positive than negative meanings. The findings related to both extrinsic and intrinsic factors that play important roles in students’ experiences of feeling (or not like academics are elaborated in the study. Recommendations for Practitioners: Supervisors should encourage their students to develop their own support networks and to participate in a wide range of academic activities as much as possible. Supervisors should encourage students to self-assess and to state the activities they feel they need to develop proficiency in. Future Research: More research is needed to examine the role of teaching in doctoral

  11. Can Escherichia coli fly? The role of flies as transmitters of E. coli to food in an urban slum in Bangladesh.

    Science.gov (United States)

    Lindeberg, Yrja Lisa; Egedal, Karen; Hossain, Zenat Zebin; Phelps, Matthew; Tulsiani, Suhella; Farhana, Israt; Begum, Anowara; Jensen, Peter Kjaer Mackie

    2018-01-01

    To investigate the transmission of faecal bacteria by flies to food under natural settings. Over a period of 2 months, paired (exposed and non-exposed) containers with cooked rice were placed on the ground in kitchen areas in an urban slum area in Dhaka, Bangladesh, and the numbers of flies landing on the exposed rice were counted. Following exposure, the surface of the rice was microbiologically and molecularly analysed for the presence of Escherichia coli and genes of diarrhoeagenic E. coli and Shigella strains. Rice was at greater risk (P E. coli if flies landed on the rice than if no flies landed on the rice (odds ratio 5·4 (P 0·6 × 103 CFU. Genes of diarrhoeagenic E. coli and Shigella species were detected in 39 of 60 (65%) of exposed rice samples. Two fly species were identified: the common housefly (Musca domestica) and the oriental latrine fly (Chrysomya megacephala). Flies may transmit large quantities of E. coli to food under field settings. The findings highlight the importance of implementing control measures to minimise exposure of food to flies to ensure food safety. Fly control measures should be considered for the prevention of diarrhoeal diseases caused by E. coli. © 2017 John Wiley & Sons Ltd.

  12. Effect of using FLiBe and FLiNaBe molten salts bearing plutonium fluorides on the neutronic performance of PACER

    International Nuclear Information System (INIS)

    Acir, Adem

    2012-01-01

    In this paper, the effects of using FLiBe and FLiNaBe Molten Salts Bearing Plutonium Fluorides on the neutronic performance of the PACER are investigated. The optimum radial thickness for tritium self-sufficiency of the blankets addition of plutonium fluorides to FLiNaBe (LiF-/NaF BeF 2 ) and FLiBe (LiF-/BeF 2 ) of a dual purpose modified PACER concept are determined. The calculations are carried out with the one dimensional transport code XSDRNPM/SCALE5. The tritium breeding capacities of FLiNaBe and FLiBe with addition of plutonium fluorides in molten salt zone are investigated and compared. The optimum molten salt zone thickness is computed as 155 cm for tritium self-sufficiency of the blankets using FLiBe +1% PuF 4 whereas, the optimum thickness with FLiNaBe +1% PuF 4 is calculated as 170 cm. In addition, neutron transport calculations have been performed to evaluate the energy multiplication factor, total fission rate, displacement per atom and helium gas generation for optimal radial thickness in the blanket. Also, the tritium production and the radiation damage limits should be evaluated together in a fusion blanket for determining the optimum thickness of molten salt layer. (orig.)

  13. What influences the job satisfaction of staff and associate specialist hospital doctors?

    Science.gov (United States)

    French, Fiona; Ikenwilo, Divine; Scott, Anthony

    2007-08-01

    Despite their rising numbers in the National Health Service (NHS), the recruitment, retention, morale and educational needs of staff and associate specialist hospital doctors have traditionally not been the focus of attention. A postal survey of all staff grades and associate specialists in NHS Scotland was conducted to investigate the determinants of their job satisfaction. Doctors in both grades were least satisfied with their pay. They were more satisfied if they were treated as equal members of the clinical team, but less satisfied if their workload adversely affected the quality of patient care. With the exception of female associate specialists, respondents who wished to become a consultant were less satisfied with all aspects of their jobs. Associate specialists who worked more sessions also had lower job satisfaction. Non-white staff grades were less satisfied with their job compared with their white counterparts. It is important that associate specialists and staff grades are promoted to consultant posts, where this is desired. It is also important that job satisfaction is enhanced for doctors who do not desire promotion, thereby improving retention. This could be achieved through improved pay, additional clinical training, more flexible working hours and improved status.

  14. Medical Service: 40 years of outpatient care

    CERN Multimedia

    2005-01-01

    On 1st June 2005 the Medical Service will be celebrating its fortieth birthday. This will mark forty years of service to the health of CERN's personnel by the Medical Service's small team of doctors, nurses, laboratory assistants and secretaries. Since 1965, 27 280 medical files have been archived and computerised. The Medical Service. From left to right, front row : Mireille Vosdey, Marloeke Bol and Nicole De Matos. From left to right, back row : Katie Warrilow-Thomson, Dr Eric Reymond, Dr Véronique Fassnacht, Isabelle Auvigne and Françoise Lebrun-Klauser. The Medical Service was founded on 1st June 1965, with a staff of four: the doctor, Jean-Paul Diss, a nurse, a laboratory assistant and a secretary. Previously, a private medical practitioner had come to CERN to perform the medical check-ups on the personnel and the Fire Brigade was responsible for first aid. However, in view of increasing staff numbers and the specific needs of a Laboratory like CERN, an on-site Medical Service had become ess...

  15. Surface treated fly ash filled modified epoxy composites

    Directory of Open Access Journals (Sweden)

    Uma Dharmalingam

    2015-01-01

    Full Text Available Abstract Fly ash, an inorganic alumino silicate has been used as filler in epoxy matrix, but it reduces the mechanical properties due to its poor dispersion and interfacial bonding with the epoxy matrix. To improve its interfacial bonding with epoxy matrix, surface treatment of fly ash was done using surfactant sodium lauryl sulfate and silane coupling agent glycidoxy propyl trimethoxy silane. An attempt is also made to reduce the particle size of fly ash using high pressure pulverizer. To improve fly ash dispersion in epoxy matrix, the epoxy was modified by mixing with amine containing liquid silicone rubber (ACS. The effect of surface treated fly ash with varying filler loadings from 10 to 40% weight on the mechanical, morphological and thermal properties of modified epoxy composites was investigated. The surface treated fly ash was characterized by particle size analyzer and FTIR spectra. Morphological studies of surface treated fly ash filled modified epoxy composites indicate good dispersion of fillers in the modified epoxy matrix and improves its mechanical properties. Impact strength of the surface treated fly ash filled modified epoxy composites show more improvement than unmodified composites.

  16. Time to Revisit Recommendations on Doctor to Population Ratio in India.

    Science.gov (United States)

    Deo, Madhav G

    2017-10-01

    A buzzword in Indian press and amongst the policy makers is that India is short of the WHO recommended doctor to population ratio of 1:1000. The recommendations were formulated to facilitate programs to achieve some of the health related UN-Millennium Development Goals (MDGs). Infections and malnutrition, which can be comfortably handled by a basic MBBS doctor, were the dominant health issues at the time of the formulation of the MDGs. However, all countries worldwide are going through health epidemiological transition and health impact of the non-communicable disorders (NCDs) can be no more ignored even by the low income nations. Very soon India will need large number of specialists and super-specialists to meet the challenge posed by the avalanche of NCDs, as an ordinary MBBS is not trained to handle the NCDs. One of the major flaws in the recommendations is that for the purposes of computation of the ratio, doctors of all hue, basic doctors, specialists and super-specialists are lumped together. It is time to define the requirements discipline wise and tailor medical education to produce specialists and super-specialists on a fast track. Expansion of specialization in medicine should be associated with simultaneous strengthening of primary health care, a challenged faced even by the most developed nations. To provide health services for routine minor health problems a cadre of Nurse Practitioners (NPs), a concept developed 50 years ago in the USA and now endorsed by many nations, could be adopted. © Journal of the Association of Physicians of India 2011.

  17. Female physicist doctoral experiences

    OpenAIRE

    Katherine P. Dabney; Robert H. Tai

    2013-01-01

    The underrepresentation of women in physics doctorate programs and in tenured academic positions indicates a need to evaluate what may influence their career choice and persistence. This qualitative paper examines eleven females in physics doctoral programs and professional science positions in order to provide a more thorough understanding of why and how women make career choices based on aspects both inside and outside of school and their subsequent interaction. Results indicate that female...

  18. Flying the Needles: Flight Deck Automation Erodes Fine-Motor Flying Skills Among Airline Pilots.

    Science.gov (United States)

    Haslbeck, Andreas; Hoermann, Hans-Juergen

    2016-06-01

    The aim of this study was to evaluate the influence of practice and training on fine-motor flying skills during a manual instrument landing system (ILS) approach. There is an ongoing debate that manual flying skills of long-haul crews suffer from a lack of flight practice due to conducting only a few flights per month and the intensive use of automation. However, objective evidence is rare. One hundred twenty-six randomly selected airline pilots had to perform a manual flight scenario with a raw data precision approach. Pilots were assigned to four equal groups according to their level of practice and training by fleet (short-haul, long-haul) and rank (first officer, captain). Average ILS deviation scores differed significantly in relation to the group assignments. The strongest predictor variable was fleet, indicating degraded performance among long-haul pilots. Manual flying skills are subject to erosion due to a lack of practice on long-haul fleets: All results support the conclusion that recent flight practice is a significantly stronger predictor for fine-motor flying performance than the time period since flight school or even the total or type-specific flight experience. Long-haul crews have to be supported in a timely manner by adequate training tailored to address manual skills or by operational provisions like mixed-fleet flying or more frequent transitions between short-haul and long-haul operation. © 2016, Human Factors and Ergonomics Society.

  19. Hybrid Doctoral Program: Innovative Practices and Partnerships

    Science.gov (United States)

    Alvich, Dori; Manning, JoAnn; McCormick, Kathy; Campbell, Robert

    2012-01-01

    This paper reflects on how one mid-Atlantic University innovatively incorporated technology into the development of a hybrid doctoral program in educational leadership. The paper describes a hybrid doctoral degree program using a rigorous design; challenges of reworking a traditional syllabus of record to a hybrid doctoral program; the perceptions…

  20. Cultural and musical activity among Norwegian doctors.

    Science.gov (United States)

    Nylenna, Magne; Aasland, Olaf Gjerløw

    2013-06-25

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

  1. Will Medical Technology Deskill Doctors?

    Science.gov (United States)

    Lu, Jingyan

    2016-01-01

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

  2. Doctorate Program Trains Industrial Chemists.

    Science.gov (United States)

    Chemical and Engineering News, 1982

    1982-01-01

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

  3. Flying Training Capacity Model: Initial Results

    National Research Council Canada - National Science Library

    Lynch, Susan

    2005-01-01

    OBJECTIVE: (1) Determine the flying training capacity for 6 bases: * Sheppard AFB * Randolph AFB * Moody AFB * Columbus AFB * Laughlin AFB * Vance AFB * (2) Develop versatile flying training capacity simulation model for AETC...

  4. Louse flies on birds of Baja California

    OpenAIRE

    Tella, José Luis; Rodríguez-Estrella, Ricardo; Blanco, Guillermo

    2000-01-01

    Louse flies were collected from 401 birds of 32 species captured in autumn of 1996 in Baja California Sur (México). Only one louse fly species (Microlynchia pusilla) was found. It occurred in four of the 164 common ground doves (Columbina passerina) collected. This is a new a host species for this louse fly.

  5. Eradicating tsetse flies: Senegal nears first victory

    International Nuclear Information System (INIS)

    Dixit, Aabha

    2015-01-01

    After a four-year eradication programme including nuclear techniques, the Niayes region of Senegal is now almost free of the tsetse fly, which used to decimate livestock. “I have not seen a single tsetse fly for a year now,” said cattle farmer Oumar Sow. “This is in contrast to earlier, when they increased in numbers, especially during the cold season. The flies were really a nuisance to our animals and we had to carefully select the time for milking. Now, there is no problem with that.” The tsetse fly is a bloodsucking insect that kills more than three million livestock in sub-Saharan Africa every year, costing the agriculture industry more than US $4 billion annually. The tsetse fly transmits parasites that cause a wasting disease called nagana in cattle. In some parts of Africa the fly also causes over 75 000 cases of human ‘sleeping sickness’, which affects the central nervous system, and causes disorientation, personality changes, slurred speech, seizures, difficulty walking and talking, and ultimately death.

  6. The association between number of doctors per bed and readmission of elderly patients with pneumonia in South Korea.

    Science.gov (United States)

    Lee, Joo Eun; Kim, Tae Hyun; Cho, Kyoung Hee; Han, Kyu-Tae; Park, Eun-Cheol

    2017-06-08

    There is an urgent need to reduce readmission of patients with pneumonia and improve quality of care. To assess the association between hospital resources and quality of care, we examined the effect of number of doctors per bed on 30-day readmission and investigated the combined effect of number of doctors per bed and number of beds. We used nationwide cohort sample data of health insurance claims by the National Health Insurance Service (NHIS) from 2002 to 2013. Pneumonia admissions to acute care hospitals among 7446 inpatients older than 65 were examined. We conducted a multivariate Cox proportional hazard model to analyze the association between the number of doctors per bed and 30-day readmission, as well as that of pneumonia-specific 30-day readmission with the combined effects of number of doctors per bed and number of beds. Overall, 1421 (19.1%) patients were readmitted within 30 days and 756 (11.2%) patients were readmitted for pneumonia within 30 days. Patients with pneumonia treated by very low or low number of doctors per bed showed higher readmission (pneumonia-specific readmission: hazard ratio [HR] = 1. 406, 95% confidence interval [CI] = 1.072-1.843 for low number of doctors per bed; all-cause readmissions: HR = 1.276, 95% CI = 1.026-1.587 for very low number of doctors per bed, and HR = 1.280, 95% CI = 1.064-1.540 for low number of doctors per bed). This empirical study showed that patients with pneumonia cared for in hospitals with more doctors were less likely to be readmitted. Pneumonia-specific 30-day readmission was also significantly associated with the combined effect of the number of doctors and the number of hospital beds.

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

    Science.gov (United States)

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

    2014-02-13

    Social networking sites such as Facebook have become immensely popular in recent years and present a unique opportunity for researchers to eavesdrop on the collective conversation of current societal issues. We sought to explore doctor-related humor by examining doctor jokes posted on Facebook. We performed a cross-sectional study of 33,326 monitored Facebook users, 263 (0.79%) of whom posted a joke that referenced doctors on their Facebook wall during a 6-month observation period (December 15, 2010 to June 16, 2011). We compared characteristics of so-called jokers to nonjokers and identified the characteristics of jokes that predicted joke success measured by having elicited at least one electronic laugh (eg, an LOL or "laughing out loud") as well as the total number of Facebook "likes" the joke received. Jokers told 156 unique doctor jokes and were the same age as nonjokers but had larger social networks (median Facebook friends 227 vs 132, PFacebook likes (rate ratio [RR] 2.36, 95% CI 0.97-5.74). This study provides insight into the use of social networking sites for research pertaining to health and medicine, including the world of doctor-related humor.

  8. The Mexican Fruit Fly Eradication Programme

    Energy Technology Data Exchange (ETDEWEB)

    Reyes F, Jesus; Santiago M, Guillermo; Hernandez M, Porfirio [Comision Nacional de Sanidad Agropecuaria (Mexico)

    2000-07-01

    The goal of the Mexican Fruit Fly Eradication Programme is to control, suppress or eradicate from Mexico four species of fruit flies of economic and quarantine importance (Anastrepha ludens Loew, A. obliqua Macquart, A. serpentina Wied. and A. striata Schiner). These pests cause damage amounting to US$710 million per year. In addition to this cost, there are other expenses from pest control actions and the loss of international markets, because fruit importing countries have established stringent quarantine measures to restrict the entry of these pests. For purposes of the programme's implementation, Mexico was divided into three working zones, defined by agro-ecological characteristics, the number of fruit fly species present and the size of fruit growing regions. In addition, a cost:benefit analysis was carried out which indicated that the rate of return, in a 12-year time frame, might be as much as 33:1 in Northern Mexico, and 17:1 in the rest of the country, for an area over 100,000 hectares. Eradication technology involves: 1) surveys of pest populations by trapping and host fruit harvesting to monitor the presence and density of fruit flies, 2) reduction of pest populations applying cultural practices and using selective bait sprays, 3) mass release of sterile flies and augmentative release of parasitoids to eliminate populations and, 4) enforcement of quarantine measures to protect fruit fly free areas.

  9. The Mexican Fruit Fly Eradication Programme

    International Nuclear Information System (INIS)

    Reyes F, Jesus; Santiago M, Guillermo; Hernandez M, Porfirio

    2000-01-01

    The goal of the Mexican Fruit Fly Eradication Programme is to control, suppress or eradicate from Mexico four species of fruit flies of economic and quarantine importance (Anastrepha ludens Loew, A. obliqua Macquart, A. serpentina Wied. and A. striata Schiner). These pests cause damage amounting to US$710 million per year. In addition to this cost, there are other expenses from pest control actions and the loss of international markets, because fruit importing countries have established stringent quarantine measures to restrict the entry of these pests. For purposes of the programme's implementation, Mexico was divided into three working zones, defined by agro-ecological characteristics, the number of fruit fly species present and the size of fruit growing regions. In addition, a cost:benefit analysis was carried out which indicated that the rate of return, in a 12-year time frame, might be as much as 33:1 in Northern Mexico, and 17:1 in the rest of the country, for an area over 100,000 hectares. Eradication technology involves: 1) surveys of pest populations by trapping and host fruit harvesting to monitor the presence and density of fruit flies, 2) reduction of pest populations applying cultural practices and using selective bait sprays, 3) mass release of sterile flies and augmentative release of parasitoids to eliminate populations and, 4) enforcement of quarantine measures to protect fruit fly free areas

  10. Aerodynamic characteristics of flying fish in gliding flight.

    Science.gov (United States)

    Park, Hyungmin; Choi, Haecheon

    2010-10-01

    The flying fish (family Exocoetidae) is an exceptional marine flying vertebrate, utilizing the advantages of moving in two different media, i.e. swimming in water and flying in air. Despite some physical limitations by moving in both water and air, the flying fish has evolved to have good aerodynamic designs (such as the hypertrophied fins and cylindrical body with a ventrally flattened surface) for proficient gliding flight. Hence, the morphological and behavioral adaptations of flying fish to aerial locomotion have attracted great interest from various fields including biology and aerodynamics. Several aspects of the flight of flying fish have been determined or conjectured from previous field observations and measurements of morphometric parameters. However, the detailed measurement of wing performance associated with its morphometry for identifying the characteristics of flight in flying fish has not been performed yet. Therefore, in the present study, we directly measure the aerodynamic forces and moment on darkedged-wing flying fish (Cypselurus hiraii) models and correlated them with morphological characteristics of wing (fin). The model configurations considered are: (1) both the pectoral and pelvic fins spread out, (2) only the pectoral fins spread with the pelvic fins folded, and (3) both fins folded. The role of the pelvic fins was found to increase the lift force and lift-to-drag ratio, which is confirmed by the jet-like flow structure existing between the pectoral and pelvic fins. With both the pectoral and pelvic fins spread, the longitudinal static stability is also more enhanced than that with the pelvic fins folded. For cases 1 and 2, the lift-to-drag ratio was maximum at attack angles of around 0 deg, where the attack angle is the angle between the longitudinal body axis and the flying direction. The lift coefficient is largest at attack angles around 30∼35 deg, at which the flying fish is observed to emerge from the sea surface. From glide polar

  11. Rosetta performs ESA's closest-ever Earth fly-by

    Science.gov (United States)

    2005-03-01

    Rosetta’s unique instruments, such as its ultraviolet light instrument ALICE, should be able to make critical contributions to the American mission. About Rosetta Rosetta is the first mission designed to both orbit and land on a comet, and consists of an orbiter and a lander. The spacecraft carries 11 scientific experiments and will be the first mission to undertake long-term exploration of a comet at close quarters. After entering orbit around Comet 67P/Churyumov-Gerasimenko in 2014, the spacecraft will release a small lander onto the icy nucleus. Rosetta will orbit the comet for about a year as it heads towards the Sun, remaining in orbit for another half-year past perihelion (closest approach to the Sun). Comets hold essential information about the origin of our Solar System because they are the most primitive objects in the Solar System and their chemical composition has changed little since their formation. By orbiting and landing on Comet 67P/Churyumov-Gerasimenko, Rosetta will help us reconstruct the history of our own neighbourhood in space. Note for broadcasters: The ESA TV Service will transmit a TV exchange with images of the fly-by, together with science results/images from observations as far as available on 11 March. For further details : http://television.esa.int

  12. For People with Osteoporosis: How to Find a Doctor

    Science.gov (United States)

    ... With Osteoporosis: How to Find a Doctor For People With Osteoporosis: How to Find a Doctor Isabel ... a doctor with expertise in osteoporosis. For many people, finding a doctor who is knowledgeable about osteoporosis ...

  13. Effect of four commercial fungal formulations on mortality and sporulation of house flies (Musca domestica) and stable flies (Stomoxys calcitrans)

    Science.gov (United States)

    House flies (Musca domestica L.) and stable flies (Stomoxys calcitrans (L.)) (Diptera: Muscidae) are major pests of livestock. Biological control is an important tool in an integrated control framework. Increased mortality in filth flies has been documented with entomopathogenic fungi, and several s...

  14. Community-Based Research (CBR in the Education Doctorate: Lessons Learned and Promising Practices

    Directory of Open Access Journals (Sweden)

    Laurie Stevahn

    2016-12-01

    Full Text Available Community-based research (CBR is an advanced form of academic service-learning through which university students, faculty, and community organizations collaborate to conduct inquiry projects aimed at producing social change. Despite its potential for advancing learning in graduate studies, little research exists on CBR implementations or outcomes in doctoral programs. This study examined the effectiveness of integrating CBR into an educational leadership doctorate across three consecutive cohorts in which students worked in teams to conduct CBR projects, each in partnership with a community organization pursuing a social justice initiative. A mixed-methods developmental case study design produced quantitative and qualitative data on students’ perceived effectiveness of cooperative/collaborative interaction and team decision making in CBR, experience with and learning from CBR in the education doctorate, and development of CBR competencies. Triangulated results overall revealed students’ (a positive attitudes toward CBR, (b enhanced understanding of and commitment to CBR and how to conduct it, (c expanded understanding and application of technical research skills, (d growth in coopera-tive/collaborative and conflict resolution skills, and (e development of leadership project management skills. These findings may assist faculty in planning innovative, authentic, applied, professional training in the education doctorate capable of advancing students’ graduate inquiry skills while also enhancing competencies for successful leadership in the field.

  15. Cholesterol - what to ask your doctor

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2014-02-06

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

  17. Flies and Campylobacter infection of broiler flocks

    DEFF Research Database (Denmark)

    Hald, Birthe; Skovgård, Henrik; Bang, Dang Duong

    2004-01-01

    A total of 8.2% of flies caught outside a broiler house in Denmark had the potential to transmit Campylobacter jejuni to chickens, and hundreds of flies per day passed through the ventilation system into the broiler house. Our study suggests that flies may be an important source of Campylobacter ...... infection of broiler flocks in summer....

  18. [Physicians' tasks in the Occupational Health Services].

    Science.gov (United States)

    von Bülow, B A

    1995-03-06

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

  19. Women, Men and the Doctorate.

    Science.gov (United States)

    Centra, John A; Kuykendall, Nancy M.

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

  20. The role of the female doctorally prepared nurse in caring for infertile women.

    Science.gov (United States)

    Marshak, L S

    1993-01-01

    Today, in medical and nursing literature, infertility is described as a couple problem, with interventions aimed at treating the couple. While not dismissing the fact that the conception does involve both genders, the reality of infertility treatment is that the woman, not the couple, undergoes the majority of infertility testing and treatment. The numerous physical demands made of women during infertility investigation and therapy are associated with significant emotional and informational needs. As such, all infertility practices should offer supportive counseling to their clients. Incorporation of such services into general infertility treatment will ensure that the greatest number of female infertility clients receive the information and emotional support they need. The health care professional best qualified to provide these services is the female doctorally prepared nurse. By virtue of both her gender and training, she is more likely to be capable of intervening therapeutically, woman to woman, in a sensitive and empathic manner. Furthermore, she can anticipate extending her role to include the following services: (a) provision of basic gynecological care, (b) follow-up of patients on hormone therapy, (c) coordination of patient care, (d) provision of supportive counseling, and (e) participation in research. To secure a position, the female doctorally prepared nurse needs to recognize the importance of promoting herself in the infertility marketplace. Ultimately, both the establishment and survival of her role will depend on her professional uniqueness.

  1. Psychosocial risk factors in medical personnel of a health service in Cartagena de Indias, Colombia

    Directory of Open Access Journals (Sweden)

    Irma Y. Castillo Á

    2011-11-01

    Full Text Available Objective: to determine the variables associated with psychosocial risk factors among the doctors of a stateowned social welfare enterprise providing health services in Cartagena. Methodology: a cross-sectional study on a population of 197 doctors from the enterprise’s outpatient and emergency services. The istas21 questionnaire, a Spanish adaptation of the Copenhagen Psychosocial Questionnaire (copsoq, was used to assess psychosocial factors. Statistical analysis was performed using the program SPSS® version 17, and the non-parametric Mann-Whitney U test was applied to estimate the associations between variables. Results: 170 doctors participated in this study; 88.8% of which had favorable exposure to risk factors in the following dimensions: social support and quality of leadership and Double presence. 69.4% showed adverse exposure in the insecurity dimension. In the dimensions Insecurity and Double Presence, general practitioners were in worse conditions than specialists (Mann-Whitney U Prob<0.05. Additionally, doctors from the outpatient service showed more deterioration in the social support and quality of leadership dimensions than those from the emergency service (Mann-Whitney U Prob<0.05. As for the psychological demands dimension, doctors from higher socioeconomic strata showed higher unfavorable scores than those from lower strata (Mann-Whitney U Prob<0.05.

  2. Doctoral Education

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner

    2015-01-01

    Doctoral education covers the “third cycle” of degrees following the bachelor’s and the master’s degree. The education of researchers is necessary for developing music therapy as a scientific discipline and calls for a certain research culture that not only brings knowledge on research...... with an integration of science and practice. This leads to a description of the principles of problem-based learning as a social constructive approach, problematization, self-directed learning and learning community. The chapter is concluded with an example of a model of doctoral education, the Aalborg model, where...... the coursework, supervision, and curriculum is based on problem-based learning. About the book: 'International Perspectives in Music Therapy Education and Training: Adapting to a Changing World,' the first anthology of its kind, edited by Professor Karen Goodman, brings noted educators from Brazil, Canada...

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

    Science.gov (United States)

    Siu, Judy Yuen-Man

    2014-02-06

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

  4. Schlieren photography on freely flying hawkmoth.

    Science.gov (United States)

    Liu, Yun; Roll, Jesse; Van Kooten, Stephen; Deng, Xinyan

    2018-05-01

    The aerodynamic force on flying insects results from the vortical flow structures that vary both spatially and temporally throughout flight. Due to these complexities and the inherent difficulties in studying flying insects in a natural setting, a complete picture of the vortical flow has been difficult to obtain experimentally. In this paper, Schlieren , a widely used technique for highspeed flow visualization, was adapted to capture the vortex structures around freely flying hawkmoth ( Manduca ). Flow features such as leading-edge vortex, trailing-edge vortex, as well as the full vortex system in the wake were visualized directly. Quantification of the flow from the Schlieren images was then obtained by applying a physics-based optical flow method, extending the potential applications of the method to further studies of flying insects. © 2018 The Author(s).

  5. Birth of a health service.

    Science.gov (United States)

    Anderson, G

    On April 18th, independent Zimbabwe celebrated its 3rd birthday. In 1980, within days after taking power, Robert Mugabe's government announced that health care was to be free to everyone earning less then Z150 (60 British pounds) a month--the vast majority of the population. Although the free services are a good public relations policy, more important was the decision to expand the health services at grassroots level and to shift emphasis from an urban based curative system to rural based preventive care. Zimbabwe desperately needs doctors. According to the World Health Organization (WHO), the country has some 1400 registered doctors, roughly 1 for every 6000 people. Yet, of the 1400, under 300 work in the government health services and many of those are based in Harare, the capital. Of Zimbabwe's 28 district hospitals, only 14 have a full-time doctor. In some rural areas, there is 1 doctor/100,000 or more people. The nature of the country's health problems, coupled with the government's severe shortage of cash, shows why nursing is so crucial to Zimbabwe's development. If the rural communities, which make up 85% of the population, were to have easy access to a qualified nurse, or even a nursing assistant, the quality of life would double. The only thing that is more important is a clean water supply. Possibly the most important role for nurses in Zimbabwe is that of education. Nurses can spread awareness of basic hygiene, raise the skill of local people in dealing with minor health problems independently, carry out immunization programs, offer contraceptive advice, give guidance on breastfeeding and infant nutrition, and work with practitioners of traditional African medicines to make sure they possess basic scientific knowledge. Rebuilding after the war was not a major problem for the Mugabe health ministry, for in many areas there was simply nothing to rebuild. There were never any health services. A far greater problem has been the top heavy structure of the

  6. Doctoral Program Selection Using Pairwise Comparisons.

    Science.gov (United States)

    Tadisina, Suresh K.; Bhasin, Vijay

    1989-01-01

    The application of a pairwise comparison methodology (Saaty's Analytic Hierarchy Process) to the doctoral program selection process is illustrated. A hierarchy for structuring and facilitating the doctoral program selection decision is described. (Author/MLW)

  7. House Fly (Musca domestica L. Attraction to Insect Honeydew.

    Directory of Open Access Journals (Sweden)

    Kim Y Hung

    Full Text Available House flies are of major concern as vectors of food-borne pathogens to food crops. House flies are common pests on cattle feedlots and dairies, where they develop in and feed on animal waste. By contacting animal waste, house flies can acquire human pathogenic bacteria such as Escherichia coli and Salmonella spp., in addition to other bacteria, viruses, or parasites that may infect humans and animals. The subsequent dispersal of house flies from animal facilities to nearby agricultural fields containing food crops may lead to pre-harvest food contamination with these pathogens. We hypothesized that odors from honeydew, the sugary excreta produced by sucking insects feeding on crops, or molds and fungi growing on honeydew, may attract house flies, thereby increasing the risk of food crop contamination. House fly attraction to honeydew-contaminated plant material was evaluated using a laboratory bioassay. House flies were attracted to the following plant-pest-honeydew combinations: citrus mealybug on squash fruit, pea aphid on faba bean plants, whitefly on navel orange and grapefruit leaves, and combined citrus mealybug and cottony cushion scale on mandarin orange leaves. House flies were not attracted to field-collected samples of lerp psyllids on eucalyptus plants or aphids on crepe myrtle leaves. Fungi associated with field-collected honeydews were isolated and identified for further study as possible emitters of volatiles attractive to house flies. Two fungal species, Aureobasidium pullulans and Cladosporium cladosporioides, were repeatedly isolated from field-collected honeydew samples. Both fungal species were grown in potato dextrose enrichment broth and house fly attraction to volatiles from these fungal cultures was evaluated. House flies were attracted to odors from A. pullulans cultures but not to those of C. cladosporioides. Identification of specific honeydew odors that are attractive to house flies could be valuable for the

  8. House Fly (Musca domestica L.) Attraction to Insect Honeydew.

    Science.gov (United States)

    Hung, Kim Y; Michailides, Themis J; Millar, Jocelyn G; Wayadande, Astri; Gerry, Alec C

    2015-01-01

    House flies are of major concern as vectors of food-borne pathogens to food crops. House flies are common pests on cattle feedlots and dairies, where they develop in and feed on animal waste. By contacting animal waste, house flies can acquire human pathogenic bacteria such as Escherichia coli and Salmonella spp., in addition to other bacteria, viruses, or parasites that may infect humans and animals. The subsequent dispersal of house flies from animal facilities to nearby agricultural fields containing food crops may lead to pre-harvest food contamination with these pathogens. We hypothesized that odors from honeydew, the sugary excreta produced by sucking insects feeding on crops, or molds and fungi growing on honeydew, may attract house flies, thereby increasing the risk of food crop contamination. House fly attraction to honeydew-contaminated plant material was evaluated using a laboratory bioassay. House flies were attracted to the following plant-pest-honeydew combinations: citrus mealybug on squash fruit, pea aphid on faba bean plants, whitefly on navel orange and grapefruit leaves, and combined citrus mealybug and cottony cushion scale on mandarin orange leaves. House flies were not attracted to field-collected samples of lerp psyllids on eucalyptus plants or aphids on crepe myrtle leaves. Fungi associated with field-collected honeydews were isolated and identified for further study as possible emitters of volatiles attractive to house flies. Two fungal species, Aureobasidium pullulans and Cladosporium cladosporioides, were repeatedly isolated from field-collected honeydew samples. Both fungal species were grown in potato dextrose enrichment broth and house fly attraction to volatiles from these fungal cultures was evaluated. House flies were attracted to odors from A. pullulans cultures but not to those of C. cladosporioides. Identification of specific honeydew odors that are attractive to house flies could be valuable for the development of improved house

  9. House Fly (Musca domestica L.) Attraction to Insect Honeydew

    Science.gov (United States)

    Hung, Kim Y.; Michailides, Themis J.; Millar, Jocelyn G.; Wayadande, Astri; Gerry, Alec C.

    2015-01-01

    House flies are of major concern as vectors of food-borne pathogens to food crops. House flies are common pests on cattle feedlots and dairies, where they develop in and feed on animal waste. By contacting animal waste, house flies can acquire human pathogenic bacteria such as Escherichia coli and Salmonella spp., in addition to other bacteria, viruses, or parasites that may infect humans and animals. The subsequent dispersal of house flies from animal facilities to nearby agricultural fields containing food crops may lead to pre-harvest food contamination with these pathogens. We hypothesized that odors from honeydew, the sugary excreta produced by sucking insects feeding on crops, or molds and fungi growing on honeydew, may attract house flies, thereby increasing the risk of food crop contamination. House fly attraction to honeydew-contaminated plant material was evaluated using a laboratory bioassay. House flies were attracted to the following plant-pest-honeydew combinations: citrus mealybug on squash fruit, pea aphid on faba bean plants, whitefly on navel orange and grapefruit leaves, and combined citrus mealybug and cottony cushion scale on mandarin orange leaves. House flies were not attracted to field-collected samples of lerp psyllids on eucalyptus plants or aphids on crepe myrtle leaves. Fungi associated with field-collected honeydews were isolated and identified for further study as possible emitters of volatiles attractive to house flies. Two fungal species, Aureobasidium pullulans and Cladosporium cladosporioides, were repeatedly isolated from field-collected honeydew samples. Both fungal species were grown in potato dextrose enrichment broth and house fly attraction to volatiles from these fungal cultures was evaluated. House flies were attracted to odors from A. pullulans cultures but not to those of C. cladosporioides. Identification of specific honeydew odors that are attractive to house flies could be valuable for the development of improved house

  10. Tsetse flies and their control.

    Science.gov (United States)

    Rogers, D J; Hendrickx, G; Slingenbergh, J H

    1994-12-01

    The authors use a quantitative modelling framework to describe and explore the features of the biology of tsetse flies (Glossina spp.) which are important in determining the rate of transmission of the African trypanosomiases between hosts. Examples are presented of the contribution of previous research on tsetse to quantified epidemiological and epizootiological understanding, and areas of current ignorance are identified for future study. Spatial and temporal variations in risk are important (but rarely-studied) determinants of the impact of trypanosomiasis on humans, domestic animals and agricultural activities. Recent grid-based sampling surveys to Togo provide valuable data sets on tsetse, cattle and trypanosomiasis throughout the country. A combination of ground-based meterological and remotely-sensed satellite data, within linear discriminant analytical models, enables description of the observed distributions of the five species of tsetse occurring in Togo, with accuracies of between 72% (Glossina palpalis and G. tachinoides) and 98% (G. fusca). Abundance classes of the two most widespread species, G. palpalis and G. tachinoides, are described with accuracies of between 47% and 83%. This is especially remarkable given the relatively small differences between the average values of the predictor variables in areas of differing fly abundance. Similar analyses could be used to predict the occurrence and abundance of flies in other areas, which have not been surveyed to date, in order to plan tsetse control campaigns or explore development options. Finally, some recent tsetse control campaigns are briefly reviewed. The shift of emphasis from fly eradication to fly control is associated with a devolution of responsibility for control activities from central government to local areas, communities or even individuals. The future role of central governments will remain crucial, however, in determining the areas in which different control options are practised, in

  11. Doctor and pharmacy shopping for controlled substances.

    Science.gov (United States)

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

    2012-06-01

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

  12. Angina - what to ask your doctor

    Science.gov (United States)

    What to ask your doctor about angina and heart disease; Coronary artery disease - what to ask your doctor ... the signs and symptoms that I am having angina? Will I always have the same symptoms? What ...

  13. Africa and the tsetse fly

    International Nuclear Information System (INIS)

    1985-01-01

    Trypanosomiasis, an infection transmitted by the tsetse fly and causing sleeping sickness in man and Nagana disease in animals, is widespread in Africa. It affects 37 countries (an area as large as the United States) and leads to great losses in the national economy. It can be fought effectively by programmes to eradicate the tsetse fly with the sterile insect technique. The film shows the tsetse habitats and biology and demonstrates how its reproduction circle can be interrupted by sterilization of male flies with gamma rays. This method has proven an effective alternative to the use of pesticides because its efficiency increases with each generation and it causes no environmental pollution problems

  14. Africa and the tsetse fly

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1986-12-31

    Trypanosomiasis, an infection transmitted by the tsetse fly and causing sleeping sickness in man and Nagana disease in animals, is widespread in Africa. It affects 37 countries (an area as large as the United States) and leads to great losses in the national economy. It can be fought effectively by programmes to eradicate the tsetse fly with the sterile insect technique. The film shows the tsetse habitats and biology and demonstrates how its reproduction circle can be interrupted by sterilization of male flies with gamma rays. This method has proven an effective alternative to the use of pesticides because its efficiency increases with each generation and it causes no environmental pollution problems

  15. An Australian government dental scheme: Doctor-dentist-patient tensions in the triangle.

    Science.gov (United States)

    Weerakoon, Arosha; Fitzgerald, Lisa; Porter, Suzette

    2014-11-30

    Autonomy of participants is challenged when legislation to provide a public health service is weakly designed and implemented. Australia's Chronic Disease Dental Scheme was instigated to provide a government subsidy for private dental treatment for people suffering chronic illness impacting their oral health or vice versa. They were allocated AUD$4250 towards comprehensive treatment over 2 years with their eligibility determined by their general medical doctor. A qualitative research study was conducted to explore the experiences from the perspectives of the patient, medical and dental practitioner. One of the research outcomes identified a frequently reported level of discomfort in the patient/doctor/dentist triangle. Doctors and dentists reported feeling forced by patients into positions that compromised their autonomy in obeying the intent (if not the law) of the scheme. Additionally, dentists felt under pressure from doctors and patients to provide subsidized treatment to those eligible. In turn, the patients reported difficulties in gaining access to the scheme and in some cases, experiencing full or partially unmet oral health needs. REASON FOR CONFLICT: Poor inter-professional communication and lack of understanding about profession-unique patient-driven pressures, ultimately contributed to dissonance. Ill-defined eligibility guidelines rendered the doctor's ability to gate-keep challenging. OUTCOME OF CONFLICT: Inefficient gate-keeping led to exponential increase in referrals, resulting in unprecedented cost blow-outs. Ensuing government-led audits caused political tensions and contributed to the media-induced vilification of dentists. In December 2013, government financing of dental treatment through Chronic Disease Dental Scheme was discontinued, leaving many Australians without a viable alternative. There is a need for qualitative research methods to help identify social issues that affect public health policy process. In order to succeed, new health

  16. Utilize Cementitious High Carbon Fly Ash (CHCFA) to Stabilize Cold In-Place Recycled (CIR) Asphalt Pavement as Base Coarse

    Energy Technology Data Exchange (ETDEWEB)

    Wen, Haifang; Li, Xiaojun; Edil, Tuncer; O' Donnell, Jonathan; Danda, Swapna

    2011-02-05

    The purpose of this study was to evaluate the performance of cementitious high carbon fly ash (CHCFA) stabilized recycled asphalt pavement as a base course material in a real world setting. Three test road cells were built at MnROAD facility in Minnesota. These cells have the same asphalt surface layers, subbases, and subgrades, but three different base courses: conventional crushed aggregates, untreated recycled pavement materials (RPM), and CHCFA stabilized RPM materials. During and after the construction of the three cells, laboratory and field tests were carried out to characterize the material properties. The test results were used in the mechanistic-empirical pavement design guide (MEPDG) to predict the pavement performance. Based on the performance prediction, the life cycle analyses of cost, energy consumption, and greenhouse gasses were performed. The leaching impacts of these three types of base materials were compared. The laboratory and field tests showed that fly ash stabilized RPM had higher modulus than crushed aggregate and RPM did. Based on the MEPDG performance prediction, the service life of the Cell 79 containing fly ash stabilized RPM, is 23.5 years, which is about twice the service life (11 years) of the Cell 77 with RPM base, and about three times the service life (7.5 years) of the Cell 78 with crushed aggregate base. The life cycle analysis indicated that the usage of the fly ash stabilized RPM as the base of the flexible pavement can significantly reduce the life cycle cost, the energy consumption, the greenhouse gases emission. Concentrations of many trace elements, particularly those with relatively low water quality standards, diminish over time as water flows through the pavement profile. For many elements, concentrations below US water drinking water quality standards are attained at the bottom of the pavement profile within 2-4 pore volumes of flow.

  17. Australian doctors and the visual arts. Part 2. Doctors as collectors, donors, gallery supporters and writers in New South Wales.

    Science.gov (United States)

    Hamilton, D G

    1986-04-28

    The contribution of doctors to the visual arts if being discussed in a series of six articles. The first article dealt with doctor-artists in new South Wales. In this, the second, doctors are discussed as collectors, donors, gallery supporters and writers in this State.

  18. The influence of sex and fly species on the development of trypanosomes in tsetse flies.

    Directory of Open Access Journals (Sweden)

    Lori Peacock

    Full Text Available Unlike other dipteran disease vectors, tsetse flies of both sexes feed on blood and transmit pathogenic African trypanosomes. During transmission, Trypanosoma brucei undergoes a complex cycle of proliferation and development inside the tsetse vector, culminating in production of infective forms in the saliva. The insect manifests robust immune defences throughout the alimentary tract, which eliminate many trypanosome infections. Previous work has shown that fly sex influences susceptibility to trypanosome infection as males show higher rates of salivary gland (SG infection with T. brucei than females. To investigate sex-linked differences in the progression of infection, we compared midgut (MG, proventriculus, foregut and SG infections in male and female Glossina morsitans morsitans. Initially, infections developed in the same way in both sexes: no difference was observed in numbers of MG or proventriculus infections, or in the number and type of developmental forms produced. Female flies tended to produce foregut migratory forms later than males, but this had no detectable impact on the number of SG infections. The sex difference was not apparent until the final stage of SG invasion and colonisation, showing that the SG environment differs between male and female flies. Comparison of G. m. morsitans with G. pallidipes showed a similar, though less pronounced, sex difference in susceptibility, but additionally revealed very different levels of trypanosome resistance in the MG and SG. While G. pallidipes was more refractory to MG infection, a very high proportion of MG infections led to SG infection in both sexes. It appears that the two fly species use different strategies to block trypanosome infection: G. pallidipes heavily defends against initial establishment in the MG, while G. m. morsitans has additional measures to prevent trypanosomes colonising the SG, particularly in female flies. We conclude that the tsetse-trypanosome interface works

  19. Ge extraction from gasification fly ash

    Energy Technology Data Exchange (ETDEWEB)

    Oriol Font; Xavier Querol; Angel Lopez-Soler; Jose M. Chimenos; Ana I. Fernandez; Silvia Burgos; Francisco Garcia Pena [Institute of Earth Sciences ' Jaume Almera' , Barcelona (Spain)

    2005-08-01

    Water-soluble germanium species (GeS{sub 2}, GeS and hexagonal-GeO{sub 2}) are generated during coal gasification and retained in fly ash. This fact together with the high market value of this element and the relatively high contents in the fly ashes of the Puertollano Integrated Gasification in Combined Cycle (IGCC) plant directed our research towards the development of an extraction process for this element. Major objectives of this research was to find a low cost and environmentally suitable process. Several water based extraction tests were carried out using different Puertollano IGCC fly ash samples, under different temperatures, water/fly ash ratios, and extraction times. High Ge extraction yields (up to 84%) were obtained at room temperature (25{sup o}C) but also high proportions of other trace elements (impurities) were simultaneously extracted. Increasing the extraction temperature to 50, 90 and 150{sup o}C, Ge extraction yields were kept at similar levels, while reducing the content of impurities, the water/fly ash ratio and extraction time. The experimental data point out the influence of chloride, calcium and sulphide dissolutions on the Ge extraction. 16 refs., 9 figs., 6 tabs.

  20. Doctor Shoja-ad-Din Sheikholeslamzadeh and his Achievements

    Directory of Open Access Journals (Sweden)

    Ahmadreza Afshar

    2015-01-01

    Full Text Available Doctor Shoja-ad-Din Sheikholeslamzadeh (also known as Dr. Sheikh (1931-2014 was an outstanding orthopedic surgeon. He is credited for the establishment of the Iranian Association of Rehabilitation, Shafa Yahyaian Hospital as an Orthopedic and Rehabilitation Center, the Social Welfare Organization, Iran’s emergency dispatch center (115 and many other major projects that led to the upgrading of health care services in Iran. He also served as the Minister of Social Welfare and Minister of Health and Welfare before the Islamic revolution. The history of modern health care management and modern orthopedic surgery in Iran are indebted to the great leadership and executive abilities of Dr. Sheikh

  1. Doctor Shoja-ad-Din Sheikholeslamzadeh and his Achievements.

    Science.gov (United States)

    Afshar, Ahmadreza; Ziaei, Majid Eyvaz; Ahmadi, Aziz

    2015-01-01

    Doctor Shoja-ad-Din Sheikholeslamzadeh (also known as Dr. Sheikh) (1931-2014) was an outstanding orthopedic surgeon. He is credited for the establishment of the Iranian Association of Rehabilitation, Shafa Yahyaian Hospital as an Orthopedic and Rehabilitation Center, the Social Welfare Organization, Iran's emergency dispatch center (115) and many other major projects that led to the upgrading of health care services in Iran. He also served as the Minister of Social Welfare and Minister of Health and Welfare before the Islamic revolution. The history of modern health care management and modern orthopedic surgery in Iran are indebted to the great leadership and executive abilities of Dr. Sheikh.

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

    Science.gov (United States)

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

    2005-08-01

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

  3. A Three-Level Process Framework for Contract-Based Dynamic Service Outsourcing

    NARCIS (Netherlands)

    Grefen, P.W.P.J.; Angelov, S.A.

    Service outsourcing is the business paradigm, in which an organization has part of its business process performed by a service provider. In dynamic markets, service providers are selected on the fly during process enactment. The cooperation between the parties is specified in a dynamically made

  4. Acidolysis of coal fly ash by Aspergillus niger

    Energy Technology Data Exchange (ETDEWEB)

    Torma, A.E.; Singh, A.K. (EG and G Idaho Inc., Idaho Falls, ID (United States). Center for Biological Processing Technology)

    1993-12-01

    The kinetics of aluminium extraction were investigated, using as-received and calcined fly ash samples and a pure culture of [ital Aspergillus niger]. This fungus metabolized sucrose to citric and oxalic acids, which were involved in the acidolysis of fly ash. Aluminium extraction from as-received fly ash was only 5-8%, whereas from calcined fly ash it was up to 93.5%. The order of reaction and the overall reaction rate constant were determined by the van't Hoff technique with respect to the concentration of calcined fly ash. A linearized form of a modified Monod expression was applied to the experimental data to assess the kinetic constants for the acidolysis process. Statistically designed experiments were carried out with calcined fly ash and synthetic solutions containing citric and oxalic acids to determine the optimum leaching conditions. The acidolysis reaction mechanism is discussed. 28 refs., 6 figs., 3 tabs.

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

    Science.gov (United States)

    2014-01-01

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

  6. Fruit fly eradication: Argentina

    International Nuclear Information System (INIS)

    2003-01-01

    Fruit exports account for 9% of Argentina's total agricultural exports and generate annually close to $450 million. This could be increased but for fruit flies that cause damage equivalent to 15% to 20% of present production value of fruit and also deny export access to countries imposing quarantine barriers. The Department of Technical Co-operation is sponsoring a programme, with technical support from the Joint FAO/IAEA Division, to eradicate the Mediterranean fruit fly using the Sterile Insect Technique (SIT). (IAEA)

  7. Viability of healthcare service delivery alternatives for the Australian mining sector.

    Science.gov (United States)

    Williams, Patricia A H; Giles, Margaret

    2012-01-01

    The changing and demanding nature of the mining workforce in rural and remote Australia brings unique challenges to the delivery of healthcare services. In an attempt to control costs whilst delivering cost effective and quality healthcare, new models of delivery must be considered. For a workforce that is fly-in/fly-out, the provision of healthcare is problematic given the lack of consistency in location. A cost-benefit framework is analysed comparing three models of service provision using travel to a major location, locum services and remote health monitoring. Ultimately, new models of care must be considered to address the issues of increasing workforce turnover, to cater for rising healthcare costs, and to improve the health of such communities.

  8. Perceived needs of pharmaceutical care services among healthcare professionals in South Korea: a qualitative study.

    Science.gov (United States)

    Lee, Iyn-Hyang; Rhie, Sandy Jeong; Je, Nam Kyung; Rhew, Ki Yon; Ji, Eunhee; Oh, Jung Mi; Lee, Euni; Yoon, Jeong-Hyun

    2016-10-01

    Purpose To explore the need for pharmaceutical care services, key features of desirable pharmacy services, and perceived barriers for advancing the services in hospital environments with doctors and nurses who are key co-workers of the interdisciplinary team care services.Methods Semi-structured, in-depth interviews with eighteen doctors and fifteen nurses employing purposive and snowballing sampling strategies were conducted in ten hospitals in South Korea. Results The level of pharmaceutical care was varied across regions or institutions in South Korea. The concept of pharmaceutical care was insufficiently defined, and tended to be limited to some parts of medication counseling. Through pharmaceutical care services, doctors desired to acquire comprehensive drug information from and to share clinical responsibilities with pharmacists. Nurses wished to lower their burdens of medication counseling services from their daily practices. Doctors and nurses asked for pharmacists providing essential and carefully selected medication information to their patients in a patient-centered manner. The listed barriers to pharmaceutical care included the lack of appropriate systems for reward, insufficient accessibility to patient records by pharmacists, ambiguous role descriptions of pharmacist, and absence of effective communication among professionals. Conclusion A successful pharmaceutical care service model should allow efficient exchange of information among healthcare professionals to build inter-professional trust and to provide a continuity of care both in terms of time and setting. As prerequisites of such system, it was warranted to develop clinical evidence and an appropriate reward system for pharmaceutical care services.

  9. Guidance for packing, shipping, holding and release of sterile flies in area-wide fruit fly control programmes

    International Nuclear Information System (INIS)

    Enkerlin, W.

    2007-01-01

    This guidance represents the recommendations, reached by consensus of an international group of experts, on the standard procedures for the packing, shipping, holding and release of mass reared and sterilized tephritid flies that are to be used in area-wide programmes that include the Sterile Insect Technique (SIT). The majority of the procedures were initially designed specifically for the Mediterranean fruit fly Ceratitis capitata (Wiedemann) (or Medfly), but they are applicable, with minor modifications, for other tephritid species such as those in the genera Anastrepha, Bactrocera and Dacus. The guidance is designed to be a working document that can be subject to periodic updates due to technological developments and research contributions. Future editions will endeavour to include more specific recommendations for other species of fruit flies as the relevant data become available. The procedures described in this guidance will help ensure that released sterile fruit flies will be of optimal quality and that the resulting field density of these flies will be as closely aligned to the individual programme needs. It is hoped that this guidance will help to quickly identify and correct problems in programme effectiveness, resulting from less than optimal emergence and release conditions

  10. Global medicine: Is it ethical or morally justifiable for doctors and other healthcare workers to go on strike?

    Science.gov (United States)

    2013-01-01

    Background Doctor and healthcare worker (HCW) strikes are a global phenomenon with the potential to negatively impact on the quality of healthcare services and the doctor-patient relationship. Strikes are a legitimate deadlock breaking mechanism employed when labour negotiations have reached an impasse during collective bargaining. Striking doctors usually have a moral dilemma between adherence to the Hippocratic tenets of the medical profession and fiduciary obligation to patients. In such circumstances the ethical principles of respect for autonomy, justice and beneficence all come into conflict, whereby doctors struggle with their role as ordinary employees who are rightfully entitled to a just wage for just work versus their moral obligations to patients and society. Discussion It has been argued that to deny any group of workers, including "essential workers" the right to strike is akin to enslavement which is ethically and morally indefensible. While HCW strikes occur globally, the impact appears more severe in developing countries challenged by poorer socio-economic circumstances, embedded infrastructural deficiencies, and lack of viable alternative means of obtaining healthcare. These communities appear to satisfy the criteria for vulnerability and may be deserving of special ethical consideration when doctor and HCW strikes are contemplated. Summary The right to strike is considered a fundamental right whose derogation would be inimical to the proper functioning of employer/employee collective bargaining in democratic societies. Motivations for HCW strikes include the natural pressure to fulfil human needs and the paradigm shift in modern medical practice, from self-employment and benevolent paternalism, to managed healthcare and consumer rights. Minimizing the incidence and impact of HCW strikes will require an ethical approach from all stakeholders, and recognition that all parties have an equal moral obligation to serve the best interests of society

  11. Global medicine: is it ethical or morally justifiable for doctors and other healthcare workers to go on strike?

    Science.gov (United States)

    Chima, Sylvester C

    2013-01-01

    Doctor and healthcare worker (HCW) strikes are a global phenomenon with the potential to negatively impact on the quality of healthcare services and the doctor-patient relationship. Strikes are a legitimate deadlock breaking mechanism employed when labour negotiations have reached an impasse during collective bargaining. Striking doctors usually have a moral dilemma between adherence to the Hippocratic tenets of the medical profession and fiduciary obligation to patients. In such circumstances the ethical principles of respect for autonomy, justice and beneficence all come into conflict, whereby doctors struggle with their role as ordinary employees who are rightfully entitled to a just wage for just work versus their moral obligations to patients and society. It has been argued that to deny any group of workers, including "essential workers" the right to strike is akin to enslavement which is ethically and morally indefensible. While HCW strikes occur globally, the impact appears more severe in developing countries challenged by poorer socio-economic circumstances, embedded infrastructural deficiencies, and lack of viable alternative means of obtaining healthcare. These communities appear to satisfy the criteria for vulnerability and may be deserving of special ethical consideration when doctor and HCW strikes are contemplated. The right to strike is considered a fundamental right whose derogation would be inimical to the proper functioning of employer/employee collective bargaining in democratic societies. Motivations for HCW strikes include the natural pressure to fulfil human needs and the paradigm shift in modern medical practice, from self-employment and benevolent paternalism, to managed healthcare and consumer rights. Minimizing the incidence and impact of HCW strikes will require an ethical approach from all stakeholders, and recognition that all parties have an equal moral obligation to serve the best interests of society. Employers should implement

  12. The blow fly, Chrysomya megacephala, and the house fly, Musca domestica, as mechanical vectors of pathogenic bacteria in Northeast Thailand.

    Science.gov (United States)

    Chaiwong, T; Srivoramas, T; Sueabsamran, P; Sukontason, K; Sanford, M R; Sukontason, K L

    2014-06-01

    The Oriental latrine fly, Chrysomya megacephala (Fabricius) (Diptera: Calliphoridae) and the house fly, Musca domestica L., (Diptera: Muscidae) are synanthropic flies which are adapted to live in close association with human habitations, thereby making them likely mechanical vectors of several pathogens to humans. There were two main aims of this study. The first aim was to determine the prevalence of these two fly species from five types of human habitations including: fresh-food markets, garbage piles, restaurants, school cafeterias and paddy fields, in the Muang Ubon Ratchathani and Warinchamrap districts of Ubon Ratchathani province of Northeast Thailand. Flies collection were conducted monthly from September 2010-October 2011 using a reconstructable funnel trap, containing 1 day-tainted beef offal as bait. A total of 7 750 flies (6 401 C. megacephala and 1 349 M.domestica) were collected. The second aim was to examine the potential of these flies to carry pathogenic bacteria. Bacteria were isolated from 994 individual flies collected using a sweep net (555 C. megacephala and 439 M. domestica). A total of 15 bacterial genera were isolated from the external surfaces, comprising ten genera of gram-negative bacteria and five gram-positive bacteria. The most common bacteria isolated from both species were coagulase-negative staphylococci, followed by Streptococcus group D non-enterococci. Human pathogenic enteric bacteria isolated were Salmonella sp., Shigella sp., Escherichia coli O157:H7, Salmonella typhi, Bacillus sp., and Enterococcus sp., of which S. typhi is the first report of isolation from these fly species. Other human pathogens included Staphylococcus aureus and Pseudomonas aeruginosa. Not only were the number of C. megacephala positive for bacteria significantly higher than for M. domestica, but they were also carrying ~11-12 times greater bacterial load than M. domestica. These data suggest that both fly species should be considered potential

  13. Reduction of metal leaching in brown coal fly ash using geopolymers

    International Nuclear Information System (INIS)

    Bankowski, P.; Zou, L.; Hodges, R.

    2004-01-01

    Current regulations classify fly ash as a prescribed waste and prohibit its disposal in regular landfill. Treatment of the fly ash can reduce the leach rate of metals, and allow it to be disposed in less prescribed landfill. A geopolymer matrix was investigated as a potential stabilisation method for brown coal fly ash. Precipitator fly ash was obtained from electrostatic precipitators and leached fly ash was collected from ash disposal ponds, and leaching tests were conducted on both types of geopolymer stabilised fly ashes. The ratio of fly ash to geopolymer was varied to determine the effects of different compositions on leaching rates. Fourteen metals and heavy metals were targeted during the leaching tests and the results indicate that a geopolymer is effective at reducing the leach rates of many metals from the fly ash, such as calcium, arsenic, selenium, strontium and barium. The major element leachate concentrations obtained from leached fly ash were in general lower than that of precipitator fly ash. Conversely, heavy metal leachate concentrations were lower in precipitator fly ash than leached pond fly ash. The maximum addition of fly ash to this geopolymer was found to be 60 wt% for fly ash obtained from the electrostatic precipitators and 70 wt% for fly ash obtained from ash disposal ponds. The formation of geopolymer in the presence of fly ash was studied using 29Si MAS-NMR and showed that a geopolymer matrix was formed. X-ray diffraction (XRD) analysis and scanning electron microscopy (SEM) imaging showed the interaction of the fly ash with the geopolymer, which was related to the leachate data and also the maximum percentage fly ash addition

  14. Investigation of Hong Kong doctors' current knowledge, beliefs, attitudes, confidence and practices: implications for the treatment of tobacco dependency.

    Science.gov (United States)

    Abdullah, Abu Saleh M; Rahman, A S M Mujibur; Suen, Chau Wai; Wing, Lau Sun; Ling, Lau Wai; Mei, Li Yuen; Tat, Lun Chung; Tai, Mak Nin; Wing, Tsai Nga; Yuen, Wu Tsz; Kwan, Yam H

    2006-10-01

    Physicians play a crucial role in promoting smoking cessation. However, there are lack of data on Chinese doctors' knowledge, beliefs, attitudes, confidence and usual practices in relation to smoking cessation. Understanding of these indicators is important in the design of any effective intervention program targeting doctors. To assess Chinese doctors' knowledge, beliefs, attitudes, confidence and usual practices in relation to smoking cessation, a mailed questionnaire survey was conducted among 4,000 doctors registered with the Hong Kong Medical Association (HKMA) in 2002. Of the 757 respondents (18.9% response rate), 78% were male, 94% were non-smokers and 50% had received no basic training on smoking cessation. More than half of the doctors did not hold adequate knowledge (53%) or favorable attitudes (55%) towards smoking cessation; 44% were less confident in their smoking cessation skills. About 77% of the doctors obtained information on their patients' smoking status and recorded it in their medical record, and 29% advised all smoking patients to quit. Doctors who gave smoking cessation advice were more likely to be aged above 50 years, with more than 30 years' practice experience, working in the private sector, non- or ex-smokers, with more positive beliefs towards smoking cessation, and with higher confidence in smoking cessation skills (p confidence on smoking cessation-related matters were also identified. The survey has shown that existing smoking cessation service provision in Hong Kong for patients who smoke is inadequate, and has identified a lack of smoking cessation skills among doctors. Action should be taken to train doctors in smoking cessation skills and encourage them to routinely establish the smoking status of their patients and to advise all smokers to quit smoking.

  15. Genetic quality control in mass-reared melon flies

    International Nuclear Information System (INIS)

    Miyatake, T.

    2002-01-01

    Quality control in mass-reared melon flies, Bactrocera cucurbitae, after eradication is discussed, based on the results of artificial selection experiments. First, a brief history of quality control in mass-rearing of insects is described. In practical mass- rearing of melon fly, many traits have already been differentiated between mass-reared and wild flies. These differing traits are reviewed and the factors which caused these differences are considered. It was considered that the differences between wild and mass-reared melon flies depended on the selection pressures from the mass-rearing method. Next, the results of several artificial selection experiments using the melon fly are reviewed. Finally, consideration is given to some correlated responses to artificial selection in mass-rearing. Longevity that is correlated to early fecundity was successfully controlled by artificial selection for reproduction in the mass-rearing system. On the basis of these results, an improved method for quality control in mass-reared melon fly with considerations for quantitative genetics is discussed

  16. Increased Transmissibility of Leishmania donovani From the Mammalian Host to Vector Sand Flies After Multiple Exposures to Sand Fly Bites.

    Science.gov (United States)

    Valverde, Joanna G; Paun, Andrea; Inbar, Ehud; Romano, Audrey; Lewis, Michael; Ghosh, Kashinath; Sacks, David

    2017-04-15

    Patients with active visceral leishmaniasis are important reservoirs in the anthroponotic transmission cycle of Leishmania donovani. The role of the blood or skin as a source of infection to sand flies remains unclear, and the possible effect of multiple exposures to fly bites on transmissibility has not been addressed. L. donovani-infected hamsters underwent xenodiagnoses with Lutzomyia longipalpis on the same or different sites on the abdomen on 2 consecutive days or by artificial feeding on the skin or blood. The transmission of L. donovani from sick hamsters to flies was surprisingly low (mean, 24% of fed flies). New flies fed on the same site acquired significantly more infections (mean, 61%; P Leishmania donovani. Using the hamster model of visceral disease, we demonstrate that prior exposure to bites of uninfected sand flies potentiates their ability to transmit infection to the vector. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  17. Possibilities of municipal solid waste incinerator fly ash utilisation.

    Science.gov (United States)

    Hartmann, Silvie; Koval, Lukáš; Škrobánková, Hana; Matýsek, Dalibor; Winter, Franz; Purgar, Amon

    2015-08-01

    Properties of the waste treatment residual fly ash generated from municipal solid waste incinerator fly ash were investigated in this study. Six different mortar blends with the addition of the municipal solid waste incinerator fly ash were evaluated. The Portland cement replacement levels of the municipal solid waste incinerator fly ash used were 25%, 30% and 50%. Both, raw and washed municipal solid waste incinerator fly ash samples were examined. According to the mineralogical composition measurements, a 22.6% increase in the pozzolanic/hydraulic properties was observed for the washed municipal solid waste incinerator fly ash sample. The maximum replacement level of 25% for the washed municipal solid waste incinerator fly ash in mortar blends was established in order to preserve the compressive strength properties. Moreover, the leaching characteristics of the crushed mortar blend was analysed in order to examine the immobilisation of its hazardous contents. © The Author(s) 2015.

  18. Patient satisfaction with healthcare provided by family doctors: primary dimensions and an attempt at typology.

    Science.gov (United States)

    Marcinowicz, Ludmila; Chlabicz, Slawomir; Grebowski, Ryszard

    2009-04-16

    Patient satisfaction is a complex and difficult concept to measure, thus precluding the use of exclusively quantitative methods for its description. The purpose of this survey was firstly to identify particular healthcare dimensions that determine a patient's satisfaction or dissatisfaction; and secondly to attempt to typologise the patients' responses based on their evaluation of healthcare. Using a qualitative research design, thirty-six in-depth interviews with patients of family physicians were conducted: four patients from each of 9 family practices in different regions of Poland were interviewed. The main outcome measure was factors associated with patient satisfaction/dissatisfaction. In their evaluations of their contacts with family doctors, the patients cited mostly issues concerning interpersonal relationships with the doctor. Nearly 40% of the statements referred to this aspect of healthcare, with nearly equal proportions of positive and negative comments. The second most frequent category of responses concerned contextual factors (21%) that related to conditions of medical service, with two-thirds of the evaluations being negative. Statements concerning the doctor's competencies (12.9%) and personal qualities (10.5%) were less common. To improve the quality of healthcare, family doctors should take special care to ensure the quality of their interactions with patients.

  19. Optimal foraging in seasonal environments: implications for residency of Australian flying foxes in food-subsidized urban landscapes

    OpenAIRE

    Paez, David J; Restif, Olivier Louis; Eby, Peggy; Plowright, Raina K

    2018-01-01

    Bats provide important ecosystem services such as pollination of native forests; they are also a source of zoonotic pathogens for humans and domestic animals. Human-induced changes to native habitats may have created more opportunities for bats to reside in urban settings, thus decreasing pollination services to native forests and increasing opportunities for zoonotic transmission. In Australia, fruit bats (Pteropus spp. flying foxes) are increasingly inhabiting urban areas where they feed on...

  20. Peculiarities of the organizational behavior of Russian doctors

    Directory of Open Access Journals (Sweden)

    Zh V Puzanova

    2014-12-01

    Full Text Available The article considers the peculiarities of the organizational behavior of Russian doctors and conditions of its formation determined by the development of the national health care system in the Russian and Soviet periods. The authors analyze the changes in the national health care system since the Semashko model that was created in the first years of Soviet power and evolved in the post-war period into a multi-level system of medical care with clearly differentiated structure of services and later into the Soviet model focusing on specialized outpatient care and large staff of narrowly focused specialists; from the first private medical clinics in the late 1980s to the decline of the sphere in the 1990s and the reforms of the beginning of the XXI century. All stages of the national health care system evolution are the determinants of the Russian doctors’ organizational behavior changes, the crisis of professional ethics, the transformations of the professional consciousness from the ideas of service and medical care to the principle of providing medical services. The authors also consider some implications of the national project ‘Health’ in the contemporary Russia.

  1. Talking to Your Doctor (For Teens)

    Science.gov (United States)

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

  2. Service provision and use of anticoagulants in atrial fibrillation.

    Science.gov (United States)

    Sudlow, C. M.; Rodgers, H.; Kenny, R. A.; Thomson, R. G.

    1995-01-01

    Several large trials have shown that the risk of stroke in patients with non-valvar atrial fibrillation is reduced by treatment with warfarin. Implementing this research evidence requires not only an understanding of the trials' results and of the changes that they imply for clinicians' treatment decisions but also an appreciation of the organisation, quantity, and quality of services required to support these changes. Understanding of these implications is crucial for developing services that allow changes in practice to produce reductions in stroke incidence while minimising the risks of treatment. This article considers the developments in service provision that will probably be required to support the changes in clinical practice suggested by the trials' results. These services will be provided largely by doctors, and their development has implications for doctors in both primary and secondary care. Images FIG 1 PMID:7663216

  3. Burnout among middle-grade doctors of tertiary care hospital in Saudi Arabia.

    Science.gov (United States)

    Agha, Adnan; Mordy, Ayedh; Anwar, Eram; Saleh, Noha; Rashid, Imran; Saeed, Mona

    2015-01-01

    Burnout Syndrome is a mental condition caused by chronic exposure to work related stress and is identified by the presence of any of the three distinct elements of emotional exhaustion, depersonalization and lack of personal accomplishment. Middle grade doctors are the backbone of any tertiary care hospital / medical institution, partaking in unscheduled and inpatient care. The aim of this study was to assess the presence of burnout syndrome in the middle grade doctors in a tertiary care hospital in Saudi Arabia. The study was conducted at the Armed Forces Hospital Southern Region, Khamis Mushyt, from August to October 2012 in departments with at least fifty inpatient admissions per month and with at least five middle grade (Resident, Registrar and Senior Registrar) doctors. The departments were Obstetrics and Gynecology, Internal Medicine, Pediatrics, Emergency, General Surgery and Nephrology. This was a cross sectional descriptive and analytical study using the Maslach Burnout Inventory-Health Services Survey and a self-reported stressor-identifying questionnaire to ascertain possible precursors of, or contributing factors to, Burnout Syndrome. A total of 96 proformas/questionnaires were collected anonymously to maintain confidentiality and burnout syndrome was identified in as high as 88.5% of the respondents with high emotional exhaustion in 68.8%, high depersonalization in 63.6% and low personal accomplishment in 38.5%. The authors concluded that burnout syndrome is high among the middle-grade doctors in this medical facility and that urgent steps are needed to address this problem to ensure that these physicians remain physically and mentally healthy.

  4. Entomopathogenic Fungi in Flies Associated with Pastured Cattle in Denmark

    DEFF Research Database (Denmark)

    Steenberg, Tove; Jespersen, Jørgen B.; Jensen, Karl-Martin Vagn

    2001-01-01

    Cattle flies, including Musca autumnalis, Haematobia irritans, and Hydrotaea irritans, are pests of pastured cattle. A 2-year study of the natural occurrence of entomopathogenic fungi in adult cattle flies and other flies associated with pastures showed that the four species included in the Entom......Cattle flies, including Musca autumnalis, Haematobia irritans, and Hydrotaea irritans, are pests of pastured cattle. A 2-year study of the natural occurrence of entomopathogenic fungi in adult cattle flies and other flies associated with pastures showed that the four species included...

  5. Physical, chemical and mineralogical properties of fly ash

    International Nuclear Information System (INIS)

    Khairul Nizar Ismail; Kamaruddin Hussin; Mohd Sobri Idris

    2007-01-01

    Fly ash is the finely divided mineral residue resulting from the combustion of coal in electric generating plants. Fly ash consists of inorganic, incombustible matter present in the coal that has been fused during combustion into a glassy, amorphous structure. Fly ash particles are generally spherical in shape and range in size from 2 μm to 10 μm. They consist mostly of silicon dioxide (SiO 2 ), aluminium oxide (Al 2 O 3 ) and iron oxide (Fe 2 O 3 ). Fly ash like soil contains trace concentrations of the following heavy metals: nickel, vanadium, cadmium, barium, chromium, copper, molybdenum, zinc and lead. The chemical compositions of the sample have been examined and the fly ash are of ASTM C618 Class F. (Author)

  6. Burnout and Doctors: Prevalence, Prevention and Intervention

    Science.gov (United States)

    Kumar, Shailesh

    2016-01-01

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

  7. Burnout and Doctors: Prevalence, Prevention and Intervention

    Directory of Open Access Journals (Sweden)

    Shailesh Kumar

    2016-06-01

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

  8. Practices and attitudes of doctors and patients to downward referral in Shanghai, China.

    Science.gov (United States)

    Yu, Wenya; Li, Meina; Nong, Xin; Ding, Tao; Ye, Feng; Liu, Jiazhen; Dai, Zhixing; Zhang, Lulu

    2017-04-03

    downward referral. Doctors and patients should promote understandings of downward referral. Hospitals should realise the necessity of downward referral, effectively reduce workloads and provide continuing education for doctors. Increasing monetary reimbursement is urgent, as is improving the medical insurance system. 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/.

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

    Science.gov (United States)

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

    2017-05-01

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

  10. [Physician's role in "medical drama" pitfall? Reflection of stereotypical images of doctors in context of contemporary doctor's series].

    Science.gov (United States)

    Köhler, M; Grabsch, C; Zellner, M; Noll-Hussong, M

    2014-04-17

    In contemporary U.S. doctor's series, the characters are usually represented by good-looking or typical character actors. The aim of our pilot study was to investigate whether the long-term impact of this format on German television viewers could have an influence on the choice of doctor in Germany. Two different groups of people anticipating TV consumption patterns were questioned: a first group of younger adults who knew theTV series was asked to judge their doctor choice using a web-based survey tool with respect to three criteria (sympathy, expertise and own treatment preference). The second group of adults beyond the 40th year of life who need not know theTV series were shown photos of the serial figures. Study participants should select the "doctor" of which they would most likely want to be treated and this based on two predetermined reasons (sympathy or expertise). Our results indicate that stereotypical images of doctors found high approval only in the first group of people, while the participants in the second group decided in majorityfora more realistic representation of average appearance.

  11. The Professional Doctorate in Nursing: A Position Paper

    Science.gov (United States)

    Newman, Margaret A.

    1975-01-01

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

  12. Richard W. Ziolkowski Receives Honorary Doctorate

    DEFF Research Database (Denmark)

    Breinbjerg, Olav

    2012-01-01

    At the annual Commemoration of the Technical University of Denmark (DTU) on April 27, 2012, Prof. Richard W. Ziolkowski, University of Arizona (UoA), received DTU's highest academic degree, the Honorary Doctor degree: Doctor Technices Honoris Causa (Figure 1). Prof. Ziolkowski has been a close...

  13. Removal of chloride from MSWI fly ash.

    Science.gov (United States)

    Chen, Wei-Sheng; Chang, Fang-Chih; Shen, Yun-Hwei; Tsai, Min-Shing; Ko, Chun-Han

    2012-10-30

    The high levels of alkali chloride and soluble metal salts present in MSWI fly ash is worth noting for their impact on the environment. In addition, the recycling or reuse of fly ash has become an issue because of limited landfill space. The chloride content in fly ash limits its application as basis for construction materials. Water-soluble chlorides such as potassium chloride (KCl), sodium chloride (NaCl), and calcium chloride hydrate (CaCl(2) · 2H(2)O) in fly ash are easily washed away. However, calcium chloride hydroxide (Ca(OH)Cl) might not be easy to leach away at room temperature. The roasting and washing-flushing processes were applied to remove chloride content in this study. Additionally, air and CO(2) were introduced into the washing process to neutralize the hazardous nature of chlorides. In comparison with the water flushing process, the roasting process is more efficient in reducing the process of solid-liquid separation and drying for the reuse of Cl-removed fly ash particles. In several roasting experiments, the removal of chloride content from fly ash at 1050°C for 3h showed the best results (83% chloride removal efficiency). At a solid to liquid ratio of 1:10 the water-flushing process can almost totally remove water-soluble chloride (97% chloride removal efficiency). Analyses of mineralogical change also prove the efficiency of the fly ash roasting and washing mechanisms for chloride removal. Copyright © 2012 Elsevier B.V. All rights reserved.

  14. Junior doctors' experiences of managing patients with medically unexplained symptoms: a qualitative study.

    Science.gov (United States)

    Yon, Katherine; Nettleton, Sarah; Walters, Kate; Lamahewa, Kethakie; Buszewicz, Marta

    2015-12-01

    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/

  15. 76 FR 43804 - Movement of Hass Avocados From Areas Where Mediterranean Fruit Fly or South American Fruit Fly Exist

    Science.gov (United States)

    2011-07-22

    ... dorsalis), peach fruit fly (Anastrepha zonata), and sapote fruit fly (Anastrepha serpentina) in the... obliqua, Anastrepha serpentina, and Anastrepha striata (Diptera: Tephritidae) in Mexico. J. Econ. Entomol...

  16. How China's new health reform influences village doctors' income structure: evidence from a qualitative study in six counties in China.

    Science.gov (United States)

    Zhang, Shengfa; Zhang, Weijun; Zhou, Huixuan; Xu, Huiwen; Qu, Zhiyong; Guo, Mengqi; Wang, Fugang; Zhong, You; Gu, Linni; Liang, Xiaoyun; Sa, Zhihong; Wang, Xiaohua; Tian, Donghua

    2015-05-05

    In 2009, health-care reform was launched to achieve universal health coverage in China. A good understanding of how China's health reforms are influencing village doctors' income structure will assist authorities to adjust related polices and ensure that village doctors employment conditions enable them to remain motivated and productive. This study aimed to investigate the village doctors' income structure and analyse how these health policies influenced it. Based on a review of the previous literature and qualitative study, village doctors' income structure was depicted and analysed. A qualitative study was conducted in six counties of six provinces in China from August 2013 to January 2014. Forty-nine village doctors participated in in-depth interviews designed to document their income structure and its influencing factors. The themes and subthemes of key factors influencing village doctors' income structure were analysed and determined by a thematic analysis approach and group discussion. Several policies launched during China's 2009 health-care reform had major impact on village doctors. The National Essential Medicines System cancelled drug mark-ups, removing their primary source of income. The government implemented a series of measures to compensate, including paying them to implement public health activities and provide services covered by social health insurance, but these have also changed the village doctors' role. Moreover, integrated management of village doctors' activities by township-level staff has reduced their independence, and different counties' economic status and health reform processes have also led to inconsistencies in village doctors' payment. These changes have dramatically reduced village doctors' income and employment satisfaction. The health-care reform policies have had lasting impacts on village doctors' income structure since the policies' implementation in 2009. The village doctors have to rely on the salaries and subsidies from

  17. Fruit Flies Help Human Sleep Research

    Science.gov (United States)

    ... like us, without enough sleep, flies feel the effects of sleep deprivation. Cirelli has shown that they are a good model for researching human sleep. She has found fruit fly genes that seem to have a powerful effect on sleep. In time, her research could lead ...

  18. Transaction Management in Service-Oriented Systems : Requirements and a Proposal

    NARCIS (Netherlands)

    Sun, Chang-ai; Khoury, Elie el; Aiello, Marco

    2011-01-01

    Service-Oriented Computing (SOC) is becoming the mainstream development paradigm of applications over the Internet, taking advantage of remote independent functionalities. The cornerstone of SOC’s success lies in the potential advantage of composing services on the fly. When the control over the

  19. Pilot oriental fruit fly management program in Guimaras island

    International Nuclear Information System (INIS)

    Manoto, E.C.; Obra, G.B.; Resilva, S.S.; Reyes, M.R.; Golez, H.G.; Covacha, S.A.; Bignayan, H.G.; Gaitan, E.G.; Zamora, N.F.; Maranon, R.P.

    1999-01-01

    The pilot project on the integrated fruit fly management program based on sterile insect technique (SIT) was conducted in Guimaras island. The first island-wide male annihilation treatment (MAT) was implemented from February to October 1997. A total of 6 applications consisting of 525,534 pieces of lured particle board squares (PBS) were distributed in Guimaras both by aerial and ground applications. There was a significant reduction in fruit fly population indicating fruit fly suppression through MAT. However, MAT only reduces the male fruit fly density so many fruits were still found infested with fruit flies. Hence, biweekly releases of sterile flies were conducted from November 1997 to April 1998. About 91.74 million sterile pupae were sent by the Philippine Nuclear Research Institute (PNRI) to Guimaras. A total of 34,490,888 sterile flies were released by aerial applications and 12,632,163 sterile flies were released by ground applications. An increase in the S/N ratio was observed from 0.37 in December 1997 to 4.19 in April 1998. However, since the eradication phase was discontinued due to budgetary constraints, the required S/N ratio of more than 10 for a successful application of SIT was not achieved. A second series of MAT application were again conducted from May to September 1998. A total of 4 applications consisting of 357,650 pcs. of lured PBS were distributed throughout the island. Interestingly, the results of fruit fly density estimation before (1995) and after application (1998) of MAT and SIT using Lincoln method showed that the number of fruit flies per hectare was significantly reduced in all areas in Guimaras. Continues biweekly releases of 25 million flies therefore have to be undertaken to eradicate the remaining population. (Author)

  20. Slaves of the state – medical internship and community service in ...

    African Journals Online (AJOL)

    Owing to a chronic shortage of medical staff in South Africa, sleep-deprived medical interns and community service doctors work up to 200 hours of overtime per month under the state's commuted overtime policy. Nurses moonlight in circumvention of the Basic Conditions of Employment Act. For trainee doctors, overtime ...

  1. The use of fly larvae for organic waste treatment.

    Science.gov (United States)

    Čičková, Helena; Newton, G Larry; Lacy, R Curt; Kozánek, Milan

    2015-01-01

    The idea of using fly larvae for processing of organic waste was proposed almost 100 years ago. Since then, numerous laboratory studies have shown that several fly species are well suited for biodegradation of organic waste, with the house fly (Musca domestica L.) and the black soldier fly (Hermetia illucens L.) being the most extensively studied insects for this purpose. House fly larvae develop well in manure of animals fed a mixed diet, while black soldier fly larvae accept a greater variety of decaying organic matter. Blow fly and flesh fly maggots are better suited for biodegradation of meat processing waste. The larvae of these insects have been successfully used to reduce mass of animal manure, fecal sludge, municipal waste, food scrapes, restaurant and market waste, as well as plant residues left after oil extraction. Higher yields of larvae are produced on nutrient-rich wastes (meat processing waste, food waste) than on manure or plant residues. Larvae may be used as animal feed or for production of secondary products (biodiesel, biologically active substances). Waste residue becomes valuable fertilizer. During biodegradation the temperature of the substrate rises, pH changes from neutral to alkaline, ammonia release increases, and moisture decreases. Microbial load of some pathogens can be substantially reduced. Both larvae and digested residue may require further treatment to eliminate pathogens. Facilities utilizing natural fly populations, as well as pilot and full-scale plants with laboratory-reared fly populations have been shown to be effective and economically feasible. The major obstacles associated with the production of fly larvae from organic waste on an industrial scale seem to be technological aspects of scaling-up the production capacity, insufficient knowledge of fly biology necessary to produce large amounts of eggs, and current legislation. Technological innovations could greatly improve performance of the biodegradation facilities and

  2. Doctoral Education in Nursing: Future Directions

    Science.gov (United States)

    Downs, Florence S.

    1978-01-01

    Problems that confront nursing education and the quality of doctoral preparation are discussed in this article and include the steep rise in requests from nurses for admission into doctoral programs and tight university budgets; other concerns are the development of scholars and sharing research findings. (TA)

  3. A New Flying Wire System for the Tevatron

    Science.gov (United States)

    Blokland, Willem; Dey, Joseph; Vogel, Greg

    1997-05-01

    A new Flying Wires system replaces the old system to enhance the analysis of the beam emittance, improve the reliability, and handle the upcoming upgrades of the Tevatron. New VME data acquisition modules and timing modules allow for more bunches to be sampled more precisely. The programming language LabVIEW, running on a Macintosh computer, controls the VME modules and the nuLogic motion board that flies the wires. LabVIEW also analyzes and stores the data, and handles local and remote commands. The new system flies three wires and fits profiles of 72 bunches to a gaussian function within two seconds. A new console application operates the flying wires from any control console. This paper discusses the hardware and software setup, the capabilities and measurement results of the new Flying Wires system.

  4. Oblique-Flying-Wing Supersonic Transport Airplane

    Science.gov (United States)

    Van Der Velden, Alexander J. M.

    1992-01-01

    Oblique-flying-wing supersonic airplane proposed as possible alternative to B747B (or equivalent). Tranports passengers and cargo as fast as twice speed of sound at same cost as current subsonic transports. Flies at same holding speeds as present supersonic transports but requires only half takeoff distance.

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

    Science.gov (United States)

    Stanton, Josephine; Randal, Patte

    2016-05-20

    To better understand the complexities of developing an effective psychiatrist-patient relationship when both people involved are doctors. In-depth, semistructured interviews were conducted with 11 doctors with experiences as patients of psychiatrists (DPs) and eight psychiatrists with experience of treating doctors (TPs). A thematic analysis was undertaken. The medical culture of unrealistically high standards with limited room for vulnerability and fallibility, vigilance for judgment and valuing clinical over personal knowledge affected both people in the relationship. DPs struggled with the contradictions involved in entering the patient role but tried hard to be good patients. They wanted guidance but found it hard to accept and seldom communicated dissatisfaction or disagreement to their TPs. They described widely varying responses to diagnosis and treatment within the biomedical model. TPs described enjoyment and satisfaction and extreme challenge in engaging with TPs. Despite focusing on providing ordinary care they described providing extra care in many ways. This study brings forward important issues when a psychiatrist is building a therapeutic relationship with another doctor. These are also likely to arise with other people and contribute to making truly patient-centred 'ordinary care' a hard ideal to fulfil. They include: (1) doctors' sense of ourselves as invincible, (2) TPs' sense of personal connection to, and identity with, DPs, (3) having extensive medical knowledge and (4) striving to be good patients. We need to make these issues explicit and enable the DP (or other patients) to tell their story and speak about their experience of the consultation so that any potential rupture in the therapeutic relationship can be addressed early. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. Mais Médicos program: provision of medical doctors in rural, remote and socially vulnerable areas of Brazil, 2013-2014.

    Science.gov (United States)

    Pereira, Lucélia L; Santos, Leonor M P; Santos, Wallace; Oliveira, Aimê; Rattner, Daphne

    2016-01-01

    The Mais Médicos program was introduced in 2013 with the aim of reducing the shortage of doctors in priority regions and diminishing regional inequalities in health. One of the strategies has been to offer 3-year contracts for doctors to work in primary healthcare services in small towns, inland, rural, remote, and socially vulnerable areas. This report describes the program's implementation and the allocation of doctors to these target areas in 2014. To describe the provision of doctors in the first year of implementation, we compared the doctor-to-population ratio in the 5570 municipalities of Brazil before and after the program, based on the Federal Board of Medicine database (2013), and the official dataset provided by the Ministry of Health (2014). In its first public call (July 2013) 3511 municipalities joined the Mais Médicos program, requesting a total of 15 460 doctors; although the program prioritizes the recruitment of Brazilians, only 1096 nationals enrolled and were hired, together with 522 foreign doctors. As a consequence, an international cooperation agreement was set in place to recruit Cuban doctors. In 12 months the program recruited 14 462 doctors: 79.0% Cubans, 15.9% Brazilians and 5.1% of other nationalities, covering 93.5% of the doctors demanded; they were assigned to all the 3785 municipalities enrolled. The study reveals a major decrease in the number of municipalities with fewer than 0.1 doctors per thousand inhabitants, which dropped from 374 in 2013 to 95 in 2014 (75% reduction). Of the total, 294 doctors were sent to work in the country's 34 Indigenous Health Districts (100% coverage) and 3390 doctors were deployed in municipalities containing certified rural maroon communities (formed centuries ago by runaway slaves). After 1 year of implementation, the municipalities with maroon communities with less than 0.1 doctors per thousand inhabitants were reduced by 87% in the poorest north region. More than 30% of municipalities with

  7. The seaweed fly (Coelopidae) can facilitate environmental survival and transmission of E. coli O157 at sandy beaches.

    Science.gov (United States)

    Swinscoe, Isobel; Oliver, David M; Gilburn, Andre S; Quilliam, Richard S

    2018-06-19

    The sustainable management of recreational beaches is essential for minimising risk of human exposure to microbial pathogens whilst simultaneously maintaining valuable ecosystem services. Decaying seaweed on public beaches is gaining recognition as a substrate for microbial contamination, and is a potentially significant reservoir for human pathogens in close proximity to beach users. Closely associated with beds of decaying seaweed are dense populations of the seaweed fly (Coelopidae), which could influence the spatio-temporal fate of seaweed-associated human pathogens within beach environments. Replicated mesocosms containing seaweed inoculated with a bioluminescent strain of the zoonotic pathogen E. coli O157:H7, were used to determine the effects of two seaweed flies, Coelopa frigida and C. pilipes, on E. coli O157:H7 survival dynamics. Multiple generations of seaweed flies and their larvae significantly enhanced persistence of E. coli O157:H7 in simulated wrack habitats, demonstrating that both female and male C. frigida flies are capable of transferring E. coli O157:H7 between individual wrack beds and into the sand. Adult fly faeces can contain significant concentrations of E. coli O157:H7, which suggests they are capable of acting as biological vectors and bridge hosts between wrack habitats and other seaweed fly populations, and facilitate the persistence and dispersal of E. coli O157:H7 in sandy beach environments. This study provides the first evidence that seaweed fly populations inhabiting natural wrack beds contaminated with the human pathogen E. coli O157:H7 have the capacity to amplify the hazard source, and therefore potential transmission risk, to beach users exposed to seaweed and sand in the intertidal zone. The risk to public health from seaweed flies and decaying wrack beds is usually limited by human avoidance behaviour; however, seaweed fly migration and nuisance inland plagues in urban areas could increase human exposure routes beyond the

  8. Looking Back at Doctoral Education in South Africa

    Science.gov (United States)

    Herman, Chaya

    2017-01-01

    This article provides a quantitative picture of doctoral education in South Africa up to 2010, from the time the first doctorate was awarded in 1899. It identifies the different institutional profiles and emphases of doctoral graduation in South African universities at various periods of time in the context of economic, political and social…

  9. Acetylation Increases EWS-FLI1 DNA Binding and Transcriptional Activity

    International Nuclear Information System (INIS)

    Schlottmann, Silke; Erkizan, Hayriye V.; Barber-Rotenberg, Julie S.; Knights, Chad; Cheema, Amrita; Üren, Aykut; Avantaggiati, Maria L.; Toretsky, Jeffrey A.

    2012-01-01

    Ewing Sarcoma (ES) is associated with a balanced chromosomal translocation that in most cases leads to the expression of the oncogenic fusion protein and transcription factor EWS-FLI1. EWS-FLI1 has been shown to be crucial for ES cell survival and tumor growth. However, its regulation is still enigmatic. To date, no functionally significant post-translational modifications of EWS-FLI1 have been shown. Since ES are sensitive to histone deacetylase inhibitors (HDI), and these inhibitors are advancing in clinical trials, we sought to identify if EWS-FLI1 is directly acetylated. We convincingly show acetylation of the C-terminal FLI1 (FLI1-CTD) domain, which is the DNA binding domain of EWS-FLI1. In vitro acetylation studies showed that acetylated FLI1-CTD has higher DNA binding activity than the non-acetylated protein. Over-expression of PCAF or treatment with HDI increased the transcriptional activity of EWS-FLI1, when co-expressed in Cos7 cells. However, our data that evaluates the acetylation of full-length EWS-FLI1 in ES cells remains unclear, despite creating acetylation specific antibodies to four potential acetylation sites. We conclude that EWS-FLI1 may either gain access to chromatin as a result of histone acetylation or undergo regulation by direct acetylation. These data should be considered when patients are treated with HDAC inhibitors. Further investigation of this phenomenon will reveal if this potential acetylation has an impact on tumor response.

  10. Quantitative Preparation in Doctoral Education Programs: A Mixed-Methods Study of Doctoral Student Perspectives on their Quantitative Training

    Directory of Open Access Journals (Sweden)

    Sarah L Ferguson

    2017-07-01

    Full Text Available Aim/Purpose: The purpose of the current study is to explore student perceptions of their own doctoral-level education and quantitative proficiency. Background: The challenges of preparing doctoral students in education have been discussed in the literature, but largely from the perspective of university faculty and program administrators. The current study directly explores the student voice on this issue. Methodology: Utilizing a sequential explanatory mixed-methods research design, the present study seeks to better understand doctoral-level education students’ perceptions of their quantitative methods training at a large public university in the southwestern United States. Findings: Results from both phases present the need for more application and consistency in doctoral-level quantitative courses. Additionally, there was a consistent theme of internal motivation in the responses, suggesting students perceive their quantitative training to be valuable beyond their personal interest in the topic. Recommendations for Practitioners: Quantitative methods instructors should emphasize practice in their quantitative courses and consider providing additional support for students through the inclusion of lab sections, tutoring, and/or differentiation. Pre-testing statistical ability at the start of a course is also suggested to better meet student needs. Impact on Society: The ultimate goal of quantitative methods in doctoral education is to produce high-quality educational researchers who are prepared to apply their knowledge to problems and research in education. Results of the present study can inform faculty and administrator decisions in doctoral education to best support this goal. Future Research: Using the student perspectives presented in the present study, future researchers should continue to explore effective instructional strategies and curriculum design within education doctoral programs. The inclusion of student voice can strengthen

  11. Non-European Union doctors in the National Health Service: why, when and how do they come to the United Kingdom of Great Britain and Northern Ireland?

    Directory of Open Access Journals (Sweden)

    Jude Edward B

    2007-02-01

    Full Text Available Abstract Background As many as 30% of doctors working for the National Health System (NHS of the United Kingdom of Great Britain and Northern Ireland (UK have obtained their primary qualifications from a country outside the European Union. However, factors driving this migration of doctors to the UK merit continuing exploration. Our objective was to obtain training and employment profile of UK doctors who obtained their primary medical qualification outside the European Union (non-European doctors and to assess self-reported reasons for their migration. Methods We conducted an online survey of non-European doctors using a pre-validated questionnaire. Results One thousand six hundred and nineteen doctors of 26 different nationalities completed the survey. Of the respondents, 90.1% were from India and over three-quarters migrated to the UK mainly for 'training'. Other reasons cited were 'better pay' (7.2%, 'better work environment' (7.1% and 'having family and friends in the UK' (2.8%. Many of the respondents have been in the UK for more than a year (88.8%, with 31.3% having spent more than 3 years gaining experience of working in the NHS. Most respondents believe they will be affected by recent changes to UK immigration policy (86.6%, few report that they would be unaffected (3.7% and the rest are unsure (9.8%. Conclusion The primary reason for many non-European doctors to migrate to the UK is for training within the NHS. Secondary reasons like better pay, better work environment and having friends and family in the UK also play a role in attracting these doctors, predominantly from the Indian subcontinent and other British Commonwealth countries.

  12. Stabilization of Fly Ash Deposits through Selected Cereal Crops

    Directory of Open Access Journals (Sweden)

    Florica Morariu

    2012-10-01

    Full Text Available Fly ash, a waste product from burning coal in power plants, occupies important spaces and is a major harm forenvironment: water, air, soil and associated ecosystems. New deposits do not have available nutrients for plantgrowth. The study presents a process of stimulating growth of oats in deposits of fly ash, which eliminates listed.Phytostabilization of new deposit is fast after fertilization with sewage sludge-based compost in the presence/absence of native or modified volcanic tuff with grain species, Avena sativa L., and variety Lovrin 1. Experimentalstudies have shown the species adaptability to climatic conditions and a growth rate until the maturity correlated withtype of treatment of upper layers of fly ash deposit. Fly ash with sewage sludge compost treatment 50 t/hadetermined the growth with 75% of the amount of grains vs. the amount of grains harvested from untreated fly ash.Fly ash with sewage sludge compost mixed with modified indigenous volcanic tuff 2.5 t/ha treatment determined thegrowth with 80% vs. the amount of grains harvested from untreated fly ash. If oat straw harvested from fertilizedvariant without modified indigenous volcanic tuff increases in weight are 30% and for fertilized variant in thepresence of tuff increases in weight are 39.8% vs. quantities harvested from untreated fly ash.

  13. Stress in doctors and dentists who teach.

    Science.gov (United States)

    Rutter, Harry; Herzberg, Joe; Paice, Elisabeth

    2002-06-01

    To explore the relationship between a teaching role and stress in doctors and dentists who teach. Medline, PubMed, BIDS database for social sciences literature, and the ERIC database for educational literature were searched using the key words 'stress' or 'burnout' with the terms doctor, physician, dentist, teacher, lecturer, academic staff, and university staff. Other books and journals known to the authors were also used. Many studies have shown high levels of stress in doctors, dentists, teachers, and lecturers. A large number of factors are implicated, including low autonomy, work overload, and lack of congruence between power and responsibility. Doctors and dentists who take on a teaching role in addition to their clinical role may increase their levels of stress, but there is also evidence that this dual role may reduce job-related stress. Working as a doctor or dentist may entail higher levels of stress than are experienced by the general population. In some situations adding in the role of teacher reduces this stress, but more research is needed to explain this finding.

  14. Mating Reverses Actuarial Aging in Female Queensland Fruit Flies.

    Directory of Open Access Journals (Sweden)

    Sarsha Yap

    Full Text Available Animals that have a long pre-reproductive adult stage often employ mechanisms that minimize aging over this period in order to preserve reproductive lifespan. In a remarkable exception, one tephritid fruit fly exhibits substantial pre-reproductive aging but then mitigates this aging during a diet-dependent transition to the reproductive stage, after which life expectancy matches that of newly emerged flies. Here, we ascertain the role of nutrients, sexual maturation and mating in mitigation of previous aging in female Queensland fruit flies. Flies were provided one of three diets: 'sugar', 'essential', or 'yeast-sugar'. Essential diet contained sugar and micronutrients found in yeast but lacked maturation-enabling protein. At days 20 and 30, a subset of flies on the sugar diet were switched to essential or yeast-sugar diet, and some yeast-sugar fed flies were mated 10 days later. Complete mitigation of actuarial aging was only observed in flies that were switched to a yeast-sugar diet and mated, indicating that mating is key. Identifying the physiological processes associated with mating promise novel insights into repair mechanisms for aging.

  15. Epilepsy - what to ask your doctor - child

    Science.gov (United States)

    What to ask your doctor about epilepsy - child; Seizures - what to ask your doctor - child ... should I discuss with my child's teachers about epilepsy? Will my child need to take medicines during ...

  16. The Plight of the Woman Doctoral Student

    Science.gov (United States)

    Holmstrom, Engin Inel; Holmstrom, Robert W.

    1974-01-01

    This study investigated factors underlying discrimination against woman doctoral students. Analyses revealed that faculty attitudes and behavior toward woman doctoral students contributed significantly to their emotional stresses and self-doubts. (Author/NE)

  17. Surviving the Doctoral Years

    Directory of Open Access Journals (Sweden)

    Scott P. Kerlin

    1995-11-01

    Full Text Available This article probes the implications of neo-conservative public education policies for the future of the academic profession through a detailed examination of critical issues shaping contemporary doctoral education in U.S. and Canadian universities. Institutional and social factors such as financial retrenchment, declining support for affirmative action, downward economic mobility, a weak academic labor market for tenure-track faculty, professional ethics in graduate education, and backlash against women's progress form the backdrop for analysis of the author's survey of current doctoral students' opinions about funding, support, the job market, and quality of learning experiences.

  18. Removal mechanism of phosphate from aqueous solution by fly ash.

    Science.gov (United States)

    Lu, S G; Bai, S Q; Zhu, L; Shan, H D

    2009-01-15

    This work studied the effectiveness of fly ash in removing phosphate from aqueous solution and its related removal mechanism. The adsorption and precipitation of phosphate by fly ash were investigated separately in order to evaluate their role in the removal of phosphate. Results showed that the removal of phosphate by fly ash was rapid. The removal percentage of phosphate in the first 5min reached 68-96% of the maximum removal of phosphate by fly ash. The removal processes of phosphate by fly ash included a fast and large removal representing precipitation, then a slower and longer removal due to adsorption. The adsorption of phosphate on fly ash could be described well by Freundlich isotherm equation. The pH and Ca2+ concentration of fly ash suspension were decreased with the addition of phosphate, which suggests that calcium phosphate precipitation is a major mechanism of the phosphate removal. Comparison of the relative contribution of the adsorption and precipitation to the total removal of phosphate by fly ash showed that the adsorption accounted for 30-34% of the total removal of phosphate, depending on the content of CaO in fly ash. XRD patterns of the fly ash before and after phosphate adsorption revealed that phosphate salt (CaHPO4 x 2H2O) was formed in the adsorption process. Therefore, the removal of phosphate by fly ash can be attributed to the formation of phosphate precipitation as a brushite and the adsorption on hydroxylated oxides. The results suggested that the use of fly ash could be a promising solution to the removal of phosphate in the wastewater treatment and pollution control.

  19. Hydrothermal treatment of municipal solid waste incineration fly ash for dioxin decomposition

    International Nuclear Information System (INIS)

    Hu, Yuyan; Zhang, Pengfei; Chen, Dezhen; Zhou, Bin; Li, Jianyi; Li, Xian-wei

    2012-01-01

    Highlights: ► The first study to apply Fe-sulfate in hydrothermal treatment of municipal solid waste incineration fly ash for dioxin decomposition. ► The first study to comprehensively evaluate the effect of hydrothermal treatment on dioxin decomposition and heavy metal stabilization in municipal solid waste incineration fly ash. ► Gaussian software chemical computational simulation was performed to investigate the mechanism of dioxin decomposition based on quantum chemistry calculation, and to support the experimental data by the calculation results. - Abstract: Hydrothermal treatment of MSWI fly ash was performed in this paper with a purpose to reduce its dioxin content. First a hydrothermal reactor was set up with a mixture of ferric sulphate and ferrous sulphate serviced as the reactant, then the effects caused by reaction conditions such as reaction temperature, pre-treatment by water-washing and reactant dosage were checked; the results showed that as a promising technology, hydrothermal treatment exhibited considerable high efficiencies in decomposition of PCDDs/PCDFs and good stabilization of heavy metals as well. Experimental results also showed that for dioxin destruction, higher reaction temperature is the most important influencing factor followed by Fe addition, and pre-treatment of raw fly ash by water-washing increased the destruction efficiencies of dioxins only very slightly. Finally with help of Gaussian software chemical computational simulation was performed to investigate the mechanism of dioxin decomposition based on quantum chemistry calculation. The calculation results were supported by the experimental data. The leaching toxicities of hydrothermal products were higher than upper limits defined in the latest Chinese standard GB 16889-2008 for sanitary landfill disposal, thus an auxiliary process is suggested after the hydrothermal treatment for heavy metal stabilization.

  20. Discrete event simulation modelling of patient service management with Arena

    Science.gov (United States)

    Guseva, Elena; Varfolomeyeva, Tatyana; Efimova, Irina; Movchan, Irina

    2018-05-01

    This paper describes the simulation modeling methodology aimed to aid in solving the practical problems of the research and analysing the complex systems. The paper gives the review of a simulation platform sand example of simulation model development with Arena 15.0 (Rockwell Automation).The provided example of the simulation model for the patient service management helps to evaluate the workload of the clinic doctors, determine the number of the general practitioners, surgeons, traumatologists and other specialized doctors required for the patient service and develop recommendations to ensure timely delivery of medical care and improve the efficiency of the clinic operation.

  1. Concussion - what to ask your doctor - child

    Science.gov (United States)

    What to ask your doctor about concussion - child; Mild brain injury - what to ask your doctor - child ... What type of symptoms or problems will my child have? Will my child have problems thinking or ...

  2. [The virtuous doctor in cinema: the final examination].

    Science.gov (United States)

    Figueroa, Gustavo

    2014-10-01

    The virtuous doctor has subscribed an oath and by subscribing to this solemn promise, he is committed to live in accordance with the purposes, obligations and virtues established in the medical profession. Cinematic art has shown only a superficial interest in complex aspects of medical profession. An exception is Ingmar Bergman's film "Wild Strawberries", where Professor Isak Borg, a widowed 76-year-old physician, is to be awarded the Doctor Jubilaris degree, 50 years after he received his doctorate at Lund University. During the trip, Isak is forced by a nightmare to reevaluate his professional life as not being a virtuous doctor.

  3. Skills and Competences of a Doctor of Engineering

    Directory of Open Access Journals (Sweden)

    Michael H. W. Hoffmann

    2011-12-01

    Full Text Available Not only in Europe but also on other continents, it is felt that a reform of the doctoral phase in tertiary education is necessary. To make this reform a success, it is necessary to first define the skills and competences of a doctor in general and of a doctor of engineering in particular to dispose of measurable criteria for the outcomes of the reform. These criteria are intended to foster not only an academic career but also careers in industry and administration, i.e. to support the careers of future chief executives. It is also presented how these skills and competences are seen by industrial companies as well as by the young Doctors of Engineering. Finally, it is discussed how existing methods might be reformed to further improve the doctoral phase at and in cooperation with universities.

  4. Newborn jaundice - what to ask your doctor

    Science.gov (United States)

    Jaundice - what to ask your doctor; What to ask your doctor about newborn jaundice ... What causes jaundice in a newborn child? How common is newborn jaundice? Will the jaundice harm my child? What are the ...

  5. Clinical reasoning of junior doctors in emergency medicine: a grounded theory study.

    Science.gov (United States)

    Adams, E; Goyder, C; Heneghan, C; Brand, L; Ajjawi, R

    2017-02-01

    Emergency medicine (EM) has a high case turnover and acuity making it a demanding clinical reasoning domain especially for junior doctors who lack experience. We aimed to better understand their clinical reasoning using dual cognition as a guiding theory. EM junior doctors were recruited from six hospitals in the south of England to participate in semi-structured interviews (n=20) and focus groups (n=17) based on recall of two recent cases. Transcripts were analysed using a grounded theory approach to identify themes and to develop a model of junior doctors' clinical reasoning in EM. Within cases, clinical reasoning occurred in three phases. In phase 1 (case framing), initial case cues and first impressions were predominantly intuitive, but checked by analytical thought and determined the urgency of clinical assessment. In phase 2 (evolving reasoning), non-analytical single cue and pattern recognitions were common which were subsequently validated by specific analytical strategies such as use of red flags. In phase 3 (ongoing uncertainty) analytical self-monitoring and reassurance strategies were used to precipitate a decision regarding discharge. We found a constant dialectic between intuitive and analytical cognition throughout the reasoning process. Our model of clinical reasoning by EM junior doctors illustrates the specific contextual manifestations of the dual cognition theory. Distinct diagnostic strategies are identified and together these give EM learners and educators a framework and vocabulary for discussion and learning about clinical reasoning. 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/.

  6. The home management of Artificial Nutrition: a survey among doctors and nurses.

    Science.gov (United States)

    Gamberi, Sara; Calamassi, Diletta; Coletta, David; Dolenti, Silvia; Valoriani, Alice; Tarquini, Roberto

    2017-08-23

    The management of Artificial Nutrition (NA), especially in the home environment (HAN) requires specific skills in order to ensure the correct therapeutic education, prevention of complications and the provision of appropriate treatment to the person. The aim of this survey was to identify the perceptions of nurses and doctors, as well as comparing to their perceived competence in NA and the gap between their perceived versus actual knowledge and management methods. This observational study was conducted in a Tuscan health region of Italy, involving 50 Home Care Services nurses and 50 general practitioners. Participants were asked to complete an online questionnaire that was constructed for purpose. The results show that for the management of the person with NA, both for doctors and for nurses show great variability in responses. Less than half of those providing care make assessments of nutritional status and dysphagia as well as the possibility of re-feeding by natural means in NA patients. Care providers expressed uncertainty as to which professional should carry out such assessments. A mismatch was also evident between the skills possessed and the self-assessments performed regarding their knowledge base of NA. Almost all of doctors of nurses indicated a desire to participate in training events relating to NA. The results highlight the need for caregivers to have specific operating protocols. The results also highlight the need to aim to work as a team, emphasizing the importance of basic communication as well as the need for clarity as to the responsibilities and roles of the professionals involved.Key words: Artificial Nutrition, Nurses, Doctors, home management, skills, training, team.

  7. The Doctor Can See You Now: A Key Stakeholder Study Into The Acceptability Of Ambulance Based Telemedicine.

    LENUS (Irish Health Repository)

    Gilligan, P

    2018-06-01

    Using telecommunications technology it would be possible to link a patient and paramedic to a Doctor in the Emergency Department (ED) at the point of first patient contact. A questionnaire-based study on telemedicine in the pre-hospital environment involving patients, paramedics, doctors and nurses in the ED, was performed to assess if they would want and accept telemedicine in pre-hospital emergency care. When asked 98.5% (55) of patients, 89% (11) of doctors, 76% (14) of nurses and 91% (42) of ambulance personnel saw the potential of an audio-visual link from the pre-hospital environment to the ED. The potential benefits were felt to be in diagnosis of time-dependent illnesses, time management, increased hospital preparedness for incoming patients and increased triage efficiency. Stakeholder enthusiasm for pre-hospital telemedicine must be met with the technological requirements to provide such a service. As noted by one patient a pre-hospital audio-visual link to the ED could be “potentially a life saving service”.

  8. Doctors' health: obstacles and enablers to returning to work.

    Science.gov (United States)

    Cohen, D; Rhydderch, M; Reading, P; Williams, S

    2015-08-01

    For doctors returning to work after absence due to ill-health or performance concerns, the obstacles can seem insurmountable. Doctors' perspectives of these obstacles have been investigated. To support them more effectively, the perspectives of organizations that interact with such doctors should also be considered. To explore the obstacles and enablers to doctors' return to work after long-term absence from the perspective of key organizations involved in assessment and support. We identified organizations operating in the field of doctors' health, well-being and performance. We conducted semi-structured, 30-45 min telephone interviews with representatives of the organizations, exploring problems that they had encountered that were experienced by doctors with health or performance concerns returning to work after absence of a month or longer. We analysed our field notes using theoretical analysis. We conducted 11 telephone interviews. Data analysis identified four key themes of obstacles and enablers to returning to work: 'communication', 'return to work', 'finance and funding' and 'relationships and engagement'. Sub-themes relating to the organization and the individual also emerged. Organizations responsible for supporting doctors back to work reported poor communication as a significant obstacle to doctors returning to work after illness. They also reported differences between specialities, employing organizations, occupational health departments and human resources in terms of knowledge and expertise in supporting doctors with complex issues. Clear communication channels, care pathways and support processes, such as workplace advocates, were perceived as strong enablers to return to work for doctors after long-term absence. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Design, aerodynamics and autonomy of the DelFly

    International Nuclear Information System (INIS)

    De Croon, G C H E; Groen, M A; De Wagter, C; Remes, B; Ruijsink, R; Van Oudheusden, B W

    2012-01-01

    One of the major challenges in robotics is to develop a fly-like robot that can autonomously fly around in unknown environments. In this paper, we discuss the current state of the DelFly project, in which we follow a top-down approach to ever smaller and more autonomous ornithopters. The presented findings concerning the design, aerodynamics and autonomy of the DelFly illustrate some of the properties of the top-down approach, which allows the identification and resolution of issues that also play a role at smaller scales. A parametric variation of the wing stiffener layout produced a 5% more power-efficient wing. An experimental aerodynamic investigation revealed that this could be associated with an improved stiffness of the wing, while further providing evidence of the vortex development during the flap cycle. The presented experiments resulted in an improvement in the generated lift, allowing the inclusion of a yaw rate gyro, pressure sensor and microcontroller onboard the DelFly. The autonomy of the DelFly is expanded by achieving (1) an improved turning logic to obtain better vision-based obstacle avoidance performance in environments with varying texture and (2) successful onboard height control based on the pressure sensor.

  10. The quality of doctoral nursing education in South Africa

    Directory of Open Access Journals (Sweden)

    Siedine K. Coetzee

    2015-07-01

    Full Text Available Background: The number of doctoral programmes in nursing has multiplied rapidly throughout the world. This has led to widespread concern about nursing doctoral education, specifically with regard to the quality of curricula and faculty, as well as to the availability of appropriate institutional resources. In South Africa, no study of these issues has been conducted at a national level. Objective: To explore and describe the quality of nursing doctoral education in South Africa from the perspectives of deans, faculty, doctoral graduates and students. Method: A cross-sectional survey design was used. All deans (N = 15; n = 12, faculty (N = 50; n = 26, doctoral graduates (N = 43; n = 26 and students (N = 106; n = 63 at South African nursing schools that offer a nursing doctoral programme (N = 16; n = 15 were invited to participate. Data were collected by means of structured email-mediated Quality of Nursing Doctoral Education surveys. Results: Overall, the graduate participants scored their programme quality most positively of all the groups and faculty scored it most negatively. All of the groups rated the quality of their doctoral programmes as good, but certain problems related to the quality of resources, students and faculty were identified. Conclusion: These evaluations, by the people directly involved in the programmes, demonstrated significant differences amongst the groups and thus provide valuable baseline data for building strategies to improve the quality of doctoral nursing education in South Africa.

  11. Leaching of assimilable silicon species from fly ash

    International Nuclear Information System (INIS)

    Piekos, R.; Paslawska, S.

    1998-01-01

    The objective of this study was to investigate the leaching of assimilable silicon species from coal fly ash with distilled water, sea waterand synthetic sea water at various fly ash/water ratios, pHs and temperatures. At the 1 g/100 ml fly ash/water ratio, less than 1 mg Si was found in 11 of aqueous slurries over the pH range 4-8 after 2 h at ambient temperature. The leaching was most effective at pH 10.5. At the fly ash/waterratio indicated, the pH of the suspensions decreased from 10.4 to 8.4 after 5days. The pH of fly ash slurries in sea water varied only slightly over time as compared with that in distilled water. Generally, the leaching of assimilable silicon species with distilled water was more intense than that with the sea water. 27 refs., 6 figs., 3 tabs

  12. Patient‑doctor relationship: The practice orientation of doctors in Kano

    African Journals Online (AJOL)

    2013-08-19

    Aug 19, 2013 ... relationship borders mainly on patients' satisfaction[12‑16] from either the .... Female. 47 (22.0). Marital status. Single. 87 (40.7). Married. 127 (59.3) ... doctors' place of work was only statistically significant in the “sharing” ...

  13. The hospital doctor in legislation and medical deontology: tension between profession and institution.

    Science.gov (United States)

    Schutyser, K

    1998-01-01

    1. Every health policy should make clear the organization of its offer of care; also, more particularly, the role of the individual professionals and their groups, as well as the role of the services and institutions, all within the chosen private, public or mixed framework. 2. Both in public law and in private law as well as in deontology, clear rules will have to be formulated concerning the relationship of doctor-patient and institution-patient; therefore also concerning the relationship of hospital-doctor. 3. It is evident that the lack of clarity frequently encountered in the Belgian and many other national legal systems with respect to these matters is unfortunately also reflected in international health law. 4. The issue of the legal relationships in the patient-doctor-hospital triangle should no longer be delayed until the catastrophic moment when medical liability should be considered. 5. Can we indeed speak of integral quality of a hospital, when it is anything but clear whether it concerns a single integrated enterprise or a roof under which two or more enterprises or entrepreneurs organize their own separate services to the clients? 6. Although the decision is a societal matter, the organisations of institutions and professionals should (continue to) play an important role in the preparation of this debate, which must bring the necessary clarity to the present relations and preferably also about the future options with respect to these relations. 7. A fundamental question, which remains to be solved for the future health policy, appears to be whether hospitals can be integrated institutions and, in the affirmative, whether they should be so. 8. The law, with priority to deontology, should formulate basic rules to clarify all possibilities in the patient-hospital-doctor triangle relationship--which is evolving into a polygon through fusion and group practices--and especially to trace out the consequences of health policy options with regard to the

  14. Is networking different with doctors working part-time? Differences in social networks of part-time and full-time doctors.

    Science.gov (United States)

    Heiligers, Phil J M; de Jong, Judith D; Groenewegen, Peter P; Hingstman, Lammert; Völker, Beate; Spreeuwenberg, Peter

    2008-10-04

    Part-time working is a growing phenomenon in medicine, which is expected to influence informal networks at work differently compared to full-time working. The opportunity to meet and build up social capital at work has offered a basis for theoretical arguments. Twenty-eight teams of medical specialists in the Netherlands, including 226 individuals participated in this study. Interviews with team representatives and individual questionnaires were used. Data were gathered on three types of networks: relationships of consulting, communication and trust. For analyses, network and multilevel applications were used. Differences between individual doctors and between teams were both analysed, taking the dependency structure of the data into account, because networks of individual doctors are not independent. Teams were divided into teams with and without doctors working part-time. Contrary to expectations we found no impact of part-time working on the size of personal networks, neither at the individual nor at the team level. The same was found regarding efficient reachability. Whereas we expected part-time doctors to choose their relations as efficiently as possible, we even found the opposite in intended relationships of trust, implying that efficiency in reaching each other was higher for full-time doctors. But we found as expected that in mixed teams with part-time doctors the frequency of regular communication was less compared to full-time teams. Furthermore, as expected the strength of the intended relationships of trust of part-time and full-time doctors was equally high. From these findings we can conclude that part-time doctors are not aiming at efficiency by limiting the size of networks or by efficient reachability, because they want to contact their colleagues directly in order to prevent from communication errors. On the other hand, together with the growth of teams, we found this strategy, focussed on reaching all colleagues, was diminishing. And our data

  15. Human resource management practices in a medical complex in the Eastern Cape, South Africa: assessing their impact on the retention of doctors.

    Science.gov (United States)

    Longmore, Bruce; Ronnie, Linda

    2014-03-26

    Human resource management (HRM) practices have the potential to influence the retention of doctors in the public health sector. To explore the key human resource (HR) practices affecting doctors in a medical complex in the Eastern Cape, South Africa. We used an open-ended questionnaire to gather data from 75 doctors in this setting. The most important HR practices were paying salaries on time and accurately, the management of documentation, communication, HR staff showing that they respected and valued the doctors, and reimbursement for conferences and special leave requests. All these practices were judged to be poorly administered. Essential HR characteristics were ranked in the following order: task competence of HR staff, accountability, general HR efficiency, occupation-specific dispensation adjustments and performance management and development system efficiency, and availability of HR staff. All these characteristics were judged to be poor. HRM practices in this Eastern Cape medical complex were inadequate and a source of frustration. This lack of efficiency could lead to further problems with regard to retaining doctors in public sector service.

  16. Pore Structure Characterization in Concrete Prepared with Carbonated Fly Ash

    Science.gov (United States)

    Sahoo, Sanjukta

    2018-03-01

    Carbon dioxide capture and storage (CCS) is a technique to address the global concern of continuously rising CO2 level in the atmosphere. Fly ash is considered as a suitable medium for CCS due to presence of metal oxides. The fly ash which has already sequestered carbon dioxide is referred to as carbonated fly ash. Recent research reveals better durability of concretes using carbonated fly ash as part replacement of cement. In the present research pore structure characterization of the carbonated fly ash concrete has been carried out. Mercury Intrusion porosimetry test has been conducted on control concrete and concrete specimens using fly ash and carbonated fly ash at replacement levels of 25% and 40%. The specimens have been water cured for 28 days and 90 days. It is observed that porosity reduction rate is more pronounced in carbonated fly ash concrete compared to control concrete at higher water curing age. Correlation analysis is also carried out which indicates moderately linear relationship between porosity % and pore distribution with particle size and water curing.

  17. An overview of quarantine for fruit flies

    International Nuclear Information System (INIS)

    Frampton, E.R.

    2000-01-01

    What is meant by 'quarantine for fruit flies'? The Collins dictionary describes 'quarantine' as a period of isolation or detention, especially of persons or animals arriving from abroad, to prevent the spread of disease. In providing an overview of quarantine for fruit flies, a broader definition needs to be applied, that is, the combination of activities required to maintain the fruit fly status of a particular geographical area - perhaps better referred to as a 'quarantine system'. Familiarity with New Zealand's quarantine system for fruit flies (Diptera: Tephritidae) provides a useful basis for subsequent comparison with other countries' systems where some fruit fly species may be present. But, why have 'quarantine for fruit flies'? The multivoltine life history of many species. combined with a relatively long-lived adult stage and highly fecund females, results in a high potential for rapid population increase (Bateman 1979, Fletcher 1987). These factors and the close association of fruit flies with harvested fruit or vegetables explain the high quarantine profile of these insects. However, there is no international requirement for a country to have a quarantine system and unless there are natural quarantine barriers (e.g., mountain range, oceans, deserts) that can be utilised, effective quarantine by an individual country may be an impossible task. The implementation of a successful quarantine system is very expensive and therefore, it would be expected that any benefits attained outweigh the costs (Ivess 1998). Ivess (1998) listed the following benefits from the implementation of an effective quarantine system: minimising production costs (including post harvest treatments), maintaining competitive advantages for market access due to the ongoing freedom from particular pests of quarantine significance, an environment free from many pests harmful to plant health, the maintenance of ecosystems

  18. 42 CFR 410.73 - Clinical social worker services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Clinical social worker services. 410.73 Section 410... Clinical social worker services. (a) Definition: clinical social worker. For purposes of this part, a clinical social worker is defined as an individual who— (1) Possesses a master's or doctor's degree in...

  19. Investigation of gliding flight by flying fish

    Science.gov (United States)

    Park, Hyungmin; Jeon, Woo-Pyung; Choi, Haecheon

    2006-11-01

    The most successful flight capability of fish is observed in the flying fish. Furthermore, despite the difference between two medium (air and water), the flying fish is well evolved to have an excellent gliding performance as well as fast swimming capability. In this study, flying fish's morphological adaptation to gliding flight is experimentally investigated using dry-mounted darkedged-wing flying fish, Cypselurus Hiraii. Specifically, we examine the effects of the pectoral and pelvic fins on the aerodynamic performance considering (i) both pectoral and pelvic fins, (ii) pectoral fins only, and (iii) body only with both fins folded. Varying the attack angle, we measure the lift, drag and pitching moment at the free-stream velocity of 12m/s for each case. Case (i) has higher lift-to-drag ratio (i.e. longer gliding distance) and more enhanced longitudinal static stability than case (ii). However, the lift coefficient is smaller for case (i) than for case (ii), indicating that the pelvic fins are not so beneficial for wing loading. The gliding performance of flying fish is compared with those of other fliers and is found to be similar to those of insects such as the butterfly and fruitfly.

  20. Critical and Creative Thinking Nexus: Learning Experiences of Doctoral Students

    Science.gov (United States)

    Brodin, Eva M.

    2016-01-01

    Critical and creative thinking constitute important learning outcomes at doctoral level across the world. While the literature on doctoral education illuminates this matter through the lens of experienced senior researchers, the doctoral students' own perspective is missing. Based upon interviews with 14 doctoral students from four disciplines at…

  1. Making clinical academic careers more attractive: views from questionnaire surveys of senior UK doctors.

    Science.gov (United States)

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

    2015-08-01

    To report on doctors' reasons, as expressed to our research group, for choosing academic careers and on factors that would make a career in clinical academic medicine more attractive to them. Postal, email and web questionnaires. UK. A total of 6936 UK-trained doctors who graduated in 1996, 1999 and 2000. Open-ended comments about a career in clinical academic medicine. Of doctors who provided reasons for pursuing a long-term career in clinical academic medicine, the main reasons were enjoyment of academic work and personal satisfaction, whether expressed directly in those terms, or in terms of intellectual stimulation, enjoyment of research, teaching and the advancement of medicine, and the job being more varied than and preferable to clinical work alone. Doctors' suggestions for making clinical academic medicine more attractive included improved pay and job security, better funding of research, greater availability of academic posts, more dedicated time for research (and less service work) and more support and mentoring. Women were more likely than men to prioritise flexible working hours and part-time posts. Medical schools could provide more information, as part of student teaching, about the opportunities for and realities of a career in clinical academic medicine. Women, in particular, commented that they lacked the role models and information which would encourage them to consider seriously an academic career. Employers could increase academic opportunities by allowing more time for teaching, research and study and should assess whether job plans make adequate allowance for academic work.

  2. PROVISION OF THE DUTY SERVICE IN GYNECOLOGY AND OBSTETRICS IN SLOVENIA

    Directory of Open Access Journals (Sweden)

    Iztok Takač

    2018-02-01

    Full Text Available Background: Duty service of gyecology and obstetrics in Slovenia is organized on the regional basis and consists of ten regional hospitals, two hospitals for gynecology and obstetrics and two university clinical centres. Methods: Heads of hospitals where duty service is performed, have answered the questionnaires about the doctors who perform duty service. Results: Specialists and trainees in gynecology and obstetrics perform duty service on 21 posts and on 6 on-call posts. In Slovenia there are 287 active specialists in gynecology and obstetrics. 139 (48.4% among them are active on the primary level (outpatient clinics and 148 (51.6% in the hospitals and both clinical centres. Among hospital gynecologists and obstetricians 54 (36.5% of them are older than 55 years. Conclusions: Duty service of gyecology and obstetrics in Slovenia does not meet legislation criteria regard- ing doctors’ work time. Adequate changes for increasing the number of available doctors for duty service are proposed.

  3. Encouraging formative assessments of leadership for foundation doctors.

    Science.gov (United States)

    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.

  4. Doctor's Orders

    Institute of Scientific and Technical Information of China (English)

    VALERIE SARTOR

    2010-01-01

    @@ "To become a doctor is like becoming a bomb expert:It takes a long time to learn this skill; you must use care and intuition; and you must understand that your work has grave consequences for those around you,"said Amgalan Gamazhapov,an advanced medical student who studies traditional Chinese and Mongolian medicine at the Inner Mongolia Medical University.

  5. Distinction of Fly Artifacts from Human Blood using Immunodetection.

    Science.gov (United States)

    Rivers, David B; Acca, Gillian; Fink, Marc; Brogan, Rebecca; Chen, Dorothy; Schoeffield, Andrew

    2018-02-21

    Insect stains produced by necrophagous flies are indistinguishable morphologically from human bloodstains. At present, no diagnostic tests exist to overcome this deficiency. As the first step toward developing a chemical test to recognize fly artifacts, polyclonal antisera were generated in rats against three distinct antigenic sequences of fly cathepsin D-like proteinase, an enzyme that is structurally distinct in cyclorrhaphous Diptera from other animals. The resulting rat antisera bound to artifacts produced by Protophormia terraenovae and synthetic peptides used to generate the polyclonal antisera, but not with any type of mammalian blood tested in immunoassays. Among the three antisera, anti-md3 serum displayed the highest reactivity for fly stains, demonstrated cross-reactivity for all synthetic peptides representing antigenic sequences of the mature fly enzyme, and bound artifacts originating from the fly digestive tract. Further work is needed to determine whether the antisera are suitable for non-laboratory conditions. © 2018 American Academy of Forensic Sciences.

  6. High Temperature Fission Chamber for He- and FLiBe-cooled Reactors

    Energy Technology Data Exchange (ETDEWEB)

    Bell, Zane W. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Giuliano, Dominic R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Holcomb, David Eugene [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Lance, Michael J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Miller, Roger G. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Warmack, Robert J. Bruce [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wilson, Dane F. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Harrison, Mark J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-01-01

    We have evaluated candidate technologies for in-core fission chambers for high-temperature reactors to monitor power level via measurements of neutron flux from start-up through full power at up to 800°C. This research is important because there are no commercially available instruments capable of operating above 550 °C. Component materials and processes were investigated for fission chambers suitable for operation at 800 °C in reactors cooled by molten fluoride salt (FLiBe) or flowing He, with an emphasis placed on sensitivity (≥ 1 cps/nv), service lifetime (2 years at full power), and resistance to direct immersion in FLiBe. The latter gives the instrument the ability to survive accidents involving breach of a thimble. The device is envisioned to be a two-gap, three-electrode instrument constructed from concentric nickel-plated alumina cylinders and using a noble gas–nitrogen fill-gas. We report the results of measurements and calculations of the response of fill gasses, impurity migration in nickel alloy, brazing of the alumina insulator, and thermodynamic calculations.

  7. Doctor-Shopping Behavior among Patients with Eye Floaters

    Directory of Open Access Journals (Sweden)

    Gow-Lieng Tseng

    2015-07-01

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

  8. Doctor-Shopping Behavior among Patients with Eye Floaters.

    Science.gov (United States)

    Tseng, Gow-Lieng; Chen, Cheng-Yu

    2015-07-13

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

  9. Find a Doctor

    Science.gov (United States)

    ... Manager Book Appointments Getting Care When on Active Duty Getting Care When Traveling What's Covered Health Care Dental Care ... Manager Book Appointments Getting Care When on Active Duty Getting Care When Traveling Bread Crumbs Home Find a Doctor ...

  10. KINETICS OF FLY ASH BENEFICIATION BY CARBON BURNOUT

    Energy Technology Data Exchange (ETDEWEB)

    Dr. Joseph N.D. Dodoo; Dr. Joseph M. Okoh

    2000-11-01

    Surface area analyses performed on fly ash samples reveal that the surface area is controlled by carbon content. The higher surface areas found in large particles are due to the presence of highly porous carbonaceous particles. Adsorption-desorption isotherms and t-plots of fly ash samples indicate that fly ash is porous. BJH Adsorption/Desorption pore size analysis reveal that pore diameters are independent of sieve size. They appear to be dependent only on the nature of the material which confers porosity. Based on the results of Brown and Dykstra (41) it is reasonable to assume that calculations of reaction rates at temperatures above 550 C were confounded by weight losses from processes other than carbon oxidation and, therefore, are not useful in determination of the temperature dependence of carbon oxidation in fly ash. The results of the present study indicate that temperatures below 550 C should be used for future studies in order to satisfactorily assess the temperature dependence of carbon oxidation in fly ash. Furthermore, it is also advisable that percent carbon determinations be performed on fly ash samples after the oxidation reactions to determine whether all carbon present in fly ash is oxidized. This will ensure that reaction rates are representative of the complete oxidation of carbon. An inverse relationship was determined between reaction rates and oxygen concentration for this study. As discussed, this may be due to volatilization of volatiles from fly ash and ease of transport of products away from the reaction sites by the action of the vacuum applied to the samples. A more accurate determination of oxygen dependence of carbon oxidation can be accomplished by the use of specialty gases containing different concentrations of oxygen which could eliminate the need to apply vacuum to the samples.

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

    Science.gov (United States)

    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

  12. Australian doctors and the visual arts. Part 5. Doctor-artists in South Australia, Tasmania, Western Australia and Queensland.

    Science.gov (United States)

    Hamilton, D G

    1986-11-17

    The contributions of Australian doctors to the visual arts are being described in a series of six articles. Work from doctors in New South Wales and Victoria has been covered previously. Now activities in South Australia, Tasmania, Western Australia, Queensland and the Northern Territory are presented.

  13. Comparison of Anastrepha ludens (Diptera: Tephritidae) Bisexual and Genetic Sexing (Tapachula-7) Strains: Effect of Hypoxia, Fly Density, Chilling Period, and Food Type on Fly Quality.

    Science.gov (United States)

    Arredondo, José; Ruiz, Lía; Hernández, Emilio; Montoya, Pablo; Díaz-Fleischer, Francisco

    2016-04-01

    The use of genetic sexing strain (GSS) insects in the sterile insect technique (SIT) makes necessary the revision of quality parameters of some stressful steps used during the packing process for aerial release because of possible differences in tolerance between fly strains. Here, we determined the effect of three periods of hypoxia (12, 24, and 36 h at pupal stage), three cage densities (1.0, 1.3, and 1.5 flies/cm2), two different foods (protein/sugar (1/24) and Mubarqui), and three chilling times (20 min [control], 90, and 180 min) on the quality parameters of flies of two Anastrepha ludens (Loew) strains (bisexual and GSS Tapachula-7). In general, the response to stressful conditions of both fly strains was qualitatively equivalent but quantitatively different, as flies of both strains responded equally to the stressful factors; however, flies of Tapachula-7 exhibited lower quality parameters than the control flies. Thus, hypoxia affected the flying ability but not the emergence or longevity of flies. The food type affected the adult weight; protein/sugar produced heavier flies that also survived longer and had a greater mating propensity. Flies under the lowest density were better fliers that those at the other two densities. Increasing chilling time reduced flight ability but not longevity or mating propensity. The implications of these findings for the use of A. ludens GSS in SIT programs are discussed herein.

  14. Training for the future NHS: training junior doctors in the United Kingdom within the 48-hour European working time directive.

    Science.gov (United States)

    Datta, Shreelatta T; Davies, Sally J

    2014-01-01

    Since August 2009, the National Health Service of the United Kingdom has faced the challenge of delivering training for junior doctors within a 48-hour working week, as stipulated by the European Working Time Directive and legislated in the UK by the Working Time Regulations 1998. Since that time, widespread concern has been expressed about the impact of restricted duty hours on the quality of postgraduate medical training in the UK, particularly in the "craft" specialties--that is, those disciplines in which trainees develop practical skills that are best learned through direct experience with patients. At the same time, specialist training in the UK has experienced considerable change since 2007 with the introduction of competency-based specialty curricula, workplace-based assessment, and the annual review of competency progression. The challenges presented by the reduction of duty hours include increased pressure on doctors-in-training to provide service during evening and overnight hours, reduced interaction with supervisors, and reduced opportunities for learning. This paper explores these challenges and proposes potential responses with respect to the reorganization of training and service provision.

  15. Gender variations in specialties among medical doctors working in ...

    African Journals Online (AJOL)

    Background: Gender variations exist in the choice of specialties among ... as it affects the distribution of doctors in public health institutions and patient care. ... For female doctors,pediatrics was the topmost specialty (25%) followed by ... Keywords: Gender variation,Specialties,Doctors,Public healthcare,Health workforce ...

  16. Evaluation of the mechanical properties of class-F fly ash

    Energy Technology Data Exchange (ETDEWEB)

    Kim, B.; Prezzi, M. [Purdue University, West Lafayette, IN (United States)

    2008-07-01

    Coal-burning power plants in the United States (US) generate more than 70 million tons of fly ash as a by-product annually. Recycling large volumes of fly ash in geotechnical applications may offer an attractive alternative to the disposal problem as most of it is currently dumped in ponds or landfills. Class-F fly ash, resulting from burning of bituminous or anthracite coals, is the most common type of fly ash in the US. In the present study, the mechanical characteristics (compaction response, compressibility, and shear strength) of class-F fly ash were investigated by performing various laboratory tests (compaction test, one-dimensional compression test, direct shear test and consolidated-drained triaxial compression test) on fly ash samples collected from three power plants in the state of Indiana (US). Test results have shown that despite some morphological differences, class-F fly ash exhibits mechanical properties that are, in general, comparable to those observed in natural sandy soils.

  17. Fly ash. Quality recycling material

    Energy Technology Data Exchange (ETDEWEB)

    Blomster, D.; Leisio, C.

    1996-11-01

    Imatran Voima`s coal-fired power plants not only generate power and heat but also produce fly ash which is suitable raw material for recycling. This material for recycling is produced in the flue gas cleaning process. It is economical and, thanks to close quality control, is suitable for use as a raw material in the building materials industry, in asphalt production, and in earthworks. Structures made from fly ash are also safe from an environmental point of view. (orig.)

  18. Development and oviposition preference of house flies and stable flies (Diptera: Muscidae) in six substrates from Florida equine facilities

    Science.gov (United States)

    House flies, Musca domestica L., and stable flies, Stomoxys calcitrans (L.), (Diptera: Muscidae), common pests on equine facilities, were studied in the laboratory to determine their oviposition preferences and larval development on six substrates commonly found on equine facilities. The substrates...

  19. INCAS—Interactive Teleconsultation Network for Worldwide Healthcare Services

    Science.gov (United States)

    Castelli, A.; Colombo, C.; Garlaschelli, A.; Pepe, G.

    2001-01-01

    The INCAS Project arises from the needs of an Italian oil company in order to support the doctors responsible for the healthcare in remote drilling sites. The INCAS telemedicine1 system implements a prototype of teleconsultation medical service allowing for the interactive on-line connection with Italian healthcare reference centres in order to: • provide support to the expatriate doctor with the diagnoses and treatment of routine complaints; • contribute to the general improvement of healthcare in remote areas.

  20. The Doctorate in Chemistry. Carnegie Essays on the Doctorate: Chemistry.

    Science.gov (United States)

    Breslow, Ronald

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

  1. Tetrameric structure of the flagellar cap protein FliD from Serratia marcescens.

    Science.gov (United States)

    Cho, So Yeon; Song, Wan Seok; Hong, Ho Jeong; Lee, Geun-Shik; Kang, Seung Goo; Ko, Hyun-Jeong; Kim, Pyeung-Hyeun; Yoon, Sung-Il

    2017-07-15

    Bacterial motility is provided by the flagellum. FliD is located at the distal end of the flagellum and plays a key role in the insertion of each flagellin protein at the growing tip of the flagellar filament. Because FliD functions as an oligomer, the determination of the oligomeric state of FliD is critical to understanding the molecular mechanism of FliD-mediated flagellar growth. FliD has been shown to adopt a pentameric or a hexameric structure depending on the bacterial species. Here, we report another distinct oligomeric form of FliD based on structural and biochemical studies. The crystal structures of the D2 and D3 domains of Serratia marcescens FliD (smFliD) were determined in two crystal forms and together revealed that smFliD assembles into a tetrameric architecture that resembles a four-pointed star plate. smFliD tetramerization was also confirmed in solution by cross-linking experiments. Although smFliD oligomerizes in a head-to-tail orientation using a common primary binding interface between the D2 and D3' domains (the prime denotes the second subunit in the oligomer) similarly to other FliD orthologs, the smFliD tetramer diverges to present a unique secondary D2-D2' binding interface. Our structure-based comparative analysis of FliD suggests that bacteria have developed diverse species-specific oligomeric forms of FliD that range from tetramers to hexamers for flagellar growth. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Eradication of the melon fly, Bactrocera cucurbitae Coquillett, by mass release of sterile flies in Okinawa prefecture, Japan

    International Nuclear Information System (INIS)

    Kakinohana, H.; Kuba, H.; Kohama, T.; Kinjo, K.; Taniguchi, M.; Nakamori, H.; Tanahara, A.; Sokei, Y.

    1997-01-01

    In 1972, MAFF, Japan and the Okinawa Prefectural Government initiated an experimental eradication project of the melon fly from Kume Island, Okinawa Prefecture, Japan using the sterile insect technique (SIT). Following the successful eradication on Kume Island in 1978, large scale SIT was started to eradicate the melon fly on the 3 groups of islands, Miyako, Okinawa and Yaeyama of Okinawa Prefecture, Japan in 1984, 1986 and 1989, and eradication was achieved in 1987, 1990 and 1993, respectively. For the successful eradication on Miyako, Okinawa and Yaeyama groups of islands, about 6,340, 30,940 and 15,440 million sterile melon flies were released, respectively

  3. Producing zeolites from fly ash

    International Nuclear Information System (INIS)

    Rayalu, S.; Labhestwar, N.K.; Biniwale, R.B.; Udhoji, J.S.; Meshram, S.U.; Khanna, P.

    1998-01-01

    Fly ash has virtually become a menace of thermal power generation, leading to its devastating effects on the environment. Development of alternate methods of its disposal - especially those with recourse to recovery of valuable materials-has thus become imperative. This paper deals with the utilisation of fly ash for the production of high value-added products, viz., commercial grade zeolites. The physico-chemical and morphological characteristics of fly ash based Zeolite-A (FAZ-A) compares well with commercial Zeolite-A. High calcium binding capacity, appropriate particle/pore size and other detergency characteristics of FAZ-A brings forth its potential as a substitute for phosphatic detergent builder. The technology is extremely versatile, and other products like Zeolite-X, Zeolite-Y, sodalite and mordenite are also amenable for cost effective production with modifications in certain reaction parameters. Low temperature operations, ready availability of major raw materials, simplicity of process and recycling of unused reactants and process water are special features of the process. (author)

  4. Episodic radiations in the fly tree of life

    DEFF Research Database (Denmark)

    Wiegmann, Brian M.; Trautwein, Michelle D.; Winkler, Isaac S.

    2011-01-01

    Flies are one of four superradiations of insects (along with beetles, wasps, and moths) that account for the majority of animal life on Earth. Diptera includes species known for their ubiquity (Musca domestica house fly), their role as pests (Anopheles gambiae malaria mosquito), and their value......), and Schizophora (65 Ma)—and a number of life history transitions to hematophagy, phytophagy, and parasitism in the history of fly evolution over 260 million y....

  5. 'You can't be a person and a doctor': the work-life balance of doctors in training-a qualitative study.

    Science.gov (United States)

    Rich, Antonia; Viney, Rowena; Needleman, Sarah; Griffin, Ann; Woolf, Katherine

    2016-12-02

    Investigate the work-life balance of doctors in training in the UK from the perspectives of trainers and trainees. Qualitative semistructured focus groups and interviews with trainees and trainers. Postgraduate medical training in London, Yorkshire and Humber, Kent, Surrey and Sussex, and Wales during the junior doctor contract dispute at the end of 2015. Part of a larger General Medical Council study about the fairness of postgraduate medical training. 96 trainees and 41 trainers. Trainees comprised UK graduates and International Medical Graduates, across all stages of training in 6 specialties (General Practice, Medicine, Obstetrics and Gynaecology, Psychiatry, Radiology, Surgery) and Foundation. Postgraduate training was characterised by work-life imbalance. Long hours at work were typically supplemented with revision and completion of the e-portfolio. Trainees regularly moved workplaces which could disrupt their personal lives and sometimes led to separation from friends and family. This made it challenging to cope with personal pressures, the stresses of which could then impinge on learning and training, while also leaving trainees with a lack of social support outside work to buffer against the considerable stresses of training. Low morale and harm to well-being resulted in some trainees feeling dehumanised. Work-life imbalance was particularly severe for those with children and especially women who faced a lack of less-than-full-time positions and discriminatory attitudes. Female trainees frequently talked about having to choose a specialty they felt was more conducive to a work-life balance such as General Practice. The proposed junior doctor contract was felt to exacerbate existing problems. A lack of work-life balance in postgraduate medical training negatively impacted on trainees' learning and well-being. Women with children were particularly affected, suggesting this group would benefit the greatest from changes to improve the work-life balance of

  6. Requirements for satisfactory flying qualities of airplanes

    Science.gov (United States)

    Gilruth, R R

    1943-01-01

    Report discusses the results of an analysis of available data to determine what measured characteristics are significant in defining satisfactory flying qualities, what characteristics are reasonable to require of an airplane, and what influence the various design features have on the observed flying qualities.

  7. Area occupancy and detection probabilities of the Virginia northern flying squirrel (Glaucomys sabrinus fuscus) using nest-box surveys

    Science.gov (United States)

    W. Mark Ford; Kurtis R. Moseley; Craig W. Stihler; John W. Edwards

    2010-01-01

    Concomitant with the delisting of the endangered Virginia northern flying squirrel (Glaucomys sabrinus fuscus) in 2008, the U.S. Fish and Wildlife Service mandated a 10-year post-delisting monitoring effort to ensure that subspecies population and distribution stability will persist following a changed regulatory status. Although criticized for the...

  8. Heavy metals in MSW incineration fly ashes

    DEFF Research Database (Denmark)

    Ferreira, Celia; Ribeiro, Alexandra B.; Ottosen, Lisbeth M.

    2003-01-01

    Incineration is a common solution for dealing with the increasing amount of municipal solid waste (MSW). During the process, the heavy metals initially present in the waste go through several transformations, ending up in combustion products, such as fly ash. This article deals with some issues...... related to the combustion of MSW and the formation of fly ash, especially in what concerns heavy metals. Treatment of the flue gas in air pollution control equipment plays an important role and the basic processes to accomplish this are explained. Fly ash from a semi-dry flue gas treatment system...

  9. Doctor Down

    Directory of Open Access Journals (Sweden)

    N.V. Nagornaya

    2013-09-01

    Full Text Available The article presents the biographical data of John Langdon Down, his invaluable contribution to the development of rehabilitation programs for children with Down syndrome. The basis of these programs was the socialization of people with intellectual disabilities. In doctor Down’s rehabilitation center there were used methods, including health care, education, physical education, the formation of correct behavior.

  10. Doctoral Dissertation Defences: Performing Ambiguity between Ceremony and Assessment

    NARCIS (Netherlands)

    van der Heide, Arjen; Rufas, Alix; Supper, Alexandra

    2016-01-01

    Dissertation defenses are ambiguous affairs, which mark both the end of a long process of doctoral education and the inauguration of a doctoral candidate into a body of experts. At Maastricht University (and other Dutch universities), the decision to award a doctoral degree is made on the basis of

  11. Reconstructing the behavior of walking fruit flies

    Science.gov (United States)

    Berman, Gordon; Bialek, William; Shaevitz, Joshua

    2010-03-01

    Over the past century, the fruit fly Drosophila melanogaster has arisen as almost a lingua franca in the study of animal behavior, having been utilized to study questions in fields as diverse as sleep deprivation, aging, and drug abuse, amongst many others. Accordingly, much is known about what can be done to manipulate these organisms genetically, behaviorally, and physiologically. Most of the behavioral work on this system to this point has been experiments where the flies in question have been given a choice between some discrete set of pre-defined behaviors. Our aim, however, is simply to spend some time with a cadre of flies, using techniques from nonlinear dynamics, statistical physics, and machine learning in an attempt to reconstruct and gain understanding into their behavior. More specifically, we use a multi-camera set-up combined with a motion tracking stage in order to obtain long time-series of walking fruit flies moving about a glass plate. This experimental system serves as a test-bed for analytical, statistical, and computational techniques for studying animal behavior. In particular, we attempt to reconstruct the natural modes of behavior for a fruit fly through a data-driven approach in a manner inspired by recent work in C. elegans and cockroaches.

  12. [Analysis on workload for hospital DOTS service].

    Science.gov (United States)

    Nagata, Yoko; Urakawa, Minako; Kobayashi, Noriko; Kato, Seiya

    2014-04-01

    , ward clerks, head nurses, and doctors were 100, 90, 87, 86, and 63 min, respectively. For other professions, including medical social workers, nursing aids, nutritionists, and physical therapists, the working times for each activity of the DOTS service were 31, 18, 10, and 8 min, respectively. The professionals who spent a longer time on health education, support for patient adherence, and coordination with the health center were pharmacists, doctors, and head nurses; nurses, pharmacists, and doctors; and head nurses, doctors, and ward clerks, respectively. Aging of tuberculosis patients was associated with problems on adherence in many patients, including patients who were not suited for a standard regimen, patients whose activity of daily life had deteriorated due to senile dementia, patients with diabetes mellitus, etc. Smoking cessation and mental care for cases of multi-drug resistant disease are new challenges in tuberculosis patient care. The present study clearly indicated that activities including patient education, support for patient adherence, and coordination with the health center--essential components of the hospital DOTS service according to the Japanese DOTS Strategy--were performed by a team of professionals including doctors, nurses, pharmacists, medical social workers, etc., depending on the features and roles that they serve and the needs of each patient. For good practice of hospital DOTS, it is essential to not only provide DOTS, but also effectively provide individual or group health education and coordinate with health centers, thus aiming towards a better community DOTS service after patient discharge.

  13. Tolerance of house fly, Musca domestica L. (Diptera: Muscidae) to dichlorvos (76% EC) an insecticide used for fly control in the tsunami-hit coastal villages of southern India.

    Science.gov (United States)

    Srinivasan, R; Jambulingam, P; Gunasekaran, K; Boopathidoss, P S

    2008-02-01

    The Directorate of Public Health (DPH), Tamil Nadu, in southern India employed spraying of dichlorvos (76% EC) for quick elimination of fly concentrations in the tsunami-hit coastal villages at the concentration of 304g (a.i.)/10,000m(2). However, nuisance of house flies remained high particularly in temporary shelters and centralized relief kitchens. Susceptibility of house fly, Musca domestica to dichlorvos was determined in the laboratory to provide information for an effective management of this pest. Various concentrations of dichlorvos (76% EC) viz., 0.1, 0.2, 0.4, 0.6 and 0.8microg (a.i.) per fly, were tested using topical application against F(1) progenies of house flies collected 12 months after insecticide applications from different habitats in the tsunami-hit coastal villages. Fly mortality was recorded at 24h post treatment. Parallel controls were maintained for comparison. Mortality of the house flies varied between 17.5% and 100% and increased with an increase in dosage of the insecticide. Mortality was >80% at 0.6 and 0.8microg (a.i.) per fly. The LD(50) of dichlorvos tested against flies collected from different villages varied from 0.218microg (a.i.) to 0.235microg (a.i.) per fly and the LD(90) varied from 0.574microg (a.i.) to 0.639microg (a.i.) per fly. House flies collected from a rural village, Thirukanur that had never been exposed for insecticide treatment in the past one decade, when tested, the mortality varied between 92.5% and 100% and increased with concentration of dichlorvos. Mortality was >90% from 0.2microg (a.i.) per fly and the LD(50) was 0.0399microg (a.i.)/fly, while the LD(90) was 0.1604microg (a.i.)/fly. The LD(90) values of the flies collected from the tsunami-hit villages were 3.5-3.9 times higher than that of the flies collected from Thirukanur. Fly abundance remained high in tsunami-hit villages with no marked reduction, suggesting that the flies had developed tolerance to dichlorvos. It is suggested that for an effective

  14. Life Satisfaction and Frequency of Doctor Visits

    Science.gov (United States)

    Kim, Eric S.; Park, Nansook; Sun, Jennifer K.; Smith, Jacqui; Peterson, Christopher

    2015-01-01

    Objective Identifying positive psychological factors that reduce health care use may lead to innovative efforts that help build a more sustainable and high quality health care system. Prospective studies indicate that life satisfaction is associated with good health behaviors, enhanced health, and longer life, but little information is available about the association between life satisfaction and health care use. We tested whether higher life satisfaction was prospectively associated with fewer doctor visits. We also examined potential interactions between life satisfaction and health behaviors. Methods Participants were 6,379 adults from the Health and Retirement Study, a prospective and nationally representative panel study of American adults over the age of 50. Participants were tracked for four years. We analyzed the data using a generalized linear model with a gamma distribution and log link. Results Higher life satisfaction was associated with fewer doctor visits. On a six-point life satisfaction scale, each unit increase in life satisfaction was associated with an 11% decrease in doctor visits—after adjusting for sociodemographic factors (RR = 0.89, 95% CI = 0.86 to 0.93). The most satisfied respondents (N=1,121; 17.58%) made 44% fewer doctor visits than the least satisfied (N=182; 2.85%). The association between higher life satisfaction and reduced doctor visits remained even after adjusting for baseline health and a wide range of sociodemographic, psychosocial, and health-related covariates (RR = 0.96, 95% CI = 0.93 to 0.99). Conclusions Higher life satisfaction is associated with fewer doctor visits, which may have important implications for reducing health care costs. PMID:24336427

  15. Life satisfaction and frequency of doctor visits.

    Science.gov (United States)

    Kim, Eric S; Park, Nansook; Sun, Jennifer K; Smith, Jacqui; Peterson, Christopher

    2014-01-01

    Identifying positive psychological factors that reduce health care use may lead to innovative efforts that help build a more sustainable and high-quality health care system. Prospective studies indicate that life satisfaction is associated with good health behaviors, enhanced health, and longer life, but little information about the association between life satisfaction and health care use is available. We tested whether higher life satisfaction was prospectively associated with fewer doctor visits. We also examined potential interactions between life satisfaction and health behaviors. Participants were 6379 adults from the Health and Retirement Study, a prospective and nationally representative panel study of American adults older than 50 years. Participants were tracked for 4 years. We analyzed the data using a generalized linear model with a gamma distribution and log link. Higher life satisfaction was associated with fewer doctor visits. On a 6-point life satisfaction scale, each unit increase in life satisfaction was associated with an 11% decrease in doctor visits--after adjusting for sociodemographic factors (relative risk = 0.89, 95% confidence interval = 0.86-0.93). The most satisfied respondents (n = 1121; 17.58%) made 44% fewer doctor visits than did the least satisfied (n = 182; 2.85%). The association between higher life satisfaction and reduced doctor visits remained even after adjusting for baseline health and a wide range of sociodemographic, psychosocial, and health-related covariates (relative risk = 0.96, 95% confidence interval = 0.93-0.99). Higher life satisfaction is associated with fewer doctor visits, which may have important implications for reducing health care costs.

  16. Where have they gone? - a discussion on the balancing act of female doctors between work and family.

    Science.gov (United States)

    Jerg-Bretzke, Lucia; Limbrecht, Kerstin

    2012-01-01

    The increasing number of vacant positions for doctors increasingly puts the issue of reconciling work and family into the spotlight in companies, hospitals and universities, as increased expectations of a better work-life balance are seen as one of the reasons for these vacancies. Highly qualified professionals are trained, but not available to the labour market. The aim is to summarise what difficulties doctors who want to have a family and their potential employers must face. The following articles show the current state of research and potential starting points for an optimisation of the medical profession from a family-friendly perspective and intend to stimulate debate. Some basic steps towards better work-life balance have already been taken, such as the provision of childcare places and the increasing availability of more flexible working patterns. But it seems that these measures, since they have been implemented neither sufficiently nor universally, do not suffice to secure the next generation of staff. Especially women in leadership positions are still rare to find. Both male and female doctors want better quality of life by achieving a better work-life balance. The expansion of family-friendly services is seen as a necessary step to allow female doctors to successfully combine work and family.

  17. Towards an inter-domain billing system to support dynamic service provisioning

    OpenAIRE

    Le, V.M.

    2009-01-01

    Today, billing is a big challenge for service providers. With a growing number of rich services such as music, mobile TV, Video-on-Demand and eHealth delivered to the mass market, service providers are missing business opportunities because current billing solutions are not fully capable. In particular, the delivery of on-the-fly composite services, composed of many service components provided by different service providers causes many complexities. This book proposes a billing system that de...

  18. A desk evaluation review of project URT/5/007 tsetse fly eradication. Project desk evaluation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-06-01

    Project URT/5/007 was initiated in 1984 to assist the Government of the United Republic of Tanzania in developing membrane feeding technology for the mass breeding of tsetse flies, which is required for the application of the sterile insect technique to eradicate the tsetse fly from the island of Zanzibar. As the project progressed the objectives focused on the development of inter-related management practices with SIT to control and eventually eradicate the tsetse species infesting Zanzibar. As depicted by the project title, tsetse fly eradication on Zanzibar is the ultimate goal of on-going work of project URT/5/007; however, tsetse fly eradication is not the immediate objective of this project. The total budget of the project for the years 1984 through 1994 includes 53 man-months of expert services, $402,755 for equipment, and $1,959 for fellowship training. Additional funds for 57 man-months of fellowship training were provided from sources outside of the project. Resources provided by the United Republic of Tanzania for the project included staff, local facilities, and local running costs. A Desk Evaluation Review (DER) of Project URT/5/007 was requested by the Africa Section to provide an assessment of project achievements and to determine to what end the project may lead in the near future. Also the review could help determine how experiences gained during the developments of this project might be utilized in the management and implementation of similar projects in Tanzania or the region.

  19. A desk evaluation review of project URT/5/007 tsetse fly eradication. Project desk evaluation

    International Nuclear Information System (INIS)

    1993-01-01

    Project URT/5/007 was initiated in 1984 to assist the Government of the United Republic of Tanzania in developing membrane feeding technology for the mass breeding of tsetse flies, which is required for the application of the sterile insect technique to eradicate the tsetse fly from the island of Zanzibar. As the project progressed the objectives focused on the development of inter-related management practices with SIT to control and eventually eradicate the tsetse species infesting Zanzibar. As depicted by the project title, tsetse fly eradication on Zanzibar is the ultimate goal of on-going work of project URT/5/007; however, tsetse fly eradication is not the immediate objective of this project. The total budget of the project for the years 1984 through 1994 includes 53 man-months of expert services, $402,755 for equipment, and $1,959 for fellowship training. Additional funds for 57 man-months of fellowship training were provided from sources outside of the project. Resources provided by the United Republic of Tanzania for the project included staff, local facilities, and local running costs. A Desk Evaluation Review (DER) of Project URT/5/007 was requested by the Africa Section to provide an assessment of project achievements and to determine to what end the project may lead in the near future. Also the review could help determine how experiences gained during the developments of this project might be utilized in the management and implementation of similar projects in Tanzania or the region

  20. IDRC Doctoral Research Awards 2018 | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2018-05-30

    May 30, 2018 ... You must be enrolled at a Canadian university at the doctoral level ... IDRC Doctoral Research Awards are intended to promote the capacity and growth of ... including academic training, local language capacity, professional ... funding opportunity to support Canadian-African research teams studying Ebola.

  1. Differential growth in doctor-patient communications skills

    NARCIS (Netherlands)

    M van Es, Judith; Wieringa-de Waard, Margreet; Visser, Mechteld R. M.

    2013-01-01

    Although doctor-patient communication is considered a core competency for medical doctors, the effect of training has not been unequivocally established. Moreover, knowledge about the variance in the growth of different skills and whether certain patterns in growth can be detected could help us to

  2. Diarrhea - what to ask your doctor - child

    Science.gov (United States)

    What to ask your doctor about diarrhea - child; Loose stools - what to ask your doctor - child ... FOODS What foods can make my child's diarrhea worse? How should I prepare the foods for my child? If my child is still breastfeeding or bottle feeding, do I ...

  3. The feminisation of Canadian medicine and its impact upon doctor productivity.

    Science.gov (United States)

    Weizblit, Nataly; Noble, Jason; Baerlocher, Mark Otto

    2009-05-01

    We examined the differences in work patterns between female and male doctors in Canada to gain insight into the effect of an increased number of female doctors on overall doctor productivity. Data on the practice profiles of female and male doctors across Canada were extracted from the 2007 National Physician Survey. A doctor productivity measure, 'work hours per week per population' (WHPWPP), was created, based on the number of weekly doctor hours spent providing direct patient care per 100,000 citizens. The predicted WHPWPP was calculated for a hypothetical time-point when the female and male doctor populations reach equilibrium. The differences in current and predicted WHPWPP were then analysed. Female medical students currently (2007) outnumber male medical students (at 57.8% of the medical student population). The percentage of practising doctors who are women is highest in the fields of paediatrics, obstetrics and gynaecology, psychiatry and family practice. Female doctors work an average of 47.5 hours per week (giving 30.0 hours of direct patient care), compared with 53.8 hours worked by male doctors (35.0 hours of direct patient care) (P work less on call hours per week and see fewer patients while on-call. Female doctors are also more likely to take parental leave or a leave of absence (P work patterns described in the present study persist, an overall decrease in doctor productivity is to be anticipated.

  4. Population Dynamics of the Mediterranean Fruit Fly in Montenegro

    Directory of Open Access Journals (Sweden)

    Sanja Radonjić

    2013-01-01

    Full Text Available Population dynamics of the Mediterranean fruit fly was studied along Montenegro seacoast. Tephri traps baited with 3 component female-biased attractants were used in 11 different localities to monitor the fruit fly population in commercial citrus orchards, mixed-fruit orchards, and in backyards. From 2008–2010, the earliest captures were recorded no earlier than July. In 2011, the first adult fly was detected in mid-June. Low captures rates were recorded in July and August (below 0.5 flies per trap per day; FTD and peaked from mid-September to the end of October of each year. Our results indicate fluctuation of fly per trap per day depending on dates of inspection and locality, with significant differences in the adult population density. A maximum population was always reached in the area of Budva-Herceg Novi with an FTD of 66.5, 89.5, 71.63, and 24.64 (from 2008–2011 respectively. Fly activity lasts from mid-June/early-July to end December, with distinct seasonal variation in the population.

  5. Vestibular schwannoma and fitness to fly.

    Science.gov (United States)

    Pons, Yoann; Raynal, Marc; Hunkemöller, Iris; Lepage, Pierre; Kossowski, Michel

    2010-10-01

    When a pilot is referred for vestibular schwannoma (VS), his or her fitness to fly may be questioned. The objective of this retrospective study was to describe a series of VS cases in a pilot population and to discuss their fitness to fly options. Between September 2002 and March 2010, the ENT/Head and Neck Surgery Department of the National Pilot Expertise Center conducted nearly 120,000 expert consultations for 40,000 pilots. We examined the files of 10 pilots who were referred to our 2 national experts for VS. At the time of the expert consultation, hypoacusis was present in nine cases (four with total deafness), tinnitus in one case, and vertigo in nine cases. In our series, only 2 of the 10 pilots experienced a negative impact on their fitness to fly. Decisions on fitness to fly were based on several factors: minimally disturbed audition, i.e., less than a 35-dB hearing loss with a good speech discrimination score; good balance, i.e., no reported difficulties; no spontaneous nystagmus recorded on videonystagmography (VNG); no postural deviation; and a normal head-shaking test. The delay and the VS's evolution between diagnosis and expert consultation are important because the selection of a treatment to control VS is critical in minimizing the possible associated complications. When a pilot is referred for VS, his or her fitness to fly is determined by the size of the tumor, balance, auditory status, and the follow-up results of these findings. The complications that may arise from VS treatments must also be considered.

  6. The social gradient in doctor-patient communication

    Directory of Open Access Journals (Sweden)

    Verlinde Evelyn

    2012-03-01

    Full Text Available Abstract Objective In recent years, the importance of social differences in the physician-patient relationship has frequently been the subject of research. A 2002 review synthesised the evidence on this topic. Considering the increasing importance of social inequalities in health care, an actualization of this review seemed appropriate. Methods A systematic search of literature published between 1965 and 2011 on the social gradient in doctor-patient communication. In this review social class was determined by patient's income, education or occupation. Results Twenty original research papers and meta-analyses were included. Social differences in doctor-patient communication were described according to the following classification: verbal behaviour including instrumental and affective behaviour, non-verbal behaviour and patient-centred behaviour. Conclusion This review indicates that the literature on the social gradient in doctor-patient communication that was published in the last decade, addresses new issues and themes. Firstly, most of the found studies emphasize the importance of the reciprocity of communication. Secondly, there seems to be a growing interest in patient's perception of doctor-patient communication. Practice implications By increasing the doctors' awareness of the communicative differences and by empowering patients to express concerns and preferences, a more effective communication could be established.

  7. Hierarchical zeolites from class F coal fly ash

    Science.gov (United States)

    Chitta, Pallavi

    Fly ash, a coal combustion byproduct is classified as types class C and class F. Class C fly ash is traditionally recycled for concrete applications and Class F fly ash often disposed in landfills. Class F poses an environmental hazard due to disposal and leaching of heavy metals into ground water and is important to be recycled in order to mitigate the environmental challenges. A major recycling option is to reuse the fly ash as a low-cost raw material for the production of crystalline zeolites, which serve as catalysts, detergents and adsorbents in the chemical industry. Most of the prior literature of fly ash conversion to zeolites does not focus on creating high zeolite surface area zeolites specifically with hierarchical pore structure, which are very important properties in developing a heterogeneous catalyst for catalysis applications. This research work aids in the development of an economical process for the synthesis of high surface area hierarchical zeolites from class F coal fly ash. In this work, synthesis of zeolites from fly ash using classic hydrothermal treatment approach and fusion pretreatment approach were examined. The fusion pretreatment method led to higher extent of dissolution of silica from quartz and mullite phases, which in turn led to higher surface area and pore size of the zeolite. A qualitative kinetic model developed here attributes the difference in silica content to Si/Al ratio of the beginning fraction of fly ash. At near ambient crystallization temperatures and longer crystallization times, the zeolite formed is a hierarchical faujasite with high surface area of at least 360 m2/g. This work enables the large scale recycling of class F coal fly ash to produce zeolites and mitigate environmental concerns. Design of experiments was used to predict surface area and pore sizes of zeolites - thus obviating the need for intense experimentation. The hierarchical zeolite catalyst supports tested for CO2 conversion, yielded hydrocarbons

  8. Low back pain and low level flying

    NARCIS (Netherlands)

    J.C.F.M. Aghina

    1989-01-01

    textabstractLow level flying is a very good tactical possibility to carry out a mission unseen by a hostile radarsystem. Nowadays, Western Europe in general and the Federal Republic of Germany in particular, decreased . the permissions to low level flying in assigned regions. That's why the

  9. Barriers facing junior doctors in rural practice.

    Science.gov (United States)

    Smith, Deborah M

    2005-01-01

    Early postgraduate, or junior doctors, are still required to practise in rural and remote communities, and they continue to face numerous issues and difficulties. Within the hospital setting, exposure to rural practice appears to be very limited during internship, and also to some extent, during the second postgraduate year and beyond. This is a major issue for those required to undertake country relieving, rural terms or who will be bonded to rural and remote practice for several years after internship. This research investigated the current issues and difficulties faced by junior doctors, required to undertake rural and remote practice in Queensland, Australia. An exploratory study was undertaken. Primary data were collected through semi-structured interviews held with key stakeholders. Stakeholders included: directors of clinical training; medical educators; junior doctors; rural practitioners; academic rural practitioners; and medical administrators. Of the 23 people approached, a total of 19 agreed to be interviewed. The response rate was 82.6%. Similar to the issues identified in the literature, there are currently a number of barriers influencing the ability of junior doctors to practise competently and confidently when undertaking practice in rural and remote communities. Minimal clinical experience, lack of supervision and on-site support, inadequate orientation and uninformed expectations, limited access to relevant education, and the influence of isolation, results in an overall lack of preparation both professionally and personally. When asked, respondents supported the identification of core skills and knowledge, and integration of these and other issues affecting rural practice, into their hospital-based programs. Current hospital-based education and training programs were not adequately preparing junior doctors for rural and remote practice. It was commented that orientation and education, with a rural emphasis, could assist junior doctors in their

  10. The complex thinking and prospect of actions of future doctors

    Directory of Open Access Journals (Sweden)

    Patrícia Segtowich

    2011-12-01

    Full Text Available This paper aims at discussing prospects of actions manifested by future doctors in the beginning of their doctoral training. The research started through my involvement in the ambit of doctoral education in the curriculum component Epistemological Basis of Research on Education in Science and Mathematics, offered in the Postgraduate Course in Science and Mathematics Education, at Federal University of Pori (UFPA in 2010 academic year. At these meetings, the teachers trainers requested the doctoral students, in pairs, to elaborate three questions about the following positioning: "HOW DO I SEE MYSELF AS A DOCTOR?" These questions were discussed by all the doctoral students and subsequently reduced to five to be answered by all individually. The responses to this questionnaire provided the data for this research. The answers revealed that doctoral students are not tied to methodologies or unique processes, this positioning being demonstrated through prospects of performance in ways that were diverse and interactive

  11. OBTAINING A PERMIT-TO-FLY FOR A HALE-UAV IN BELGIUM

    Directory of Open Access Journals (Sweden)

    J. Everaerts

    2012-09-01

    Full Text Available Ever since 2000, VITO has been working on the Pegasus project. This involves a solar High Altitude Long Endurance Unmanned Aerial Vehicle (HALE-UAV as a stratospheric platform for Earth Observation. This aircraft, called Mercator, is designed to fly for prolonged duration at altitudes up to 20 km. The technology has been proven by the aircraft’s manufacturer, QinetiQ (UK by a series of test flights over the past years, culminating in a world record flight in duration of over 14 days duration. All test flights, however, were conducted in test ranges, where other air traffic does not pose a concern. Pegasus aims to demonstrate the viability of stratospheric Earth Observation in Belgium, as a proof of concept for other areas around the world. The Belgian air space is completely different from a test range. More than 1 million aircraft movements take place over Belgium and Luxembourg every year, with routes to Amsterdam, Paris, Frankfurt, and London. Although Pegasus will usually be flying above this dense traffic, it does interfere with it during ascent and landing, and needs to be monitored during the cruise phase for safety reasons. Air traffic management in Belgium is a shared responsibility of Air Navigation Service Providers (ANSPs Belgocontrol (civil, ATCC (military and Eurocontrol MUAC (high altitude. In 2010, VITO applied for a permit-to-fly for a test flight of one day duration. Although the Belgian Civil Aviation Authority (CAA had issued a regulation on UAVs in 2007, it was the first application for a permit to fly in controlled airspace. The Belgian CAA decided to use it as a test for the procedures as well. A prerequisite for flying in controlled airspace was that the aircraft has to carry a mode-S transponder and navigation lights. During first half of 2010, the ANSPs collaborated on a Temporary Operations Instruction and studied the safety impact of this flight on their operations. As an outcome, they decided that the Pegasus

  12. The Sterile Insect Technique (SIT) against tsetse flies

    International Nuclear Information System (INIS)

    1984-01-01

    The video gives general information on the reproductive anatomy and the reproductive cycles of tsetse flies, shows in detail the steps to make a membrane for food supply of mass-reared flies, and explains how their feed is prepared and processed. The different stages of mass-rearing of flies, including their irradiation and the effects of irradiation on eggs and spermatozoa, are demonstrated. The video also introduces the insect sterilization programme BICOT carried out in Nigeria

  13. The Sterile Insect Technique (SIT) against tsetse flies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1985-12-31

    The video gives general information on the reproductive anatomy and the reproductive cycles of tsetse flies, shows in detail the steps to make a membrane for food supply of mass-reared flies, and explains how their feed is prepared and processed. The different stages of mass-rearing of flies, including their irradiation and the effects of irradiation on eggs and spermatozoa, are demonstrated. The video also introduces the insect sterilization programme BICOT carried out in Nigeria

  14. Stress and wellbeing of junior doctors in Australia: a comparison with American doctors and population norms

    OpenAIRE

    Soares, Deanne S.; Chan, Lewis

    2016-01-01

    Background Stress in doctors adversely affects decision-making, memory, information-recall and attention, thereby negatively impacting upon the provision of safe and high quality patient care. As such, stress in doctors has been subject to increasing scientific scrutiny and has amassed greater public awareness in recent years. The aims of this study are to describe stress levels and the psychological wellbeing of current junior medical officers (JMOs), and to compare this to their predecessor...

  15. Consumer preferences for general practitioner services.

    Science.gov (United States)

    Morrison, Mark; Murphy, Tom; Nalder, Craig

    2003-01-01

    This study focuses on segmenting the market for General Practitioner services in a regional setting. Using factor analysis, five main service attributes are identified. These are clear communication, ongoing doctor-patient relationship, same gender as the patient, provides advice to the patient, and empowers the patient to make his/her own decisions. These service attributes are used as a basis for market segmentation, using both socio-demographic variables and cluster analysis. Four distinct market segments are identified, with varying degrees of viability in terms of target marketing.

  16. [Effect of doctor-patient communication education on oral clinical practice].

    Science.gov (United States)

    Wang, Yi; Tang, Yu; He, Yan; Zhu, Ya-qin

    2012-08-01

    To evaluate the effect of doctor-patient communication education on dental clinical practice. The process of 61 dental interns' clinical practice was divided into two stages. The dental interns were taught with traditional teaching method in the first stage. Doctor-patient communication and communication skill training were added to the second stage. Scale of medical student's doctor-patient communication behavior was used to evaluate the dental interns' behavior by themselves after two stages. The SEGUE frame work was used to evaluate the dental interns' behavior by teachers after two stages. All statistical analysis was performed using SPSS 13.0 software package. The result of scale of medical student's doctor-patient communication behavior was analyzed using Fisher exact test or Chi-square test. The score of the SEGUE frame work was analyzed using Student's t test. The result of Scale of medical student's doctor-patient communication behavior showed only 37.71% of dental interns could establish good doctor-patient relationship in the first stage. After doctor-patient communication and communication skill training, the percentage became 75.4%. The result of the SEGUE frame work showed the score was raised from 16.066±3.308 to 21.867±2.456, and a significant difference was found between the two stages. Doctor-Patient communication education can improve dental interns' communication skills and help to establish a good doctor-patient relationship.

  17. Effect of mechanical activation of fly ash added to Moroccan Portland cement

    Directory of Open Access Journals (Sweden)

    Ez-zaki H.

    2018-01-01

    This study aims to investigate the influence of grinding fly ash on the physico-chemical and mechanical properties of fly ash blended CPJ45 cement. The addition of the fly ash particles to the grinder leads respectively to the breakage of the particles and to reduce the agglomeration effect in the balls of cement grinder. Fly ash milling was found to improve particles fineness, and increase the silica and alumina content in the cement. Furthermore, milled fly ash blended cements show higher compressive strength compared to unmilled fly ash blended cements, due to improved fly ash reactivity through their mechanical activation.

  18. Definition of satellite servicing technology development missions for early space stations. Volume 2: Technical

    Science.gov (United States)

    1983-01-01

    Early space station accommodation, build-up of space station manipulator capability, on-orbit spacecraft assembly test and launch, large antenna structure deployment, service/refurbish satellite, and servicing of free-flying materials processing platform are discussed.

  19. Doctor of Professional Counseling: The Next Step

    Science.gov (United States)

    Southern, Stephen; Cade, Rochelle; Locke, Don W.

    2012-01-01

    Professional doctorates have been established in the allied health professions by clinicians seeking the highest levels of independent practice. Allied health professional doctorates include nursing practice (DNP), occupational therapy (OTD), psychology (PsyD), social work (DSW), and marriage and family therapy (DMFT). Lessons learned from the…

  20. Do doctors need statistics? Doctors' use of and attitudes to probability and statistics.

    Science.gov (United States)

    Swift, Louise; Miles, Susan; Price, Gill M; Shepstone, Lee; Leinster, Sam J

    2009-07-10

    There is little published evidence on what doctors do in their work that requires probability and statistics, yet the General Medical Council (GMC) requires new doctors to have these skills. This study investigated doctors' use of and attitudes to probability and statistics with a view to informing undergraduate teaching.An email questionnaire was sent to 473 clinicians with an affiliation to the University of East Anglia's Medical School.Of 130 respondents approximately 90 per cent of doctors who performed each of the following activities found probability and statistics useful for that activity: accessing clinical guidelines and evidence summaries, explaining levels of risk to patients, assessing medical marketing and advertising material, interpreting the results of a screening test, reading research publications for general professional interest, and using research publications to explore non-standard treatment and management options.Seventy-nine per cent (103/130, 95 per cent CI 71 per cent, 86 per cent) of participants considered probability and statistics important in their work. Sixty-three per cent (78/124, 95 per cent CI 54 per cent, 71 per cent) said that there were activities that they could do better or start doing if they had an improved understanding of these areas and 74 of these participants elaborated on this. Themes highlighted by participants included: being better able to critically evaluate other people's research; becoming more research-active, having a better understanding of risk; and being better able to explain things to, or teach, other people.Our results can be used to inform how probability and statistics should be taught to medical undergraduates and should encourage today's medical students of the subjects' relevance to their future careers. Copyright 2009 John Wiley & Sons, Ltd.