Gender identity disorder: general overview and surgical treatment for vaginoplasty in male-to-female transsexuals.

Science.gov (United States)

Selvaggi, Gennaro; Ceulemans, Peter; De Cuypere, Griet; VanLanduyt, Koen; Blondeel, Phillip; Hamdi, Moustapha; Bowman, Cameron; Monstrey, Stan

2005-11-01

After studying this article, the participant should be able to discuss: 1. The terminology related to male-to-female gender dysphoria. 2. The different theories regarding cause, epidemiology, and treatment of gender dysphoria. 3. The surgical goals of sex reassignment surgery in male-to-female transsexualism. 4. The surgical techniques available for sex reassignment surgery in male-to-female transsexualism. Gender identity disorder (previously "transsexualism") is the term used for individuals who show a strong and persistent cross-gender identification and a persistent discomfort with their anatomical sex, as manifested by a preoccupation with getting rid of one's sex characteristics, or the belief of being born in the wrong sex. Since 1978, the Harry Benjamin International Gender Dysphoria Association (in honor of Dr. Harry Benjamin, one of the first physicians who made many clinicians aware of the potential benefits of sex reassignment surgery) has played a major role in the research and treatment of gender identity disorder, publishing the Standards of Care for Gender Dysphoric Persons. The authors performed an overview of the terminology related to male-to-female gender identity disorder; the different theories regarding cause, epidemiology, and treatment; the goals expected; and the surgical technique available for sex reassignment surgery in male-to-female transsexualism. Surgical techniques available for sex reassignment surgery in male-to-female transsexualism, with advantages and disadvantages offered by each technique, are reviewed. Other feminizing nongenital operative interventions are also examined. This review describes recent etiopathogenetic theories and actual guidelines on the treatment of the gender identity disorder in male-to-female transsexuals; the penile-scrotal skin flap technique is considered the state of the art for vaginoplasty in male-to-female transsexuals, whereas other techniques (rectosigmoid flap, local flaps, and isolated skin

The surgical management of male breast cancer: Time for an easy access national reporting database?

Directory of Open Access Journals (Sweden)

Robert M.T. Staruch

2016-08-01

Discussion: We report a series of seven cases of male breast cancer encountered over three years, evaluating patient demographics as well as treatment and outcomes. In our series patients were managed with mastectomy. New evidence is questioning the role of mastectomy against breast conserving surgery in male patients. Furthermore there is a lack of reporting infrastructure for national data capture of the benefits of surgical modalities. Literature review highlights the varied clinical experience between units that remains reported as podium presentation but not published. The establishment of an online international reporting registry would allow for efficient analysis of surgical outcomes to improve patient care from smaller single centres. This would facilitate large scale meta analysis by larger academic surgical centres.

The usefulness of the surgical knowledge and skills acquired via the university curriculum for doctors' medical practice several years after graduation.

Science.gov (United States)

Zyluk, Andrzej; Puchalski, Piotr; Szlosser, Zbigniew

2015-01-01

Teaching surgery during university curriculum comprises transferring theoretical knowledge traditionally and simultaneously acquiring manual skills, i.e., suturing, stitch removal, limb immobilization, catheterization, and assisting operations. Observations of doctors several years after graduation led to the reflection that teachers' ideas about surgical knowledge and skills that are useful in daily practice frequently fail to meet the facts of the case. The objective of this study was to determine which part of the surgical knowledge and skills taught via the university surgical curriculum proved to be useful in the daily practice of young doctors. A custom-made questionnaire was designed and mailed to 200 randomly chosen doctors who had graduated from the medical faculty at the authors' university 5 to 6 years previously. The questionnaire comprised 9 items concerning the knowledge and skills that proved to be the most useful in participants' daily practice, regardless of their specialty. A total of 64 completed questionnaires were returned (32% of 200 sent) and were the subject of analysis. The most useful knowledge in daily practice was that acquired from general surgery, followed by oncological and vascular surgery. The most useful was knowledge about the rational interpretation of clinical symptoms and signs acquired from examination of the patient, followed by arriving at an accurate diagnosis through logical analysis, and next developing "oncological sensitivity" to diagnosing neoplasms. The most effective teaching model was specialized outpatient clinic rounds, followed by training manual skills on a model and classical ward-round teaching. The most frequently learned (acquired) manual skills were removal of stitches, rectal examination, and examination of the abdomen. Of these skills, the most useful in daily practice appeared to be removal of stitches, catheterization of the urinary bladder, and wound suturing. Learning and practicing manual skills

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.

Mediating Effects of Patients' Stigma and Self-Efficacy on Relationships Between Doctors' Empathy Abilities and Patients' Cellular Immunity in Male Breast Cancer Patients.

Science.gov (United States)

Yang, Ningxi; Cao, Yingnan; Li, Xiaoyan; Li, Shiyue; Yan, Hong; Geng, Qingshan

2018-06-12

BACKGROUND Doctors' empathy is closely related to patients' health. This study aimed to examine whether patients' stigma and self-efficacy play a mediating role in the relationship between doctors' empathy abilities and patients' cellular immunity in male patients with breast cancer. MATERIAL AND METHODS Doctors' empathy scores and patients' demographic data, disease condition, stigma, and self-efficacy were measured. Patient T cell subset was tested at admission and 3 months after the operation and was compared by paired t test. The multivariate linear regression model was applied to analyze the factors influencing the immune index. Pearson correlation analysis and structural equation modeling were applied to explore the relationships among patients' stigma, self-efficacy, and cellular immunity and doctors' empathy abilities. RESULTS At the 2 time points, only the change in NK subset was statistically significant, while the changes in percentage of CD3+, CD4+, CD8+, and B cells were not statistically significant. The doctors' empathy abilities were negatively correlated with patients' stigma and were positively related to patients' self-efficacy. Patients' stigma was negatively related to NK subset, while self-efficacy was positively associated with NK subset. Patients' stigma and self-efficacy played a mediating role in the relationship between doctors' empathy abilities and patients' NK subset, and stigma had a stronger effect than self-efficacy. CONCLUSIONS Doctors' empathy abilities affected breast cancer patients' NK subset through their stigma and self-efficacy. The mental health of male breast cancer patients need more attention and empathy education needs to be improved.

A survey to determine the potential impact of foundation year career aims on surgical specialty training.

Science.gov (United States)

Patel, Rikesh Kumar; Sayers, Adele Elizabeth; Akbar, Muhammad Jawaid; Hunter, Iain Andrew

2014-03-01

The competition for Core Surgical Training (CST) positions and subsequent Surgical Specialty Training (ST3) posts throughout the UK is fierce. Our aim was to conduct a pilot study to assess whether current foundation year doctors were considering pursuing a career in surgery and the reasons guiding their decisions. A ten-item questionnaire was voluntarily completed by foundation doctors at a large acute teaching trust. Factors evaluated included: experience working within a surgical rotation; previous consideration of a career in surgery; whether they found a career in surgery appealing; reasons guiding their decision and would they be applying to CST. All 67 foundation doctors approached agreed to participate: of which 56 (83.6%) had experience working within a surgical rotation. Males were significantly more likely to find a career in surgery appealing (p career, only 11 (16.4%) would be applying to CST. Reasons for finding a career in surgery appealing included: job satisfaction (84.2%), diversity of work (79.0%) and working environment/colleagues (47.4%). Of those that did not consider a career in surgery to be appealing, reasons included: working hours (75.0%), work/life balance (62.5%), working environment/colleagues (50%). Although only a small proportion of current foundation doctors were surveyed in our study, only 16.4% were considering applying for CST. These figures are lower than previously suggested and would indicate that there will be fewer applicants for CST in future years, which may potentially reduce the current bottleneck of applicants at ST3.

Nanocarrier-mediated delivery of α-mangostin for non-surgical castration of male animals

OpenAIRE

Yostawonkul, Jakarwan; Surassmo, Suvimol; Namdee, Katawut; Khongkow, Mattaka; Boonthum, Chatwalee; Pagseesing, Sasithon; Saengkrit, Nattika; Ruktanonchai, Uracha Rungsardthong; Chatdarong, Kaywalee; Ponglowhapan, Suppawiwat; Yata, Teerapong

2017-01-01

The overpopulation of abandoned and stray companion animals has become a global crisis. The main purpose of this study was to develop a novel nanomedicine-based antifertility compound for non-surgical castration of male animals. Mangosteen (Garcinia mangostana L) pericarp extract has been shown to exhibit anti-fertility property. α-mangostin (AM)-loaded nanostructured lipid carrier (AM-NLC) was developed to improve male germ cell apoptosis. This study was conducted to investigate physicochemi...

[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.

Surgical Management of Anatomic Bladder Outlet Obstruction in Males with Neurogenic Bladder Dysfunction: A Systematic Review.

Science.gov (United States)

Noordhoff, Toscane C; Groen, Jan; Scheepe, Jeroen R; Blok, Bertil F M

2018-03-15

Surgical treatment of anatomic bladder outlet obstruction (BOO) may be indicated in males with neurogenic bladder dysfunction. A bothersome complication after surgery is urinary incontinence. To identify the optimal practice in the surgical treatment of anatomic BOO in males with neurogenic bladder dysfunction, due to multiple sclerosis, Parkinson disease, spinal cord injury (SCI), spina bifida, or cerebrovascular accident (CVA). A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Medline, Embase, Cochrane controlled trial databases, Web of Science, and Google Scholar were searched for publications until January 2017. A total of 930 abstracts were screened. Eight studies were included. The types of anatomic BOO discussed were benign prostate obstruction, urethral stricture, and bladder neck sclerosis. The identified surgical treatments were transurethral resection of the prostate (TURP) in patients with Parkinson, CVA or SCI, endoscopic treatment of urethral stricture by laser ablation or urethrotomy (mainly in SCI patients), and bladder neck resection (BNR) in SCI patients. The outcome of TURP may be highly variable, and includes persistent or de novo urinary incontinence, regained normal micturition control, and urinary continence. Good results were seen in BNR and endoscopic urethrotomy studies. Laser ablation and cold knife urethrotomy resulted in restarting intermittent catheterization or adequate voiding. Overall, a high risk of bias was found. This systematic review provides an overview of the current literature on the outcome of several surgical approaches of different types of anatomic BOO in males with neurogenic bladder dysfunction. Identifying the optimal practice was impossible due to limited availability of high-quality studies. The outcome of several surgical approaches in males with neurogenic bladder dysfunction with benign prostate obstruction, urethral stricture

Outcome of Vaginoplasty in Male-to-Female Transgenders: A Systematic Review of Surgical Techniques.

Science.gov (United States)

Horbach, Sophie E R; Bouman, Mark-Bram; Smit, Jan Maerten; Özer, Müjde; Buncamper, Marlon E; Mullender, Margriet G

2015-06-01

Gender reassignment surgery is the keystone of the treatment of transgender patients. For male-to-female transgenders, this involves the creation of a neovagina. Many surgical methods for vaginoplasty have been opted. The penile skin inversion technique is the method of choice for most gender surgeons. However, the optimal surgical technique for vaginoplasty in transgender women has not yet been identified, as outcomes of the different techniques have never been compared. With this systematic review, we aim to give a detailed overview of the published outcomes of all currently available techniques for vaginoplasty in male-to-female transgenders. A PubMed and EMBASE search for relevant publications (1995-present), which provided data on the outcome of techniques for vaginoplasty in male-to-female transgender patients. Main outcome measures are complications, neovaginal depth and width, sexual function, patient satisfaction, and improvement in quality of life (QoL). Twenty-six studies satisfied the inclusion criteria. The majority of these studies were retrospective case series of low to intermediate quality. Outcome of the penile skin inversion technique was reported in 1,461 patients, bowel vaginoplasty in 102 patients. Neovaginal stenosis was the most frequent complication in both techniques. Sexual function and patient satisfaction were overall acceptable, but many different outcome measures were used. QoL was only reported in one study. Comparison between techniques was difficult due to the lack of standardization. The penile skin inversion technique is the most researched surgical procedure. Outcome of bowel vaginoplasty has been reported less frequently but does not seem to be inferior. The available literature is heterogeneous in patient groups, surgical procedure, outcome measurement tools, and follow-up. Standardized protocols and prospective study designs are mandatory for correct interpretation and comparability of data. © 2015 International Society for

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

Science.gov (United States)

Offiah, Gozie; Doherty, Eva

2018-03-01

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

Factors influencing incident reporting in surgical care.

Science.gov (United States)

Kreckler, S; Catchpole, K; McCulloch, P; Handa, A

2009-04-01

To evaluate the process of incident reporting in a surgical setting. In particular: the influence of event outcome on reporting behaviour; staff perception of surgical complications as reportable events. Anonymous web-based questionnaire survey. General Surgical Department in a UK teaching hospital. Of 203 eligible staff, 55 (76.4%) doctors and 82 (62.6%) nurses participated. Knowledge and use of local reporting system; propensity to report incidents which vary by outcome (harm, no harm, harm prevented); propensity to report surgical complications; practical and psychological barriers to reporting. Nurses were significantly more likely to know of the local reporting system and to have recently completed a report than doctors. The level of harm (F(1.8,246) = 254.2, pvs 53%, z = 4.633, psystems.

Outcome of Vaginoplasty in Male-to-Female Transgenders: A Systematic Review of Surgical Techniques

NARCIS (Netherlands)

Horbach, S.E.R.; Bouman, M.B.; Smit, J.M.; Özer, M.; Buncamper, M.E.; Mullender, M.G.

2015-01-01

Introduction: Gender reassignment surgery is the keystone of the treatment of transgender patients. For male-to-female transgenders, this involves the creation of a neovagina. Many surgical methods for vaginoplasty have been opted. The penile skin inversion technique is the method of choice for most

Application of 3D Printing in the Surgical Planning of Trimalleolar Fracture and Doctor-Patient Communication

Directory of Open Access Journals (Sweden)

Long Yang

2016-01-01

Full Text Available To evaluate the effect of 3D printing in treating trimalleolar fractures and its roles in physician-patient communication, thirty patients with trimalleolar fractures were randomly divided into the 3D printing assisted-design operation group (Group A and the no-3D printing assisted-design group (Group B. In Group A, 3D printing was used by the surgeons to produce a prototype of the actual fracture to guide the surgical treatment. All patients underwent open reduction and internal fixation. A questionnaire was designed for doctors and patients to verify the verisimilitude and effectiveness of the 3D-printed prototype. Meanwhile, the operation time and the intraoperative blood loss were compared between the two groups. The fracture prototypes were accurately printed, and the average overall score of the verisimilitude and effectiveness of the 3D-printed prototypes was relatively high. Both the operation time and the intraoperative blood loss in Group A were less than those in Group B (P<0.05. Patient satisfaction using the 3D-printed prototype and the communication score were 9.3±0.6 points. A 3D-printed prototype can faithfully reflect the anatomy of the fracture site; it can effectively help the doctors plan the operation and represent an effective tool for physician-patient communication.

Autotelic vs instrumental motivation of doctors and their medical specialty choice in relation to sense of coherence.

Science.gov (United States)

Jabłoński, Marcin J; Szot-Parda, Magdalena; Grzegorek, Tomasz; Prusak, Jacek; Jach, Robert; Posadzka, Ewa

2016-01-01

Analysis and comparison of two types of motivation (autotelic and non-autotelic) which are behind the choice of medical specialisation by doctors in relation to their sense of coherence. Questionnaire method was used in the study. The study included a group of 86 graduates of the Faculty of Medicine of the Jagiellonian University, who have completed postgraduate internships at the Department of Haematology and Oncology, Department of Gynaecology of the Jagiellonian University and the L. Rydygier hospital in Krakow in 2010-2012. Statistical analyses were performed using the IBM SPSS Statistics 21. The level of significance was alpha = 0.05. It has been shown that doctors are more frequently characterised by the autotelic type of motivation. It has also been proven that there is a relationship between the male sex of the surveyed doctors and their autotelic type of motivation. Moreover, it has been demonstrated that there is a correlation between the comprehensibility component of the sense of coherence and the male sex. It has been also demonstrated that there is a correlation between meaningfulness component of the sense of coherence and the choice of surgical specialisation. Autotelic motivation prevails when choosing a medical specialty and this tendency is more noticeable in men than in women. The meaningfulness component of SoC plays a regulatory role in making career decisions related to the greater physical and mental pressure put on doctors. The observed differences in the types of motivation and the size of the components of the sense of coherence in groups of surveyed doctors - men and women - encourage further observations of these relationships on a larger population.

Use of Exogenous Testosterone for the Treatment of Male Factor Infertility: A Survey of Nigerian Doctors.

Science.gov (United States)

Omisanjo, Olufunmilade Akinfolarin; Ikuerowo, Stephen Odunayo; Abdulsalam, Moruf Adekunle; Ajenifuja, Sheriff Olabode; Shittu, Khadijah Adebisi

2017-01-01

Though exogenous testosterone is known for its contraceptive effects in men, it is sometimes prescribed by medical practitioners for the treatment of male factor infertility in the mistaken belief that exogenous testosterone improves sperm count. The aim of this study was to evaluate the scope of testosterone use in the treatment of male factor infertility by medical practitioners in Lagos, Nigeria. A survey using a structured questionnaire was carried out amongst doctors attending a regular Continuing Medical Education (CME) programme in Lagos, Nigeria. There were 225 respondents. Most of the respondents (69.8%, n = 157) indicated that exogenous testosterone increases sperm count. Only 22 respondents (9.8%) indicated (correctly) that exogenous testosterone decreases sperm count. Seventy-seven respondents (34.2%) had prescribed some form of exogenous testosterone in the treatment of male factor infertility. The vast majority of respondents who had prescribed testosterone (81.8%, n = 63) thought exogenous testosterone increases sperm count. There was no statistically significant difference in the pattern of prescription across the respondents' specialty ( p = 0.859) or practice type ( p = 0.747). The misuse of exogenous testosterone for the treatment of male infertility was common amongst the respondents, with most of them wrongly believing that exogenous testosterone increases sperm count.

Effect of Surgical and Immunological Castration on Haematological ...

African Journals Online (AJOL)

olayemitoyin

Summary: Welfare concerns are growing regarding surgical castration (SC) in pets, necessitating the need for non-surgical alternatives. ..... Doctoral Thesis. Swedish ... Pharmacological advances in canine and feline reproduction. Topics in.

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

Significance of gender in the attitude towards doctor-patient communication in medical students and physicians.

Science.gov (United States)

Löffler-Stastka, Henriette; Seitz, Tamara; Billeth, Sabrina; Pastner, Barbara; Preusche, Ingrid; Seidman, Charles

2016-09-01

Gender-specific differences in the attitudes towards doctor-patient communication among medical students and physicians were assessed. A total of 150 medical students and 51 physicians from different departments took part in the study. The association, attitude and experiences regarding doctor-patient communication were assessed with a series of tools and questionnaires. Female doctors and students tended to describe the doctor-patient communication with positive attributes, such as "helpful", "sentimental", "voluble", "sociable", "gentle", "yielding" and "peaceful". Male students and physicians, on the other hand, described doctor-patient communication as "overbearing", "robust" and "inhibited". The most frequent associations females had with the term doctor-patient communication were "empathy", "confidence", "openess", while the most frequent association of the male colleagues was "medical history". Female doctors reported speaking about the psychosocial situation of the patient significantly more often and believed in higher patient satisfaction by sharing more information. Furthermore, they reported having longer conversations with a more equal partnership than their male colleagues. Compared to male students, female students were willing to take part in training their communication skills more often and had more interest in research about doctor-patient communication. Male medical students reported self-doubt during conversations with female patients, while one third of the male physicians talked about "the power over the patient". This study indicates a gender-dependent communication style influenced by stereotypes. At the establishment of communication training these differences should be taken into account, especially to strengthen male communication skills and improve their attitudes.

Patients' preferences for doctors' attire in Japan.

Science.gov (United States)

Yamada, Yasuhiro; Takahashi, Osamu; Ohde, Sachiko; Deshpande, Gautam A; Fukui, Tsuguya

2010-01-01

Physicians' attire is one important factor to enhance the physician-patient relationship. However, there are few studies that examine patients' preferences for physicians' attire in Japan. We sought to assess patients' preference regarding doctors' attire and to assess the influence of doctors' attire on patients' confidence in their physician. Furthermore, we examined whether patients' preferences would change among various clinical situations. Employing a cross-sectional design, Japanese outpatients chosen over one week in October 2008 from waiting rooms in various outpatient departments at St. Luke's International Hospital, Tokyo, were given a 10-item questionnaire. A 5-point Likert scale was used to estimate patient preference for four types of attire in both male and female physicians, including semi-formal attire, white coat, surgical scrubs, and casual wear. In addition, a 4-point Likert Scale was used to measure the influence of doctors' attire on patient confidence. Japanese outpatients consecutively chosen from waiting rooms at St. Luke's International Hospital in Tokyo for one week in October 2008. Of 2,272 outpatients enrolled, 1483 (67.1%) of respondents were women. Mean age of subjects was 53.8 years (SD 16.2 years). Respondents most preferred the white coat (mean rank: 4.18, SD: 0.75) and preferred casual attire the least (mean rank: 2.32, SD: 0.81). For female physicians, 1.4% of respondents ranked the white coat little/least preferred while 64.7% of respondents ranked casual wear little/least preferred. Among respondents who most preferred the white coat for physician attire, perceived hygiene (62.7%) and inspiring confidence (59.3%) were important factors for doctor's attire. Around 70% of all respondents reported that physicians' attire has an influence on their confidence in their physician. This study confirms that Japanese outpatients prefer a white coat. Furthermore, this study strongly suggests that wearing a white coat could favorably

Junior doctors and undergraduate teaching: the influence of gender on the provision of medical education.

Science.gov (United States)

Prichard, David; Collins, Niamh; Boohan, Mairead; Wall, Catherine

2011-04-01

International experience has demonstrated that the medical profession is becoming less dominated by men. This "feminization of medicine" has been a topic of much debate in the medical literature. As the gender ratio in the profession changes, it is likely that a greater proportion of undergraduate education will be provided by women. Whether this shift away from the male-dominated provision of medical education will have an effect on undergraduate education is unknown. The aim of this research was to clarify whether there are differences between the attitudes and practices of male and female junior doctors regarding the practice of undergraduate teaching. A survey methodology among a cohort of nonconsultant hospital doctors in a major Irish teaching hospital was utilized. The overall response rate was 93%. The cohort held a positive attitude toward teaching undergraduates, and the majority were actively engaged in this activity. Doctors of both genders expressed a willingness to undertake teacher training. There were no significant differences between the genders regarding the self-reported quantity of teaching provided to undergraduates. Male doctors perceived themselves as more confident educators when compared to female doctors, but this is likely to reflect cohort demographics in which a greater proportion of male doctors were more senior. This study demonstrates that male and female doctors have similar attitudes toward, and practices in, voluntary undergraduate teaching. As a result, any gender shift in medicine is unlikely to result in a significant change in junior doctors' attitudes toward undergraduate medical education.

Smoking trends amongst young doctors of a tertiary care hospital - Mayo Hospital, Lahore - Pakistan

International Nuclear Information System (INIS)

Chudhary, M.K.; Younis, M.; Bukhari, M.H.

2011-01-01

The World Health Organization cites tobacco use as one of the biggest public health threats the world has ever faced. Tobacco is the number one preventable cause of disability and death. Tobacco has many negative health effects which many of the smokers know them well. In Pakistan tobacco use is common in general public and the health professionals don't lack behind this habit. To study the smoking trends amongst young doctors of Mayo Hospital. Questionnaire based descriptive study. This study was conducted at the Institute of Chest Medicine, Mayo Hospital - A tertiary care hospital affiliated with King Edward Medical University, Lahore. Out of 250 doctors, 180 (72%) were males and 70 (28%) were female. Amongst 180 male doctors 97 (53.88%) were smokers and 83 (46.21%) were non smokers. Amongst 70 female doctors 8 (11.43%) were smokers and 62 (88.57%) were non smokers. Smoking is common among male young doctors but it is less common in female doctors. (author)

Work-family conflict and burnout among Chinese doctors: the mediating role of psychological capital.

Science.gov (United States)

Wang, Yang; Liu, Li; Wang, Jiana; Wang, Lie

2012-01-01

The aim of this study was to investigate the relation between work-family conflict and burnout, and the mediating role of psychological capital (PsyCap) in the relation between work-family conflict and burnout, among Chinese doctors. This cross-sectional study was performed during the period of September/October 2010. A questionnaire that comprised work-family conflict assessed by the work-family conflict scale, PsyCap assessed by the PCQ-24 scale and burnout assessed by the Maslach Burnout Inventory-General Survey (MBI-GS), as well as age and gender, was distributed to 1,300 doctors in Liaoning Province, China. A total of 1,011 effective respondents became our final study subjects. Hierarchical linear regression analyses were performed by using SPSS 17.0 to explore the mediating role of PsyCap in the relation between work-family conflict and burnout. Both work interfering family conflict (WIF) and family interfering work conflict (FIW) were positively related with emotional exhaustion and cynicism among both male and females doctors. However, WIF was positively related with professional efficacy only among male doctors, whereas FIW was negatively related with professional efficacy among both male and female doctors. PsyCap partially mediated the relation between WIF and professional efficacy among male doctors and partially mediated the relations of FIW with emotional exhaustion, cynicism and professional efficacy among female doctors. Work-family conflict was associated with burnout among Chinese doctors. PsyCap was a mediator between work-family conflict and burnout. PsyCap might be a positive resource to reduce the negative effect of work-family conflict on burnout of doctors, especially female doctors, in China.

One-Stage Gender-Confirmation Surgery as a Viable Surgical Procedure for Female-to-Male Transsexuals.

Science.gov (United States)

Stojanovic, Borko; Bizic, Marta; Bencic, Marko; Kojovic, Vladimir; Majstorovic, Marko; Jeftovic, Milos; Stanojevic, Dusan; Djordjevic, Miroslav L

2017-05-01

Female-to-male gender-confirmation surgery (GCS) includes removal of breasts and female genitalia and complete genital and urethral reconstruction. With a multidisciplinary approach, these procedures can be performed in one stage, avoiding multistage operations. To present our results of one-stage sex-reassignment surgery in female-to-male transsexuals and to emphasize the advantages of single-stage over multistage surgery. During a period of 9 years (2007-2016), 473 patients (mean age = 31.5 years) underwent metoidioplasty. Of these, 137 (29%) underwent simultaneous hysterectomy, and 79 (16.7%) underwent one-stage GCS consisting of chest masculinization, total transvaginal hysterectomy with bilateral adnexectomy, vaginectomy, metoidioplasty, urethral lengthening, scrotoplasty, and implantation of bilateral testicular prostheses. All surgeries were performed simultaneously by teams of experienced gynecologic and gender surgeons. Primary outcome measurements were surgical time, length of hospital stay, and complication and reoperation rates compared with other published data and in relation to the number of stages needed to complete GCS. Mean follow-up was 44 months (range = 10-92). Mean surgery time was 270 minutes (range = 215-325). Postoperative hospital stay was 3 to 6 days (mean = 4). Complications occurred in 20 patients (25.3%). Six patients (7.6%) had complications related to mastectomy, and one patient underwent revision surgery because of a breast hematoma. Two patients underwent conversion of transvaginal hysterectomy to an abdominal approach, and subcutaneous perineal cyst, as a consequence of colpocleisis, occurred in nine patients. There were eight complications (10%) from urethroplasty, including four fistulas, three strictures, and one diverticulum. Testicular implant rejection occurred in two patients and testicular implant displacement occurred in one patient. Female-to-male transsexuals can undergo complete GCS, including mastectomy

Surgical and procedural skills training at medical school - a national review.

Science.gov (United States)

Davis, Christopher R; Toll, Edward C; Bates, Anthony S; Cole, Matthew D; Smith, Frank C T

2014-01-01

This national study quantifies procedural and surgical skills training at medical schools in the United Kingdom (UK), a stipulated requirement of all graduates by the General Medical Council (GMC). A questionnaire recorded basic procedural and surgical skills training provided by medical schools and surgical societies in the UK. Skills were extracted from (1) GMC Tomorrows Doctors and (2) The Royal College of Surgeons Intercollegiate Basic Surgical Skills (BSS) course. Data from medical school curricula and extra-curricular student surgical societies were compared against the national GMC guidelines and BSS course content. Data were analysed using Mann-Whitney U tests. Representatives from 23 medical schools completed the survey (71.9% response). Thirty one skills extracted from the BSS course were split into 5 categories, with skills content cross referenced against GMC documentation. Training of surgical skills by medical schools was as follows: Gowning and gloving (72.8%), handling instruments (29.4%), knot tying (17.4%), suturing (24.7%), other surgical techniques (4.3%). Surgical societies provided significantly more training of knot tying (64.4%, P = 0.0013) and suturing (64.5%, P = 0.0325) than medical schools. Medical schools provide minimal basic surgical skills training, partially supplemented by extracurricular student surgical societies. Our findings suggest senior medical students do not possess simple surgical and procedural skills. Newly qualified doctors are at risk of being unable to safely perform practical procedures, contradicting GMC Guidelines. We propose a National Undergraduate Curriculum in Surgery and Surgical Skills to equip newly qualified doctors with basic procedural skills to maximise patient safety. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Junior doctors and undergraduate teaching: the influence of gender on the provision of medical education.

LENUS (Irish Health Repository)

Prichard, David

2012-02-01

BACKGROUND: International experience has demonstrated that the medical profession is becoming less dominated by men. This "feminization of medicine" has been a topic of much debate in the medical literature. As the gender ratio in the profession changes, it is likely that a greater proportion of undergraduate education will be provided by women. Whether this shift away from the male-dominated provision of medical education will have an effect on undergraduate education is unknown. PURPOSE: The aim of this research was to clarify whether there are differences between the attitudes and practices of male and female junior doctors regarding the practice of undergraduate teaching. METHOD: A survey methodology among a cohort of nonconsultant hospital doctors in a major Irish teaching hospital was utilized. The overall response rate was 93%. The cohort held a positive attitude toward teaching undergraduates, and the majority were actively engaged in this activity. Doctors of both genders expressed a willingness to undertake teacher training. RESULTS: There were no significant differences between the genders regarding the self-reported quantity of teaching provided to undergraduates. Male doctors perceived themselves as more confident educators when compared to female doctors, but this is likely to reflect cohort demographics in which a greater proportion of male doctors were more senior. CONCLUSIONS: This study demonstrates that male and female doctors have similar attitudes toward, and practices in, voluntary undergraduate teaching. As a result, any gender shift in medicine is unlikely to result in a significant change in junior doctors\\' attitudes toward undergraduate medical education.

Seroprevalence of Hepatitis B and C in Clinical Staffs (Doctor an

Directory of Open Access Journals (Sweden)

Hamid Mokhayeri

2016-11-01

Full Text Available Health care workers who have contact with blood and secretions have an increased occupational risk for blood transmitted infections. The aim of this study was to determine the seroprevalence of Hepatitis B and C infections and evaluation of the level of HBV antibody titer in clinical staffs (doctor and Nurse of the four hospitals in Khorramabad city, Iran. This cross sectional study investigated 462 clinical staffs (doctor and nurse in the government hospitals of Khorramabad city. The history of HB vaccination and contact with blood and secretions and body fluids recorded. 5cc blood was collected from each person and HBSAg and HBSAb and HCVAb were measured by ELISA method. Among 462 participants 381 (82.47% were women and 81 (17.53% were men, 9(1.95% participants were positive for hepatitis, there were 7 (1.52% cases positive for HBs Ag, 2 (0.43% cases for HCV Ab. HCV and HBV prevalence was highest in the age group of 45 to 54 and 30 to 40 years respectively, prevalence rates were higher in females compared to males, from a total of 9 Infected participants, 3 had a history of needle stick injury, 6 had a history of surgery, also, none of these nine hepatitis positive subjects had the experience of blood reception, hepatitis patients have work experience in the surgical ward, operating rooms and emergency. According to the results of this study prevalence of HBV and HCV in clinical staffs (doctor and nurse in hospitals less than other people. The doctors and nurses have the highest rate of knowledgeable about preventive and control methods of hepatitis.

Effects of neonatal surgical castration and immunocastration in male pigs on blood T lymphocytes and health markers

OpenAIRE

Leclercq, Caroline; Prunier, Armelle; Merlot, Elodie

2014-01-01

Surgical castration in pig husbandry is criticized for welfare reasons. Thus, it is necessary to evaluate alternative ways of rearing male pigs, such as entire or immunocastrated animals. Immunocastration is a vaccination directed against gonadotropin-releasing hormone (GnRH) to suppress the production of sexual hormones. This study aimed at investigating the effects of these two methods of castration in comparison with intact male pigs on blood T-lymphocyte subsets and function, the immunogl...

Determinants of doctors' decisions to inquire about sexual dysfunction in Malaysian primary care settings.

Science.gov (United States)

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

2013-12-01

Perceptions of how receptive men are to sexual health inquiry may affect Malaysian primary care doctors' decisions to initiate such a discussion with their male patients. This paper quantifies the impact of doctors' perceptions of men's receptivity on male sexual health inquiry. Sexual health inquiry is one of the five areas in a study on determinants of offering preventive health checks to Malaysian men. This was a cross sectional survey among primary care doctors in Malaysia. The questionnaire was based on an empirical model defining the determinants of primary care doctors' intention to offer health checks. The questionnaire measured: (I) perceived receptivity of male patients to sexual health inquiry; (II) doctors' attitudes towards the importance of sexual health inquiries; (III) perceived competence and, (IV) perceived external barriers. The outcome variable was doctors' intention in asking about sexual dysfunction in three different contexts (minor complaints visits, follow-up visits and health checks visits). All items were measured on the Likert scale of 1 to 5 (strongly disagree/unlikely to strongly agree/likely) and internally validated. 198 doctors participated (response rate 70.4%). Female primary care doctors constituted 54.5%. 78% of respondents were unlikely to ask about sexual dysfunction in visits for minor complaints to their male patients, 43.6% in follow up visits and 28.2% in health checks visits. In ordinal regression analysis, positive perception of men's receptivity to sexual health inquiry significantly predicted the doctors' intention in asking sexual dysfunction in all three contexts; i.e., minor complaints visits (P=0.013), follow-up visits (Phealth checks visits (P=0.002). Perceived competence in sexual health inquiry predicted their intention in the follow-up visits (P=0.006) and health checks visits (Phealth checks only predicted their intention in the follow-up visits (P=0.010). Whilst sexual health inquiry should be initiated in an

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.

DOES GENDER IMPACT ON FEMALE DOCTORS' EXPERIENCES IN THE TRAINING AND PRACTICE OF SURGERY?

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Umoetok, F; van Wyk, J; Madiba, T E

2017-06-01

Surgery has been a male-dominated speciality both in South Africa and abroad. This mixed methodology case study collected data from a purposive sample of female surgical registrars enrolled at one institution in South Africa. A self-administered questionnaire was used to explore whether or not female doctors perceived any benefits of being in a male-dominated specialty. It explored problems encountered due to gender, the participants' perceptions of the influence of gender on their surgical training, practice and challenges. Thirty-two female registrars participated in the study. The respondents were mainly South African (91%) and enrolled in seven surgical specialities. Twenty-seven (84%) respondents were satisfied with their practical training and skills development as surgeons. Twenty-four (75%) respondents had identified a mentor from the department and all respondents indicated that the gender of their mentor did not impact on the quality of their training. Seventeen (53%) respondents perceived having received differential treatment due to their gender and 25 (78.2%) thought that the gender of their mentor did not impact on the quality of the guidance in surgery. Challenges included physical threats to them as females from patients and disrespect, emotional threats and defaming statements from male registrars. Other challenges included time-constraints for family and academic work, poor work life balance and being treated differently due to their gender. Seventeen (53%) respondents would consider teaching in the Department of Surgery. Twenty-five respondents (78%) would recommended the specialty to young female students, as they were convinced that surgery had been the right choice for them. Seventeen respondents (53%) were also open to pursuing teaching posts in the Department of Surgery. Generally, females had positive perceptions of their training in Surgery. They expressed concern about finding a worklife balance. The gender of their mentor did not impact

Patients' choice of general practitioner: importance of patients' and doctors' sex and ethnicity.

OpenAIRE

Ahmad, W I; Kernohan, E E; Baker, M R

1991-01-01

The relative importance of sex and ethnicity in patients' choice of doctor is not known. A total of 1633 consultations at a health centre in Bradford, with a mixed ethnic list, were examined over a four week period to test the relative importance of these variables. Patients had the choice to consult any one of: a male Asian, a male white or a female white doctor. Asian patients, irrespective of sex, were significantly (P less than 0.001) more likely to consult the Asian doctor then either of...

Management of female-to-male transgender persons: medical and surgical management, life expectancy.

Science.gov (United States)

Gooren, Louis J

2014-06-01

Hormonal treatment of transgender people is becoming a normal part of medicine, though numbers of subjects remain small because of low prevalence. Information on treatment is scattered and this review brings together the latest information on treatment goals and potential side-effects of androgen treatment of female-to-male transsexual subjects. Androgen treatment of female-to-male transsexuals is usually uneventful, with a good patient compliance. Goals of hormonal treatment are elimination of secondary sex characteristics of the female sex and induction of those of the male sex. Completion takes approximately 2 years. Hormonal treatment is eventually followed by surgical ablation of breasts and removal of uterus and ovaries. Phalloplasty may be considered. Concerns are the sequelae of hypogonadism following surgery, such as loss of bone mass. Contrary to earlier expectations, there is no increase in cardiovascular disease. (Hormone-related) cancers are rare, but vaginal, cervical, endometrial carcinomas have been reported. Cancers of the breasts are of greater concern and have been found in residual mammary tissue after breast ablation. So far, androgen treatment has not raised major safety concerns. Regrets about changing sex have not been reported. Testosterone treatment of female-to-male transsexuals is effective and well tolerated.

A method of handing down surgical clipping technique for cerebral aneurysm

International Nuclear Information System (INIS)

Idei, Masaru; Yamane, Kanji; Okita, Shinji; Kumano, Kiyoshi; Nakae, Ryuta

2009-01-01

Meticulous clipping techniques are essential to obtain good results. Recently, the introduction of intravascular surgery for cerebral aneurysms has decreased the number of the direct clipping surgeries. And the increasing number of the lawsuits against doctors further discourages young surgeons from attempting clipping. As a result, young neurosurgeons, have less experience performing clipping. Therefore, we must learn clipping techniques from expert neurosurgeons under the limitation of having fewer opportunities to perform clipping surgery. In this paper, I present my experiences and discuss ways to obtain techniques for clipping surgery. I performed surgical clipping in 19 cases, 12 unruptured and 7 ruptured aneurysms, 7 males and 12 females aged from 36 to 79 years old (mean 61.9 years). Postoperatively, there were no symptomatic complications, but there were 2 asymptomatic infarctions that were revealed on CT scan. Intraoperative premature rupture occurred in 1 patient with a ruptured aneurysm. Techniques of manipulation with micro-forceps, suction and spatula are required for successful clipping. Off-the-job training of dissecting chicken wing arteries and rat abdominal aortas and vena cavas is useful. Moreover, actual experiences of surgical operations are essential. Surgical experiences raise the motivation of young neurosurgeons and encourage them to train more. We believe that this benign cycle contributes to meticulous surgical skills. (author)

A Qualitative Study Investigating Gender Differences in Primary Work Stressors and Levels of Job Satisfaction in Greek Junior Hospital Doctors

Science.gov (United States)

Antoniou, Alexander-Stamatios; Cooper, Cary L.; Davidson, Marilyn J.

2008-01-01

Primary work stressors and job satisfaction/dissatisfaction in Greek Junior Hospital Doctors (JHDs) are investigated to identify similarities and differences in the reports obtained from male and female hospital doctors. Participants in the study included 32 male and 28 female Greek hospital doctors who provided information through…

Qualitative and Quantitative Analyses on "Greetings" Exchanged by Japanese Doctors and Patients in Metical Interviews

OpenAIRE

植田, 栄子

2007-01-01

The study aims to analyze the interactional verbal and non-verbal behaviors between doctors and patients in medical interviews, focusing on the exchange of "greetings" at the opening of each interview. The conversational data of medical interviews were recorded in Tokyo and Osaka, consisting of 91 interviews by male doctors and 3 interviews by female doctors. There were 36 male patients (14 in Tokyo and 22 in Osaka) and 58 female patients (31 in Tokyo and 27 in Osaka). The average age of the ...

Contemporary surgical devices for male stress urinary incontinence: a review of technological advances in current continence surgery.

Science.gov (United States)

Chung, Eric

2017-07-01

Male stress urinary incontinence (SUI) remains a debilitating condition that adversely impacts all domains of quality of life and is associated with significant social stigma and health economic burden. The incidence of post-prostatectomy urinary incontinence (PPI) depends on the definition of urinary incontinence and the length of patient follow up. In patients with persistent PPI following failure of conservative measures, surgical treatment is recommended although there is no published guideline on when surgery should be performed, and what the best surgical option is. Male slings (MS) can be divided into adjustable or non-adjustable types, and offers an attractive option for patients who wish to avoid mechanical handling during urinary voiding. Published intermediate data supports good safety and efficacy rate in men with mild to moderate degree of SUI. The AMS 800 artificial urinary sphincter (AUS) remains the standard of treatment for complete continence and has the longest efficacy and safety records. Other AUS-like devices are designed to address current AMS 800 limitations but themselves are fraught with their own issues.

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.

Have restricted working hours reduced junior doctors' experience of fatigue? A focus group and telephone interview study.

Science.gov (United States)

Morrow, Gill; Burford, Bryan; Carter, Madeline; Illing, Jan

2014-03-06

To explore the effects of the UK Working Time Regulations (WTR) on trainee doctors' experience of fatigue. Qualitative study involving focus groups and telephone interviews, conducted in Spring 2012 with doctors purposively selected from Foundation and specialty training. Final compliance with a 48 h/week limit had been required for trainee doctors since August 2009. Framework analysis of data. 9 deaneries in all four UK nations; secondary care. 82 doctors: 53 Foundation trainees and 29 specialty trainees. 36 participants were male and 46 female. Specialty trainees were from a wide range of medical and surgical specialties, and psychiatry. Implementation of the WTR, while acknowledged as an improvement to the earlier situation of prolonged excessive hours, has not wholly overcome experience of long working hours and fatigue. Fatigue did not only arise from the hours that were scheduled, but also from an unpredictable mixture of shifts, work intensity (which often resulted in educational tasks being taken home) and inadequate rest. Fatigue was also caused by trainees working beyond their scheduled hours, for reasons such as task completion, accessing additional educational opportunities beyond scheduled hours and staffing shortages. There were also organisational, professional and cultural drivers, such as a sense of responsibility to patients and colleagues and the expectations of seniors. Fatigue was perceived to affect efficiency of skills and judgement, mood and learning capacity. Long-term risks of continued stress and fatigue, for doctors and for the effective delivery of a healthcare service, should not be ignored. Current monitoring processes do not reflect doctors' true working patterns. The effectiveness of the WTR cannot be considered in isolation from the culture and context of the workplace. On-going attention needs to be paid to broader cultural issues, including the relationship between trainees and seniors.

Distribution pattern of surgically treated symptomatic prolapsed lumbar and sacral intervertebral discs in males.

Science.gov (United States)

Nnamdi, Ibe Michael Onwuzuruike

2013-09-01

The pattern of distribution of surgically treated symptomatic prolapsed lumbar and sacral intervertebral discs has been published, though scantily, especially in males. We decided to look at our own series, compare and contrast ours with some of those published. We treated 88 locations of this lesion in 68 males. The clinical features were those of lower back pains, with or without radiation into the lower extremities, sensory loss and paresis of the limbs. There was a case of loss of urinary bladder and ano-rectal control. All lesions were confirmed through cauda-equinograms and treated under general anaesthesia in knee-chest position (MECCA position). The patients were followed up for 3-6 months post-operatively. There were 88 locations in 68 males of 21-70 years of age, with 29 prolapses occurring during the age range 31-40 years, while 54 locations were on the left and 48 at L4/5. The procedures were well tolerated by all patients and there were no post-operative complications. This lesion in our series occurred mostly on the left, at the L4/5 level and peaked at 31-40 years age range. The predictability of occurrence of this disease, using side, level and age is still not feasible in males from our series.

Women's Doctoral Student Experiences and Degree Progress in Education versus Engineering

Science.gov (United States)

Masterman, Ann Katherine

2014-01-01

This study's purpose was to compare the lived experiences of doctoral women studying Education, a prototypically female field, with women studying Engineering, a prototypically male field to illustrate the phenomenon of doctoral degree progress in the two fields. Using critical feminist theory and Valian's (1999) concept of gender schemas, this…

Perceptions of gender equality, work environment, support and social issues for women doctors at a university hospital in Riyadh, Kingdom of Saudi Arabia.

Science.gov (United States)

Baqi, Shehla; Albalbeesi, Amal; Iftikhar, Sundus; Baig-Ansari, Naila; Alanazi, Mohammad; Alanazi, Awadh

2017-01-01

The Kingdom of Saudi Arabia (KSA) is an Islamic monarchy and was established in 1932. Saudi women first entered the medical field in 1975 and the country has since seen a steady increase in women pursuing medicine. However, there is limited data on gender related issues for women doctors practicing in Saudi Arabia. Therefore, our study objective was to assess the perception amongst peers regarding gender equality and social issues faced by women doctors in Saudi Arabia. An online anonymous cross-sectional survey was administered in English to doctors at King Khalid Hospital, affiliated to King Saud University, in Riyadh, between April and May of 2016. Of 1015 doctors, 304 (30%) participated, of which 129 (42.4%) were females and 231 (76%) were Saudi nationals. The average age was 32.4 years (±SD: 8.7). The majority opined that there was no gender discrimination in salaries (73.7% p-value = 0.4), hospital benefits (62.2% p-value = 0.06) or entry into any field of Medicine/Pediatrics (68.4% p-value = 0.207). However, only a minority believed that there was no gender discrimination for entry into surgery (37.3% p-value = .091). A higher proportion of male doctors agreed that promotion opportunities are equal (66.3% vs 45.7%, p-value = 0.002). However, of 54 consultants, only 18 (33.3%) were women. Over half of the women (52.3%) reported that they never wear the face veil. Only a minority of male and female doctors (12.2%) believed women doctors should wear the veil since they examine male patients. Fewer respondents believed that female doctors face harassment from male doctors (14.5%) whereas 30.7% believed female doctors face harassment from male patients. More females, than males, agreed with the statement that female doctors are as committed to their careers as are males (92.2% vs 67.4%, p-valueequal proportions between males and females (68% vs 70.5%, p-value = 0.79). In conclusion, our survey of male and female doctors at a government university hospital in

Surgical virtual reality - highlights in developing a high performance surgical haptic device.

Science.gov (United States)

Custură-Crăciun, D; Cochior, D; Constantinoiu, S; Neagu, C

2013-01-01

Just like simulators are a standard in aviation and aerospace sciences, we expect for surgical simulators to soon become a standard in medical applications. These will correctly instruct future doctors in surgical techniques without there being a need for hands on patient instruction. Using virtual reality by digitally transposing surgical procedures changes surgery in are volutionary manner by offering possibilities for implementing new, much more efficient, learning methods, by allowing the practice of new surgical techniques and by improving surgeon abilities and skills. Perfecting haptic devices has opened the door to a series of opportunities in the fields of research,industry, nuclear science and medicine. Concepts purely theoretical at first, such as telerobotics, telepresence or telerepresentation,have become a practical reality as calculus techniques, telecommunications and haptic devices evolved,virtual reality taking a new leap. In the field of surgery barrier sand controversies still remain, regarding implementation and generalization of surgical virtual simulators. These obstacles remain connected to the high costs of this yet fully sufficiently developed technology, especially in the domain of haptic devices. Celsius.

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

Perceptions of gender equality, work environment, support and social issues for women doctors at a university hospital in Riyadh, Kingdom of Saudi Arabia.

Directory of Open Access Journals (Sweden)

Shehla Baqi

Full Text Available The Kingdom of Saudi Arabia (KSA is an Islamic monarchy and was established in 1932. Saudi women first entered the medical field in 1975 and the country has since seen a steady increase in women pursuing medicine. However, there is limited data on gender related issues for women doctors practicing in Saudi Arabia. Therefore, our study objective was to assess the perception amongst peers regarding gender equality and social issues faced by women doctors in Saudi Arabia. An online anonymous cross-sectional survey was administered in English to doctors at King Khalid Hospital, affiliated to King Saud University, in Riyadh, between April and May of 2016. Of 1015 doctors, 304 (30% participated, of which 129 (42.4% were females and 231 (76% were Saudi nationals. The average age was 32.4 years (±SD: 8.7. The majority opined that there was no gender discrimination in salaries (73.7% p-value = 0.4, hospital benefits (62.2% p-value = 0.06 or entry into any field of Medicine/Pediatrics (68.4% p-value = 0.207. However, only a minority believed that there was no gender discrimination for entry into surgery (37.3% p-value = .091. A higher proportion of male doctors agreed that promotion opportunities are equal (66.3% vs 45.7%, p-value = 0.002. However, of 54 consultants, only 18 (33.3% were women. Over half of the women (52.3% reported that they never wear the face veil. Only a minority of male and female doctors (12.2% believed women doctors should wear the veil since they examine male patients. Fewer respondents believed that female doctors face harassment from male doctors (14.5% whereas 30.7% believed female doctors face harassment from male patients. More females, than males, agreed with the statement that female doctors are as committed to their careers as are males (92.2% vs 67.4%, p-value<0.0001. Of 304 participants, 210 (69.1% said that they would still choose to become a doctor with approximately equal proportions between males and females (68% vs

Does computer-aided surgical simulation improve efficiency in bimaxillary orthognathic surgery?

Science.gov (United States)

Schwartz, H C

2014-05-01

The purpose of this study was to compare the efficiency of bimaxillary orthognathic surgery using computer-aided surgical simulation (CASS), with cases planned using traditional methods. Total doctor time was used to measure efficiency. While costs vary widely in different localities and in different health schemes, time is a valuable and limited resource everywhere. For this reason, total doctor time is a more useful measure of efficiency than is cost. Even though we use CASS primarily for planning more complex cases at the present time, this study showed an average saving of 60min for each case. In the context of a department that performs 200 bimaxillary cases each year, this would represent a saving of 25 days of doctor time, if applied to every case. It is concluded that CASS offers great potential for improving efficiency when used in the planning of bimaxillary orthognathic surgery. It saves significant doctor time that can be applied to additional surgical work. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

Fitzgerald, J E F; Caesar, B C

2012-01-01

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

Penile fracture with disruption of both cavernosal bodies and complete urethral rupture in a 15-years-old male: Delayed surgical approach

Directory of Open Access Journals (Sweden)

Carolina Talini

2016-09-01

Full Text Available Penile fracture is defined as the traumatic rupture of the tunica albuginea of the corpus cavernosa usually associated to trauma during sexual intercourse or masturbation. Historically penile fracture has been managed conservatively, but contemporary management includes early surgical exploration. The case presents a 15-year-old male who suffered a blunt penile trauma and was first managed with cystostomy and no penile exploration. Five months after trauma was submitted to definitive surgical correction of both, urethral rupture and bilateral corporal fracture. The proposed surgical techinique was a diamond-shape corpora anastomosis. Surgery did well and after 3 years he presented no late complications.

Gender and power: Nurses and doctors in Canada

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Phillips Susan P

2003-02-01

Full Text Available Abstract Background The nurse-doctor relationship is historically one of female nurse deference to male physician authority. We investigated the effects of physicians' sex on female nurses' behaviour. Methods Nurses at an urban, university based hospital completed one of two forms of a vignette-based survey in January, 2000. Each survey included four clinical scenarios. In form 1 of the questionnaire the physicians described were female, male, female, and male. In form 2, vignettes were identical but the physician sex was changed to male, female, male, and female. Differences in responses to questions based on the sex of the physician in each vignette were studied Results 199 self-selected nurses completed the survey. The responses of 177 female respondents and 11 respondents who did not specifiy their sex, and were assumed to be female based on the overall sex ratio of respondents, were analysed. Persistent sex-role stereotypes influenced the relationship between female nurses and physicians. Nurses were more willing to serve and defer to male physicians. They approached female physicians on a more egalitarian basis, were more comfortable communicating with them, yet more hostile toward them. Conclusion When nurses and doctors are female, traditional power imbalances in their relationship diminish, suggesting that these imbalances are based as much on gender as on professional hierarchy. The effects of this change on the authority of the medical profession, the role of nurses, and on patient care merit further exploration.

Providing surgical care in Somalia: A model of task shifting.

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Chu, Kathryn M; Ford, Nathan P; Trelles, Miguel

2011-07-15

Somalia is one of the most political unstable countries in the world. Ongoing insecurity has forced an inconsistent medical response by the international community, with little data collection. This paper describes the "remote" model of surgical care by Medecins Sans Frontieres, in Guri-El, Somalia. The challenges of providing the necessary prerequisites for safe surgery are discussed as well as the successes and limitations of task shifting in this resource-limited context. In January 2006, MSF opened a project in Guri-El located between Mogadishu and Galcayo. The objectives were to reduce mortality due to complications of pregnancy and childbirth and from violent and non-violent trauma. At the start of the program, expatriate surgeons and anesthesiologists established safe surgical practices and performed surgical procedures. After January 2008, expatriates were evacuated due to insecurity and surgical care has been provided by local Somalian doctors and nurses with periodic supervisory visits from expatriate staff. Between October 2006 and December 2009, 2086 operations were performed on 1602 patients. The majority (1049, 65%) were male and the median age was 22 (interquartile range, 17-30). 1460 (70%) of interventions were emergent. Trauma accounted for 76% (1585) of all surgical pathology; gunshot wounds accounted for 89% (584) of violent injuries. Operative mortality (0.5% of all surgical interventions) was not higher when Somalian staff provided care compared to when expatriate surgeons and anesthesiologists. The delivery of surgical care in any conflict-settings is difficult, but in situations where international support is limited, the challenges are more extreme. In this model, task shifting, or the provision of services by less trained cadres, was utilized and peri-operative mortality remained low demonstrating that safe surgical practices can be accomplished even without the presence of fully trained surgeon and anesthesiologists. If security improves

ORIGINAL ARTICLES Ethics and surgical training in ancient India ...

African Journals Online (AJOL)

2008-03-01

Mar 1, 2008 ... Ancient India's contributions to ethics and surgical training ... business of health care becomes increasingly venal. Doctors are better informed .... 'Friendship, sympathy towards the sick, interest in cases .... Textbook of Surgery.

Presenile dementia in a 41-year old male Nigerian medical doctor ...

African Journals Online (AJOL)

Presenile dementia reflects an underlying pathology that affects the cerebral cortex, its sub-cortical connections or both occurring in persons below 65 years of age. In this study, a case report of a 41-yr old medical doctor whose mental illness spanned 8 yrs is presented. Initially he came with paranoid psychosis of the acute ...

Cost awareness among doctors in an Irish university-affiliated teaching hospital

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William H.C. Tiong

2011-11-01

Full Text Available Previous studies in USA and Canada have found that physicians and physicians in training have a limited understanding of medical care costs. In this study, we set out to survey all grades of doctors in the surgical department, emergency department, and anaesthetic department in a university-affiliated, Irish teaching hospital. Open-ended questionnaires on cost of 25 routinely used items in the hospital were sent to each department. The aims of the study were to assess the present knowledge of cost among the various grades of doctors, and to evaluate the level of professional experience on cost awareness and their confidence in their estimates. We had an overall response rate of 56.8% with 68.5% of doctors admitted to have estimated more than 90% of their responses. Ninety three percent of doctors have no confidence in their estimates on cost of listed items. We found that the lack of cost awareness was universal among doctors of all grades (P = 0.236. The doctors in our study population showed a high level of inaccuracy on their estimates of cost of routinely used items with 84% of the items overestimated. Our results were discouraging and demonstrated that considerable educational activity will be necessary if doctors are to be more cost effective in meeting the national health care budget.

THE KNOWLEDGE OF HEALTH CARE WORKERS AND DOCTORS REGARDING HAND SCRUB

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Rahul Sanjeev Chaudhary

2016-08-01

Full Text Available BACKGROUND Hand hygiene practices of health care workers has been shown to be an effective measure in preventing hospital acquired infections. This concept has been aptly used to improve understanding, training, monitoring, and reporting hand hygiene among healthcare workers. We conducted this study to assess the knowledge of doctors and health care workers regarding hand scrub. METHODS A study was conducted among doctors and health care workers in a tertiary care hospital. Knowledge was evaluated by using self-structured questionnaire based on the guidelines of hand hygiene prescribed by WHO. RESULTS The awareness and knowledge of preoperative surgical hand scrubbing was moderate in doctors, but unfortunately poor in HCWs. CONCLUSION Our study highlights the need for introducing measures in order to increase the knowledge of preoperative hand scrub in teaching hospital which may translate into good practices.

Information Needs and Information Gathering Behavior of Medical Doctors in Maiduguri, Nigeria

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Jonathan A. Ocheibi

2003-06-01

Full Text Available Survey data describes the results of an investigation on the information needs and information gathering behaviour of Medical doctors in Maiduguri, Nigeria. A total of 158 Medical doctors (128 males and 30 (females were used for the study. The overall response rate was around 70.2 percent. Medical doctors need specific medical information to enhance their knowledge on a day-to-day basis, particularly with the information explosion such as e-mail and internet facilities. Medical doctors prefer the use of publishers catalogues as the most important source for new developments in their relevant fields. Many do not have access to local data bases that are supposed to have remarkable impact on their information gathering behaviour.

Chaperones and intimate physical examinations: what do male and female patients want?

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Fan, V C; Choy, H T; Kwok, G Yj; Lam, H G; Lim, Q Y; Man, Y Y; Tang, C K; Wong, C C; Yu, Y F; Leung, G Kk

2017-02-01

Many studies of patients' perception of a medical chaperone have focused on female patients; that of male patients are less well studied. Moreover, previous studies were largely based on patient populations in English-speaking countries. Therefore, this study was conducted to investigate the perception and attitude of male and female Chinese patients to the presence of a chaperone during an intimate physical examination. A cross-sectional guided questionnaire survey was conducted on a convenient sample of 150 patients at a public teaching hospital in Hong Kong. Over 90% of the participants considered the presence of a chaperone appropriate during intimate physical examination, and 84% felt that doctors, irrespective of gender, should always request the presence of a chaperone. The most commonly cited reasons included the availability of an objective account should any legal issue arise, protection against sexual harassment, and to provide psychological support. This contrasted with the experience of those who had previously undergone an intimate physical examination of whom only 72.6% of women and 35.7% of men had reportedly been chaperoned. Among female participants, 75.0% preferred to be chaperoned during an intimate physical examination by a male doctor, and 28.6% would still prefer to be chaperoned when being examined by a female doctor. Among male participants, over 50% indicated no specific preference but a substantial minority reported a preference for chaperoned examination (21.2% for male doctor and 25.8% for female doctor). Patients in Hong Kong have a high degree of acceptance and expectations about the role of a medical chaperone. Both female and male patients prefer such practice regardless of physician gender. Doctors are strongly encouraged to discuss the issue openly with their patients before they conduct any intimate physical examination.

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

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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.

Not Equal for All: Gender and Race Differences in Salary for Doctoral Degree Recipients

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Webber, Karen L.; Canché, Manuel González

2015-01-01

Despite a recent increase in women and racial/ethnic minorities in U.S. postsecondary education, doctoral recipients from these groups report lower salaries than male and majority peers. With a longitudinal sample of approximately 10,000 respondents from the "Survey of Doctorate Recipients," this study adds to the limited literature…

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

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Stamm, Martina; Buddeberg-Fischer, Barbara

2011-05-01

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

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

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Gjerberg, Elisabeth

2003-10-01

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

Perception of Female Doctors\\' Clinical Practice and Teaching in ...

African Journals Online (AJOL)

The reasons adduced for these include socio-cultural misconceptions, gender concordance and sensitivity. We conclude that female doctors should improve their practice style and content and veer into male dominated specialties to clarify these misconceptions. Journal of Medicine and Biomedical Research Vol.

"A plea for the prostate": doctors, prostate dysfunction, and male sexuality in late 19th- and early 20th-century Canada.

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O'Shea, Christopher D

2012-01-01

Historical examinations of medical discourse concerning male sexuality have focused on the perceived linkage between masturbation and sexual neurasthenia. However, more tangible conditions such as prostatic hypertrophy were also linked to the sexual misconduct of young and old men. This paper examines both the medical discourse concerning prostatic hypertrophy and how the development of treatment was influenced by contemporary concerns with both sexuality and masculinity. It argues that mainstream doctors moved away from the Victorian preoccupation with the dangers of illicit sexuality and increasingly regarded the restoration of sexual function as being in the best interests of their patients. This view was particularly evident in their quest for an operative method that would cure prostatic hypertrophy while preserving potency.

Perceived Organizational Support Impacts on the Associations of Work-Family Conflict or Family-Work Conflict with Depressive Symptoms among Chinese Doctors.

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Hao, Junhui; Wang, Jiana; Liu, Li; Wu, Wei; Wu, Hui

2016-03-16

As a common mental disorder, depressive symptoms had been studied extensively all over the world. However, positive resources for combating depressive symptoms among Chinese doctors were rarely studied. Our study aimed to investigate the relationships between work-family conflict (WFC) and family-work conflict (FWC) with depressive symptoms among Chinese doctors. Meanwhile, the role of perceived organizational support (POS) in this association was explored at an organizational level. The investigation was conducted between March and April 2014. Questionnaires that measured WFC, FWC, depressive symptoms and POS were distributed to 1200 doctors in Shenyang, China. The final study subjects were 931 doctors (effective response rate: 77.6%). In all analyses, male and female doctors were analyzed separately because of possible gender differences. Hierarchical linear regression analyses were used to examine the moderating role of POS. Baron and Kenny's technique and asymptotic and resampling strategies were used to explore the mediating role of POS on the associations of WFC or FWC with depressive symptoms. WFC and FWC had positive relations with depressive symptoms among doctors. POS played a partial mediating role on the correlation of FWC with depressive symptoms among male doctors, and POS played a partial mediating role on the correlation of WFC with depressive symptoms among female doctors. POS had a positive moderating effect on the relationship between WFC and depressive symptoms among doctors. WFC and FWC could aggravate doctors' depressive symptoms, and POS, as an organizational resource, could fight against doctors' depressive symptoms. When POS functioned as a mediator, FWC had a negative effect on POS, which could increase male doctors' depressive symptoms, and WFC had a negative effect on POS, which could increase female doctors' depressive symptoms. In the meantime, POS, as a moderator, could enhance the effects of WFC on depressive symptoms.

[Doctors in love].

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de Leeuw, Peter W

2012-01-01

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

Surgical treatment of a Pattern I Obstructive Sleep Apnea Syndrome individual - clinical case report

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Christiane Cavalcante Feitoza

Full Text Available Obstructive Sleep Apnea Syndrome (OSA is a multifactorial disease that highly alters a persons quality of life. It is characterized by the repeated interruption of breathing during sleep, due to an obstruction or the collapse of the upper airways. Since it is a multifactorial etiological disorder, it requires a thorough diagnosis and treatment with an interdisciplinary team, which comprises several professionals such as a surgical dentist, phonoaudiologist, otorhinolaryngologist, sleep doctor, neurologist and physiotherapist. The diagnosis and the degree of severity of the syndrome is determined through a polysomnography examination. After that, the best form of treatment is devised depending on the gravity of the case. In cases of moderate to severe apnea, invasive treatment through surgical procedures such as maxillomandibular advancement remains the preferred option as it increases the posterior air space, reducing and/or eliminating the obstruction. Thus, improving the patients respiratory function and, consequently, his quality of life as it is shown in the clinical case at hand. In which the male patient, facial pattern type I, 41 years of age, diagnosed with moderate OSA (Apnea-Hypopnea Index - AHI of 23.19, decided to have a surgical treatment instead of a conservative one, resulting in the cure of apnea (AHI of 0.3.

Patients' experiences and satisfaction about care provided by male nurses in medical surgical units in Islamabad, Pakistan: A pilot study.

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Younas, Ahtisham; Sundus, Amara

2018-01-01

Nursing is predominantly a female profession and caring has been considered an attribute of female nurses, which could imply a noncaring image of male nurses. To determine patients' experiences and satisfaction from care provided by male nurses in a private hospital in Islamabad, Pakistan. This cross-sectional study included a purposive sample of 50 patients admitted to medical surgical units for at least 2 days and who had at least three professional interactions with a male nurse. The Newcastle Satisfaction with Nursing Scale was used for data collection. Descriptive statistics were used for data analysis. The total score for experience and satisfaction was 81 and 51, respectively. A statistically significant difference existed between experience and satisfaction scores of male and female participants, indicating that males were more pleased and satisfied with their experience of receiving care from male nurses compared to the female participants. The male nurses were concerned for their patients, they were knowledgeable about the patients' condition and care, and provided them with clear explanations of the medical and nursing procedures. However, they seem to lack interpersonal relationship with patients and did not take initiative in understanding their patients. © 2017 Wiley Periodicals, Inc.

Usefulness and capability of three-dimensional, full high-definition movies for surgical education.

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Takano, M; Kasahara, K; Sugahara, K; Watanabe, A; Yoshida, S; Shibahara, T

2017-12-01

Because of changing surgical procedures in the fields of oral and maxillofacial surgery, new methods for surgical education are needed and could include recent advances in digital technology. Many doctors have attempted to use digital technology as educational tools for surgical training, and movies have played an important role in these attempts. We have been using a 3D full high-definition (full-HD) camcorder to record movies of intra-oral surgeries. The subjects were medical students and doctors receiving surgical training who did not have actual surgical experience ( n  = 67). Participants watched an 8-min, 2D movie of orthognathic surgery and subsequently watched the 3D version. After watching the 3D movie, participants were asked to complete a questionnaire. A lot of participants (84%) felt a 3D movie excellent or good and answered that the advantages of a 3D movie were their appearance of solidity or realism. Almost all participants (99%) answered that 3D movies were quite useful or useful for medical practice. Three-dimensional full-HD movies have the potential to improve the quality of medical education and clinical practice in oral and maxillofacial surgery.

[Vaginism - a surgical or consultative problem? (author's transl)].

Science.gov (United States)

Wenderlein, J M

1982-04-01

For the last one hundred years or so doctors have been confronted with the phenomenon of vaginism as a functional sexual disturbance. 70 years ago the psychogenetic nature of this disturbance was recognized, and yet gynaecologists and surgeons are still suggesting and practising surgical and mechanical interventions at the vaginal orifice. This is indeed regrettable - and not only because such attempts remain unsuccessful: in this manner doctors are fixed on the idea of an organic cause of the disturbance instead of motivating the patients to undergo consultative treatment. Vaginism may even entail psychosocial advantages for the women in some cases.

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

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

2018-05-01

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

[Surgical research in Germany--an international comparison].

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Fendrich, V; Rothmund, M

2010-04-01

Surgical research in Germany occupies a lower position in international ranking than expected. According to the size of the population, the economic impact, the gross domestic product and the research funding capacity, the impact of German surgical research should be much higher. Reasons are a more intensive commitment to patient care, structural differences and a changing lifestyle in younger doctors in comparison to many leading countries. If the situation is to be improved all factors have to be evaluated and, if possible, changed. Overall, German surgeons are underrepresented as readers and authors in the scientific market, which is mostly in the English language.

The self-construal of nurses and doctors: beliefs on interdependence and independence in the care of older people.

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Voyer, Benjamin G; Reader, Tom

2013-12-01

To compare the self-construal of nurses and doctors and establish whether their roles affect perceptions of independence and interdependence. Previous research has identified that errors in patient care occur when health professionals do not work cohesively as a team and have divergent beliefs about collaboration. Thus, it is important to understand factors shaping these beliefs. Although these are usually explained by aspects of group norms, the concept of self-construal may serve as an underlying explanation. A quasi-experimental design was used. One hundred and two nurses and doctors working in three nursing homes in Belgium took part in this study in 2009. Nurses' and doctors' self-construal was measured at their workplace, using Singelis' self-construal scale. Statistical differences between nurses and doctors were investigated using analysis of covariance. Results showed statistically significant differences between doctors' and nurses' self-construal. Doctors reported higher and dominant levels of 'independent self-construal' compared with nurses. There were no differences between nurses and doctors for interdependence. However, gender differences emerged with male doctors reporting lower levels of interdependent self-construal than male nurses. Conversely, female doctors reported higher levels of interdependent self-construal than female nurses. Differences in the roles and training of nurses and doctors and in knowledge of their interdependencies may explain differences in self-construal. This might be useful for understanding why nurses and doctors develop divergent attitudes towards teamwork. Training that focuses on sharing knowledge on team interdependencies may positively influence teamwork attitudes and behaviour. © 2013 John Wiley & Sons Ltd.

Hostile sexist male patients and female doctors: a challenging encounter.

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Klöckner Cronauer, Christina; Schmid Mast, Marianne

2014-01-01

Patient characteristics and attitudes can affect how patients react to the physician's communication style, and this reaction can then influence consultation outcomes. The goal of the present study was to investigate whether the attitude of a sexist male patient affects how he perceives a female physician's nonverbal communication and whether this then results in expecting less positive consultation outcomes. Participants were analog patients who viewed four videotaped male and four videotaped female physicians in a consultation with one of their patients. Physician videos were preselected to represent a range of high and low patient-centered physician nonverbal behavior. Participants filled in questionnaires to assess how patient-centered they perceived the female and male physicians' nonverbal communication to be, and participants indicated how positive they expected the consultation outcomes to be. Moreover, we assessed the participants' sexist attitudes with a questionnaire measuring hostile and benevolent sexism. Students (N = 60) from a French-speaking university in Switzerland were recruited on campus. The main outcome measures were the extent to which analog patients expect the consultation outcomes to be positive (high satisfaction, increased trust in the physician, intention to adhere to treatment recommendations, and perceived physician competence) and the extent to which analog patients perceive physicians as patient-centered (judged from the physicians' nonverbal cues). Male analog patients' hostile sexism was negatively related to perceiving the physicians as patient-centered, and male analog patients' hostile sexism was also negatively related to expected positive consultation outcomes. For male patients viewing female physicians, mediation analysis revealed that perceived physician patient-centeredness mediated the negative relationship between hostile sexism and expected positive consultation outcomes. Male hostile sexist patients perceive a female

PROSTATE CANCER SCREENING: PSA TEST AWARENESS AMONG ADULT MALES.

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Obana, Michael; O'Lawrence, Henry

2015-01-01

The overall purpose of this study was to determine whether visits to the doctor in the last 12 months, education level, and annual household income for adult males increased the awareness of prostate-specific antigen (PSA) tests. The effect of these factors for the knowledge of PSA exams was performed using statistical analysis. A retrospective secondary database was utilized for this study using the questionnaire in the California Health Interview Survey from 2009. Based on this survey, annual visits to the doctor, higher educational levels attained, and greater take-home pay were statistically significant and the results of the study were equivalent to those hypothesized. This also reflects the consideration of marketing PSA blood test screenings to those adult males who are poor, uneducated, and do not see the doctor on a consistent basis.

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

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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.

[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.

Preparing students to be doctors: introduction of a sub-internship program.

LENUS (Irish Health Repository)

Robb, W B

2011-04-05

Preparing graduates for the transformation from medical student to doctor provides medical schools with a real challenge. Medical educators advocate a process of graduated delegation of responsibility in the clinical years of medical school. This is best exemplified in the North American system of sub-internship programmes; an educational approach which European medical schools have been slow to adopt. This study reports on the introduction of an intensive two-week surgical sub-internship for final medical year students. "Sub-interns" were asked to complete pre and post sub-internship online questionnaires assessing their readiness to perform clinical and practical skills, attitudes towards the program, and how well it prepared students for internship. Forty-nine students completed a questionnaire pre sub-internship and 47 completed the post-questionnaire. Student confidence towards practical and clinical skills and their first day at work increased over the two weeks. Mean Iikert scores for all 6 practical and clinical skills improved post sub-internship. The introduction of a surgical sub-internship is timely and welcomed by medical students. Its development helps bridge the gap in responsibilities between medical student and doctor.

From theater to the world wide web--a new online era for surgical education.

LENUS (Irish Health Repository)

O'Leary, D Peter

2012-07-01

Traditionally, surgical education has been confined to operating and lecture theaters. Access to the World Wide Web and services, such as YouTube and iTunes has expanded enormously. Each week throughout Ireland, nonconsultant hospital doctors work hard to create presentations for surgical teaching. Once presented, these valuable presentations are often never used again.

Counseling Psychology Doctoral Students' Training Experiences in Primary Care Psychology

Science.gov (United States)

Cox, Jared

2011-01-01

This qualitative study focused on counseling psychology doctoral students' perspectives regarding their practicum training experience in primary care psychology. The four participants included three females and one male. Semi-structured individual and focus group interviews were used to explore participants' experiences. The participants described…

Treatment choices for patients with invasive lobular breast cancer: a doctor survey.

Science.gov (United States)

Jacobs, Carmel; Ibrahim, Mohamed F K; Clemons, Mark; Hutton, Brian; Simos, Demetrios; Caudrelier, Jean-Michel; Graham, Ian D; Smith, Stephanie; Addison, Christina; Arnaout, Angel

2015-08-01

Invasive lobular breast cancer (ILC) has distinct features that present challenges for management. We surveyed doctors regarding management approaches, opinions on quality of evidence supporting their practice, and future research needs. An online questionnaire was developed and circulated to breast cancer surgical, radiation and medical oncologists. The questionnaire was completed by 88/428 doctors (20.6%); 22/56 (39.3%) surgeons, 21/64 (32.8%) radiation oncologists and 45/308 (14.6%) medical oncologists. The majority (65%) of surgeons were comfortable treating ILC patients using the same surgical management as patients with invasive ductal cancers (IDC). Furthermore, 25% would perform a similar surgery but would obtain larger gross margins. There was equipoise for radiation oncologists regarding whether or not ILC was an independent risk factor for local-regional recurrence after either breast-conserving surgery or mastectomy. Of those radiation oncologists who believe ILC is an independent risk factor for recurrence after mastectomy, 44.4% would offer radiation in the absence of usual indications. Medical oncologists approached systemic therapy for ILC patients similarly to those with comparable IDCs. Areas identified as most controversial and requiring future research were preoperative magnetic resonance imaging, radiotherapy post-mastectomy and the responsiveness of ILC to adjuvant chemotherapy compared with endocrine therapy. There is a variation in doctors' beliefs, management and opinions regarding the quality of evidence for the management of ILC. Clinical trials specifically assessing the management of ILC are required to guide clinical practice. © 2015 John Wiley & Sons, Ltd.

Survival strategies of male nurses in rural areas of Japan.

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Asakura, Kyoko; Watanabe, Ikue

2011-12-01

This study seeks to describe the survival strategies of male nurses in Japanese rural areas. Interviews were conducted with 12 male nurses who described their occupational experiences. The modified grounded theory approach was used for the data collection and analysis. The survival strategies of these male nurses can be categorized into four types: (i) giving priority to the achievement of financial security; (ii) agreeing to a dependent relationship with doctors; (iii) maintaining one's male identity through supporting the female nurses; and (iv) making an appeal to the significance of men in the female-dominated nursing profession. The survival strategies that were used by the male nurses were subtle, allowing them to influence indirectly both the female nurses and the doctors. These findings contribute to our understanding of the experiences of male nurses, a gendered minority in a female-dominated workplace, and encourage gender equality in the nursing profession. © 2011 The Authors. Japan Journal of Nursing Science © 2011 Japan Academy of Nursing Science.

Doctors' duty to disclose error: a deontological or Kantian ethical analysis.

Science.gov (United States)

Bernstein, Mark; Brown, Barry

2004-05-01

Medical (surgical) error is being talked about more openly and besides being the subject of retrospective reviews, is now the subject of prospective research. Disclosure of error has been a difficult issue because of fear of embarrassment for doctors in the eyes of their peers, and fear of punitive action by patients, consisting of medicolegal action and/or complaints to doctors' governing bodies. This paper examines physicians' and surgeons' duty to disclose error, from an ethical standpoint; specifically by applying the moral philosophical theory espoused by Immanuel Kant (ie. deontology). The purpose of this discourse is to apply moral philosophical analysis to a delicate but important issue which will be a matter all physicians and surgeons will have to confront, probably numerous times, in their professional careers.

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.

Prevalence and correlates of job stress among junior doctors in the ...

African Journals Online (AJOL)

Prevalence and correlates of job stress among junior doctors in the ... Journal Home > Vol 14, No 2 (2016) > ... Descriptive statistics were generated. ... 61.3% were males, 59% had spent less than 5 years in medical practice, and 34.8% were ...

Retrospective analysis of factors affecting the efficacy of surgical treatment of the scar.

Science.gov (United States)

Yang, Z; Shi, X; Zhang, Y; Wang, S; Lei, Z; Liu, X; Fan, D

2014-04-01

The scar is a major problem in the medical profession. Its timely treatment is very important for the better outcome of the scar treatment and for the improvement of the life quality of the patients. The aim of this study was retrospectively analyzed the epidemiological characteristics affecting the efficacy of the scar surgical treatment of the people in the western part of China. Total 414 scar cases were retrospectively analyzed to clarify the epidemiological characteristics and the factors affecting the scar surgical treatment efficacy. The factors included were sex, age, area distribution, treatment seasons, injury sites, injury causes, and the time from scarring to the surgical treatment. All scar cases were surgically treated with the repairing technology including skin graft, flap and soft tissue dilation. There were 206 males and 208 females with the average age 20.53±12.9 years (age range 1-68 years). The patient proportions in the age groups of 0-20, 21-40 and >40 years were 61.4% (254 cases), 29.2% (121 cases), and 9.4% (39 cases) respectively. The patient's attendance rate reached the highest during the summer and winter. Most patients were from the rural areas with an increasing tendency each year. The burn scars were the most abundant and the injury sites were mostly the head and face. Univariate analysis showed that the time from scarring to the surgical treatment and the injury sites were significantly influenced the scar surgical treatment efficacy. Logistic regression analysis demonstrated that the injured sites of the head and face significantly influenced the scar surgical treatment efficacy. With the development of economy in China, more scar patients especially younger and children visit doctors predominantely from the rural areas. Usually, they get their scars in the exposed area of their bodies (head and face) which seriously affect the patient's appearance and function. Factors influencing the scar surgical treatment efficacy has

Attitudes towards euthanasia and physician-assisted suicide among Pakistani and Indian doctors: A survey

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Syed Qamar Abbas

2008-01-01

Full Text Available Aim: This study attempts to assess the attitude of Pakistani and Indian doctors to euthanasia and physician-assisted suicide. Methods: We used a questionnaire survey that included one case history of a patient with cancer and another of one suffering from motor neurone disease (MND. Results: Fifty-two of 100 doctors from Pakistan returned the completed questionnaires. Eight of the 52 (15.3% doctors agreed with the concept of euthanasia being an acceptable option for the patient with MND. Six of the 52 (11.5% supported a similar approach for the cancer patient. From India, 60/100 doctors returned the completed questionnaires. Sixteen of the 60 (26.6% doctors supported euthanasia as an option for the patient with MND whereas 15 (25% supported a similar option for the cancer patient. Conclusion: We conclude that only a minority of the doctors support euthanasia. This group belongs to a younger age group. In Pakistan, they were more likely to be males. The religion of the doctors did not appear to be a determining factor.

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

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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.

Doctors' attitudes about prescribing and knowledge of the costs of common medications.

LENUS (Irish Health Repository)

McGuire, C

2012-02-01

INTRODUCTION: Compliance with medical therapy may be compromised because of the affordability of medications. Inadequate physician knowledge of drug costs may unwittingly contribute to this problem. METHODS: We measured attitudes about prescribing and knowledge of medication costs by written survey of medical and surgical non consultant hospital doctors and consultants in two University teaching hospitals (n = 102). Sixty-eight percent felt the cost of medicines was an important consideration in the prescribing decision, however, 88% often felt unaware of the actual costs. Only 33% had easy access to drug cost data, and only 3% had been formally educated about drug costs. Doctors\\' estimates of the cost of a supply of ten commonly used medications were accurate in only 12% of cases, too low for 50%, and too high for 38%. CONCLUSIONS: Interventions are needed to educate doctors about drug costs and provide them with reliable, easily accessible cost information in real-world practice.

Effects of neonatal surgical castration and immunocastration in male pigs on blood T lymphocytes and health markers.

Science.gov (United States)

Leclercq, C; Prunier, A; Merlot, E

2014-05-01

Surgical castration in pig husbandry is criticized for welfare reasons. Thus, it is necessary to evaluate alternative ways of rearing male pigs, such as entire or immunocastrated animals. Immunocastration is a vaccination directed against gonadotropin-releasing hormone (GnRH) to suppress the production of sexual hormones. This study aimed at investigating the effects of these two methods of castration in comparison with intact male pigs on blood T-lymphocyte subsets and function, the immunoglobulin (Ig) response to an influenza vaccine and health markers during sexual development. A total of 70 animals were allocated to three experimental groups: entire (E), surgically castrated at 5 to 6 days of age (SC), and immunized against GnRH at 3 and 4 months of age (IC). Blood samples were collected at 3, 4 and 5 months. At slaughter, global health status and body and spleen weights were measured. Results showed that SC male pigs had fewer blood lymphocytes than E pigs at 4 and 5 months (Ppigs did not differ significantly from E pigs. The percentages of CD3+, CD3+CD4+ and CD3+CD8+ lymphocytes were not altered by treatment (P>0.1). Compared with E pigs, the SC pigs had a higher percentage of CD3+CD4+CD8+ cells at 4 months, whereas the IC pigs had a higher percentage at 5 months (Ppigs had a lower percentage than E pigs at 4 and 5 months (Ppigs did not differ significantly from E pigs at any age. However, there were no consequences on T-lymphocyte proliferation and total IgG or anti-influenza Ig. At slaughter, relative spleen weight was decreased in IC pigs, whereas pneumonia score was decreased in SC pigs relatively to E pigs. Overall, no clear functional consequences of either method on commercial pig immune abilities were demonstrated, but more investigations are required to ascertain this conclusion.

Reducing maternal mortality in conflict areas: Surgical-anesthetic experience in Boost Hospital - Afghanistan

OpenAIRE

Izquierdo, Gilda; Trelles, Miguel; Khan, Nasrullah

2016-01-01

Introduction: Helmand province, whose capital is Lashkar-Gah, is one of the most volatile provinces affected by the conflict in Afghanistan. Doctors without Borders began to work in Boost Hospital in 2009. Method: Retrospective review of surgical procedures at the Doctors without Borders Operational Center in Brussels, February 11, 2010 to September 30, 2012. Results: 5719 surgeries were performed on 4334 patients. 47% were emergency interventions and 75% were first interventions. 39.7% (n = ...

A randomized, controlled, multicenter contraceptive efficacy clinical trial of the intravas device, a nonocclusive surgical male sterilization

Directory of Open Access Journals (Sweden)

Wen-Hong Lu

2014-06-01

Full Text Available Because of unavoidable complications of vasectomy, this study was undertaken to assess the efficacy and safety of male sterilization with a nonobstructive intravas device (IVD implanted into the vas lumen by a mini-surgical method compared with no-scalpel vasectomy (NSV. IVDs were categorized into two types: IVD-B has a tail used for fixing to the vas deferens (fixed wing whereas IVD-A does not. A multicenter prospective randomized controlled clinical trial was conducted in China. The study was comprised of 1459 male volunteers seeking vasectomy who were randomly assigned to the IVD-A (n = 487, IVD-B (n = 485 or NSV (n = 487 groups and underwent operation. Follow-up included visits at the 3 rd -6 th and 12 th postoperative months. The assessments of the subjects involved regular physical examinations (including general and andrological examinations and semen analysis. The subjects' partners also underwent monitoring for pregnancy by monthly interviews regarding menstruation and if necessary, urine tests. There were no significant differences in pregnancy rates (0.65% for IVD-A, 0 for IVD-B and 0.21% for NSV among the three groups (P > 0.05. The cumulative rates of complications at the 12 th postoperative month were zero, 0.9% and 1.7% in the three groups, respectively. In conclusion, IVD male sterilization exhibits a low risk of long-term adverse events and was found to be effective as a male sterilization method, similar to the NSV technique. IVD male sterilization is expected to be a novel contraceptive method.

A randomized, controlled, multicenter contraceptive efficacy clinical trial of the intravas device, a nonocclusive surgical male sterilization

Science.gov (United States)

Lu, Wen-Hong; Liang, Xiao-Wei; Gu, Yi-Qun; Wu, Wei-Xiong; Bo, Li-Wei; Zheng, Tian-Gui; Chen, Zhen-Wen

2014-01-01

Because of unavoidable complications of vasectomy, this study was undertaken to assess the efficacy and safety of male sterilization with a nonobstructive intravas device (IVD) implanted into the vas lumen by a mini-surgical method compared with no-scalpel vasectomy (NSV). IVDs were categorized into two types: IVD-B has a tail used for fixing to the vas deferens (fixed wing) whereas IVD-A does not. A multicenter prospective randomized controlled clinical trial was conducted in China. The study was comprised of 1459 male volunteers seeking vasectomy who were randomly assigned to the IVD-A (n = 487), IVD-B (n = 485) or NSV (n = 487) groups and underwent operation. Follow-up included visits at the 3rd–6th and 12th postoperative months. The assessments of the subjects involved regular physical examinations (including general and andrological examinations) and semen analysis. The subjects’ partners also underwent monitoring for pregnancy by monthly interviews regarding menstruation and if necessary, urine tests. There were no significant differences in pregnancy rates (0.65% for IVD-A, 0 for IVD-B and 0.21% for NSV) among the three groups (P > 0.05). The cumulative rates of complications at the 12th postoperative month were zero, 0.9% and 1.7% in the three groups, respectively. In conclusion, IVD male sterilization exhibits a low risk of long-term adverse events and was found to be effective as a male sterilization method, similar to the NSV technique. IVD male sterilization is expected to be a novel contraceptive method. PMID:24589454

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....

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

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...

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.

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

Surgical Vision: Google Glass and Surgery.

Science.gov (United States)

Chang, Johnny Yau Cheung; Tsui, Lok Yee; Yeung, Keith Siu Kay; Yip, Stefanie Wai Ying; Leung, Gilberto Ka Kit

2016-08-01

Google Glass is, in essence, a smartphone in the form of a pair of spectacles. It has a display system, a bone conduction "speaker," video camera, and connectivity via WiFi or Bluetooth technologies. It can also be controlled by voice command. Seizing Google Glass' capabilities as windows of opportunity, surgeons have been the first group of doctors trying to incorporate the technology into their daily practices. Experiences from different groups have demonstrated Google Glass' potential in improving perioperative care, intraoperative communication and documentation, surgical outcome as well as surgical training. On the other hand, the device has technical limitations, notably suboptimal image qualities and a short battery life. Its operational functions also bring forth concerns on the protection of patient privacy. Nonetheless, the technological advances that this device embodies hold promises in surgical innovations. Further studies are required, and surgeons should explore, investigate, and embrace similar technologies with keen and informed anticipation. © The Author(s) 2016.

Aesthetic surgery of the male genitalia.

Science.gov (United States)

Alter, Gary J; Salgado, Christopher J; Chim, Harvey

2011-08-01

Appearance of the male genitalia is linked with self-esteem and sexual identity. Aesthetic surgery of the male genitalia serves to correct perceived deficiencies as well as physical deformities, which may cause psychological distress. Attention to patient motivation for surgery and to surgical technique is key to achieving optimal results. In this review, the authors describe aesthetic surgical techniques for treatment of penile and scrotal deficiencies. They also discuss techniques for revision in patients with previous surgery.

Induction Based Training leads to Highly Significant Improvements of Objective and Subjective Suturing Ability in Junior Doctors

Directory of Open Access Journals (Sweden)

Kevin Garry

2018-03-01

Full Text Available Background: Simulation based training has shown to be of benefit in the education of medical students. However, the impact of induction based clinical simulation on surgical ability of qualified doctors remains unclear.The aim of this study was to establish if a 60 minute teaching session integrated into an Emergency Medicine speciality induction program produces statistically significant improvements in objective and subjective suturing abilities of junior doctors commencing an Emergency Medicine rotation.Methods: The objective suturing abilities of 16 Foundation Year Two doctors were analysed using a validated OSATs scale prior to a novel teaching intervention. The doctors then undertook an intensive hour long workshop receiving one to one feedback before undergoing repeat OSATs assessment.Subjective ability was measured using a 5 point likert scale and self-assessed competency reporting interrupted suturing before and after the intervention. Photographs of wound closure before and after the intervention were recorded for further blinded assessment of impact of intervention. A survey regarding continued ability was repeated at four months following the intervention. The study took place on 7/12/16 during the Belfast Health and Social Care Trust Emergency Medicine induction in the Royal Victoria Hospital Belfast. The hospital is a regional level 1 trauma centre that has annual departmental attendances in excess of 200,000.All new junior doctors commencing the Emergency Medicine rotation were invited to partake in the study. All 16 agreed. The group consisted of a mixture of undergraduate and postgraduate medicaldoctors who all had 16 months experience working in a variety of medical or surgical jobs previously.Results: Following the teaching intervention objective and subjective abilities in interrupted suturing showed statistically significant improvement (P>0.005. Self-reporting of competency of independently suturingwounds improved from 50

[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.

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

Science.gov (United States)

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

2011-03-01

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

Surgical efficiencies and quality in the performance of voluntary medical male circumcision (VMMC procedures in Kenya, South Africa, Tanzania, and Zimbabwe.

Directory of Open Access Journals (Sweden)

Dino Rech

Full Text Available This analysis explores the association between elements of surgical efficiency in voluntary medical male circumcision (VMMC, quality of surgical technique, and the amount of time required to conduct VMMC procedures in actual field settings. Efficiency outcomes are defined in terms of the primary provider's time with the client (PPTC and total elapsed operating time (TEOT.Two serial cross-sectional surveys of VMMC sites were conducted in Kenya, Republic of South Africa, Tanzania and Zimbabwe in 2011 and 2012. Trained clinicians observed quality of surgical technique and timed 9 steps in the VMMC procedure. Four elements of efficiency (task-shifting, task-sharing [of suturing], rotation among multiple surgical beds, and use of electrocautery and quality of surgical technique were assessed as explanatory variables. Mann Whitney and Kruskal Wallis tests were used in the bivariate analysis and linear regression models for the multivariate analyses to test the relationship between these five explanatory variables and two outcomes: PPTC and TEOT. The VMMC procedure TEOT and PPTC averaged 23-25 minutes and 6-15 minutes, respectively, across the four countries and two years. The data showed time savings from task-sharing in suturing and use of electrocautery in South Africa and Zimbabwe (where task-shifting is not authorized. After adjusting for confounders, results demonstrated that having a secondary provider complete suturing and use of electrocautery reduced PPTC. Factors related to TEOT varied by country and year, but task-sharing of suturing and/or electrocautery were significant in two countries. Quality of surgical technique was not significantly related to PPTC or TEOT, except for South Africa in 2012 where higher quality was associated with lower TEOT.SYMMACS data confirm the efficiency benefits of task-sharing of suturing and use of electrocautery for decreasing TEOT. Reduced TEOT and PPTC in high volume setting did not result in decreased

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…

Doctors who considered but did not pursue specific clinical specialties as careers: questionnaire surveys.

Science.gov (United States)

Goldacre, Michael J; Goldacre, Raph; Lambert, Trevor W

2012-04-01

To report doctors' rejection of specialties as long-term careers and reasons for rejection. Postal questionnaires. United Kingdom. Graduates of 2002, 2005 and 2008 from all UK medical schools, surveyed one year after qualification. Current specialty choice; any choice that had been seriously considered but not pursued (termed 'rejected' choices) with reasons for rejection. 2573 of 9155 respondents (28%) had seriously considered but then not pursued a specialty choice. By comparison with positive choices, general practice was under-represented among rejected choices: it was the actual choice of 27% of respondents and the rejected choice of only 6% of those who had rejected a specialty. Consideration of 'job content' was important in not pursuing general practice (cited by 78% of those who considered but rejected a career in general practice), psychiatry (72%), radiology (69%) and pathology (68%). The surgical specialties were the current choice of 20% of respondents and had been considered but rejected by 32% of doctors who rejected a specialty. Issues of work-life balance were the single most common factor, particularly for women, in not pursuing the surgical specialties, emergency medicine, the medical hospital specialties, paediatrics, and obstetrics and gynaecology. Competition for posts, difficult examinations, stressful working conditions, and poor training were mentioned but were mainly minority concerns. There is considerable diversity between doctors in their reasons for finding specialties attractive or unattractive. This underlines the importance of recruitment strategies to medical school that recognize diversity of students' interests and aptitudes.

Incidental unilateral and bilateral ductal carcinoma in situ encountered in the surgical management of young male gynecomastia.

Science.gov (United States)

Shirah, Bader Hamza; Shirah, Hamza Assad

2016-07-28

The increased risk for malignant tumors associated with male gynecomastia has been well established and many authors have reported cases of concurrent gynecomastia and ductal carcinoma in situ (DCIS) in the same breast. Synchronous bilateral breast cancer in association with gynecomastia is exceptionally rare. We aim to report and evaluate the management outcome of 5 cases of gynecomastia associated with DCIS (1 bilateral and 4 unilateral). A retrospective database analysis of the surgical treatment outcome of 74 male patients who had gynecomastia was done. A bilateral subcutaneous nipple-preserving mastectomy approach was done to all. Histopathology reports were reviewed. 74 patients diagnosed and treated for gynecomastia were included. The incidence rate of gynecomastia in our hospital male patients was 0.17%. The mean age was 22 years, range 17-29 years. Five (6.76%) patients were found in histopathology specimens to have DCIS, 1 patient (23 years old) had bilateral DCIS of low grade, 4 patients had unilateral positive involvement, 3 had right breast DCIS, and 1 had left breast DCIS, and all were of low-grade papillary subtype. The incidence of ductal carcinoma in situ among our series gynecomastia patients was 6.76%. We conclude that gynecomastia is a benign breast disease but recent reports had described malignant variants, mostly DCIS, including 5 young males in our series. Therefore, regardless of the age group, histopathological examination of the resected gynecomastia tissue should be carefully done in all patients. Further evidence-based studies are needed to investigate the optimum management of incidental DCIS in gynecomastia specimens.

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

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.

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.

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....

Resource utilization in surgery after the revision of surgical fee schedule in Japan.

Science.gov (United States)

Nakata, Yoshinori; Yoshimura, Tatsuya; Watanabe, Yuichi; Otake, Hiroshi; Oiso, Giichiro; Sawa, Tomohiro

2015-01-01

The purpose of this paper is to examine whether the current surgical reimbursement system in Japan reflects resource utilization after the revision of fee schedule in 2014. The authors collected data from all the surgical procedures performed at Teikyo University Hospital from April 1 through September 30, 2014. The authors defined the decision-making unit as a surgeon with the highest academic rank in the surgery. Inputs were defined as the number of medical doctors who assisted surgery, and the time of operation from skin incision to closure. An output was defined as the surgical fee. The authors calculated surgeons' efficiency scores using data envelopment analysis. The efficiency scores of each surgical specialty were significantly different (p=0.000). This result demonstrates that the Japanese surgical reimbursement scales still fail to reflect resource utilization despite the revision of surgical fee schedule.

Employment experiences of vocationally trained doctors.

Science.gov (United States)

Osler, K

1991-09-28

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

Responsibility and expectations in antiretroviral therapy--patients' versus doctors' perspective.

Science.gov (United States)

Largu, Maria Alexandra; Dorobăţ, Carmen; Oprea, L; Astărăstoae, V; Manciuc, Carmen

2015-01-01

This paper aims to uncover what patients really expect form ART, and also what infectious diseases doctors expect from a patient's ART regime, thus exploring an important side of adherence to ART. From July to November 2014 we have conducted a qualitative study regarding both patients' and doctors' expectations form the ART. We interviewed 30 patients and 4 doctors. We used semi-structured interviews that were conducted in the Psychosocial Compartment of the HIV/AIDS Regional Center in Iasi. The patients we interviewed came from all 6 counties in the Moldova area. Age varied from 16 years to 59 years; 55% were female and 45% male. 30% came from a rural area. The most common expectations that patients have regarding ART are: "to help me live", "not to make me feel sick", "to be easy to take (not to big, not a lot)", "not to show on the outside what I have on the inside". The infectious diseases doctors that we interviewed work in the HIV/AIDS Regional Center in Iasi. Their expectations regarding an ART regimen for patients were: "to reduce HIV viral load", "to increase CD4 cell count" and "to have minimal impact on the proper functioning of other organs". Patients consider themselves the only factors responsible for their own ART adherence in 56.6% of cases; 20% consider the doctor to be responsible for their adherence, 16.6% feel that their family, friends, and spouse are responsible, and 6.6% (2 patients) couldn't answer. Infectious diseases doctors considered that patients are 100% responsible for adhering to the antiretroviral therapy. In order to assure adherence to the ART it is important to explore both the doctor and the patient's perspective and to find ways to find a common ground in building a healthy relationship.

A survey of pharmaceutical company representative interactions with doctors in Libya

Directory of Open Access Journals (Sweden)

Mustafa A. Alssageer

2012-09-01

Full Text Available Objectives: To examine the frequency of pharmaceutical company representative (PCR interactions with doctors in Libya and review possible associations between these interactions and the personal and practice setting characteristics of doctors. Method: An anonymous survey questionnaire was circulated to 1,000 Libyan doctors in selected public and private practice settings in Tripoli, Benghazi and Sebha. Results: A questionnaire return rate of 61% (608 returned questionnaires was achieved. Most respondents (94% reported that they had been visited by PCRs at least ‘once’ in the last year. Fifty per cent of respondents met with PCRs at least once a month, and 20% at least once a week. The following characteristics were significantly associated with meeting with a representative more than once a week: age, gender (male > female, years of practice, being a specialist (other than an anaesthesiologist or working in private practice. Ninety-one per cent of doctors reported that they had received at least one kind of relationship gift during the last year. Printed materials (79%, simple gifts (73% and drug samples (69% were the most common relationship products given to respondents. Reimbursements or sponsored items were reported by 33% of respondents. Physician specialists were more likely to receive drug samples or sponsored items than residents, general practitioners, anaesthesiologists or surgeons (P<0.01. Participants working in private practice alone or in both sectors were more likely to receive printed materials, simple gifts or free samples from PCRs than doctors working in the public sector (P<0.05. Conclusion: Libyan doctors are frequently visited by PCRs. Doctors, working in private practice or specialist practice, are especially targeted by promotional activities. An agreed code of conduct for pharmaceutical promotion in Libya between doctors and PCRs should be created.

Surgical pitfalls in patients with Ehlers–Danlos type IV: A case of spontaneous sigmoid perforation in a 17-year-old male

Directory of Open Access Journals (Sweden)

Kai Lyn Ng

2011-07-01

Full Text Available Ehlers–Danlos syndrome (EDS is a group of well described connective tissue disorders in which collagen production is impaired. The surgical management of affected individuals remains challenging, with no general consensus. We report a case of spontaneous sigmoid perforation in a 17-year-old Eurasian male, in whom we subsequently established the diagnosis of EDS type IV (EDS-IV. We review the literature to discuss the clinical features and diagnosis, and the recommended therapeutic management.

Becoming a caregiver: attachment theory and poorly performing doctors.

Science.gov (United States)

Adshead, Gwen

2010-02-01

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

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

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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.

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…

Interdisciplinary Dissertation Research Among Public Health Doctoral Trainees, 2003-2015.

Science.gov (United States)

Golembiewski, Elizabeth H; Holmes, Ann M; Jackson, Joanna R; Brown-Podgorski, Brittany L; Menachemi, Nir

Given the call for more interdisciplinary research in public health, the objectives of this study were to (1) examine the correlates of interdisciplinary dissertation completion and (2) identify secondary fields most common among interdisciplinary public health graduates. We analyzed pooled cross-sectional data from 11 120 doctoral graduates in the Survey of Earned Doctorates, 2003-2015. The primary outcome was interdisciplinary dissertation completion. Covariates included primary public health field, sociodemographic characteristics, and institutional attributes. From 2003 to 2015, a total of 4005 of 11 120 (36.0%) doctoral graduates in public health reported interdisciplinary dissertations, with significant increases observed in recent years. Compared with general public health graduates, graduates of environmental health (odds ratio [OR] = 1.74; P dissertation work, whereas graduates from biostatistics (OR = 0.51; P dissertation was associated with being male, a non-US citizen, a graduate of a private institution, and a graduate of an institution with high but not the highest level of research activity. Many secondary dissertation fields reported by interdisciplinary graduates included other public health fields. Although interdisciplinary dissertation research among doctoral graduates in public health has increased in recent years, such work is bounded in certain fields of public health and certain types of graduates and institutions. Academic administrators and other stakeholders may use these results to inform greater interdisciplinary activity during doctoral training and to evaluate current and future collaborations across departments or schools.

The Role and Validity of Surgical Simulation

OpenAIRE

Agha, Riaz A.; Fowler, Alexander J.

2015-01-01

In the last three decades, simulation has become a key tool in the training of doctors and the maintenance of patient safety. Simulation offers an immersive, realistic way of learning technical skills. Recent changes to the training schemes in many surgical specialities mean that the hours spent working between senior house officer and consultant have been reduced. This, combined with other pressures (such as reduced operating hours), means that surgery has moved away from its traditional app...

Minimally invasive surgical approach to treat posterior urethral diverticulum

Directory of Open Access Journals (Sweden)

Ossamah Alsowayan

2015-01-01

Full Text Available Urethral diverticulum is a localized saccular or fusiform out-pouching of the urethra. It may occur at any point along the urethra in both male and females. Male urethral diverticulum is rare, and could be either congenital or acquired, anterior or posterior. The mainstay treatment of posterior urethral diverticulum (PUD is the open surgical approach. Here we discuss our minimally invasive surgical approach (MIS in managing posterior urethral diverticulum.

Mentoring Factors in Doctoral Programs of Mexican American and American Indian Students.

Science.gov (United States)

Williamson, Madeline J.; Fenske, Robert H.

The purpose of this study was to determine factors affecting satisfaction of Mexican American (MA) and American Indian (AI) students with their doctoral programs. Faculty mentoring plays an extremely significant role in minority education. Previous research indicates differences between males and females in their interaction with faculty. Minority…

The Sex Difference in Basic Surgical Skills Learning: A Comparative Study.

Science.gov (United States)

Lou, Zheng; Yan, Fei-Hu; Zhao, Zhi-Qing; Zhang, Wei; Shui, Xian-Qi; Liu, Jia; Zhuo, Dong-Lan; Li, Li; Yu, En-da

2016-01-01

Very little is known of sex-related differences among medical students in the acquisition of basic surgical skills at an undergraduate level. The aim of this study was to investigate the sex differences in basic surgical skills learning and the possible explanations for sex disparities within basic surgical skills education. A didactic description of 10 surgical skills was performed, including knot tying, basic suture I, basic suture II, sterile technique, preoperative preparation, phlebotomy, debridement, laparotomy, cecectomy, and small bowel resection with hand-sewn anastomosis. The students were rated on a 100-point scale for each basic surgical skill. Later during the same semester all the students took the final theoretical examination. A total of 342 (male = 317 and female = 25) medical students participated in a single skills laboratory as part of their third-year medical student clerkship. The mean scores for each of the 10 surgical skills were higher in female group. The difference in sterile technique, preoperative preparation, cecectomy, and small bowel resection with hand-sewn anastomosis reached the significant level. Compared with male medical students, the mean theory examination score was significantly higher in female medical students. Approximately 76% of the (19 of 25) female students expressed their interest in pursuing a surgical career, whereas only 65.5% (207 of 317) male students wanted to be surgical professionals (p = 0.381). Female medical students completed basic surgical skills training more efficiently and passed the theoretical examination with significantly higher scores than male medical students. In the future, studies should be done in other classes in our institution and perhaps other schools to see if these findings are reliable or valid or just a reflection of this 1 sample. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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.

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.

Improving Weekend Out Of hours Surgical Handover (WOOSH).

Science.gov (United States)

Boyer, Melissa; Tappenden, Janine; Peter, Mark

2016-01-01

An effective surgical handover is imperative to optimise patient care and safety, whilst ensuring progression of clinical management and the delivery of an efficient service. The introduction of full-shift working, as a response to progressive implementation of the European Working Time Directive (EWTD), has placed the spotlight on patient and doctor safety. Effective handover between shifts is vital to protect patient safety and assist doctors with clinical governance. The weekend is a critical point where the transfer of patient care to the ongoing weekend team is efficient, thorough and informative, as this is a point in the patient journey where the patient is the most vulnerable. The weekend team is often not responsible for the management of the patient throughout the week and poor or incomplete information can have disastrous consequences on patient safety. (1,2,3) There is a general consensus and anecdotal evidence that this process is variable, occasionally unsafe or of poor quality, and can be improved. (4,5,6,7,8,9,10,11) However, no standardised format is deemed optimal or available. The aim therefore, was to design and implement a weekend handover proforma, in order to deliver a more efficient and safer system for patient care over the weekend without increasing junior doctor workload. The Weekend Out Of Hours Surgical Handover (WOOSH) form was designed following consultation with medical, nursing and allied health professionals. All staff were instructed how to complete the form, with pre- and post-intervention questionnaires undertaken. The results of the study enforce and advocate the permanent practice of the WOOSH form with 93.33% endorsing the permanent introduction of the form and 100% finding the form useful.

Contributing factors of elective surgical case cancellation: a retrospective cross-sectional study at a single-site hospital.

Science.gov (United States)

Yu, Kaiye; Xie, Xiaolei; Luo, Li; Gong, Renrong

2017-09-11

Case cancellation (CC) has significant impact on the efficiency of operating room (OR) management, which can be mitigated by taking preventive measures. In this study, using the data of the West China Hospital (WCH), we identified the effect of contributing factors and recommended hospital interventions to facilitate CC prevention. We conducted a retrospective review of 11,331 elective surgical cases from January 1 to December 31, 2014. CC reasons were grouped into six categories. The methods of descriptive statistics and hypothesis test were used to identify the effect of factors. CC reasons (746) were divided into six broad categories: workup related (preoperative diagnostic assessment issues or sudden medical condition changes) (25.8%), non-specified reasons (25.8%), coordination issues (15.1%), patient related (13.0%), support system issues (11.8%), and doctor related (8.5%). The types of the most frequently performed operations are identified, as well as their CRs. The cancellation rate (CR) of males was lower than that of females (16.7% to 18.3%). A large difference in the CRs existed among doctors. The CR on Monday was significantly higher than the other four weekdays. Workup related issues, the types of procedures, the menstrual cycle of females, highly imbalanced CRs among doctors, and tendency of cancellation on Monday are the major identified factors, which account for a significant amount of preventable cancellations. It is suggested that corresponding hospital interventions can reduce CR and improve OR efficiency, including maintaining effective coordination, good communication and well-designed preoperative assessment processes, focusing on the type of procedures which are more time-consuming and complex, paying special attention to the physiology of females during surgery planning, taking measures to reduce CR of top eight doctors, and improving surgery scheduling on Monday.

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).

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.

[Comparative effectiveness of surgical and non-surgical treatment for pediatric mandibular condylar fractures].

Science.gov (United States)

Hu, Min; Wang, Yanyi; Zhang, Lihai; Yao, Jun

2010-12-01

To compare the effectiveness of open reduction and conservative treatment for pediatric mandibular condylar fractures and to provide the evidence for the selection of clinical therapy. The clinical data were retrospectively analyzed from 25 patients with the mandibular condylar fractures between January 1988 and December 2006. Of them, 8 patients (11 fractures) were treated with surgical treatment (surgical group) and 17 patients (22 fractures) with non-surgical treatment (non-surgical group). In surgical group, there were 6 males (9 fractures) and 2 females (2 fractures) with an age range of 8-13 years; fracture was caused by tumbling in 7 cases and by traffic accident in 1 with an interval of 1-6 days between injury and hospitalization; and 5 cases were identified as unilateral condylar fractures (3 complicated by mental fractures) and 3 cases as bilateral condylar fractures complicated by mental fractures. In non-surgical group, there were 12 males (15 fractures) and 5 females (7 fractures) with an age range of 3-12 years; fracture was caused by falling from height in 4 cases, by tumbling in 10, and by traffic accident in 3 with an interval of 1-25 days between injury and hospitalization; and 12 cases were identified as unilateral condylar fractures (3 complicated by mental fractures) and 5 cases as bilateral condylar fractures (1 complicated by mental fracture). Incision healed by first intention in surgical group, and 25 cases were followed up 1-6 years with an average of 3.5 years. At 12 months after treatment, no temporomandibular joint pain, eating disorder, or limited mandibular movement occurred in 2 groups. No significant difference was observed in opening mouth extent, protrusive and lateral movements between 2 groups at 6 and 12 months (P > 0.05). During centric occlusion, mental point located at the midline with symmetric face figure. Two patients in surgical group and 3 in non-surgical group had slight snap when opening their mouths. Mandible

Risk-adjusted morbidity in teaching hospitals correlates with reported levels of communication and collaboration on surgical teams but not with scale measures of teamwork climate, safety climate, or working conditions.

Science.gov (United States)

Davenport, Daniel L; Henderson, William G; Mosca, Cecilia L; Khuri, Shukri F; Mentzer, Robert M

2007-12-01

Since the Institute of Medicine patient safety reports, a number of survey-based measures of organizational climate safety factors (OCSFs) have been developed. The goal of this study was to measure the impact of OCSFs on risk-adjusted surgical morbidity and mortality. Surveys were administered to staff on general/vascular surgery services during a year. Surveys included multiitem scales measuring OCSFs. Additionally, perceived levels of communication and collaboration with coworkers were assessed. The National Surgical Quality Improvement Program was used to assess risk-adjusted morbidity and mortality. Correlations between outcomes and OCSFs were calculated and between outcomes and communication/collaboration with attending and resident doctors, nurses, and other providers. Fifty-two sites participated in the survey: 44 Veterans Affairs and 8 academic medical centers. A total of 6,083 surveys were returned, for a response rate of 52%. The OCSF measures of teamwork climate, safety climate, working conditions, recognition of stress effects, job satisfaction, and burnout demonstrated internal validity but did not correlate with risk-adjusted outcomes. Reported levels of communication/collaboration with attending and resident doctors correlated with risk-adjusted morbidity. Survey-based teamwork, safety climate, and working conditions scales are not confirmed to measure organizational factors that influence risk-adjusted surgical outcomes. Reported communication/collaboration with attending and resident doctors on surgical services influenced patient morbidity. This suggests the importance of doctors' coordination and decision-making roles on surgical teams in providing high-quality and safe care. We propose risk-adjusted morbidity as an effective measure of surgical patient safety.

Factors influencing surgical career choices and advancement in Ireland and Britain.

Science.gov (United States)

Corrigan, Mark A; Shields, Conor J; Redmond, Henry P

2007-10-01

The aim of this study was to analyze the factors that influence the advancement and the career choices of doctors and medical students. Using the combined databases of the iformix and surgent websites, 450 doctors and medical students were invited to complete an internet-based survey. Surgent (http://www.surgent.ie) and iformix (http://www.iformix.com) are two free internet services administered by the authors. Surgent is a medical educational website, while iformix facilitates the online submission of abstracts to surgical and medical conferences across Britain and Ireland. The combined database of these two websites is approximately 4500 entries. Four hundred and fifty users represented a 10% sample based on an expected 40%-45% response rate. This was anticipated to yield between 180 and 202 respondents, statistically sufficient to analyze the data. A detailed Likert scale assessed the importance of "academic," "clinical," and "lifestyle" factors in determining career choice and progression. Analysis included descriptive statistics and inferential testing. Fifty percent (N = 222) of surveys were returned; 142 men and 78 women. Thirty-seven percent of respondents were Irish, 28% British, and 35% non-European. Fifteen percent were undergraduates, 4% interns, 12% had 2-4 years of clinical experience, while 69% had completed more than 4 years. Fifty-six percent had decided upon a career in general surgery. Overall, the most important factors for career choice were intellectual challenge (95%), academic opportunities (61%), and research opportunities(54%). Doctors with more than 4 years of experience deemed duration of training (p = 0.002), lifestyle during training (p = 0.02), and stress (0.005) as less important factors when considering career choice. Correlation analyses demonstrated that prestige (p = 0.002), patient relationships (p = 0.006), and advice from friends or family (p = 0.01) were more important influencing factors for interns. In terms of career

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

Science.gov (United States)

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

2018-01-01

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

Gender gap in medicine: only one woman councilor in the Japan Surgical Society.

Science.gov (United States)

Tomizawa, Yasuko

2015-02-01

Japan ranks low in the global gender gap index. Academic promotion is difficult for women doctors, and the leaky pipeline of women doctors is evident in academic medicine. The Japan Surgical Society (JSS) has 2,874 (7.2% of total membership) female members as of April 2014. The total number of councilors in JSS has increased, but there is still only one female member on the Council. The fact that there are so few women in decision-making positions makes it challenging to fight for equality. The Japanese Association of Medical Science (JAMS) is an association with exclusive institutional membership comprising the major medical societies in Japan, and currently has a membership of 122 specialist medical societies. It is essential to have at least one female committee member in each committee of the JAMS, which would provide opportunities to establish career paths for women doctors, to make rules that suit the lifestyle of women doctors, and to improve work-life balance.

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

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 ...

Male sexuality.

Science.gov (United States)

Ginsberg, Terrie B

2010-05-01

It should be recognized that sexuality in the aging male is of such import that a complete sexual history must be performed. By taking a complete sexual history, facts can be obtained that will allow for appropriate focus relating to a holistic evaluation and will enable us to dispel antiquated sexual myths pertaining to the aging male. If initiated by the history taker, questions concerning sexuality may be discussed more comfortably by the patient. Erectile dysfunction, male sexual response cycle, testosterone, sexually transmitted diseases, human immunodeficiency virus, long-term illness, along with religion and culture are explored in this article with the aim of improving one's knowledge base, self reflection, and awareness of the importance of male sexuality. A complete understanding and appreciation of the aging male's medical history, surgical history, social history, and emotional history as well as his sexual, cultural, and religious concepts will allow the health care provider to better analyze information, and to recommend and provide appropriate advice and treatment to the aging male patient. Copyright 2010 Elsevier Inc. All rights reserved.

[Investigation of doctors' and nurses' perceptions and implementation of delirium management in intensive care unit].

Science.gov (United States)

Luo, H B; Wang, X T; Tang, B; Zhu, Z N; Guo, H L; Li, Z Z; Sun, J H; Liu, D W

2017-12-01

Objective: To investigate doctors' and nurses' perceptions and implementation of delirium management in intensive care unit. Methods: A total of 197 doctors and nurses in 2 general ICUs and 3 special ICUs at Peking Union Medical College Hospital finished a self-designed questionnaire of delirium management. Results: There were 47 males and 150 females, 43 doctors and 154 nurses who participated in the survey.One hundred and twenty five participators were from general ICU and the others from special ICU. The ICU staff had a significant difference on the perceptions and implementation of delirium management( P delirium assessment" ( P delirium management,especially in special ICUs. Delirium management should be included as a routine care in ICU to improve patients' outcome.

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…

ICT and the future of health care: aspects of doctor-patient communication.

Science.gov (United States)

Haluza, Daniela; Jungwirth, David

2014-07-01

The current digital revolution is particularly relevant for interactions of healthcare providers with patients and the community as a whole. The growing public acceptance and distribution of new communication tools such as smart mobile phones provide the prerequisite for information and communication technology (ICT) -assisted healthcare applications. The present study aimed at identifying specifications and perceptions of different interest groups regarding future demands of ICT-supported doctor-patient communication in Austria. German-speaking Austrian healthcare experts (n = 73; 74 percent males; mean age, 43.9 years; SD 9.4) representing medical professionals, patient advocates, and administrative personnel participated in a 2-round online Delphi process. Participants evaluated scenario-based benefits and obstacles for possible prospect introduction as well as degree of innovation, desirability, and estimated implementation dates of two medical care-related future set ups. Panelists expected the future ICT-supported doctor-patient dialogue to especially improve the three factors doctors-patient relationship, patients' knowledge, and quality of social health care. However, lack of acceptance by doctors, data security, and monetary aspects were considered as the three most relevant barriers for ICT implementation. Furthermore, inter-group comparison regarding desirability of future scenarios showed that medical professionals tended to be more skeptical about health-related technological innovations (p ICT-supported collaboration and communication between doctors and patients.

[Quality of surgical continuing education in Germany].

Science.gov (United States)

Ansorg, J; Hassan, I; Fendrich, V; Polonius, M J; Rothmund, M; Langer, P

2005-03-11

One of the reasons for young doctors to leave the clinical work to go abroad or into non-clinical fields is insufficient quality of training under bad circumstances. Aim of the study was to evaluate the surgical training in Germany from the viewpoint of the residents. A questionnaire was prepared by residents and consultants and approved by the German surgical societies (Deutsche Gesellschaft fur Chirurgie und Berufsverband der Deutschen Chirurgen). It was sent to surgical residents between June 2003 and June 2004, published in "Der Chirurg BDC" and distributed among residents taking part in courses conducted by the BDC. It could be answered anonymously by email, mail or online. The questionnaire was sent back by 584 surgical residents (about 30 % of all). 58 % of the residents declared that they finished the training in the intended time (6 years). Rotation-systems as part of a structured residency program existed for 43 %. Standard surgical procedures were discussed or explained before the procedure in only 46 %. 61 % of the residents were not satisfied with the teaching assistance by their clinical teachers in the OR. Only 33 % had regular talks with the Chief about their progress in surgical training. 18 % of residents felt, that the hospital is interested in their progress in training. Indication-conferences took place in 52 % and mortality-conferences in only 20 % of programs. Regular seminars on recent issues took place in 62 %, and 61 % of residents did not get financial support to attend congresses. 36 % of residents had to use their holidays to attend congresses. Surgical training structures are not well established in about 50 % of the training hospitals from where we got answers to our survey. The training potential of daily surgical work is not used appropriately. It is therefore imperative to develop guidelines for surgical training, the use of log-books and rotation-programs.

Edinburgh doctors and their physic gardens.

Science.gov (United States)

Doyle, D

2008-12-01

Edinburgh has had eight physic gardens on different sites since its first one was created by the Incorporation of Barbers and Surgeons in 1656. As the gardens grew in size, they evolved from herb gardens to botanic gardens with small herbaria for the supply of medical herbs. They were intended for the instruction of medical, surgical and apothecary students and, in the case of the physicians, to demonstrate the need for a physicians' college and a pharmacopoeia. Some of the doctors in charge of them were equally famous and influential in botany as in medicine, and while Edinburgh Town Council enjoyed the fame the gardens brought to the city it was parsimonious and slow to support its botanical pioneers. The gardens are celebrated today in the Sibbald Garden within the Royal College of Physicians of Edinburgh.

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.

[Women and work, with a specific focus on doctors and dentists].

Science.gov (United States)

van Doorne-Huiskes, A

2017-11-01

The differences between men and women in their participation in the labour force and education are diminishing: in 2015, 71% of all women between the ages of 20 and 65 had a paid job (in comparison with 82% of men) and the Emancipation monitor 2016 reveals that women more often receive higher education than men. In the study of medicine, this expresses itself in the fact that 68% of new students in 2015 were women. As a consequence the number of women doctors is increasing. The numbers for 2013 show that 65% of active dentists are men and 35% women. They, too, indicate an obvious increase of women. Statements that medicine, including dentistry, is feminising are incorrect because there are still more male doctors than female. The male-female ratio among medical specialists is 60:40 at the moment. It can be concluded that the medical and dental professions serve a well-educated and diverse public. It is precisely for this reason, that the medical and dental professions should offer positions to men and women and to people (m/f) with a Dutch and an immigrant background.

Should surgical novices trade their retractors for joysticks? Videogame experience decreases the time needed to acquire surgical skills.

Science.gov (United States)

Shane, Matthew D; Pettitt, Barbara J; Morgenthal, Craig B; Smith, C Daniel

2008-05-01

Video game experience (VGE) has been identified as a possible predictive factor for surgical skill. We hypothesized that surgical novices with previous VGE would acquire new surgical skills faster than those without. Fourth-year medical students (M4) and first-year surgical residents (PG-1) completed a survey asking about standard demographic data and previous VGE. Gamers had high VGE, defined as more than 3 h per week of videogame playing. Nongamers had little or no VGE. Both groups trained to proficiency on two tasks (AcquirePlace and Traversal) of the MIST-VR simulator, with proficiency defined as meeting previously validated criteria on two consecutive trials. The number of trials required to achieve proficiency for each task was recorded. The 26 participants included 11 M4s and 15 PG-1s: 17 males (8 gamers/9 nongamers) and 9 females (3 gamers/6 nongamers), mean age 27.8 years. There were no differences in time to proficiency between the M4 and PG-1 residents, and there were no significant differences in the relative number of gamers per gender. All participants eventually met proficiency criteria. The 11 gamers reached proficiency more quickly than the 15 nongamers (median 0 trials versus 6 trials, p = 0.01). Gamers scored lower than nongamers on their initial attempts. Women overall took longer to reach proficiency than did men (median 10 trials versus 0 trials, p = 0.002). When stratified according to VGE, female nongamers took longer to reach proficiency than male nongamers (median 11 trials versus 1 trial, p = 0.006) but among gamers, there was no difference between females and males (median 0 trials versus 0.5 trials, NS). Previous VGE shortens time to achieve proficiency on two tasks on a validated surgical simulator. The possibility that VGE may ameliorate gender differences in length of time required to acquire surgical skills should be explored further.

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)

Gynaecomastia and scrotal rhacosis: two aesthetic surgical operations for men in Byzantine times.

Science.gov (United States)

Papadakis, Marios; Manios, Andreas; de Bree, Eelco; Trompoukis, Constantinos; Tsiftsis, Dimitris D

2010-08-01

Nowadays, as in the past, much attention is paid to aesthetic operations in women, while only infrequently have such operations been referred to in males. Generally, male aesthetic surgery was introduced to surgical practise during the 19th century. In this study, we analysed the practise of such operations in Byzantine times and in other ancient cultures with surgical knowledge, i.e. ancient India and China The sixth book of Paul of Aegina's "Epitome of Medicine" was studied for description of aesthetic operations in males in the Byzantine period, since this book is completely devoted to surgery and is generally considered to be the most important reference for surgery in Byzantine times. The original text and its excellent translation by Francis Adams were used. References concerning aesthetic operations for males were identified. Accordingly, historical work and reviews on plastic surgery in ancient India and China were studied. Mainly, two aesthetic surgical procedures for males in the Byzantine period were identified. These two procedures comprise gynaecomastia and rhacosis (scrotal relaxation). Two different techniques were reported for the surgical management of gynaecomastia, through sub-mammary or supra-mammary access. Two procedures were noted for rhacosis, for which Paul of Aegina reproduced the respective chapters from Leonides' and Antyllus' works. Evidence supporting male aesthetic surgery in ancient India and China or elsewhere was not found. Despite the dubious aesthetic result, the existence of different aesthetic surgical techniques in males substantiate the advanced level of surgery achieved by physicians in the Byzantine period. Copyright 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Hazardous alcohol use among doctors in a Tertiary Health Center

Directory of Open Access Journals (Sweden)

Adetunji Obadeji

2015-01-01

Full Text Available Background: Doctors have been identified as one of the key agents in the prevention of alcohol-related harm, however, their level of use and attitudes toward alcohol will affect such role. Aim: This study is aimed at describing the pattern of alcohol use and the predictors of hazardous drinking among hospital doctors. Setting: Study was conducted at the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. Design: A cross-sectional survey involving all the doctors in the teaching hospital. Materials and Methods: All the consenting clinicians completed a sociodemographic questionnaire and alcohol use was measured using the 10-item alcohol use disorder identification test (AUDIT and psychological well-being was measured by the 12-item General Health Questionnaire (GHQ-12. Statistical Analysis Used: Statistical analyses were done using the Statistical Package for Social Sciences version 16. Chi-square tests with Yates correction were used to describe the relationship between respondent′s characteristics and AUDIT scores as appropriate. Results: There were a total of 122 participants. Eighty-five (69.7% of them were abstainers, 28 (23% were moderate drinkers, and 9 (7.3% hazardous drinkers. With the exception of age, there was no significant relationship between sociodemographic status, years of practice, specialty of practice, and hazardous alcohol use. Experiencing stress or GHQ score above average is significantly associated with hazardous drinking. Conclusion: Hazardous drinking among hospital doctors appears to be essentially a problem of the male gender, especially among those older than 40 years. Stress and other form of psychological distress seem to play a significant role in predicting hazardous drinking among doctors.

Rapid, minimally invasive adult voluntary male circumcision: A ...

African Journals Online (AJOL)

Background. Voluntary medical male circumcision (VMMC) is a priority HIV preventive intervention. To facilitate VMMC scale-up, the World Health Organization is seeking circumcision techniques that are faster, easier, and safer than open surgical methods. Objective. To compare open surgical circumcision with suturing v.

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…

Assessment of Educational Environment of Surgical Theatre at a Teaching Hospital of a Saudi University: Using Surgical Theatre Educational Environment Measures

Directory of Open Access Journals (Sweden)

Mona Faisal Al-Qahtani

2012-05-01

Full Text Available Objectives: This study was aimed to determine how medical interns perceive the important factors of the learning environment the surgical theatre at the teaching hospital of the medical school, University of Dammam (UoD. The study also investigated the relationships between the learning environment and academic achievements. Finally, it determined the role and significance of gender on the above perceptions and relationships.Methods: The Surgical Theatre Educational Environment Measure (STEEM was used to identify the perceptions of interns on the most important factors prevalent in the surgical theatre as an educational environment. STEEM was administered to all interns during the period of June-September 2009. Ninety-one out of 145 students completed the questionnaire representing a response rate of 63%. Non-parametric statistical analysis was performed using Statistical Package for the Social Sciences (SPSS Version 17.Results: The STEEM was shown to be internally consistent for the assessment of the overall educational environment in the surgical theatre of UoD. The overall STEEM mean score was 110. For male and female students, the mean scores were 114 and 107 respectively. There were statistically significant gender differences in the perceptions of "learning opportunities" and "teaching and training". Females rated these subscales lower than males. There were no significant associations between academic achievements and perceptions of the educational environment.Conclusion: The interns perceived the learning environment of the surgical theatre as less than satisfactory. In comparison with the males; the perception of the females was less positive, particularly in the areas of learning opportunities, and teaching and training. The study also revealed some other problematic areas in the learning environment of surgical theatre of the teaching hospital of UoD. The results imply that there is much room for improvement. They also indicate that

Effects of testosterone replacement therapy on bone metabolism in male post-surgical hypogonadotropic hypogonadism: focus on the role of androgen receptor CAG polymorphism.

Science.gov (United States)

Tirabassi, G; delli Muti, N; Gioia, A; Biagioli, A; Lenzi, A; Balercia, G

2014-04-01

The relationship between androgen receptor (AR) CAG polymorphism and bone metabolism is highly controversial. We, therefore, aimed to evaluate the independent role of AR CAG repeat polymorphism on bone metabolism improvement induced by testosterone replacement therapy (TRT) in male post-surgical hypogonadotropic hypogonadism, a condition frequently associated with hypopituitarism and in which the effects of TRT have to be distinguished from those resulting from concomitant administration of pituitary function replacing hormones. 12 men affected by post-surgical hypogonadotropic hypogonadism [mean duration of hypogonadism 8.3 ± 2.05 (SD) months] were retrospectively assessed before and after TRT (from 74 to 84 weeks after the beginning of therapy). The following measures were studied: parameters of bone metabolism [serum markers and bone mineral density (BMD)], pituitary dependent hormones and genetic analysis (AR CAG repeat number). Total testosterone, estradiol, free T4 (FT4) and insulin-like growth factor-1 (IGF-1) increased between the two phases, while follicle stimulating hormone (FSH) decreased. While serum markers did not vary significantly between the two phases, BMD improved slightly but significantly in all the studied sites. The number of CAG triplets correlated negatively and significantly with all the variations (Δ-) of BMDs. Conversely, Δ-testosterone correlated positively and significantly with all studied Δ-BMDs, while Δ-FSH, Δ-estradiol, Δ-FT4, and Δ-IGF-1 did not correlate significantly with any of the Δ-BMDs. Multiple linear regression analysis, after correction for Δ-testosterone, showed that CAG repeat length was negatively and significantly associated with ∆-BMD of all measured sites. Our data suggest that, in post-surgical male hypogonadotropic hypogonadism, shorter AR CAG tract is independently associated with greater TRT-induced improvement of BMD.

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.

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.

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.

The difficulty of professional continuation among female doctors in Japan: a qualitative study of alumnae of 13 medical schools in Japan

Science.gov (United States)

Nomura, Kyoko; Yamazaki, Yuka; Gruppen, Larry D; Horie, Saki; Takeuchi, Masumi; Illing, Jan

2015-01-01

Objectives To investigate the difficulties Japanese female doctors face in continuing professional practice. Design A qualitative study using the Kawakita Jiro method. Setting A survey conducted in 2011 of 13 private Japanese medical school alumni associations. Participants 359 female doctors. Primary outcome measures Barriers of balancing work and gender role. Results The female doctors reported that professional practice was a struggle with long working hours due to a current shortage of doctors in Japan. There was also a severe shortage of childcare facilities in the workplace. Some women appeared to have low confidence in balancing the physician's job and personal life, resulting in low levels of professional pursuit. There appeared to be two types of stereotypical gender roles, including one expected from society, stating that “child rearing is a woman's job”, and the other perceived by the women themselves, that some women had a very strong desire to raise their own children. Male doctors and some female doctors who were single or older were perceived to be less enthusiastic about supporting women who worked while raising children because these coworkers feared that they would have to perform additional work as a result of the women taking long periods of leave. Conclusions Important factors identified for promoting the continuation of professional practice among female doctors in Japan were the need to improve working conditions, including cutting back on long working hours, a solution to the shortage of nurseries, a need for the introduction of educational interventions to clarify professional responsibilities, and redefinition of the gender division of labour for male and female doctors. In addition, we identified a need to modernise current employment practices by introducing temporary posts to cover maternity leave and introducing flexible working hours during specialist training, thus supporting and encouraging more women to continue their medical

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.

PREVALENCE AND CORRELATES OF JOB STRESS AMONG JUNIOR DOCTORS IN THE UNIVERSITY COLLEGE HOSPITAL, IBADAN.

Science.gov (United States)

Adeolu, J O; Yussuf, O B; Popoola, O A

2016-12-01

Doctors respond differently to their complex work environment, some find it stimulating while others find it stressful. This study aimed to assess the prevalence and correlates of stress among junior doctors in a teaching hospital in Southwest Nigeria. A descriptive cross sectional survey of all junior doctors employed at the University College Hospital, Ibadan was carried out. Information was collected with a structured pretested questionnaire from 253 doctors. Descriptive statistics were generated. T-test, chi square and logistic regression analyses were conducted using SPSS version 16. Statistical significance was set at 5%. Mean age of respondents was 29.9 (±4.1) years, 61.3% were males, 59% had spent less than 5 years in medical practice, and 34.8% were married. Majority (79.4%) were resident doctors. Prevalence of stress, job dissatisfaction and poor mental health were 31.6%, 15.4% and 9.9% respectively. Age, gender, years of medical practice, religion, ethnicity and marital status were not significantly associated with job stress (p>0.05). Doctors who were stressed were more likely to be dissatisfied with their jobs (OR=2.33; CI=1.08-4.04) and to have poor mental health (OR=3.82; CI=1.47-9.95) than those who were not stressed. The prevalence of stress in this study is high, and job dissatisfaction and poor mental health have been implicated as determinants of stress. As such, there should be an improvement in doctors' welfare, health care facilities and delivery.

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

Gender-related perceptions of careers in surgery among new medical graduates: results of a cross-sectional study.

Science.gov (United States)

Fitzgerald, J Edward F; Tang, Siau-Wei; Ravindra, Pravisha; Maxwell-Armstrong, Charles A

2013-07-01

Despite promotional measures at a national level, female surgeons account for only 10% of the consultant workforce in the United Kingdom. With rising proportions of female medical graduates, it is important that surgery continues to recruit the most able candidates regardless of sex. This study investigates the differing perceptions of surgical careers among recent medical school graduates and identifies factors discouraging female doctors from pursuing a career in surgery. Newly qualified graduates from the University of Nottingham Medical School, Nottingham, UK, were invited to complete a nonmandatory questionnaire investigating career intentions and factors influencing this. Two hundred and eight questionnaires were returned (a 66% response rate). Male respondents were significantly more likely to rate surgery as an attractive or very attractive career (P = .0116). Overall, only 33 (25%) female doctors expressed interest in a surgical career as opposed to 33 (42%) male doctors (P = .010). Frequently cited reasons included no interest in surgery itself (21%) and negative attitudes toward women in surgery among the surgical teams (18%). Irrespective of career interests, 59% of male and 68% of female respondents believed surgery was not a career welcoming women (P = .186). Reasons included difficulty maintaining family life, limited flexible training, and lack of role models. This study identifies significant sex differences in the perception of surgical careers. The majority believes surgery does not welcome female trainees. Future strategies to promote surgery must address attitudes and behaviors in both sexes while taking active steps to support female surgeons during their training and in the workplace. Copyright © 2013 Elsevier Inc. All rights reserved.

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...

Development of a waste management protocol based on assessment of knowledge and practice of healthcare personnel in surgical departments.

Science.gov (United States)

Mostafa, Gehan M A; Shazly, Mona M; Sherief, Wafaa I

2009-01-01

Good healthcare waste management in a hospital depends on a dedicated waste management team, good administration, careful planning, sound organization, underpinning legislation, adequate financing, and full participation by trained staff. Hence, waste management protocols must be convenient and sensible. To assess the knowledge and practice related to waste management among doctors, nurses, and housekeepers in the surgical departments at Al-Mansoura University Hospital, and to design and validate a waste management protocol for the health team in these settings. This cross-sectional study was carried out in the eight surgical departments at Al-Mansoura University Hospital. All health care personnel and their assistants were included: 38 doctors, 106 nurses, and 56 housekeepers. Two groups of jury were included for experts' opinions validation of the developed protocol, one from academia (30 members) and the other from service providers (30 members). Data were collected using a self-administered knowledge questionnaire for nurses and doctors, and an interview questionnaire for housekeepers. Observation checklists were used for assessment of performance. The researchers developed the first draft of the waste management protocol according to the results of the analysis of the data collected in the assessment phase. Then, the protocol was presented to the jury group for validation, and then was implemented. Only 27.4% of the nurses, 32.1% of the housekeepers, and 36.8% of the doctors had satisfactory knowledge. Concerning practice, 18.9% of the nurses, 7.1% of the housekeepers, and none of the doctors had adequate practice. Nurses' knowledge score had a statistically significant weak positive correlation with the attendance of training courses (r=0.23, pwaste management. The knowledge among nurses is positively affected by attendance of training programs. Based on the findings, a protocol for healthcare waste management was developed and validated. It is recommended to

Working with doctors and nurses

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... 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 ...

Rhabdomyolysis in Critically Ill Surgical Patients.

Science.gov (United States)

Kuzmanovska, Biljana; Cvetkovska, Emilija; Kuzmanovski, Igor; Jankulovski, Nikola; Shosholcheva, Mirjana; Kartalov, Andrijan; Spirovska, Tatjana

2016-07-27

Rhabdomyolysis is a syndrome of injury of skeletal muscles associated with myoglobinuria, muscle weakness, electrolyte imbalance and often, acute kidney injury as severe complication. of this study is to detect the incidence of rhabdomyolysis in critically ill patients in the surgical intensive care unit (ICU), and to raise awareness of this medical condition and its treatment among the clinicians. A retrospective review of all surgical and trauma patients admitted to surgical ICU of the University Surgical Clinic "Mother Teresa" in Skopje, Macedonia, from January 1 st till December 31 st 2015 was performed. Patients medical records were screened for available serum creatine kinase (CK) with levels > 200 U/l, presence of myoglobin in the serum in levels > 80 ng/ml, or if they had a clinical diagnosis of rhabdomyolysis by an attending doctor. Descriptive statistical methods were used to analyze the collected data. Out of totally 1084 patients hospitalized in the ICU, 93 were diagnosed with rhabdomyolysis during the course of one year. 82(88%) patients were trauma patients, while 11(12%) were surgical non trauma patients. 7(7.5%) patients diagnosed with rhabdomyolysis developed acute kidney injury (AKI) that required dialysis. Average values of serum myoglobin levels were 230 ng/ml, with highest values of > 5000 ng/ml. Patients who developed AKI had serum myoglobin levels above 2000 ng/ml. Average values of serum CK levels were 400 U/l, with highest value of 21600 U/l. Patients who developed AKI had serum CK levels above 3000 U/l. Regular monitoring and early detection of elevated serum CK and myoglobin levels in critically ill surgical and trauma patients is recommended in order to recognize and treat rhabdomyolysis in timely manner and thus prevent development of AKI.

Factors influencing surgical career choices and advancement in Ireland and Britain.

LENUS (Irish Health Repository)

Corrigan, Mark A

2012-02-03

BACKGROUND: The aim of this study was to analyze the factors that influence the advancement and the career choices of doctors and medical students. METHODS: Using the combined databases of the iformix and surgent websites, 450 doctors and medical students were invited to complete an internet-based survey. Surgent (http:\\/\\/www.surgent.ie) and iformix (http:\\/\\/www.iformix.com) are two free internet services administered by the authors. Surgent is a medical educational website, while iformix facilitates the online submission of abstracts to surgical and medical conferences across Britain and Ireland. The combined database of these two websites is approximately 4500 entries. Four hundred and fifty users represented a 10% sample based on an expected 40%-45% response rate. This was anticipated to yield between 180 and 202 respondents, statistically sufficient to analyze the data. A detailed Likert scale assessed the importance of "academic," "clinical," and "lifestyle" factors in determining career choice and progression. Analysis included descriptive statistics and inferential testing. RESULTS: Fifty percent (N = 222) of surveys were returned; 142 men and 78 women. Thirty-seven percent of respondents were Irish, 28% British, and 35% non-European. Fifteen percent were undergraduates, 4% interns, 12% had 2-4 years of clinical experience, while 69% had completed more than 4 years. Fifty-six percent had decided upon a career in general surgery. Overall, the most important factors for career choice were intellectual challenge (95%), academic opportunities (61%), and research opportunities(54%). Doctors with more than 4 years of experience deemed duration of training (p = 0.002), lifestyle during training (p = 0.02), and stress (0.005) as less important factors when considering career choice. Correlation analyses demonstrated that prestige (p = 0.002), patient relationships (p = 0.006), and advice from friends or family (p = 0.01) were more important influencing factors

Surgical Management of Post-Prostatectomy Incontinence

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Arthi Satyanarayan

2016-04-01

Full Text Available Post-prostatectomy incontinence (PPI is a common and significant issue that can affect the quality of life in men who are undergoing treatment for prostate cancer. While some patients opt for conservative management of their incontinence, many elect to undergo surgical treatment as a result of the significant impact to quality of life. The most commonly employed surgical techniques to address PPI are placement of a male sling or artificial urinary sphincter (AUS. Currently, the AUS continues to serve as the gold standard for management, with robust data concerning longitudinal outcomes available. However, in recent years, the various methods to place the male sling have emerged as viable, less complex alternatives that avoid the need for pump manipulation. In the present review, we discuss these main surgical treatment modalities for PPI, and focus on the selection criteria that may influence appropriate operative stratification of PPI patients. Indeed, an individualised, comprehensive assessment of baseline urinary function, age, radiation, prior surgeries, functional status, and other comorbidities must be considered in the context of shared decision-making between the treatment provider and the patient in determining the optimal approach to managing PPI.

Getting the right balance? A mixed logit analysis of the relationship between UK training doctors' characteristics and their specialties using the 2013 National Training Survey.

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Rodriguez Santana, Idaira; Chalkley, Martin

2017-08-11

To analyse how training doctors' demographic and socioeconomic characteristics vary according to the specialty that they are training for. Descriptive statistics and mixed logistic regression analysis of cross-sectional survey data to quantify evidence of systematic relationships between doctors' characteristics and their specialty. Doctors in training in the United Kingdom in 2013. 27 530 doctors in training but not in their foundation year who responded to the National Training Survey 2013. Mixed logit regression estimates and the corresponding odds ratios (calculated separately for all doctors in training and a subsample comprising those educated in the UK), relating gender, age, ethnicity, place of studies, socioeconomic background and parental education to the probability of training for a particular specialty. Being female and being white British increase the chances of being in general practice with respect to any other specialty, while coming from a better-off socioeconomic background and having parents with tertiary education have the opposite effect. Mixed results are found for age and place of studies. For example, the difference between men and women is greatest for surgical specialties for which a man is 12.121 times more likely to be training to a surgical specialty (relative to general practice) than a woman (p-valuevalue<0.01). There are systematic and substantial differences between specialties in respect of training doctors' gender, ethnicity, age and socioeconomic background. The persistent underrepresentation in some specialties of women, minority ethnic groups and of those coming from disadvantaged backgrounds will impact on the representativeness of the profession into the future. Further research is needed to understand how the processes of selection and the self-selection of applicants into specialties gives rise to these observed differences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article

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

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...

Disease spectrum and treatment patterns in a local male infertility clinic.

Science.gov (United States)

Ho, K L; Tsu, James H L; Tam, P C; Yiu, M K

2015-02-01

To review disease spectrum and treatment patterns in a local male infertility clinic. Case series. Male infertility clinic in a teaching hospital in Hong Kong. Patients who were seen as new cases in a local male infertility clinic between January 2008 and December 2012. Infertility assessment and counselling on treatment options. Disease spectrum and treatment patterns. A total of 387 new patients were assessed in the male infertility clinic. The mean age of the patients and their female partners was 37.2 and 32.1 years, respectively. The median duration of infertility was 3 years. Among the patients, 36.2% had azoospermia, 8.0% had congenital absence of vas deferens, and 48.3% of patients had other abnormalities in semen parameters. The commonest causes of male infertility were unknown (idiopathic), clinically significant varicoceles, congenital absence of vas deferens, mumps after puberty, and erectile or ejaculatory dysfunction. Overall, 66.1% of patients chose assisted reproductive treatment and 12.4% of patients preferred surgical correction of reversible male infertility conditions. Altogether 36.7% of patients required either surgical sperm retrieval or correction of male infertility conditions. The present study provided important local data on the disease spectrum and treatment patterns in a male infertility clinic. The incidences of azoospermia and congenital absence of vas deferens were much higher than those reported in the contemporary literature. A significant proportion of patients required either surgical sperm retrieval or correction of reversible male infertility conditions.

Surgical correction of the webbed neck: an alternative lateral approach

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Mehri Turki, Imen

2017-03-01

Full Text Available Objective: The webbed neck deformity or pterygium colli is the number one symptom of the Turner syndrome that leads the patient to consult a doctor. Various but rare surgical approaches have been described to correct this deformity. We reviewed our experience with the surgical correction of the pterygium colli.Methods: Through five clinical cases, we describe the surgical technique with a lateral approach which provides a better control of the operative site, allows for the excision of the underlying trapezial fascial web, thus preventing recurrence seen in the posterior approach, and restores a normal hairline. Results: No postoperative wound infection occurred. No recurrence was observed through 24 months. Three patients developed hypertrophic scars.Conclusion: The lateral approach associated with an advanced flap and a Z-plasty is an effective technique for correction of this neck deformity. The presence of a multidisciplinary team, formed with maxillofacial and plastic surgeons, endocrinologists and psychologists, is required to treat these patients allowing reintegration into society and family.

Trends in the Surgical Correction of Gynecomastia

OpenAIRE

Brown, Rodger H.; Chang, Daniel K.; Siy, Richard; Friedman, Jeffrey

2015-01-01

Gynecomastia refers to the enlargement of the male breast due to a proliferation of ductal, stromal, and/or fatty tissue. Although it is a common condition affecting up to 65% of men, not all cases require surgical intervention. Contemporary surgical techniques in the treatment of gynecomastia have become increasingly less invasive with the advent of liposuction and its variants, including power-assisted and ultrasound-assisted liposuction. These techniques, however, have been largely limited...

Evaluation of Histopathological and Histomorphological Effects of Kombucha Extract (Camellia sinenesis on Stomach Surgical Wound Healing in Adult Male Rat

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Fariborz Moayer

2017-04-01

Full Text Available Background & Objectives: Wounds healing especially as to surgical wounds is considered clinical problem. Kombucha is used as a food and adminstarted for wound healing. The aim of this study was to assess histopathological and histomorphometrical effect of Kombucha on surgical wound healing process in stomach of rat. Methods: Thirty adult male Wistar rats with 10-week-old and weighted between 200-250 g were randomly divided into two groups (Control and Experimenral. After anesthesia, rats’ stomach was removed and a gastrotomy incision with the length of 1 cm was made in greater curvature, thereafter, sutured in 2 layers. Experimental group received Kombucha extract (1 ml/100gbw and control group received normal saline (1 ml/100gbw daily for 14 days through the gavage. In 3, 7 and 14 days after operation, five rats of each group were euthanized and stomach tissue specimens were collected for histopatholocical study by H&E and Masson's trichrome staining. Histopathological and histomorphometrical studies of wound healing among the groups were carried out considering more effective agents on wound healing including proliferation of fibroblasts, angiogenesis, re-epithelialization and collagen organization in healing tissue. Results: The numbers of fibroblasts, capillary buds and organized collagen content in healing site of experimental group were significantly more than control group (p<0.05. The size of epithelial gap in experimental group was significantly lesser than control group (p<0.05. Conclusion: Based on the results, Kombucha extract possesses beneficial effects on healing of stomach surgical wounds in rats.

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

Mobile technology supporting trainee doctors' workplace learning and patient care: an evaluation.

Science.gov (United States)

Hardyman, Wendy; Bullock, Alison; Brown, Alice; Carter-Ingram, Sophie; Stacey, Mark

2013-01-21

The amount of information needed by doctors has exploded. The nature of knowledge (explicit and tacit) and processes of knowledge acquisition and participation are complex. Aiming to assist workplace learning, Wales Deanery funded "iDoc", a project offering trainee doctors a Smartphone library of medical textbooks. Data on trainee doctors' (Foundation Year 2) workplace information seeking practice was collected by questionnaire in 2011 (n = 260). iDoc baseline questionnaires (n = 193) collected data on Smartphone usage alongside other workplace information sources. Case reports (n = 117) detail specific instances of Smartphone use. Most frequently (daily) used information sources in the workplace: senior medical staff (80% F2 survey; 79% iDoc baseline); peers (70%; 58%); and other medical/nursing team staff (53% both datasets). Smartphones were used more frequently by males (p mobile technology used for simple (information-based), complex (problem-based) clinical questions and clinical procedures (skills-based scenarios). From thematic analysis, the Smartphone library assisted: teaching and learning from observation; transition from medical student to new doctor; trainee doctors' discussions with seniors; independent practice; patient care; and this 'just-in-time' access to reliable information supported confident and efficient decision-making. A variety of information sources are used regularly in the workplace. Colleagues are used daily but seniors are not always available. During transitions, constant access to the electronic library was valued. It helped prepare trainee doctors for discussions with their seniors, assisting the interchange between explicit and tacit knowledge.By supporting accurate prescribing and treatment planning, the electronic library contributed to enhanced patient care. Trainees were more rapidly able to medicate patients to reduce pain and more quickly call for specific assessments. However, clinical decision-making often requires

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)

Interventional Radiology of Male Varicocele: Current Status

International Nuclear Information System (INIS)

Iaccarino, Vittorio; Venetucci, Pietro

2012-01-01

Varicocele is a fairly common condition in male individuals. Although a minor disease, it may cause infertility and testicular pain. Consequently, it has high health and social impact. Here we review the current status of interventional radiology of male varicocele. We describe the radiological anatomy of gonadal veins and the clinical aspects of male varicocele, particularly the physical examination, which includes a new clinical and ultrasound Doppler maneuver. The surgical and radiological treatment options are also described with the focus on retrograde and antegrade sclerotherapy, together with our long experience with these procedures. Last, we compare the outcomes, recurrence and persistence rates, complications, procedure time and cost-effectiveness of each method. It clearly emerges from this analysis that there is a need for randomized multicentre trials designed to compare the various surgical and percutaneous techniques, all of which are aimed at occlusion of the anterior pampiniform plexus.

Interventional Radiology of Male Varicocele: Current Status

Energy Technology Data Exchange (ETDEWEB)

Iaccarino, Vittorio, E-mail: vittorio.iaccarino@unina.it; Venetucci, Pietro [University of Naples ' Federico II' , Diagnostic Imaging Department-Cardiovascular and Interventional Radiology, School of Medicine (Italy)

2012-12-15

Varicocele is a fairly common condition in male individuals. Although a minor disease, it may cause infertility and testicular pain. Consequently, it has high health and social impact. Here we review the current status of interventional radiology of male varicocele. We describe the radiological anatomy of gonadal veins and the clinical aspects of male varicocele, particularly the physical examination, which includes a new clinical and ultrasound Doppler maneuver. The surgical and radiological treatment options are also described with the focus on retrograde and antegrade sclerotherapy, together with our long experience with these procedures. Last, we compare the outcomes, recurrence and persistence rates, complications, procedure time and cost-effectiveness of each method. It clearly emerges from this analysis that there is a need for randomized multicentre trials designed to compare the various surgical and percutaneous techniques, all of which are aimed at occlusion of the anterior pampiniform plexus.

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....

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 ...

[Surgical treatment of gynecomastia: an algorithm].

Science.gov (United States)

Wolter, A; Scholz, T; Diedrichson, J; Liebau, J

2013-04-01

Gynecomastia is a persistent benign uni- or bilateral enlargement of the male breast ranging from small to excessive findings with marked skin redundancy. In this paper we introduce an algorithm to facilitate the selection of the appropriate surgical technique according to the presented morphological aspects. The records of 118 patients (217 breasts) with gynecomastia from 01/2009 to 08/2012 were retrospectively reviewed. The authors conducted three different surgical techniques depending on four severity grades. The outcome parameters complication rate, patient satisfaction with the aesthetic result, nipple sensitivity and the need to re-operate were observed and related to the employed technique. In 167 (77%) breasts with moderate breast enlargement without skin redundancy (Grade I-IIa by Simon's classification) a subcutaneous semicircular periareolar mastectomy was performed in combination with water-jet assisted liposuction. In 40 (18%) breasts with skin redundancy (Grade IIb) a circumferential mastopexy was performed additionally. An inferior pedicled mammaplasty was used in 10 (5%) severe cases (Grade III). Complication rate was 4.1%. Surgical corrections were necessary in 17 breasts (7.8%). The patient survey revealed a high satisfaction level: 88% of the patients rated the aesthetic results as "very good" or "good", nipple sensitivity was rated as "very good" or "good" by 83%. Surgical treatment of gynecomastia should ensure minimal scarring while respecting the aesthetic unit. The selection of the appropriate surgical method depends on the severity grade, the presence of skin redundancy and the volume of the male breast glandular tissue. The presented algorithm rarely leads to complications, is simple to perform and shows a high satisfaction rate and a preservation of the nipple sensitivity. © Georg Thieme Verlag KG Stuttgart · New York.

The quality of voluntary medical male circumcision done by mid-level workers in Tshwane District, South Africa: A retrospective analysis.

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Sanele Ngcobo

Full Text Available Voluntary medical male circumcision (VMMC reduces the acquisition of human immunodeficiency virus (HIV in heterosexual men by up to 60%. One HIV infection is averted for every 5 to 15 VMMCs. To conduct VMMCs in large populations, large numbers of trained healthcare professionals are needed. Countries in Sub-Saharan Africa have a high burden of HIV and a shortage of healthcare professionals, creating a healthcare conundrum. To bridge this gap, South Africa launched a new cadre of mid-level medical worker called Clinical Associates (CA. We assessed the ability of CAs to perform circumcisions of adequate quality and their subsequent usefulness to meet the demands of VMMCs in a population with a high HIV burden.We conducted a retrospective analysis, reviewing patient files (n = 4850 of surgical VMMCs conducted over a 16-month period. Patient files were sourced from clinics and hospitals that provided free VMMCs in Tshwane district in South Africa.Clinical associates performed 88.66% of the circumcisions and doctors performed the remaining 11.34% (p < 0.001. The number of adverse events did not differ between the two groups. Data on intra-operative adverse events were available for 4 738 patients. Of these, 341 (7.2% experienced intra-operative adverse events. For the whole sample, 44 (8.1%, n = 543 adverse events occurred during circumcisions done by doctors and 297 (7.1%, n = 4195 occurred during circumcisions done by CAs (p = 0.385. Clinical associates performed circumcisions in shorter times (duration: 14.63 minutes compared to doctors (duration: 15.25 minutes, t = -7.46; p < 0.001. Recorded pain, bleeding, swelling, infection and wound destruction did not differ between clients circumcised by CAs and doctors. This study is limited by the use of data from a single district.Clinical associates contribute to the demands for high numbers of VMMCs in Tshwane district, South Africa. Clinical associates perform VMMCs at a clinical standard that is

Job Satisfaction among Doctors of a Government Medical College and Hospital of Eastern India.

Science.gov (United States)

Bhattacherjee, Sharmistha; Ray, Kuntala; Kumar Roy, Jayanta; Mukherjee, Abhijit; Roy, Hironmoy; Datta, Saikat

2016-10-01

Job satisfaction expresses the extent of congruence between an individual’s expectation of the job and the reward that the job provides.Job satisfaction among doctors is an issue that is of utmost importance because offactors like patient relationships and time pressures associated with managed care. The current study was done to determine the level of job satisfaction in doctors posted in a tertiary care hospital of eastern India and to find out the factors associated with it. A descriptive cross sectional study was conducted among 255 doctors posted in a tertiary care hospital of eastern India. Data werecollected using a self-reported questionnaire consisting of 49 items addressing the seven domains of job satisfaction, where higher values indicated higher level of satisfaction. The average scores of items were computed to construct factor scores for each individual. Two stage cluster analysis was performed to get the proportion of satisfied doctors and binary logistic regression was used for comparison of predictors of job satisfaction. The proportion of job satisfaction was found to be 59.6% and the most important factor was found to be working space. On adjustment, the odds of being satisfied were found to be higher in the older age groups, among males, doctors posted in preclinical or paraclinical departments and those staying in present setting for 5 years or more. More than half of the doctors were found to be satisfied with their job which can help the policy makers to make necessary strategies to increase the level of satisfaction of the employees. .

Knowledge and awareness of medical doctors, medical students and nurses about dentistry in Nigeria.

Science.gov (United States)

Oyetola, Elijah Olufemi; Oyewole, Taiwo; Adedigba, Micheal; Aregbesola, Stephen Tunde; Umezudike, Kehinde; Adewale, Adedotun

2016-01-01

Various studies have reported poor awareness and knowledge of dentistry in the Nigerian population. There is, however, paucity of information assessing the knowledge and awareness of medical doctors/students and nurses about dentistry. The present study is aimed at determining the knowledge and awareness of medical doctors/students and nurses about dentistry. Self-administered questionnaires were randomly distributed among medical doctors/students, and nurses of Obafemi Awolowo Teaching Hospitals' Complex, Ile-Ife, Nigeria. Information collected using the questionnaire included participants' biodata, questions evaluating dental awareness, knowledge of systemic and oral health connections as well as referral practices. The data analysis was done with STATA version 11 software. A total of 300 questionnaires were randomly distributed among doctors/students and nurses, 206 were returned (response rate of 69%). Of the returned questionnaires, 129(63%) were males and 77(37%) were females. There were 42 medical doctors, 49 nurses and 115 medical students. The mean age of the participants was 26.7 years (SD 5.2). Majority (99.5%) was aware of dental profession, but 92% had never referred patients for dental consultation. One third (31%) of medical doctors believed that Ludwig angina was a cardiac disease. A large proportion of the respondents (61%) see no need for routine dental visit while 27% would want to visit the dentist only when they had a dental complaint. Although a large percentage of the participants claimed to be aware of dentistry, our findings revealed low level of knowledge and attitude to Dentistry. Efforts should be made towards closing this knowledge gap to achieve efficient oral health.

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.

Gender awareness among physicians – the effect of specialty and gender. A study of teachers at a Swedish medical school

Directory of Open Access Journals (Sweden)

Hamberg Katarina

2003-10-01

Full Text Available Abstract Background An important goal for medical education today is professional development including gender equality and awareness of gender issues. Are medical teachers prepared for this task? We investigated gender awareness among physician teachers, expressed as their attitudes towards the role of gender in professional relationships, and how it varied with physician gender and specialty. We discuss how this might be related to the gender climate and sex segregation in different specialties. Method Questionnaires were sent to all 468 specialists in the clinical departments and in family medicine, who were engaged in educating medical students at a Swedish university. They were asked to rate, on visual analogue scales, the importance of physician and patient gender in consultation, of preceptor and student gender in clinical tutoring and of physician gender in other professional encounters. Differences between family physicians, surgical, and non-surgical hospital doctors, and between women and men were estimated by chi-2 tests and multivariate logistic regression analyses. Results The response rate was 65 %. There were differences between specialty groups in all investigated areas mainly due to disparities among men. The odds for a male family physician to assess gender important were three times higher, and for a male non-surgical doctor two times higher when compared to a male surgical doctor. Female teachers assessed gender important to a higher degree than men. Among women there were no significant differences between specialty groups. Conclusions There was an interaction between physician teachers' gender and specialty as to whether they identified gender as important in professional relationships. Male physicians, especially from the surgical group, assessed gender important to a significantly lower degree than female physicians. Physicians' degree of gender awareness may, as one of many factors, affect working climate and the

Self-perceived readiness to perform at the attending level following surgical specialist training in Denmark

DEFF Research Database (Denmark)

Fabricius, Rasmus; Sillesen, Martin; Hansen, Morten Sejer

2017-01-01

not previously been studied. In the present study, we aim to investigate the role of supervision in the national surgical residency programme and the self-perceived readiness to undertake the role of a specialist doctor in gastrointestinal surgery in a cohort of gastrointestinal surgeons graduating in 2012......: A total of 30 graduated residents (55%) responded to the Danish survey. Among those, 14 (47%) felt ready to be a specialist in surgery. A total of 25 (83%) answered that increased supervision would have increased their selfperceived competencies to serve as a surgical specialist. Self -perceived readiness...... was significantly associated with level of supervision during surgical training (p = 0.02), whereas no association with operative volume could be established. CONCLUSIONS: A worryingly high number of graduates did not feel ready to undertake their role as a gastrointestinal surgical specialist. Adequate supervision...

Influence of the revision of surgical fee schedule on surgeons' productivity in Japan: A cohort analysis of 7602 surgical procedures in 2013-2016.

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Nakata, Yoshinori; Watanabe, Yuichi; Narimatsu, Hiroto; Yoshimura, Tatsuya; Otake, Hiroshi; Sawa, Tomohiro

2018-02-01

The goal of this study is to evaluate the pure impact of the revision of surgical fee schedule on surgeons' productivity. We collected data from the surgical procedures performed by the surgeons working in Teikyo University Hospital from 1 April through 30 September in 2013-2016. We employed non-radial and non-oriented Malmquist model. We defined the decision-making unit as a surgeon with the highest academic rank in surgery. Inputs were defined as (1) the number of doctors who assisted surgery and (2) the time of surgical operation. The output was defined as the surgical fee for each surgery. We focused on the revisions in 2014 and 2016. We first calculated each surgeon's natural logarithms of the changes in productivity, technique and efficiency in 2013-2014, in 2014-2015 and in 2015-2016. Then, we subtracted the changes in 2014-2015 from the changes in 2013-2014 and in 2015-2016. We analyzed 62 surgeons who performed 7602 surgical procedures. The productivity changes were not significantly different from 0. Their efficiency change was significantly greater than 0, while their technical change was smaller than 0 in revision 2014. Their efficiency change was significantly smaller than 0, while their technical change was greater than 0 in revision 2016 (p increase overall productivity through revision if we could increase both efficiency and technique.

What Clinical Information Is Valuable to Doctors Using Mobile Electronic Medical Records and When?

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Kim, Junetae; Lee, Yura; Lim, Sanghee; Kim, Jeong Hoon; Lee, Byungtae; Lee, Jae-Ho

2017-10-18

There has been a lack of understanding on what types of specific clinical information are most valuable for doctors to access through mobile-based electronic medical records (m-EMRs) and when they access such information. Furthermore, it has not been clearly discussed why the value of such information is high. The goal of this study was to investigate the types of clinical information that are most valuable to doctors to access through an m-EMR and when such information is accessed. Since 2010, an m-EMR has been used in a tertiary hospital in Seoul, South Korea. The usage logs of the m-EMR by doctors were gathered from March to December 2015. Descriptive analyses were conducted to explore the overall usage patterns of the m-EMR. To assess the value of the clinical information provided, the usage patterns of both the m-EMR and a hospital information system (HIS) were compared on an hourly basis. The peak usage times of the m-EMR were defined as continuous intervals having normalized usage values that are greater than 0.5. The usage logs were processed as an indicator representing specific clinical information using factor analysis. Random intercept logistic regression was used to explore the type of clinical information that is frequently accessed during the peak usage times. A total of 524,929 usage logs from 653 doctors (229 professors, 161 fellows, and 263 residents; mean age: 37.55 years; males: 415 [63.6%]) were analyzed. The highest average number of m-EMR usage logs (897) was by medical residents, whereas the lowest (292) was by surgical residents. The usage amount for three menus, namely inpatient list (47,096), lab results (38,508), and investigation list (25,336), accounted for 60.1% of the peak time usage. The HIS was used most frequently during regular hours (9:00 AM to 5:00 PM). The peak usage time of the m-EMR was early in the morning (6:00 AM to 10:00 AM), and the use of the m-EMR from early evening (5:00 PM) to midnight was higher than during regular

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

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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…

Healthy Doctors – Sick Medicine

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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

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

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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

The difficulty of professional continuation among female doctors in Japan: a qualitative study of alumnae of 13 medical schools in Japan.

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Nomura, Kyoko; Yamazaki, Yuka; Gruppen, Larry D; Horie, Saki; Takeuchi, Masumi; Illing, Jan

2015-03-27

To investigate the difficulties Japanese female doctors face in continuing professional practice. A qualitative study using the Kawakita Jiro method. A survey conducted in 2011 of 13 private Japanese medical school alumni associations. 359 female doctors. Barriers of balancing work and gender role. The female doctors reported that professional practice was a struggle with long working hours due to a current shortage of doctors in Japan. There was also a severe shortage of childcare facilities in the workplace. Some women appeared to have low confidence in balancing the physician's job and personal life, resulting in low levels of professional pursuit. There appeared to be two types of stereotypical gender roles, including one expected from society, stating that "child rearing is a woman's job", and the other perceived by the women themselves, that some women had a very strong desire to raise their own children. Male doctors and some female doctors who were single or older were perceived to be less enthusiastic about supporting women who worked while raising children because these coworkers feared that they would have to perform additional work as a result of the women taking long periods of leave. Important factors identified for promoting the continuation of professional practice among female doctors in Japan were the need to improve working conditions, including cutting back on long working hours, a solution to the shortage of nurseries, a need for the introduction of educational interventions to clarify professional responsibilities, and redefinition of the gender division of labour for male and female doctors. In addition, we identified a need to modernise current employment practices by introducing temporary posts to cover maternity leave and introducing flexible working hours during specialist training, thus supporting and encouraging more women to continue their medical careers. Published by the BMJ Publishing Group Limited. For permission to use (where not

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

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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.

Male Midlife Depression: Multidimensional Contributing Factors and Renewed Practice Approaches

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Grove, Debbie L.

2012-01-01

Based on original doctoral research conducted with midlife women and men who completed counselling for depression, this article presents research findings of male participant perspectives and experiences in managing midlife depression and the role of counselling. Hermeneutic inquiry using conversational semistructured interviews generated multiple…

Talking to Your Doctor

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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 ...

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

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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.

Talking to Your Doctor

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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 ...

Emotions and identity in the figured world of becoming a doctor.

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Dornan, Tim; Pearson, Emma; Carson, Peter; Helmich, Esther; Bundy, Christine

2015-02-01

There is little room in clerkship curricula for students to express emotions, particularly those associated with the development of a caring identity. Yet it is recognised that competence, alone, does not make a good doctor. We therefore set out to explore the relationship between emotions and identity in clerkship education. Our exploration was conceptually oriented towards Figured Worlds theory, which is linked to Bakhtin's theory of dialogism. Nine female and one male member of a mixed student cohort kept audio-diaries and participated in both semi-structured and cognitive individual interviews. The researchers identified 43 emotionally salient utterances in the dataset and subjected them to critical discourse analysis. They applied Figured Worlds constructs to within-case and cross-case analyses, supporting one another's reflexivity and openness to different interpretations, and constantly comparing their evolving interpretation against the complete set of transcripts. Students' emotions were closely related to their identity development in the world of medicine. Patients were disempowered by their illnesses. Doctors were powerful because they could treat those illnesses. Students expressed positive emotions when they were granted positions in the world of medicine and were able to identify with the figures of doctors or other health professionals. They identified with doctors who behaved in caring and professionally appropriate ways towards patients and supportively towards students. Students expressed negative emotions when they were unable to develop their identities. Critical discourse analysis has uncovered a link between students' emotions and their identity development in the powerful world of becoming and being a doctor. At present, identity development, emotions and power are mostly tacit in undergraduate clinical curricula. We speculate that helping students to express emotions and exercise power in the most effective ways might help them to develop

Talking to Your Doctor

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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 ...

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)

Talking to Your Doctor

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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) ...

Talking to Your Doctor

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

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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…

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

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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…

Refusal of Treatment by Mentally Competent Patient: The Choice of Doctor-Patient Relationship Models

Directory of Open Access Journals (Sweden)

Andrei M. Beliaev

2010-01-01

Full Text Available Introduction: In modern medicine professional relationship between the clinician and the patient is patient-centered. Patients become actively involved in the treatment decision making process and are encouraged to express their health-related preferences. Some patients may, however, refuse a favorable risk/benefit ratio treatment. This manuscript presents three cases of refusal of treatment by mentally competent surgical patients and discusses differences in their management. Conclusion: To achieve the best medical outcome for patients who possess the Actual Understanding test of mental competence clinicians use the deliberate model of medical professional relationship. For patients demonstrating the Understanding test of mental competence and wishing to utilize their health-related preferences physicians are obliged to deploy the interpretive model of doctor-patient relationship. In mentally competent patients with an illness-induced acute psychological regression the interpretive model of doctor-patient relationship as an initial strategy and cognitive behavior therapy can be useful in modifying treatment rejecting behavior and improving medical outcome.

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

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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.

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

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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.

The effects of a slow release GnRH agonist implant on male rabbits

DEFF Research Database (Denmark)

Goericke-Pesch, Sandra Kathrin; Groeger, Gesa; Wehrend, Axel

2015-01-01

Surgical castration is done in male pet rabbits for reproduction control, to reduce inter-male aggression and to control hyper-sexuality, territory marking and aggression against humans. Alternatives to surgical castration are requested because of a relatively great anaesthetic risk in rabbits....... Long-term application of a GnRH agonist implant results in a fully reversible "hormonal" castration in male dogs, cats, boars and many other species. Therefore, the present study using New Zealand White hybrid and German Giant rabbits aimed to investigate the effects of a 4.7mg deslorelin implant...

Talking to Your Doctor

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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 ...

Dementia - what to ask your doctor

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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/ ...

Surgical treatment of gynecomastia: complications and outcomes.

Science.gov (United States)

Li, Chun-Chang; Fu, Ju-Peng; Chang, Shun-Cheng; Chen, Tim-Mo; Chen, Shyi-Gen

2012-11-01

Gynecomastia is defined as the benign enlargement of the male breast. Multiple surgical options have been used to improve outcomes. The aim of this study was to analyze the surgical approaches to the treatment of gynecomastia and their outcomes over a 10-year period. All patients undergoing surgical correction of gynecomastia in our department between 2000 and 2010 were included for retrospective evaluation. The data were analyzed for etiology, stage of gynecomastia, surgical technique, complications, risk factors, and revision rate. The surgical result was evaluated with self-assessment questionnaires. A total of 41 patients with 75 operations were included. Techniques included subcutaneous mastectomy alone or with additional ultrasound-assisted liposuction (UAL) and isolated UAL. The surgical revision rate for all patients was 4.8%. The skin-sparing procedure gave good surgical results in grade IIb and grade III gynecomastia with low revision and complication rates. The self-assessment report revealed a good level of overall satisfaction and improvement in self-confidence (average scores 9.4 and 9.2, respectively, on a 10-point scale). The treatment of gynecomastia requires an individualized approach. Subcutaneous mastectomy combined with UAL could be used as the first choice for surgical treatment of grade II and III gynecomastia.

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.

[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.

Doctoral Programs Need Changes to Attract and Retain Underrepresented Groups

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Bernard, R. E.; Mayfield, K. K.

2017-12-01

Geoscience is currently recognized as the least diverse of all STEM fields. While attention typically focuses on K-12 and undergraduate populations, the extreme lack of diversity among graduate students, and doctoral students in particular, should be examined and addressed. In 2016, members of underrepresented minority (URM) groups made up only 6% of those graduating with geoscience PhDs. In all STEM fields, only 48% of Hispanic/Latino and 38% of Black/African American doctoral studies had earned doctorates within 7 years, with 36% of members of these groups leaving the program entirely. Recent studies suggest that these high attrition rates can be attributed, in part, to a mismatch between motivations of URM members and PhD-granting institutions while students are pursuing scientific education and careers. Traditional STEM doctoral programs do not offer, facilitate, or incentivize substantial opportunities to integrate social justice issues, community involvement, and altruism—factors which have been found to be of more importance to these populations than to male members of well-represented groups. URM members are also less likely to be interested in purely academic research careers, so doctoral programs may be failing to attract (and failing to prepare) diverse populations by not offering experiences beyond typical research and TA duties. In this presentation, trends in motivation and persistence among URM students in STEM will be discussed, in addition to highlighting education and outreach activities that can be successfully incorporated for a more fulfilling, balanced, attractive, and preparatory education experience. Specific activities undertaken and recommended by the presenter in her PhD experience include the following: a federal research internship, a state government policy internship, a formal partnership with a local K-12 teacher though a former NSF GK-12 program, a two-week education workshop aboard a scientific research drillship, and attending a

[Gender patterns in Spanish otolaryngologic doctoral theses].

Science.gov (United States)

Prim-Espada, María Pilar; De Diego-Sastre, Juan Ignacio; Pérez-Fernández, Elia

2010-01-01

In last decades women in Spain have a greater access to postgraduate education. The objective of this study was to perform a gender analysis on the Otolaryngology doctoral theses presented in a 25 year-period. The TESEO data base on doctoral theses was searched for theses on Otorhinolaryngology written between 1981 and 2005. As strategy for the research we employed the terms: 1) Otorrinolaringología (Otorhinolaryngology); 2) Cirugía de garganta, nariz y oídos (Ear, nose and throat surgery); 3) Fisiología de la audición (Physiology of hearing); 4) Fisiología del equilibrio (Physiology of balance); 5) Física de la audición (Physics of hearing); and 6) Bioacústica (Bioacoustics). A total of 450 theses (18.0±8.3 theses/year) were found, of which 129 were written by females (28.6%). There was a gender imbalance among authors, with 5.2±3.4 theses/year for women vs. 12.9±6.6 theses/year for men (p=0.0002). Nevertheless, there was a tendency toward equality in the last 10 years (p=0.001). On the other hand, the PhD student's gender was clearly related to the supervisor's gender (p=0.0001). With respect to the main topics in our area (otology, audiology/vestibular diseases, rhinology and pathology of paranasal sinuses and neck diseases), there were no significant differences between males and females (p=0.231). These results indicate a tendency towards equality in the number of men and women successfully completing doctoral studies in Otolaryngology. However, the PhD student's gender is clearly related to the supervisor's gender. Copyright © 2010 Elsevier España, S.L. All rights reserved.

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…

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\\

[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.

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...

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

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’....

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.

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

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...

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 ...

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.

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.

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…

The Religious and Spiritual Experiences of Undergraduate Gay Males Attending a Religiously Affiliated Institution of Higher Education

Science.gov (United States)

Adams, Melvin D., III

2013-01-01

This doctoral thesis studied the religious and spiritual experiences of undergraduate gay males at a Protestant affiliated higher education institution and how undergraduate gay males made sense of their personal journeys. Data was collected from four participants and analyzed using interpretative phenomenological analysis. Five themes emerged…

[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

Understanding the Barriers to Hiring and Promoting Women in Surgical Subspecialties.

Science.gov (United States)

Valsangkar, Nakul; Fecher, Alison M; Rozycki, Grace S; Blanton, Cassie; Bell, Teresa M; Freischlag, Julie; Ahuja, Nita; Zimmers, Teresa A; Koniaris, Leonidas G

2016-08-01

The objective of this study was to characterize potential disparities in academic output, NIH-funding, and academic rank between male and female surgical faculty and identify subspecialties in which these differences may be more pronounced. Eighty metrics for 4,015 faculty members at the top-55 NIH-funded departments of surgery were collected. Demographic characteristics, NIH funding details, and scholarly output were analyzed. A new metric, academic velocity (V), reflecting recent citations is defined. Overall, 21.5% of surgical faculty are women. The percentage of female faculty is highest in science/research (41%) and surgical oncology (34%), and lowest in cardiothoracic surgery (9%). Female faculty are less likely to be full professors (22.7% vs 41.2%) and division chiefs (6.2% vs 13.6%). The fraction of women who are full professors is lowest in cardiothoracic surgery. Overall median numbers of publications/citations are lower for female faculty compared with male surgical faculty (21 of 364 vs 43 of 723, p women and men, and surgical departments with more female full professors have higher NIH funding ranking (R(2) = 0.14, p barriers for entry of women into certain subspecialties, causes for the observed lower number of publications/citations among female assistant professors, and obstacles for attaining leadership roles need to be determined. We propose a new metric for assessment of publications/citations that can offset the effects of seniority differences between male and female faculty members. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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.

What determines the income gap between French male and female GPs - the role of medical practices.

Science.gov (United States)

Dumontet, Magali; Le Vaillant, Marc; Franc, Carine

2012-09-21

In many OECD countries, the gender differences in physicians' pay favour male doctors. Due to the feminisation of the doctor profession, it is essential to measure this income gap in the French context of Fee-for-service payment (FFS) and then to precisely identify its determinants. The objective of this study is to measure and analyse the 2008 income gap between males and females general practitioners (GPs). This paper focuses on the role of gender medical practices differentials among GPs working in private practice in the southwest region of France. Using data from 339 private-practice GPs, we measured an average gender income gap of approximately 26% in favour of men. Using the decomposition method, we examined the factors that could explain gender disparities in income. The analysis showed that 73% of the income gap can be explained by the average differences in doctors' characteristics; for example, 61% of the gender income gap is explained by the gender differences in workload, i.e., number of consultations and visits, which is on average significantly lower for female GPs than for male GPs. Furthermore, the decomposition method allowed us to highlight the differences in the marginal returns of doctors' characteristics and variables contributing to income, such as GP workload; we found that female GPs have a higher marginal return in terms of earnings when performing an additional medical service. The findings of this study help to understand the determinants of the income gap between male and female GPs. Even though workload is clearly an essential determinant of income, FFS does not reduce the gender income gap, and there is an imperfect relationship between the provision of medical services and income. In the context of feminisation, it appears that female GPs receive a lower income but attain higher marginal returns when performing an additional consultation.

Prepubertal gonadectomy in cats: different surgical techniques and comparison with gonadectomy at traditional age.

Science.gov (United States)

Porters, N; Polis, I; Moons, C; Duchateau, L; Goethals, K; Huyghe, S; de Rooster, H

2014-09-06

Feasibility, surgical time and complications of different surgical techniques for prepubertal gonadectomy (PPG; 8-12 weeks of age) in cats were studied and compared to gonadectomy at traditional age (TAG; 6-8 months of age). Kittens were randomly assigned to PPG or TAG. Ovarian pedicle haemostasis for PPG was achieved by ligatures (n=47), vascular clips (n=50), bipolar electrocoagulation (n=50), or pedicle tie (n=50); for TAG (n=34) ligatures were used. In male cats, PPG consisted of closed castration by spermatic cord knot (n=92) or ligature (n=91) while TAG (n=34) was an open castration by spermatic cord knot. A linear (surgical time) and a logistic regression (complications) model were designed. Significance was set at 0.05. For female PPG, clips and coagulation were the fastest procedures; placement of ligatures was most time-consuming. In male PPG, knot placement was significantly faster than ligation. In both sexes, very few intraoperative or wound complications were observed, irrespective of the surgical technique used. Surgical times in females (ligatures) as well as in males (knot) were significantly shorter for PPG than for TAG. PPG was as safe as TAG, yet took less time to perform and did not result in a greater rate of postoperative complications. British Veterinary Association.

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…

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...

Evolving a common surgical curriculum for ASEAN nations with a public health approach.

Science.gov (United States)

Lum, Siew Kheong

2013-03-01

The Association of Southeast Asian Nations (ASEAN) Mutual Recognition Arrangement (MRA) on medical practitioners' agreement will become a reality in the year 2015. Doctors registered in one ASEAN country will be given reciprocal recognition in another country under this agreement. Rapid and excessive movement of human resources between countries in a short span of time is undesirable and can be destabilizing. The surgical fraternity in the ASEAN countries should plan for a common surgical curriculum, a common examination and an ASEAN Board of Surgery so that standards of future trainees in different countries are comparable. The curriculum should take into consideration the diversity of the countries in socio-economic development. Ideally, it should be based on a public health approach to bring affordable quality surgical care to the masses in an efficient and effective manner. © 2013 The Author. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

Improving the accuracy of operation coding in surgical discharge summaries

Science.gov (United States)

Martinou, Eirini; Shouls, Genevieve; Betambeau, Nadine

2014-01-01

Procedural coding in surgical discharge summaries is extremely important; as well as communicating to healthcare staff which procedures have been performed, it also provides information that is used by the hospital's coding department. The OPCS code (Office of Population, Censuses and Surveys Classification of Surgical Operations and Procedures) is used to generate the tariff that allows the hospital to be reimbursed for the procedure. We felt that the OPCS coding on discharge summaries was often incorrect within our breast and endocrine surgery department. A baseline measurement over two months demonstrated that 32% of operations had been incorrectly coded, resulting in an incorrect tariff being applied and an estimated loss to the Trust of £17,000. We developed a simple but specific OPCS coding table in collaboration with the clinical coding team and breast surgeons that summarised all operations performed within our department. This table was disseminated across the team, specifically to the junior doctors who most frequently complete the discharge summaries. Re-audit showed 100% of operations were accurately coded, demonstrating the effectiveness of the coding table. We suggest that specifically designed coding tables be introduced across each surgical department to ensure accurate OPCS codes are used to produce better quality surgical discharge summaries and to ensure correct reimbursement to the Trust. PMID:26734286

Surgically treated cases of lumbar spondylolysis and isthmic spondylolisthesis: a multicenter study.

Science.gov (United States)

Hirano, Kenichi; Imagama, Shiro; Matsuyama, Yukihiro; Kawakami, Noriaki; Yukawa, Yasutsugu; Kato, Fumihiko; Hachiya, Yudo; Kanemura, Tokumi; Kamiya, Mitsuhiro; Deguchi, Masao; Ito, Zenya; Wakao, Norimitsu; Ando, Kei; Tauchi, Ryoji; Muramoto, Akio; Ishiguro, Naoki

2015-06-01

Prospective database study. To grasp the characteristics of surgically treated cases with lumbar spondylolysis or isthmic spondylolisthesis. A detailed analysis of surgically treated cases with spondylolysis or isthmic spondylolisthesis has never been reported. An epidemiological study in Japan conducted on 2000 subjects found the incidence of lumbar spondylolysis in the Japanese general population (population-based study) to be 5.9% (males: 7.9%, females: 3.9%). Among 124 vertebrae with spondylolysis, there were 0.8% L2 lesions, 3.2% L3 lesions, 5.6% L4 lesions, and 90.3% L5 lesions, including 5 cases (4.3%) with multiple-level lesions. We have been registering surgically treated spine cases in our database since 2000. From this database, we prospectively collected cases with lumbar spondylolysis or isthmic spondylolisthesis that were treated surgically between January 2000 and December 2009. We determined the age at surgery, sex, and vertebral level of spondylolysis. Of the 564 spondylolysis patients treated surgically, 66.8% were male and 33.2% were female. The mean age at surgery was 52.5 years (range, 13-84 y). There were 585 vertebrae with spondylolysis including 21 cases (3.7%) with multiple-level lesions. L5 spondylolysis affected 432 vertebrae and was the most common location (73.8%), followed by 125 L4 lesions (21.4%), 24 L3 lesions (4.1%), and 2 L2 lesions (0.7%). The percentage of L4 lesions in our study was significantly higher and of L5 lesions was significantly lower than those lesions' percentages in the population-based study. L4 spondylolysis may be more unstable or cause clinical symptoms more frequently leading to more surgical intervention. The percentage of multiple-level spondylolysis was similar between the 2 studies, suggesting these patients respond relatively well to conservative treatment. The male/female ratio was 2:1 in both studies, indicating that males and females require surgery at a similar frequency.

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

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

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.

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.

Job satisfaction and turnover intention among Iraqi doctors--a descriptive cross-sectional multicentre study.

Science.gov (United States)

Ali Jadoo, Saad Ahmed; Aljunid, Syed Mohamed; Dastan, Ilker; Tawfeeq, Ruqiya Subhi; Mustafa, Mustafa Ali; Ganasegeran, Kurubaran; AlDubai, Sami Abdo Radman

2015-04-19

During the last two decades, the Iraqi human resources for health was exposed to an unprecedented turnover of trained and experienced medical professionals. This study aimed to explore prominent factors affecting turnover intentions among Iraqi doctors. A descriptive cross-sectional multicentre study was carried out among 576 doctors across 20 hospitals in Iraq using multistage sampling technique. Participants completed a self-administered questionnaire, which included socio-demographic information, work characteristics, the 10-item Warr-Cook-Wall job satisfaction scale, and one question on turnover intention. Descriptive and bivariate and multiple logistic regression analyses were conducted to identify significant factors affecting turnover intentions. More than one half of Iraqi doctors (55.2%) were actively seeking alternative employment. Factors associated with turnover intentions among doctors were low job satisfaction score (odds ratio (OR) = 0.97; 95% confidence interval (CI): 0.95, 0.99), aged 40 years old or less (OR = 2.9; 95% CI: 1.74, 4.75), being male (OR = 4.2; 95% CI: 2.54, 7.03), being single (OR = 5.0; 95% CI: 2.61, 9.75), being threatened (OR = 3.5; 95% CI: 1.80, 6.69), internally displaced (OR = 3.1; 95% CI: 1.43, 6.57), having a perception of unsafe medical practice (OR = 4.1; 95% CI: 1.86, 9.21), working more than 40 h per week, (OR = 2.3; 95% CI: 1.27, 4.03), disagreement with the way manager handles staff (OR = 2.2; 95% CI: 1.19, 4.03), being non-specialist, (OR = 3.9, 95% CI: 2.08, 7.13), and being employed in the government sector only (OR = 2.0; 95% CI: 1.09, 3.82). The high-turnover intention among Iraqi doctors is significantly associated with working and security conditions. An urgent and effective strategy is required to prevent doctors' exodus.

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.

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.

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…

Medical Students Teaching Medical Students Surgical Skills: The Benefits of Peer-Assisted Learning.

Science.gov (United States)

Bennett, Samuel Robert; Morris, Simon Rhys; Mirza, Salman

2018-04-10

Teaching surgical skills is a labor intensive process, requiring a high tutor to student ratio for optimal success, and teaching for undergraduate students by consultant surgeons is not always feasible. A surgical skills course was developed, with the aim of assessing the effectiveness of undergraduate surgical peer-assisted learning. Five surgical skills courses were conducted looking at eight domains in surgery, led by foundation year doctors and senior medical students, with a tutor to student ratio of 1:4. Precourse and postcourse questionnaires (Likert scales 0-10) were completed. Mean scores were compared precourse and postcourse. Surgical skills courses took place within clinical skills rooms in the Queen Elizabeth Hospital Birmingham (UK). Seventy students (59 medical, 2 dental, and 9 physician associate students) from a range of academic institutions across the UK completed the course. There was an overall increase in mean scores across all eight domains. Mean improvement score precourse and postcourse in WHO surgical safety checklist (+3.94), scrubbing (+2.99), gowning/gloving (+3.34), knot tying (+5.53), interrupted sutures (+5.89), continuous sutures (+6.53), vertical mattress sutures (+6.46), and local anesthesia (+3.73). Peer-assisted learning is an effective and feasible method for teaching surgical skills in a controlled environment, subsequently improving confidence among healthcare undergraduates. Such teaching may provide the basis for feasibly mass-producing surgical skills courses for healthcare students. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Surgical-orthodontic correction of a Class III dentofacial deformity.

Science.gov (United States)

Devanna, Raghu; Kakkirala, Neelima

2010-04-01

This case report describes the surgical-orthodontic treatment of a 26-year-old post-pubertal male patient with a Class III dentofacial deformity. In the pre-surgical orthodontic phase of treatment, a reverse overjet of 5.5 mm was created and arch compatibility was obtained. A mandibualr set back with BSSO was performed during surgery to restore ideal overjet, overbite, occlusion and optimal esthetics. After 1 year of treatment, the results remained stable.

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.

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

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

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.

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...

Pivotal role of families in doctor-patient communication in oncology: a qualitative study of patients, their relatives and cancer clinicians.

Science.gov (United States)

Datta, S S; Tripathi, L; Varghese, R; Logan, J; Gessler, S; Chatterjee, S; Bhaumik, J; Menon, U

2017-09-01

Families are a unique source of support for many cancer patients. Most advanced communication skills training for oncologists are patient centred and do not cover interactions with family members. The current study used in-depth qualitative interviews of patients, relatives and cancer clinicians with thematic analysis to explore the role of family members in the communication process. Forty-one participants included 10 cancer patients, 10 relatives ensuring proportionate representation of both gender and primary cancer site and 21 doctors representing both medical and surgical oncology. Nineteen of 20 patients and relatives wanted an "open and honest" discussion with their doctors. All patients, relatives and doctors preferred involvement of the family at most stages of cancer treatment. Five themes were identified in relation to communication with family members. The participants highlighted the "importance of family for physical and psychological care," they emphasised the need to "balance patient autonomy and relatives desire to be protective" using varied "negotiating strategies" that are influenced by "socioeconomic circumstances of both patient and family." The doctor-patient-relative communication process was not static with preferences changing over time. The data suggests that communication skills training of cancer clinicians should incorporate modules on better communication with relatives. © 2016 John Wiley & Sons Ltd.

Mobile surgical services in primary care in a rural and remote setting: Experience and evidence from Yala, Cross River State, Nigeria

Directory of Open Access Journals (Sweden)

Emmanuel Monjok

2009-07-01

Full Text Available Surgical conditions account for 11 to 15% of the global burden of disease. Yet, surgical services are very scarce in the rural areas of Nigeria where approximately 60 to 80% of the population resides. Among other basic contributing factors is the shortage of surgical workforce, since Nigeria’s few surgeons practise in the urban centre of the major cities. One way to respond to this acute shortage of surgeons is the training of generalist medical doctors to undertake surgery in rural areas. The introduction of mobile surgical services in rural populations as part of the existing primary health care activities in the Local Government Areas (districts can reduce surgical morbidity and mortality in Nigeria. This can be done by the generalist physician with training and experience in surgery using local health staff and simple surgical equipment. A number of recommendations are made.

Distribution pattern of surgically treated symptomatic prolapsed ...

African Journals Online (AJOL)

Background: The pattern of distribution of surgically treated symptomatic prolapsed lumbar and sacral intervertebral discs has been published, though scantily, especially in males. We decided to look at our own series, compare and contrast ours with some of those published. Materials and Methods: We treated 88 locations ...

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.

Morphologic and biochemical changes in male rat lung after surgical and pharmacological castration

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M.S. Ojeda

2000-03-01

Full Text Available The morphology of the rat lung was studied by light microscopy in different situations: after surgical and pharmacological castration and after administration of testosterone to the castrated rat to determine if the androgen is required to maintain the normal morphology of the lung. We also determined the effect of flutamide on the phospholipid composition of both the surfactant and microsomes of the lung. Rats were separated into five groups: I - control non-castrated rats, II - castrated rats sacrificed 21 days after castration, III - castrated rats that received testosterone daily from day 2 to day 21 after castration, IV - castrated rats that received testosterone from day 15 to day 21 after castration, and V - control rats injected with flutamide for 7 days. The amount of different phospholipids in the surfactant and microsomes of the lung was measured in group I and V rats. At the light microscopy level, the surgical and pharmacological castration provoked alterations in the morphology of the lung, similar to that observed in human lung emphysema. The compositions of surfactant and microsomes of the lung were similar to those previously reported by us for the surgically castrated rats. These results indicate that androgens are necessary for the normal morphology as well as for some metabolic aspects of the lung.

Epilepsy - what to ask your doctor - adult

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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 ...

The European Working Time Directive and the effects on training of surgical specialists (doctors in training): a position paper of the surgical disciplines of the countries of the EU.

Science.gov (United States)

Benes, V

2006-11-01

Legislation launched with the EWTD was born as a "Protection of the clinical personnel against overwork for the benefit of Patients" (consumer protection and safety). It appeared that this legislation is in direct and severe conflict with former EU legislation to train competent surgical specialists. First experiences with the EWTD show far reaching and serious consequences on the training of surgical specialists as well as on medical care. There will be a reduction of about 30-35% of clinical and operative experience acquired during the usual 6 yrs of training, with many other negative aspects (see p. 7). All measures proposed so far to overcome the ensuing problems are unworkable. The training of competent surgical specialists as required by the Directive 93/16 EEC is no longer possible and serious problems with safe patient care will occur in the short term, if no political actions are taken. The surgical specialties, represented in the UEMS, provide a proposal for a working hour model consisting of 48 hrs working time (incl. service duties) plus additional 12 hrs reserved and protected for teaching and training. This model would adhere to the EWTD on the one hand, yet maintain the desired standard of training. This proposed exemption from the EWTD would be limited to the time of specialist training. We ask the responsible politicians to find a solution rapidly to prevent serious negative consequences. This motion is supported by the surgical specialties (neurosurgery, general surgery, orthopaedic surgery, paediatric surgery, cardio-thoracic surgery, vascular surgery, oto-rhino-laryngology, list not complete) of the member states of the EU, representing more than 80,000 surgical specialists.

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.

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.

An audit of generic prescribing in a general surgical department.

LENUS (Irish Health Repository)

Gleeson, M

2013-01-17

BACKGROUND: The Health Service Executive introduced a generic prescription policy to reduce costs. Despite this, generic prescription rates remain low. AIM: To audit in-patient prescription practice in a single surgical department and identify potential savings which could be realised by adherence to the generic prescribing policy. METHODS: Surgical in-patient charts were obtained at the point of discharge and their drug prescription information was recorded. RESULTS: 51 % of prescriptions involved a trade-name prescription where an appropriate generic equivalent existed. The cost implications for hospital and community patients were found to be greatly affected by substitution policies that exist at hospital pharmacy level. CONCLUSION: There is a need to promote greater adherence to generic prescribing amongst hospital doctors in line with international best practice. It can have a positive impact in terms of safe prescribing and can have cost implications at both hospital and community level.

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.

Surgical-orthodontic correction of a Class III dentofacial deformity

Directory of Open Access Journals (Sweden)

Raghu Devanna

2010-01-01

Full Text Available This case report describes the surgical-orthodontic treatment of a 26-year-old post-pubertal male patient with a Class III dentofacial deformity. In the pre-surgical orthodontic phase of treatment, a reverse overjet of 5.5 mm was created and arch compatibility was obtained. A mandibualr set back with BSSO was performed during surgery to restore ideal overjet, overbite, occlusion and optimal esthetics. After 1 year of treatment, the results remained stable.

YouTube as an educational tool regarding male urethral catheterization.

Science.gov (United States)

Nason, Gregory J; Kelly, Padraig; Kelly, Michael E; Burke, Matthew J; Aslam, Asadullah; Giri, Subhasis K; Flood, Hugh D

2015-04-01

Urethral catheterization (UC) is a common procedure carried out on a daily basis. The aims of this study were to assess the quality of YouTube as an educational tool regarding male UC and to assess the experience of newly qualified doctors regarding UC. YouTube was searched for videos containing relevant information about male UC. A checklist for evaluating content for male UC was devised. The top-ranked video was shown to interns and they were questioned regarding their experience of UC and the usefulness of the video. A total of 100 videos was screened and 49 unique videos were identified. The median length of video was 7 min 15 s (range 1 min 44 s to 26 min 44 s). Regarding the Safe Catheter Insertion Score, the mean score was 5.18 ± 1.64. 9 (18.4%) deemed useful, 24 (49%) somewhat useful and 16 (32.7%) not useful. There was no difference in the number of views (p = 0.487), duration of video (p = 0.364) or number of days online (p = 0.123) between those categorized as useful, somewhat useful and not useful. Twenty-six interns (89.7%) attended the UC teaching session. All reported the video to be a useful educational adjunct. Nine of the respondents (42.9%) had independently inserted a urinary catheter before the educational session. The quality of videos on YouTube regarding male UC is widely variable. Preselected videos are deemed useful by junior doctors regarding male UC and can be used as an educational adjunct before performing hands-on tasks.

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.

Assessing the extent of utilization of biopsychosocial model in doctor-patient interaction in public sector hospitals of a developing country.

Science.gov (United States)

Nadir, Maha; Hamza, Muhammad; Mehmood, Nadir

2018-01-01

Biopsychosocial (BPS) model has been a mainstay in the ideal practice of modern medicine. It is attributed to improve patient care, compliance, and satisfaction and to reduce doctor-patient conflict. The study aimed to understand the importance given to BPS model while conducting routine doctor-patient interactions in public sector hospitals of a developing country where health resources are limited. The study was conducted in Rawalpindi, Pakistan. The study design is qualitative. Structured interviews were conducted from 44 patients from surgical and medical units of Benazir Bhutto Hospital and Holy Family Hospital. The questions were formulated based on patient-centered interviewing methods by reviewing the literature on BPS model. The analysis was done thematically using the software NVivo 11 for qualitative data. The study revealed four emerging themes: (1) Lack of doctor-patient rapport. (2) Utilization of a paternalistic approach during treatment. (3) Utilization of a reductionist biomedical approach during treatment. (4) Patients' concern with their improvement in health and doctor's demeanor. The study highlights the fact that BPS is not given considerable importance while taking routine medical history. This process remains doctor centered and paternalistic. However, patients are more concerned with their improvement in health rather than whether or not they are being provided informational care. Sequential studies will have to be conducted to determine whether this significantly affects patient care and compliance and whether BPS is a workable model in the healthcare system in the third world.

Conocimiento del consentimiento informado en servicios quirúrgicos Knowledge of informed consent in surgical services

Directory of Open Access Journals (Sweden)

Verónica Castillo Pérez

2013-02-01

Full Text Available Introducción: el conocimiento informado constituye un elemento esencial de la relación médico paciente actualmente. Objetivo: diagnosticar el conocimiento que sobre el consentimiento informado tienen los miembros de los servicios quirúrgicos así como los pacientes que en esta etapa de la investigación se le practicó alguna intervención quirúrgica. Método: se realizó un estudio en los servicios quirúrgicos del Hospital Clínico Quirúrgico Docente Dr. León Cuervo Rubio de Pinar del Río en el período de Enero a Marzo del 2012, para ello se encuestaron profesionales de los servicios de cirugía y anestesiología así como a pacientes que fueron intervenidos quirúrgicamente en igual período de tiempo. Con un universo de 73 profesionales médicos y 253 pacientes, con una muestra de 45 médicos e igual cantidad de personal de enfermería así como 220 pacientes Resultados: existe un dominio incompleto del consentimiento informado en los pacientes, en la mayoría de los cirujanos y enfermeros no tienen dominio y no aplican correctamente el mismo, sin embargo habían recibido perfeccionamiento sobre dicho tema. Conclusiones: el reconocimiento de la autonomía del paciente y el proceso provocó un cambio en la relación médico paciente en la práctica de la cirugía. Además de la profundización en el estudio de los principios bioéticos y su aplicación, se hace necesaria la búsqueda de respuestas útiles a los problemas bioéticos en estos servicios que afectan la propia relación médico paciente así como la seguridad que les debemos brindar a los pacientes para respaldar el procedimiento quirúrgico.Introduction: current knowledge of informed consent constitutes an essential element of doctor-patient relationship. Objective: to identify knowledge of informed consent in the members of surgical services and in patients who underwent surgeries during the period of investigation. Method: a study was conducted in the surgical services

Supra-aural gossypiboma: case report of a retained textile surgical sponge in an unusual location.

Science.gov (United States)

Chawla, N; Gupta, N; Dhawan, N

2016-11-01

Gossypiboma or retained surgical sponge is an infrequently encountered surgical complication, more so in the head and neck region. A literature search did not reveal a previously reported case of retained or concealed surgical sponge after microscopic ear surgery. We present a unique and previously unreported case of a 25-year-old male who presented with a cystic swelling in the right supra-aural region 5 months post-modified radical mastoidectomy of the right ear. Surgical excision of the swelling revealed a retained surgical sponge. We emphasise the importance of counting surgical sponges after every surgical step to minimise the incidence of such retained surgical items.

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...

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 ...

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

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.

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…

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…

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...

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.

Patient reported outcome measures in male incontinence surgery.

Science.gov (United States)

Tran, M G B; Yip, J; Uveili, K; Biers, S M; Thiruchelvam, N

2014-10-01

Patient reported outcome measures (PROMs) were used to evaluate outcomes of the artificial urinary sphincter (AUS) and the AdVance™ (American Medical Systems, Minnetonka, MN, US) male sling system (AVMS) for the symptomatic management of male stress urinary incontinence. All male patients with stress urinary incontinence referred to our specialist clinic over a two-year period completed the ICIQ-UI SF (International Consultation on Incontinence Questionnaire on Urinary Incontinence Short Form) and the ICIQ-MLUTS LF (International Consultation on Incontinence Questionnaire on Male Lower Urinary Tract Symptoms Long Form) at consultation as well as at subsequent follow-up appointments. The Wilcoxon signed-rank test for non-parametric paired data was used for pre and postoperative comparisons. The chi-squared test was used for categorical variables. Thirty-seven patients (forty surgical cases) completed a preoperative and at least one follow-up questionnaire. There was a statistically significant improvement in PROMs postoperatively, regardless of mode of surgery (p25) had greater improvement with an AUS than with the AVMS (p<0.01). This prospective study shows that completion and collection of PROMs as part of routine clinical practice is achievable and useful in the assessment of male stress incontinence surgery. PROMs are important instruments to assess effectiveness of healthcare intervention and they are useful adjuncts in surgical studies.

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...

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…

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.

Surgical site infections in an abdominal surgical ward at Kosovo Teaching Hospital.

Science.gov (United States)

Raka, Lul; Krasniqi, Avdyl; Hoxha, Faton; Musa, Ruustem; Mulliqi, Gjyle; Krasniqi, Selvete; Kurti, Arsim; Dervishaj, Antigona; Nuhiu, Beqir; Kelmendi, Baton; Limani, Dalip; Tolaj, Ilir

2008-01-01

Abdominal surgical site infections (SSI) cause substantial morbidity and mortality for patients undergoing operative procedures. We determined the incidence of and risk factors for SSI after abdominal surgery in the Department of Abdominal Surgery at the University Clinical Centre of Kosovo (UCCK). Prospective surveillance of patients undergoing abdominal surgery was performed between December 2005 and June 2006. CDC definitions were followed to detect SSI and study forms were based on Europe Link for Infection Control through Surveillance (HELICS) protocol. A total of 253 surgical interventions in 225 patients were evaluated. The median age of patients was 42 years and 55.1% of them were male. The overall incidence rate of SSI was 12%. Follow-up was achieved for 84.1% of the procedures. For patients with an SSI, the median duration of hospitalization was 9 days compared with 4 days for those without an SSI (p 2, use of antibiotic prophylaxis and NNIS class of > 2 were all significant at p < .001. The SSI rates for the NNIS System risk classes 0, 1 and 2-3 were 4.2%, 46.7% and 100%, respectively. SSI caused considerable morbidity among surgical patients in UCCK. Appropriate active surveillance and infection control measures should be introduced during preoperative, intra-operative, and postoperative care to reduce infection rates.

Will Medical Technology Deskill Doctors?

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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…

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…

Surgical training and the European Working Time Directive: The role of informal workplace learning.

Science.gov (United States)

Giles, James A

2010-01-01

The introduction of European Working Time Directive, limiting doctors' working hours to 48 per week, has caused recent controversy within the profession. The Royal College of Surgeons of England in particular has been one of the loudest critics of the legislation. One of the main concerns is regarding the negative impact on training hours for those embarking on surgical careers. Simulation technology has been suggested as a method to overcome this reduction in hospital training hours, and research suggests that this is a good substitute for operative training in a theatre. However, modern educational theory emphasises the power of informal workplace learning in postgraduate education, and the essential role of experience in training future surgeons. Copyright 2010 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

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.

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 ...

Aspects of spirituality in medical doctors and their relation to specific views of illness and dealing with their patients' individual situation

DEFF Research Database (Denmark)

Büssing, Arndt; Hirdes, Almut Tabea; Baumann, Klaus

2013-01-01

. Data from an anonymous survey enrolling 237 medical doctors from Germany (mean age 45.7 +/- 9.6, 58% male, 42% female) indicated that secular forms of spirituality scored highest, while specific religious orientation had the lowest scores. Physicians with a specific specialization in complementary...

Comparison of postoperative surgical site infection after preoperative marking done with non-sterile stationary grade markers versus sterile surgical markers

International Nuclear Information System (INIS)

Mir, Z.A.

2015-01-01

Objectives: To compare the frequencies of post- operative surgical site infection after preoperative marking done with non-sterile stationary. grade markers versus sterile surgical markers in the same patient. Design: Randomized control trial. Place and Duration of Study: The department of Plastic surgery, Mayo hospital, Lahore from August 2013 to August 2014. Methods: This study was conducted after taking approval from the departmental ethical committee. Forty consecutive patients were included. A sterile surgical marker was used to mark one incision site while an alcohol based stationary grade marker was used to mark another incision site on the same patient. A standard preoperative, intraoperative and postoperative protocol was followed. Cultures were performed on swabs taken from the incision sites and surgical site infection was assessed for 30 days. Results: The study included 40 patients; 17 males and 23 females. The mean age of subjects was 25.32 ± 19.69 years with the minimum age being 2 years and the maximum being 63 years. No growth was seen in cultures taken from all the incision sites after skin preparation in the non sterile stationary grade marker group as well as the sterile surgical grade marker group. Also no surgical site infection appeared during the 30 day postoperative observation period in the non sterile stationary grade marker group as well as the sterile surgical grade marker group. (author)

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 ...

Sexual behaviour of men that consulted in medical outpatient clinics in Western Switzerland from 2005-2006: risk levels unknown to doctors?

Directory of Open Access Journals (Sweden)

Dubois-Arber Françoise

2010-09-01

Full Text Available Abstract Background To determine male outpatient attenders' sexual behaviours, expectations and experience of talking about their sexuality and sexual health needs with a doctor. Methods A survey was conducted among all male patients aged 18-70, recruited from the two main medical outpatient clinics in Lausanne, Switzerland, in 2005-2006. The anonymous self-administered questionnaire included questions on sexual behaviour, HIV/STI information needs, expectations and experiences regarding discussion of sexual matters with a doctor. Results The response rate was 53.0% (N = 1452. The mean age was 37.7 years. Overall, 13.4% of patients were defined as at STI risk - i.e. having not consistently used condoms with casual partners in the last 6 months, or with a paid partner during the last intercourse - regarding their sexual behaviour in the last year. 90.9% would have liked their physician to ask them questions concerning their sexual life; only 61.4% had ever had such a discussion. The multivariate analysis showed that patients at risk tended to have the following characteristics: recruited from the HIV testing clinic, lived alone, declared no religion, had a low level of education, felt uninformed about HIV/AIDS, were younger, had had concurrent sexual partners in the last 12 months. However they were not more likely to have discussed sexual matters with their doctor than patients not at risk. Conclusion Recording the sexual history and advice on the prevention of the risks of STI should become routine practice for primary health care doctors.

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;…

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.

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...

"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

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)

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.

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 ...

Surgical Management Of Porencephalic Cyst In Patients With ...

African Journals Online (AJOL)

Objective: To detect the ability of surgical management of porencephalic cyst to control intractable epilepsy. Methods: Five patients diagnosed with porencephalic cyst causing epilepsy that could not be controlled with adequate dosing of three anti-epileptic drugs were included in the study. The study included four males ...

Surgical Masculinization of the Breast: Clinical Classification and Surgical Procedures.

Science.gov (United States)

Cardenas-Camarena, Lazaro; Dorado, Carlos; Guerrero, Maria Teresa; Nava, Rosa

2017-06-01

Aesthetic breast area improvements for gynecomastia and gender dysphoria patients who seek a more masculine appearance have increased recently. We present our clinical experience in breast masculinization and a classification for these patients. From July 2003 to May 2014, 68 patients seeking a more masculine thorax underwent surgery. They were divided into five groups depending on three factors: excess fatty tissue, breast tissue, and skin. A specific surgical treatment was assigned according to each group. The surgical treatments included thoracic liposuction, subcutaneous mastectomy, periareolar skin resection in one or two stages, and mastectomy with a nipple areola complex graft. The evaluation was performed 6 months after surgery to determine the degree of satisfaction and presence of complications. Surgery was performed on a total of 68 patients, 45 male and 22 female, with ages ranging from 18 to 49 years, and an average age of 33 years. Liposuction alone was performed on five patients; subcutaneous mastectomy was performed on eight patients; subcutaneous mastectomy combined with liposuction was performed on 27 patients; periareolar skin resection was performed on 11 patients; and mastectomy with NAC free grafts was performed on 16 patients. The surgical procedure satisfied 94% of the patients, with very few complications. All patients who wish to obtain a masculine breast shape should be treated with only one objective regardless patient's gender: to obtain a masculine thorax. We recommend a simple mammary gland classification for determining the best surgical treatment for these patients LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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.

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.

"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

Pattern of surgical procedures performed in the orthopaedic units of a tertiary hospital in South West Nigeria

Directory of Open Access Journals (Sweden)

Thomas O Adekoya-Cole

2016-01-01

Full Text Available Background: Lagos University Teaching Hospital (LUTH is one of the foremost teaching institutions in Nigeria. It is a recognized training institution for residency training in Nigeria. However, a thorough evaluation of the procedures being undertaken by the orthopaedic teams in this centre and the impact on the type of training being passed on to the resident doctors in training is the focus of this paper. Objectives: To determine the pattern of procedures performed by the orthopaedic units of the Department of Surgery, LUTH with a view to import the findings in re-organizing its structure based on service requirement, manpower allocation and to make recommendation. Methods: We retrospectively reviewed data including age, sex, procedures and leading surgeons retrieved from all our operating theatres over a period from 1st January 2010 to 31st December 2011. The data retrieved was analyzed. Results: A total 741 procedures were performed over the 2 year period. More male patients (58.5% had procedures performed on them than the female patients. The mean age of patients treated was 37.2±15.5 years. Trauma related procedures accounted for 68.8% of the total procedures. Open reduction and internal fixation surgical operations were the most common trauma related procedure while ablative surgical operations following Diabetic Mellitus foot syndrome were the most common non-trauma related procedure performed. Conclusion: Trauma related surgery remains the most common procedures in our teaching hospital. Efforts should be made to increase the number of elective operations like Arthroplasties, Arthroscopic operations and Spinal axis correction operations being performed.

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

'RIG'- surgical gamma probe for early breast cancer detection

International Nuclear Information System (INIS)

Walinjkar, P.B.; Singh, Gursharan; Kumar, Umesh; Pendharkar, A.S.; Choudhary, P.S.

2004-01-01

Breast cancer is one of the most common cancers in women, which if detected in early stage can be effectively treated and cured. Early detection is carried out by collecting a sentinel lymph node (SLN) and testing it for cancer. The surgical gamma probe is a hand-held device used in the localization of SLN. It enables the localization of the active node. Isotope Applications Division, BARC has developed indigenously a RIG Surgical Gamma Probe in consultation with the doctors from Rajiv Gandhi Cancer Institute and Research Centre, New Delhi. The system consists of microcomputer-based gamma counting system that displays the number of pulses detected by the probe in counts per second and has an audible signal in direct correlation with the count density. The detector probe is based on the scintillation detector housed in a stainless steel housing with lead collimator. The physical parameters are a high sensitivity of 5000 cps/MBq at probe tip with good spatial resolution. The performance of this probe was clinically evaluated on the basis of spatial resolution and accuracy to detect the active node. (author)

Surgical management of gynecomastia--a 10-year analysis.

Science.gov (United States)

Handschin, A E; Bietry, D; Hüsler, R; Banic, A; Constantinescu, M

2008-01-01

Gynecomastia is defined as the benign enlargement of the male breast. Most studies on surgical treatment of gynecomastia show only small series and lack histopathology results. The aim of this study was to analyze the surgical approach in the treatment of gynecomastia and the related outcome over a 10-year period. All patients undergoing surgical gynecomastia corrections in our department between 1996 and 2006 were included for retrospective evaluation. The data were analyzed for etiology, stage of gynecomastia, surgical technique, complications, risk factors, and histological results. A total of 100 patients with 160 operations were included. Techniques included subcutaneous mastectomy alone or with additional hand-assisted liposuction, isolated liposuction, and formal breast reduction. Atypical histological findings were found in 3% of the patients (spindle-cell hemangioendothelioma, papilloma). The surgical revision rate among all patients was 7%. Body mass index and a weight of the resected specimen higher than 40 g were identified as significant risk factors for complications (p gynecomastia requires an individualized approach. Caution must be taken in performing large resections, which are associated with increased complication rates. Histological tissue analysis should be routinely performed in all true gynecomastia corrections, because histological results may reveal atypical cellular pathology.

Surgical management of spasmodic torticollis

Directory of Open Access Journals (Sweden)

Wael Fouad

2011-12-01

Full Text Available Introduction: Spasmodic torticollis (ST is a neuromuscular disorder characterized by uncontrolled clonic and intermittently tonic spasm of the neck muscles. Objective: This retrospective study was done to study clinical picture and to evaluate the surgical results of different surgical procedures in 11 patients who had spasmodic torticollis. Methods: The male to female ratio was 1–2 (4 males and 7 females and their ages ranged from 18 to 65 years. The X-ray of the cervical spine was performed before the operation to exclude cervical disorders that can cause symptoms similar to spasmodic torticollis. MRI of the head and neck was performed in all patients, without finding significant brain lesions. Electromyography of the cervical muscles was performed preoperatively and postoperatively. All cases underwent surgery in the form of variable combinations of ventral rhizotomy of C1, C2+ selective peripheral denervation of neck muscles involved according to the type of torticollis. Mean postoperative follow up period was 24 months. Results: There was no operative mortality. As regards the morbidity, one patient had deficiency of shoulder elevation that was transient and improved after 3 months; one patient had wound infection that responded well to antibiotics after culture and sensitivity. Postoperative dysphagia was found in two cases that improved in one of them after two months. At the last follow up examination period, excellent results were obtained in 55% of patients, good results in 18% of patients, fair results in 18% of patients, and poor results in 9% of cases. Conclusion: There is no standard surgical procedure for treatment of ST; this is adapted to each patient according to type of torticollis. Better results were obtained in simple torticollis (excellent results in 100%, than in complex type (excellent and good results in 33.3%. Keywords: Focal dystonia, Spasmodic torticollis, Anterior rhizotomy, Selective denervation

Uncommon surgical emergencies in neonatology

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R. Angotti

2014-12-01

Full Text Available Objective. Over the past decade, multiple factors have changed the pattern of neonatal surgical emergencies. An increase in prenatal screenings and the development of neonatal tertiary care centres have changed the clinical approach to these kids. Materials and methods. Between 1995 to 2011 were retrospectively reviewed 34 patients with diagnosis of uncommon rare neonatal surgical emergencies at our institute. We analyzed: sex, gestational age, weight at birth, primary pathology, prenatal diagnosis, associated anomalies, age and weight at surgery, clinical presentation, start of oral feeding and hospitalization. The follow-up was performed at 6,12, 24 and 36 months. Results. There were 21 male and 13 female. The gestational age ranged between 28 and 36 weeks. The weight at birth ranged between 700 and 1400 grams. Oral feeding was started between 4th and 10th postoperative day. The average hospitalization was about 70.47 days. To date, all patients have finished the followup. They are healthy. Conclusion. The outcome of the patients with uncommon surgical emergencies is different based on the etiology. Overall survival is generally good but is influenced by the associated anomalies.

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

Goals: 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. Methods: 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. Results: 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. Conclusions: 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. PMID:22558025

[Pre- and post-surgical orthodontic treatment for skeletal open bite].

Science.gov (United States)

Zhou, Y; Hu, W; Sun, Y

2001-05-01

To Study the principles and rules of pre- and post-surgical orthodontic treatment for skeletal open bite patients. Thirty-two surgically treated open bite cases were analyzed, of which 9 were males, and 23 were females, aged from 16 to 38. Open bite was from 1 to 8.5 mm, average was 4 mm. 31 patients were Class III malocclusion, while 1 patient was Class II malocclusion. 1. Totally 21 patients were treated with orthodontics before and after orthognathic surgery, while 8 patients had pre-surgical orthodontics only, and other 3 had post-surgical orthodontics only. The duration for pre-surgical orthodontics was from 4 to 33 months, average was 12 months. The duration for post-surgical orthodontics was from 3 to 17 months, average was 8.5 months. 2. Presurgical orthodontic treatment included: Alignment of arches, decompensation of incisors, avoiding extrusion of incisors, and slight expansion of arches for coordination of arches. 3. Post-surgical orthodontic treatment included: Closure of residual spaces in the arches, realignment of arches, vertical elastics and Class II or III intermaxillary elastics. Skeletal open bites require combined orthodontic-orthognathic surgery for optimal and esthetical pleasing results.

The attitudes of general hospital doctors toward patients with comorbid mental illness.

Science.gov (United States)

Noblett, Joanne E; Lawrence, Robert; Smith, Jared G

2015-01-01

What are the attitudes of general hospital doctors toward patients with comorbid mental illness? Do certain characteristics of the health professional related to attitude valence to patients with comorbid mental illness? An anonymous questionnaire was sent out to a cohort of doctors working in three General Hospitals in South West London. The questionnaire included vignettes to assess the respondents' attitudes toward eight patients presenting with a physical compliant with different clinical histories, including depression, schizophrenia, personality disorder, diabetes, and criminal behavior. A total of 52 participants completed the questionnaire; 40 females and 12 males. Across all domains, the most positive attitudes were held toward patients without a diagnosis of mental illness. The least positive attitudes were toward patients with schizophrenia, personality disorder, and those classified as "criminals," and negative attitudes relating to the unpredictability of patients was identified in these categories. There was no statistically significant difference in attitudes depending on age or level of training. However, female participants tended to endorse more positive attitudinal responses, most clearly toward patients with depression and heroin addiction. Negative attitudes of doctors were identified toward certain mental illness diagnoses and are likely to contribute the physical health disparity between patients with and without a comorbid mental illness. This raises the question as to how these attitudes can be changed in order to improve the parity of physical health care between patient with and without mental illness. © The Author(s) 2015.

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 ...

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

Science.gov (United States)

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

2018-03-12

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

Surgical Scales: Primary Closure versus Gastric Resection for ...

African Journals Online (AJOL)

Perforated gastric ulcer is one of the most life‑threatening complications of peptic ulcer disease with high morbidity and mortality rates. The surgical strategy for gastric perforation in contrast with duodenal perforations often requires consilium and intraoperative debates. The subject of the debate is a 59‑year‑old male patient ...

Oral and maxillofacial surgical conditions in Nigeria. | Adebayo ...

African Journals Online (AJOL)

The Niger Delta region comprises 9 of the 36 states in the Federal Republic of Nigeria. ... 2000 and 2004, our center offered specialized maxillofacial surgical services to ... Ratio of male to female patients was 1.7:1 while patients were aged between 9 ... Health promotion activities are needed to improve awareness for early

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

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.

Gender differences in the acquisition of surgical skills

DEFF Research Database (Denmark)

Ali, Amir; Subhi, Yousif; Ringsted, Charlotte

2015-01-01

BACKGROUND: Females are less attracted than males to surgical specialties, which may be due to differences in the acquisition of skills. The aim of this study was to systematically review studies that investigate gender differences in the acquisition of surgical skills. METHODS: We performed...... a comprehensive database search using relevant search phrases and MeSH terms. We included studies that investigated the role of gender in the acquisition of surgical skills. RESULTS: Our search yielded 247 studies, 18 of which were found to be eligible and were therefore included. These studies included a total...... of 2,106 study participants. The studies were qualitatively synthesized in five categories (studies on medical students, studies on both medical students and residents, studies on residents, studies on gender differences in needed physical strength, and studies on other gender-related training...

[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.

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)

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...

Surgical instruction for general practitioners: how, who and how often?

LENUS (Irish Health Repository)

Collins, Anne M

2010-07-01

Educational programmes, designed to meet the training needs of General Practitioners (GPs) performing minor surgical procedures, have previously been shown to increase their surgical workload. The change in the level of competence following these programmes has not been assessed. The aims of this study were two-fold: to evaluate the vertical mattress suture for construct validity and to assess the impact of plastic surgery training on the surgical skill of GPs. Thirty non-consultant hospital doctors and 27 self-selected GPs were included. Using a modified objective structured assessment of technical skills (OSATS) scoring system, construct validity of the vertical mattress suture was confirmed. The median total OSATS score was 16 points (26.7%) in the novice group (medical registrars), 38.5 points (64.2%) in the intermediate group (surgical SHOs) and 59 points (98.3%) in the expert group (surgical registrars, p<0.001, Kruskal-Wallis test). Objective assessment in the GP group immediately following practical instruction revealed a median overall improvement of 31.7% (19 points) in total OSATS scores (p<0.001, Friedman non-parametric test, F). At six months follow-up all course participants had improved compared to their baseline. A median overall improvement of 13 points (21.7%) was noted (p<0.001, F). However, the majority (80%, n=20) had deteriorated from the standard set immediately after the course with a median overall reduction in total OSATS scores of six points (10%, p=0.001, F). Plastic surgery training is immediately efficacious in improving the technical proficiency of GPs. Through objective assessment of a standardised suture task we demonstrated a low rate of educational decay of 10% over a six-month period.

Undergraduate Training in Human Sexuality-Evaluation of the Impact on Medical Doctors' Practice Ten Years After Graduation.

Science.gov (United States)

Clegg, Mary; Pye, Joanne; Wylie, Kevan R

2016-09-01

It has been suggested that an indicator of a doctor's ability to assess patients' sexual function relates to the level of earlier training. The amount and quality of training the doctor receives at the undergraduate level and beyond could contribute to the doctor's confidence and competence. To evaluate whether doctors found that the teaching in human sexuality received at medical school was sufficient for their future practice and whether their chosen medical specialty and exposure to issues related to sexual health affected this opinion. One hundred seventy doctors maintaining contact with the University of Sheffield Medical School Alumni Office after qualifying in 2004 were sent self-completion postal questionnaires. Space was allocated for supplementary comments to their answers. Self-completion postal questionnaire. Although the response rate was low, there appeared to be an impact of the teaching of human sexuality on the clinical practice of doctors. More than two-thirds of respondents rated the teaching as useful and more than 70% felt more confident in diagnosing and managing male and female sexual issues. The results show a link between the undergraduate teaching of sexual medicine and education and a subsequent proactive approach to sexuality issues; unfortunately, the study does not provide any information about the level of skills or ability in this field of medicine. We have confirmed that the Sheffield model might be suitable for teaching sexual medicine issues in the United Kingdom but cannot confirm that the current format is suitable for international undergraduate audiences. Future study could include other medical schools and a comparison of sexual medicine practice among physicians who received undergraduate medical education and overall numbers could be increased to compare current practice with the number of hours of sexual medicine education as a key parameter. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Stated preferences of doctors for choosing a job in rural areas of Peru: a discrete choice experiment.

Directory of Open Access Journals (Sweden)

J Jaime Miranda

Full Text Available Doctors' scarcity in rural areas remains a serious problem in Latin America and Peru. Few studies have explored job preferences of doctors working in underserved areas. We aimed to investigate doctors' stated preferences for rural jobs.A labelled discrete choice experiment (DCE was performed in Ayacucho, an underserved department of Peru. Preferences were assessed for three locations: rural community, Ayacucho city (Ayacucho's capital and other provincial capital city. Policy simulations were run to assess the effect of job attributes on uptake of a rural post. Multiple conditional logistic regressions were used to assess the relative importance of job attributes and of individual characteristics. A total of 102 doctors participated. They were five times more likely to choose a job post in Ayacucho city over a rural community (OR 4.97, 95%CI 1.2; 20.54. Salary increases and bonus points for specialization acted as incentives to choose a rural area, while increase in the number of years needed to get a permanent post acted as a disincentive. Being male and working in a hospital reduced considerably chances of choosing a rural job, while not living with a partner increased them. Policy simulations showed that a package of 75% salary increase, getting a permanent contract after two years in rural settings, and getting bonus points for further specialisation increased rural job uptake from 21% to 77%. A package of 50% salary increase plus bonus points for further specialisation would also increase the rural uptake from 21% to 52%.Doctors are five times more likely to favour a job in urban areas over rural settings. This strong preference needs to be overcome by future policies aimed at improving the scarcity of rural doctors. Some incentives, alone or combined, seem feasible and sustainable, whilst others may pose a high fiscal burden.

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 ...

Location, vocation, procreation: how choice influences life expectancy in doctors.

Science.gov (United States)

Holleyman, R; Vann Jones, S

2016-06-01

Stress and mortality are negatively correlated and it is generally accepted that certain professions are more stressful than others. Medical graduates begin as a relatively homogenous population who then choose vastly different career options making doctors an ideal population in which to try to assess whether job stress is likely to be causal to increased mortality. To establish the influence of various modifiable risk factors on the life expectancy of UK doctors. We analysed a decade of obituaries from the British Medical Journal published between January 2003 and December 2012. Data included age at death (AAD), specialty, region (deanery), marriage status and children. A total of 3068 obituaries were eligible for inclusion. Mean AAD was 78.5 years. Male sex was associated with a significantly increased AAD by an additional 3.8 years (95% CI 2.4-5.2 years, P affect life expectancy. While this does not necessarily reflect quality of life, the additional years of life gained from having extra children have a positive effect on your quantity of life. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Power imbalance and consumerism in the doctor-patient relationship: health care providers' experiences of patient encounters in a rural district in India.

Science.gov (United States)

Fochsen, Grethe; Deshpande, Kirti; Thorson, Anna

2006-11-01

The aim of this study is to explore health care providers' experiences and perceptions of their encounters with male and female patients in a rural district in India with special reference to tuberculosis (TB) care. The authors conducted semistructured interviews with 22 health care providers, 17 men and 5 women, from the public and private health care sectors. Findings reveal that doctors adopted an authoritarian as well as a consumerist approach in the medical encounter, indicating that power imbalances in the doctor-patient relationship are negotiable and subject to change. Gender was identified as an influencing factor of the doctor's dominance. A patient-centered approach, acknowledging patients' own experiences and shared decision making, is called for and should be included in TB control activities. This seems to be especially important for female patients, whose voices were not heard in the medical encounter.

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...

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…

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)

The Prevalence and Incidence of Latent Tuberculosis Infection and Its Associated Factors among Village Doctors in China.

Directory of Open Access Journals (Sweden)

Guangxue He

Full Text Available China is a high tuberculosis (TB burden country. More than half of acute TB cases first seek medical care in village doctors' clinics or community health centers. Despite being responsible for patient referral and management, village doctors are not systematically evaluated for TB infection or disease. We assessed prevalence and incidence of latent TB infection (LTBI among village doctors in China.A longitudinal study was conducted in Inner Mongolia Autonomous Region. We administered a questionnaire on demographics and risk factors for TB exposure and disease; Tuberculin skin testing (TST and QuantiFERON-TB Gold in-tube assay (QFT-GIT was conducted at baseline and repeated 12 months later. We used a logistic regression model to calculate adjusted odds ratios (ORs for risk factors for TST and QFT-GIT prevalence and incidence. At the time of follow up, 19.5% of the 880 participating village doctors had a positive TST and 46.0% had a positive QFT-GIT result. Factors associated with TST prevalence included having a BCG scar (OR = 1.45, 95%CI 1.03-2.04 and smoking (OR = 1.69, 95%CI 1.17-2.44. Risk factors associated with QFT-GIT prevalence included being male (OR = 2.17, 95%CI 1.63-2.89, below college education (OR=1.42, 95%CI 1.01-1.97, and working for ≥25 years as a village doctor (OR = 1.64, 95%CI 1.12-2.39. The annual incidence of LTBI was 11.4% by TST and 19.1% by QFT-GIT. QFT-GIT conversion was associated with spending 15 minutes or more per patient on average (OR = 2.62, 95%CI 1.39-4.97 and having BCG scar (OR = 0.53, 95%CI 0.28-1.00.Prevalence and incidence of LTBI among Chinese village doctors is high. TB infection control measures should be strengthened among village doctors and at village healthcare settings.

Surgical sterilization of free-ranging wolves.

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Spence, C E; Kenyon, J E; Smith, D R; Hayes, R D; Baer, A M

1999-02-01

The objective of the study was to determine whether surgical sterilization of both males and females in wolf pairs alters basic wolf social and territorial behaviors. Wolves were located from the air by snow-tracking methods and were tranquilizer-darted from a helicopter. Surgeries were performed either in a tent at the capture site or in a heated building in a nearby village. Six vasectomies and seven uterine horn ligations were performed in January and February of 1996 and 1997. Two females died: one likely related to the capture procedure, the other of a peritonitis unrelated to the surgery. One wolf had a litter. None of the wolves have shown changes in behavioral patterns. Surgical sterilization can be effective, but other, less invasive, fertility control techniques should be investigated.

Report of a case of surgical ciliated cyst in the left maxillary sinus

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Amirhossein Pakravan

2017-06-01

Full Text Available Surgical ciliated cyst happens as a delayed complication in the maxillary sinus, and is more frequent in Asia in comparison with Western countries. We report a case of surgical ciliated cyst in maxillary sinus in a male patient after 30 years of surgery for sinusitis treatment. The patient had swelling and pain in the region, and his radiographic views showed a cystic lesion. Incisional biopsy was performed and surgical ciliated cyst was reported as diagnosis. Then, Enucleation with curettage was performed for him as treatment.

Looking Back at Doctoral Education in South Africa

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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…

Bilateral pneumothorax, surgical emphysema and pneumomediastinum in a young male patient following MDMA intake.

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Obiechina, Nonyelum Evangeline; Jayakumar, Ahrane; Khan, Yusra; Bass, James

2018-04-07

MDMA (3,4-methylenedioxymethamphetamine) or 'Ecstasy' is an illicit drug frequently used by young people at parties and 'raves'. It is readily available in spite of the fact that it is illegal. 1 It is perceived by a lot of young people as being 'harmless', but there have been a few high-profile deaths associated with its use. 2 Known side effects of MDMA include hyperthermia, rhabdomyolysis, coagulopathy and cardiac arrhythmias. 3 Rarer side effects include surgical emphysema and pneumomediastinum, which have been better described with cocaine abuse. 4-6 We present a case of bilateral pneumothorax, surgical emphysema and pneumomediastinum in a young man after taking ecstasy. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Quantitative Preparation in Doctoral Education Programs: A Mixed-Methods Study of Doctoral Student Perspectives on their Quantitative Training

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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

Stress in doctors and dentists who teach.

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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.

Surgical management of colloid cyst of the third ventricle

DEFF Research Database (Denmark)

Brostigen, C S; Meling, T R; Marthinsen, P B

2017-01-01

BACKGROUND: The aim of this study of third ventricular colloid cysts (TVCC) from a defined population was to estimate the incidence, the presenting features, the surgical treatment, the treatment related complications, and the clinical and surgical outcomes. METHODS: A reprospective study of 32...... consecutive primary surgeries for TVCC was performed at Oslo University Hospital in the time period 2002-2015. RESULTS: The estimated incidence rate for TVCC was 0.9 per million. Mean age was 41 years and the male-to-female ratio was 1:1.5. The most common presenting symptoms were headache (100%), ataxia (25...

Postgraduates' perceptions of preparedness for work as a doctor and making future career decisions: support for rural, non-traditional medical schools.

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Eley, D S

2010-08-01

The intern year is a critical time for making career decisions and gaining confidence in clinical skills, communication and teamwork practices; this justifies an interest in junior doctors' perceptions of their level of preparedness for hospital work. This study explored Australian junior doctors' perspectives regarding the transition from student to doctor roles, their preparation as medical undergraduates within either traditional metropolitan schools or smaller, outer metropolitan-based (rural) programs such as Rural Clinical Schools (RCS), and the educational environment they experienced in their internship. A qualitative cross-sectional design used semi-structured interviews with postgraduate year one and two junior doctors (9 females and 11 males) within teaching hospitals in Queensland Australia. Interview questions focussed on four major content areas: preparedness for hospital work, undergraduate training, building confidence and career advice. Data were analyzed using a framework method to identify and explore major themes. Junior doctors who spent undergraduate years training at smaller, non-traditional medical schools felt more confident and better prepared at internship. More hands-on experience as students, more patient contact and a better grounding in basic sciences were felt by interns to be ideal for building confidence. Junior doctors perceived a general lack of career guidance in both undergraduate and postgraduate teaching environments to help them with the transition from the student to junior doctor roles. Findings are congruent with studies that have confirmed student opinion on the higher quality of undergraduate medical training outside a traditional metropolitan-based program, such as a RCS. The serious shortage of doctors in rural and remote Australia makes these findings particularly relevant. It will be important to gain a better understanding of how smaller non-traditional medical programs build confidence and feelings of work

Epilepsy - what to ask your doctor - child

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What to ask your doctor about epilepsy - child; Seizures - what to ask your doctor - child ... should I discuss with my child's teachers about epilepsy? Will my child need to take medicines during ...

The Plight of the Woman Doctoral Student

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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)

From theater to the world wide web--a new online era for surgical education.

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O'Leary, D Peter; Corrigan, Mark A; McHugh, Seamus M; Hill, A D; Redmond, H Paul

2012-01-01

Traditionally, surgical education has been confined to operating and lecture theaters. Access to the World Wide Web and services, such as YouTube and iTunes has expanded enormously. Each week throughout Ireland, nonconsultant hospital doctors work hard to create presentations for surgical teaching. Once presented, these valuable presentations are often never used again. We aimed to compile surgical presentations online and establish a new online surgical education tool. We also sought to measure the effect of this educational tool on surgical presentation quality. Surgical presentations from Cork University Hospital and Beaumont Hospital presented between January 2010 and April 2011 were uploaded to http://www.pilgrimshospital.com/presentations. A YouTube channel and iTunes application were created. Web site hits were monitored. Quality of presentations was assessed by 4 independent senior surgical judges using a validated PowerPoint assessment form. Judges were randomly given 6 presentations; 3 presentations were pre-web site setup and 3 were post-web site setup. Once uploading commenced, presenters were informed. A total of 89 presentations have been uploaded to date. This includes 55 cases, 17 journal club, and 17 short bullet presentations. This has been associated with 46,037 web site page views. Establishment of the web site was associated with a significant improvement in the quality of presentations. Mean scores for pre- and post-web site group were 6.2 vs 7.7 out of 9 respectively, p = 0.037. This novel educational tool provides a unique method to enable surgical education become more accessible to trainees, while also improving the overall quality of surgical teaching PowerPoint presentations. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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.

[Male contraception and its perspectives].

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Belaisch, J

1982-11-01

Doctors specializing in male contraception are aware of the very real difficulties hindering the development of an effective method in this field. Others believe that the reason this type of contraception is lagging behind is male chauvinism or a certain fear that men have of losing their virility along with their fertilizing capacity. Since available methods of contraception (condom, vasectomy) have low levels of acceptability and reversibility, research has proceeded along other avenues. 1) Gossypol reduces the number and motility of spermatozoa but its general side effects are not exceptional. 2) Restraining hormonal action (progrestogens, LH-RH agonists) also reduce testicular function and for this reason, require simultaneous administration of androgens. Thus far this has not been resolved; azoospermia is not obtained in every case and when it is, it does not necessarily last. 3) A method involving the epididymis, with a view to preventing spermatozoa from acquiring their normal motility and fertilizing capacity by affecting protein and enzyme synthesis, is also being studied. Perhaps, as has been suggested by the Bicetre Hospital research team, we should be content with methods applicable to certain categories of men. Male contraception would then develop step by step rather than by huge bounds as female contraception. full text

Congenital Double Lip: A Rare Deformity Treated Surgically

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Aggarwal, Titiksha; Chawla, Kirti; Lamba, Arundeep Kaur; Faraz, Farukh; Tandon, Shruti

2016-01-01

Lip is an important aspect of facial features affecting ones personality. A deformity of the lip characterized by excessive tissue sagging below the usual giving it thicker wider appearance is referred to as double lip. It is a rare occurrence with a proposed male predilection. This article is a report of a 20 years old male with this deformity who presented with the complaint of difficult speech and poor aesthetics. There was no other history patient being systemically healthy. It was successively treated with a simple surgical technique without recurrence over a period of 12 months. PMID:27853696

What influences national and foreign physicians' geographic distribution? An analysis of medical doctors' residence location in Portugal.

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Russo, Giuliano; Ferrinho, Paulo; de Sousa, Bruno; Conceição, Cláudia

2012-07-02

The debate over physicians' geographical distribution has attracted the attention of the economic and public health literature over the last forty years. Nonetheless, it is still to date unclear what influences physicians' location, and whether foreign physicians contribute to fill the geographical gaps left by national doctors in any given country. The present research sets out to investigate the current distribution of national and international physicians in Portugal, with the objective to understand its determinants and provide an evidence base for policy-makers to identify policies to influence it. A cross-sectional study of physicians currently registered in Portugal was conducted to describe the population and explore the association of physician residence patterns with relevant personal and municipality characteristics. Data from the Portuguese Medical Council on physicians' residence and characteristics were analysed, as well as data from the National Institute of Statistics on municipalities' population, living standards and health care network. Descriptive statistics, chi-square tests, negative binomial and logistic regression modelling were applied to determine: (a) municipality characteristics predicting Portuguese and International physicians' geographical distribution, and; (b) doctors' characteristics that could increase the odds of residing outside the country's metropolitan areas. There were 39,473 physicians in Portugal in 2008, 51.1% of whom male, and 40.2% between 41 and 55 years of age. They were predominantly Portuguese (90.5%), with Spanish, Brazilian and African nationalities also represented. Population, Population's Purchasing Power, Nurses per capita and Municipality Development Index (MDI) were the municipality characteristics displaying the strongest association with national physicians' location. For foreign physicians, the MDI was not statistically significant, while municipalities' foreign population applying for residence

Knowledge and attitudes of doctors toward the sexuality of older people in Turkey.

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Dogan, Sultan; Demir, Basaran; Eker, Engin; Karim, Salman

2008-10-01

Few studies have looked at healthcare professionals' knowledge of and attitudes to later life sexuality in both Western and Eastern cultures. Here we examine the attitudes and knowledge of Turkish medical doctors toward sexuality in older people. Eighty-seven doctors, from various specialties, who were directly involved in the care of older people, were contacted by post and asked to complete the Turkish version of the Aging Sexual Knowledge and Attitudes Scale (ASKAS). A majority of physicians indicated that they had limited information and knowledge regarding sexual health issues in older people (69%). Although a small percentage (14.5%) reported that they "always" discuss sexuality and sexual problems with older patients, the majority (69%) indicated that they "sometimes" raise questions about sexuality with these patients. A high percentage (81%) stated that they would be helpful and receptive should an elderly patient initiate a discussion about sexual issues. Most participants (77%) thought that the patient's gender was of no importance when taking a sexual history. Overall, the responses to ASKAS showed that physicians had limited knowledge but their attitude was positive toward sexuality in the elderly. Female physicians had less knowledge than males and had more negative attitudes toward sexuality in this age group. Total and knowledge subscale scores of ASKAS showed that older physicians had more knowledge than younger physicians but similar attitudes. A comparison of the knowledge and attitude scores of psychiatrists, surgeons and non-surgeons showed no significant difference among the three groups. This study identified a low level of awareness of later life sexuality among Turkish medical doctors. These findings identify a need to improve the education and training of doctors at both undergraduate and postgraduate levels to enable them to provide better sexual health care to older people.

Attracting and retaining doctors in rural Nepal.

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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.

Concussion - what to ask your doctor - child

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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 ...

[The virtuous doctor in cinema: the final examination].

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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.

Investigation of effectiveness of surgical treatment of chronic dacryocystitis - endonasal dacryocystorhinostomy

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Borodulya V.L.

2017-10-01

Full Text Available Prolonged and conti­nuous lacrimation (symptom of epiphora causes discomfort, inclination to conjunctiva infect, reduces visual acuity and ultimately the quality of life of the patient. Despite the fact that there is a large number of various surgical interventions to restore tearing in patients with chronic dacryocystitis, the problem of lacrimation remains relevant. We have studied the operation of endonasal dacryocystorhinostomy and its long-term consequences. Surgical intervention in endonasal dacryocystorhinostomy is aimed at eliminating lacrimation by eliminating stenosis and forming a new combination of the cavity of the laryngeal canal with the nasal cavity, as well as the sanation of purulent foci of infection in the throat. There were 8 surgical interventions. Period of observation of patients in the postoperative period by ophthalmologist and ENT-doctor is from 1.5 to 2 years. The evaluation of the result was carried out in 6 months or more after the operation. A complete recovery with the recovery of the tear excretion in the nasal cavity has been achieved in all patients. The formed rhinostoma was wide, well functioning. Thus, endonasal dacryocystorhinostomy is a highly effective and should be a method of choice for inflammation of the lacrimal sac at any stage of development.

Surgical management of gynecomastia: experience of a general surgery center.

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Longheu, A; Medas, F; Corrias, F; Farris, S; Tatti, A; Pisano, G; Erdas, E; Calò, P G

2016-01-01

Gynecomastia is a common finding in male population of all ages. The aim of our study was to present our experience and goals in surgical treatment of gynecomastia. Clinical records of patients affected by gynecomastia referred to our Department of Surgery between September 2008 and January 2015 were analyzed. 50 patients were included in this study. Gynecomastia was monolateral in 12 patients (24%) and bilateral in 38 (76%); idiopathic in 41 patients (82%) and secondary in 9 (18%). 39 patients (78%) underwent surgical operation under general anaesthesia, 11 (22%) under local anaesthesia. 3 patients (6%) presented recurrent disease. Webster technique was performed in 28 patients (56%), Davidson technique in 16 patients (32%); in 2 patients (4%) Pitanguy technique was performed and in 4 patients (8%) a mixed surgical technique was performed. Mean surgical time was 80.72±35.14 minutes, median postoperative stay was 1.46±0.88 days. 2 patients (4%) operated using Davidson technique developed a hematoma, 1 patient (2%) operated with the same technique developed hypertrophic scar. Several surgical techniques are described for surgical correction of gynecomastia. If performed by skilled general surgeons surgical treatment of gynecomastia is safe and permits to reach satisfactory aesthetic results.

Skills and Competences of a Doctor of Engineering

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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.

Newborn jaundice - what to ask your doctor

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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 ...

Doctors' health: obstacles and enablers to returning to work.

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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.

The quality of doctoral nursing education in South Africa

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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.

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” ...

General beliefs about medicines among doctors and nurses in out-patient care: a cross-sectional study

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Hedenrud Tove

2009-05-01

Full Text Available Abstract Background Doctors and nurses are two natural partners in the healthcare team, but they usually differ in their perspectives on how to work for increased health. These professions may also have different beliefs about medicines, a factor important for adherence to medicines. The aim was to explore general beliefs about medicines among doctors and nurses. Methods Questionnaires were sent to 306 private practitioners (PPs, 298 general practitioners (GPs and 303 nurses in the county of Västra Götaland, Sweden. The questionnaire included sociodemographic questions and the general part of the Beliefs about Medicines Questionnaire (BMQ, which measures the beliefs people have about medicines in general. General beliefs about medicines in relation to background variables were explored with independent t-tests and ANOVA analyses. Differences between occupations and influences of interaction variables were analysed with multiple linear regression models for general beliefs about medicines. Results The data collection resulted in 616 questionnaires (62.1% PPs; 61.6% GPs; 80.5% nurses. The majority of the PPs and 40% of the GPs were male but most of the nurses were female. The GPs' mean age was 47 years, PPs' 60 years and nurses' 52 years. Few nurses originated from non-Nordic countries while 15% of the PPs and 25% of the GPs did. Nurses saw medicines as more harmful and less beneficial than did PPs and GPs. These differences could not be explained by the included interaction variables. GPs with a Nordic background saw medicines as more beneficial and less harmful than did GPs with a non-Nordic background. Furthermore, GPs of non-Nordic origin were most likely to believe that medicines were overprescribed by doctors. Conclusion Doctors were more positive about medicines than nurses. The differences in beliefs about medicines found between doctors and nurses could not be explained by any of the included interaction variables. These differences in

Is networking different with doctors working part-time? Differences in social networks of part-time and full-time doctors.

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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

Critical and Creative Thinking Nexus: Learning Experiences of Doctoral Students

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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…

Investigating the influence of African American and African Caribbean race on primary care doctors' decision making about depression.

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Adams, A; Vail, L; Buckingham, C D; Kidd, J; Weich, S; Roter, D

2014-09-01

This paper explores differences in how primary care doctors process the clinical presentation of depression by African American and African-Caribbean patients compared with white patients in the US and the UK. The aim is to gain a better understanding of possible pathways by which racial disparities arise in depression care. One hundred and eight doctors described their thought processes after viewing video recorded simulated patients presenting with identical symptoms strongly suggestive of depression. These descriptions were analysed using the CliniClass system, which captures information about micro-components of clinical decision making and permits a systematic, structured and detailed analysis of how doctors arrive at diagnostic, intervention and management decisions. Video recordings of actors portraying black (both African American and African-Caribbean) and white (both White American and White British) male and female patients (aged 55 years and 75 years) were presented to doctors randomly selected from the Massachusetts Medical Society list and from Surrey/South West London and West Midlands National Health Service lists, stratified by country (US v.UK), gender, and years of clinical experience (less v. very experienced). Findings demonstrated little evidence of bias affecting doctors' decision making processes, with the exception of less attention being paid to the potential outcomes associated with different treatment options for African American compared with White American patients in the US. Instead, findings suggest greater clinical uncertainty in diagnosing depression amongst black compared with white patients, particularly in the UK. This was evident in more potential diagnoses. There was also a tendency for doctors in both countries to focus more on black patients' physical rather than psychological symptoms and to identify endocrine problems, most often diabetes, as a presenting complaint for them. This suggests that doctors in both countries

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.

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.

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.

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.

A Simple and Automatic Method for Locating Surgical Guide Hole

Science.gov (United States)

Li, Xun; Chen, Ming; Tang, Kai

2017-12-01

Restoration-driven surgical guides are widely used in implant surgery. This study aims to provide a simple and valid method of automatically locating surgical guide hole, which can reduce operator's experiences and improve the design efficiency and quality of surgical guide. Few literatures can be found on this topic and the paper proposed a novel and simple method to solve this problem. In this paper, a local coordinate system for each objective tooth is geometrically constructed in CAD system. This coordinate system well represents dental anatomical features and the center axis of the objective tooth (coincide with the corresponding guide hole axis) can be quickly evaluated in this coordinate system, finishing the location of the guide hole. The proposed method has been verified by comparing two types of benchmarks: manual operation by one skilled doctor with over 15-year experiences (used in most hospitals) and automatic way using one popular commercial package Simplant (used in few hospitals).Both the benchmarks and the proposed method are analyzed in their stress distribution when chewing and biting. The stress distribution is visually shown and plotted as a graph. The results show that the proposed method has much better stress distribution than the manual operation and slightly better than Simplant, which will significantly reduce the risk of cervical margin collapse and extend the wear life of the restoration.

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 ...

The unerupted maxillary canine - a post-surgical review.

LENUS (Irish Health Repository)

O'Dowling, Ian

2009-10-01

The orthodontic records of 685 patients referred for surgical exposure of an unerupted impacted maxillary canine tooth were examined. The condition was more common among females than males, slightly less than 2:1. The impacted teeth had a palatal-labial ratio of 3:1. All of the teeth were exposed using the open surgical technique and in 98% of cases the tooth erupted and was orthodontically aligned. In 2% of cases ankylosis occurred and the teeth were subsequently extracted. The presence of peg-shaped lateral incisors associated with the impacted maxillary canine tooth was 3.4% of the total number of impacted teeth and congenital absence was found in 1.7% of impacted teeth.

The unerupted maxillary canine--a post-surgical review.

Science.gov (United States)

O'Dowling, Ian

2009-01-01

The orthodontic records of 685 patients referred for surgical exposure of an unerupted impacted maxillary canine tooth were examined. The condition was more common among females than males, slightly less than 2:1. The impacted teeth had a palatal-labial ratio of 3:1. All of the teeth were exposed using the open surgical technique and in 98% of cases the tooth erupted and was orthodontically aligned. In 2% of cases ankylosis occurred and the teeth were subsequently extracted. The presence of peg-shaped lateral incisors associated with the impacted maxillary canine tooth was 3.4% of the total number of impacted teeth and congenital absence was found in 1.7% of impacted teeth.

[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

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.

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 ...

Impact on sexual function of surgical treatment in rectal cancer

Directory of Open Access Journals (Sweden)

Pedro Costa

Full Text Available ABSTRACT Introduction The development of new surgical techniques and medical devices, like therapeutical multimodal approaches has allowed for better outcomes on patients with rectal cancer (RCa. Owing to that, an increased awareness and investment towards better outcomes regarding patients’ sexual and urinary function has been recently observed. Aim Evaluate and characterize the sexual dysfunction of patients submitted to surgical treatment for RCa. Materials and Methods An observational retrospective study including all male patients who underwent a surgical treatment for RCa between January 2011 December 2014 (n=43 was performed, complemented with an inquiry questionnaire to every patient about its sexual habits and level of function before and after surgery. Discussion All patients were male, with an average of 64yo. (range 42-83yo.. The surgical procedure was a rectum anterior resection (RAR in 22 patients (56% and an abdominoperineal resection (APR in 19(44%. Sixty three percent described their sexual life as important/very important. Sexual function worsening was observed in 76% (65% with complains on erectile function, and 27% on ejaculation. Fourteen patients (38% didn't resume sexual activity after surgery. Increased age (p=0.007, surgery performed (APR (p=0.03 and the presence of a stoma (p=0.03 were predictors of ED after surgery. A secondary analysis found that the type of surgery (APR (p=0.04, lower third tumor's location (p=0.03 and presence of comorbidities (p=0.013 (namely, smokers and diabetic patients were predictors of de novo ED after surgery. Conclusions This study demonstrated the clear negative impact in sexual function of patients submitted to a surgical treatment for RCa. Since it is a valued feature for patients, it becomes essential to correctly evaluate/identify these cases in order to offer an adequate therapeutical option.

Characteristics of uveitic glaucoma and evaluation of its surgical treatment

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Shimizu A

2014-11-01

Full Text Available Ai Shimizu, Kazuichi Maruyama, Yu Yokoyama, Satoru Tsuda, Morin Ryu, Toru Nakazawa Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan Purpose: To investigate the characteristics of uveitic glaucoma (UG and evaluate surgical treatments.Methods: This study examined a retrospective, nonrandomized comparative interventional case series of 105 UG patients (141 eyes followed between April 1, 2001 and July 30, 2014 at the outpatient clinic of Tohoku University Hospital. The study group included 47 patients (47 eyes who underwent glaucoma surgery: trabeculectomy, trabeculotomy, and trabectome surgery. The analysis used Kaplan–Meier life tables, with surgical failure defined as intraocular pressure ≧21 mmHg or the need for additional glaucoma surgery.Results: UG patients represented 9.73% of our database of glaucoma patients. The mean follow-up period was 40.32±32.53 months. Seventy-one patients had granulomatous uveitis (67.62% and 34 had nongranulomatous uveitis (32.38%. The causes of uveitis included sarcoidosis (n=25, Behçet’s disease (n=11, Vogt–Koyanagi–Harada disease (n=9, Posner–Schlossman syndrome (n=12, herpes simplex virus infectious uveitis (n=7, acute anterior uveitis (n=5, intermediate uveitis (n=4, scleritis (n=4, inflammatory bowel disease (n=4, varicella zoster virus uveitis (n=2, and others (n=6. An additional 16 patients were diagnosed with idiopathic UG. Surgical success rates were 82.86% for trabeculectomy, 62.50% for trabeculotomy, and 75.00% for trabectome. Significant risk factors for surgical failure included male sex (P=0.02, age less than 45 years (P=0.0009, nongranulomatous uveitis (P=0.04, and postoperative inflammation (P=0.01.Conclusion: Young male patients with nongranulomatous uveitis had a significant risk of surgical failure. Moreover, prolonged postoperative inflammation created a susceptibility to surgical failure, indicating the importance of postoperative

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…

Trends in the Surgical Correction of Gynecomastia.

Science.gov (United States)

Brown, Rodger H; Chang, Daniel K; Siy, Richard; Friedman, Jeffrey

2015-05-01

Gynecomastia refers to the enlargement of the male breast due to a proliferation of ductal, stromal, and/or fatty tissue. Although it is a common condition affecting up to 65% of men, not all cases require surgical intervention. Contemporary surgical techniques in the treatment of gynecomastia have become increasingly less invasive with the advent of liposuction and its variants, including power-assisted and ultrasound-assisted liposuction. These techniques, however, have been largely limited in their inability to address significant skin excess and ptosis. For mild to moderate gynecomastia, newer techniques using arthroscopic morcellation and endoscopic techniques promise to address the fibrous component, while minimizing scar burden by utilizing liposuction incisions. Nevertheless, direct excision through periareolar incisions remains a mainstay in treatment algorithms for its simplicity and avoidance of additional instrumentation. This is particularly true for more severe cases of gynecomastia requiring skin resection. In the most severe cases with significant skin redundancy and ptosis, breast amputation with free nipple grafting remains an effective option. Surgical treatment should be individualized to each patient, combining techniques to provide adequate resection and optimize aesthetic results.

Reducing the risk of surgical site infection: a case controlled study of contamination of theatre clothing.

Science.gov (United States)

Sivanandan, Indu; Bowker, Karen E; Bannister, Gordon C; Soar, Jasmeet

2011-02-01

Surgical site infections are one of the most important causes of healthcare associated infections (HCAI), accounting for 20% of all HCAIs. Surgical site infections affect 1% of joint replacement operations. This study was designed to assess whether theatre clothing is contaminated more inside or outside the theatre suite. Petri dishes filled with horse blood agar were pressed on theatre clothes at 0, 2, 4, 6 and 8 hours to sample bacterial contamination in 20 doctors whilst working in and outside the theatre suite. The results showed that there was greater bacterial contamination when outside the theatre suite at 2 hours. There were no differences in the amount of contamination at 4, 6 and 8 hours. This study suggests that the level of contamination of theatre clothes is similar both inside and outside the theatre setting.

REHABILITATION OF A SURGICALLY REPAIRED RUPTURE OF THE DISTAL BICEPS TENDON IN AN ACTIVE MIDDLE AGED MALE: A CASE REPORT

Science.gov (United States)

Sayers, Stephen P.; LaFontaine, Tom; Scheussler, Scott

2012-01-01

Background: Complete rupture of the distal tendon of the biceps brachii is relatively rare and there is little information to guide therapists in rehabilitation after this injury. The purposes of this case report are to review the rehabilitation concepts used for treating such an injury, and discuss how to modify exercises during rehabilitation based on patient progression while adhering to physician recommended guidelines and standard treatment protocols. Case Presentation: The patient was an active 38‐year old male experienced in weight‐training. He presented with a surgically repaired right distal biceps tendon following an accident on a trampoline adapted with a bungee suspension harness. The intervention focused on restoring range of motion and strengthening of the supporting muscles of the upper extremity without placing undue stress on the biceps brachii. Outcomes: The patient was able to progress from a moderate restriction in ROM to full AROM two weeks ahead of the physician's post‐operative orders and initiate a re‐strengthening protocol by the eighth week of rehabilitation. At the eighth post‐operative week the patient reported no deficits in functional abilities throughout his normal daily activities with his affected upper extremity. Discussion: The results of this case report strengthen current knowledge regarding physical therapy treatment for a distal biceps tendon repair while at the same time providing new insights for future protocol considerations in active individuals. Most current protocols do not advocate aggressive stretching, AROM, or strengthening of a surgically repaired biceps tendon early in the rehabilitation process due to the fear of a re‐rupture. In the opinion of the authors, if full AROM can be achieved before the 6th week of rehabilitation, initiating a slow transition into light strengthening of the biceps brachii may be possible. Level of evidence: 4‐Single Case report PMID:23316429

Gender reassignment surgery - a 13 year review of surgical outcomes

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R. Rossi Neto

2012-02-01

Full Text Available PURPOSE: The aim of this study is to thoroughly report on surgical outcomes from 332 patients who underwent male to female gender reassignment surgery (GRS. MATERIAL AND METHODS: Records from 332 patients who underwent GRS from 1995 to 2008 were reviewed. All patients were submitted to penile inversion vaginoplasty with glans-derived sensate clitoroplasty. Mean age was 36.7 years (range 19-68 years. Surgical complications were stratified in 6 main groups: genital region, urinary tract, gastrointestinal events, wound healing disorders and unspecific events. RESULTS: Progressive obstructive voiding disorder due to meatal stenosis was the main complication observed in 40% of the patients, feasibly corrected during the second setting. Stricture recurrence was found in 15%. Stricture of vaginal introitus was observed in 15% of the cases followed by 12% and 8% of vaginal stenosis and lost of vaginal depth, respectively. Rectal injury was seen in 3% and minor wound healing disorders in 33% of the subjects. CONCLUSION: Regarding male to female GRS, a review of the current literature demonstrated scarce description of complications and their treatment options. These findings motivated a review of our surgical outcomes. Results showed a great number of adverse events, although functionality preserved. Comparision of our outcomes with recent publications additionally showed that treatment options provide satisfying results. Moreover, outcomes reaffirm penile inversion vaginoplasty in combination with glans-derived sensate clitoroplasty as a safe technique. Nevertheless, discussing and improving surgical techniques in order to reduce complications and their influence on patient's quality of life is still strongly necessary and theme of our future reports.

AME survey-003 A1-part 2: the motivation factors of medical doctors in China.

Science.gov (United States)

Wáng, Yì-Xiáng J; Káplár, Zoltán; L, Yáo T

2015-12-01

The professional moral and job satisfaction of medical profession remain highly disputed in media in China. On the other hand, there is wide disaffection of patients toward doctors in China. This survey aims to obtain a better understanding of the motivation of Chinese medical professionals. An anonymous online cross-sectional survey, AME survey III, was conducted using the platform provided by DXY (www.dxy.cn) during the period of September 10-23, 2015. In total 2,356 DXY users completed the survey, including 1,740 males and 617 females, with a mean age of 31.96±7.03 yrs. The reasons (multiple choices) for career disaffection included poor patient/doctor relationship (88.6%), imbalance between workload and pay (79.5%), could not enter the preferred specialty (14.14%), and working in small clinics with no career progress (11.17%). If given the choice to enter the specialty as well as the hospital grade of their choice, 73.8% dissatisfied respondents replied they would like to be a doctor. For the dis-satisfied respondents, university teacher appeared to be the most popular career choice. The cited high workload was considered to be due to (I) imbalance in geographical allocation of doctors and insufficient training of doctors; (II) many red-tapism formalities; (III) Chinese patients often have unreasonable requests; (IV) over-examination and over-treatment; (V) high pressure to publish papers. One hundred and twelve respondents have their child/children attending university or graduated from university, 25.0% of them are pursuing a career in medicine. Nine hundred and ninety respondents have child/children while did not reach university age yet, among them 23.62% would like their child/children to study medicine. 64.87% of the 2,356 participants favor China to open up medical market to qualified foreign medical organizations to take part in fair competition, and 57.91% favor the government supporting regulated private hospitals. The moral and motivation of medical

Rhinologic headache caused by mucosal contact with a surgical solution. A case report

Directory of Open Access Journals (Sweden)

Ignacio ALCALÁ-RUEDA

2016-03-01

Full Text Available Introduction and objective: Rhinologic headache caused by mucosal contact is a difficult definition condition with good response to surgical approach. Description: We present a case of a 31 year-old male with rhinologic headache criteria. We decided to offer a surgical approach, successfully. Discussion: Rhinologic headache is included in the group of “Headache caused by disorders of the nasal mucosa, turbinates or septum”. There is no agreement about its cause because the prevalence of mucosal nasal contact is similar in patients with and without facial pain. There is evidence in the resolution of facial pain with a surgical approach. Conclusions: Despite the evidence of success in the surgical approach, some doubts still persist about the causes of this entity.

Doctor Down

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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.

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

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

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.

Evaluation of obstetricians' surgical decision making in the management of uterine rupture.

Science.gov (United States)

Eze, Justus Ndulue; Anozie, Okechukwu Bonaventure; Lawani, Osaheni Lucky; Ndukwe, Emmanuel Okechukwu; Agwu, Uzoma Maryrose; Obuna, Johnson Akuma

2017-06-08

Uterine rupture is an obstetric calamity with surgery as its management mainstay. Uterine repair without tubal ligation leaves a uterus that is more prone to repeat rupture while uterine repair with bilateral tubal ligation (BTL) or (sub)total hysterectomy predispose survivors to psychosocial problems like marital disharmony. This study aims to evaluate obstetricians' perspectives on surgical decision making in managing uterine rupture. A questionnaire-based cross-sectional study of obstetricians at the 46th annual scientific conference of Society of Gynaecology and Obstetrics of Nigeria in 2012. Data was analysed by descriptive and inferential statistics. Seventy-nine out of 110 obstetricians (71.8%) responded to the survey, of which 42 (53.2%) were consultants, 60 (75.9%) practised in government hospitals and 67 (84.8%) in urban hospitals, and all respondents managed women with uterine rupture. Previous cesarean scars and injudicious use of oxytocic are the commonest predisposing causes, and uterine rupture carries very high incidences of maternal and perinatal mortality and morbidity. Uterine repair only was commonly performed by 38 (48.1%) and uterine repair with BTL or (sub) total hysterectomy by 41 (51.9%) respondents. Surgical management is guided mainly by patients' conditions and obstetricians' surgical skills. Obstetricians' distribution in Nigeria leaves rural settings starved of specialist for obstetric emergencies. Caesarean scars are now a rising cause of ruptures. The surgical management of uterine rupture and obstetricians' surgical preferences vary and are case scenario-dependent. Equitable redistribution of obstetricians and deployment of medical doctors to secondary hospitals in rural settings will make obstetric care more readily available and may reduce the prevalence and improve the outcome of uterine rupture. Obstetrician's surgical decision-making should be guided by the prevailing case scenario and the ultimate aim should be to avert

Surgical management of perforated duodenal ulcer: the changing scene.

Science.gov (United States)

Plummer, J M; McFarlane, M E C; Newnham

2004-12-01

To determine the management of perforated duodenal ulcer at the University Hospital of the West Indies (UHWI) in this era of Helicobacter pylori, the medical records of all patients seen at the UHWI during the period July 1997 to June 2002 with an intra-operative diagnosis of perforated peptic ulcer were reviewed The records were analyzed for the following: age, gender, duration of symptoms, non-steroidal anti-inflammatory drug (NSAID) use, smoking status, operative repair duration of hospitalization, Helicobacter pylori status and medical therapy, peri-operative complications, mortality and recurrence. Ninety per cent of the cases were males. All females in whom perforation occurred were age 50 years and older compared to males where 58% of cases presented before age 50 years. Perforations in acute ulcers occurred in 80% of cases. The majority of patients were male smokers. Non-steroidal anti-inflammatory drug use was also an important risk factor in elderly females. Simple surgical closure and standard triple therapy antibiotics to eradicate Helicobacter pylori was the most common treatment offered. Mortality was one per cent and follow-up poor but 11% of patients had documented recurrent peptic ulceration. In this study population, perforated duodenal ulcer occured overwhelmingly in males less than 50 years of age. There is a trend towards exclusive simple surgical closure and H pylori eradication at the UHWI for patients with perforated duodenal ulcer but this needs to be supported by documentation of H pylori prevalence in the population of patients presenting with perforated peptic ulcers.

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.

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

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 ...

Effect of Promotional Strategies of Pharmaceutical Companies on Doctors' Prescription Pattern in South East Nigeria

Directory of Open Access Journals (Sweden)

Linus Onah

2010-02-01

Full Text Available AIM: Drug promotions use multifaceted approaches incorporating hospital and office detailing by marketing representatives. Very few studies exist on their influence on doctors’ prescription pattern in Nigeria. We examined the scope and effects of marketing strategies on the prescription habits of doctors in Enugu, South East Nigeria. METHOD: This was a cross-sectional study; 210 self-administered structured questionnaires were distributed among doctors in six major hospitals in Enugu. Ethical approval was obtained from the University of Nigeria Teaching Hospital Ethics Committee, Enugu. RESULTS: There was 88% response rate, with more males than females (M:F= 2.2: 1. Most were residents-in-training/ house officers (69% while consultants were 7.1% of the group. Stickers, drug presentations/ launches and personal souvenirs were most commonly employed marketing strategies. Most doctors (60% attending a drug presentation felt influenced. While 87.5% appreciated the benefits of marketing strategies, about 70% would consider patients’ socioeconomic status before prescribing. Continuing medical education and stiff competition were reasons adduced for the marketing strategies. CONCLUSION: Pharmaceutical companies in Nigeria adopt varied strategies to influence doctors’ prescriptions. Often this aim is achieved. The practice is accepted by most who nevertheless will consider other factors when deciding on what to prescribe. [TAF Prev Med Bull 2010; 9(1.000: 1-6

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.

Surgical sterilization of free-ranging wolves.

OpenAIRE

Spence, C E; Kenyon, J E; Smith, D R; Hayes, R D; Baer, A M

1999-01-01

The objective of the study was to determine whether surgical sterilization of both males and females in wolf pairs alters basic wolf social and territorial behaviors. Wolves were located from the air by snow-tracking methods and were tranquilizer-darted from a helicopter. Surgeries were performed either in a tent at the capture site or in a heated building in a nearby village. Six vasectomies and seven uterine horn ligations were performed in January and February of 1996 and 1997. Two females...

Giant Condyloma Acuminatum: A Surgical Riddle

Directory of Open Access Journals (Sweden)

Shukla

2016-08-01

Full Text Available Giant condyloma acuminatum (GCA commonly known as Buschke-Lowenstein tumor (BLT is a rare sexually transmitted disease, which is always preceded by condyloma accuminata and linked to human papillomavirus (HPV. Most commonly affected sites are male and female genitalia, anal and perianal regions. Giant condyloma acuminatum is well-known as slow growing but locally destructive with a high rate of recurrence and increased frequency of malignant transformation. Surgical management is considered to be the best among all the options.

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

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

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...

[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.

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…

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.

The master degree: A critical transition in STEM doctoral education

Science.gov (United States)

Lange, Sheila Edwards

The need to broaden participation in the nation's science, technology, engineering, and mathematics (STEM) undergraduate and graduate programs is currently a matter of national urgency. The small number of women and underrepresented minorities (URM) earning doctoral degrees in STEM is particularly troubling given significant increases in the number of students earning master's degrees since 1990. In the decade between 1990 and 2000, the total number of master's recipients increased by 42%. During this same time period, the number of women earning master's degrees increased by 56%, African Americans increased by 132%, American Indians by 101%, Hispanics by 146%, and Asian Americans by 117% (Syverson, 2003). Growth in underrepresented group education at the master's level raises questions about the relationship between master's and doctoral education. Secondary data analysis of the Survey of Earned Doctorates (SED) was used to examine institutional pathways to the doctorate in STEM disciplines and transitions from master's to doctoral programs by race and gender. While the study revealed no significant gender differences in pathways, compared to White and Asian American students, URM students take significantly different pathways to the doctorate. URM students are significantly more likely to earn the bachelor's, master's, and doctoral degrees at three different institutions. Their path is significantly more likely to include earning a master's degree en route to the doctorate. Further, URM students are more likely to experience transition between the master's and doctoral degrees, and the transitions are not limited to those who earn master's degrees at master's-only institutions. These findings suggest that earning a master's degree is more often a stepping stone to the doctorate for URM students. Master's degree programs, therefore, have the potential to be a valuable resource for policymakers and graduate programs seeking to increase the diversity of URM students

Obstacles to Success--Doctoral Student Attrition in South Africa

Science.gov (United States)

Herman, Chaya

2011-01-01

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

The hundredth Gentner Doctoral Student has started at CERN

CERN Multimedia

CERN Bulletin

2016-01-01

Almost ten years after the start of the programme in 2007, the hundredth Gentner Doctoral Student started his PhD at CERN.   The hundredth Gentner Doctoral Student, Christian Zimmer, in front of the AEgIS detector in the AD hall, where he will spend a significant portion of the next 3 years. In 2007, the German Gentner Doctoral Student Programme was established at CERN, named in honour of the celebrated nuclear physicist Wolfgang Gentner, President of the CERN Council from 1972-74. On 1 July 2016, the 100th Gentner Doctoral Student, Christian Zimmer, started his PhD at CERN, where he will work on setting up the sympathetic laser cooling of antiprotons at the AEgIS experiment. CERN’s Doctoral Student Programme has been running for many years, with 200 students currently enrolled. The Gentner programme is fully integrated into the general CERN Doctoral Student Programme, but is entirely funded by the German Federal Ministry of Education and Research (BMBF). The programme sponsors 30 to 40...

Exploring a shared leadership perspective for NHS doctors.

Science.gov (United States)

Willcocks, Stephen George; Wibberley, Gemma

2015-01-01

The purpose of this paper is to explore involving doctors in shared leadership. It examines the policies that have led to the focus on shared leadership and the implications for practice. This is a conceptual paper, examining policy developments and key literature to understand the move towards shared leadership. It focuses on UK NHS, and in particular doctors, although the concepts will be relevant to other disciplines in healthcare, and healthcare systems in other countries. This paper suggests that the shared-leadership approach for doctors has potential given the nature of clinical practice, the inherently collaborative nature of healthcare and the demands of new healthcare organisations. Health policy reform, generally, will mean that all doctors need to be engaged with leadership, albeit, perhaps, at different levels, and with different degrees of formality. Leadership will remain an important precondition for the success of the reforms. This is likely to be the case for other countries involved in healthcare reform. To highlight the benefits and barriers to shared leadership for doctors. Offers an alternative to traditional approaches to leadership.

Agency doctorates

Energy Technology Data Exchange (ETDEWEB)

NONE

1970-07-01

Mr. Wen-chuan Li of China has become the first student to obtain a doctor's degree as a result of research work carried out in the Agency. Mr. Li, who is 33, graduated as a Bachelor of Agriculture at Taiwan Provincial Chung-hsing University in 1960 and in 1966 was granted a fellowship to study mutations in plant breeding at the Agency's Seibersdorf Laboratory near Vienna, under the direction of Dr. Knut Mikaelsen, a professor of the University of Bergen. The Hochschule fur Bodenkultur of Vienna accepted the research as being suitable for a thesis and have now granted the degree of Doctor of Agriculture. The subject of the thesis was modifying factors influencing the mutagenic effects of alkylating agents as compared with ionizing radiations in barley. Alkylating agents are involved in the use of chemicals as a means of changing the characteristics of seeds to bring about changes aimed at improving the quality of crops. Mr. Li's work is regarded as a significant contribution to the understanding of the mechanics by which mutations are induced, to the efficient use of chemicals and ionizing radiations in practical applications, and to the efforts of the Agency in collaboration with the Food and Agriculture Organization to benefit food supplies. Mr. Li has now completed his fellowship with the Agency and has been appointed an Assistant Professor in Plant Breeding at Taiwan Provincial Chung-hsing University. The photograph, taken in the plastic hot house at Seibersdorf, shows him studying rice plants grown from seeds subjected to irradiation. Another noteworthy achievement is that of Mr. Karl-Franz Lacina, a security guard at the Agency's headquarters. At the age of 50 he has been accorded the degree of Doctor of Philosophy at Vienna University, the result of six years' work in his leisure time. The major subject was Arabic, with French and philosophy as supporting subject. (author)

Agency doctorates

International Nuclear Information System (INIS)

1970-01-01

Mr. Wen-chuan Li of China has become the first student to obtain a doctor's degree as a result of research work carried out in the Agency. Mr. Li, who is 33, graduated as a Bachelor of Agriculture at Taiwan Provincial Chung-hsing University in 1960 and in 1966 was granted a fellowship to study mutations in plant breeding at the Agency's Seibersdorf Laboratory near Vienna, under the direction of Dr. Knut Mikaelsen, a professor of the University of Bergen. The Hochschule fur Bodenkultur of Vienna accepted the research as being suitable for a thesis and have now granted the degree of Doctor of Agriculture. The subject of the thesis was modifying factors influencing the mutagenic effects of alkylating agents as compared with ionizing radiations in barley. Alkylating agents are involved in the use of chemicals as a means of changing the characteristics of seeds to bring about changes aimed at improving the quality of crops. Mr. Li's work is regarded as a significant contribution to the understanding of the mechanics by which mutations are induced, to the efficient use of chemicals and ionizing radiations in practical applications, and to the efforts of the Agency in collaboration with the Food and Agriculture Organization to benefit food supplies. Mr. Li has now completed his fellowship with the Agency and has been appointed an Assistant Professor in Plant Breeding at Taiwan Provincial Chung-hsing University. The photograph, taken in the plastic hot house at Seibersdorf, shows him studying rice plants grown from seeds subjected to irradiation. Another noteworthy achievement is that of Mr. Karl-Franz Lacina, a security guard at the Agency's headquarters. At the age of 50 he has been accorded the degree of Doctor of Philosophy at Vienna University, the result of six years' work in his leisure time. The major subject was Arabic, with French and philosophy as supporting subject. (author)

Comparison of stress and burnout among anesthesia and surgical residents in a tertiary care teaching hospital in North India.

Science.gov (United States)

Gandhi, K; Sahni, N; Padhy, S K; Mathew, P J

2017-10-23

The residents undergoing training at hospitals in our country face challenges in terms of infrastructure and high workload with undefined working hours. The aim of the study was to compare the stress and burnout levels in trainee doctors doing residency in surgical fields and anesthesia at a tertiary care academic center in North India. A comparative, observational study was conducted in a tertiary care teaching hospital in North India. After Ethics Committee approval, 200 residents (100 each from surgical branches and anesthesia) were required to fill a questionnaire with information about age, sex, year of residency, marital status, and the Perceived Stress Scale-10, and Burnout Clinical Subtype Questionnaire-12. Burnout and perceived stress were compared between residents of anesthesia and surgical specialties. Residents of both surgical and anesthesia branches scored high in perceived stress, namely 21 and 18, respectively. The score was significantly higher in surgical residents (P = 0.03) and increased progressively with the year of residency. The majority of residents (90% surgical, 80% anesthesia) felt that they were being overloaded with work. However, only 20%-30% of respondents felt that there was lack of development of individual skills and still fewer (<10%) reported giving up in view of difficulties. There is high level of stress and overload dimension of burnout among the residents of anesthesia and surgical branches at our tertiary care academic institution and the surgical residents score marginally higher than anesthesia residents.

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 ... & Compliance Grants News/Blog Contracts Loan Repayment More » ...

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 ...

Can non-urological doctors play a role in early prostate cancer detection?

Science.gov (United States)

Yazici, Cenk M; Dogan, Cagri

2014-05-06

To evaluate the awareness of non-urological doctors for their role in evaluating prostate cancer (Pca) in scientific manner which may be a possible probability for late diagnosis of Pca. A total of 936 non-urological specialists working in 1 university and 4 education and research hospital who were able to evaluate male patients over 50 years of age were included to the survey. A face to face questionnaire had been administered to all participants. A total of 92 (9.8%) participants were evaluating prostate-specific antigen (PSA) level to all their elderly male patients while 404 (43.2%) participants had never made this evaluation. Among the participants who were evaluating PSA, none was performing an informed decision making consult and even they did not have any idea about the meaning of this strategy. About the criteria for urological consultation, 56 (6%) reported that they consult all their elderly male patients, whereas 880 (94%) answered that they perform consultation if their patients has sought help for any urological symptom. Urologists must remind the non-urological specialists that their approaches to Pca evaluation may change mortality rates of this disease and give them proper information about the scientific evaluation of Pca. This may help us to decrease the mortality rates of Pca.

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

Science.gov (United States)

Wheeler, Rebecca McCombs; Eichelberger, Lisa Wright

2017-08-01

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

Newly qualified doctors' views on the significance and accessibility of career advice during medical training in Saudi Arabia.

Science.gov (United States)

Mehmood, Syed Imran; Norcini, John J; Borleffs, Jan C C

2013-01-01

Career advice is an important instrument to help students with the proper specialty selection. The study aims (1) to explore the views of newly graduated doctors in Saudi Arabia about their experience with the current status of career support system during medical training and (2) to identify cross-cultural similarities and differences. A cross-sectional design study was conducted using a questionnaire to elicit the responses of participants from newly qualified doctors concerning the availability and significance of career advice. SPSS (version 11.0; Chicago, IL) was used to analyze the data and statistical tests, such as chi-square and unpaired t tests, were used to analyze the observations. A response rate of 94.7% was obtained. Among this group, 102 were males and 78 were females. Only 53% did receive career advice. The majority of men felt that career advice during medical studies was inadequate, while women were less negative (69% versus 32%; p = 0.0001). Furthermore, men were more disappointed about the possibilities for career advice after graduating than women (34% versus 13%, p = 0.0001). The results show that only half of newly graduated doctors had received any career advice during medical training. As the health care system cannot afford the potential waste of time and resources for doctors, career guidance should begin in undergraduate training so that the process of thinking about their future career starts longtime before they make their career choice.

Importance and benefits of the doctoral thesis for medical graduates

Science.gov (United States)

Giesler, Marianne; Boeker, Martin; Fabry, Götz; Biller, Silke

2016-01-01

Introduction: The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates’ view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation. Method: Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514) and 2010/2011 (N=598) were analysed. Results: One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently “a doctorate is usual” (85%) and “improvement of job opportunities” (75%), 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not. Discussion: Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious. PMID:26958656

Importance and benefits of the doctoral thesis for medical graduates.

Science.gov (United States)

Giesler, Marianne; Boeker, Martin; Fabry, Götz; Biller, Silke

2016-01-01

The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates' view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation. Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514) and 2010/2011 (N=598) were analysed. One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently "a doctorate is usual" (85%) and "improvement of job opportunities" (75%), 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not. Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious.

Importance and benefits of the doctoral thesis for medical graduates

Directory of Open Access Journals (Sweden)

Giesler, Marianne

2016-02-01

Full Text Available Introduction: The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates’ view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation.Method: Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514 and 2010/2011 (N=598 were analysed.Results: One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently “a doctorate is usual” (85% and “improvement of job opportunities” (75%, 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not.Discussion: Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious.

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.

Result of surgical therapy in esophagogastric junction adenocarcinoma

International Nuclear Information System (INIS)

Shirinzadeh, A.; Fakhrjoo, E.

2007-01-01

To assess the outcome of surgical therapy and choice of surgical strategy for patients with adenocarcinoma of the gastroesophageal junction. Between February 1989 and January 2005 during 16 years, 335 patients (65 female, 270 male, mean age 56 years) with esophagogastric junction adenocarcinoma underwent surgical operation. The choice of surgical approach was based on the anatomical location of the tumor mass. Outcome of surgery, histopathologic characteristics, demographic data and long term survival rates were compared among three types of tumor defined as follows. Type I: Adenocarcinoma of the distal esophagus which infiltrates the esophagogastric junction from above. Type II: True carcinoma of the cardia arising immediately at the esophagogastric junction. Type III: Subcardial gastric carcinoma that infiltrates the esophagogastric junction and distal esophagus from below. Of the 335 patients undergoing resection, 110 (33%) had type I, 96 (28%) had type II, and 129 (39%) had type III. The preponderance of the male sex and the prevalence of metaplasia in distal esophagus decreased from type I to type III tumors (P<0.01). The prevalence of undifferentiated tumors increased from type I to type III tumors (P<0.01). Esophagectomy with resection of the proximal stomach for type I and extended total gastrectomy with transhiatal resection of the distal esophagus for type II and III were the primary procedures. The mean number of removed lymph node was higher in type III and II compared to type I tumors. The overall postoperative 30-day mortality was 8.4%. The death rate in transthoracic esophagectomy was higher than with extended total gastrectomy. The classification of adenocarcinoma of the esophagogastric junction into type I, II and III tumors helps in the selection of surgical approach. Type I tumors are approached as distal esophageal cancer. Type III tumors are a special form of gastric cancer and treated as a gastric cancer. The relation of type II tumors to