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Sample records for male surgical doctor

  1. Why are junior doctors deterred from choosing a surgical career?

    Rogers, Mary E; Creed, Peter A; Searle, Judy

    2012-05-01

    To identify the reasons why interns would not choose a surgical career. This qualitative study used semi-structured telephone interviews to explore the future career choices of 41 junior doctors (14 men, 27 women). Doctors were asked to identify specialties they would not take up, and state why this was the case. Thirty (73.2%) of the 41 interns nominated surgery as a specialty they would not choose. Themes relating to reasons for not wanting to pursue a surgical career included the lifestyle associated with surgery (66.7%), the culture within the surgical work environment (53.3%), the lack of interest in performing surgical work (36.7%), and the training requirements associated with surgery (33.3%). Both sexes had similar reasons for not wanting to choose a surgical career; but additionally, women referred to the male domination of surgery, and the difficulty and inflexibility of the training program as deterrents. Efforts are needed to promote interest in surgery as a career especially for women, to improve the surgical work environment so that medical students and junior doctors have exposure to positive role models and surgical placements, and to provide a more flexible approach to surgical training.

  2. Professional recognition of female and male doctors.

    Bruguera, M; Arrizabalaga, P; Londoño, M C; Padrós, J

    2014-03-01

    The awards for the excellence of the Official College of Physicians of Barcelona (COMB) were instituted in 2004 to recognize the excellence of the professional exercise. The winners are yearly chosen by juries appointed by the board of government, whose members propose for the award doctors who, in their opinion, have an exemplary professional and human behaviour. The number of male and female doctors who have obtained this recognition has been analysed in relation with the sex distribution in the juries. Likewise it has been compared the ratios men-to-women of those who have been rewarded and this ratio among physicians of more than 45 years. Between the awarded physicians the ratio men-to-women was of 2.7/1 (range, from 1.2/1 for awardees in primary care to 6/1 in research). The men-to-women ratio among those who were awarded was in parallel to the man-to-women ratios of the juries. The ratio between men and women among members of the COMB of more than 45 years was 1.4/1, whereas in those who were awarded it was of 2.7/1. The increase in the proportion of women in the juries in the last four years has been followed by an increase in the number of female physicians awarded. This data demonstrates that the predominance of male doctors among those who were awarded does not depend so much on the age factor, but basically on the proportion of male and female doctors in the juries. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  3. A surgical career for New Zealand junior doctors? Factors influencing this choice.

    Du, Jason; Sathanathan, Janarthanan; Naden, Gill; Child, Stephen

    2009-08-07

    To discover the level of interest in a surgical career amongst junior doctors and trainee interns in the Auckland region. Secondary aims are to identify the factors that influence career choice as well as the timing of career choice. An anonymous and structured questionnaire was distributed to all trainee interns and junior doctors in their first to fifth postgraduate years in the Auckland region. Questions were based on basic demographics, level of training, career preference and factors from previous experiences in surgery that may have influenced their career choice. Total of 87 replies with 36% expressed interest in surgery whereas 64% were interested in non-surgical specialties. Top three factors influencing career choice were similar in both groups: Lifestyle, career ambitions and family. Personal interest, practical hands-on and positive previous experiences were the top reasons why junior doctors chose surgery. Poor lifestyle, lacking of interest, limited future part-time work and previous negative experiences were the top reasons why junior doctors did not choose surgery. A significantly (pcareers earlier. Career aspirations of New Zealand junior doctors were similar to findings reported overseas. To promote surgery amongst junior doctors and medical students, attention should be paid to the key factors which may influence career choice. By improving working conditions and have better surgical education with good mentoring, team atmosphere and opportunities for early exposure will hopefully allow better recruitment and training of future surgeons.

  4. Personal values of male and female doctors: gender aspects.

    Neittaanmäki, L; Gross, E B; Virjo, I; Hyppölä, H; Kumpusalo, E

    1999-02-01

    The aim of this study was to elucidate the personal values of physicians. It was part of the Physician 93 Study, the purpose of which was to shed light on the life situation, career and future plans of young doctors and their views on medical education. The survey population included all the medical doctors registered during the years 1982-1991 in Finland (N = 4671). In the spring of 1993 a postal questionnaire was sent to a random sample of 2341 doctors. After two reminder letters, 1818 questionnaires (78%) were returned. 59% of the respondents were women. Subjects were asked to rate on a 4-point scale each of a set of 17 potentially important values listed in the questionnaire, five of which were seen by the majority of physicians as very important. These values were: family life, health, close friends, success in work or in studies and children's success. The potentially important values were conceptualized as indicative of eight important dimensions of the values of physicians: close friends, health. self actualization, success, universal values, well-being, family and ideology. Women doctors rated close friends, health, success, universalism and ideology as more important than men doctors.

  5. Doctors' perspectives of informed consent for non-emergency surgical procedures: a qualitative interview study.

    Wood, Fiona; Martin, Sean Michael; Carson-Stevens, Andrew; Elwyn, Glyn; Precious, Elizabeth; Kinnersley, Paul

    2016-06-01

    The need to involve patients more in decisions about their care, the ethical imperative and concerns about ligation and complaints has highlighted the issue of informed consent and how it is obtained. In order for a patient to make an informed decision about their treatment, they need appropriate discussion of the risks and benefits of the treatment. To explore doctors' perspectives of gaining informed consent for routine surgical procedures. Qualitative study using semi-structured interviews selected by purposive sampling. Data were analysed thematically. Twenty doctors in two teaching hospitals in the UK. Doctors described that while consent could be taken over a series of consultations, it was common for consent to be taken immediately prior to surgery. Juniors were often taking consent when they were unfamiliar with the procedure. Doctors used a range of communication techniques to inform patients about the procedure and its risks including quantifying risks, personalizing risk, simplification of language and use of drawings. Barriers to effective consent taking were reported to be shortage of time, clinician inexperience and patients' reluctance to be involved. Current consent processes do not appear to be ideal for many doctors. In particular, junior doctors are often not confident taking consent for surgical procedures and require more support to undertake this task. This might include written information for junior staff, observation by senior colleagues when undertaking the task and ward-based communication skills teaching on consent taking. © 2014 John Wiley & Sons Ltd.

  6. An audit of the knowledge and attitudes of doctors towards Surgical Informed Consent (SIC).

    Ashraf, Bushra; Tasnim, Nasira; Saaiq, Muhammad; Zaman, Khaleeq-Uz-

    2014-11-01

    The Surgical Informed Consent (SIC) is a comprehensive process that establishes an information-based agreement between the patient and his doctor to undertake a clearly outlined medical or surgical intervention. It is neither a casual formality nor a casually signed piece of paper. The present study was designed to audit the current knowledge and attitudes of doctors towards SIC at a tertiary care teaching hospital in Pakistan. This cross-sectional qualitative investigation was conducted under the auspices of the Department of Medical Education (DME), Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad over three months period. A 19-item questionnaire was employed for data collection. The participants were selected at random from the list of the surgeons maintained in the hospital and approached face-to-face with the help of a team of junior doctors detailed for questionnaire distribution among them. The target was to cover over 50% of these doctors by convenience sampling. Out of 231 respondents, there were 32 seniors while 199 junior doctors, constituting a ratio of 1:6.22. The respondents variably responded to the questions regarding various attributes of the process of SIC. Overall, the junior doctors performed poorer compared to the seniors. The knowledge and attitudes of our doctors particularly the junior ones, towards the SIC are less than ideal. This results in their failure to avail this golden opportunity of doctor-patient communication to guide their patients through a solidly informative and legally valid SIC. They are often unaware of the essential preconditions of the SIC; provide incomplete information to their patients; and quite often do not ensure direct involvement of their patients in the process. Additionally they lack an understanding of using interactive computer-based programs as well as the concept of nocebo effect of informed consent.

  7. An Audit of the Knowledge and Attitudes of Doctors towards Surgical Informed Consent (SIC

    Bushra Ashraf

    2014-11-01

    Full Text Available Background The Surgical Informed Consent (SIC is a comprehensive process that establishes an informationbased agreement between the patient and his doctor to undertake a clearly outlined medical or surgical intervention. It is neither a casual formality nor a casually signed piece of paper. The present study was designed to audit the current knowledge and attitudes of doctors towards SIC at a tertiary care teaching hospital in Pakistan. Methods This cross-sectional qualitative investigation was conducted under the auspices of the Department of Medical Education (DME, Pakistan Institute of Medical Sciences (PIMS, Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU, Islamabad over three months period. A 19-item questionnaire was employed for data collection. The participants were selected at random from the list of the surgeons maintained in the hospital and approached face-to-face with the help of a team of junior doctors detailed for questionnaire distribution among them. The target was to cover over 50% of these doctors by convenience sampling. Results Out of 231 respondents, there were 32 seniors while 199 junior doctors, constituting a ratio of 1:6.22. The respondents variably responded to the questions regarding various attributes of the process of SIC. Overall, the junior doctors performed poorer compared to the seniors. Conclusion The knowledge and attitudes of our doctors particularly the junior ones, towards the SIC are less than ideal. This results in their failure to avail this golden opportunity of doctor-patient communication to guide their patients through a solidly informative and legally valid SIC. They are often unaware of the essential preconditions of the SIC; provide incomplete information to their patients; and quite often do not ensure direct involvement of their patients in the process. Additionally they lack an understanding of using interactive computer-based programs as well as the concept of nocebo effect of informed

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

    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

  9. The mentoring of male and female scientists during their doctoral studies

    Filippelli, Laura Ann

    The mentoring relationships of male and female scientists during their doctoral studies were examined. Male and female biologists, chemists, engineers and physicists were compared regarding the importance of doctoral students receiving career enhancing and psychosocial mentoring from their doctoral chairperson and student colleagues. Scientists' satisfaction with their chairperson and colleagues as providers of these mentoring functions was also investigated. In addition, scientists identified individuals other than their chairperson and colleagues who were positive influencers on their professional development as scientists and those who hindered their development. A reliable instrument, "The Survey of Accomplished Scientists' Doctoral Experiences," was developed to assess career enhancing and psychosocial mentoring of doctoral chairpersons and student colleagues based on the review of literature, interviews with scientists and two pilot studies. Surveys were mailed to a total of 400 men and women scientists with earned doctorates, of which 209 were completed and returned. The findings reveal that female scientists considered the doctoral chairperson furnishing career enhancing mentoring more important than did the men, while both were in accordance with the importance of them providing psychosocial mentoring. In addition, female scientists were not as satisfied as men with their chairperson providing most of the career enhancing and psychosocial mentoring functions. For doctoral student colleagues, female scientists, when compared to men, indicated that they considered student colleagues more important in providing career enhancing and psychosocial mentoring. However, male and female scientists were equally satisfied with their colleagues as providers of these mentoring functions. Lastly, the majority of male scientists indicated that professors served as a positive influencer, while women revealed that spouses and friends positively influenced their professional

  10. A UK perspective on smartphone use amongst doctors within the surgical profession.

    Patel, Rikesh K; Sayers, Adele E; Patrick, Nina L; Hughes, Kaylie; Armitage, Jonathan; Hunter, Iain Andrew

    2015-06-01

    Hospitals are increasingly looking for mobile solutions to meet their information technology needs. Medical professionals are using personal mobile devices to support their work, because of limitations in both time and space. Our aims were to assess smartphone use amongst UK surgical doctors, the prevalence of medical app use and online activity. A thirteen-item questionnaire was derived to identify the proportion of surgical doctors of all grades using smartphones within the workplace. The following factors were evaluated: use of medical apps; use of online medical resources and if users were willing to use their own smartphone for clinical use. A total of 341 participants were surveyed with a complete response rate: 93.5% of which owned a smartphone, with 54.2% of those owning medical apps and 86.2% using their device to access online medical resources. Junior doctors were more likely to use medical apps over their senior colleagues (p = 0.001) as well as access the Internet on their smartphone for medical information (p smartphone for clinical use, which was found not to be dependent on seniority (p = 0.922). Online resources contribute significantly to clinical activities with the majority of smartphone users willing to use their own device. The information gathered from this study can aid developers to create software dedicated to the smartphone operating systems in greatest use and to potentially increase the use of a bring your own device (BYOD) scheme.

  11. Professional burnout syndrome in doctors of surgical specialties in Ukraine: causes, consequences, labor optimization ways.

    Skurupii, Dmytro A; Kholod, Dmytro A; Sonnik, Evgen G

    The professional burnout syndrome (PBS) affects quality of medical care provision for people, which is acquires the special actuality in terms of reforming the health care system. To study ways to improve the efficiency of doctors of surgical specialties based on analyzes of PBS and its consequences. A survey of psychological tests and 62 surgical doctors was carried out. It was found out that the PBS reaches a peak after 11 to 15 years of working experience. Anesthesiologists have high levels of PBS, emotional exhaustion, cynicism, low desire for career growth, frequent misunderstanding with the administration, they prefer 8-hour working day, and relieve stress by sleeping and consuming alcohol. Obstetrician-gynecologists show moderate level of PBS and emotional exhaustion, high degree of cynicism, strong desire for career growth, frequent misunderstandings with patients and their relatives, prefer 8-hour working day, relieve stress by smoking and socializing with family and friends. Traumatic surgeons have moderate level of PBS, emotional exhaustion, high degree of cynicism, strong desire for career growth, frequent misunderstandings with their colleagues of related specialties, prefer the 24-hour working day, and reli eve their stress with alcohol and sports. Surgeons have moderate level of PBS, emotional exhaustion, low degree of cynicism, moderate desire for career growth, frequent misunderstandings with their colleagues of related specialties, prefer the 8-hour working day, and relieve stress by smoking and sleeping. PBS is most expressed in doctors having working experience of 11 to 15 years and in anesthesiologists. They get professional deformations. These features should be considered in course of organization of working process of medical teams.

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

    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.

  13. Diagnosis and Surgical Management of Male Pelvic, Inguinal, and Testicular Pain.

    Belanger, Gabriel V; VerLee, Graham T

    2016-06-01

    Pain occurs in the male genitourinary organs as for any organ system in response to traumatic, infectious, or irritative stimuli. A knowledge and understanding of chronic genitourinary pain can be of great utility to practicing nonurologists. This article provides insight into the medical and surgical management of subacute and chronic pelvic, inguinal, and scrotal pain. The pathophysiology, diagnosis, and medical and surgical treatment options of each are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    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.

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

    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 ...

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

    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...

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

    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

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

    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

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

    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.

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

    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

  1. Surgical Procedures for BPH/LUTS: Impact on Male Sexual Health.

    Becher, Edgardo F; McVary, Kevin T

    2014-01-01

    Lower urinary tract symptoms (LUTS) because of benign prostatic hyperplasia (BPH) are a highly prevalent condition in men over 50 years old, and their incidence increases with age. The relationship between LUTS and erectile dysfunction (ED) has received increased attention recently because both diseases are highly prevalent, frequently co-associated in the same aging male group, and contribute significantly to the overall quality of life. In this review, we will examine the literature to assess the impact of surgical and minimally invasive treatments for LUTS/BPH on the male's sexual health. The impact of the various surgical and minimally invasive treatments for LUTS/BPH was reviewed to ascertain the impact on erectile and ejaculatory function. Sexual side effects of treatment for LUTS/BPH are underappreciated by urologists but likely play a prominent role in patient decision making, creating a disparity between provider and patient. Almost all accepted therapies for LUTS (surgical or medical) can affect some aspect of sexual health, making it imperative that health-care professionals understand their patients' concerns and motivations in these two linked diseases. The incidence of newly diagnosed postoperative ED in patients treated with monopolar transurethral resection (TURP) is around 14%, with reported values in various studies ranging from 0-32.5%, 7.7%, 6.5%, 17%, to 14%. Importantly, there is no significant difference reported between bipolar and monopolar TURP on sexual function. The risk of sexual side effects is an important one to consider in discussing the implications for any LUTS intervention as they play a prominent role in patient motivation, acceptance of bother and decision making concerning surgical intervention, thus creating a potential disparity between provider and patient. Becher EF and McVary KT. Surgical procedures for BPH/LUTS: Impact on male sexual health. Sex Med Rev 2014;2:47-55. Copyright © 2014 International Society for Sexual

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

    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

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

    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.

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

    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.

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

    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.

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

    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

  7. [Gender differences in career motivation: female doctors' ambitions benefit from family friendly work environment].

    Pas, B R; Lagro-Janssen, A L M; Doorewaard, J A C M; Eisinga, R N; Peters, C P

    2008-10-04

    To determine gender differences in career motivation and the effect of a family friendly work environment. Cross-sectional pilot investigation. A web survey among male and female doctors (n = 107; 72 women and 35 men) in different specialties, including surgical, internal medicine and general practitioners, was used to gather information on different dimensions of career motivation and perceptions of the family friendliness of the work environment. Differences were analysed by means of t-tests and regression analyses. Male doctors had higher scores on career identity and on career planning than female doctors. However, male and female doctors did not differ in their willingness to achieve top positions. Female doctors were more determined concerning their career goals than their male counterparts. The family friendliness of the work environment had an overall positive effect on career motivation for both male and female doctors. However, a family friendly work environment had a negative effect on the career identity of male doctors. For male and female doctors alike, support to achieve career goals and elimination of career barriers lead to increased career identity. Male and female doctors differed in certain dimensions of career motivation. Offering support for career goals and taking away career barriers leads to a higher career motivation than offering a family friendly work environment.

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

    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...

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

    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.

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

    Gray, Judith

    1982-01-01

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

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

    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.

  12. Suicide in doctors and wives of doctors.

    Sakinofsky, I

    1980-06-01

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

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

    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.

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

    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.

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

    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.

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

    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.

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

    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.

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

    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

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

    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

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

    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.

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

    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.

  2. Single coronary artery; extremely rare coronary anomaly successfully treated surgically in young adult male.

    Shah, A R

    2010-05-01

    Single coronary artery arising from aortic root, is a rare congenital anomaly. A 30-year-old male presented with acute myocardial infarction (MI) complaining of chest pain and raised troponin levels. Emergency angiography showed no coronary lesions but both left and right coronary arteries arising from single ostium. Patient was operated electively and perioperative findings confirmed the diagnosis of single coronary artery, as left coronary artery after taking origin from right sinus of valsalva runs through the septum, before dividing into left anterior descending and circumflex branches. The single coronary ostium opened with a slit like incision over the course of left main coronary, making the size of ostium three to four times bigger than the native one. In addition left internal mammary artery was harvested and grafted to the left anterior descending branch distally. Patient made successful recovery. Four months follow up dobutamine stress echo showed no inducible ischemia.

  3. [Gender differences in career motivation: female doctors' ambitions benefit from family friendly work environment

    Pas, B.R.; Lagro-Janssen, A.L.M.; Doorewaard, J.A.C.M.; Eisinga, R.N.; Peters, P.

    2008-01-01

    OBJECTIVE: To determine gender differences in career motivation and the effect of a family friendly work environment. DESIGN: Cross-sectional pilot investigation. METHOD: A web survey among male and female doctors (n = 107; 72 women and 35 men) in different specialties, including surgical, internal

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

    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.

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

    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

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

    Himmelstein, Mary S; Sanchez, Diana T

    2016-03-01

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

  7. Doctors Today

    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.

  8. Spin doctoring

    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...

  9. [Job satisfaction among Norwegian doctors].

    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.

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

    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.

  11. Evaluation of patients' attitudes to their care during oral and maxillofacial surgical outpatient consultations: the importance of waiting times and quality of interaction between patient and doctor.

    Dimovska, E O F; Sharma, S; Trebble, T M

    2016-06-01

    Knowing what patients think about their care is fundamental to the provision of an effective, quality service, and it can help to direct change and reduce costs. Much of the work in oral and maxillofacial departments concerns the treatment of outpatients, but as little is known about what they think about their care, we aimed to find out which aspects were associated with satisfaction. Consecutive patients (n=244) who attended the oral and maxillofacial outpatient department at Southampton University Hospital NHS Foundation Trust over a 7-day period were given a questionnaire to complete before and after their consultation. It included questions with Likert scale responses on environmental, procedural, and interactive aspects of the visit, and a 16-point scale to rank their priorities. A total of 187 patients (77%) completed the questionnaires. No association was found between expected (p=0.93) or actual (p=0.41) waiting times, and 90% of patients were satisfied with their visit. Seeing the doctor, having confidence in the treatment plan, being listened to, and the ability of the doctor to recognise their personal needs, were ranked as important. Environmental and procedural aspects were considered the least important. These findings may be of value in the development of services to improve patient-centred care. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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

    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

  13. 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.

    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.

  14. Doctor's Orders

    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.

  15. Doctor Down

    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.

  16. Barriers to becoming a female surgeon and the influence of female surgical role models.

    Kerr, Hui-Ling; Armstrong, Lesley Ann; Cade, Jennifer Ellen

    2016-10-01

    We aim to investigate the reasons that medical students and junior doctors who are women are less likely to pursue a career in surgery compared with their male counterparts. An anonymous questionnaire was distributed to female final year medical students and female junior doctors in two UK hospitals between August and September 2012. Topics included career choice, attitudes to surgery, recognition of female surgical role models and perceived sexual discrimination. 50 medical students and 50 junior doctors were given our survey. We received a 96% response rate; 46 medical students and 50 junior doctors. 6/50 (12%) junior doctors planned a career in surgery compared with 14/46 (30%) medical students. 'Work-life balance' was the main reason cited for not wishing to pursue surgery (29/46 (63%) medical students and 25/50 (50%) junior doctors). 28/46 (61%) medical students and 28/50 (56%) junior doctors had encountered a female surgical role model; only five students and two junior doctors felt that these were influential in their career decision. Of those who had not, approximately 40% in each group felt that if they had, they may have considered surgery. Approximately 30% in each group had encountered female surgeons that had dissuaded them from a surgical career. Work-life balance is still cited by female junior doctors as being the main deterrent to a surgical career. The paucity of female role models and some perceived sexual discrimination may cause female doctors to discount surgery as a career. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Doctoral Education

    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...

  18. Agency doctorates

    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

  19. Agency doctorates

    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)

  20. Agency doctorates

    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)

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

    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.

  2. Observed Differences between Males and Females in Surgically Treated Carpal Tunnel Syndrome Among Non-manual Workers: A Sensitivity Analysis of Findings from a Large Population Study

    Farioli, Andrea; Curti, Stefania; Bonfiglioli, Roberta; Baldasseroni, Alberto; Spatari, Giovanna; Mattioli, Stefano; Violante, Francesco Saverio

    2018-01-01

    Abstract Objectives We aimed at assessing whether differences among males and females in carpal tunnel syndrome (CTS) epidemiology might be attributable to segregation with respect to occupational biomechanical exposures or differential access to care by sex. Methods We analysed surgically treated cases of CTS occurring among non-manual workers in Tuscany between 1997 and 2000. We conducted a Monte Carlo simulation to estimate the difference in occupational biomechanical exposures between males and females necessary to explain the observed incidence rate ratios. We also accounted for the sex-specific probability of receiving surgery after the diagnosis of CTS, as women were reported to be more likely to undergo surgery in a subset of our study population. We quantified the hypothetical biomechanical overload through the hand activity level (HAL) metric proposed by the American Conference of Governmental Industrial Hygienists. To quantify the effect of HAL on CTS risk, we assumed a prior distribution based on findings from two large cohort studies of industrial workers. Results After adjustment for the probability of receiving surgery, women showed a 4-fold incidence of CTS as compared with men. To explain this association among non-manual workers, women should have an average value of HAL at least 5 points higher. Conclusions Our analysis does not support the hypothesis that the difference in CTS incidence between males and females is entirely attributable to occupational risk factors or to differential access to surgery. The causal pathway between sex and CTS might include more determinants such as hormonal factors, anthropometric characteristics, and non-occupational exposure to biomechanical overload (e.g. household tasks). PMID:29579135

  3. Patients' preferences for doctors' attire in Japan.

    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

  4. [Doctors in love].

    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.

  5. Not a surgical vaccine: there is no case for boosting infant male circumcision to combat heterosexual transmission of HIV in Australia.

    Darby, Robert; Van Howe, Robert

    2011-10-01

    To conduct a critical review of recent proposals that widespread circumcision of male infants be introduced in Australia as a means of combating heterosexually transmitted HIV infection. These arguments are evaluated in terms of their logic, coherence and fidelity to the principles of evidence-based medicine; the extent to which they take account of the evidence for circumcision having a protective effect against HIV and the practicality of circumcision as an HIV control strategy; the extent of its applicability to the specifics of Australia's HIV epidemic; the benefits, harms and risks of circumcision; and the associated human rights, bioethical and legal issues. Our conclusion is that such proposals ignore doubts about the robustness of the evidence from the African random-controlled trials as to the protective effect of circumcision and the practical value of circumcision as a means of HIV control; misrepresent the nature of Australia's HIV epidemic and exaggerate the relevance of the African random-controlled trials findings to it; underestimate the risks and harm of circumcision; and ignore questions of medical ethics and human rights. The notion of circumcision as a 'surgical vaccine' is criticised as polemical and unscientific. Circumcision of infants or other minors has no place among HIV control measures in the Australian and New Zealand context; proposals such as these should be rejected. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

  6. Building doctoral ecologies

    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....

  7. Cost incentives for doctors

    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....

  8. Doctoral Women: Managing Emotions, Managing Doctoral Studies

    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…

  9. Talking to Your Doctor

    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 ...

  10. Finding the Right Doctor

    ... 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 ...

  11. Talking to Your Doctor

    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 ...

  12. Talking to Your Doctor

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

  13. Talking to Your Doctor

    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 ...

  14. Rural surgery in Guinea Bissau: an experience of Doctors Worldwide Turkey.

    Alimoglu, Orhan; Sagiroglu, Julide; Eren, Tunc; Kinik, Kerem

    2015-01-01

    In Africa, there is critical shortage of surgeons. Majority of the surgeons work in urban centers, and almost none of them is working in the rural areas. This study documents surgical interventions performed in Guinea-Bissau by Doctors Worldwide Turkey. A group of surgeons from the Doctors Worldwide Turkey performed various surgical interventions in the Simao Mendes, Gabu and Bafata community hospitals. Demographics, surgical methods, anesthesia techniques and complications were recorded. Sixty- four procedures were undertaken between 5-16 February 2010 and 6-11 May 2011. The patient population consisted of 47 male (82.5%) and 10 female (17.5%) patients with a mean age of 44.5 (range: 6-81) years. Five emergency cases were observed. Hartmann's procedure for rectal carcinoma; modified radical mastectomy for breast carcinoma; 2 right total thyroidectomies, 1 bilateral subtotal thyroidectomy; 2 incisional hernia repairs with mesh, 1 breast lumpectomy, 3 mass excisions, 2 keloidectomies, and various techniques of hernia repair for 35 inguinal hernias (4 bilateral, 3 strangulated and 2 coexisting with hydrocele), Winkelmann's procedure for 5 hydroceles (1 bilateral), and unilateral orchiectomy for 1 bilateral hydrocele were recorded. Sixteen patients received general (23.5%), 23 spinal (33.8%), 7 epidural (10.3%), 15 local (22.1%), and 7 ketamine (10.3%) anesthesia. There was no mortality. Surgical diseases, majority of which are hernias threaten public health in underdeveloped regions of Africa. Blitz surgery may be an efficient temporary solution.

  15. Talking to Your Doctor

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

  16. Doctors in Balzac's work.

    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.

  17. Doctors and pharmaceutical industry.

    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.

  18. Effect of Surgical and Immunological Castration on Haematological ...

    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.

  19. Surgical Assisting

    ... instruction, including: Microbiology Pathophysiology Pharmacology Anatomy and physiology Medical terminology Curriculum . Course content includes: Advanced surgical anatomy Surgical microbiology Surgical pharmacology Anesthesia methods and agents Bioscience Ethical ...

  20. Abortion - surgical

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  1. Talking to Your Doctor

    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) ...

  2. Talking to Your Doctor

    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 ...

  3. Coaching doctoral students

    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....

  4. The doctoral learning penumbra

    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...

  5. Working with doctors and nurses

    ... 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 ...

  6. Choose your doctorate.

    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

  7. The feminisation of Canadian medicine and its impact upon doctor productivity.

    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.

  8. Talking to Your Doctor

    Full Text Available ... honest communication between you and your physician can help you both make smart choices about your health. ... recovery. Here are a few tips that can help you talk to your doctor and make the ...

  9. Talking to Your Doctor

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    Full Text Available ... concerns before your appointment. Consider bringing a close friend or family member with you. Take notes about what the doctor says, or ask a friend or family member to take notes for you. ...

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  20. The Doctor and Society*

    the pressure of his own discipline he should be an edu- cated person in the ... found and multiform influence on social norms and human .destiny. The paths of ... This broad approach is fundamental to a sound doctor- patient relationship.

  1. Find a Doctor

    ... 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 ...

  2. Female physicist doctoral experiences

    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...

  3. Male sexuality.

    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.

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

    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…

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

    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

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

    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.

  7. Wanted--doctors who care.

    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).

  8. Medical thrillers: doctored fiction for future doctors?

    Charpy, Jean-Pierre

    2014-12-01

    Medical thrillers have been a mainstay of popular fiction since the late 1970s and still attract a wide readership today. This article examines this specialized genre and its core conventions within the context of professionally-based fiction, i.e. the class of thrillers written by professionals or former professionals. The author maps this largely unchartered territory and analyzes the fictional representations of doctors and medicine provided in such novels. He argues that medical thrillers, which are not originally aimed at specialized readers and sometimes project a flawed image of medicine, may be used as a pedagogical tool with non-native learners of medical English.

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

    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.

  10. Surgical lighting

    Knulst, A.J.

    2017-01-01

    The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,

  11. [Murder of the doctor].

    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.

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

    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.

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

    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.

  14. Surviving the Doctoral Years

    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.

  15. Tratamiento quirúrgico de la región mamaria masculina prominente Surgical treatment of the prominent mammal region in male

    W. Calderón

    2010-03-01

    Full Text Available La ginecomastia es la anomalía mamaria más frecuente en el sexo masculino. La pseudoginecomastia es un cuadro que a menudo se confunde con la ginecomastia y consiste en el aumento de tejido graso en la región pectoral. El equipo de Cirugía Plástica del Hospital Militar de Santiago (Chile, por atender una población de jóvenes que realizan el servicio militar obligatorio, ha tenido una gran experiencia en el manejo de esta enfermedad; es por esto que nos planteamos como objetivo de estudio evaluar el manejo de los pacientes operados por esta patología en el Hospital Militar y la Clínica Santa María de Santiago, e intentar ofrecer pautas para el manejo de esta patología de la Cirugía General a nivel nacional. Realizamos un estudio retrospectivo y descriptivo sobre 106 pacientes operados con diagnóstico de ginecomastia o pseudoginecomastia entre Enero de 1987 y Julio de 2005 en las instituciones antes mencionadas. El promedio de edad de los pacientes incluidos en el estudio fue de 24 años (rango: 15 a 50 años: 32% por ginecomastia pura, 29,4% por pseudoginecomastia y 38,8% por ambas. Todos fueron grado I y IIa de la clasificación de Simon. En el 50% de los casos se realizó adenectomía más lipoaspiración; adenectomía sola en 26,4% y lipoaspiración exclusiva en 23,6%. Casos complicados, 3,8% con hematomas y equimosis. La ginecomastia es una enfermedad frecuente en la adolescencia que además de provocar alteraciones estéticas, provoca alteraciones psicológicas en el paciente. La liposucción se consagra como una técnica quirúrgica importante para el tratamiento quirúrgico de esta anormalidad.Gynecomastia is common among men. Pseudogynecomastia, caused by an increased subcutaneous fat in the mammary area, can be confused with gynecomastia. We report our experience with the surgical treatment of both making a review of medical records of 106 patients, aged 15 to 50 years, operated at the Plastic Surgery Unit of the Military

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

    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.

  17. Fourth Doctoral Student Assembly

    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...

  18. Talking to Your Doctor

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

  19. Choosing a Family Doctor

    ... age or sex. This includes care for your physical, mental, and emotional health. Family doctors get to know their patients. They ... and Wellness Staying Healthy Healthy Living Travel Occupational Health First Aid and ... Pets and Animals myhealthfinder Food and Nutrition Healthy Food ...

  20. Talking to Your Doctor

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

  1. Talking to Your Doctor

    Full Text Available ... Repayment More » Search the NIH Guide Quick Links RePORT eRA Commons NIH Common Fund NIH and the ... if you feel embarrassed or shy. Have an open dialogue with your doctor — ask questions to make ...

  2. Talking to Your Doctor

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

  3. Talking to Your Doctor

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

  4. Surgical smoke.

    Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

    2009-10-01

    Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.

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

    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.

  6. Reinventing The Doctor

    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.

  7. Radon house doctor

    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

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

    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.

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

    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.

  10. Nursing doctoral education in Turkey.

    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.

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

    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...

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

    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.

  13. Factors influencing incident reporting in surgical care.

    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.

  14. Female physicist doctoral experiences

    Katherine P. Dabney

    2013-04-01

    Full Text Available 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 physicists experience conflict in achieving balance within their graduate school experiences and personal lives and that this then influences their view of their future careers and possible career choices. Female physicists report both early and long-term support outside of school by family, and later departmental support, as being essential to their persistence within the field. A greater focus on informal and out-of-school science activities for females, especially those that involve family members, early in life may help influence their entrance into a physics career later in life. Departmental support, through advisers, mentors, peers, and women’s support groups, with a focus on work-life balance can help females to complete graduate school and persist into an academic career.

  15. The Business of Doctoring

    Moyez Jiwa

    2012-06-01

    Full Text Available The core business of medicine is the consultation. During the consultation one human being responds to another in distress. Most doctors spend more time talking with people than performing surgery, prescribing pills or ordering tests. The extent to which the doctor succeeds as a communicator may even govern the ‘success’ of any procedure performed, if we define success as relief from the condition causing distress. As human beings our ability to benefit from what is offered to alleviate our symptoms is limited by the extent to which we feel that we have been heard and supported with empathy. It has been demonstrated that the human body has the capacity to heal and that healers are limited by their capacity to facilitate that process. That is not to say that ‘talking’ can spare us the need for other interventions. In this review the author examines the factors that impact on the medical consultation with particular emphasis on the scope for harm when the consultation is interrupted.

  16. Female physicist doctoral experiences

    Dabney, Katherine P.; Tai, Robert H.

    2013-06-01

    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 physicists experience conflict in achieving balance within their graduate school experiences and personal lives and that this then influences their view of their future careers and possible career choices. Female physicists report both early and long-term support outside of school by family, and later departmental support, as being essential to their persistence within the field. A greater focus on informal and out-of-school science activities for females, especially those that involve family members, early in life may help influence their entrance into a physics career later in life. Departmental support, through advisers, mentors, peers, and women’s support groups, with a focus on work-life balance can help females to complete graduate school and persist into an academic career.

  17. [Health behaviour of doctors].

    Németh, Anikó

    2016-07-01

    Health behaviour involves maintaining, improving and restoration of health. The aim of the author was to assess correlations of health behaviour with age, gender, job type and overtime. A quantitative cross-sectional study was conducted using an online questionnaire (N = 186). Data were analyzed with chi-square, Kolmogorov-Smirnov, Mann-Whitney and Kruskal-Wallis tests. Doctors working in in-patient care drink more coffee (p = 0.034) and energy drinks (p = 0.018); they eat undisturbed only on weekends at home (p = 0.032). Men consume more alcohol (p = 0.003), red meats (pmeals (p = 0.018) and their daily fluid consumption exceeds 2 litres (p = 0.005); their body mass index values are higher compared to women (peat more hot meals (p = 0.005), and those under the age of 30 consume more crisps, fast food (p = 0.001) and energy drinks (p = 0.005), while they are more active (p = 0.010). Dietary habits of doctors are not ideal and their physical activity is diminished compared to international trends. Orv. Hetil., 2016, 157(30), 1198-1206.

  18. Surgical, pathological and clinical correlation of Tc-99m DISIDA hepatobiliary imaging in 138 adult males, in the diagnosis of functional cystic duct obstruction VS acute or chronic cholecystitis

    Yoo, J.H.K.; Beal, W.H.; Ware, R.W.; Straw, J.D.; Chaudhuri, T.K.

    1985-01-01

    Despite the wide acceptance of the hepatobiliary scintigraphy as a popular diagnostic imaging modality for gallbladder and hepatobiliary disease, correlation between radionuclide diagnoses and the final clinical and/or pathologic findings have not been thoroughly evaluated. The lack of correlative studies frequently generates difficulties in making appropriate diagnostic interpretation of the objective findings. A retrospective clinical pathological and surgical correlative study was undertaken by the authors in 138 male veteran patients, who underwent computer assisted minute by minute Tc-99m DISIDA cholescintigraphy. A very high percentage (75%) revealed abnormalities; non-visualization of gallbladder (GB) with normal choledochus system (46%), choledochal obstruction with no GB visualization (13%), choledochal obstruction with normal GB visualization (6%), severe hepatocellular disease with non-diagnostic GB (4%), and delayed GB visualization (longer than 60 minutes) (3%). Non-visualization of GB but normal choledochus demonstrated diverse pathologic etiologies, acute and chronic cholecystitis (64%), S/P cholecystectomy (8%), functional obstruction secondary to sepsis or pancreatitis (6%), and various other pathologies including porcelain GB and cholangitis (22%). The most important cause of choledochal obstruction was mass lesions or local infiltration with metastases (33%) rather than acute cholecystitis (27%). Although the sensitivity (98%) and specificity (92%) for cystic duct obstruction were very high, the specificity decreases significantly for cholecystitis

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

    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.

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

    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.

  1. [Patients, doctors and the internet].

    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.

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

    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

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

    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…

  4. Surgical orthodontics.

    Strohl, Alexis M; Vitkus, Lauren

    2017-08-01

    The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.

  5. Changing doctor prescribing behaviour

    Gill, P.S.; Mäkelä, M.; Vermeulen, K.M.

    1999-01-01

    Collaboration on Effective Professional Practice. This register is kept up to date by searching the following databases for reports of relevant research: DHSS-DATA; EMBASE; MEDLINE; SIGLE; Resource Database in Continuing Medical Education (1975-1994), along with bibliographies of related topics, hand searching......The aim of this overview was to identify interventions that change doctor prescribing behaviour and to derive conclusions for practice and further research. Relevant studies (indicating prescribing as a behaviour change) were located from a database of studies maintained by the Cochrane...... of key journals and personal contact with content area experts. Randomised controlled trials and non-equivalent group designs with pre- and post-intervention measures were included. Outcome measures were those used by the study authors. For each study we determined whether these were positive, negative...

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

    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

  7. A marketing clinical doctorate programs.

    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.

  8. Will Medical Technology Deskill Doctors?

    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…

  9. Women, Men and the Doctorate.

    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;…

  10. Doctorate Program Trains Industrial Chemists.

    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…

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

    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

  12. Counseling Psychology Doctoral Students' Training Experiences in Primary Care Psychology

    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…

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

    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.

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

    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…

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

    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…

  16. Intolerance and Violence Against Doctors.

    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

  17. Employment experiences of vocationally trained doctors.

    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.

  18. Evaluating the cost of adult voluntary medical male circumcision in a mixed (surgical and PrePex site compared to a hypothetical PrePex-only site in South Africa

    Hae-Young Kim

    2015-12-01

    Full Text Available Background: Several circumcision devices have been evaluated for a safe and simplified male circumcision among adults. The PrePex device was prequalified for voluntary male medical circumcision (VMMC in May 2013 by the World Health Organization and is expected to simplify the procedure safely while reducing cost. South Africa is scaling up VMMC. Objective: To evaluate the overall unit cost of VMMC at a mixed site vs. a hypothetical PrePex-only site in South Africa. Design: We evaluated the overall unit cost of VMMC at a mixed site where PrePex VMMC procedure was added to routine forceps-guided scalpel-based VMMC in Soweto, South Africa. We abstracted costs and then modeled these costs for a hypothetical PrePex-only site, at which 9,600 PrePex circumcisions per year could be done. We examined cost drivers and modeled costs, varying the price of the PrePex device. The healthcare system perspective was used. Results: In both sites, the main contributors of cost were personnel and consumables. If 10% of all VMMC were by PrePex at the mixed site, the overall costs of the surgical method and PrePex were similar – US$59.62 and $59.53, respectively. At the hypothetical PrePex-only site, the unit cost was US$51.10 with PrePex circumcisions having markedly lower personnel and biohazardous waste management costs. In sensitivity analysis with the cost of PrePex kit reduced to US$10 and $2, the cost of VMMC was further reduced. Conclusions: Adding PrePex to an existing site did not necessarily reduce the overall costs of VMMC. However, starting a new PrePex-only site is feasible and may significantly reduce the overall cost by lowering both personnel and capital costs, thus being cost-effective in the long term. Achieving a lower cost for PrePex will be an important contributor to the scale-up of VMMC.

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

    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.

  20. Smoking prevalence among doctors and nurses-2013 New Zealand census data.

    Edwards, Richard; Tu, Danny; Stanley, James; Martin, Greg; Gifford, Heather; Newcombe, Rhiannon

    2018-03-09

    To examine recent smoking trends among doctors and nurses in New Zealand. Analysis of smoking prevalence in the 2013 New Zealand Census and comparison with previous census data. The 2013 census included 7,065 male and 5,619 female doctors, and 2,988 male and 36,138 female nurses. Non-response to smoking questions was less than 3%. In 2013, 2% of male and female doctors and 9% of male and 8% of female nurses were regular cigarette smokers. This compared with 4% male and 3% female doctors, and 20% male and 13% female nurses in 2006. Psychiatric nurses had the highest smoking prevalence (15% male, 18% female). More Māori doctors (6.8%) and nurses (19.3%) smoked. Around 96% of young (New Zealand doctors had achieved the Smokefree 2025 goal of minimal (workplace smoking cessation support may be an efficient means to reduce smoking among key occupational groups, and may help reduce population smoking prevalence.

  1. Turning Doctors Into Employees

    Matthew Anderson

    2014-05-01

    Full Text Available Background: Much of the contentious debate surrounding the Patient Protection and Affordable Care Act (“Obamacare” concerned its financing and its attempt to guarantee (near universal access to healthcare through the private insurance market.  Aside from sensationalist stories of “death panels,” much less attention went to implications of the bill for the actual provision of healthcare. Methodology: This paper examines the "patient-centered medical home" (PCMH model which has been widely promoted as a means of reviving and improving primary care (i.e. general internal medicine, family medicine, and pediatrics. Argument: The PCMH and many of its components (e.g pay-for-performance, electronic medical records were interventions that were implemented on a massive basis without any evidence of benefit. Recent research has not generally supported clinical benefits with the PCMH model. Instead it seems to designed to de-professionalize (make proletarians of health care workers and enforce corporate models of health. The core values of professional work are undermined while the PCMH does nothing to address the structural marginalization of primary care within US health care. Conclusions: The development of alternative models will require political changes. Both doctors and teachers are in a position of advocate for more progressive systems of care and education.

  2. Epilepsy - what to ask your doctor - adult

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

  3. Edinburgh doctors and their physic gardens.

    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.

  4. Surgical competence.

    Patil, Nivritti G; Cheng, Stephen W K; Wong, John

    2003-08-01

    Recent high-profile cases have heightened the need for a formal structure to monitor achievement and maintenance of surgical competence. Logbooks, morbidity and mortality meetings, videos and direct observation of operations using a checklist, motion analysis devices, and virtual reality simulators are effective tools for teaching and evaluating surgical skills. As the operating theater is also a place for training, there must be protocols and guidelines, including mandatory standards for supervision, to ensure that patient care is not compromised. Patients appreciate frank communication and honesty from surgeons regarding their expertise and level of competence. To ensure that surgical competence is maintained and keeps pace with technologic advances, professional registration bodies have been promoting programs for recertification. They evaluate performance in practice, professional standing, and commitment to ongoing education.

  5. TESIS DOCTORALES Doctoral dissertations

    Esteban Hernández Esteve

    2006-07-01

    Full Text Available TESIS DOCTORALES Doctoral dissertations María Soledad Campos Lucena: El control de las arcas municipales a través de la rendición de cuentas. La transformación del proceso del Antiguo al Nuevo régimen y la consolidación del modelo liberal: 1745-1914 The control of municipal coffers by means of account rendering. The change from Ancien Régime to the New Regime and the consolidation of liberalism: 1745-1914 Candelaria Castro Pérez: La institución parroquial a través de los registros contables del Señorío episcopal de la Villa de Agüimes. (1500-1860 The parochial institution seen through the account books of the Episcopal domain of the city of Aguimes (1500-1860 José Julián Hernández Borreguero: El Cabildo Catedral de Sevilla: organización y sistema contable. (1625-1650 Administrative and accounting organization of the Seville Cathedral. (1625-1650 Juan Lanero Fernández: El esplendor de la teneduría de libros: la partida doble en los tratados contables ingleses de la dinastia Tudor (1543-1588 Bookkeeping splendor: double-entry in the English accounting treatises at the time of the Tudor dynasty (1543-1588 María Llompart Bibiloni: Un análisis histórico-contable de la Procuración del Real Patrimonio en el Reino de Mallorca, período 1310-1330 An accounting historical análisis of the Royal Exchequer of the Kingdom of Mallorca (1310-1330

  6. Doctors do cry.

    Pruthi, Sonal; Goel, Ashish

    2014-01-01

    Physicians have tried to understand whether crying for a patient is a raw emotion that demonstrates their lack of control over themselves and the situation, or whether it is a sign of humanity and concern for one's fellow beings. Studies on medical students and doctors'narrations of times when they have shed tears over a patient's suffering or death have established beyond doubt that medical students and physicians are not immune to their patients'suffering and may cry when overwhelmed by stress and emotions. Even though humanity is the cornerstone of medicine, depersonalisation has somehow crept into the physician-patient relationship and crying is considered incompatible with the image of a good physician, who is supposed to be strong, confident and fully in charge. Thus, crying has been equated to weakness and at times, incompetence. This could be attributed to the fact that our medical curriculum has ingrained in us the belief that emotion clouds rationality and prevents us from being objective while making decisions regarding a patient's clinical progress. Our curriculum fails to teach us how to handle emotional situations, witness the dying process, communicate bad news, interact with the bereaved during the period of grief immediately following death, and reduce the professional stress involved in working with newly bereaved persons. Our training focuses on cure, amelioration of disease and the restoration of good health, with little emphasis on death, which is an absolute reality. It is crucial that medical educators take note of these lacunae in the curriculum. Physicians and teachers must recognise and accept the emotions that medical students experience in these situations, and teach them to offer their patients a sound blend of rationality and compassion with an attitude of humility.

  7. Family Planning Attitude and Practice Amongst Male Doctors in ...

    % of these would not allow their adolescent children access to contraception. 75.6% of the respondents were against legalization of abortion as a back-up for contraceptive failure mainly on religious grounds and because it will increase ...

  8. Feasible utopias in doctoral education

    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...

  9. Penumbra: Doctoral support as drama

    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’....

  10. Surgical Navigation

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan

    2017-01-01

    Purpose: This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indicatio...

  11. Surgical Instrument

    Dankelman, J.; Horeman, T.

    2009-01-01

    The present invention relates to a surgical instrument for minimall-invasive surgery, comprising a handle, a shaft and an actuating part, characterised by a gastight cover surrounding the shaft, wherein the cover is provided with a coupler that has a feed- through opening with a loskable seal,

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

    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

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

    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 ...

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

    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...

  15. Healthy Doctors – Sick Medicine

    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

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

    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.

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

    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.

  18. A method of handing down surgical clipping technique for cerebral aneurysm

    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)

  19. Are doctors risk takers?

    Pikkel D

    2016-06-01

    Full Text Available Dvora Pikkel,1 Yael Sara Pikkel Igal,2 Adi Sharabi-Nov,3,4 Joseph Pikkel2,51Risk Management and Patient Safety Unit, Assuta Medical Center, Ramat Hahayal, Tel Aviv, 2Faculty of Medicine, Bar-Ilan University, 3Research Wing, Ziv Medical Center, Safed, 4Tel-Hai Academic College, Upper Galilee, 5Department of Ophthalmology, Ziv Medical Center, Safed, Israel Objective: Risk taking affects human behavior in general and decisions in medicine in particular. We used game theory to assess physicians' risk-taking tendencies. Methods: Physicians were recruited to the study by advertisement. It was explained that they would receive a sum of money for correct prediction of the flipping of a coin. They could try to sell their opportunity to flip the coin for an amount of money they determined. The sum offered by the participants was considered an indicator of risk taking. A demographic questionnaire assessed age, sex, seniority, and area of specialization of the participants. A multivariate analysis assessed associations between risk-taking behavior and, seniority, and specialization. Results: Sixty-two physicians participated, 36 males and 26 females, seniority 1–34 years. Of a possible range of 0–10, the mean score for risk taking was 5.5 – just slightly more than indifference. Negative correlations were found between risk taking and seniority, and between risk taking and age (β=–0.45, P<0.001 for both. Surgeons and anesthesiologists showed greater risk taking than did other physicians (β=0.69, P<0.05; and females less than males, though the latter correlation was not statistically significant. Conclusion: Understanding the tendency of physicians to risk taking may elucidate their decision-making processes and contribute to understanding of causes of adverse events and to the education of physicians. Keywords: risk taking, game theory, seniority, surgeons, anesthesiologists

  20. [Gender patterns in Spanish otolaryngologic doctoral theses].

    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.

  1. Work of female rural doctors.

    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

  2. URGENT NEED OF A DOCTOR

    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...

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

    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

  4. [Life conditions of Togolese doctors].

    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

  5. Mrs Hitler and her doctor.

    Macleod, Sandy

    2005-12-01

    The doctor who attended the mother of Adolf Hitler in her terminal illness has been blamed as a cause of the Holocaust. The medical details recorded of this professional relationship are presented and discussed. Dr Bloch's medical care of Mrs Hitler was consistent with the prevailing medical practice of the management of fungating breast carcinoma. Indeed, the general practitioner's care and attention of the family appear to have been astute and supportive. There is nothing to suggest that Dr Bloch's medical care was other than competent. Doctors who have the (mis)fortune to professionally attend major figures of history may be unfairly viewed, despite their appropriate and adequate care.

  6. The Doctorate in Chemistry. Carnegie Essays on the Doctorate: Chemistry.

    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…

  7. Gender and power: Nurses and doctors in Canada

    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.

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

    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.

  9. The Role and Validity of Surgical Simulation

    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...

  10. Newborn jaundice - what to ask your doctor

    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 ...

  11. Epilepsy - what to ask your doctor - child

    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 ...

  12. Doctoral Program Selection Using Pairwise Comparisons.

    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)

  13. Cholesterol - what to ask your doctor

    ... 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 ...

  14. Angina - what to ask your doctor

    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 ...

  15. The Plight of the Woman Doctoral Student

    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)

  16. Concussion - what to ask your doctor - child

    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 ...

  17. Proceedings of Arcom Doctoral Workshop Research Methodology

    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 ...

  18. Hybrid Doctoral Program: Innovative Practices and Partnerships

    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…

  19. Dementia - what to ask your doctor

    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/ ...

  20. The Trouble with Doctoral Aspiration Now

    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…

  1. Headache - what to ask your doctor

    ... 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 ...

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

    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

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

    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.

  4. Another successful Doctoral Student Assembly

    Katarina Anthony

    2014-01-01

    On Wednesday 2 April, CERN hosted its third Doctoral Student Assembly in the Council Chamber.   CERN PhD students show off their posters in CERN's Main Building. Speaking to a packed house, Director-General Rolf Heuer gave the assembly's opening speech and introduced the poster session that followed. Seventeen CERN PhD students presented posters on their work, and were greeted by their CERN and University supervisors. It was a very successful event!

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

    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)

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

    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.

  7. Becoming a caregiver: attachment theory and poorly performing doctors.

    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.

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

    ... 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 ...

  9. Teaching doctors to treat doctors: medical student peer counselling.

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

    1980-01-01

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

  10. Aesthetic surgery of the male genitalia.

    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.

  11. Male Infertility

    ... hypothalamus, pituitary, thyroid and adrenal glands. Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes. Defects of tubules that transport sperm. Many ... syndrome — in which a male is born with two X chromosomes and one ...

  12. Surgical Vision: Google Glass and Surgery.

    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.

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

    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

  14. Hazardous alcohol use among doctors in a Tertiary Health Center

    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.

  15. Doctoral Programs Need Changes to Attract and Retain Underrepresented Groups

    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

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

    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.

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

    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.

  18. [Quality of surgical continuing education in Germany].

    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.

  19. Urgent need of a doctor

    2003-01-01

    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or: SOS MEDECINS (24H/24H) 022 748-49-50 Or: ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: • HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 URGENCES PEDIATRIQUES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGIQUE 22 Alcide Jentzer 022 382-84-00 • HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTES Meyrin 022 719-66-80 EMERGENCIES: AMBULANCES (GENEVE AND VAUD) 144 FIRE BRIGADE CERN 022 767-44-44 FIRE BRIGADE 118 POLICE 117 CENTRE ANTI-POISON (24H/24H): 01-251-51-51 EUROPEAN EMERGENCY CALL: 112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: • HOPITAL DE ST. JULIEN rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES rue Amédée VIII de Savoie 04-50-49-65-83 MATERNITY r...

  20. Urgent Need of a Doctor

    2004-01-01

    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or: SOS MEDECINS (24H/24H) 022 748-49-50 Or: ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: • HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 PAEDIATRIC EMERGENCIES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGY 22 Alcide Jentzer 022 382-84-00 • HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTS Meyrin 022 719-66-80 EMERGENCIES: AMBULANCE (GENEVE AND VAUD) 144 FIRE BRIGADE 118 FIRE BRIGADE CERN 022 767-44-44 POLICE 117 ANTI POISON CENTRE (24H/24H) 01-251-51-51 EUROPEAN EMERGENCY CALL  112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: • HOPITAL DE ST. JULIEN Rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES Rue Amédée VIII de Savoie 04.50-49-65-83 MATERNITY Rue Am&...

  1. Urgent Need of a Doctor

    2004-01-01

    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or: SOS MEDECINS (24H/24H) 022 748-49-50 Or: ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: • HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 PAEDIATRIC EMERGENCIES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGY 22 Alcide Jentzer 022 382-84-00 • HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTS Meyrin 022 719-66-80 EMERGENCIES: AMBULANCE (GENEVE AND VAUD) 144 FIRE BRIGADE 118 FIRE BRIGADE CERN 022 767-44-44 POLICE 117 ANTI POISON CENTRE (24H/24H) 01-251-51-51 EUROPEAN EMERGENCY CALL  112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: • HOPITAL DE ST. JULIEN Rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES Rue Amédée VIII de Savoie 04.50-49-65-83 MATERNITY Rue Am...

  2. Urgent need of a doctor

    2003-01-01

    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or : SOS MEDECINS (24H/24H) 022 748-49-50 Or : ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 EMERGENCIES PEDIATRIQUES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGIQUE 22 Alcide Jentzer 022 382-84-00 HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTS Meyrin 022 719-66-80 EMERGENCIES: AMBULANCES (GENEVE ET VAUD) 144 FIRE BRIGADE CERN 022 767-44-44 FIRE BRIGADE 118 POLICE 117 CENTRE ANTI-POISON 24H/24H: 01-251-51-51 EUROPEAN EMERGENCY CALL : 112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: HOPITAL DE ST. JULIEN rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES rue Amédée VIII de Savoie 04-50-49-65-83 MATERNITY rue Amédée VIII de Savoie 04-50-49-66-07 HOPITAL D'ANNEMASSE 1...

  3. URGENT NEED OF A DOCTOR

    2003-01-01

    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or: SOS MEDECINS (24H/24H) 022 748-49-50 Or: ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 EMERGENCIES PEDIATRIQUES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGIQUE 22 Alcide Jentzer 022 382-84-00 HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTES Meyrin 022 719-66-80 EMERGENCIES: AMBULANCES (GENEVE ET VAUD) 144 FIRE BRIGADE CERN 022 767-44-44 FIRE BRIGADE 118 POLICE 117 CENTRE ANTI-POISON: 24H/24H 01-251-51-51 EUROPEAN EMERGENCY CALL: 112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: HOPITAL DE ST. JULIEN rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES rue Amédée VIII de Savoie 04-50-49-65-83 MATERNITY rue Amédée VIII de Savoie 04-50-49-66-07 HOPITAL D'ANNEMASSE 17 r...

  4. URGENT NEED OF A DOCTOR

    2003-01-01

    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or : SOS MEDECINS (24H/24H) 022 748-49-50 Or : ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 EMERGENCIES PEDIATRIQUES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGIQUE 22 Alcide Jentzer 022 382-84-00 HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTES Meyrin 022 719-66-80 EMERGENCIES: AMBULANCES (GENEVE ET VAUD) 144 FIRE BRIGADE CERN 022 767-44-44 FIRE BRIGADE 118 POLICE 117 CENTRE ANTI-POISON: 24H/24H 01-251-51-51 EUROPEAN EMERGENCY CALL: 112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: HOPITAL DE ST. JULIEN rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES rue Amédée VIII de Savoie 04-50-49-65-83 MATERNITY rue Amédée VIII de Savoie 04-50-49-66-07 HOPITAL D'ANNEMASSE 17 rue du Jura, Ambilly 04-50-87-47-47 EMERGENCIES 17 rue...

  5. URGENT NEED OF A DOCTOR

    2002-01-01

    GENEVA PATIENT NOT FIT TO BE MOVED: Call your family doctor  Or SOS MEDECINS (24H/24H) Or ASSOC. MEDECINS DE GENEVE (7H-23H) 022 748-49-50 022 322-20-20 PATIENT CAN BE MOVED: HOPITAL CANTONAL 24 Micheli du Crest  022 372-33-11 / 022 382-33-11 URGENCES PEDIATRIQUES  30 Bd de la Cluse  022 382-45-55  MATERNITY 24 Micheli du Crest  022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGIQUE 22 Alcide Jentzer  022 382-84-00 HOPITAL DE LA TOUR  Meyrin  022 719-61-11 URGENCES ADULTES  Meyrin  022 719-66-80  URGENCES : AMBULANCE (GENEVE ET VAUD) : 144 FIRE BRIGADE CERN 767-44-44  FIRE BRIGADE 118 POLICE 117 CENTRE ANTI-POISON 24H/24H  01-251-51-510 APPEL D'URGENCE EUROPEEN 112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (ou­or 15) PATIENT CAN BE MOVED: HOPITAL DE ST. JULIEN  Rue Amédée VIII de Savoie&a...

  6. Doctor's dilemma (medical decision making)

    Ganatra, R.D.

    2003-01-01

    Disagreement between experts is presumed to be uncommon in medical diagnosis. Radiology is considered to be a particularly objective means of diagnosis and expert radiographic interpretation is expected to be infallible. Five military radiologists were made to review independently chest radiographs of 1256 patients recorded in four image formats and interpret each as positive or negative for tuberculosis. The results were unexpected. Ability to detect tuberculosis varied little between various image formats but the extent of disagreement between doctors was remarkable. The number of cases judged positive varied from 56 to 100 among the five readers. Of cases judged positive at least once, the mean rate of disagreement between pairs of readers was 19%. The validity of these findings have been confirmed repeatedly in several subsequent trials. Other diagnostic modalities show equally surprising rates of diagnostic dissonance. Extensive observer disagreement was found to be a universal problem in medical diagnosis, giving credence to the proverbial adage that 'no two doctors agree'. The magnitude of disagreement between experts is the principal theoretic problem of diagnosis. Even a stochastic theory of diagnosis is devised which accounts for the disagreement between experts, where the disagreement approaches a theoretic maximum even for ideal diagnosticians

  7. Doctor shopping: a concept analysis.

    Worley, Julie; Hall, Joanne M

    2012-01-01

    Prescription drug abuse is a significant problem in the United States that poses a serious health risk to Americans and is therefore significant to the field of nursing. The prescription drugs that are designated in the United States as having abuse potential are called controlled or scheduled drugs. The most common types of abused prescription drugs are benzodiazepines prescribed for anxiety, opioids prescribed for pain, and stimulants prescribed for attention deficit disorder. These prescription drugs are abused by taking larger doses than prescribed for nonmedical use to achieve a high or euphoric feeling, or are sold illicitly for profit. In 2009, there were 2.4 million nonmedical users of prescription opioids in the United States. These prescription drugs are often obtained by seeing multiple prescribers, often under false pretenses or with complicity from the prescribers that leads to abuse and illicit sales. The term doctor shopping has been used not only to refer to this phenomenon but has also had other meanings throughout the past decades. Thus, concept analysis is the focus of this article for clarification using the Walker and Avant method. Health implications and suggestions for minimizing doctor shopping are included.

  8. Male Hypogonadism

    ... the hormone that plays a key role in masculine growth and development during puberty — or has an ... Adulthood In adult males, hypogonadism may alter certain masculine physical characteristics and impair normal reproductive function. Signs ...

  9. Male Infertility

    ... to have a baby? If treatment doesn’t work, what are our other options? Resources National Institute of Child Health and Human Development, What Causes Male Infertility? Last Updated: May 30, 2017 This ...

  10. Male contraception.

    Amory, John K

    2016-11-01

    Although female contraceptives are very effective at preventing unintended pregnancy, some women can not use them because of health conditions or side-effects, leaving some couples without effective contraceptive options. In addition, many men wish to take active responsibility for family planning. Thus, there is a great need for male contraceptives to prevent unintended pregnancies, of which 80-90 million occur annually. At present, effective male contraceptive options are condoms and vasectomy, which are not ideal for all men. Therefore, efforts are under way to develop novel male contraceptives. This paper briefly reviews the advantages and disadvantages of condoms and vasectomies and then discusses the research directed toward development of novel methods of male contraception. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Condoms - male

    Prophylactics; Rubbers; Male condoms; Contraceptive - condom; Contraception - condom; Barrier method - condom ... your health care provider or pharmacy about emergency contraception ("morning-after pills"). PROBLEMS WITH CONDOM USE Some ...

  12. Doctoral education in a successful ecological niche

    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...

  13. Women who doctor shop for prescription drugs.

    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.

  14. Male contraception

    Mathew, Vivek; Bantwal, Ganapathi

    2012-01-01

    Contraception is an accepted route for the control of population explosion in the world. Traditionally hormonal contraceptive methods have focused on women. Male contraception by means of hormonal and non hormonal methods is an attractive alternative. Hormonal methods of contraception using testosterone have shown good results. Non hormonal reversible methods of male contraception like reversible inhibition of sperm under guidanceare very promising. In this article we have reviewed the curren...

  15. Trends in the Surgical Correction of Gynecomastia

    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...

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

    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.

  17. The Cape doctor 1807-1910: perspectives.

    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.

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

    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.

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

    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

  20. Doctoral education in the nuclear sector

    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)

  1. Psychiatric Prescribers' Experiences With Doctor Shoppers.

    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.

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

    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.

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

    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.

  4. Micro-surgical endodontics.

    Eliyas, S; Vere, J; Ali, Z; Harris, I

    2014-02-01

    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

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

    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.

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

    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

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

    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...

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

    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.

  9. When doctors cross the line.

    Feldman, M K

    1994-05-01

    Everybody's doing it. Lawyers. Professors. Yes, even doctors. Professionals in positions of authority and trust are taking a closer look at how they relate to their clients, students, or patients. Perhaps it all started with Anita Hill, the woman who sounded the wake-up call that was heard around America with the message that sexual harassment, even sexual innuendo, will no longer be tolerated. It's a new day and age. Today, for ethical as well as practical reasons, some bar associations (including Minnesota's) are warning lawyers not to have sex with clients, and many colleges are forbidding professors from getting involved with students. The American Medical Association and state medical boards are also re-evaluating the rules, because in today's climate even something as simple as a pat on the knee can get a physician in trouble.

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

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

    2015-06-01

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

  11. Doctoral research on cadastral development

    Cagdas, Volkan; Stubkjær, Erik

    2009-01-01

    of the countries concerned. The cadastre, however, is the core of both systems as it provides for systematic and official descriptions of land parcels or real property units. The research mentioned often has a development perspective, and in this article we will motivate the introduction of the research domain...... of cadastral development. This research is multi-disciplinary and draws on elements of theories and methodologies from the natural, the social, the behavioral, and the formal sciences. During the last decade or so, doctoral dissertations have come to constitute a substantial part of this research effort...... with a call for a shared terminology and a shared set of concepts which may contribute to further theory building within the cadastral domain. Udgivelsesdato: OCT...

  12. Male baldness.

    Clarke, Philip

    2016-04-01

    Male baldness is very common. Its effect on individuals is extremely variable, and in some people it will have a significant adverse effect on their quality of life. The objectives of this article are to help general practitioners (GPs) be aware of potential health problems related to male baldness, to have an approach to assessing hair loss and to be aware of treatment options. Male baldness is, most often, a normal occurrence, but it may have significant effects on a man's health. It may also be a pointer to other potential health issues. The GP is in the ideal position to conduct an initial evaluation, consider other health issues and advise on treatment options.

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

    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.

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

    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…

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

    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…

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

    Felder, Pamela

    2010-01-01

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

  17. Doctoral Education in Nursing: Future Directions

    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)

  18. Richard W. Ziolkowski Receives Honorary Doctorate

    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...

  19. IDRC Doctoral Research Awards 2018 | IDRC - International ...

    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.

  20. Talking to Your Doctor (For Teens)

    ... 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 ...

  1. Doctor of Professional Counseling: The Next Step

    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…

  2. Cultural and musical activity among Norwegian doctors.

    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.

  3. Diarrhea - what to ask your doctor - child

    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 ...

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

    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.

  5. THE KNOWLEDGE OF HEALTH CARE WORKERS AND DOCTORS REGARDING HAND SCRUB

    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.

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

    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

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

    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.

  8. Burnout and Doctors: Prevalence, Prevention and Intervention

    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

  9. Burnout and Doctors: Prevalence, Prevention and Intervention

    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.

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

    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 ...

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

    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…

  12. Surgical treatment of gynecomastia: complications and outcomes.

    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.

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

    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.

  14. American Pediatric Surgical Association

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  15. Abortion - surgical - aftercare

    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  16. Urogynecologic Surgical Mesh Implants

    ... procedures performed to treat pelvic floor disorders with surgical mesh: Transvaginal mesh to treat POP Transabdominal mesh to treat ... address safety risks Final Order for Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair Final Order for Effective ...

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

    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.

  18. Professionalism for future humanistic doctors

    SEDIGHEH EBRAHIMI

    2013-07-01

    Full Text Available Dear editor Clinical environments encounter is an important part of studying medicine (1. Patient contact as an integral part of medical education occurs in various formats in the clinical settings (2, 3. During clinical training, medical students may experience high levels of stress, and some may not deal with it well. The abruptness of students’ transition to the clinical setting generated positive and negative emotions. Due to being a novice, they did not receive adequate training on how to get emotionally prepared for meeting seriously ill people. In such circumstances, the shortage of training will have predictably crucial consequences. Early clinical contact has been suggested to reduce these stresses and help the students adapt effectively to changes in the hospital climate (2. Patient contact creates an environment where each student appreciates cultural diversity and reinforces the development of clinical professional interpersonal skills through social, emotional and cognitive experiences (4, 5. It encourages validating of the relationship between patients and doctors and allows students to experience a more personal relationship with patients and nurture the ability to empathize with them, providing considerable benefits for trainees and patients. In this way, the social emotions that students experience when empathizing with a patient represent a uniquely human achievement. By internalizing their subjective interpretations of patient’s beliefs and feelings, the student’s body, brain and mind come together to produce cognition and emotion . They construct culturally relevant knowledge and make decisions about how to act and think about the patient’s problems as if they were their own. On the other hand, patient interaction in undergraduate education offers students a valuable early insight into the day-to-day role of a doctor and the patients’ perspective on specific conditions. Early experience provides a greater knowledge

  19. Doctor's dilemma: Medical decision making

    Ganatra, R.D.

    1992-01-01

    How a doctor arrives at a decision is of interest to both the developed and the developing countries. The developed and the developing want to walk on the same road but from different directions: one wants to develop a little more and the other wants to develop a little less for cost containment. To justify nuclear medicine in a developing country we have to see nuclear medicine in a new role. It is not for putting the diagnostic labels, not for differential diagnosis as we have been conditioned to think so far. In a developing country it should be for differential management, How does it alter the management decision in respect to a particular patient? If management outcomes are restricted, there is no need for an investigation which does not help in any way the management of the patient. If there is no bypass surgery, what use is the thallium perfusion? Although primarily a diagnostic discipline for its justification and survival in the developing country it should lead to a sensible differential management

  20. Best practices in doctoral retention: Mentoring

    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

  1. Open notes: doctors and patients signing on.

    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.

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

    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.

  3. Distribution pattern of surgically treated symptomatic prolapsed ...

    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 ...

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

    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.

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

    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 = ...

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

    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.

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

    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.

  8. HOMENAJE AL DOCTOR JORGE CAVELIER

    Guillermo Rueda Montaña

    1979-06-01

    Full Text Available

    (Palabras del doctor Guillermo Rueda Montaña, durante el entierro del doctor Jorge Cavelier, el 25 de junio de 1978.

    Señores:

    Cuentan viejos relatos indígenas, de la "Tierra de los árboles inmensos", que en los grandes bosques se produce un silencio total de muchas horas, cuando cae uno de esos titanes. Varias veces centenario. Como si la tierra y todas sus criaturas recibieran el impacto y el profundo dolor de la caída de un ser aparentemente inmortal. Así nosotros, absortos y asombrados, presenciamos el derrumbe de este otro gigante que proyectó su sombra sobre el Territorio Nacional, y se constituyó por sus ejecutorias, en figura casi mística en la Medicina Colombiana.

    Pues fue JORGE CAVELIER el hombre - acción. Si hubiera vivido en el Egipto clásico, habría construído una pirámide, si en los tiempos medioevales, habría emprendido una cruzada o levantado una Catedral.
    Tenía una visión muy clara y era capaz de traducirla a fuerza de mandobles si fuere necesario, en una obra de interés común.
    La hercúlea conformación de su raza, mezcla de celtas y vikingos, creadora de marinos, de hombres de acción, de grandes capitanes, lo impulsaba a la ejecución.
    Cuando se fijaba una meta, siempre orientada hacia el progreso de la comunidad, se lanzaba en procura sin que ningún obstáculo pudiera detener el impulso emocional de su voluntad ejecutiva. Así también, con esa misma garra, se enfrentó a la muerte, a rompe y rasga, sin cuartel, sin concesiones, porque quería vivir, para continuar haciendo.

    Esos ojos profundamente azules, que en tantas ocasiones reflejaron la ira, cuando algo o alguien se interponía en el camino de su férrea voluntad, eran también capaces de brillar emocionados cuando se tocaba sus más íntimas fibras de aguda sensibilidad social y
    completa solidaridad humana.
    Fué intemperante y fue soberbio, pero fue grande en sus prop

  9. A survey of pharmaceutical company representative interactions with doctors in Libya

    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.

  10. Minimally invasive surgical approach to treat posterior urethral diverticulum

    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.

  11. Cultural initiation of medical doctors.

    Zsinkó-Szabó, Zoltán; Lázár, Imre

    2013-12-01

    Eighteen years experience of teaching medical anthropology at a Hungarian medical school offers insight into the dynamics of interference between the rationalist epistemological tradition of biomedicine as one of the central paradigms of modernism and the cultural relativism of medical anthropology, as cultural anthropology is considered to be one of the generators of postmodern thinking. Tracing back the informal "prehistory" of our Institute, we can reveal its psychosomatic, humanistic commitment and critical basis as having represented a kind of counterculture compared with the technocrats of state-socialist Hungary's health ideology. The historical change and socio-cultural transition in Hungary after 1989 was accompanied by changes in the medical system as well as in philosophy and in the structure of the teaching of social sciences. The developing pluralism in the medical system together with the pluralism of social ideologies allowed the substitution of the dogmatic Marxist-Leninist framework with the more pragmatic and empiricist behavioral sciences including medical sociology and medical anthropology. The conflict between the initiation function of the hard preclinical training of the first two years, and the reflective, relativistic and critical narrative on "biomedicine as culture bound entity" constructed by medical anthropology during the second year of medical training is discussed. We also submit our fieldwork data gained as a result of a two year investigation period focusing on diverse initiation types of "would be" physicians. The main proportion of our data derives from individual semi structured deep interviews together with focus group interviews carried out with medical students of upper years. Finally, the role of medical anthropology in the "rite of passage" of becoming a medical doctor is summarized, paying attention to their field work reports and the risks and gains in this process.

  12. Reasons for doctor migration from South Africa

    Push factors motivating migration most frequently include dissatisfaction with ... The year of graduation ranged from 1964 to 2000 (median 1985), and the year of leaving ... South African doctors working in Canada had increased by more than.

  13. Reasons for doctor migration from South Africa

    Zealand, United Arab Emirates, Bahrain, United Kingdom, Canada, Yemen and Australia. ..... media. Of the 13.8% of the doctors with children who were either studying ... become a significant social and economic burden to the country.

  14. Heart Failure Questions to Ask Your Doctor

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Heart Failure Questions to Ask Your Doctor Updated:May 9, ... you? This content was last reviewed May 2017. Heart Failure • Home • About Heart Failure • Causes and Risks for ...

  15. Doctors with dyslexia: strategies and support.

    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.

  16. First district sanitary doctor of Katerynoslav

    M.P. Chaban; Z.I. Shevtsova; V.V. Gaponov

    2017-01-01

    The life and professional activity of Vasyl Tymofiiovych Skrylnikov — a famous doctor-hygienist, scientist, and public figure have been represented. V.T. Skrylnikov contributed to the development of sanitary-prophylaxis direction in zemstvo medicine in Katerynoslav province in the second half of the 19th century; he was the first district sanitary doctor in Katerynoslav. The scientist actively studied medical features of natural agents, namely Tymofiivska clay. He successfully worked at Slovi...

  17. Doctor and pharmacy shopping for controlled substances.

    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.

  18. Pregnancy and childbirth: is the doctor necessary?

    Llewellyn-Jones, D

    1979-05-01

    The changing fashions in childbirth over the past 200 years are related to the present demand by women and their partners for "participatory" childbirth, including homebirth. The argument is advanced that doctors must be responsive to these changes. The opinion is made that home birth is currently inappropriate, but that hospitals should provide "birth centres"; and that obstetrics should be conducted by a "team", in which nurse-midwives and family doctors play as important a role as specialist obstetricians.

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

    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...

  20. Rhabdomyolysis in Critically Ill Surgical Patients.

    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.

  1. Uncommon surgical emergencies in neonatology

    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.

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

    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.

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

    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)

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

    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 .

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

    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.

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

    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.

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

    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.

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

    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

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

    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

  10. Surgical management of spasmodic torticollis

    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

  11. Patient perception of smartphone usage by doctors

    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

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

    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.

  13. Imaging of male urethra

    Pavlica, Pietro; Barozzi, Libero; Menchi, Ilario

    2003-01-01

    The male urethral imaging and pathology is not widespread in the radiology literature because this part of the urinary tract is easily studied by urologists with clinical or endoscopic examinations. Ultrasonography and MR imaging are increasingly being used in association with voiding cystourethrography and retrograde urethrography. The posterior urethra is being studied with voiding cystourethrography or voiding sonography which allows the detection of bladder neck pathology, post-surgical stenosis, and neoplasms. The functional aspects of the bladder neck and posterior urethra can be monitored continuously in patients with neuromuscular dysfunction of the bladder. The anterior urethral anatomy and pathology is commonly explored by retrograde urethrography, but recently sonourethrography and MR imaging have been proposed, distending the lumen with simple saline solution instead of iodinated contrast media. They are being used to study the urethral mucosa and the periurethral spongy tissue which can be involved in the urethral pathologies such as strictures, diverticula, trauma, and tumors. Imaging has an important role to play in the study of the diseases of the male urethra since it can detect pathology not visible on urethroscopy. The new imaging techniques in this area, such as sonography and MR, can provide adjunct information that cannot be obtained with other modalities. (orig.)

  14. Imaging of male urethra

    Pavlica, Pietro [Department of Diagnostic Radiology, Hospital M. Malpighi, Via Palagi 9, 40138 Bologna (Italy); Barozzi, Libero [Department of Emergency Radiology, Hospital S. Orsola-Malpighi, 40138 Bologna (Italy); Menchi, Ilario [Department of Diagnostic Radiology, Hospital S. Maria Nuova, 55100 Florence (Italy)

    2003-07-01

    The male urethral imaging and pathology is not widespread in the radiology literature because this part of the urinary tract is easily studied by urologists with clinical or endoscopic examinations. Ultrasonography and MR imaging are increasingly being used in association with voiding cystourethrography and retrograde urethrography. The posterior urethra is being studied with voiding cystourethrography or voiding sonography which allows the detection of bladder neck pathology, post-surgical stenosis, and neoplasms. The functional aspects of the bladder neck and posterior urethra can be monitored continuously in patients with neuromuscular dysfunction of the bladder. The anterior urethral anatomy and pathology is commonly explored by retrograde urethrography, but recently sonourethrography and MR imaging have been proposed, distending the lumen with simple saline solution instead of iodinated contrast media. They are being used to study the urethral mucosa and the periurethral spongy tissue which can be involved in the urethral pathologies such as strictures, diverticula, trauma, and tumors. Imaging has an important role to play in the study of the diseases of the male urethra since it can detect pathology not visible on urethroscopy. The new imaging techniques in this area, such as sonography and MR, can provide adjunct information that cannot be obtained with other modalities. (orig.)

  15. Critical and Creative Thinking Nexus: Learning Experiences of Doctoral Students

    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…

  16. The pregnant female surgical resident

    Shifflette V

    2018-05-01

    Full Text Available Vanessa Shifflette,1 Susannah Hambright,2 Joseph Darryl Amos,1 Ernest Dunn,3 Maria Allo4 1Associates in Surgical Acute Care, Methodist Dallas Medical Center, Dallas, TX, USA; 2Methodist Surgical Associates, Methodist Dallas Medical Center, Dallas, TX, USA; 3Graduate Medical Education - General Surgery, Methodist Dallas Medical Center, Dallas, TX, USA; 4Santa Clara Valley Medical Center, San Jose, CA, USA Background: Surgery continues to be an intense, time-consuming residency. Many medical students decide against surgery as a profession due to the long work hours and family strain. The pregnant female surgical resident has an added stress factor compared to her male counterpart. Methods: We distributed an electronic, online 26-question survey to 32 general surgery programs in the southwestern region of the United States. Each program distributed our survey to the female surgical residents who had been pregnant during residency in the last 5 years. Each program was re-contacted 6 weeks after the initial contact. Most questions were in a 5-point Likert scale format. The responses were collected and analyzed using the Survey Monkey website. Results: An unvalidated survey was sent to 32 general surgery programs and 26 programs responded (81%. Each program was asked for the total number of possible responses from female residents that met our criteria (60 female residents. Seven of the programs (27% stated that they have had zero residents pregnant. We had 22 residents respond (37%. Over half of the residents (55% were pregnant during their 2nd or 3rd year of residency, with only 18% pregnant during a research year. Thirty-one percent had a lower American Board of Surgery In-Training Exam (ABSITE score. Ninety percent of the residents were able to take 4 weeks or more for maternity leave. Most of the residents (95% stated that they would do this again during residency given the opportunity, but many of the residents felt that returning back to work

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

    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.

  18. Attracting and retaining doctors in rural Nepal.

    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.

  19. The Criminal Justice Doctorate: A Study of Doctoral Programs in the 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…

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

    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…

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

    Gopaul, Bryan

    2011-01-01

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

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

    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

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

    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)

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

    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…

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

    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.

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

    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…

  7. Barriers facing junior doctors in rural practice.

    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

  8. IN URGENT NEED OF A DOCTOR

    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 ...

  9. Stress in doctors and dentists who teach.

    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.

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

    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.

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

    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.

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

    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.

  13. [Generation Y in ENT: leading a young generation of doctors].

    Schmidt, K; Meyer, J; Liebeneiner, J; Schmidt, C E; Hüttenbrink, K B

    2012-11-01

    The shortage of qualified doctors and nurses has led to a competition between hospitals. Analyzing the circumstances of the competition, nurses and doctors of so-called generation Y are important. These employees are mainly female and have different requirements compared to previous generations. Therefore, knowledge of these requirements will become a critical success factor for hospitals in the future. We interviewed medical students in Kiel and Hannover from 2005 to 2011 about the clinical department chosen, the criteria for choosing a specific clinic, and the importance of MD and PhD programs. In addition, we conducted an internet and Medline search for scientific studies on labor shortage, generation Y, and demographics. The data were sorted by main categories and relevance for hospitals. Statistical analyses were performed using descriptive measures. We received 1,097 answers which represents approx. 75% of all students. Sixty-seven percent of the students were female, 33% male. Preferences for departments revealed internal medicine, pediatrics, and anesthesiology as the top three. ENT followed at rank 10. The main criteria for choosing a clinic were working climate, structure and broadness of education, family friendliness, and respect. MD programs were rated 2.6, while PhD programs were rated 3.6. Staff members of Generation Y "live while working" and disagree with hierarchies. Internet and computers are part of their daily routine. Employees of Generation Y challenge leadership in hospitals by increasing demands. However, Generation Y can increase professionalization and competitiveness for hospitals significantly.

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

    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.

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

    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.

  16. Physical (Surgical) Castration as Treatment of Male Sex Offenders?

    Škvain, Petr

    2014-01-01

    Roč. 97, č. 1 (2014), s. 40-47 ISSN 0026-9301 Institutional support: RVO:68378122 Keywords : sex offenders * treatment of sex offenders * Czech Republic Subject RIV: AG - Legal Sciences Impact factor: 0.136, year: 2014

  17. Deriving DICOM surgical extensions from surgical workflows

    Burgert, O.; Neumuth, T.; Gessat, M.; Jacobs, S.; Lemke, H. U.

    2007-03-01

    The generation, storage, transfer, and representation of image data in radiology are standardized by DICOM. To cover the needs of image guided surgery or computer assisted surgery in general one needs to handle patient information besides image data. A large number of objects must be defined in DICOM to address the needs of surgery. We propose an analysis process based on Surgical Workflows that helps to identify these objects together with use cases and requirements motivating for their specification. As the first result we confirmed the need for the specification of representation and transfer of geometric models. The analysis of Surgical Workflows has shown that geometric models are widely used to represent planned procedure steps, surgical tools, anatomical structures, or prosthesis in the context of surgical planning, image guided surgery, augmented reality, and simulation. By now, the models are stored and transferred in several file formats bare of contextual information. The standardization of data types including contextual information and specifications for handling of geometric models allows a broader usage of such models. This paper explains the specification process leading to Geometry Mesh Service Object Pair classes. This process can be a template for the definition of further DICOM classes.

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

    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.

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

    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.

  20. Recognizing surgical patterns

    Bouarfa, L.

    2012-01-01

    In the Netherlands, each year over 1700 patients die from preventable surgical errors. Numerous initiatives to improve surgical practice have had some impact, but problems persist. Despite the introduction of checklists and protocols, patient safety in surgery remains a continuing challenge. This is

  1. Surgical medical record

    Bulow, S.

    2008-01-01

    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

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

    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.

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

    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.

  4. What Questions Should I Ask My Doctor?

    ... and Care Surgical Treatment Laparoscopic Surgery Vaccine Radiation Therapy Chemotherapy Clinical Trials Pain Management Nutrition and Exercise Holistic Care Pathology Intraductal Papillary Mucinous Neoplasms Islet Cell ...

  5. Profesor Doctor Fernando Sonnet: In Memoriam

    Alberto José Figueras

    2016-07-01

    Full Text Available Recuerdo del Profesor Doctor Fernando Sonnet, destacado docente e investigador, en las áreas de economía agraria, economía de empresas y microeconomía, en el Instituto de Economía y Finanzas de la Facultad de Ciencias Económicas, Universidad Nacional de Córdoba.Palabras Clave: Fernando H. Sonnet; Recuerdo; Universidad Nacional de Córdoba.Código JEL: B32. Professor Doctor Fernando Sonnet: In MemoriamAbstractRemembrance of Professor Doctor Fernando Sonnet, a senior lecturer and researcher in the areas of agricultural economics, business economics and microeconomics at the Institute of Economics and Finance at the Faculty of Economics, Universidad Nacional de Córdoba.Keywords: Fernando H. Sonnet; Memory; Universidad Nacional de CórdobaJEL Classification: B32.

  6. Disorganized junior doctors fail the MRCP (UK).

    Stanley, Adrian G; Khan, Khalid M; Hussain, Walayat; Tweed, Michael

    2006-02-01

    Career progression during undergraduate and early postgraduate years is currently determined by successfully passing examinations. Both academic factors (secondary school examination results, learning style and training opportunities) and non-academic factors (maturity, ethnic origin, gender and motivation) have been identified as predicting examination outcome. Few studies have examined organization skills. Disorganized medical students are more likely to perform poorly in end-of-year examinations but this observation has not been examined in junior doctors. This study asked whether organization skills relate to examination outcome amongst junior doctors taking the clinical Part II examination for the Membership of the Royal College of Physicians (Practical Assessment of Clinical Examination Skills). The study was conducted prospectively at four consecutive clinical courses that provided clinical teaching and practice to prepare trainees for the examination. Arrival time at registration for the course was the chosen surrogate for organization skills. Trainees were advised that they should arrive promptly at 8.00 a.m. for registration and it was explained that the course would start at 8.30 a.m. Recorded arrival times were compared with the pass lists published by the Royal College of Physicians. The mean arrival time was 8.17 a.m. A total of 81 doctors (53.3%) passed the examination with a mean arrival time of 8.14 a.m. However, 71 doctors failed the exam and arrived, on average, six minutes later than doctors who passed (p?=?0.006). Better-prepared junior doctors were more likely to pass the final examination. Arriving on time represents a composite of several skills involved in the planning of appropriate travel arrangements and is therefore a valid marker of organization skills and preparation. This novel study has shown that good time-keeping skills are positively associated with examination outcome.

  7. Life Satisfaction and Frequency of Doctor Visits

    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

  8. Life satisfaction and frequency of doctor visits.

    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.

  9. Improving professional IT doctorate completion rates

    Oliver Kisalay Burmeister

    2015-08-01

    Full Text Available Professional doctorates in Information Technology (IT have been a relatively recent phenomenon, giving IT professionals career management choices not previously available to them. However, successful completion rates are the lowest of all disciplines. Completed doctorates rate in quality equivalent to PhDs, and retention has been identified as a major obstacle to completion. This qualitative study, involving 44 semi-structured interviews with students, supervisors and institutional support personnel, investigated the obstacles. Amongst the strategies discovered to improve completion rates were retention, student engagement with supervisors, feedback on progress, student engagement in the course, and student involvement in institutional communities of practice.

  10. First district sanitary doctor of Katerynoslav

    M.P. Chaban

    2017-02-01

    Full Text Available The life and professional activity of Vasyl Tymofiiovych Skrylnikov — a famous doctor-hygienist, scientist, and public figure have been represented. V.T. Skrylnikov contributed to the development of sanitary-prophylaxis direction in zemstvo medicine in Katerynoslav province in the second half of the 19th century; he was the first district sanitary doctor in Katerynoslav. The scientist actively studied medical features of natural agents, namely Tymofiivska clay. He successfully worked at Sloviansk resort, was the editor of a local newspaper. V.T. Skrylnikov is an author of many works on balneotherapy.

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

    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.

  12. PROSTATE CANCER SCREENING: PSA TEST AWARENESS AMONG ADULT MALES.

    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.

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

    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.

  14. [Male contraception and its perspectives].

    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

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

    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

  16. Surgical ethics: surgical virtue and more.

    Vercler, Christian J

    2015-01-01

    The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.

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

    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.

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

    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.

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

    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.

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

    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.

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

    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.

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

    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.

  3. NEW, GOOD DOCTORS FOR AN ALTERED SOCIETY*

    idea of being a doctor, and who is the central man, the species-type of a .... suspicious every time we get a cold in the head, but how greatly our .... It's hard not to fall for the .... ways, but the truth remains that health is single and in- divisible; that ...

  4. Hombres: Doctor Luis Ángel Arango

    Boletín Cultural y Bibliográfico Banco de la República

    1958-02-01

    Full Text Available En el documento se realiza la nota de conmemoración  del fallecimiento del Doctor Luis Ángel Arango  Esta nota tiene como fin realizar un homenaje a tan reputado ciudadano colombiano y mienbro de la comunidad de funcionarios del Banco de la República.

  5. Do Doctors differ from Medical Laboratory Scientists?

    Background: Doctors and laboratory scientists are at risk of infection from blood borne pathogens during routine clinical duties. After over 20 years of standard precautions, health care workers knowledge and compliance is not adequate. Aim: This study is aimed at comparing adherence and knowledge of standard ...

  6. IN URGENT NEED OF A DOCTOR

    Medical Service

    2002-01-01

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

  7. Appraisal of family doctors: an evaluation study.

    Lewis, M.I.; Elwyn, G.; Wood, F.

    2003-01-01

    BACKGROUND: Appraisal has evolved to become a key component of workforce management. However, it is not clear from existing proposals for appraisal of doctors whether employers, health authorities or primary care organisations should take responsibility for appraisal processes. AIMS: To evaluate the

  8. Student Socialization in Interdisciplinary Doctoral Education

    Boden, Daniel; Borrego, Maura; Newswander, Lynita K.

    2011-01-01

    Interdisciplinary approaches are often seen as necessary for attacking the most critical challenges facing the world today, and doctoral students and their training programs are recognized as central to increasing interdisciplinary research capacity. However, the traditional culture and organization of higher education are ill-equipped to…

  9. The Doctorate in the Nordic Countries.

    Kyvik, Svein; Tvede, Olaf

    1998-01-01

    Overview of research training systems leading to doctoral degrees in Denmark, Finland, Norway, and Sweden emphasizes the structure of postgraduate education, administration and funding, number of students, time to degree, completion rates, labor market, and study abroad. Comparisons to U.S., British, German, and French systems suggests a trend…

  10. How Six Sigma Methodology Improved Doctors' Performance

    Zafiropoulos, George

    2015-01-01

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

  11. Understanding Critical Thinking to Create Better Doctors

    Zayapragassarazan, Zayabalaradjane; Menon, Vikas; Kar, Sitanshu Sekhar; Batmanabane, Gitanjali

    2016-01-01

    Medical students master an enormous body of knowledge, but lack systematic problem solving ability and effective clinical decision making. High profile reports have called for reforms in medical education to create a better generation of doctors who can cope with the system based problems they would encounter in an interdisciplinary and…

  12. Leadership Preparation in an Education Doctorate Program

    Ryerson, Dean

    2011-01-01

    This was a study of an education doctorate program at a small, private college. It examined the following nine components: theory of leadership for school improvement; candidate recruitment and selection based on leadership; coherent curriculum; use of active learning strategies; knowledgeable faculty; high quality internships; social and…

  13. Academic programme satisfaction and doctorate aspiration among ...

    The number of doctorates in Nigerian universities is grossly below the bench mark. Among the obvious reasons for this unhealthy situation in the universities is about holders of the apex degree. They are in short supply. This study fundamentally examined mentoring experience as antecedent of academic programme ...

  14. Doctoral Students' Experience of Information Technology Research

    Bruce, Christine; Stoodley, Ian; Pham, Binh

    2009-01-01

    As part of their journey of learning to research, doctoral candidates need to become members of their research community. In part, this involves coming to be aware of their field in ways that are shared amongst longer-term members of the research community. One aspect of candidates' experience we need to understand, therefore, involves how they…

  15. The Carnegie Project on the Education Doctorate

    Perry, Jill Alexa

    2015-01-01

    Beginning with 21 US schools of education, the Carnegie Project on the Education Doctorate (CPED) has created a network of education faculty who are differentiating the EdD from the PhD in order to better meet the needs of their practitioner-scholar students. Their discussions center on two questions: "What are the knowledge, skills, and…

  16. NEW, GOOD DOCTORS FOR AN ALTERED SOCIETY*

    NEW, GOOD DOCTORS FOR AN ALTERED SOCIETY*. ANrHONY BARKER ... the concept of trying to become one is just a psychological throwback? ... called all these things and many things besides, yet this ... sex (women ought to be better at it than men, but often are not) .... foundations to lay for a specialized career.

  17. Framing doctoral supervision as formative assessment

    Kobayashi, Sofie

    Doctoral supervision has been described through a number of models useful for understanding different aspects of supervision. None of these are all-encompassing, but each emphasizes a particular perspective, like the relationship, personal vs. structural support, process vs. product orientation. ...

  18. Promoting Team Leadership Skills in Doctoral Candidates

    Suleiman, Mahmoud; Whetton, Danny

    2014-01-01

    Doctoral programs can serve as an optimal opportunity for candidates to engage in tasks and activities to transform them and their schools. The paradigm shifts in such preparation involve moving from sitting and getting to making and taking. Most importantly, it requires building leadership skills and styles necessary to bring about desired change…

  19. Examining the Doctoral Thesis: A Discussion

    Carter, Susan

    2008-01-01

    The examination of doctoral theses controls an important academic threshold, yet practices are often private, codes non-specific, and individuals isolated. This article adds to recent investigation of the examination culture by reporting informal panel discussion amongst a total of 23 University of Auckland (New Zealand) faculty members as to…

  20. Terminating the Doctor-Patient Relationship

    Kay, Jarald

    1978-01-01

    Emotional aspects of ending the physician-patient relationship should be illustrated in clinical teaching courses. Teaching opportunities include examination of this relationship and professional development, unresolved doctor-patient conflicts, role underevaluation, patient gifts, and referral procedures. (Author/LBH)

  1. 2011 African Doctoral Dissertation Research Fellowship

    smwero

    The African Population and Health Research Center (APHRC) in partnership with the International Development. Research Centre (IDRC) is pleased to announce the fourth call for applications for the African Doctoral Dissertation. Research Fellowships (ADDRF). The 2011 ADDRF seeks to facilitate more rigorous ...

  2. Training and experience of doctors administering obstetric ...

    Background All the published Saving Mothers Reports generated by the National Committee of the Confidential Enquiries into Maternal Deaths in South Africa have associated anaesthesia-related maternal deaths with the lack of skills of the doctors administering the anaesthesia. The Reports have shown the Free State to ...

  3. Male Midlife Depression: Multidimensional Contributing Factors and Renewed Practice Approaches

    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…

  4. The male breast: radiological abnormalities

    Maranhao, Norma; Costa, Isis; Nascimento, Raquel Cristine Gomes do

    1998-01-01

    Mammography of male breast account for less than 1% of mammographic examinations in most breast services. Due to the low incidence of breast cancer in men the significant majority of mammographic diagnosis reveals benign diseases, mostly gynecomastia. Therefore it is most important to identify features of benign conditions, such as gynecomastia, in order to reduce the number of unnecessary surgical biopsies performed in these patients, for the same reason suspicious lesions must be recognized as well. Indications for mammography in men include evaluation of palpable mass, recent onset of breast nipple-areolar skin changes or papillary discharge, and previous history of cancer. (author)

  5. Medical Doctors Perceptions of Genetically Modified Foods

    Hasan Savas

    2014-12-01

    Full Text Available Aim: Recombinant DNA and with similar technical changes made on genes or transferred isolated gene the living organisms have been named genetically modified organisms (GMOs. Thanks to advances in genetic technology, the advancement of enzyme and fermentation techniques result obtained by the use of GMOs in food industry products of genetically modified (GM foods are named. In this study, GM foods about the possible harmful effects have information and community advice on this matter to be medical doctors on this issue perceptions, knowledge, attitudes and behaviors aimed to measure.Material and Method: The study was made on including 200 medical doctors aged 23-65, 118 men (59%, 82 women (41%. In the statistical analysis based on the responses of medical doctors, against GM food risk perception, knowledge, attitudes and behaviors were assessed. Results: 80.5% of the participants’ think that GM foods are harmful. 22% of the participants were expressed that their knowledge are ‘’good’’ and ‘’very good’’ about GM food. While 38% of the participants use internet and 23.5% of the participants  use media, only 4.5% of the participants use medical schools as a source of sufficient information about GM foods. Discussion: While the risk perception of medical doctors about GM foods is high, the knowledge on this issue is observed low. Though the consumption and the prevelance of GM foods are increasing, medical doctors should have more information about this issue to enlighten and guide the community.

  6. North Korean refugee doctors' preliminary examination scores

    Sung Uk Chae

    2016-12-01

    Full Text Available Purpose Although there have been studies emphasizing the re-education of North Korean (NK doctors for post-unification of the Korean Peninsula, study on the content and scope of such re-education has yet to be conducted. Researchers intended to set the content and scope of re-education by a comparative analysis for the scores of the preliminary examination, which is comparable to the Korean Medical Licensing Examination (KMLE. Methods The scores of the first and second preliminary exams were analyzed by subject using the Wilcoxon signed rank test. The passing status of the group of NK doctors for KMLE in recent 3 years were investigated. The multiple-choice-question (MCQ items of which difficulty indexes of NK doctors were lower than those of South Korean (SK medical students by two times of the standard deviation of the scores of SK medical students were selected to investigate the relevant reasons. Results The average scores of nearly all subjects were improved in the second exam compared with the first exam. The passing rate of the group of NK doctors was 75%. The number of MCQ items of which difficulty indexes of NK doctors were lower than those of SK medical students was 51 (6.38%. NK doctors’ lack of understandings for Diagnostic Techniques and Procedures, Therapeutics, Prenatal Care, and Managed Care Programs was suggested as the possible reason. Conclusion The education of integrated courses focusing on Diagnostic Techniques and Procedures and Therapeutics, and apprenticeship-style training for clinical practice of core subjects are needed. Special lectures on the Preventive Medicine are likely to be required also.

  7. Surgical site infections

    Decrease the inflammatory response Vasodilatation leads to better perfusion and ... Must NOT be allowed to come in contact with brain, meninges, eyes or .... project (SCIP): Evolution of National Quality Measure. Surgical. Infection 2008 ...

  8. Surgical Critical Care Initiative

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  9. Ambulatory Surgical Measures - Facility

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  10. Surgical Management of Hemorrhoids

    Agbo, S. P.

    2011-01-01

    Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding. PMID:22413048

  11. Surgical site infections

    Surgical site infections (SSIs) are a worldwide problem that has ... deep tissue is found on clinical examination, re-opening, histopathological or radiological investigation ..... Esposito S, Immune system and SSI, Journal of Chemotherapy, 2001.

  12. Surgical management of pain

    If these therapies fail, and with a thorough multidisciplinary approach involving carefully ... Generally, surgical pain management is divided into neuro- modulative .... 9 suggested. It is important to be sure that the underlying instability or.

  13. [Simulation in surgical training].

    Nabavi, A; Schipper, J

    2017-01-01

    Patient safety during operations hinges on the surgeon's skills and abilities. However, surgical training has come under a variety of restrictions. To acquire dexterity with decreasingly "simple" cases, within the legislative time constraints and increasing expectations for surgical results is the future challenge. Are there alternatives to traditional master-apprentice learning? A literature review and analysis of the development, implementation, and evaluation of surgical simulation are presented. Simulation, using a variety of methods, most important physical and virtual (computer-generated) models, provides a safe environment to practice basic and advanced skills without endangering patients. These environments have specific strengths and weaknesses. Simulations can only serve to decrease the slope of learning curves, but cannot be a substitute for the real situation. Thus, they have to be an integral part of a comprehensive training curriculum. Our surgical societies have to take up that challenge to ensure the training of future generations.

  14. EHR adoption among doctors who treat the elderly.

    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.

  15. Stress and wellbeing of junior doctors in Australia: a comparison with American doctors and population norms

    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...

  16. Interventional Radiology of Male Varicocele: Current Status

    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.

  17. Interventional Radiology of Male Varicocele: Current Status

    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.

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

    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.

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

    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. .

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

    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

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

    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.

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

    McGowan, Yvonne

    2013-03-11

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

  3. Ear tube surgery - what to ask your doctor

    What to ask your doctor about ear tube surgery; Tympanostomy - what to ask your doctor; Myringotomy - what ... other treatments? What are the risks of the surgery? Is it safe to wait before getting ear ...

  4. When may doctors give nurses telephonic treatment instructions?

    When is it legal for doctors to give nurses telephonic treatment instructions? ... telemedicine? Telemedicine is defined as 'the practice of medicine, from a distance, ... [6] Therefore, if in such circumstances the doctors cannot reach the patients in ...

  5. Exercise: When to Check with Your Doctor First

    ... check with your doctor before you start to exercise. By Mayo Clinic Staff Regular exercise can help you control your weight, reduce your ... talk to your doctor before starting a new exercise routine. Although moderate physical activity such as brisk ...

  6. Lonely Days and Lonely Nights: Completing the Doctoral Dissertation.

    Germeroth, Darla

    1991-01-01

    Surveys holders of doctorates in speech communication to discover the greatest barriers to dissertation completion and the forms of emotional support perceived as most useful. Offers advice to help doctoral candidates succeed in completing a dissertation. (SR)

  7. Talking With Your Doctor: MedlinePlus Health Topic

    ... 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 ...

  8. High blood pressure - what to ask your doctor

    What to ask your doctor about high blood pressure; Hypertension - what to ask your doctor ... problems? What medicines am I taking to treat high blood pressure? Do they have any side effects? What should ...

  9. General FAQs regarding the IDRC Doctoral Research Awards 2018 ...

    This award covers field research expenses for advanced doctoral students who intend ... serious security challenges, IDRC may ask you to delay your field research, .... Women candidates applying to IDRC Doctoral Research Awards calls in ...

  10. Post surgical complications from students' large animal surgical ...

    A retrospective study of post surgical complications was conducted on records of students' Large Animal Surgical Laboratories in the Faculty of Veterinary Medicine (F.V.M.), Ahmadu Bello University (A.B.U), Zaria from 1989 to 1993. Three hundred and eleven surgical complications were recorded from five surgical ...

  11. Arab doctors, evolving society and corruption: a medical student's perspective.

    Alamri, Yassar

    2015-01-01

    Doctors, especially junior doctors, face immense pressure in their day-to-day work. As a result, the rates of depression and anxiety are particularly high in this demanding profession. The pressure, which is compounded by constantly being under societal scrutiny, can unfortunately drive the doctor to breaking point. However, we can help doctors deal with these pressures in a more meaningful way if we make them aware of their wider environment (within a social paradigm) and the implications of their actions.

  12. 'Covering doctors' standing in for unavailable colleagues: What is ...

    2018-01-19

    Jan 19, 2018 ... [1] In terms of contract, a doctor 'undertakes to treat a patient with the required skill and care, and a patient undertakes to pay their fees'.[1] Under the law of delict, once a doctor begins to provide care to a person or instructs other healthcare personnel on how to treat such a person, the doctor is regarded as ...

  13. The Professional Doctorate in Nursing: A Position Paper

    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)

  14. Focusing on Doctoral Students' Experiences of Engagement in Thesis Work

    Vekkaila, Jenna; Pyhältö, Kirsi; Lonka, Kirsti

    2013-01-01

    Little is known about what inspires students to be involved in their doctoral process and stay persistent when facing challenges. This study explored the nature of students' engagement in the doctoral work. Altogether, 21 behavioural sciences doctoral students from one top-level research community were interviewed. The interview data were…

  15. "Tough Love and Tears": Learning Doctoral Writing in the Sciences

    Aitchison, Claire; Catterall, Janice; Ross, Pauline; Burgin, Shelley

    2012-01-01

    Contemporary changes to the doctorate mean student researchers are likely to be expected to write differently, write more and more often, and yet, despite a growing interest in doctoral education, we still know relatively little about the teaching and learning practices of students and supervisors vis-a-vis doctoral writing. This paper draws from…

  16. Who are the job seekers? : Explaining unemployment among doctoral recipients

    Yerkes, M.; Van de Schoot, R.; Sonneveld, H.

    2012-01-01

    Despite increased attention for doctoral education in recent years, one particular phenomenon has received little attention—the unemployment of doctoral candidates following graduation. While the unemployment of doctoral recipients is relatively low in comparison to the general popula-tion, the

  17. Doctoral Dissertation Defences: Performing Ambiguity between Ceremony and Assessment

    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

  18. State Level Review of Doctoral Programs in Texas.

    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…

  19. The role of clinic visits: perceptions of doctors | Couper | South ...

    A range of important themes emerged from the interviews, relating to the intended function of the clinics and their resources, the operationalisation of doctors' visits, the varied roles that doctors play in clinics and the importance of teamwork and support. Doctors working full time in the clinics shared a more positive view.

  20. Gender variations in specialties among medical doctors working in ...

    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 ...

  1. Obstacles to Success--Doctoral Student Attrition in South Africa

    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…

  2. Looking Back at Doctoral Education in South Africa

    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…

  3. [Are advance directives useful for doctors and what for?].

    Fournier, Véronique; Berthiau, Denis; Kempf, Emmanuelle; d'Haussy, Julie

    2013-06-01

    In France, the law has introduced the possibility to write advance directives since 2005. In this paper, we will present the results of a study designed for checking how much people over 75 years are interested by this new tool. The inquiry consisted in deep qualitative interviews (around 45') to further understand what people included in the study have to say about advance directives, but also about the conditions of ageing and dying. The study sample was composed of 8 over 75 years subgroups, chosen for being illustrative of different health status and/or disabling status. Finally, a last subgroup was also included, called "referent", because composed of people, all members of the "Association pour le droit à mourir dans la dignité" (ADMD), and as such supposed to be pro-advance directives. Interviews content was analysed through qualitative analysis referent methods ("Analyse qualitative en sciences humaines et sociales", Paillé et Muschielli, "Grounded Theory", Glaser). POPULATION OF THE STUDY: One hundred and eighty-six patients were included (106 female, 80 male, mean age 82.7 ans), 167 in the general group and 19 in the "ADMD" group. Ninety percent in the general group said that they never heard about advance directives before the inquiry. After having been informed by us about what advance directives were for, 83% remained not interested they said, some because they felt they were not personally concerned, others expressed that the tool appears to them inefficient - "things never happen the way you planned it", not useful - "doctors will act as they will decide whatever will be written", or even more potentially dangerous - "writing advance directives might lead doctors not to be as much therapeutically aggressive as for other people". Only 28 persons in the general group (17%), together with the 19 of the ADMD group, said they were interested by advance directives. They all were quite similar according to their personal character: they were quite strong

  4. Surgical-orthodontic correction of a Class III dentofacial deformity.

    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.

  5. Surgical-orthodontic correction of a Class III dentofacial deformity

    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.

  6. LAZA K. LAZAREVIC, DOCTOR AND WRITER

    Rade R. Babić

    2006-04-01

    Full Text Available Laza K. Lazarevic was born on the 13th of May in 1851. He died on the 11th of January in 1891 in Belgrade. Laza K. Lazarevic was a Serb, jurist, warrior, doctor and writer. He studied medicine in Berlin and law in Belgrade. He took part in the Serbian-Turkish war and the Serbian-Bulgarian war. He published seventy-two professional and scientific papers on medicine. He gave some explanations on the appearance of pain in sciatica. He wrote nine short stories. He is an Associate Member of the Serbian Royal Academy. He spoke Russian, German and French. He was a personal doctor of King Milan.

  7. Medical humanities: a resident doctor's perspective.

    Pauranik, Anvita

    2012-01-01

    The barrage of competitive examinations, overwork, sleep deprivation, and the pressure of expectations all combine to destroy the dreams that resident doctors have when they start medical school. The empathy they had before entering this field fades away, and they eventually become insensitive to their patients. Medical humanities may be the means to halt this trend. Sensitising young minds, using the arts, literature, history and lessons on social issues, may bring about a paradigm shift in these doctors' outlook towards their patients. However, for the humanities to be integrated into medical education, the current curriculum must be modified and made more clinically and socially relevant. Further, the humanities cannot be taught in lecture halls; they need to be integrated into all aspects of medical school. For this, the medical school faculty should be sensitised to, and trained in, humanities education.

  8. The Spin Doctors of news sources

    Aldo Antonio Schmitz

    2013-06-01

    Full Text Available This paper examines in a historical context, with reference to concrete cases, the phenomenon of spin doctors. What is it? How does it act? What is its purpose? Where does it operate? And what are its consequences? These questions are raised in order to help identify the actions and strategies benefitting news sources, as well as the impact on journalism: the accommodation of journalists, the reduction or elimination of investigative journalism, the transference of the news to digital social networks, and the expansion of media sources. The article draws on a survey conducted with 163 news sources and journalists, on the premise that spin doctors are professional communicators, who are able to forge public opinion using processes, procedures, journalist’s co-optation, and knowledge of journalism and public relations, in order to be successful in the media, or directly with the target audience.

  9. THE SPIN DOCTORS OF NEWS SOURCES

    Aldo Antonio Schmitz

    2013-06-01

    Full Text Available This paper examines in a historical context, with reference to concrete cases, the phenomenon of spin doctors. What is it? How does it act? What is its purpose? Where does it operate? And what are its consequences? These questions are raised in order to help identify the actions and strategies benefitting news sources, as well as the impact on journalism: the accommodation of journalists, the reduction or elimination of investigative journalism, the transference of the news to digital social networks, and the expansion of media sources. The article draws on a survey conducted with 163 news sources and journalists, on the premise that spin doctors are professional communicators, who are able to forge public opinion using processes, procedures, journalist’s co-optation, and knowledge of journalism and public relations, in order to be successful in the media, or directly with the target audience.

  10. 3D Surgical Simulation

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2009-01-01

    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  11. [Surgical treatment of gynecomastia: an algorithm].

    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.

  12. Family doctors' involvement with families in Estonia

    Lember Margus

    2004-10-01

    Full Text Available Abstract Background Family doctors should care for individuals in the context of their family. Family has a powerful influence on health and illness and family interventions have been shown to improve health outcomes for a variety of health problems. The aim of the study was to investigate the Estonian family doctors' (FD attitudes to the patients' family-related issues in their work: to explore the degree of FDs involvement in family matters, their preparedness for management of family-related issues and their self-assessment of the ability to manage different family-related problems. Methods A random sample (n = 236 of all FDs in Estonia was investigated using a postal questionnaire. Altogether 151 FDs responded to the questionnaire (response rate 64%, while five of them were excluded as they did not actually work as FDs. Results Of the respondents, 90% thought that in managing the health problems of patients FDs should communicate and cooperate with family members. Although most of the family doctors agreed that modifying of the health damaging risk factors (smoking, alcohol and drug abuse of their patients and families is their task, one third of them felt that dealing with these problems is ineffective, or perceived themselves as poorly prepared or having too little time for such activities. Of the respondents, 58% (n = 83 were of the opinion that they could modify also relationship problems. Conclusions Estonian family doctors are favourably disposed to involvement in family-related problems, however, they need some additional training, especially in the field of relationship management.

  13. Marcel Proust's fictional diseases and doctors.

    Bogousslavsky, Julien

    2013-01-01

    Marcel Proust (1875-1922), the son and brother of famous physicians, had close and continuous contact with medicine and doctors in connection with chronic asthma, neurasthenia, medical 'tourism', and self-medication. This proximity to medical issues is obvious in his work, particularly his novel In Search of Lost Time, which today is still considered one of the most important literary works ever. In this novel, medicine, patients, and doctors are everywhere, and it can be claimed that while it is often considered to be the great novel of memory, medicine in itself also can be seen as a true character of the story, in which Proust displays surprisingly extensive knowledge. Neurasthenia and asthma (i.e. Proust's diseases), as well as specific neurological disorders, such as stroke, migraine, epilepsy, and dementia, appear in the novel. The disease of the narrator's grandmother remains a piece of anthology, and probably remains the best literary report of a progressive stroke leading to death. Proust also quoted neurological conditions which were virtually unreported in his time, such as phantom limb syndrome and poststroke depression associated with aphasia in Baron Charlus. Doctors are nearly systematically depicted as incompetent and superficial, characteristics which appear to increase with academic titles and glory. The main physician of the novel, Professor Cottard, even ends up writing fake certificates for his rich friend Mrs. Verdurin during World War I so that she can obtain fresh croissants for breakfast, while poor people around her are starving. When called to examine a dying patient, one of the real doctors of the novel, Professor Dieulafoy, says and does nothing except ask for his fees. This defiance and criticism of physicians were indeed those of Proust in real life. Copyright © 2013 S. Karger AG, Basel.

  14. Home care, hospitalizations and doctor visits

    Gonçalves Judite; Weaver France

    2014-01-01

    This study estimates the effects of formal home care on hospitalizations and doctor visits. We compare the effects of medically- and non-medically-related home care and investigate heterogeneous effects by age group and informal care availability. Two-part models are estimated, using data from Switzerland. In this federal country, home care policy is decentralized into cantons (i.e. states). The endogeneity of home care is addressed by using instrumental variables, canton and time fixed effec...

  15. Doctoral Students Becoming Researchers: An Innovative Curriculum

    Deborah S. Garson

    2016-12-01

    Full Text Available Creating a quality literature review is fundamental to doctoral student professionalization, yet research into how the literature review is taught, learned, or experienced is limited.  Responding to this under-addressed but critical key to doctoral education, the focus of this mixed methods study is on students’ perceptions of a year-long course, co-taught by a faculty member and embedded librarian, devoted specifically to addressing the literature review.  Analysis of students’ course evaluations and written reflections/feedback over an eight year period revealed four primary themes: 1 Entering students’ technological know-how does not guarantee effective information literacy skill and without the requisite skills one-shot library workshops are insufficient for making learning whole;  2 Rather than conceiving of the literature review as a product, constructing a literature review represents a pivotal process in doctoral students’ research and literacy skill development; 3 Creating a literature review, and the process it entails, signals in students the development of their professional researcher identity, involving movement beyond “how to” to address questions of “why” and “for whom”; 4 The literature review course was experienced as a substantively different course than is typical in the doctoral experience, mirroring the course’s  foundational assumption that librarians, instructors, and learners share agency in creating the literature review process. The course curriculum is framed by two simultaneous learning streams: information literacy competencies and student research agenda. The course curriculum aligns information literacy competencies and research methodology with the goal of exploring and purposefully integrating creativity and curiosity in the search and research construction process.

  16. Doctors' perspectives of informed consent for non-emergency surgical procedures: a qualitative interview study

    Wood, F.; Martin, S.M.; Carson-Stevens, A.; Elwyn, G.; Precious, E.; Kinnersley, P.

    2016-01-01

    BACKGROUND: The need to involve patients more in decisions about their care, the ethical imperative and concerns about ligation and complaints has highlighted the issue of informed consent and how it is obtained. In order for a patient to make an informed decision about their treatment, they need

  17. A UK perspective on smartphone use amongst doctors within the surgical profession

    Rikesh K. Patel

    2015-06-01

    Conclusion: Online resources contribute significantly to clinical activities with the majority of smartphone users willing to use their own device. The information gathered from this study can aid developers to create software dedicated to the smartphone operating systems in greatest use and to potentially increase the use of a bring your own device (BYOD scheme.

  18. Anxiety in veterinary surgical students

    Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff

    2012-01-01

    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...

  19. [Occupational stress and job burnout in doctors].

    Zhu, Wei; Wang, Zhi-Ming; Wang, Mian-Zhen; Lan, Ya-Jia; Wu, Si-Ying

    2006-03-01

    To investigate the status of job burnout in doctors and its relationship with occupational stress. A total of 561 doctors from three provincial hospitals were randomly selected. The Maslach Burnout Inventory-General Survey (MBI-GS) was used to identify job burnout. The occupation stress inventory revised edition (OSI-R) was used to evaluate the level of occupational stress. Surgeon and doctors working in the internal medicine wards scored significantly higher in job burnout than their colleagues (P < 0.05). The 30-40 years of age group scored highest in exhaustion. The score of professional efficacy decreased with age and increased with educational levels. Role overload, responsibility, physical environment, reaction and self-care were major predictors for exhaustion. Role insufficiency, role overload and responsibility were major predictors for cynicism. Role insufficiency, social support and rational/cognitive were major predictors for professional efficacy. Maintaining moderate professional duty and responsibility, clearly defining job requirements, enriching leisure activities, and improving self-care ability are important measures to preventing job burnout.

  20. Epistaxis management: current understanding amongst junior doctors.

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

    2016-03-01

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

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

    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.

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

    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…

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

    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.

  4. SURGICAL SITE INFECTION: REVIEW

    P. H. M. Bonai

    2016-07-01

    Full Text Available Nosocomial infection or nosocomial infection (NI is one of the factors that increase the cost of maintaining patients in the health system, even in processes that should safely occur, such as hospital patients and performing simple and routine surgical procedures surgical centers and clinics leading to complications resulting from these infections that prolong hospital stay and promote pain and suffering to the patient, resulting in the defense of the quality of services and influencing negatively the hospitals. Therefore, the aim of this study was to review the factors that result in surgical site infection, with the purpose of better understanding of the subject and the possibility of preventive actions to better treatment outcome of the patient.

  5. Male pattern baldness

    Alopecia in men; Baldness - male; Hair loss in men; Androgenetic alopecia ... Male pattern baldness is related to your genes and male sex hormones. It usually follows a pattern of receding hairline and ...

  6. Genital sores - male

    Sores - male genitals; Ulcers - male genitals ... A common cause of male genital sores are infections that are spread through sexual contact, such as: Genital herpes (small, painful blisters filled with clear ...

  7. Retained surgical sponge

    Koyama, Masashi; Kurono, Kenji; Iida, Akihiko; Suzuki, Hirochika; Hara, Masaki; Mizutani, Hirokazu; Ohba, Satoru; Mizutani, Masaru; Nakajima, Yoichiro.

    1993-01-01

    The CT, US, and MRI findings of confirmed retained surgical sponges were reviewed. The CT examinations in eight lesions demonstrated round or oval masses with heterogeneous internal structures. The US examinations in 5 lesions demonstrated low echogenic masses with high echogenic internal structures, which suggested retained surgical sponges. MR imagings in three lesions showed slightly high intensity comparable to that of muscles on T1-weighted images and high signal intensity on T2-weighted images, suggesting fluid collections of high protein concentration. (author)

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

    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

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

    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.

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

    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.

  11. The complex thinking and prospect of actions of future doctors

    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

  12. 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.

    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…

  13. Surgical Management of Post-Prostatectomy Incontinence

    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.

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

    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

  15. Surgical infections with Mycoplasma

    Levi-Mazloum, Niels Donald; Prag, Jørgen Brorson; Jensen, J S

    1997-01-01

    Mycoplasma hominis and Ureaplasma urealyticum are common inhabitants of the human genital tract. Evidence for an aetiological role in pyelonephritis, pelvic inflammatory disease, post-abortion and post-partum fever has been presented. There are sporadic reports of Mycoplasma causing serious...... extragenital infection such as septicemia, septic arthritis, neonatal meningitis and encephalitis. We review 38 cases of surgical infections with Mycoplasma....

  16. [Surgical therapy of gynecomastia].

    Heckmann, A; Leclère, F M; Vogt, P M; Steiert, A

    2011-09-01

    Nowadays surgical intervention is an essential part of the treatment of idiopathic gynecomastia. Choosing the right method is crucial and is based on the current status in the clinical and histological evaluation. Before finalizing the process of choosing a specific method a prior interdisciplinary evaluation of the patient is necessary to ascertain clear indications for a surgical intervention. Liposuction is one of the methods which have become popular in recent years. The advantages are the possible combination with traditional techniques, such as subcutaneous mastectomy or periareolar mastopexy. The main indication is for gynecomastia stage IIa/b and is justifiable due to the reduction in surgical complications and scarring. Furthermore this technique provides an excellent aesthetical outcome for the patient. A total of 162 patients suffering from gynecomastia stages I-III (according to Simon) were surgically treated between 2000 and 2010 and these cases were retrospectively evaluated. The results showed a decline in the use of a T-shaped incision in combination with subcutaneous mastectomy with periareolar tightening compared to an increase in the use of subcutaneous mastectomy in combination with liposuction. The excised tissue should always be sent for histological examination to make sure no malignant cells were present.

  17. Surgical manifestations of filariasis

    Subrahmanyam M

    1978-01-01

    Full Text Available Surgical manifestations of filariasis as seen in 150 cases over a period of three years in the department of Surgery, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha are reviewed. The genital manifestations are more common than the elephantiasis in this endemic zone.

  18. Improving surgical weekend handover.

    Culwick, Caroline; Devine, Chris; Coombs, Catherine

    2014-01-01

    Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unified weekend list ordering all surgical patients by ward and bed number was introduced. Discrepancies in the layout of each team's weekday list necessitated the design of a new weekday list to match the weekend list to facilitate the easy transfer of information between the two lists. A colour coding system was also used to highlight specific jobs. Prior to this improvement project only 7.1% of those polled were satisfied with the existing system, after a series of interventions satisfaction increased to 85.7%. The significant increase in overall satisfaction with surgical handover following the introduction of the unified weekend list is promising. Locating patients and identifying jobs is easier and weekend ward rounds can conducted in a more logical and timely fashion. It has also helped facilitate the transition to consultant ward rounds of all surgical inpatients at the weekends with promising feedback from a recent consultants meeting.

  19. [Surgical complications of colostomies].

    Ben Ameur, Hazem; Affes, Nejmeddine; Rejab, Haitham; Abid, Bassem; Boujelbene, Salah; Mzali, Rafik; Beyrouti, Mohamed Issam

    2014-07-01

    The colostomy may be terminal or lateral, temporary or permanent. It may have psychological, medical or surgical complications. reporting the incidence of surgical complications of colostomies, their therapeutic management and trying to identify risk factors for their occurrence. A retrospective study for a period of 5 years in general surgery department, Habib Bourguiba hospital, Sfax, including all patients operated with confection of a colostomy. Were then studied patients reoperated for stoma complication. Among the 268 patients who have had a colostomy, 19 patients (7%) developed surgical stoma complications. They had a mean age of 59 years, a sex ratio of 5.3 and a 1-ASA score in 42% of cases. It was a prolapse in 9 cases (reconfection of the colostomy: 6 cases, restoration of digestive continuity: 3 cases), a necrosis in 5 cases (reconfection of the colostomy), a plicature in 2 cases (reconfection of the colostomy) a peristomal abscess in 2 cases (reconfection of the colostomy: 1 case, restoration of digestive continuity: 1 case) and a strangulated parastomal hernia in 1 case (herniorrhaphy). The elective incision and the perineal disease were risk factors for the occurrence of prolapse stomial. Surgical complications of colostomies remain a rare event. Prolapse is the most common complication, and it is mainly related to elective approach. Reoperation is often required especially in cases of early complications, with usually uneventful postoperative course.

  20. Open core control software for surgical robots.

    Arata, Jumpei; Kozuka, Hiroaki; Kim, Hyung Wook; Takesue, Naoyuki; Vladimirov, B; Sakaguchi, Masamichi; Tokuda, Junichi; Hata, Nobuhiko; Chinzei, Kiyoyuki; Fujimoto, Hideo

    2010-05-01

    In these days, patients and doctors in operation room are surrounded by many medical devices as resulting from recent advancement of medical technology. However, these cutting-edge medical devices are working independently and not collaborating with each other, even though the collaborations between these devices such as navigation systems and medical imaging devices are becoming very important for accomplishing complex surgical tasks (such as a tumor removal procedure while checking the tumor location in neurosurgery). On the other hand, several surgical robots have been commercialized, and are becoming common. However, these surgical robots are not open for collaborations with external medical devices in these days. A cutting-edge "intelligent surgical robot" will be possible in collaborating with surgical robots, various kinds of sensors, navigation system and so on. On the other hand, most of the academic software developments for surgical robots are "home-made" in their research institutions and not open to the public. Therefore, open source control software for surgical robots can be beneficial in this field. From these perspectives, we developed Open Core Control software for surgical robots to overcome these challenges. In general, control softwares have hardware dependencies based on actuators, sensors and various kinds of internal devices. Therefore, these control softwares cannot be used on different types of robots without modifications. However, the structure of the Open Core Control software can be reused for various types of robots by abstracting hardware dependent parts. In addition, network connectivity is crucial for collaboration between advanced medical devices. The OpenIGTLink is adopted in Interface class which plays a role to communicate with external medical devices. At the same time, it is essential to maintain the stable operation within the asynchronous data transactions through network. In the Open Core Control software, several

  1. [da Vinci surgical system].

    Watanabe, Gou; Ishikawa, Norihiro

    2014-07-01

    The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

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

    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

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

    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.

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

    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

  5. Recordando al doctor Alberto Pradilla Ferreira

    Mercedes de Onís; Beatriz Gracia

    2012-01-01

    Brillante, sencillo, reservado, amigo solidario, colega entusiasta, trabajador incansable, maestro. Adjetivos que abrigan el recuerdo de quien dejó un legado importante para la salud pública, la pediatría y la docencia en salud pública, centrado principalmente en la nutrición.Médico y Cirujano de la Universidad Nacional de Colombia (1956), el doctor Alberto Pradilla fue uno de los pocos médicos colombianos que además de su especialidad médica como pediatra, se formó en el área de nutrición.Se...

  6. Are Danish doctors comfortable teaching in English?

    Nilas, Lisbeth; Løkkegaard, Ellen Christine Leth; Laursen, Jacob Brink

    2016-01-01

    English skills was perceived low. Conclusion Teaching in English was rated as 30 % more difficult than in Danish, and a significant subgroup of doctors had difficulties in all forms of communication in English, resulting in challenges when introducing international students in non-native English speaking...... medical departments. Keywords International students Clinical teaching Teaching in foreign language Doctors’ English skills Self-assessment......Background From 2012–2015, the Departments of Obstetrics and Gynecology and of Pediatrics at the University of Copenhagen conducted a project, “Internationalization at Home ”, offering clinical teaching in English. The project allowed international students to work with Danish speaking students...

  7. Surgical management of necrotizing sialometaplasia of palate

    S M Balaji

    2015-01-01

    Full Text Available Necrotizing sialometaplasia (NSM is a rare benign, inflammatory disease of both major and minor salivary glands, although more commonly reported in the minor glands of the palate. The characteristic clinical presentation can perplex the clinician and may be mistaken for a malignant neoplasm, such as mucoepidermoid carcinoma, as well as invasive squamous cell carcinoma. The clinical and histological similarity between this entity and a malignant lesion may result in unnecessary or mis-treatment. Though clinically mimics malignancy, NSM is considered to be a self-limiting disease, and takes about 3-12 weeks to resolve. Majority of the case resolves itself or by supportive and symptomatic treatment. Surgical intervention is rarely required in NSM except the diagnostic biopsy. Herein we report the clinical, histopathological feature and surgical management of a case of NSM of hard palate in a young adult male.

  8. Surgical management of necrotizing sialometaplasia of palate.

    Balaji, S M; Balaji, Preetha

    2015-01-01

    Necrotizing sialometaplasia (NSM) is a rare benign, inflammatory disease of both major and minor salivary glands, although more commonly reported in the minor glands of the palate. The characteristic clinical presentation can perplex the clinician and may be mistaken for a malignant neoplasm, such as mucoepidermoid carcinoma, as well as invasive squamous cell carcinoma. The clinical and histological similarity between this entity and a malignant lesion may result in unnecessary or mis-treatment. Though clinically mimics malignancy, NSM is considered to be a self-limiting disease, and takes about 3-12 weeks to resolve. Majority of the case resolves itself or by supportive and symptomatic treatment. Surgical intervention is rarely required in NSM except the diagnostic biopsy. Herein we report the clinical, histopathological feature and surgical management of a case of NSM of hard palate in a young adult male.

  9. Surgical sterilization of free-ranging wolves.

    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.

  10. Conceptualising Doctoral Writing as an Affective-political Practice

    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.

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

    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.

  12. Male gender and prematurity are risk factors for incarceration in pediatric inguinal hernia: A study of 922 children

    Amine Ksia

    2017-01-01

    Conclusion: IH occurs mainly in male infants. Prematurity and male gender were identified as risk factors of incarceration. Contralateral metachronous hernia was reported, especially in female infants and after a left side surgical repair of the hernia.

  13. Paediatric Abdominal Surgical Emergencies in a General Surgical ...

    ... organized for general surgeons undertaking paediatric surgical emergencies. More paediatric surgeons should be trained and more paediatric surgical units should established in the country. Key Words: Paediatric Abdominal Surgical Emergencies; Paediatric Surgeons, General Surgeons. Journal of College of Medicine ...

  14. Limb ischemia, an alarm signal to a thromboembolic cascade - renal infarction and nephrectomy followed by surgical suppression of the left atrial appendage.

    Caraşca, Cosmin; Borda, Angela; Incze, Alexandru; Caraşca, Emilian; Frigy, Attila; Suciu, HoraŢiu

    2016-01-01

    We present the case of a 55-year-old male with mild hypertension and brief episodes of paroxysmal self-limiting atrial fibrillation (AF) since 2010. Despite a small cardioembolic risk score, CHA2DS2-Vasc=1 (Congestive heart failure, Hypertension, Age=75, Diabetes melitus, prior Stroke), the patient is effectively anticoagulated using acenocumarol. In December 2014, he showed signs of plantar transitory ischemia, for which he did not address the doctor. In early January 2015, he urgently presented at the hospital with left renal pain, caused by a renal infarction, diagnosed by computed tomography (CT) angiography. Left nephrectomy was performed with pathological confirmation. He was discharged with effective anticoagulation treatment. Within the next two weeks, he suffered a transitory ischemic event and a stroke, associated with right sided hemiparesis. On admission, AF was found and converted to sinus rhythm with effective anticoagulation - international normalized ratio (INR) of 2.12. Transthoracic echocardiography detected no pathological findings. Transesophageal echocardiography showed an expended left atrial appendage (LAA) with a slow blood flow (0.2 m÷s) and spontaneous echocontrast. Considering these clinical circumstances, surgical LAA suppression was decided on as a last therapeutic resort. Postoperative evolution was favorable; the patient is still free of ischemic events, one year post-intervention. Some morphological and hemodynamic characteristics of LAA may add additional thromboembolic risk factors, not included in scores. Removing them by surgical LAA suppression may decrease the risk of cardioembolic events. Intraoperative presence of thrombus makes it an indisputable proof.

  15. Beard reconstruction: A surgical algorithm.

    Ninkovic, M; Heidekrueger, P I; Ehrl, D; von Spiegel, F; Broer, P N

    2016-06-01

    Facial defects with loss of hair-bearing regions can be caused by trauma, infection, tumor excision, or burn injury. The presented analysis evaluates a series of different surgical approaches with a focus on male beard reconstruction, emphasizing the role of tissue expansion of regional and free flaps. Locoregional and free flap reconstructions were performed in 11 male patients with 14 facial defects affecting the hair-bearing bucco-mandibular or perioral region. In order to minimize donor-site morbidity and obtain large amounts of thin, pliable, hair-bearing tissue, pre-expansion was performed in five of 14 patients. Eight of 14 patients were treated with locoregional flap reconstructions and six with free flap reconstructions. Algorithms regarding pre- and intraoperative decision making are discussed and long-term (mean follow-up 1.5 years) results analyzed. Major complications, including tissue expander infection with the need for removal or exchange, partial or full flap loss, occurred in 0% (0/8) of patients with locoregional flaps and in 17% (1/6) of patients undergoing free flap reconstructions. Secondary refinement surgery was performed in 25% (2/8) of locoregional flaps and in 67% (4/6) of free flaps. Both locoregional and distant tissue transfers play a role in beard reconstruction, while pre-expansion remains an invaluable tool. Paying attention to the presented principles and considering the significance of aesthetic facial subunits, range of motion, aesthetics, and patient satisfaction were improved long term in all our patients while minimizing donor-site morbidity. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. Surgical camps: the Ugandan experience

    . The planned visits were advertised locally and in the national media. Screening of the patients was done first by the local medical teams and later by the visiting surgical teams. The surgical teams were comprised of the following personnel:.

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

    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.

  18. Patient‑doctor relationship: The practice orientation of doctors in Kano

    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” ...

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

    Chan, Tony F.

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

  20. The Carnegie Initiative on the Doctorate: The Case of Mathematics. Carnegie Essays on the Doctorate: Mathematics.

    Bass, Hyman

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

  1. Reflections on Doctoral Education in Chemistry. Carnegie Essays on the Doctorate: Chemistry.

    Kwiram, Alvin L.

    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…

  2. Doctor performance assessment in daily practise: does it help doctors or not? A systematic review.

    Overeem, K.; Faber, M.J.; Arah, O.A.; Elwyn, G.; Lombarts, K.M.; Wollersheim, H.C.H.; Grol, R.P.T.M.

    2007-01-01

    CONTEXT: Continuous assessment of individual performance of doctors is crucial for life-long learning and quality of care. Policy-makers and health educators should have good insights into the strengths and weaknesses of the methods available. The aim of this study was to systematically evaluate the

  3. Doctor performance assessment in daily practise: does it help doctors or not? A systematic review

    Overeem, Karlijn; Faber, Marjan J.; Arah, Onvebuchi A.; Elwyn, Glyn; Lombarts, Kiki M. J. M. H.; Wollersheim, Hub C.; Grol, Richard P. T. M.

    2007-01-01

    CONTEXT Continuous assessment of individual performance of doctors is crucial for life-long learning and quality of care. Policy makers and health educators should have good insights into the strengths and weaknesses of the methods available. The aim of this study was to systematically evaluate the

  4. Are Danish doctors comfortable teaching in English?

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

    2016-08-27

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

  5. Improving surgical weekend handover

    Culwick, Caroline; Devine, Chris; Coombs, Catherine

    2014-01-01

    Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unif...

  6. Acquiring minimally invasive surgical skills

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room. This thesis has led to an enlarged insight in the organization of surgical skills training during residency training of surgical medical specialists.

  7. An audit of generic prescribing in a general surgical department.

    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.

  8. Robotic surgical training.

    Ben-Or, Sharon; Nifong, L Wiley; Chitwood, W Randolph

    2013-01-01

    In July 2000, the da Vinci Surgical System (Intuitive Surgical, Inc) received Food and Drug Administration approval for intracardiac applications, and the first mitral valve repair was done at the East Carolina Heart Institute in May 2000. The system is now approved and used in many surgical specialties. With this disruptive technology and accepted use, surgeons and hospitals are seeking the most efficacious training pathway leading to safe use and responsible credentialing.One of the most important issues related to safe use is assembling the appropriate team of professionals involved with patient care. Moreover, proper patient selection and setting obtainable goals are also important.Creation and maintenance of a successful program are discussed in the article focusing on realistic goals. This begins with a partnership between surgeon leaders, hospital administrators, and industry support. Through this partnership, an appropriate training pathway and clinical pathway for success can be outlined. A timeline can then be created with periods of data analysis and adjustments as necessary. A successful program is attainable by following this pathway and attending to every detail along the journey.

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

    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

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

    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

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

    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.

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

    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.

  13. Surgical Treatment for Pulmonary Hamartomas

    Funda Ižncekara

    2015-11-01

    Full Text Available Aim: In this study, we evaluated the patients operated for hamartoma and treated endobronchially and the diagnostic value of this approach has been examined. Material and Method: 59 patients (24 females, 35 males; mean age 53 years, range 28-78 years which were operated and endobronchial treated for hamartoma in our clinic between January 2003 - January 2013 were analyzed retrospectively. Patient age, sex, symptoms, histopathological, surgical procedures and treatment outcomes were evaluated. Results: The most common complaint was shortness of breath, while 25 patients were asymptomatic. Thoracotomy and mass enucleation in 29 patients (%49,15, thoracotomy and wedge resection in 18 patients (%30.5, VATS and wedge resection in 4 patients (%6.77, thoracotomy and upper lobectomy in 4 patients (%6.77, thoracotomy and lower lobectomy in 2 patients (%3.38 and left upper lobe segmentectomy in 1 patient (%1.69 and right upper bronchial sleeve resection in 1 patient were performed. The postoperative pathology of lesions examined and diagnosis were chondroid hamartoma in 28 , pulmonary hamartoma in 20 , hamartoma chondrolypomatous in 11 and the bronchial hamartoma in 2 . No mortality was observed intraoperatively. Discussion: Although hamartomas are benign , diagnosis should be made because it can be confused with lung cancer. Definitive diagnosis and treatment can be performed successfully through VATS in primarily appropriate cases with minimal morbidity or thoracotomy or endobronchial treatment.

  14. Surgical experts: born or made?

    Sadideen, Hazim; Alvand, Abtin; Saadeddin, Munir; Kneebone, Roger

    2013-01-01

    The concept of surgical expertise and the processes involved in its development are topical, and there is a constant drive to identify reliable measures of expert performance in surgery. This review explores the notion of whether surgical experts are "born" or "made", with reference to educational theory and pertinent literature. Peer-reviewed publications, books, and online resources on surgical education, expertise and training were reviewed. Important themes and aspects of expertise acquisition were identified in order to better understand the concept of a surgical expert. The definition of surgical expertise and several important aspects of its development are highlighted. Innate talent plays an important role, but is insufficient on its own to produce a surgical expert. Multiple theories that explore motor skill acquisition and memory are relevant, and Ericsson's theory of the development of competence followed by deliberate self-practice has been especially influential. Psychomotor and non-technical skills are necessary for progression in the current climate in light of our training curricula; surgical experts are adaptive experts who excel in these. The literature suggests that surgical expertise is reached through practice; surgical experts are made, not born. A deeper understanding of the nature of expert performance and its development will ensure that surgical education training programmes are of the highest possible quality. Surgical educators should aim to develop an expertise-based approach, with expert performance as the benchmark. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  15. Surgical navigation with QR codes

    Katanacho Manuel

    2016-09-01

    Full Text Available The presented work is an alternative to established measurement systems in surgical navigation. The system is based on camera based tracking of QR code markers. The application uses a single video camera, integrated in a surgical lamp, that captures the QR markers attached to surgical instruments and to the patient.

  16. Nigerian Journal of Surgical Research

    The Nigerian Journal of Surgical Research is a publication of the Surgical Research Society with main office in Zaria, Nigeria. Zaria is home to Ahmadu Bello University (ABU), a premier university in Nigeria. The aim of The Nigerian Journal of Surgical Research is to cover developments and advances in the broad field of ...

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

    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

  18. Surgical sterilization of free-ranging wolves.

    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...

  19. Giant Condyloma Acuminatum: A Surgical Riddle

    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.

  20. How Doctors View and Use Social Media: A National Survey

    Brown, James; Ryan, Christopher; Harris, Anthony

    2014-01-01

    Background Doctors are uncertain of their ethical and legal obligations when communicating with patients online. Professional guidelines for patient-doctor interaction online have been written with limited quantitative data about doctors’ current usage and attitudes toward the medium. Further research into these trends will help to inform more focused policy and guidelines for doctors communicating with patients online. Objective The intent of the study was to provide the first national profi...