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Sample records for specialties medical

  1. Choosing Your Medical Specialty

    Science.gov (United States)

    ... the Payment Process Physician Payment Resource Center Reinventing Medical Practice Managing Your Practice CPT® (Current Procedural Terminology) Medicare & Medicaid Private Payer Reform Claims Processing & Practice ...

  2. History of Medical Specialty Interest Assessment

    Science.gov (United States)

    Burns, Stephanie T.

    2016-01-01

    Medical specialties require decidedly different abilities, skills, and talents; which results in divergent experiences, lifestyles, skill sets, and income levels. To help medical students select their preferred medical specialty and alleviate shortages in medical specialty staffing, US medical schools and associations invest time and money in…

  3. Medical Litigation Across Specialties

    LENUS (Irish Health Repository)

    Murphy, JFA

    2013-07-01

    Medical negligence is a major cause of fear and anxiety for doctors. The threat of malpractice consists of 3 factors, the risk of a claim, the probability of a claim leading to a payment, and the size of the payment. The Clinical Indemnity Scheme (CIS) insures against indemnity payments but it cannot protect the doctor against the indirect consequences of litigation including stress, the long hours mounting a defence against the allegation, and the damage to one’s reputation. The adversarial tort system focuses on punishment, blame and compensation. The emotional anguish and potential damage to the doctor’s reputation can be considerable. Doctors subjected to malpractice suits regardless of the outcome may experience depression, anger, frustration and excessive use of alcohol

  4. Social Dominance Theory and Medical Specialty Choice

    Science.gov (United States)

    Lepièce, Brice; Reynaert, Christine; van Meerbeeck, Philippe; Dory, Valérie

    2016-01-01

    Understanding how medical students select their specialty is a fundamental issue for public health and educational policy makers. One of the factors that students take into account is a specialty's prestige which hinges partly on its focus on technique rather than whole person. We examine the potential of a psychological framework, social…

  5. Factors Influencing Medical Students' Choice of Specialty

    OpenAIRE

    Chang, Pei-Yeh; Hung, Chih-Young; Wang, Kuei-lng; Huang, Yuan-Huei; Chang, King-Jen

    2006-01-01

    Medical school graduates are the source of a country's physicians. Determining how the graduates of these schools select their areas of specialization is the key to achieving a balanced distribution of doctors among all specialties. The purposes of this study were to determine the factors that influence medical students' choice of medical specialty, and to derive the relative weight of each factor. Methods: We constructed a two-tiered analytic hierarchy process (AHP) model which was repres...

  6. The long overdue medical specialty: bioethiatrics.

    Science.gov (United States)

    Kevorkian, J

    1986-11-01

    Traditional bioethical codes have been unable to cope with the results of modern technology and the drastic changes in life patterns. The medical profession can reestablish bioethical order and reassert leadership through a new and urgently needed medical specialty, which the author tentatively calls bioethiatrics or bioethiatry. Bioethiatrics embodies a unique combination of ethical action and moral judgment.Training for the specialty would start with a residency program, consisting of thorough training in philosophy and religion coupled with continued experience in clinical medicine and indoctrination in contemporary research. Requirements would include the practice of general medicine for at least two years after internship, the passing of oral and written examinations after four years of residency, board certification, and subsequent periodic evaluations.Bioethiatricians would assume all the usual privileges, obligations, and risks associated with the practice of any medical specialty, thereby averting unnecessary ethical crises and ensuring a more rational response to present and future moral challenges.

  7. medical students' preference for choice of clinical specialties

    African Journals Online (AJOL)

    Zamzar

    This study seeks to determine the medical student preference for the clinical specialty and the factors that they consider in making ... undergraduates in selecting these specialties is important. .... effect of National Health Insurance on changes.

  8. Medical specialty preferences in early medical school training in Canada.

    Science.gov (United States)

    Vo, Anthony; McLean, Laurie; McInnes, Matthew D F

    2017-11-14

    To understand what medical students consider when choosing their specialty, prior to significant clinical exposure to develop strategies to provide adequate career counseling. A cross-sectional study was performed by distributing optional questionnaires to 165 first-year medical students at the University of Ottawa in their first month of training with a sample yield of 54.5% (n=90).  Descriptive statistics, analysis of variance, Spearman's rank correlation, Cronbach's alpha coefficient, Kaiser-Meyer-Olkin Measure, and exploratory factor analyses were used to analyze the anonymized results. "Job satisfaction", "lifestyle following training" and, "impact on the patient" were the three highest rated considerations when choosing a specialty.  Fifty-two and seventeen percent (n=24) and 57.89% (n=22) of males and females ranked non-surgical specialties as their top choice. Student confidence in their specialty preferences was moderate, meaning their preference could likely change (mean=2.40/5.00, SD=1.23). ANOVA showed no significant differences between confidence and population size (F(2,86)=0.290, p=0.75) or marital status (F(2,85)=0.354, p=0.70) in both genders combined. Five underlying factors that explained 44.32% of the total variance were identified. Five themes were identified to enhance career counseling. Medical students in their first month of training have already considered their specialty preferences, despite limited exposure. However, students are not fixed in their specialty preference. Our findings further support previous results but expand what students consider when choosing their specialty early in their training. Medical educators and administrators who recognize and understand the importance of these considerations may further enhance career counseling and medical education curricula.

  9. Factors affecting future specialty choice among medical students in Kuwait.

    Science.gov (United States)

    Al-Fouzan, Rawan; Al-Ajlan, Sarah; Marwan, Yousef; Al-Saleh, Mervat

    2012-01-01

    Choosing a medical specialty can be either a daunting and confusing experience for some medical students and junior doctors or a foregone conclusion to others. The aim of this study is to evaluate factors affecting future specialty choice among medical students in Kuwait University. A self-administered questionnaire was used to collect data from medical students registered in Kuwait University during the academic year 2011/2012. Chi-square test and logistic regression were used to test the association between deciding a future specialty and students' sociodemographic and academic factors. Of the 422 students approached, 387 (91.7%) decided to participate. A total of 144 (37.2%) students made a decision regarding their choice of future medical specialty. Pediatrics, general surgery, and cardiology were the most desired specialties - 18 (12.5%), 17 (11.8%), and 16 (11.1%) students requested these specialties, respectively. Only 61 (42.4%) of those who selected a future specialty received advice regarding their choice. Looking for a good treatment outcome for patients (66; 45.8%) and a challenging specialty (58; 40.3%) were the most influencing incentives when selecting a future specialty. Students in the clinical phase of their study were 3.014 (95% CI: 1.498-6.065) more likely to report on their decision regarding a future specialty compared to students in the basic medical sciences phase (p=0.002). A variety of factors appeared to inspire medical students in Kuwait to choose a future medical specialty. When identified, these factors can be used by mentors of medical students and directors of residency training programs to motivate students to choose specialties that are limited in Kuwait.

  10. Factors affecting future specialty choice among medical students in Kuwait

    Directory of Open Access Journals (Sweden)

    Rawan Al-Fouzan

    2012-12-01

    Full Text Available Background: Choosing a medical specialty can be either a daunting and confusing experience for some medical students and junior doctors or a foregone conclusion to others. The aim of this study is to evaluate factors affecting future specialty choice among medical students in Kuwait University. Methods: A self-administered questionnaire was used to collect data from medical students registered in Kuwait University during the academic year 2011/2012. Chi-square test and logistic regression were used to test the association between deciding a future specialty and students’ sociodemographic and academic factors. Results: Of the 422 students approached, 387 (91.7% decided to participate. A total of 144 (37.2% students made a decision regarding their choice of future medical specialty. Pediatrics, general surgery, and cardiology were the most desired specialties – 18 (12.5%, 17 (11.8%, and 16 (11.1% students requested these specialties, respectively. Only 61 (42.4% of those who selected a future specialty received advice regarding their choice. Looking for a good treatment outcome for patients (66; 45.8% and a challenging specialty (58; 40.3% were the most influencing incentives when selecting a future specialty. Students in the clinical phase of their study were 3.014 (95% CI: 1.498–6.065 more likely to report on their decision regarding a future specialty compared to students in the basic medical sciences phase (p=0.002. Conclusion : A variety of factors appeared to inspire medical students in Kuwait to choose a future medical specialty. When identified, these factors can be used by mentors of medical students and directors of residency training programs to motivate students to choose specialties that are limited in Kuwait.

  11. Factors Influencing Medical Students' Choice of Specialty

    Directory of Open Access Journals (Sweden)

    Pei-Yeh Chang

    2006-01-01

    Conclusion: This study found that personal intelligence/ability preference and career opportunities were more important factors to the current generation of students in choosing a specialty. Knowledge of these students' attitudes could form the basis for the development of strategies to enhance the attractiveness of specialties facing the problem of a shortage of manpower.

  12. Gender bias in specialty preferences among Danish medical students

    DEFF Research Database (Denmark)

    Pedersen, Laura Erna Toftegaard; Skytte, Nanna Hasle Bak; Dissing, Agnete Skovlund

    2011-01-01

    Female medical students tend to prefer person-oriented specialties characterized by close doctor-patient contact and aspects of care. Conversely, male medical students tend to seek towards specialties with elements of autonomy, technology and "action" . Furthermore, female doctors will outnumber ...

  13. Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate.

    Science.gov (United States)

    Sitkin, Nicole A; Pachankis, John E

    2016-12-01

    Sexual and gender minorities (SGMs) in medicine experience unique stressors in training. However, little is known about SGM specialty choice. This study examined predictors of SGM specialty choice, associations between specialty prestige and perceived SGM inclusion, and self-reported influences on specialty choice. Medical trainees and practitioners (358 SGM, 1528 non-SGM) were surveyed online. We operationalized specialty choice at the individual level as respondents' specialty of practice; at the specialty level, as a percentage of SGM respondents in each specialty. We examined specialty prestige, perceived SGM inclusivity, and medical school climate as predictors of SGM specialty choice, and we compared additional influences on specialty choice between SGM and non-SGM. The percentage of SGM in each specialty was inversely related to specialty prestige (P = 0.001) and positively related to perceived SGM inclusivity (P = 0.01). Prestigious specialties were perceived as less SGM inclusive (P gender identity strongly influenced specialty choice (P role models, and work-life balance as strong influences on specialty choice. Exposure as a medical student to SGM faculty did not predict specialty prestige among SGM. Specialty prestige and perceived inclusivity predict SGM specialty choice. SGM diversity initiatives in prestigious specialties may be particularly effective by addressing SGM inclusion directly. Further research is needed to inform effective mentorship for SGM medical students. Exposure to SGM in medical training reduces anti-SGM bias among medical professionals, and SGM in medicine often assume leadership roles in clinical care, education, and research regarding SGM health. Supporting and promoting SGM diversity across the spectrum of medical specialties, therefore, represents a critical avenue to improve the care delivered to SGM populations and addresses the role of providers in the health disparities experienced by SGM.

  14. Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate

    Science.gov (United States)

    Pachankis, John E.

    2016-01-01

    Abstract Purpose: Sexual and gender minorities (SGMs) in medicine experience unique stressors in training. However, little is known about SGM specialty choice. This study examined predictors of SGM specialty choice, associations between specialty prestige and perceived SGM inclusion, and self-reported influences on specialty choice. Methods: Medical trainees and practitioners (358 SGM, 1528 non-SGM) were surveyed online. We operationalized specialty choice at the individual level as respondents' specialty of practice; at the specialty level, as a percentage of SGM respondents in each specialty. We examined specialty prestige, perceived SGM inclusivity, and medical school climate as predictors of SGM specialty choice, and we compared additional influences on specialty choice between SGM and non-SGM. Results: The percentage of SGM in each specialty was inversely related to specialty prestige (P = 0.001) and positively related to perceived SGM inclusivity (P = 0.01). Prestigious specialties were perceived as less SGM inclusive (P gender identity strongly influenced specialty choice (P work–life balance as strong influences on specialty choice. Exposure as a medical student to SGM faculty did not predict specialty prestige among SGM. Conclusion: Specialty prestige and perceived inclusivity predict SGM specialty choice. SGM diversity initiatives in prestigious specialties may be particularly effective by addressing SGM inclusion directly. Further research is needed to inform effective mentorship for SGM medical students. Exposure to SGM in medical training reduces anti-SGM bias among medical professionals, and SGM in medicine often assume leadership roles in clinical care, education, and research regarding SGM health. Supporting and promoting SGM diversity across the spectrum of medical specialties, therefore, represents a critical avenue to improve the care delivered to SGM populations and addresses the role of providers in the health disparities

  15. Future Choice of Specialty among Students in a Caribbean Medical ...

    African Journals Online (AJOL)

    Background: The medical specialities chosen by medical students for their careers play an important part in ... data, generic factors considered as important in their specialty choice as well as factors that influence the students\\' attractiveness to ...

  16. Factors affecting future specialty choice among medical students in Kuwait

    OpenAIRE

    Marwan, Yousef; Al-Fouzan, Rawan; Al-Ajlan, Sarah; Al-Saleh, Mervat

    2012-01-01

    Background: Choosing a medical specialty can be either a daunting and confusing experience for some medical students and junior doctors or a foregone conclusion to others. The aim of this study is to evaluate factors affecting future specialty choice among medical students in Kuwait University. Methods: A self-administered questionnaire was used to collect data from medical students registered in Kuwait University during the academic year 2011/2012. Chi-square test and logistic regression wer...

  17. Specialty Choices: Patterns and Determinants among Medical ...

    African Journals Online (AJOL)

    2017-07-18

    Jul 18, 2017 ... Methods: This was a cross‑sectional questionnaire‑based survey carried out ... were preferentially influenced by family/societal expectations (P = 0.03) and ..... Table 5: Distribution of specialties of first choice by age, parent's ...

  18. The preference of radiology as a postgraduate medical specialty ...

    African Journals Online (AJOL)

    Background: Recruitment into medical specialties outside the core clinical departments remains a stumbling block to advancing medical practice in Nigeria. We set out to determine the factors influencing choice of diagnostic radiology as a field of specialization by the final year medical students in Usmanu Danfodiyo ...

  19. Pakistani medical students' specialty preference and the influencing factors.

    Science.gov (United States)

    Rehman, Anis; Rehman, Tariq; Shaikh, Muhammad Ateeb; Yasmin, Haleema; Asif, Ammara; Kafil, Hina

    2011-07-01

    To elucidate the specialty preferences of Pakistani medical students and the factors which influence medical students to make the decision regarding which specialty to pursue. Both basic sciences and clinical students from four medical colleges of Pakistan, i.e., Dow Medical College, Sindh Medical College, Liaquat National Medical College and Muhammad Medical College, were included in the cross-sectional survey during the period of July 2008 to Jan' 2009. After ethical acceptance, data was collected using convenient sampling technique. The questionnaire covered the following demographic details: 13 common specialties and 15 influencing factors. Questionnaires included in the analysis were 771. Most students gave preference to surgery and its associated sub-specialties (50.3%) followed by internal medicine (26.8%), paediatrics (23.2%), dermatology (16.7%), gynaecology and obstetrics (16.7%), psychiatry (13.1%), radiology (10.8%), ENT (8.8%), anaesthesiology (8.7%), administrative medicine (8.6%), orthopaedics (8.2%), ophthalmology (7.5%), and laboratory medicine (6.1%). The highly considered factors (regarding specialties) chosen by 70% of the medical students were: applicable to respective personalities of the individuals, prestige and respect, international opportunities, and time commitment. Surgical-skills, job availability, financial rating, academic performance, and a role model were moderately influencing factors. Hospital environment, parents, general practice, peer-pressure and personal health were the least influential. This trend suggests competition in surgery and its sub-specialties along with internal medicine, paediatrics, dermatology, gynaecology and obstetrics. Specialty suited to personality, time commitment, prestige/respect and international opportunity, influenced more than 70% of the students.

  20. Association of medical student burnout with residency specialty choice.

    Science.gov (United States)

    Enoch, Lindsey; Chibnall, John T; Schindler, Debra L; Slavin, Stuart J

    2013-02-01

    Given the trend among medical students away from primary care medicine and toward specialties that allow for more controllable lifestyles, the identification of factors associated with specialty choice is important. Burnout is one such factor. The purpose of this study was to examine the associations between burnout and residency specialty choice in terms of provision for a less versus more controllable lifestyle (e.g. internal medicine versus dermatology) and a lower versus higher income (e.g. paediatrics versus anaesthesiology). A survey was sent to 165 Year 4 medical students who had entered the residency matching system. Students answered questions about specialty choice, motivating factors (lifestyle, patient care and prestige) and perceptions of medicine as a profession. They completed the Maslach Burnout Inventory-Human Services (MBI), which defines burnout in relation to emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). Burnout and other variables were tested for associations with specialty lifestyle controllability and income. A response rate of 88% (n = 145) was achieved. Experiences of MBI-EE, MBI-DP and MBI-PA burnout were reported by 42 (29%), 26 (18%) and 30 (21%) students, respectively. Specialties with less controllable lifestyles were chosen by 87 (60%) students and lower-income specialties by 81 (56%). Adjusted odds ratios (ORs) indicated that the choice of a specialty with a more controllable lifestyle was associated with higher MBI-EE burnout (OR = 1.77, 95% confidence interval [CI] 1.06-2.96), as well as stronger lifestyle- and prestige-related motivation, and weaker patient care-related motivation. The choice of a higher-income specialty was associated with lower MBI-PA burnout (OR = 0.56, 95% CI 0.32-0.98), weaker lifestyle- and patient care-related motivation, and stronger prestige-related motivation. Specialty choices regarding lifestyle controllability and income were associated with the amount and type of

  1. Personality and Values as Predictors of Medical Specialty Choice

    Science.gov (United States)

    Taber, Brian J.; Hartung, Paul J.; Borges, Nicole J.

    2011-01-01

    Research rarely considers the combined influence of personality traits and values in predicting behavioral outcomes. We aimed to advance a germinal line of inquiry that addresses this gap by separately and simultaneously examining personality traits and physician work values to predict medical specialty choice. First-year medical students (125…

  2. Specialty pharmacy: an emerging area of interest for medical management.

    Science.gov (United States)

    Dong, Xiaoli; Fetterolf, Donald

    2005-04-01

    Specialty pharmaceuticals are expensive injectable and infusion therapies used to treat patients with chronic or life-threatening diseases. The high cost of these agents and their frequent usage in chronic diseases represent not only challenges, but also opportunities for medical management programs to improve the quality of care and moderate the rapid cost escalation seen in the industry. The number and variety of these agents have been increasing significantly, with hundreds of drug candidates in the development pipeline. The specialty pharmacy industry also is going through a consolidation stage, both horizontally and vertically. Industry approaches to medical management include the acquisition of specialty pharmacy companies, restrictive contracting to achieve concentrated buying power, and the development of utilization management strategies.

  3. Are new medical students' specialty preferences gendered? Related motivational factors at a Dutch medical school.

    NARCIS (Netherlands)

    Tongeren-Alers, M.L.G. van; Esch, M. van der; Verdonk, P.; Johansson, E.; Hamberg, K.; Lagro-Janssen, T.

    2011-01-01

    BACKGROUND: Female students currently outnumber male students in most medical schools. Some medical specialties are highly gender segregated. Therefore, it is interesting to know whether medical students have early specialization preferences based on their gender. Consequently, we like to know

  4. Knowledge of Medical House Officers about Dental Specialties ...

    African Journals Online (AJOL)

    Background: Some patients with oral diseases present initially to a general medical practitioner who is expected to refer the patients to the appropriate dental specialist for management. Thus they are expected to have a good knowledge of the different specialties in dentistry. This study was designed to determine the ...

  5. Burnout Comparison among Residents in Different Medical Specialties

    Science.gov (United States)

    Martini, Shahm; Arfken, Cynthia L.; Churchill, Amy; Balon, Richard

    2004-01-01

    Objective: To investigate resident burnout in relation to work and home-related factors. Method: Maslach Burnout Inventory was mailed to residents in eight different medical specialties, with a response rate of 35%. Results: Overall, 50% of residents met burnout criteria, ranging from 75% (obstetrics/gynecology) to 27% (family medicine). The first…

  6. [Medical student perception of physician values in practice by individual characteristics and preferred medical specialty field].

    Science.gov (United States)

    Park, Kwi Hwa; Yoo, Hyo Hyun; Yim, Jun

    2014-12-01

    Medical students' values figure prominently in their choice of medical specialty; yet, little research has been performed on this topic. The purpose of this study was to analyze the differences in values according to medical students' individual characteristics (medical educational system, gender, and grade) and preferred medical specialty. A total of 905 medical students participated in the study; 426 were graduate-entry medical students (GEMS), and 479 were undergraduate medical students (UMS). Further, 561 were male and 316 were female; 356 were in year 1, 219 were in year 2, 230 were in year 3, and 100 were in year 4. Students completed the Physician Values in Practice Scale (PVIPS). The PVIPS comprises six dimensions: autonomy, management, prestige, service, lifestyle, and scholarly pursuits. The data were analyzed by t-test and analysis of variance. GEMS had higher scores for service, management, and scholarly pursuits than UMS. Males had higher scores for prestige, lifestyle, and management, whereas female scored higher on service and scholarly pursuits. Higher grade was associated with increased scores for prestige, lifestyle, and management. The differences in lifestyle and scholarly pursuits were significant between preferred specialties. Students in support specialties scored significantly higher on lifestyle. With regard to scholarly pursuits, basic science specialties scored significantly higher than other specialties. There were significant differences in PVIPS according to individual characteristics and preferred medical specialty. This result could be useful in developing a medical specialty choice program for medical students.

  7. An analysis of the medical specialty training system in Spain.

    Science.gov (United States)

    Freire, José-Manuel; Infante, Alberto; de Aguiar, Adriana Cavalcanti; Carbajo, Pilar

    2015-06-02

    In this paper, we analyse the medical specialty training system in Spain (the so-called "residency system"). In order to do so, we a) summarize its historical evolution; b) describe the five major architectural pillars on which the system is currently based; c) analyse the special contract of the specialist-in-training; d) discuss the three major challenges for the medical specialist training future: the evolution and expansion of the residency system to other health professions, the issue of grouping specialties with a common core trunk and the continuity of the learning process; and e) draw four conclusions that may be relevant for those who are in the process of developing or revising their own medical specialization systems.

  8. Medical student debt and major life choices other than specialty

    Directory of Open Access Journals (Sweden)

    James Rohlfing

    2014-11-01

    Full Text Available Background: Median indebtedness at graduation is now more than $170,000 for graduates of US Medical Schools. Debate still exists as to whether higher debt levels influence students to choose high paying non-primary care specialties. Notably, no previous research on the topic has taken into account cost of attendance when constructing a debt model, nor has any research examined the non-career major life decisions that medical students face. Methods: Medical students were surveyed using an anonymous electronic instrument developed for this study. The survey was delivered through a link included in a study email and students were recruited from school wide listservs and through snowball sampling (students were encouraged to share a link to the survey with other medical students. No incentives were offered for survey completion. Results: Responses were recorded from 102 US Allopathic medical schools (n=3,032, with 22 institutions (11 public, 11 private meeting inclusion criteria of 10% student body response proportion (n=1,846. Students with higher debt relative to their peers at their home institution reported higher frequencies of feeling callous towards others, were more likely to choose a specialty with a higher average annual income, were less likely to plan to practice in underserved locations, and were less likely to choose primary care specialties. Students with higher aggregate amounts of medical student loan debt were more likely to report high levels of stress from their educational debt, to delay getting married and to report disagreement that they would choose to become a physician again, if given the opportunity to revisit that choice. Increases in both aggregate and relative debt were associated with delaying having children, delaying buying a house, concerns about managing and paying back educational debt, and worrying that educational debt will influence one's specialty choice. Conclusions: Medical student debt and particularly debt

  9. Medical student debt and major life choices other than specialty.

    Science.gov (United States)

    Rohlfing, James; Navarro, Ryan; Maniya, Omar Z; Hughes, Byron D; Rogalsky, Derek K

    2014-01-01

    Median indebtedness at graduation is now more than $170,000 for graduates of US Medical Schools. Debate still exists as to whether higher debt levels influence students to choose high paying non-primary care specialties. Notably, no previous research on the topic has taken into account cost of attendance when constructing a debt model, nor has any research examined the non-career major life decisions that medical students face. Medical students were surveyed using an anonymous electronic instrument developed for this study. The survey was delivered through a link included in a study email and students were recruited from school wide listservs and through snowball sampling (students were encouraged to share a link to the survey with other medical students). No incentives were offered for survey completion. Responses were recorded from 102 US Allopathic medical schools (n=3,032), with 22 institutions (11 public, 11 private) meeting inclusion criteria of 10% student body response proportion (n=1,846). Students with higher debt relative to their peers at their home institution reported higher frequencies of feeling callous towards others, were more likely to choose a specialty with a higher average annual income, were less likely to plan to practice in underserved locations, and were less likely to choose primary care specialties. Students with higher aggregate amounts of medical student loan debt were more likely to report high levels of stress from their educational debt, to delay getting married and to report disagreement that they would choose to become a physician again, if given the opportunity to revisit that choice. Increases in both aggregate and relative debt were associated with delaying having children, delaying buying a house, concerns about managing and paying back educational debt, and worrying that educational debt will influence one's specialty choice. Medical student debt and particularly debt relative to peers at the same institution appears to

  10. Medical costs, Cesarean delivery rates, and length of stay in specialty hospitals vs. non-specialty hospitals in South Korea.

    Directory of Open Access Journals (Sweden)

    Seung Ju Kim

    Full Text Available Since 2011, specialty hospitals in South Korea have been known for providing high- quality care in specific clinical areas. Much research related to specialty hospitals and their performance in many such areas has been performed, but investigations about their performance in obstetrics and gynecology are lacking. Thus, we aimed to compare specialty vs. non-specialty hospitals with respect to mode of obstetric delivery, especially the costs and length of stay related to Cesarean section (CS procedures, and to provide evidence to policy-makers for evaluating the success of hospitals that specialize in obstetric and gynecological (OBGYN care.We obtained National Health Insurance claim data from 2012 to 2014, which included information from 418,141 OBGYN cases at 214 hospitals. We used a generalized estimating equation model to identify a potential association between the likelihood of CS at specialty hospitals compared with other hospitals. We also evaluated medical costs and length of stay in specialty hospitals according to type of delivery.We found that 150,256 (35.9% total deliveries were performed by CS. The odds ratio of CS was significantly lower in specialty hospitals (OR: 0.95, 95% CI: 0.93-0.96compared to other hospitals Medical costs (0.74% and length of stay (1% in CS cases increased in specialty hospitals, although length of stay following vaginal delivery was lower (0.57% in specialty hospitals compared with other hospitals.We determined that specialty hospitals are significantly associated with a lower likelihood of CS delivery and shorter length of stay after vaginal delivery. Although they are also associated with higher costs for delivery, the increased cost could be due to the high level of intensive care provided, which leads to improve quality of care. Policy-makers should consider incentive programs to maintain performance of specialty hospitals and promote efficiency that could reduce medical costs accrued by patients.

  11. Gender inflexion in the construction of a new medical specialty

    Directory of Open Access Journals (Sweden)

    Rachel Aisengart Menezes

    2008-01-01

    Full Text Available This article presents the constitution of a new medical specialty, Palliative Care, directed to patients "out of therapeutic possibilities". The concept emerged around 1960 in England and was implemented in Brazil a couple of years before 1990. It is characterized by an active attendance of the dying process. It postulates a "spiritual assistance" to the patient and his/her family members, including the emotional universe. Ethnographical observation and interviews with Brazilian professionals showed a majority of women among the health teams involved in this proposal. This article discusses and analyses the connection between the construction of the specialty and gender representation among these professionals that reflects popular social images about death, beliefs, emotions and the roles played by women and men in these subjects.

  12. Gender Inflexion in the Construction of a New Medical Specialty

    Directory of Open Access Journals (Sweden)

    Rachel Aisengart Menezes

    2007-09-01

    Full Text Available This article presents the constitution of a new medical specialty, Palliative Care, directed to patients “out of therapeutic possibilities”. The concept emerged around 1960 in England and was implemented in Brazil a couple of years before 1990. It is characterized by an active attendance of the dying process. It postulates a “spiritual assistance” to the patient and his/her family members, including the emotional universe. Ethnographical observation and interviews with Brazilian professionals showed a majority of women among the health teams involved in this proposal. This article discusses and analyses the connection between the construction of the specialty and gender representation among these professionals that reflects popular social images about death, beliefs, emotions and the roles played by women and men in these subjects.

  13. Evaluation of feedback given to trainees in medical specialties.

    Science.gov (United States)

    Tham, Tony Ck; Burr, Bill; Boohan, Mairead

    2017-07-01

    The aim of this study was to evaluate the quality of feedback provided to specialty trainees (ST3 or higher) in medical specialties during their workplace-based assessments (WBAs). The feedback given in WBAs was examined in detail in a group of 50 ST3 or higher trainees randomly selected from those taking part in a pilot study of changes to the WBA system conducted by the Joint Royal Colleges of Physicians Training Board. They were based in Health Education Northeast (Northern Deanery) and Health Education East of England (Eastern Deanery). Thematic analysis was used to identify commonly occurring themes. Feedback was mainly positive but there were differences in quality between specialties. Problems with feedback included insufficient detail, such that it was not possible to map the progression of the trainee, insufficient action plans made and the timing of feedback not being contemporaneous (feedback not being given at the time of assessment). Recommendations included feedback should be more specific; there need to be more options in the feedback forms for the supervisor to compare the trainee's performance to what is expected and action plans need to be made. © Royal College of Physicians 2017. All rights reserved.

  14. Medical specialty considerations by medical students early in their clinical experience

    Directory of Open Access Journals (Sweden)

    Weissman Charles

    2012-03-01

    Full Text Available Abstract Background Specialty selection by medical students determines the future composition of the physician workforce. Selection of career specialties begins in earnest during the clinical rotations with exposure to the clinical and intellectual environments of various specialties. Career specialty selection is followed by choosing a residency program. This is the period where insight into the decision process might help healthcare leaders ascertain whether, when, and how to intervene and attempt to influence students' decisions. The criteria students consider important in selecting a specialty and a residency program during the early phases of their clinical rotations were examined. Methods Questionnaires distributed to fifth-year medical students at two Israeli medical schools. Results 229 of 275 (83% questionnaires were returned. 80% of the students had considered specialties; 62% considered one specialty, 25% two, the remainder 3-5 specialties. Students took a long-range view; 55% considered working conditions after residency more important than those during residency, another 42% considered both equally important. More than two-thirds wanted an interesting and challenging bedside specialty affording control over lifestyle and providing a reasonable relationship between salary and lifestyle. Men were more interested in well-remunerated procedure-oriented specialties that allowed for private practice. Most students rated as important selecting a challenging and interesting residency program characterized by good relationships between staff members, with positive treatment by the institution, and that provided much teaching. More women wanted short residencies with few on-calls and limited hours. More men rated as important residencies affording much responsibility for making clinical decisions and providing research opportunities. More than 50% of the students considered it important that their residency be in a leading department, and in

  15. Medical specialty selection criteria of Israeli medical students early in their clinical experience: subgroups.

    Science.gov (United States)

    Avidan, Alexander; Weissman, Charles; Elchalal, Uriel; Tandeter, Howard; Zisk-Rony, Rachel Yaffa

    2018-04-18

    Israeli medical school classes include a number of student subgroups. Therefore, interventions aimed at recruiting medical students to the various specialties should to be tailored to each subgroup. Questionnaires, distributed to 6 consecutive 5th-year classes of the Hebrew University - Hadassah School of Medicine, elicited information on criteria for choosing a career specialty, criteria for choosing a residency program and the importance of finding a specialty interesting and challenging when choosing a residency. Completed questionnaires were returned by 540 of 769 (70%) students. The decision processes for choosing a medical specialty and choosing a residency program were different. Family and colleagues had minimal influence on choosing a specialty, while family and their residential locality had much influence on choosing a residency, especially among women. Older age, marriage, and spousal influence were positively associated with choice of a specialty. Two-thirds of the students had completed military service, 20% were attending medical school prior to military service, 5% had completed national service and 9% had entered medical school without serving. Despite the pre-military subgroup being younger and having another 7 years of medical school, internship and military service before residency, they had begun thinking about which specialty to choose, just like the post-military students. When choosing a residency program, post-military women were more influenced by their families and family residential locality than their pre-military counterparts; differences ascribed to the older and often married post-military women having or wanting to begin families. This difference was reinforced by fewer post- than pre-military women willing to wait 2-3 years for a residency in the specialty that interested them most and were willing to begin residency immediately after internship in a specialty that interested them less. Medical school classes are composed of

  16. Specialty preferences and motivating factors: A national survey on medical students from five uae medical schools.

    Science.gov (United States)

    Abdulrahman, Mahera; Makki, Maryam; Shaaban, Sami; Al Shamsi, Maryam; Venkatramana, Manda; Sulaiman, Nabil; Sami, Manal M; Abdelmannan, Dima K; Salih, AbdulJabbar M A; AlShaer, Laila

    2016-01-01

    Workforce planning is critical for being able to deliver appropriate health service and thus is relevant to medical education. It is, therefore, important to understand medical students' future specialty choices and the factors that influence them. This study was conducted to identify, explore, and analyze the factors influencing specialty preferences among medical students of the United Arab Emirates (UAE). A multiyear, multicenter survey of medical student career choice was conducted with all five UAE medical schools. The questionnaire consisted of five sections. Chi-squared tests, regression analysis, and stepwise logistic regression were performed. The overall response rate was 46% (956/2079). Factors that students reported to be extremely important when considering their future career preferences were intellectual satisfaction (87%), work-life balance (71%), having the required talent (70%), and having a stable and secure future (69%). The majority of students (60%) preferred internal medicine, surgery, emergency medicine, or family Medicine. The most common reason given for choosing a particular specialty was personal interest (21%), followed by flexibility of working hours (17%). The data show that a variety of factors inspires medical students in the UAE in their choice of a future medical specialty. These factors can be used by health policymakers, university mentors, and directors of residency training programs to motivate students to choose specialties that are scarce in the UAE and therefore better serve the health-care system and the national community.

  17. Factors considered by undergraduate medical students when selecting specialty of their future careers.

    Science.gov (United States)

    Alawad, Awad Ali Mohamed Ahmed; Khan, Waleed Shabeer; Abdelrazig, Yousif Mohammed; Elzain, Yamin Ibrahim; Khalil, Hassan Osman; Ahmed, Omer Bakri Elsayed; Adam, Omeralfaroug Ahmed Ibrahim

    2015-01-01

    Medical students are the source of a country's physicians. Determining how medical students select their areas of specialization is the key to achieve a balanced distribution of doctors among all specialties. The objective is to identify the number of medical students who have decided their postgraduate specialty career, their career specialties preference, and factors that may influence their decision to select a particular specialty. A facility based cross-sectional study was conducted in September 2013 at Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan. A self-administered semi-structured questionnaire comprising demographic data and questions about future specialties preferences and factors influencing those preferences was distributed to 887 male and female students, (from first to fifth academic years) recruited in the study. Response rate was 73% with 647 questionnaires collected, out of 887 eligible medical students. Of the returned questionnaires, 604 were valid. The majority of students (541, 89.6%) have chosen a specialty. Surgery, medicine, paediatrics and obstetrics and gynecology were the most selected specialties. The least selected specialty was anaesthesiology. A significant association was found between gender and specialty choice using Chi-square test (p = 0.00). There was no association between undergraduate level and specialty choice (p = 0.633). The most common reason for choosing a specific specialty was "Personal Interest" (215, 39.7%) followed by being "Helpful to the community" (144, 26.6%). Surgery, medicine, paediatrics and obstetrics and gynecology were the most selected specialties.

  18. Are new medical students' specialty preferences gendered? Related motivational factors at a Dutch medical school.

    Science.gov (United States)

    van Tongeren-Alers, Margret; van Esch, Maartje; Verdonk, Petra; Johansson, Eva; Hamberg, Katarina; Lagro-Janssen, Toine

    2011-01-01

    Female students currently outnumber male students in most medical schools. Some medical specialties are highly gender segregated. Therefore, it is interesting to know whether medical students have early specialization preferences based on their gender. Consequently, we like to know importance stipulated to motivational factors. Our study investigates new medical students' early specialization preferences and motivational factors. New students at a Dutch medical school (n = 657) filled in a questionnaire about specialty preferences (response rate = 94%; 69.5% female, 30.5% male). The students chose out of internal medicine, psychiatry, neurology, pediatrics, surgery, gynecology and family medicine, "other" or "I don't know." Finally, they valued ten motivational factors. Forty percent of the medical students reported no specialty preference yet. Taken together, female medical students preferred pediatrics and wished to combine work and care, whereas male students opted for surgery and valued career opportunities. Gender-driven professional preferences in new medical students should be noticed in order to use competencies. Changes in specialty preferences and motivational factors in pre- and post graduates should further assess the role of medical education.

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

    African Journals Online (AJOL)

    Background: Gender variations exist in the choice of specialties among ... as it affects the distribution of doctors in public health institutions and patient care. ... For female doctors,pediatrics was the topmost specialty (25%) followed by ... Keywords: Gender variation,Specialties,Doctors,Public healthcare,Health workforce ...

  20. Meals at medical specialty society annual meetings: a preliminary assessment.

    Science.gov (United States)

    La Puma, John; Schiedermayer, David; Becker, Jennifer

    2003-01-01

    Little isd known about how meals are chosen for medical meetings. We surveyed the annual meeting planners for 20 major specialty societies. Thirteen (65%) responded; all were currently planning their next meeting. Attendance in 2000 was reported at 113,477 physicians, with 2 million planned meals and snacks. No physician was named as responsible for food choices; the meeting planner and staff were primarily responsible for deciding what food to serve, excluding exhibit halls. Twelve (92%) respondents rated "available budget" as the most important factor. "Nutritional guidelines" were rated "very important" by eight of 13 (63%). However, no specific nutritional guidelines could be identified by any planner. All respondents indicated that members would attend a meeting if "healthy" food were the only option. For 2000, 100% of respondents indicated that for each lunch and for each dinner, a dessert had been included. No annual meeting and no planned 2001 meeting excluded potato chips, snack mixes, or candies at breaks; soda pop was offered at each break. Most respondents (89%) relied on a concluding questionnaire about the meeting facilities to evaluate the food. Respondents reported no difference in charges for "special meals," including vegetarian and kosher meals. Physicians may be unaware that some food served at medical meetings may impair learning, with excessive calorie, fat, and carbohydrate consumption. Small changes can improve the quality of food and beverages selected, without increased cost, and provide choices that conform to national nutritional guidelines. Medical meetings should serve flavorful, healthful food.

  1. Medical Specialty Choice and Related Factors of Brazilian Medical Students and Recent Doctors.

    Directory of Open Access Journals (Sweden)

    Ligia Correia Lima de Souza

    Full Text Available Choosing a medical specialty is an important, complex, and not fully understood process. The present study investigated the factors that are related to choosing and rejecting medical specialties in a group of students and recent medical doctors.A cross-sectional survey of 1,223 medical students and doctors was performed in Brazil in 2012. A standardized literature-based questionnaire was applied that gathered preferable or rejected specialties, and asked questions about extracurricular experiences and the influence of 14 factors on a Likert-type scale from 0 to 4. Specialties were grouped according to lifestyle categories: controllable and uncontrollable, which were subdivided into primary care, internal medicine, and surgical specialties. Notably, the time period of rejection was usually earlier than the time period of intended choice (p < 0.0001, χ(2 = 107.2. The choice mainly occurred during the internship period in medical school (n = 466; 38.7%. An overall large frequency of participation in extracurricular activities was observed (n = 1,184; 95.8%, which were highly associated with the respective medical area. Orthopedic surgery had the highest correlation with participation in specialty-specific organized groups (OR = 59.9, 95% CI = 21.6-166.3 and psychiatry was correlated with participation in research groups (OR = 18.0, 95% CI = 9.0-36.2. With regard to influential factors in controllable lifestyle specialties, "financial reason" (mean score ± standard deviation: 2.8 ± 1.0; median = 3 and "personal time" (3.1 ± 1.3; median = 4 were important factors. In primary care, these factors were less important (1.7 ± 1.3 and 1.7 ± 1.5, respectively; median = 2 for both, and higher scores were observed for "curricular internship" (3.2 ± 1.1, median = 4 and "social commitment" (2.6 ± 1.3, median = 3.The present findings provide important insights into developing strategies to stimulate interest in specialties based on the needs of the

  2. Using marketing research concepts to investigate specialty selection by medical students.

    Science.gov (United States)

    Weissman, Charles; Schroeder, Josh; Elchalal, Uriel; Weiss, Yoram; Tandeter, Howard; Zisk-Rony, Rachel Y

    2012-10-01

    This study was intended to examine whether a marketing research approach improves understanding of medical specialty selection by medical students. This approach likens students to consumers who are deciding whether or not to purchase a product (specialty). This approach proposes that when consumers' criteria match their perceptions of a product's features, the likelihood that they will purchase it (select the specialty) increases. This study examines whether exploring students' selection criteria and perceptions of various specialties provides additional insights into the selection process. Using a consumer behaviour model as a framework, a questionnaire was designed and administered to Year 6 (final-year) students in 2008 and 2009 to elicit information on their knowledge about and interests in various specialties, the criteria they used in specialty selection, and their perceptions of six specialties. A total of 132 (67%) questionnaires were returned. In many instances, consistency between selection criteria and perceptions of a specialty was accompanied by interest in pursuing the specialty. Exceptions were noted and pointed to areas requiring additional research. For example, although > 70% of female students replied that the affordance of a controllable lifestyle was an important selection criterion, many were interested in obstetrics and gynaecology despite the fact that it was not perceived as providing a controllable lifestyle. Minimal overlap among students reporting interest in primary specialties that possess similar characteristics (e.g. paediatrics and family medicine) demonstrated the need to target marketing (recruitment) efforts for each specialty individually. Using marketing research concepts to examine medical specialty selection may precipitate a conceptual shift among health care leaders which acknowledges that, to attract students, specialties must meet students' selection criteria. Moreover, if consumers (students) deem a product (specialty

  3. Collaboration between paediatric surgery and other medical specialties in Nigeria

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    Philemon E Okoro

    2012-01-01

    Full Text Available Background: The quality of service and success of patient care and research in most fields of medicine depend on effective collaboration between different specialties. Paediatric surgery is a relatively young specialty in Nigeria and such collaborations are desirable. This survey assesses the nature and extent of collaboration between paediatric surgery and other specialties in Nigeria. Materials and Methods: This is a questionnaire survey carried out in November 2008 among paediatric surgeons and their trainees practising in Nigeria. Questionnaires were distributed and retrieved either by hand or e-mailing. The responses were then collated and analysed using the SPSS 17.0. Results: Forty-seven respondents were included in the survey. Forty-five (95.7% respondents thought that there was inadequate collaboration and that there was a need for an increased collaboration between paediatric surgery and other specialties. Anaesthesia, paediatrics and radiology are among the specialties where collaborations were most required but not adequately received. Collaboration had been required from these specialties in areas of patient care, training and research. Reasons for inadequate collaboration included the paucity of avenues for inter-specialty communication and exchange of ideas 33 (70.3%, lack of awareness of the need for collaboration 32 (68.1%, tendency to apportion blames for bad outcome 13 (27.7%, and mutual suspicion 8 (17%. Conclusion: There is presently inadequate collaboration between paediatric surgery and other specialties in Nigeria. There is a need for more inter-specialty support, communication, and exchange of ideas in order to achieve desirable outcomes.

  4. International Medical Graduates in Radiation Oncology: Historical Trends and Comparison With Other Medical Specialties

    Energy Technology Data Exchange (ETDEWEB)

    Verma, Vivek, E-mail: vivek333@gmail.com [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Shah, Chirag [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Lautenschlaeger, Tim [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Lin, Chi [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Beriwal, Sushil [Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Zhen, Weining [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Mehta, Minesh P. [Department of Radiation Oncology, Miami Cancer Institute, Coral Gables, Florida (United States); Zietman, Anthony L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2016-07-15

    Purpose: This is the first National Resident Matching Program analysis evaluating historical patterns of international medical graduates (IMGs) in radiation oncology (RO) and providing comparison with American (MD) medical graduates (AMGs), osteopathic students (DOs), unfilled positions, and other specialties. Methods and Materials: National Resident Matching Program data for IMGs were available from 2003 to 2015, with limited data for other specialty matches. The following RO-specific figures were obtained per year: total positions available; total matched positions; number of unfilled positions; and number of IMG, AMG, and DO matches. In addition, the number of IMG matches and total matched positions were obtained for 19 other specialties. Fisher exact tests and χ{sup 2} tests were considered significant at α <.05. Results: From 2010 to 2015, 0.8% of RO matches were IMGs, a decline from 2.4% in 2003 to 2009 (P=.006). Proportions of DO matches during these intervals increased by 40% (from 1.0% to 1.4%), significantly lower than IMGs for 2003 to 2009 (P=.03) but not 2010 to 2015 (P=.26). From 2003 to 2015, the percentage of IMG matches, at 1.5%, was significantly lower than the percentage of unfilled seats, at 3.5% (P<.001). In comparison with other specialties (2003-2015), RO had the fewest IMG matches (1.5%), followed by otolaryngology (1.9%) and orthopedics (2.2%); specialties with the highest IMG proportions were internal medicine (37.1%), family medicine (35.7%), and neurology (31.1%). Conclusions: Presently, IMGs represent <1% of RO matches, the lowest among major specialties. There are several speculative factors associated with this low proportion. There are significantly more unfilled positions than those filled by IMGs; programs at risk of not matching could weigh the advantages and disadvantages of interviewing IMGs.

  5. Just fun or a prejudice? - physician stereotypes in common jokes and their attribution to medical specialties by undergraduate medical students.

    Science.gov (United States)

    Harendza, Sigrid; Pyra, Martin

    2017-07-26

    Many jokes exist about stereotypical attributes of physicians in various specialties, which could lead to prejudices against physicians from a specific specialty. It is unknown whether and when medical students are aware of stereotypes about different specialties. The goal of this study was to analyze the degree of stereotypes that exist about medical specialties amongst undergraduate medical students at different stages of their education. One hundred fifty-two jokes with different content about attributes of physicians from different specialties were found by an internet search. In total, 36 characteristics of the five specialties of anesthesia, general surgery, internal medicine, orthopedics, and psychiatry were extracted from the jokes and they constituted the basis for the development of an online questionnaire. The questionnaire allowed each characteristic to be assigned to one of the five specialties and was sent to 999 undergraduate medical students from semester 1, 7, and 12 at the Medical Faculty of Hamburg University. Three hundred eight (30.8%) of the invited students completed the survey. The characteristics of general surgeons and psychiatrists were assigned congruently most frequently (>50%). For internists and orthopedics, there was a significantly more congruent assignment of the characteristics by final year students versus students in their first semester. Male students assigned the characteristics of anesthetists and internists significantly more congruently than female students. The three characteristics "…are a bit slow on the uptake", "…consider income to be relatively unimportant", and "...apologize a lot" were not assigned to any of the five specialties by more than 50% of the students. While stereotypes about physicians from certain specialties seem to exist commonly, medical educators need to be aware that stereotypes about specialties might develop during undergraduate medical training. In order to support students in their

  6. Specialty choice preference of medical students according to personality traits by Five-Factor Model.

    Science.gov (United States)

    Kwon, Oh Young; Park, So Youn

    2016-03-01

    The purpose of this study was to determine the relationship between personality traits, using the Five-Factor Model, and characteristics and motivational factors affecting specialty choice in Korean medical students. A questionnaire survey of Year 4 medical students (n=110) in July 2015 was administered. We evaluated the personality traits of Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness by using the Korean version of Big Five Inventory. Questions about general characteristics, medical specialties most preferred as a career, motivational factors in determining specialty choice were included. Data between five personality traits and general characteristics and motivational factors affecting specialty choice were analyzed using Student t-test, Mann-Whitney test and analysis of variance. Of the 110 eligible medical students, 105 (95.4% response rate) completed the questionnaire. More Agreeableness students preferred clinical medicine to basic medicine (p=0.010) and more Openness students preferred medical departments to others (p=0.031). Personal interest was the significant motivational factors in more Openness students (p=0.003) and Conscientiousness students (p=0.003). Medical students with more Agreeableness were more likely to prefer clinical medicine and those with more Openness preferred medical departments. Personal interest was a significant influential factor determining specialty choice in more Openness and Conscientiousness students. These findings may be helpful to medical educators or career counselors in the specialty choice process.

  7. Specialty choice preference of medical students according to personality traits by Five-Factor Model

    Directory of Open Access Journals (Sweden)

    Oh Young Kwon

    2016-03-01

    Full Text Available Purpose: The purpose of this study was to determine the relationship between personality traits, using the Five-Factor Model, and characteristics and motivational factors affecting specialty choice in Korean medical students. Methods: A questionnaire survey of Year 4 medical students (n=110 in July 2015 was administered. We evaluated the personality traits of Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness by using the Korean version of Big Five Inventory. Questions about general characteristics, medical specialties most preferred as a career, motivational factors in determining specialty choice were included. Data between five personality traits and general characteristics and motivational factors affecting specialty choice were analyzed using Student t-test, Mann-Whitney test and analysis of variance. Results: Of the 110 eligible medical students, 105 (95.4% response rate completed the questionnaire. More Agreeableness students preferred clinical medicine to basic medicine (p=0.010 and more Openness students preferred medical departments to others (p=0.031. Personal interest was the significant motivational factors in more Openness students (p=0.003 and Conscientiousness students (p=0.003. Conclusion: Medical students with more Agreeableness were more likely to prefer clinical medicine and those with more Openness preferred medical departments. Personal interest was a significant influential factor determining specialty choice in more Openness and Conscientiousness students. These findings may be helpful to medical educators or career counselors in the specialty choice process.

  8. Temperamental traits may be associated with medical students’ specialty preferences – pilot study

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    Agnieszka Pawełczyk

    2010-06-01

    Full Text Available Objective: This study was aimed at checking a hypothesis about a possible correlation between medical students’ temperamental traits and specialty preferences. Material and methods: The study was carried out among 202 students of the 6th year at the Medical University of Łódź in academic year 2008/2009. The examined group consisted of 140 women (69% and 62 men (31%. The average age of the students included into the study was 24.7 years (range: 23-29. The subjects were asked to fill in a questionnaire on demographic variables and the Formal Characteristics of BehaviourTemperament Inventory (FCB-TI by Zawadzki and Strelau. Results: The students taking part in the study preferred specialties in internal diseases (22%, surgery (18% and paediatrics (11%. Two point five percent of the students were indecisive in the specialty choice, 26% preferred surgical specialty and 71% – non-surgical specialty. Differences in temperamental traits were indicated between the students preferring different specialties. Students preferring surgery scored higher than those preferring internal medicine in Endurance (p=0.0036, d=0.63 and Activity (p=0.0292, d=0.63. Significantly higher average values were observed within two temperamental traits: Briskness (p=0.0083, d=0.5 and Endurance (p=0.0070, d=0.49 in students preferring surgical specialties, as compared to those choosing non-surgical specialties. Conclusions: Students’ preferring different medical specialties differ in temperamental traits. They obtained different results on the scales of Briskness, Endurance and Activity. The obtained results may be useful in vocational guidance within the choice of medical specialty.

  9. Oncofertility: A New Medical Specialty Helping Young Cancer Patients Have Children

    Science.gov (United States)

    ... Oncofertility: A New Medical Specialty Helping Young Cancer Patients Have Children Past Issues / Fall 2014 Table of ... old problem: the fertility needs of young cancer patients. The word itself was coined through NIH-sponsored ...

  10. Stability of and Factors Related to Medical Student Specialty Choice of Psychiatry.

    Science.gov (United States)

    Goldenberg, Matthew N; Williams, D Keith; Spollen, John J

    2017-09-01

    Targeted efforts are needed to increase the number of medical students choosing psychiatry, but little is known about when students decide on their specialty or what factors influence their choice. The authors examined the timing and stability of student career choice of psychiatry compared with other specialties and determined what pre- and intra-medical school factors were associated with choosing a career in psychiatry. Using survey data from students who graduated from U.S. allopathic medical schools in 2013 and 2014 (N=29,713), the authors computed rates of psychiatry specialty choice at the beginning and end of medical school and assessed the stability of that choice. A multivariate-adjusted logistic regression and recursive partitioning were used to determine the association of 29 factors with psychiatry specialty choice. Choice of psychiatry increased from 1.6% at the start of medical school to 4.1% at graduation. The stability of psychiatry specialty choice from matriculation to graduation, at just over 50%, was greater than for any other specialty. However, almost 80% of future psychiatrists did not indicate an inclination toward the specialty at matriculation. A rating of "excellent" for the psychiatry clerkship (odds ratio=2.66), a major in psychology in college (odds ratio=2.58), and valuing work-life balance (odds ratio=2.25) were the factors most strongly associated with psychiatry career choice. Students who enter medical school planning to become psychiatrists are likely to do so, but the vast majority of students who choose psychiatry do so during medical school. Increasing the percentage of medical students with undergraduate psychology majors and providing an exemplary psychiatry clerkship are modifiable factors that may increase the rate of psychiatry specialty choice.

  11. Gender difference in preference of specialty as a career choice among Japanese medical students.

    Science.gov (United States)

    Kawamoto, Ryuichi; Ninomiya, Daisuke; Kasai, Yoshihisa; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Kumagi, Teru; Abe, Masanori

    2016-11-10

    In Japan, the absolute deficiency of doctors and maldistribution of doctors by specialty is a significant problem in the Japanese health care system. The purpose of this study was to investigate the factors contributing to specialty preference in career choice among Japanese medical students. A total of 368 medical students completed the survey giving an 88.2 % response rate. The subjects comprised 141 women aged 21 ± 3 (range, 18-34) years and 227 men aged 22 ± 4 (range, 18-44) years. Binary Logistic regression analysis was performed using specialty preferences as the criterion variable and the factors in brackets as six motivational variables (e.g., Factor 1: educational experience; Factor 2: job security; Factor 3: advice from others; Factor 4: work-life balance; Factor 5: technical and research specialty; and Factor 6: personal reasons). Women significantly preferred pediatrics, obstetrics & gynecology, and psychology than the men. Men significantly preferred surgery and orthopedics than the women. For both genders, a high odds ratio (OR) of "technical & research specialty" and a low OR for "personal reasons" were associated with preference for surgery. "Technical & research specialty" was positively associated with preference for special internal medicine and negatively for pediatrics. "Work-life balance" was positively associated with preference for psychology and negatively for emergency medicine. Among the women only, "technical & research specialty" was negatively associated with preference for general medicine/family medicine and obstetrics & gynecology, and "job security" was positively associated for general medicine/family medicine and negatively for psychology. Among men only, "educational experience" and "personal reasons" were positively, and "job security" was negatively associated with preference for pediatrics. For both genders, "work-life balance" was positively associated with preference for controllable lifestyle specialties. We

  12. Gender Distribution Among American Board of Medical Specialties Boards of Directors.

    Science.gov (United States)

    Walker, Laura E; Sadosty, Annie T; Colletti, James E; Goyal, Deepi G; Sunga, Kharmene L; Hayes, Sharonne N

    2016-11-01

    Since 1995, women have comprised more than 40% of all medical school graduates. However, representation at leadership levels in medicine remains considerably lower. Gender representation among the American Board of Medical Specialties (ABMS) boards of directors (BODs) has not previously been evaluated. Our objective was to determine the relative representation of women on ABMS BODs and compare it with the in-training and in-practice gender composition of the respective specialties. The composition of the ABMS BODs was obtained from websites in March 2016 for all Member Boards. Association of American Medical Colleges and American Medical Association data were utilized to identify current and future trends in gender composition. Although represented by a common board, neurology and psychiatry were evaluated separately because of their very different practices and gender demographic characteristics. A total of 25 specialties were evaluated. Of the 25 specialties analyzed, 12 BODs have proportional gender representation compared with their constituency. Seven specialties have a larger proportion of women serving on their boards compared with physicians in practice, and 6 specialties have a greater proportion of men populating their BODs. Based on the most recent trainee data (2013), women have increasing workforce representation in almost all specialties. Although women in both training and practice are approaching equal representation, there is variability in gender ratios across specialties. Directorship within ABMS BODs has a more equitable gender distribution than other areas of leadership in medicine. Further investigation is needed to determine the reasons behind this difference and to identify opportunities to engage women in leadership in medicine. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  13. Surgery or general medicine: a study of the reasons underlying the choice of medical specialty

    Directory of Open Access Journals (Sweden)

    Patrícia Lacerda Bellodi

    Full Text Available CONTEXT: The reality of medical services in Brazil points towards expansion and diversification of medical knowledge. However, there are few Brazilian studies on choosing a medical specialty. OBJECTIVE: To investigate and characterize the process of choosing the medical specialty among Brazilian resident doctors, with a comparison of the choice between general medicine and surgery. TYPE OF STUDY: Stratified survey. SETTING: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC-FMUSP. METHODS: A randomized sample of resident doctors in general medicine (30 and surgery (30 was interviewed. Data on sociodemographic characteristics and the moment, stability and reasons for the choice of specialty were obtained. RESULTS: The moment of choice between the two specialties differed. Surgeons (30% choose the specialty earlier, while general doctors decided progressively, mainly during the internship (43%. Most residents in both fields (73% general medicine, 70% surgery said they had considered another specialty before the current choice. The main reasons for general doctors' choice were contact with patients (50%, intellectual activities (30% and knowledge of the field (27%. For surgeons the main reasons were practical intervention (43%, manual activities (43% and the results obtained (40%. Personality was important in the choice for 20% of general doctors and for 27% of surgeons. DISCUSSION: The reasons found for the choice between general medicine and surgery were consistent with the literature. The concepts of wanting to be a general doctor or a surgeon are similar throughout the world. Personality characteristics were an important influencing factor for all residents, without statistical difference between the specialties, as was lifestyle. Remuneration did not appear as a determinant. CONCLUSION: The results from this group of Brazilian resident doctors corroborated data on choosing a medical specialty from other countries

  14. Classification Model That Predicts Medical Students' Choices of Primary Care or Non-Primary Care Specialties.

    Science.gov (United States)

    Fincher, Ruth-Marie E.; And Others

    1992-01-01

    This study identified factors in graduating medical students' choice of primary versus nonprimary care specialty. Subjects were 509 students at the Medical College of Georgia in 1988-90. Students could be classified by such factors as desire for longitudinal patient care opportunities, monetary rewards, perception of lifestyle, and perception of…

  15. Factors influencing medical students' choice of emergency medicine as a career specialty-a descriptive study of Saudi medical students.

    Science.gov (United States)

    Alkhaneen, Hadeel; Alhusain, Faisal; Alshahri, Khalid; Al Jerian, Nawfal

    2018-03-07

    Choosing a medical specialty is a poorly understood process. Although studies conducted around the world have attempted to identify the factors that affect medical students' choice of specialty, data is scarce on the factors that influence the choice of specialty of Saudi Arabian medical students, in particular those planning a career in emergency medicine (EM). In this study, we investigated whether Saudi medical students choosing EM are influenced by different factors to those choosing other specialties. A cross-sectional survey was conducted at King Saud bin Abdulaziz University for Health Sciences (KSAUHS), Riyadh, Saudi Arabia. The questionnaire distributed among all undergraduate and postgraduate medical students of both sexes in the second and third phases (57% were males and 43% were females). A total of 436 students answered the questionnaire, a response rate of 53.4%. EM group was most influenced by hospital orientation and lifestyle and least influenced by social orientation and prestige provided by their specialty. Unlike controllable lifestyle (CL) group and primary care (PC) group, EM reported lesser influence of social orientation on their career choice. When compared with students primarily interested in the surgical subspecialties (SS), EM group were less likely to report prestige as an important influence. Moreover, students interested in SS reported a leaser influence of medical lifestyle in comparison to EM group. When compared with CL group, EM group reported more interest in medical lifestyle. We found that students primarily interested in EM had different values and career expectations to other specialty groups. The trends in specialty choice should be appraised to meet future needs.

  16. Gender difference in preference of specialty as a career choice among Japanese medical students

    OpenAIRE

    Kawamoto, Ryuichi; Ninomiya, Daisuke; Kasai, Yoshihisa; Kusunoki, Tomo; Ohtsuka, Nobuyuki; Kumagi, Teru; Abe, Masanori

    2016-01-01

    Abstract Background In Japan, the absolute deficiency of doctors and maldistribution of doctors by specialty is a significant problem in the Japanese health care system. The purpose of this study was to investigate the factors contributing to specialty preference in career choice among Japanese medical students. Methods A total of 368 medical students completed the survey giving an 88.2 % response rate. The subjects comprised 141 women aged 21 ± 3 (range, 18–34) years and 227 men aged 22 ± 4 ...

  17. Gender differences in specialty preference and mismatch with real needs in Japanese medical students

    Directory of Open Access Journals (Sweden)

    Harada Tadanari

    2010-02-01

    Full Text Available Abstract Background The shortage of doctors and maldistribution among specialties are of great concern in the Japanese health care system. This study investigated specialty preference in medical students of one university, and examined gender differences and compared their preference with real needs. Methods We conducted a self-administered questionnaire including specialty preference in all students of one medical university. Preference was assessed by the five-level probability of their future choice: 1 = very low, 2 = low, 3 = moderate, 4 = high, and 5 = very high. The proportion of 4 or 5 was calculated as the preference rate. The real needs (magnitude of doctor shortage in the prefecture were drawn from two different surveys. The relationship between the sex-specific preference rate by specialty and real needs was assessed by Spearman's correlation coefficient. Results Internal medicine showed the highest preference rate, followed by general surgery, pediatrics, and emergency medicine. There was no significant correlation between the preference rates of men and women (r = 0.27, p = 0.34. The preference rates for general surgery, orthopedics, neurosurgery, and emergency medicine were significantly higher in men than in women, while those of obstetrics & gynecology, pediatrics, and dermatology were significantly higher in women. The magnitude of doctor shortage by specialty from two surveys were significantly correlated with the total preference rate and men's preference rate (r = 0.54 to 0.74, but not with women's preference rate (r = 0.06 and 0.32. Conclusions This study elucidated not only gender differences in specialty preference but also the relationship to real needs. Critical gender differences and mismatch with real needs were found in women. In addition to traditional gender roles and insufficient support for women's participation in Japan, gender differences and mismatch influence the current and future maldistribution of

  18. Relationship between personality traits and choosing a medical specialty

    Directory of Open Access Journals (Sweden)

    Ji-Tseng Fang

    2015-11-01

    Conclusion: The results of this study can be used as a frame of reference in the field of medical education or in the formulation of governmental policies regarding physician human resource management.

  19. The Stability of Factors Influencing the Choice of Medical Specialty Among Medical Students and Postgraduate Radiology Trainees.

    Science.gov (United States)

    Yen, Adam J; Webb, Emily M; Jordan, Eric J; Kallianos, Kimberly; Naeger, David M

    2018-06-01

    To investigate whether general psychological motivating factors that guide career selection of a medical specialty differ over the course of medical school and to compare differences in motivating factors among students choosing "controllable" lifestyle specialties, students choosing "uncontrollable" lifestyle specialties, and a cohort of radiology residents. An anonymous survey was distributed to first- through fourth-year medical students and radiology residents at a single institution. Participants were asked to select their top three of seven factors that most influenced their choice of medical specialty. Fourth-year students were asked to designate the specialty to which they had applied. The survey was distributed to 259 students and 47 radiology residents with a response rate of 93.8% (243 of 259) and 95.7% (45 of 47), respectively. The top three factors indicated by medical students were finding the daily work fulfilling, work-life balance, and interest in the subject. These top three factors were common to all medical student classes and did not differ between students choosing "controllable" versus "uncontrollable" fields. The factors uncommonly selected were similar personality to others in the field, attending income, competitiveness or prestige, and job market conditions. For radiology residents, the top three motivating factors were the same as for medical students. Three out of seven motivating factors were universally important to trainees, regardless of their stage of medical training or their selection of a controllable versus uncontrollable lifestyle specialty. These data suggest the variety of career choices made by students may not derive from differing underlying values. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  20. Perception of 1 st year medical students towards career choices and specialty of psychiatry

    Directory of Open Access Journals (Sweden)

    Suneet Kumar Upadhyaya

    2015-01-01

    Full Text Available Background: Shortage of psychiatrists is a worldwide phenomenon. If the factors that attract or repel students towards a specialty can be identified, it may be possible to encourage them towards it. Choice of specialty as a career depends on the complex interplay of experiences before, during or after exposure to the specialty. Objectives: The aim was to understand perceptions of 1 st year medical students regarding career choices and the specialty of psychiatry through a cross-sectional questionnaire-based study. Materials and Methods: Perceptions of 137 1 st year medical students from the Government Medical College were recorded using a semi-structured questionnaire. Students provided their opinions about future career choices; perspective of these specialties in terms of financial reward, reputation, work-life balance, challenging aspect, ability to help patients effectively and emotional stability; their preferences in life and interaction with psychiatrist and its impact. Statistical Analysis Used: One-way analysis of variance (ANOVA with post-hoc analysis by Tukey-Kramer test. Results: Surgery was a high priority for 69 (50% while psychiatry was a high priority only for 11 (8%. Surgery was highest for financial reward and reputation, but lowest for work-life balance. Psychiatry had higher emotional stability, however, its the reputation was lower than surgery, medicine, obstetrics and gynaecology and paediatrics. Students preferred reputation (41% over social service opportunities (43%, work-life balance (16%, and high-income (11%. Interaction with psychiatrist increased inclination for psychiatry in 69% (9/13 students. Conclusions: Psychiatry is not a preferred specialty among 1 st year medical students due to its poor reputation.

  1. Behavioral Exploration of Career and Specialty Choice in Medical Students

    Science.gov (United States)

    Borges, Nicole J.

    2007-01-01

    Understanding the process by which students naturally construct and internalize their educational experiences relating to career development is important to career counseling. The author investigated how exploratory behaviors during a community-based field experience course contributed to the vocational development of 1st-year medical students.…

  2. The choice of surgery as a future career specialty among medical ...

    African Journals Online (AJOL)

    Aim: To determine the factors affecting the choice of surgery as a future career specialty among medical interns in a regional hospital in Nigeria. Method: A total of 74 junior doctors who completed internship training at the university of Benin teaching Hospital in 2012 were interviewed in this cross sectional study.

  3. Factors Affecting the Choice of Anesthesiology by Medical Students for Specialty Training.

    Science.gov (United States)

    Chandra, Phool; Hughes, Mark

    1984-01-01

    A study of medical students' choice of anesthesiology as a specialty and the quality of clerkships available established several factors in students' choice, including the negative effect of certified registered nurse anesthetists on the operating room floor. A study of relationships with nurse practitioners, physician's assistants, and…

  4. Medical Informatics Specialty in the Developed English-Speaking Countries: The Terminology Comparative Analysis

    Science.gov (United States)

    Kobryn, Nadia

    2015-01-01

    The article studies the development process of medical informatics specialty terminology as the ground for further research into foreign countries' experience, including the Canadian one, of specialists' professional training in the field of MI. The study determines the origin and chief stages of the formation and development of the medical…

  5. Influence of gender and other factors on medical student specialty interest.

    Science.gov (United States)

    Boyle, Veronica; Shulruf, Boaz; Poole, Phillippa

    2014-09-12

    Medical schools must select and educate to meet anticipated health needs. Factors influencing career choice include those of the student and their background as well as subsequent experience. Women have comprised over 50% of medical classes for over 20 years. This study describes gender patterns of current specialty interest among medical students at the University of Auckland, and models the predictive effect of gender compared to other career influencing factors. The study analysed career intention survey data from 711 graduating medical students (response rate, 79%) from 2006 to 2011. Interest level was highest for medicine, followed by subspecialty surgery, general practice and paediatrics. There were differences by gender for most specialties, but not for general practice. Women were more likely than men to be interested in Obstetrics and Gynaecology, Paediatrics, Geriatrics, Public Health or General Medicine, and less interested in Surgery, Anaesthesia, Emergency Medicine or post graduate study. Each specialty had a different pattern of influencing factors with the most important factor being the experience on a clinical attachment. Factors in career choice are complex and vary by gender and specialty. General practice levels of interest are too low for workforce needs. Predictive models need to be validated in longer term studies but may help guide selection and curriculum design.

  6. Medical Imaging Field of Magnetic Resonance Imaging: Identification of Specialties within the Field

    Science.gov (United States)

    Grey, Michael L.

    2009-01-01

    This study was conducted to determine if specialty areas are emerging in the magnetic resonance imaging (MRI) profession due to advancements made in the medical sciences, imaging technology, and clinical applications used in MRI that would require new developments in education/training programs and national registry examinations. In this…

  7. Motivations influencing the specialty choices of medical school graduates

    Directory of Open Access Journals (Sweden)

    zarghami M

    2003-04-01

    Full Text Available Background: Growing national concern about distortions in the size, specially composition, and availability of the physician workforce -especially after "cultural revolution n- has evoked challenges in Iran. Purpose: To determine various factors that influence medical graduates choices for residency program. Methods: All applicants for residency program in Mazandaran university of Medical Sciences and Health Services completed the Medical School Graduation Questionnaire, and rated each factor using 0 to 4 Likert-type scale. Factors' ratings were also compared across applicants of different residency program, and demographic variables. Results: The top two factors rated as having strong influences were ones related to interest in helping peop1e (rated 3.07, and intellectual content of the specially (rated 3. Malpractice insurance cost has the least influence (rated 0.98. Most of men preferred independence, whereas most of women preferred predictable working hours. Opportunity to make differences in people's l(fe influenced the specially choices of usual participants. whereas those who used war veterans quota paid more attention to independence and exercise of social responsibility. Patient contact factors were less important to graduates who chose diagnostic speciafties. Also, there was a significant association between the participants' age and four factors. Conclusion: These graduates based their specially preference heavily on the opportunity that the specially affords to help people, and intellectual content of the specially. Knowing the hierarchy of influences on graduates' motivations should help education strategists determine what experiences and perceptions must change if a different mix of specially decision is to result. Keywords: SPECIAL TY, MEDICAL SCHOOL, SARI, MAZANDARAN

  8. Pain medicine: The case for an independent medical specialty and training programs.

    Science.gov (United States)

    Dubois, Michel Y; Follett, Kenneth A

    2014-06-01

    Over the last 30 years, pain has become one of the most dynamic areas of medicine and a public health issue. According to a recent Institute of Medicine report, pain affects approximately 100 million Americans at an estimated annual economic cost of $560 to $635 billion and is poorly treated overall. The American Board of Medical Specialties (ABMS) recognizes a pain subspecialty, but pain care delivery has struggled with increasing demand and developed in an inconsistent and uncoordinated fashion. Pain education is insufficient and highly variable. Multiple pain professional organizations have led to fragmentation of the field and lack of interdisciplinary agreement, resulting in confusion regarding who speaks for pain medicine. In this Perspective, the authors argue that ABMS recognition of pain medicine as an independent medical specialty would provide much needed structure and oversight for the field and would generate credibility for the specialty and its providers among medical peers, payers, regulatory and legislative agencies, and the public at large. The existing system, managed by three ABMS boards, largely excludes other specialties that contribute to pain care, fails to provide leadership from a single professional organization, provides suboptimal training exposure to pain medicine, and lengthens training, which results in inefficient use of time and educational resources. The creation of a primary ABMS conjoint board in pain medicine with its own residency programs and departments would provide better coordinated training, ensure the highest degree of competence of pain medicine specialists, and improve the quality of pain care and patient safety.

  9. Empathy differences by gender and specialty preference in medical students: a study in Brazil.

    Science.gov (United States)

    Santos, Mariana A; Grosseman, Suely; Morelli, Thiago C; Giuliano, Isabela C B; Erdmann, Thomas R

    2016-05-21

    We have conducted this study to assess medical students' empathy and to examine empathy differences by students' socio-demographic characteristics, including gender, and specialty preference. We have conducted a cross-sectional and descriptive research. Among 595 medical students registered at the Federal University of Santa Catarina (Brazil) in 2012, we have selected a sample of 320 enrolled in the first, third, fifth, seventh, ninth, eleventh, and in the last semester of the course. The response rate obtained was 70.6% (n=226). Data was collected by using a self-report questionnaire, and the variables analyzed included course semester, socio-demographic characteristics (such as age, gender, household monthly income and parents level of education), students' specialty preference, and empathy assessed by the Jefferson Scale of Empathy. We have used descriptive statistics, 95% Confidence Interval for percentages, Student's t-test, and Analysis of Variance to analyze the data. Mean empathy among students was (M=119.7, SD=9.9), with no difference by according to semester (F=1.5, p=.2). Empathy means were higher among females (M=118.3, SD=10.6) than among males (M=121.0, SD=9.3, t=-2.1, p=.032). Students who preferred a people-oriented specialty obtained significantly higher mean scores (M=121.5, SD=8.1) in comparison to students who preferred technology-oriented specialties (M=118.0, SD=11.3, t=2.4, p=.02). Our study has found consistently high scores of empathy among medical students enrolled in all levels of training at the Federal University of Santa Catarina, and higher empathy among women and students who intend to pursue a people-oriented specialty. Conclusions on higher empathy among medical students require further study.

  10. Expanding Educators' Contributions to Continuous Quality Improvement of American Board of Medical Specialties Maintenance of Certification.

    Science.gov (United States)

    Nora, Lois Margaret; Pouwels, Mellie Villahermosa; Irons, Mira

    2016-01-01

    The American Board of Medical Specialties board certification has transformed into a career-long process of learning, assessment, and performance improvement through its Program for Maintenance of Certification (MOC). Medical educators across many medical professional organizations, specialty societies, and other institutions have played important roles in shaping MOC and tailoring its overarching framework to the needs of different specialties. This Commentary addresses potential barriers to engagement in work related to MOC for medical school (MS) and academic health center (AHC) educators and identifies reasons for, and ways to accomplish, greater involvement in this work. The authors present ways that medical and other health professions educators in these settings can contribute to the continuous improvement of the MOC program including developing educational and assessment activities, engaging in debate about MOC, linking MOC with institutional quality improvement activities, and pursuing MOC-related scholarship. MS- and AHC-based educators have much to offer this still-young and continually improving program, and their engagement is sought, necessary, and welcomed.

  11. Emergency medicine journal impact factor and change compared to other medical and surgical specialties.

    Science.gov (United States)

    Reynolds, Joshua C; Menegazzi, James J; Yealy, Donald M

    2012-11-01

    A journal impact factor represents the mean number of citations per article published. Designed as one tool to measure the relative importance of a journal, impact factors are often incorporated into academic evaluation of investigators. The authors sought to determine how impact factors of emergency medicine (EM) journals compare to journals from other medical and surgical specialties and if any change has taken place over time. The 2010 impact factors and 5-year impact factors for each journal indexed by the Thomson Reuters ISI Web of Knowledge Journal Citation Reports (JCR) were collected, and EM, medical, and surgical specialties were evaluated. The maximum, median, and interquartile range (IQR) of the current impact factor and 5-year impact factor in each journal category were determined, and specialties were ranked according to the summary statistics. The "top three" impact factor journals for each specialty were analyzed, and growth trends from 2001 through 2010 were examined with random effects linear regression. Data from 2,287 journals in 31 specialties were examined. There were 23 EM journals with a current maximum impact factor of 4.177, median of 1.269, and IQR of 0.400 to 2.176. Of 23 EM journals, 57% had a 5-year impact factor available, with a maximum of 4.531, median of 1.325, and IQR of 0.741 to 2.435. The top three EM journals had a mean standard deviation (±SD) impact factor of 3.801 (±0.621) and median of 4.142 and a mean (±SD) 5-year impact factor of 3.788 (±1.091) and median of 4.297, with a growth trend of 0.211 (95% confidence interval [CI] = 0.177 to 0.245; p journals ranked no higher than 24th among 31 specialties. Emergency medicine journals rank low in impact factor summary statistics and growth trends among 31 medical and surgical specialties. © 2012 by the Society for Academic Emergency Medicine.

  12. Primary care specialty career choice among Canadian medical students: Understanding the factors that influence their decisions.

    Science.gov (United States)

    Osborn, Heather Ann; Glicksman, Jordan T; Brandt, Michael G; Doyle, Philip C; Fung, Kevin

    2017-02-01

    To identify which factors influence medical students' decision to choose a career in family medicine and pediatrics, and which factors influence their decision to choose careers in non-front-line specialties. Survey that was created based on a comprehensive literature review to determine which factors are considered important when choosing practice specialty. Ontario medical school. An open cohort of medical students in the graduating classes of 2008 to 2011 (inclusive). The main factors that influenced participants' decision to choose a career in primary care or pediatrics, and the main factors that influenced participants' decision to choose a career in a non-front-line specialty. A total of 323 participants were included in this study. Factors that significantly influenced participants' career choice in family medicine or pediatrics involved work-life balance (acceptable hours of practice [ P = .005], acceptable on-call demands [ P = .012], and lifestyle flexibility [ P = .006]); a robust physician-patient relationship (ability to promote individual health promotion [ P = .014] and the opportunity to form long-term relationships [ P  < .001], provide comprehensive care [ P = .001], and treat patients and their families [ P = .006]); and duration of residency program ( P = .001). The career-related factors that significantly influenced participants' decision to choose a non-front-line specialty were as follows: becoming an expert ( P  < .001), maintaining a focused scope of practice ( P  < .001), having a procedure-focused practice ( P = .001), seeing immediate results from one's actions ( P  < .001), potentially earning a high income ( P  < .001), and having a perceived status among colleagues ( P  < .001). In this study, 8 factors were found to positively influence medical students' career choice in family medicine and pediatrics, and 6 factors influenced the decision to choose a career in a non-front-line specialty. Medical students can be

  13. Gender difference in preference of specialty as a career choice among Japanese medical students

    Directory of Open Access Journals (Sweden)

    Ryuichi Kawamoto

    2016-11-01

    Full Text Available Abstract Background In Japan, the absolute deficiency of doctors and maldistribution of doctors by specialty is a significant problem in the Japanese health care system. The purpose of this study was to investigate the factors contributing to specialty preference in career choice among Japanese medical students. Methods A total of 368 medical students completed the survey giving an 88.2 % response rate. The subjects comprised 141 women aged 21 ± 3 (range, 18–34 years and 227 men aged 22 ± 4 (range, 18–44 years. Binary Logistic regression analysis was performed using specialty preferences as the criterion variable and the factors in brackets as six motivational variables (e.g., Factor 1: educational experience; Factor 2: job security; Factor 3: advice from others; Factor 4: work-life balance; Factor 5: technical and research specialty; and Factor 6: personal reasons. Results Women significantly preferred pediatrics, obstetrics & gynecology, and psychology than the men. Men significantly preferred surgery and orthopedics than the women. For both genders, a high odds ratio (OR of “technical & research specialty” and a low OR for “personal reasons” were associated with preference for surgery. “Technical & research specialty” was positively associated with preference for special internal medicine and negatively for pediatrics. “Work-life balance” was positively associated with preference for psychology and negatively for emergency medicine. Among the women only, “technical & research specialty” was negatively associated with preference for general medicine/family medicine and obstetrics & gynecology, and “job security” was positively associated for general medicine/family medicine and negatively for psychology. Among men only, “educational experience” and “personal reasons” were positively, and “job security” was negatively associated with preference for pediatrics. For both genders,

  14. [Development of MEDUC-PG14 survey to assess postgraduate teaching in medical specialties].

    Science.gov (United States)

    Pizarro, Margarita; Solís, Nancy; Rojas, Viviana; Díaz, Luis Antonio; Padilla, Oslando; Letelier, Luz María; Aizman, Andrés; Sarfatis, Alberto; Olivos, Trinidad; Soza, Alejandro; Delfino, Alejandro; Latorre, Gonzalo; Ivanovic-Zuvic, Danisa; Hoyl, Trinidad; Bitran, Marcela; Arab, Juan Pablo; Riquelme, Arnoldo

    2015-08-01

    Feedback is one of the most important tools to improve teaching in medical education. To develop an instrument to assess the performance of clinical postgraduate teachers in medical specialties. A qualitative methodology consisting in interviews and focus-groups followed by a quantitative methodology to generate consensus, was employed. After generating the instrument, psychometric tests were performed to assess the construct validity (factor analysis) and reliability (Cronbach’s alpha). Experts in medical education, teachers and residents of a medical school participated in interviews and focus groups. With this information, 26 categories (79 items) were proposed and reduced to 14 items (Likert scale 1-5) by an expert’s Delphi panel, generating the MEDUC-PG14 survey, which was answered by 123 residents from different programs of medical specialties. Construct validity was carried out. Factor analysis showed three domains: Teaching and evaluation, respectful behavior towards patients and health care team, and providing feedback. The global score was 4.46 ± 0.94 (89% of the maximum). One teachers’ strength, as evaluated by their residents was “respectful behavior” with 4.85 ± 0.42 (97% of the maximum). “Providing feedback” obtained 4.09 ± 1.0 points (81.8% of the maximum). MEDUC-PG14 survey had a Cronbach’s alpha coefficient of 0.947. MEDUC-PG14 survey is a useful and reliable guide for teacher evaluation in medical specialty programs. Also provides feedback to improve educational skills of postgraduate clinical teachers.

  15. A Delphi developed syllabus for the medical specialty of sport and exercise medicine.

    Science.gov (United States)

    Humphries, David; Jaques, Rod; Dijkstra, Hendrik Paulus

    2018-04-01

    Training in the medical specialty of sport and exercise medicine is now available in many, but not all countries. Lack of resources may be a barrier to the development of this important specialty field and the International Syllabus in Sport and Exercise Medicine Group was convened to reduce one potential barrier, the need to develop a syllabus. The group is composed of 17 sport and exercise medicine specialists residing in 12 countries (Australia, Canada, India, Ireland, Malaysia, the Netherlands, Qatar, South Africa, Sweden, Switzerland, the UK and USA). This paper presents the first phase of this project covering the domains and general learning areas of a specialist training syllabus in sport and exercise medicine. © 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.

  16. How we created a peer-designed specialty-specific selective for medical student career exploration.

    Science.gov (United States)

    Keating, Elizabeth M; O'Donnell, Erin P; Starr, Stephanie R

    2013-01-01

    In recent years, medical students have recognized and advocated for opportunities to explore various specialties earlier in their medical education. A brief literature review, however, reveals little consensus on the best approach to introduce students to different fields during their preclinical years. We present one of the first reports of a student-led effort to design and implement a preclinical specialty-specific elective. At Mayo Medical School, for two consecutive years the student president of the Pediatric Interest Group has created a peer-designed weeklong group elective ("selective") experience consisting of workshops, faculty and resident panel discussions, and clinical shadowing experiences based on a student needs assessment. Each year, more than 25% of the first- and second-year medical student body participated. The majority of students who completed the selective agreed that this experience heightened their interests and expanded their knowledge about pediatrics. The pediatric group selective has provided students with important resources for their medical education and future careers. Students found the group selective beneficial to their learning experience and recommend continuing to offer it in the future.

  17. Examining Medical Student Specialty Choice Through a Gender Lens: An Orientational Qualitative Study.

    Science.gov (United States)

    Smith, Victoria; Bethune, Cheri; Hurley, Katrina F

    2018-01-01

    Phenomenon: A growing number of women are entering the medical workforce, yet their distribution across medical specialties remains nonuniform. We sought to describe how culture, bias, and socialization shape gendered thinking regarding specialty choice at a Canadian undergraduate medical institution. We analyzed transcripts from the Career Choices Project: 16 semistructured focus group discussions with 70 students graduating from Memorial University of Newfoundland in 2003, 2006, 2007, and 2008. The questions and prompts were designed to explore factors influencing specialty choice and did not specifically probe gender-based experiences. Focus groups were audio-recorded, transcribed, and deidentified before analysis. Analysis was inductive and guided by principles of orientational qualitative inquiry using a gender-specific lens. The pursuits of personal and professional goals, as well as contextual factors, were the major themes that influenced decision-making for women and men. Composition of these major themes varied between genders. Influence of a partner, consideration of familial commitments (both present and future), feeling a sense of connectedness with the field in question, and social accountability were described by women as important. Both genders hoped to pursue careers that would afford "flexibility" in order to balance work with their personal lives, though the construct of work-life balance differed between genders. Women did not explicitly identify gender bias or sexism as influencing factors, but their narratives suggest that these elements were at play. Insights: Our findings suggest that unlike men, women's decision-making is informed by tension between personal and professional goals, likely related to the context of gendered personal and societal expectations.

  18. [Impact of the Core Training Law on preventive medicine and public health training and other common medical specialties].

    Science.gov (United States)

    Latasa, Pello; Gil-Borrelli, Christian; Aguilera, José Antonio; Reques, Laura; Barreales, Saúl; Ojeda, Elena; Alemán, Guadalupe; Iniesta, Carlos; Gullón, Pedro

    2016-01-01

    The purpose of the Core Training Law (CTL) is to amend specialised medical training to include 24 months of common training. The aim of this study is to assess its potential impact on the Preventive Medicine and Public Health (PM&PH) training programme and other medical specialties. The programmes of the 21 common medical specialties were analysed and the recommended training periods for each specialty collected, before the information was agreed upon by three observers. The training impact was calculated as the percentage of months that should be amended per specialty to adapt to the common training schedule. The Preventive Medicine and Public Health training programme is the specialty most affected by the Core Training Law (100%, 24 months). Intensive medicine (0%, 0 months) and medical oncology (17%, 4 months) is the least affected. The CTL affects the common medical specialties in different ways and requires a complete reorganisation of the activities and competencies of PM&PH professionals. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

  19. Partnering with a medical specialty society to perform online public health surveillance.

    Science.gov (United States)

    Hampson, Neil B; Bell, Jeneita; Clower, Jacquelyn H; Dunn, Susan L; Weaver, Lindell K

    2012-01-01

    While accidental carbon monoxide (CO) poisoning is common, it is felt to be largely preventable through targeted public education. Development of effective education programs requires accurate epidemiologic information about the condition. Many acute, severe cases of CO poisoning are treated with hyperbaric oxygen (HBO2) at hospital-based facilities staffed by members of the Undersea and Hyperbaric Medical Society (UHMS). In 2008, the Centers for Disease Control and Prevention (CDC) began sponsoring a UHMS proposal to use online reporting by UHMS members of cases treated with HBO2. This report describes development and implementation of the internet-based surveillance system, as well as its first year of operation. From August 2008 to July 2009, a total of 740 cases were reported by the 82 hyperbaric facilities participating nationwide. Extensive epidemiologic information about CO poisoning in the United States has been collected, and the utility of partnering with a medical specialty society for disease-specific surveillance demonstrated.

  20. Association of prescription abandonment with cost share for high-cost specialty pharmacy medications.

    Science.gov (United States)

    Gleason, Patrick P; Starner, Catherine I; Gunderson, Brent W; Schafer, Jeremy A; Sarran, H Scott

    2009-10-01

    In 2008, specialty medications accounted for 15.1% of total pharmacy benefit medication spending, and per member expenditures have increased by 11.1% annually from 2004 to 2008 within a commercially insured population of 8 million members. Insurers face increasing pressure to control specialty medication expenditures and to rely on increasing member cost share through creation of a fourth copayment tier within the incentive-based formulary pharmacy benefit system. Data are needed on the influence that member out-of-pocket (OOP) expense may have on prescription abandonment (defined as the patient never actually taking possession of the medication despite evidence of a written prescription generated by a prescriber). To explore the relationship between prescription abandonment and OOP expense among individuals newly initiating high-cost medication therapy with a tumor necrosis factor (TNF) blocker or multiple sclerosis (MS) biologic agent. This observational cross-sectional study queried a midwestern and southern U.S. database of 13,172,480 commercially insured individuals to find members with a pharmacy benefit-adjudicated claim for a TNF blocker or MS specialty medication during the period from July 2006 through June 2008. Prescription abandonment was assessed among continuously enrolled members newly initiating TNF blocker or MS therapy. Prescription abandonment was defined as reversal of the adjudicated claim with no evidence of a subsequent additional adjudicated paid claim in the ensuing 90 days. Separate analyses for MS and TNF blocker therapy were performed to assess the association between member OOP expense and abandonment rate using the Cochran-Armitage test for trend and multivariate logistic regression. Members were placed into 1 of the 7 following OOP expense groups per claim: $0-$100, $101-$150, $151-$200, $201-$250, $251-$350, $351-$500, or more than $500. The association of MS or TNF blocker abandonment rate with OOP expense was tested with logistic

  1. Specialty-service lines: salvos in the new medical arms race.

    Science.gov (United States)

    Berenson, Robert A; Bodenheimer, Thomas; Pham, Hoangmai H

    2006-01-01

    Hospitals and physicians are developing and marketing discrete and profitable specialty-service lines. Although closely affiliated specialist physicians are central to hospitals' service-line products, other physicians compete directly with hospitals via physician-owned specialty facilities. Specialty-service lines may be provided in a variety of settings, both inside and outside traditional hospital walls. Thus far, the escalating battle between hospitals and physicians for control over specialty services has not affected hospital profitability. However, as the scope of care that can be safely performed in the outpatient arena expands, physician competition for control over specialty services may threaten hospitals' financial health.

  2. The cost of pursuing a medical career in the military: a tale of five specialties.

    Science.gov (United States)

    Cronin, William A; Morgan, Jessica A; Weeks, William B

    2010-08-01

    The physician payment system is a focus of potential reform in the United States. The authors explored the effects of the military's method of physician payment on physicians' returns on educational investment for several specialties. This retrospective, observational study used national data from 2003 and standard financial techniques to calculate the net present value-the current value of an expected stream of cash flows at a particular rate of interest-of the educational investments of medical students in ten 30-year career paths: either military or civilian careers in internal medicine, psychiatry, gastroenterology, general surgery, or orthopedics. At a 5% discount rate, in the civilian world, the lowest return on an educational investment accrued to psychiatrists ($1.136 million) and the highest to orthopedists ($2.489 million), a range of $1.354 million. In the military, the lowest returns accrued to internists ($1.377 million) and the highest to orthopedists ($1.604 million); however, the range was only $0.227 million, one-sixth that found in the civilian sector. The authors also found that most military physicians do not remain in the military for their full careers. Choosing a military career substantially decreases the net present value of an educational investment for interventionalists, but it does so only modestly for primary care physicians. Further, a military career path markedly diminishes specialty-specific variation in the net present values of educational investment. Adopting a military structure for engaging medical students might help reverse the current trend of declining interest in primary care.

  3. [Usefulness of an online education platform for the medical and surgical emergencies specialty in Mexico].

    Science.gov (United States)

    Loria-Castellanos, Jorge

    2014-01-01

    Determine the usefulness of a Moodle-type education platform for knowledge development with residents in the medical and surgical emergencies (MSE) specialty. This quasi-experimental study compared the departmental evaluations of MSE residents in two Mexican hospital units after they did their academic work using different educational strategies. The control group used a traditional format (classroom-style teaching with guided discussion), while the comparison group had access to a variety of resources (forums, chat, wikis, downloaded files) on a Moodle-type platform. Nonparametric statistics were used. The study was conducted during the 2010 - 2011 and 2011 - 2012 academic years. Three versions of the course were made available online, geared to the academic level of the residents (first, second, or third year). There were statistically significant differences in the mid-year evaluations, and improvements were even greater in the evaluations at the end of the academic year, especially for the third-year residents. In both academic years, the mid-year evaluations reported that only one resident in the control group performed within the average range, while the majority were in the lower range. The resources most used with the platform Moodle were downloaded files (77%) and the forum (63%). Still, 46.4% of the residents said that they encountered some type of limitation when they used the platform, the main one being lack of time (76.9%). The Moodle-type education platform appears to be useful and to offer greater opportunities for knowledge development compared with the traditional strategies. It is recommended that educational strategies based on Moodle-type platforms be implemented for MSE and other medical specialties.

  4. Prescription patterns and costs of acne/rosacea medications in Medicare patients vary by prescriber specialty.

    Science.gov (United States)

    Zhang, Myron; Silverberg, Jonathan I; Kaffenberger, Benjamin H

    2017-09-01

    Prescription patterns for acne/rosacea medications have not been described in the Medicare population, and comparisons across specialties are lacking. To describe the medications used for treating acne/rosacea in the Medicare population and evaluate differences in costs between specialties. A cross-sectional study was performed of the 2008 and 2010 Centers for Medicare and Medicaid Services Prescription Drug Profiles, which contains 100% of Medicare part D claims. Topical antibiotics accounted for 63% of all prescriptions. Patients ≥65 years utilized more oral tetracycline-class antibiotics and less topical retinoids. Specialists prescribed brand name drugs for the most common topical retinoids and most common topical antibiotics more frequently than family medicine/internal medicine (FM/IM) physicians by 6%-7%. Topical retinoids prescribed by specialists were, on average, $18-$20 more in total cost and $2-$3 more in patient cost than the same types of prescriptions from FM/IM physicians per 30-day supply. Specialists (60%) and IM physicians (56%) prescribed over twice the rate of branded doxycycline than FM doctors did (27%). The total and patient costs for tetracycline-class antibiotics were higher from specialists ($18 and $4 more, respectively) and IM physicians ($3 and $1 more, respectively) than they were from FM physicians. The data might contain rare prescriptions used for conditions other than acne/rosacea, and suppression algorithms might underestimate the number of specialist brand name prescriptions. Costs of prescriptions for acne/rosacea from specialists are higher than those from primary care physicians and could be reduced by choosing generic and less expensive options. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  5. The Effect of Medical Student Volunteering in a Student-Run Clinic on Specialty Choice for Residency.

    Science.gov (United States)

    Brown, Ashley; Ismail, Rahim; Gookin, Glenn; Hernandez, Caridad; Logan, Grace; Pasarica, Magdalena

    2017-01-09

     Student-run free clinics (SRFCs) are a recent popular addition to medical school education, and a subset of studies has looked at the influence of SRFC volunteering on the medical student's career development. The majority of the research done in this area has focused on understanding if these SRFCs produce physicians who are more likely to practice medicine in underserved communities, caring for the uninsured. The remainder of the research has investigated if volunteering in an SRFC influences the specialty choice of medical school students. The results of these specialty choice studies give no definitive answer as to whether medical students chose primary or specialty care residencies as a result of their SRFC experience. Keeping Neighbors in Good Health through Service (KNIGHTS) is the SRFC of the University of Central Florida College of Medicine (UCF COM). Both primary and specialty care is offered at the clinic. It is the goal of this study to determine if volunteering in the KNIGHTS SRFC influences UCF COM medical students to choose primary care, thereby helping to meet the rising need for primary care physicians in the United States.  A survey was distributed to first, second, and third-year medical students at the UCF COM to collect data on demographics, prior volunteering experience, and specialty choice for residency. Responses were then combined with records of volunteer hours from the KNIGHTS Clinic and analyzed for correlations. We analyzed the frequency and Pearson's chi-squared values. A p value of less than 0.05 was considered statistically significant.  Our survey had a total response rate of 39.8%. We found that neither the act of becoming a KNIGHTS Clinic volunteer nor the hours volunteered at the KNIGHTS Clinic influenced the UCF COM student's choice to enter a primary care specialty (p = NS). Additionally, prior volunteering/clinical experience or the gender of the medical school student did not influence a student's choice to volunteer at

  6. Estimated cost savings associated with the transfer of office-administered specialty pharmaceuticals to a specialty pharmacy provider in a Medical Injectable Drug program.

    Science.gov (United States)

    Baldini, Christopher G; Culley, Eric J

    2011-01-01

    A large managed care organization (MCO) in western Pennsylvania initiated a Medical Injectable Drug (MID) program in 2002 that transferred a specific subset of specialty drugs from physician reimbursement under the traditional "buy-and-bill" model in the medical benefit to MCO purchase from a specialty pharmacy provider (SPP) that supplied physician offices with the MIDs. The MID program was initiated with 4 drugs in 2002 (palivizumab and 3 hyaluronate products/derivatives) growing to more than 50 drugs by 2007-2008. To (a) describe the MID program as a method to manage the cost and delivery of this subset of specialty drugs, and (b) estimate the MID program cost savings in 2007 and 2008 in an MCO with approximately 4.6 million members. Cost savings generated by the MID program were calculated by comparing the total actual expenditure (plan cost plus member cost) on medications included in the MID program for calendar years 2007 and 2008 with the total estimated expenditure that would have been paid to physicians during the same time period for the same medication if reimbursement had been made using HCPCS (J code) billing under the physician "buy-and-bill" reimbursement rates. For the approximately 50 drugs in the MID program in 2007 and 2008, the drug cost savings in 2007 were estimated to be $15.5 million (18.2%) or $290 per claim ($0.28 per member per month [PMPM]) and about $13 million (12.7%) or $201 per claim ($0.23 PMPM) in 2008. Although 28% of MID claims continued to be billed by physicians using J codes in 2007 and 22% in 2008, all claims for MIDs were limited to the SPP reimbursement rates. This MID program was associated with health plan cost savings of approximately $28.5 million over 2 years, achieved by the transfer of about 50 physician-administered injectable pharmaceuticals from reimbursement to physicians to reimbursement to a single SPP and payment of physician claims for MIDs at the SPP reimbursement rates.

  7. Does students' exposure to gender discrimination and sexual harassment in medical school affect specialty choice and residency program selection?

    Science.gov (United States)

    Stratton, Terry D; McLaughlin, Margaret A; Witte, Florence M; Fosson, Sue E; Nora, Lois Margaret

    2005-04-01

    To examine the role of gender discrimination and sexual harassment in medical students' choice of specialty and residency program. Anonymous, self-administered questionnaires were distributed in 1997 to fourth-year students enrolled in 14 public and private U.S. medical schools. In addition to reporting the frequency of gender discrimination and sexual harassment encountered during preclinical coursework, core clerkships, elective clerkships, and residency selection, students assessed the impact of these exposures (none, a little, some, quite a bit, the deciding factor) on their specialty choices and rankings of residency programs. A total of 1,314 (69%) useable questionnaires were returned. Large percentages of men (83.2%) and women (92.8%) experienced, observed, or heard about at least one incident of gender discrimination and sexual harassment during medical school, although more women reported such behavior across all training contexts. Compared with men, significantly (p harassment influenced their specialty choices (45.3% versus 16.4%) and residency rankings (25.3% versus 10.9%). Across all specialties, more women than men experienced gender discrimination and sexual harassment during residency selection, with one exception: a larger percentage of men choosing obstetrics and gynecology experienced such behavior. Among women, those choosing general surgery were most likely to experience gender discrimination and sexual harassment during residency selection. Interestingly, correlations between exposure to gender discrimination and sexual harassment and self-assessed impact on career decisions tended to be larger for men, suggesting that although fewer men are generally affected, they may weigh such experiences more heavily in their choice of specialty and residency program. This study suggests that exposure to gender discrimination and sexual harassment during undergraduate education may influence some medical students' choice of specialty and, to a lesser

  8. Where Are the Women? The Underrepresentation of Women Physicians Among Recognition Award Recipients From Medical Specialty Societies.

    Science.gov (United States)

    Silver, Julie K; Slocum, Chloe S; Bank, Anna M; Bhatnagar, Saurabha; Blauwet, Cheri A; Poorman, Julie A; Villablanca, Amparo; Parangi, Sareh

    2017-08-01

    Membership in medical societies is associated with a number of benefits to members that may include professional education, opportunities to present research, scientific and/or leadership training, networking, and others. In this perspective article, the authors address the value that medical specialty society membership and inclusion have in the development of an academic physician's career and how underrepresentation of women may pose barriers to their career advancement. Because society membership itself is not likely sufficient to support the advancement of academic physicians, this report focuses on one key component of advancement that also can be used as a measure of inclusion in society activities-the representation of women physicians among recipients of recognition awards. Previous reports demonstrated underrepresentation of women physicians among recognition award recipients from 2 physical medicine and rehabilitation specialty organizations, including examples of zero or near-zero results. This report investigated whether zero or near-zero representation of women physicians among recognition award recipients from medical specialty societies extended beyond the field of physical medicine and rehabilitation. Examples of the underrepresentation of women physicians, as compared with their presence in the respective field, was found across a range of additional specialties, including dermatology, neurology, anesthesiology, orthopedic surgery, head and neck surgery, and plastic surgery. The authors propose a call for action across the entire spectrum of medical specialty societies to: (1) examine gender diversity and inclusion data through the lens of the organization's mission, values, and culture; (2) transparently report the results to members and other stakeholders including medical schools and academic medical centers; (3) investigate potential causes of less than proportionate representation of women; (4) implement strategies designed to improve

  9. High mercury seafood consumption associated with fatigue at specialty medical clinics on Long Island, NY

    Directory of Open Access Journals (Sweden)

    Shivam Kothari

    2015-01-01

    Full Text Available We investigated the association between seafood consumption and symptoms related to potential mercury toxicity in patients presenting to specialty medical clinics at Stony Brook Medical Center on Long Island, New York. We surveyed 118 patients from April–August 2012 about their seafood consumption patterns, specifically how frequently they were eating each type of fish, to assess mercury exposure. We also asked about symptoms associated with mercury toxicity including depression, fatigue, balance difficulties, or tingling around the mouth. Of the 118 adults surveyed, 14 consumed high mercury seafood (tuna steak, marlin, swordfish, or shark at least weekly. This group was more likely to suffer from fatigue than other patients (p = 0.02. Logistic regression confirmed this association of fatigue with frequent high mercury fish consumption in both unadjusted analysis (OR = 5.53; 95% CI: 1.40–21.90 and analysis adjusted for age, race, sex, income, and clinic type (OR = 7.89; 95% CI: 1.63–38.15. No associations were observed between fish intake and depression, balance difficulties, or tingling around the mouth. Findings suggest that fatigue may be associated with eating high mercury fish but sample size is small. Larger studies are needed to determine whether fish intake patterns or blood mercury tests warrant consideration as part of the clinical work-up in coastal regions.

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

    Directory of Open Access Journals (Sweden)

    Hamberg Katarina

    2003-10-01

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

  11. [Family medicine as a medical specialty and an academic discipline in the medical students' assessment].

    Science.gov (United States)

    Krztoń-Królewiecka, Anna; Jarczewska, Dorota Łucja; Windak, Adam

    2015-01-01

    Family medicine has been recognized as the key element of a good health care system. Despite the significance of the family physician's role the number of medical students choosing to train in family medicine has been declining in recent years. The aim of this study was to describe opinions about family medicine and family medicine teaching among medical students. A cross sectional study with an anonymous questionnaire was carried out. The study population was all sixth-year students in Faculty Medicine of Jagiellonian University Medical College, who completed family medicine course in winter semester of academic year 2012/2013. 111 students filled in the questionnaire. The response rate was 84.1%. Less than one third of respondents (30.6%) considered family medicine as a future career choice. Almost all students recognized responsibility of the family doctor for the health of community. 52% of respondents agreed that the family doctor is competent to provide most of the health care an individual may require. Experience from family medicine course was according to the students the most important factor influencing their opinions. Medical students appreciate the social role of family doctors. Family medicine teachers should not only pass on knowledge, but they also should encourage medical students to family medicine as a future career choice.

  12. Professional Identity Development Through Service Learning: A Qualitative Study of First-Year Medical Students Volunteering at a Medical Specialty Camp.

    Science.gov (United States)

    Beck, Jimmy; Chretien, Katherine; Kind, Terry

    2015-11-01

    To describe the experience of medical students volunteering at a camp for children with a variety of medical conditions. Rising second-year medical students who had served as counselors for 1 week at a medical specialty camp were invited to participate. We conducted a 2-part qualitative study using on-site focus groups and follow-up individual interviews. Nine medical students participated. Students described their experience as motivating and career reinforcing. It helped them "move beyond the textbook" and deepened their commitment to serving future patients with compassion. One theme that emerged was the idea that their camp experience fostered the development of their professional identities. A 1-week, immersive community service experience at a medical specialty camp played a role in influencing the early formative professional identities of rising second-year medical students. Medical schools could use camps as a promising community service-learning experiences to foster professional identity. © The Author(s) 2015.

  13. Geriatria, uma especialidade centenária =Geriatrics, a centenarian medical specialty

    Directory of Open Access Journals (Sweden)

    Schwanke, Carla Helena Augustin

    2009-01-01

    data: A throughout review of the literature found on MedLine and LILACS, as well as textbooks, dissertations, thesis, and government directives was performed. Summary of the findings: Geriatrics is the area of medicine that cares for the health and treatment of diseases in old age, which works with physical, mental, functional and social aspects in the acute, chronic, rehabilitative, preventive and palliative care of the elderly. Geriatrics goes beyond “medicine centered on organs and systems”, offering holistic treatment by interdisciplinary teams with the principal objective of optimizing functional capacity and improvement of quality of life and autonomy of the elderly, which make up the core of this medical specialty. Geriatrics, in daily assistance practice, works with particular questions such as: the heterogeneity of patients and of scenarios of care; concomitance of multiple diseases/disorders (plurimorbidity, including geriatric syndromes (“the giants of geriatrics”; difficulty of identifying all the problems (iceberg phenomenon; polypharmacy; fragility; vulnerability; the various losses that the elderly show; and terminality. Conclusions: Geriatrics refers to the medical specialty responsible for the clinical aspects of aging and for the various forms of health care necessary for the elderly. Because of the complexity allied to the aging process, geriatrics has become an intriguing, challenging and contemporaneous specialty.

  14. Spine Instability Neoplastic Score: agreement across different medical and surgical specialties.

    Science.gov (United States)

    Arana, Estanislao; Kovacs, Francisco M; Royuela, Ana; Asenjo, Beatriz; Pérez-Ramírez, Úrsula; Zamora, Javier

    2016-05-01

    Spinal instability is an acknowledged complication of spinal metastases; in spite of recent suggested criteria, it is not clearly defined in the literature. This study aimed to assess intra and interobserver agreement when using the Spine Instability Neoplastic Score (SINS) by all physicians involved in its management. Independent multicenter reliability study for the recently created SINS, undertaken with a panel of medical oncologists, neurosurgeons, radiologists, orthopedic surgeons, and radiation oncologists, was carried out. Ninety patients with biopsy-proven spinal metastases and magnetic resonance imaging, reviewed at the multidisciplinary tumor board of our institution, were included. Intraclass correlation coefficient (ICC) was used for SINS score agreement. Fleiss kappa statistic was used to assess agreement on the location of the most affected vertebral level; agreement on the SINS category ("stable," "potentially stable," or "unstable"); and overall agreement with the classification established by tumor board. Clinical data and imaging were provided to 83 specialists in 44 hospitals across 14 Spanish regions. No assessment criteria were pre-established. Each clinician assessed the SINS score twice, with a minimum 6-week interval. Clinicians were blinded to assessments made by other specialists and to their own previous assessment. Subgroup analyses were performed by clinicians' specialty, experience (≤7, 8-13, ≥14 years), and hospital category (four levels according to size and complexity). This study was supported by Kovacs Foundation. Intra and interobserver agreement on the location of the most affected levels was "almost perfect" (κ>0.94). Intra-observer agreement on the SINS score was "excellent" (ICC=0.77), whereas interobserver agreement was "moderate" (ICC=0.55). Intra-observer agreement in SINS category was "substantial" (k=0.61), whereas interobserver agreement was "moderate" (k=0.42). Overall agreement with the tumor board classification

  15. Compassion Fatigue is Similar in Emergency Medicine Residents Compared to other Medical and Surgical Specialties

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    M. Fernanda Bellolio

    2014-09-01

    Full Text Available Introduction: Compassion fatigue (CF is the emotional and physical burden felt by those helping others in distress, leading to a reduced capacity and interest in being empathetic towards future suffering. Emergency care providers are at an increased risk of CF secondary to their first responder roles and exposure to traumatic events. We aimed to investigate the current state of compassion fatigue among emergency medicine (EM resident physicians, including an assessment of contributing factors. Methods: We distributed a validated electronic questionnaire consisting of the Professional Quality of Life Scale with subscales for the three components of CF (compassion satisfaction, burnout and secondary traumatic stress, with each category scored independently. We collected data pertaining to day- versus night-shift distribution, hourly workload and child dependents. We included residents in EM, neurology, orthopedics, family medicine, pediatrics, obstetrics, and general surgery. Results: We surveyed 255 residents, with a response rate of 75%. Of the 188 resident respondents, 18% worked a majority of their clinical shifts overnight, and 32% had child dependents. Burnout scores for residents who worked greater than 80 hours per week, or primarily worked overnight shifts, were higher than residents who worked less than 80 hours (mean score 25.0 vs 21.5; p=0.013, or did not work overnight (mean score 23.5 vs 21.3; p=0.022. EM residents had similar scores in all three components of CF when compared to other specialties. Secondary traumatic stress scores for residents who worked greater than 80 hours were higher than residents who worked less than 80 hours (mean score 22.2 vs 19.5; p=0.048, and those with child dependents had higher secondary traumatic stress than those without children (mean score 21.0 vs 19.1; p=0.012. Conclusion: CF scores in EM residents are similar to residents in other surgical and medical specialties. Residents working primarily

  16. Resident perceptions of anatomy education: a survey of medical school alumni from two different anatomy curricula and multiple medical specialties.

    Science.gov (United States)

    Bohl, Michael A; Gest, Thomas R

    2011-01-01

    In 2004, the University of Michigan Medical School reduced its gross anatomy curriculum. To determine the effect of this reduction on resident perceptions of their clinical preparedness, we surveyed alumni that included residents from the original and new shortened curricula. A Likert-scale survey was sent to four classes of alumni. Respondents were compared in old curriculum (OC) and new curriculum (NC) groups, surgical specialty (SS) and nonsurgical specialty (NS) groups, and subgroups of SS and NS were compared for differences between OC and NC. Mean response scores were compared using independent samples T-tests. As a single population (n = 110), respondents felt their anatomy education prepared them well for residency, that a more robust anatomy curriculum would be helpful, that dissection was important to their residency preparation, and that a 4th year anatomy elective was effective in expanding their anatomy education and preparing them for residency. No significant difference existed between OC and NC groups, neither as a whole nor as SS and NS subgroups. The SS group felt dissection was more important to their residency preparation than the NS group (P = 0.001) and that a more robust anatomy curriculum would have better prepared them for residency (P = 0.001). Thirty percent of SS respondents who did not take a 4th year elective commented that they wish they had. Fourth year anatomy electives were highly valued by residents, and respondents felt that they should be offered to students as a way of revisiting anatomy following the 1st year of clinical training. Copyright © 2011 American Association of Anatomists.

  17. Knowledge and Attitudes of Oman Medical Specialty Board Residents towards Evidence-Based Medicine

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    Aiman Al Wahaibi

    2014-05-01

    Full Text Available Objective: This study aims to evaluate the knowledge and attitudes of Oman Medical Specialty Board (OMSB residents towards Evidence-Based Medicine (EBM. Methods: This cross sectional study was conducted on all OMSB residents through a self-administered online questionnaire between October 2012 and March 2013. An electronic survey was designed to identify and determine residents' knowledge and attitudes toward the use of EBM. Results: The survey was completed by 93 (21% OMSB residents, 76 (82% of whom took part in continuing education courses and 50 (54% belonged to professional practice-oriented organizations. On average, the residents were reportedly involved in patient care for approximately 70% (Standard Deviation [SD] 17% of their time, while 14% (SD 12% participated in research activities. The results showed that 53 respondents (57% were competent users of medical search engines compared to 23 residents (25% who rated their skills as neutral. Sixteen percent of the respondents strongly agreed and 46% only agreed that the facility supports the use of current research in practice. Fourteen percent strongly agreed and fifty-three percent only agreed that the foundation of EBM is part of OMSB academic preparation. On the other hand, 17% of the respondents thought that insufficient time is always a barrier against EBM, while another 27% perceived insufficient time as a usual barrier. The lack of information resources was reported to always be a barrier in 11% of the respondents while 32% thought that it usually acts as a barrier. Conclusion: Time constraints and skills in EBM were found to be the two major obstacles. This study was, however, limited by the low response rate of the survey; thus larger studies with a previously validated questionnaire should be conducted in the future.

  18. 78 FR 10608 - David Grant United States Air Force Medical Center Specialty Care Travel Reimbursement...

    Science.gov (United States)

    2013-02-14

    ... principle of the TRICARE program and the Military Health System (MHS) business design is that MTFs have... identified specialties. There will also be quarterly tracking of marketing initiatives to measure their...

  19. Physician work intensity among medical specialties: emerging evidence on its magnitude and composition.

    Science.gov (United States)

    Horner, Ronnie D; Szaflarski, Jerzy P; Ying, Jun; Meganathan, Karthikeyan; Matthews, Gerald; Schroer, Brian; Weber, Debra; Raphaelson, Marc

    2011-11-01

    Similarities and differences in physician work intensity among specialties are poorly understood but have implications for quality of care, patient safety, practice organization and management, and payment. To determine the magnitude and important dimensions of physician work intensity for 4 specialties. Cross-sectional assessment of work intensity associated with actual patient care in the examination room or operating room. A convenience sample of 45 family physicians, 20 general internists, 22 neurologists, and 21 surgeons, located in Kansas, Kentucky, Maryland, Ohio, and Virginia. Work intensity measures included the National Aeronautics and Space Administration-Task Load Index (NASA-TLX), Subjective Work Assessment Technique (SWAT), and Multiple Resource Questionnaire. Stress was measured by the Dundee Stress State Questionnaire. Physicians reported similar magnitude of work intensity on the NASA-TLX and Multiple Resource Questionnaire. On the SWAT, general internists reported work intensity similar to surgeons but significantly lower than family physicians and neurologists (P=0.035). Surgeons reported significantly higher levels of task engagement on the stress measure than the other specialties (P=0.019), significantly higher intensity on physical demand (P NASA-TLX than the other specialties (P=0.003). Surgeons reported the lowest intensity for temporal demand of all specialties, being significantly lower than either family physicians or neurologists (P=0.014). Family physicians reported the highest intensity on the time dimension of the SWAT, being significantly higher than either general internists or surgeons (P=0.008). Level of physician work intensity seems to be similar among specialties.

  20. A chemical specialty semantic network for the Unified Medical Language System

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    Morrey C

    2012-05-01

    Full Text Available Abstract Background Terms representing chemical concepts found the Unified Medical Language System (UMLS are used to derive an expanded semantic network with mutually exclusive semantic types. The UMLS Semantic Network (SN is composed of a collection of broad categories called semantic types (STs that are assigned to concepts. Within the UMLS’s coverage of the chemical domain, we find a great deal of concepts being assigned more than one ST. This leads to the situation where the extent of a given ST may contain concepts elaborating variegated semantics. A methodology for expanding the chemical subhierarchy of the SN into a finer-grained categorization of mutually exclusive types with semantically uniform extents is presented. We call this network a Chemical Specialty Semantic Network (CSSN. A CSSN is derived automatically from the existing chemical STs and their assignments. The methodology incorporates a threshold value governing the minimum size of a type’s extent needed for inclusion in the CSSN. Thus, different CSSNs can be created by choosing different threshold values based on varying requirements. Results A complete CSSN is derived using a threshold value of 300 and having 68 STs. It is used effectively to provide high-level categorizations for a random sample of compounds from the “Chemical Entities of Biological Interest” (ChEBI ontology. The effect on the size of the CSSN using various threshold parameter values between one and 500 is shown. Conclusions The methodology has several potential applications, including its use to derive a pre-coordinated guide for ST assignments to new UMLS chemical concepts, as a tool for auditing existing concepts, inter-terminology mapping, and to serve as an upper-level network for ChEBI.

  1. Preparation for a postgraduate specialty examination by medical students in Turkey: processes and sources of anxiety.

    Science.gov (United States)

    Turan, Sevgi; Üner, Sarp

    2015-01-01

    PHENOMENON: Interns in Turkey must endeavor to study for a specialty exam during their internship. The preparation process for the specialty exam and the effect of this process on the students' anxiety has not been studied comprehensively. The purpose of this study was to evaluate the interns' preparation time for the specialty exam, their perception of how the preparation process affects their training, and which factors are related to their test anxiety. A cross-sectional study was conducted with 6th-year students (interns). A questionnaire asked participants to report health status, academic achievement, exam-related anxiety, and trait anxiety. Two open-ended questions asked about views regarding the specialty exam. Multiple linear regression was used to identify the significant predictors of anxiety level due to the exam. The average duration of exam preparations of participating interns (n = 214) was 16.8 months and 14.3 hours/week. Participating interns' health status, economic level, perception of academic achievement, time allocated to study for the exam, time remaining until the exam, and trait anxiety level demonstrated a relationship with anxiety level due to the exam (R =.35, R(2) =.13, p anxiety level. The internship curriculum, requirements, and timing of the specialty exam should be reconsidered.

  2. A Methodology for Using Workforce Data to Decide Which Specialties and States to Target for Graduate Medical Education Expansion.

    Science.gov (United States)

    Fraher, Erin P; Knapton, Andy; Holmes, George M

    2017-02-01

    To outline a methodology for allocating graduate medical education (GME) training positions based on data from a workforce projection model. Demand for visits is derived from the Medical Expenditure Panel Survey and Census data. Physician supply, retirements, and geographic mobility are estimated using concatenated AMA Masterfiles and ABMS certification data. The number and specialization behaviors of residents are derived from the AAMC's GMETrack survey. We show how the methodology could be used to allocate 3,000 new GME slots over 5 years-15,000 total positions-by state and specialty to address workforce shortages in 2026. We use the model to identify shortages for 19 types of health care services provided by 35 specialties in 50 states. The new GME slots are allocated to nearly all specialties, but nine states and the District of Columbia do not receive any new positions. This analysis illustrates an objective, evidence-based methodology for allocating GME positions that could be used as the starting point for discussions about GME expansion or redistribution. © Health Research and Educational Trust.

  3. [Is the rate of medical publication from Israel similar to other countries? A comparative study of three medical specialties].

    Science.gov (United States)

    Zer, Matan; Lindner, Arie; Greenstein, Alexander; Leibovici, Dan

    2011-07-01

    0.78, 0.54, 0.62, 0.13 and 0.75 for the other countries, respectively. The regression coefficient of the quality of publications in Israel was 0.3 as opposed to 0.47, 0.36, 0.48, 0.01, and 0.78 respectively. The Israeli publications in orthopedics increased by 9.3% during the second decade compared with the first. At the same time, other countries increased the publication rate in orthopedics by 69%, 121%, 173%, 140% and 296% respectively. The regression coefficient for the publication rate in orthopedics was 0.02 for Israel, and 0.62, 0.64, 0.78, 0.34 and 0.71 for the other countries, respectively. The regression coefficient of the quality of publications in Israel was 0.05 as opposed to 0.67, 0.62, 0.75, 0.31, and 0.66 in the other countries, respectively. Israel lags behind Italy, France, Germany, Egypt and Turkey with regard to the increase of both the number and the quality of medical publications in urology and orthopedics. While the rate and quality of IsraeLi publications in cardiology surpasses those from Egypt, they lag in the number of publications in this medical field behind those of all the rest of the countries examined. In a world of rapid progress and expansion of medical research, Israel has been stagnant in publications in 3 medical specialties, rendering it inferior to other nations.

  4. Publication trends of research articles from infectious diseases specialty in a medical journal from India

    Directory of Open Access Journals (Sweden)

    KVS Hari Kumar

    2012-01-01

    Full Text Available Background: Details about research productivity in the infectious diseases specialty from India are lacking. Objective: To analyse publishing trends and research productivity of articles related to infectious diseases in the Journal of the Association of Physicians of India (JAPI. Materials and Methods : We carried out bibliometric analysis of articles related to infectious diseases specialty from JAPI published between 2000 and 2011. Data were derived from the journal′s website and the articles were analysed for type (original article, case reports, etc., microorganism (bacterial, viral, etc. place of the research and timelines for publication. Results : Out of 2977 articles published in JAPI over last 12 years, 256 articles belong to infectious diseases subspecialty. Infectious diseases contributed 11-18% of the published articles per year in JAPI during the last decade. Original articles (31%, case reports (38% and correspondence (22% constitute the majority of article types, while remaining 9% was made up by images. Bacterial (22%, protozoal and helminthic (20%, HIV (15% and mycobacterial (16% diseases lead the type of microorganisms represented in the research articles. Mumbai (16%, Delhi (9% and Kolkata (7% are the top three places contributing to the articles, followed by Chandigarh and Chennai. Original articles and case reports took approximately 14 months for publication, as compared to 6 months for an image (P < 0.0001. Conclusion : Infectious diseases specialty contributes about 15% of articles per annum in JAPI. HIV and tuberculosis together account for 30% of published litearture with fair representation from other organisms. Mumbai and Delhi are the leading contributors towards research productivity in this specialty.

  5. Plagiarism in submitted manuscripts: incidence, characteristics and optimization of screening-case study in a major specialty medical journal.

    Science.gov (United States)

    Higgins, Janet R; Lin, Feng-Chang; Evans, James P

    2016-01-01

    Plagiarism is common and threatens the integrity of the scientific literature. However, its detection is time consuming and difficult, presenting challenges to editors and publishers who are entrusted with ensuring the integrity of published literature. In this study, the extent of plagiarism in manuscripts submitted to a major specialty medical journal was documented. We manually curated submitted manuscripts and deemed an article contained plagiarism if one sentence had 80 % of the words copied from another published paper. Commercial plagiarism detection software was utilized and its use was optimized. In 400 consecutively submitted manuscripts, 17 % of submissions contained unacceptable levels of plagiarized material with 82 % of plagiarized manuscripts submitted from countries where English was not an official language. Using the most commonly employed commercial plagiarism detection software, sensitivity and specificity were studied with regard to the generated plagiarism score. The cutoff score maximizing both sensitivity and specificity was 15 % (sensitivity 84.8 % and specificity 80.5 %). Plagiarism was a common occurrence among manuscripts submitted for publication to a major American specialty medical journal and most manuscripts with plagiarized material were submitted from countries in which English was not an official language. The use of commercial plagiarism detection software can be optimized by selecting a cutoff score that reflects desired sensitivity and specificity.

  6. [Publication rates of Turkish medical specialty and doctorate theses on Medical Microbiology, Clinical Microbiology and Infectious Diseases disciplines in international journals].

    Science.gov (United States)

    Sipahi, Oğuz Reşat; Caglayan Serin, Derya; Pullukcu, Hüsnü; Tasbakan, Meltem; Köseli Ulu, Demet; Yamazhan, Tansu; Arda, Bilgin; Sipahi, Hilal; Ulusoy, Sercan

    2014-04-01

    Writing a thesis is mandatory for getting a postgraduate medical degree in Turkey. Publication of the results of the thesis in an indexed journal makes the results available to researchers, however publication rate is usually low. The aim of this retrospective observational study was to investigate the publication rate of Turkish Infectious Diseases and Clinical Microbiology, Medical Microbiology specialty theses and Microbiology doctorate theses in international peer-review journals. On August 17th 2007, the thesis database of the Council of Higher Education of the Republic of Turkey (YOK) where all specialization and doctorate theses are recorded obligatorily, was searched for Infectious Diseases and Clinical Microbiology and Medical Microbiology specialty and Microbiology doctorate theses. Assuming that publication of a thesis would last at least six months, theses dated to February 2007 and after were excluded. The publication rate of those theses was found out by searching Science Citation Index-Expanded database for thesis author and supervisor between August 17-September 12, 2007. Chi-square test was used for statistical analysis. Our search yielded a total of 834 theses dated from 1997 to 2007, however 10 of them were excluded, since they were dated to February 2007 or after. It was found that the overall publication rate was 11.4% (94/824). The publication rates for Microbiology doctorate, Medical Microbiology and Infectious Diseases and Clinical Microbiology specialty theses were 13.7% (34/249), 10.7% (33/309) and 10.2% (27/266), respectively, with no statistical significance (p> 0.05). It was determined that nine (9.6%) of the 94 published theses belonged to 1997-2001 period, whereas 85 (80.4%) were in 2002-2007 period (p< 0.05). The probable reason for this increase was thought to be related with the updated criteria of YOK carried out in 2000 for academic promotions, nevertheless the publication rate of the investigated theses in international peer

  7. Medical School Outcomes, Primary Care Specialty Choice, and Practice in Medically Underserved Areas by Physician Alumni of MEDPREP, a Postbaccalaureate Premedical Program for Underrepresented and Disadvantaged Students.

    Science.gov (United States)

    Metz, Anneke M

    2017-01-01

    Minorities continue to be underrepresented as physicians in medicine, and the United States currently has a number of medically underserved communities. MEDPREP, a postbaccalaureate medical school preparatory program for socioeconomically disadvantaged or underrepresented in medicine students, has a stated mission to increase the numbers of physicians from minority or disadvantaged backgrounds and physicians working with underserved populations. This study aims to determine how MEDPREP enhances U.S. physician diversity and practice within underserved communities. MEDPREP recruits disadvantaged and underrepresented in medicine students to complete a 2-year academic enhancement program that includes science coursework, standardized test preparation, study/time management training, and emphasis on professional development. Five hundred twenty-five disadvantaged or underrepresented students over 15 years completed MEDPREP and were tracked through entry into medical practice. MEDPREP accepts up to 36 students per year, with two thirds coming from the Midwest region and another 20% from nearby states in the South. Students complete science, test preparation, academic enhancement, and professionalism coursework taught predominantly by MEDPREP faculty on the Southern Illinois University Carbondale campus. Students apply broadly to medical schools in the region and nation but are also offered direct entry into our School of Medicine upon meeting articulation program requirements. Seventy-nine percent of students completing MEDPREP became practicing physicians. Fifty-eight percent attended public medical schools, and 62% attended medical schools in the Midwest. Fifty-three percent of program alumni chose primary care specialties compared to 34% of U.S. physicians, and MEDPREP alumni were 2.7 times more likely to work in medically underserved areas than physicians nationally. MEDPREP increases the number of disadvantaged and underrepresented students entering and graduating

  8. Assessment of personality type and medical specialty choice among medical students from Karachi; using Myers-Briggs Type Indicator (MBTI) tool.

    Science.gov (United States)

    Jafrani, Sana; Zehra, Nosheen; Zehra, Muneeza; Abuzar Ali, Syed Muhmmad; Abubakar Mohsin, Saiyed Abdullah; Azhar, Rasheed

    2017-04-01

    To assess personality type of medical students and associate it with their choice of medical specialty. This cross-sectional study was conducted in February 2014 at one public and one private medical university of Karachi, and comprised medical students. A self- administered questionnaire based on Myers-Briggs type indicator was used to collect data which was analysed using SPSS 20. Of the 400 participants, there were 200(50%) each from public and private universities. Of all, 201(50.3%) students were found to be extroverted and 199(49.8%) were introverted personality types. Clinical fields were the main preference of students after their medical degree as selected by 317(79.2%) students; of the, Extroverted-Sensing-Feeling-Perceptive was the most common type identified in39(7.2%) students. Extroverted-Sensing-Feeling-Perceptive 11(2.8%), Extroverted-Sensing-Thinking-Judging 12(3%), Extroverted-Sensing-Feeling-Judging 5(1.3%), Introverted-Sensing-Feeling-Judging 6(1.5%), Introverted-Sensing-Thinking-Perceptive 7(1.8%) had preference for surgery, medicine, gynaecology, paediatrics and cardiology, respectively. Personality had significant impact on specialty and career choice.

  9. The continuing medical education activities and attitudes of Australian doctors working in different clinical specialties and practice locations.

    Science.gov (United States)

    Stewart, Grant D; Khadra, Mohamed H

    2009-02-01

    Currently, it is not clear which continuing medical education (CME) methods are being used by senior doctors and what their attitudes towards them are. The aims of this study were to investigate which modes of CME delivery senior Australian doctors utilise, to assess doctors' attitudes towards CME and to determine any differences in modes used and attitudes between clinical specialties and practice locations. A 52-statement questionnaire enquiring about doctors' current CME activities and their attitudes towards CME was distributed to 1336 senior Australian doctors. 494 doctors responded to the questionnaire. Traditional forms of CME (eg, meetings, conferences, journals and lectures) were most commonly used. Doctors thought CME involving face-to-face interaction was superior to electronic forms of CME. All doctors, especially those in hospital practice, had a positive attitude towards CME but found lack of time a barrier to learning. Rural doctors found CME sessions more difficult to attend than did their metropolitan colleagues. Traditional forms of CME were more popular than modern CME approaches, such as e-learning. Australian doctors had a positive attitude towards undertaking CME despite struggling to find time to perform CME. The differences in attitudes towards CME demonstrated between specialties and different practice location will aid future CME planning.

  10. [Supply and demand of medical specialists in the health facilities of the Ministry of Health: national, regional and by type of specialty gaps].

    Science.gov (United States)

    Zevallos, Leslie; Pastor, Reyna; Moscoso, Betsy

    2011-06-01

    To characterize the supply, demand and the gap of medical specialists in facilities of the Ministry of Health of Peru (MINSA) at the national, regional and specialty type levels. Observational, descriptive study through which we calculated the supply of medical specialists using secondary sources of MINSA. The analysis of the demand for medical specialists was based on two methodologies: the need for specialists according to the guidelines of classification of the health facilities and according to the epidemiological and demographic profile. The arithmetic difference between the estimated demand and the supply was the procedure used to calculate the gap of medical specialists. The Ministry of Health has a total supply at the national level of 6,074 medical specialists of which 61.5% belong to the clinical specialties, 33.2% to the surgical specialties, 4.9% specialities related to aid to diagnosis and treatment and 0.4% to public health specialties. According to the categorization guideline there is a total demand of 11,176 medical specialists and according to the epidemiological and demographic profile of 11,738. The national estimated gaps found are similar in both methods, although they differ widely across regions and by type of specialty. At the regional level, the gaps are greater in Loreto, Piura, Puno and Madre de Dios when estimating the defficit in relation to the supply. Regarding the speciality, the gap is greater in the four basic specialties: gynecology and obstetrics, pediatrics, internal medicine and general surgery. There is a waid gap between supply and demand of medical specialists at the national and regional levels, as a whole representing approximately 45% of the current offer, regardless of the estimation method.

  11. The medical profession and young physicians' lifestyles in flux: challenges for specialty training and health care delivery systems.

    Science.gov (United States)

    Buddeberg-Fischer, Barbara; Stamm, Martina

    2010-12-07

    The profile of the medical profession is changing in terms of employment conditions, attitudes towards the profession and the lifestyle of young physicians. The aim of this study was to investigate (1) what modifications should be made in the specialty-qualification curriculum to allow for a better balance of career and personal life, (2) what institutional conditions and (3) what personal attitudes and behaviour are required for physicians to successfully combine career and family. As part of a prospective survey on the career development of Swiss medical school graduates (SwissMedCareer Study) begun in 2001, 526 physicians (274 females, 52.1%; 252 males, 47.9%) participated in the sixth assessment in 2010. The graduates were asked by mail-out questionnaires to provide free response answers to the three questions formulated above. Their statements were transcribed, content categories were inductively formulated for each question, and their descriptions were written down in a code manual. Responses were encoded according to the said manual and assigned to content categories (Mayring's content analysis). Frequency distributions were given for categories and tested with chi-square tests for gender differences. The 526 participants made 457 statements on the first question, 1,038 on the second, and 937 on the third. Content analysis of the physicians' answers yielded nine categories dealing with desired changes to the specialty qualification curriculum, eight categories addressing changes in institutional conditions, and nine categories concerning personal attitudes and behaviour. Of all responses to the first question, 70% fell into the top three ranking categories of "specialty qualification requirements", "part-time jobs" and "structured residency programmes". The three top-ranking categories ("childcare facilities", part-time jobs", "working hours") yielded by responses to the second question accounted for 87% of the statements. Distribution of the responses

  12. An Analysis of Applicants Presenting to a Medical Marijuana Specialty Practice in California

    Science.gov (United States)

    Nunberg, Helen; Kilmer, Beau; Pacula, Rosalie Liccardo; Burgdorf, James

    2011-01-01

    For more than a decade, medical marijuana has been at the forefront of the marijuana policy debate in the United States. Fourteen states allow physicians to recommend marijuana or provide a legal defense for patients and physicians if prosecuted in state courts; however, little is known about those individuals using marijuana for medicinal purposes and the symptoms they use it for. This study provides descriptive information from 1,655 patients seeking a physician’s recommendation for medical marijuana, the conditions for which they seek treatment, and the diagnoses made by the physicians. It conducts a systematic analysis of physician records and patient questionnaires obtained from consecutive patients being seen during a three month period at nine medical marijuana evaluation clinics belonging to a select medical group operating throughout the State of California. While this study is not representative of all medical marijuana users in California, it provides novel insights about an important population being affected by this policy. PMID:23750291

  13. An Analysis of Applicants Presenting to a Medical Marijuana Specialty Practice in California

    OpenAIRE

    Nunberg, Helen; Kilmer, Beau; Pacula, Rosalie Liccardo; Burgdorf, James

    2011-01-01

    For more than a decade, medical marijuana has been at the forefront of the marijuana policy debate in the United States. Fourteen states allow physicians to recommend marijuana or provide a legal defense for patients and physicians if prosecuted in state courts; however, little is known about those individuals using marijuana for medicinal purposes and the symptoms they use it for. This study provides descriptive information from 1,655 patients seeking a physician’s recommendation for medical...

  14. [Clinical ecomomics: a pleading for complementing the medical curriculum and specialty training].

    Science.gov (United States)

    Porzsolt, F; Weiss, M; Hege-Scheuing, G; Fangerau, H

    2010-11-01

    Clinical economics requires an understanding of clinical relationships just like health economy requires an understanding of economic relationships. Hitherto we have ensured that economists can differentiate symptoms from diagnoses and diagnostics from screening at the interface between medicine and economy. However, we overlooked the fact that physicians should be able to understand the principles of marginal benefit and medical ethics, as well as the differences among efficacy, effectiveness, and benefit, to be able to make sound decisions. To make up for this neglected demand, we present our definition of clinical economics, identify the potential conflicts between medical professionalism and commercialized medicine, describe the importance - but also the limits - of scientific evidence, explain the difference between 'prioritization' and strict rationing, and attempt to justify the fact that the necessary changes in the provision of healthcare will probably only be achieved if we instill this new way of thinking in medical students during their medical education. Complementing the medical curriculum with clinical economics would achieve this goal. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Medication therapy management services in community pharmacy: a pilot programme in HIV specialty pharmacies.

    Science.gov (United States)

    Rosenquist, Ashley; Best, Brookie M; Miller, Teresa A; Gilmer, Todd P; Hirsch, Jan D

    2010-12-01

    Pharmacist-provided medication therapy management services (MTMS) have been shown to increase patient's adherence to medications, improve health outcomes and reduce overall medical costs. The purpose of this study was to describe a pilot programme that provided pharmacy-based MTMS for patients with HIV/AIDS in the state of California, USA. Pharmacists from the 10 pilot pharmacies were surveyed using an online data collection tool. Information was collected to describe the types of MTMS offered, proportion of patients actively using specific MTMS, pharmacist beliefs regarding effect on patient outcomes and barriers to providing MTMS, ability to offer MTMS without pilot programme funding and specialized pharmacist or staff training. Each responding pharmacy (7 of 10) varied in the number of HIV/AIDS patients served and prescription volume. All pharmacists had completed HIV/AIDS-related continuing education programmes, and some had other advanced training. The type of MTMS being offered varied at each pharmacy with 'individualized counselling by a pharmacist when overuse or underuse was detected' and 'refill reminders by telephone' being actively used by the largest proportion of patients. Most, but not all, pharmacists cited reimbursement as a barrier to MTMS provision. Pharmacists believed the MTMS they provide resulted in improved satisfaction (patient and provider), medication usage, therapeutics response and patient quality of life. The type of MTMS offered, and proportion of patients actively using, varied among participating pilot pharmacies. © 2010 Blackwell Publishing Ltd.

  16. The corporate transformation of medical specialty care: the exemplary case of neonatology.

    Science.gov (United States)

    Kinney, Eleanor D

    2008-01-01

    The key to wealth in health care is the physician, who certifies to third-party payers that health care items and services are necessary for patient care. To compete more effectively for this wealth, physician specialists are organizing their practices into for-profit corporations and employing other physicians. Focusing on neonatology, this article describes the prevailing business model of these for-profit medical groups as controlling employed physicians through restrictive employment contract provisions, e.g., non-compete and mandatory arbitration clauses. With this business model and because of deficiencies in current law, for-profit medical groups eliminate competition from other physician specialists to the detriment of patients and consumers.

  17. Interprofessional conflict and medical errors: results of a national multi-specialty survey of hospital residents in the US.

    Science.gov (United States)

    Baldwin, Dewitt C; Daugherty, Steven R

    2008-12-01

    Clear communication is considered the sine qua non of effective teamwork. Breakdowns in communication resulting from interprofessional conflict are believed to potentiate errors in the care of patients, although there is little supportive empirical evidence. In 1999, we surveyed a national, multi-specialty sample of 6,106 residents (64.2% response rate). Three questions inquired about "serious conflict" with another staff member. Residents were also asked whether they had made a "significant medical error" (SME) during their current year of training, and whether this resulted in an "adverse patient outcome" (APO). Just over 20% (n = 722) reported "serious conflict" with another staff member. Ten percent involved another resident, 8.3% supervisory faculty, and 8.9% nursing staff. Of the 2,813 residents reporting no conflict with other professional colleagues, 669, or 23.8%, recorded having made an SME, with 3.4% APOs. By contrast, the 523 residents who reported conflict with at least one other professional had 36.4% SMEs and 8.3% APOs. For the 187 reporting conflict with two or more other professionals, the SME rate was 51%, with 16% APOs. The empirical association between interprofessional conflict and medical errors is both alarming and intriguing, although the exact nature of this relationship cannot currently be determined from these data. Several theoretical constructs are advanced to assist our thinking about this complex issue.

  18. [Social medicine in medical faculties: realisation of the topic in the specialty "social medicine, occupational health"].

    Science.gov (United States)

    Behmann, M; Bisson, S; Walter, U

    2011-12-01

    The 9 (th) Revision of German Medical Licensing Regulations for Physicians has come into effect on October 1 (st) 2003. Social medicine was separated into the fields "occupational health, social medicine" and the various cross-sectional modules: epidemiology, biometry, medical computer science; health economics, health-care system, public health; prevention, health promotion; rehabilitation, physical medicine, naturopathic treatment. This paper studies the realisation of teaching in the field social medicine at German medical faculties. The survey was conducted in collaboration with the German Association for Social Medicine and Prevention (DGSMP). A survey was conducted at 38 institutes of 36 German medical faculties. The written questionnaire contained mostly selection items in which chances and barriers of the field were queried with supply items. Information about time scale, general conditions and resources was aked for. On the basis of the guidelines of the DGSMP, the topics to be taught were evaluated concerning their relevance and integration into education. The response rate was 68% (n=26). Social insurance, basic principles, responsibility in the Social Security Code and the different providers were judged as the most important topics. There was a strong demand for lecturing material. 82% (n=18) of the faculties wished to have specific material, for example e-learning, examples, lesson plans, curricula and also textbooks. 91% (n=19) of the faculties requested an exchange of information between the faculties concerning educational contents, motivation of students and e-learning. The realisation of teaching is different between the faculties concerning the number of hours, teaching methods and number of students per year. The motivation of the students is one of the problems, but also the lack of acceptance within the clinic. Specific resources and exchange between the faculties are necessary concerning e-learning, which is offered at only few faculties so

  19. Influence of training changes on the stability of specialty choices of UK medical graduates: surveys of the graduates of 2002 and 2008.

    Science.gov (United States)

    Svirko, Elena; Lambert, Trevor W; Goldacre, Michael J

    2015-01-01

    To explore the impact of Modernising Medical Careers (MMC) training on the stability of medical career choices in the UK. Graduates of 2002 and 2008 from all UK medical schools, 1 and 3 years postgraduation. Questionnaire surveys were conducted of 2002 and 2008 graduates from all UK medical schools 1 and 3 years post graduation. Doctors gave their specialty choice(s) and rated the influence of each of 11 factors on their career choice. 2008 graduates were a little more likely than graduates of 2002 to retain their year 1 choice in year 3 (77.3% vs. 73.3%; p = 0.002). Among 2008 graduates, the percentage retaining their year 1 choice varied between 42% (clinical oncology) and 79% (general practice). Enthusiasm for a specialty, student experience and inclinations before medical school were associated with choice retention; consideration of domestic circumstances and hours/working conditions were associated with changes of choice. 2008 graduates were more likely than 2002s to be influenced by enthusiasm for a specialty, self-appraisal of their skills, working hours and their domestic circumstances; and less likely to be influenced by their experience of jobs, a particular teacher/department or eventual financial prospects. Post-MMC, graduates were less likely to change their career choice and more likely to be motivated by personal factors and self-assessment of their suitability to a particular area of work. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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

    Science.gov (United States)

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

    2016-01-01

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

  1. Adherence to systemic therapies for immune-mediated inflammatory diseases in Lebanon: a physicians' survey from three medical specialties.

    Science.gov (United States)

    Ammoury, Alfred; Okais, Jad; Hobeika, Mireille; Sayegh, Raymond B; Shayto, Rani H; Sharara, Ala I

    2017-01-01

    Immune-mediated inflammatory diseases (IMIDs) are chronic conditions that may cause tissue damage and disability, reduced quality of life and increased mortality. Various treatments have been developed for IMIDs, including immune modulators and targeted biologic agents. However, adherence remains suboptimal. An adherence survey was used to evaluate physicians' beliefs about adherence to medication in IMID and to evaluate if and how they manage adherence. The survey was distributed to 100 randomly selected physicians from three different specialties. Results were analyzed by four academic experts commissioned to develop an action plan to address practical and perceptual barriers to adherence, integrating it into treatment goals to maximize outcomes in IMID, thereby elevating local standards of care. Eighty-two physicians participated in this study and completed the questionnaire. Most defined adherence as compliance with prescribed treatment. Although the majority of surveyed physicians (74%) did not systematically measure adherence in their practice, 54% identified adherence as a treatment goal of equal or greater importance to therapeutic endpoints. Lack of time and specialized nursing support was reported as an important barrier to measuring adherence. The expert panel identified four key areas for action: 360° education (patient-nurse-physician), patient-physician communication, patient perception and concerns, and market access/cost. An action plan was developed centered on education and awareness, enhanced benefit-risk communication, development of adherence assessment tools and promotion of patient support programs. Nonadherence to medication is a commonly underestimated problem with important consequences. A customized target-based strategy to address the root causes of non-adherence is essential in the management of chronic immune-mediated diseases.

  2. Adherence to systemic therapies for immune-mediated inflammatory diseases in Lebanon: a physicians’ survey from three medical specialties

    Directory of Open Access Journals (Sweden)

    Ammoury A

    2017-05-01

    Full Text Available Alfred Ammoury,1 Jad Okais,2 Mireille Hobeika,3 Raymond B Sayegh,4 Rani H Shayto,5 Ala I Sharara5 1Division of Dermatology, St George Hospital University Medical Center, 2Division of Rheumatology, St Joseph University, 3AbbVie Levant, 4Division of Gastroenterology, St Joseph University, 5Department of Internal Medicine, Division of Gastroenterology, American University of Beirut Medical Center, Beirut, Lebanon Background: Immune-mediated inflammatory diseases (IMIDs are chronic conditions that may cause tissue damage and disability, reduced quality of life and increased mortality. Various treatments have been developed for IMIDs, including immune modulators and targeted biologic agents. However, adherence remains suboptimal. Methods: An adherence survey was used to evaluate physicians’ beliefs about adherence to medication in IMID and to evaluate if and how they manage adherence. The survey was distributed to 100 randomly selected physicians from three different specialties. Results were analyzed by four academic experts commissioned to develop an action plan to address practical and perceptual barriers to adherence, integrating it into treatment goals to maximize outcomes in IMID, thereby elevating local standards of care. Results: Eighty-two physicians participated in this study and completed the questionnaire. Most defined adherence as compliance with prescribed treatment. Although the majority of surveyed physicians (74% did not systematically measure adherence in their practice, 54% identified adherence as a treatment goal of equal or greater importance to therapeutic endpoints. Lack of time and specialized nursing support was reported as an important barrier to measuring adherence. The expert panel identified four key areas for action: 360° education (patient–nurse–physician, patient–physician communication, patient perception and concerns, and market access/cost. An action plan was developed centered on education and awareness

  3. Medical Ethics Code: an Analysis from Ethical-Disciplinary Cases Against Medical Professionals within the Specialty of Psychiatry

    Directory of Open Access Journals (Sweden)

    Giselle Crosara Gracindo

    2018-02-01

    Full Text Available Objective: To identify the nature of infractions committed by doctors working within the field of psychiatry, between 2010 and 2016, from the scope of appeals within ethical-disciplinary cases judged at the Plenary Tribunal of the Federal Medical Council, based on the medical ethics code, and to list some elements that make it possible to outline the professional profile of those involved. Method: This was a document-based investigation in the form of a retrospective and descriptive study. Data were gathered using the Federal Medical Council (CFM database and from consultation of judgments issued by the Plenary Body of the Medical Ethics Tribunal (TSEM, of the CFM. The investigation used a sample consisting of 206 appeals and 19 referrals, totaling 224 appeals by doctors who underwent trials. We took into account cases judged between April 13, 2010 and August 3, 2016. Three databases were used in the investigation: cases (224; doctors facing charges (191 and cases/penalties (146. Based on the records of the 191 doctors charged, the ethical-disciplinary cases of seven doctors working in psychiatry were analyzed specifically for the present study, whether or not they had a specialist title. Characterization of infractions committed encompassed references to the articles of the medical ethics code most frequently infringed in the field of psychiatry, along with a survey of the motives for these infractions and some characteristics relating to these professionals’ profile. Results: Among the findings from this investigation, infractions of the articles of the medical ethics code can be highlighted, such as article 30 “[...] Use of the profession to corrupt customs and to commit or favor crime [...]” and article 40 “[...] Taking advantage of situations arising from the doctor-patient relationship to obtain physical, emotional, financial or any other advantage [...]”. The professional profile of those involved in these cases was also shown

  4. Medical students' choice of specialty and factors determining their choice: a cross-sectional survey at the Addis Ababa University, School oF Medicine, Ethiopia.

    Science.gov (United States)

    Seyoum, Nebyou; Biluts, Hagos; Bekele, Abebe; Seme, Assefa

    2014-07-01

    A consideration of the future specialization interests of undergraduate medical students might help in understanding the needs of higher medical education and future manpower availability for healthcare in a country. This study assessed the career of choice made by medical students of the Addis Ababa University in the year 2012. A cross-sectional study was conducted among 161 medical students of the Addis Ababa University, School of Medicine, Ethiopia in April 2012 using a self-administered questionnaire. Data were analyzed using computer based statistical software IBM SPSS data editor version 20.0. In addition to descriptive statistics difference in proportions was compared using Chi-square test Of the 161 students, 101 (62.7%) were male. The mean age of respondents was 24.1 years (SD 2.02, ranging from 21 to 35). Majority, 138 (85.7) wanted to pursue their specialty training in the near future, their first career of choice being surgery for, 50 (31.1%), followed by internal medicine for, 44 (27.3%) and Obstetrics and Gynaecology for, 29 (18.0%]), However 18 (11.2%) did not specify their career of choice. The basic science fields such as anesthesiology, and oncology were the least favored choices by the students. The main reasons that influenced the students' decisions to opt for a particular specialty were inspiration during their clinical practicein 67 (41.6%). Financial reward (24.2%), dedication to the field (19.2%) possession of competency needed for the speciality (18.6%) and Influence of teacher (16.1%) were also factors that influenced future choice of speciality of the students. The majority of medical students preferred to pursue their specialty training. As the number and interest in certain specialties is huge, training centers must be ready to cater for the interests shown by the students. The lack of interest towards certain specialists such as basic sciences, anesthesiology, and oncology requires a special attention by policy makers.

  5. Comparison of Specialty Medication Use for Common Chronic Inflammatory Diseases Among Health Exchange and Other Commercially Insured Members.

    Science.gov (United States)

    Chen, Xiaoxue; Gautam, Santosh; Ruggieri, Alexander; Richards, Thomas; Devries, Andrea; Sylwestrzak, Gosia

    2018-01-01

    The Affordable Care Act of 2010 allows the purchase of health insurance through special marketplaces called "health exchanges." The majority of individuals enrolling in the exchanges were previously uninsured, older, and sicker than other commercially insured members. Early evidence also suggests that exchange plan members use more costly specialty drugs compared with other commercially insured members. To (a) examine patient characteristics and specialty drug use for common chronic inflammatory diseases (CIDs) among exchange plan members compared with other commercially insured members and (b) explore variations in specialty drug use within exchange plans by metal tiers (bronze, silver, gold, and platinum), as well as across local markets. This analysis included adults aged ≥ 18 years who were enrolled in exchange plans (exchange population) and other commercial health plans (nonexchange population). The primary outcome was the likelihood of using specialty drugs prescribed to treat common CIDs, such as rheumatoid arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, psoriatic arthritis, and psoriasis. The adjusted likelihood of using CID specialty drugs was calculated from logistic regression controlling for prevalence of CIDs and other health risk factors. A total of 931,384 exchange plan members and 2,682,855 nonexchange plan members were included in the analysis. Compared with the nonexchange population, the exchange population was older, more likely to be female, had more comorbid conditions, but filled fewer prescriptions. The 2 groups were similar in terms of CID prevalence. The observed likelihood of CID specialty drug use was 20.0% lower in the exchange versus the nonexchange populations (341 users per 100,000 exchange members vs. 427 users per 100,000 nonexchange members; P exchange population, the observed likelihood of CID specialty drug use was 132 per 100,000 bronze plan members (69.1% lower than nonexchange); 326 per 100

  6. Physician career satisfaction within specialties

    Directory of Open Access Journals (Sweden)

    Kravitz Richard L

    2009-09-01

    Full Text Available Abstract Background Specialty-specific data on career satisfaction may be useful for understanding physician workforce trends and for counseling medical students about career options. Methods We analyzed cross-sectional data from 6,590 physicians (response rate, 53% in Round 4 (2004-2005 of the Community Tracking Study Physician Survey. The dependent variable ranged from +1 to -1 and measured satisfaction and dissatisfaction with career. Forty-two specialties were analyzed with survey-adjusted linear regressions Results After adjusting for physician, practice, and community characteristics, the following specialties had significantly higher satisfaction levels than family medicine: pediatric emergency medicine (regression coefficient = 0.349; geriatric medicine (0.323; other pediatric subspecialties (0.270; neonatal/prenatal medicine (0.266; internal medicine and pediatrics (combined practice (0.250; pediatrics (0.250; dermatology (0.249;and child and adolescent psychiatry (0.203. The following specialties had significantly lower satisfaction levels than family medicine: neurological surgery (-0.707; pulmonary critical care medicine (-0.273; nephrology (-0.206; and obstetrics and gynecology (-0.188. We also found satisfaction was significantly and positively related to income and employment in a medical school but negatively associated with more than 50 work-hours per-week, being a full-owner of the practice, greater reliance on managed care revenue, and uncontrollable lifestyle. We observed no statistically significant gender differences and no differences between African-Americans and whites. Conclusion Career satisfaction varied across specialties. A number of stakeholders will likely be interested in these findings including physicians in specialties that rank high and low and students contemplating specialty. Our findings regarding "less satisfied" specialties should elicit concern from residency directors and policy makers since they

  7. Changes in prevalence of workplace violence against doctors in all medical specialties in Norway between 1993 and 2014: a repeated cross-sectional survey.

    Science.gov (United States)

    Johansen, Ingrid Hjulstad; Baste, Valborg; Rosta, Judith; Aasland, Olaf G; Morken, Tone

    2017-08-11

    The aim of this study was to investigate whether reported prevalence of experienced threats, real acts of violence and debilitating fear of violence among Norwegian doctors have increased over the last two decades. Repeated cross-sectional survey. All healthcare levels and medical specialties in Norway. Representative samples of Norwegian doctors in 1993 (n=2628) and 2014 (n=1158). Relative risk (RR) of self-reported prevalence of work-time experiences of threats and real acts of violence, and of being physically or psychologically unfit during the last 12 months due to fear of violence, in 2014 compared with 1993, adjusted by age, gender and medical specialty. There were no differences in self-reported threats (adjusted RR=1.01, 95% CI 0.95 to 1.08) or real acts (adjusted RR=0.90, 95% CI 0.80 to 1.03) of violence when comparing 2014 with 1993. The proportion of doctors who had felt unfit due to fear of violence decreased from 1993 to 2014 (adjusted RR=0.53, 95% CI 0.39 to 0.73). Although still above average, the proportion of doctors in psychiatry who reported real acts of violence decreased substantially from 1993 to 2014 (adjusted RR=0.75, 95% CI 0.60 to 0.95). A substantial proportion of doctors experience threats and real acts of violence during their work-time career, but there was no evidence that workplace violence has increased over the last two decades. Still, the issue needs to be addressed as part of the doctors' education and within work settings. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. A qualitative study on physicians' perceptions of specialty characteristics.

    Science.gov (United States)

    Park, Kwi Hwa; Jun, Soo-Koung; Park, Ie Byung

    2016-09-01

    There has been limited research on physicians' perceptions of the specialty characteristics that are needed to sustain a successful career in medical specialties in Korea. Medical Specialty Preference Inventory in the United States or SCI59 (specialty choice inventory) in the United Kingdom are implemented to help medical students plan their careers. The purpose of this study was to explore the characteristics of the major specialties in Korea. Twelve physicians from different specialties participated in an exploratory study consisting of qualitative interviews about the personal ability and emotional characteristics and job attributes of each specialty. The collected data were analysed with content analysis methods. Twelve codes were extracted for ability & skill attributes, 23 codes for emotion & attitude attributes, and 12 codes for job attributes. Each specialty shows a different profile in terms of its characteristic attributes. The findings have implications for the design of career planning programs for medical students.

  9. A qualitative study on physicians' perceptions of specialty characteristics

    Directory of Open Access Journals (Sweden)

    Kwi Hwa Park

    2016-09-01

    Full Text Available Purpose: There has been limited research on physicians’ perceptions of the specialty characteristics that are needed to sustain a successful career in medical specialties in Korea. Medical Specialty Preference Inventory in the United States or SCI59 (specialty choice inventory in the United Kingdom are implemented to help medical students plan their careers. The purpose of this study was to explore the characteristics of the major specialties in Korea. Methods: Twelve physicians from different specialties participated in an exploratory study consisting of qualitative interviews about the personal ability and emotional characteristics and job attributes of each specialty. The collected data were analysed with content analysis methods. Results: Twelve codes were extracted for ability & skill attributes, 23 codes for emotion & attitude attributes, and 12 codes for job attributes. Each specialty shows a different profile in terms of its characteristic attributes. Conclusion: The findings have implications for the design of career planning programs for medical students.

  10. Preparedness for practice : A systematic cross-specialty evaluation of the alignment between postgraduate medical education and independent practice

    NARCIS (Netherlands)

    Dijkstra, Ids S.; Pols, Jan; Remmelts, Pine; Brand, Paul L. P.

    Background: Postgraduate medical education training programs strive to prepare their trainees optimally for independent practice. Several studies have shown, however, that new consultants feel inadequately prepared for practice, and that this increases the risk of stress and burnout. Aim: To analyze

  11. Quality management in medical specialties: the use of channels and dikes in improving health care in The Netherlands

    NARCIS (Netherlands)

    Klazinga, N.; Lombarts, K.; van Everdingen, J.

    1998-01-01

    BACKGROUND: In 1989 a Dutch national policy was instituted to ensure that quality management is the responsibility of both health care professionals and management, with input from insurers and patients. In turn, quality management of medical specialists remained to a large extent self-regulatory,

  12. [Development, factor-analytical control and psychometric evaluation of a questionnaire on specialty choices among medical students].

    Science.gov (United States)

    Hermann, K; Buchholz, A; Loh, A; Kiolbassa, K; Miksch, A; Joos, S; Götz, K

    2012-07-01

    A questionnaire was developed and validated which assesses factors influencing career choices of medical students and their perception of possibilities in general practice. The first questionnaire version, which was developed based on a systematic literature review, was checked for comprehensibility and redundancy using concurrent think aloud. The revised version was filled out by a pilot sample of medical students and the factor structure was assessed using principal component analysis (PCA). The final version was filled out in an online survey by medical students of all 5 Medical Faculties in the federal state of Baden-Wuerttemberg. The factor structure was validated with a confirmatory factor analysis (CFA). Reliability was assessed as internal consistency using Cronbach's α. The questionnaire comprises 2 parts: ratings of (A) the individual importance and of (B) the possibilities in general practice on 5-point scales. The first version comprising 118 items was shortened to 63 items after conducting interviews using concurrent think aloud. A further 3 items giving no information were removed after piloting the questionnaire on 179 students. The 27 items of part A were structured in 7 factors (PCA): image, personal ambition, patient orientation, work-life balance, future perspectives, job-related ambition, and variety in job. This structure had a critical fit in the CFA applied to the final version filled out by 1 299 students. Internal consistency of the factors was satisfactory to very good (Cronbach's α=0.55-0.81). The questionnaire showed good psychometric properties. Further, not assessed factors influence career choice resulting in unexplained variance in our dataset and the critical fit of the model. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Knowledge and Awareness of Medical Practitioners of Jazan City towards Oral and Maxillofacial Surgery as a Specialty.

    Science.gov (United States)

    Ali, Fareedi Mukram; Al-Iryani, Ghassan M; Namis, Sultan Mohammed; Hezam, Asma Ali; Swaid, Salma Abdu; Alomar, Anas Esam

    2018-03-15

    In many health services communities the scope of oral and maxillofacial surgery (OMFS) as a discipline is frequently not probably understood. Good awareness towards OMFS among different branches of health services providers is essential for better referral strategies and will be for the benefit of the patient. The cross-sectional study was done using a specially prepared questionnaire distributed randomly to 125 general medical practitioners working in Jazan province. In this questionnaire, there were also some close-ended questions to evaluate awareness regarding a variety of conditions treated by the oral and maxillofacial surgeons. Out of 125 participants, 105 (84%) were aware of the oral and maxillofacial surgery as a speciality branch of dentistry. Only 52 (41.6%) participants were aware of the different treatment modalities coming under the scope of oral and maxillofacial surgery. Also in the referral of cases to the oral and maxillofacial surgeon, 50 (40%) participants referred their oral and maxillofacial region cases to OMS. Tooth removal was the only procedure where most of the medical practitioners knew it is a speciality procedure of the oral and maxillofacial surgeon. For facial fractures, 76 medical practitioners believe it comes under the scope of the orthopaedic surgeon. Similarly, for facial abscesses, 81 and 36 practitioners responded that it is a job of a general surgeon and OMS respectively. There is low awareness toward the scope of oral and maxillofacial surgery in the medical community. Knowledge and awareness of the scope of oral and maxillofacial surgery can improve the success and promptness of delivery of health services.

  14. Medical students' attitudes to mental illnesses and to psychiatry before and after the psychiatric clerkship: Training in a specialty and a general hospital.

    Science.gov (United States)

    Economou, Marina; Kontoangelos, Kontantinos; Peppou, Lily Evangelia; Arvaniti, Aikaterini; Samakouri, Maria; Douzenis, Athanasios; Papadimitriou, George N

    2017-12-01

    Medical students' attitudes to mental illnesses and psychiatry may be reshaped during the psychiatric training, with important implications in their future practice of the profession. Therefore, the present study set out to explore the impact of the psychiatric clerkship in students' attitudes, while taking into consideration the site of their practical training. To this end, a total of 678 final-year medical students were recruited. Students completed a self-reported questionnaire entailing the Attitudes to Psychiatry scale, the Attitudes to Mental Illness scale and the Greek Social Distance scale before and after their placement. Findings indicate that the psychiatric clerkship had a positive effect in reducing stigma towards both psychiatry and mental illnesses, with the effect being more pronounced in the general hospital with respect to the former, while in the specialty hospital was more marked regarding the latter. A further exploration of the determinants of change revealed that the improvement discerned in the general hospital was only among those without professional experience of mental illnesses. Therefore, the psychiatric clerkship may exert a substantial influence on shaping favourable attitudes towards mental illnesses and psychiatry; however, other elements should also be taken into consideration, if the clerkship is to tackle stigma in healthcare. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. The dental specialties related articles published in Medical Journal Armed Forces India from 2000 to 2014 over a 15-year period.

    Science.gov (United States)

    Shamim, Thorakkal

    2015-12-01

    There is a paucity of information about the dental specialties related articles published in the Medical Journal Armed Forces India (MJAFI). This study aimed to audit the dental specialities related articles published in MJAFI from 2000 to 2014 over a 15-year period. Bibliometric analysis of sixty issues of MJAFI from 2000 to 2014 were performed using web-based search. The articles published were analyzed for type of article and topic of individual dental specialities. The articles published were also evaluated to identify whether the study was an Armed Forces Medical Research Committee Project or funded research project or not. Out of the total 118 published articles related to dental specialities, original articles (55) and case reports (49) contribute the major share. The highest number of dental specialities related articles was published in 2009 with 16, followed by 2010 with 13 and 2011 with 11 and the least published year was 2013 with 3 articles. Regarding the relationship with dental specialities, the maximum number of published articles were related to oral medicine and radiology (56) followed by oral and maxillofacial surgery (49), orthodontics (23) and prosthodontics (17). Among the articles published in MJAFI, maxillofacial injuries (11) followed by orthodontic treatment (8) and craniofacial deformities (8) form the major attraction of the contributors. Among the 118 dental speciality articles, there were only 4 Armed Forces Medical Research Committee Project articles and 19 funded research project articles. An equal distribution of articles related to clinical dentistry and nonclinical dentistry is maintained for the MJAFI from 2000 to 2014 over a 15-year period.

  16. Calculations of doses for the personnel wrapped up in the radiological accident of the Specialties Hospital of the National Medical Center ''Siglo XXI''

    International Nuclear Information System (INIS)

    Cortes C, A.

    2004-01-01

    In this work the methodology used by the National Commission of Nuclear Safety and Safeguards for the determination of the internal dose due to the ingestion of coffee with I-131 for the personnel of the service of nuclear medicine of the Hospital of Specialties of the National Medical Center ''Siglo XXI'' of the Mexican Institute of the Social Insurance (IMSS), that was poured in the coffeepot of the service by a deliberate act before mentioned, is presented. Three different techniques were used to determine the initial activity incorporated starting from the measurements of retained activity in thyroid for 6 people of the service of nuclear medicine; the techniques employee provided consistent results. Using the results of the technique of the best estimator, it was applied the proposed methodology by the International Commission of Radioprotection in its publication 30 to determine the absorbed doses by the personnel involved in the accident, with which the Commission determines the administrative consequences to those that it should be held the personnel and the directive of the service of nuclear medicine of the one nosocome. (Author)

  17. Lifetime earnings for physicians across specialties.

    Science.gov (United States)

    Leigh, J Paul; Tancredi, Daniel; Jerant, Anthony; Romano, Patrick S; Kravitz, Richard L

    2012-12-01

    Earlier studies estimated annual income differences across specialties, but lifetime income may be more relevant given physicians' long-term commitments to specialties. Annual income and work hours data were collected from 6381 physicians in the nationally representative 2004-2005 Community Tracking Study. Data regarding years of residency were collected from AMA FREIDA. Present value models were constructed assuming 3% discount rates. Estimates were adjusted for demographic and market covariates. Sensitivity analyses included 4 alternative models involving work hours, retirement, exogenous variables, and 1% discount rate. Estimates were generated for 4 broad specialty categories (Primary Care, Surgery, Internal Medicine and Pediatric Subspecialties, and Other), and for 41 specific specialties. The estimates of lifetime earnings for the broad categories of Surgery, Internal Medicine and Pediatric Subspecialties, and Other specialties were $1,587,722, $1,099,655, and $761,402 more than for Primary Care. For the 41 specific specialties, the top 3 (with family medicine as reference) were neurological surgery ($2,880,601), medical oncology ($2,772,665), and radiation oncology ($2,659,657). The estimates from models with varying rates of retirement and including only exogenous variables were similar to those in the preferred model. The 1% discount model generated estimates that were roughly 150% larger than the 3% model. There was considerable variation in the lifetime earnings across physician specialties. After accounting for varying residency years and discounting future earnings, primary care specialties earned roughly $1-3 million less than other specialties. Earnings' differences across specialties may undermine health reform efforts to control costs and ensure adequate numbers of primary care physicians.

  18. Number of Published Randomized Controlled Multi Center Trials Testing Pharmacological Interventions or Devices Is Increasing in Both Medical and Surgical Specialties

    DEFF Research Database (Denmark)

    Danielsen, Anne Kjaergaard; Okholm, Cecilie; Pommergaard, Hans-Christian

    2014-01-01

    : The object of this study was to investigate the development in the organization of multicenter studies, the distribution of studies within different clinical specialties, across continents, and investigate the differences related to testing various interventions. METHODS AND MATERIALS: A literature search...... was done in MEDLINE for multicenter studies published in 1995, 2000, 2005, and 2010, respectively. Data extraction identified data related to clinical specialties, interventions, participating patients, departments, countries, and continents. RESULTS: The number of multicenter studies increased from 112...... as the number of participating departments increased during the time span, though the increase in studies was most evident in Europe and North America compared with the rest of the world....

  19. Online examiner calibration across specialties.

    Science.gov (United States)

    Sturman, Nancy; Wong, Wai Yee; Turner, Jane; Allan, Chris

    2017-09-26

    Integrating undergraduate medical curricula horizontally across clinical medical specialties may be a more patient-centred and learner-centred approach than rotating students through specialty-specific teaching and assessment, but requires some interspecialty calibration of examiner judgements. Our aim was to evaluate the acceptability and feasibility of an online pilot of interdisciplinary examiner calibration. Fair clinical assessment is important to both medical students and clinical teachers METHODS: Clinical teachers were invited to rate video-recorded student objective structured clinical examination (OSCE) performances and join subsequent online discussions using the university's learning management system. Post-project survey free-text and Likert-scale participant responses were analysed to evaluate the acceptability of the pilot and to identify recommendations for improvement. Although 68 clinicians were recruited to participate, and there were 1599 hits on recordings and discussion threads, only 25 clinical teachers rated at least one student performance, and 18 posted at least one comment. Participants, including rural doctors, appeared to value the opportunity for interdisciplinary rating calibration and discussion. Although the asynchronous online format had advantages, especially for rural doctors, participants reported considerable IT challenges. Our findings suggest that fair clinical assessment is important to both medical students and clinical teachers. Interspecialty discussions about assessment may have the potential to enrich intraspecialty perspectives, enhance interspecialty engagement and collaboration, and improve the quality of clinical teacher assessment. Better alignment of university and hospital systems, a face to face component and other modifications may have enhanced clinician engagement with this project. Findings suggest that specialty assessment cultures and content expertise may not be barriers to pursuing more integrated

  20. Physicians' occupational stress, depressive symptoms and work ability in relation to their working environment: a cross-sectional study of differences among medical residents with various specialties working in German hospitals.

    Science.gov (United States)

    Bernburg, Monika; Vitzthum, Karin; Groneberg, David A; Mache, Stefanie

    2016-06-15

    This study aimed to analyse and compare differences in occupational stress, depressive symptoms, work ability and working environment among residents working in various medical specialties. 435 German hospital residents in medical training working in 6 different medical specialties participated in a cross-sectional survey study. Physicians were asked about their working conditions and aspects of mental health and work ability. The Copenhagen Psychosocial Questionnaire, the Work Ability Index, the ICD-10 Symptom Rating and the Perceived Stress Questionnaire were used to measure working conditions, mental health and work ability. Results show that up to 17% of the physicians reported high levels of occupational distress and 9% reported high levels of depressive symptoms. 11% of the hospital physicians scored low in work ability. Significant differences between medical specialties were demonstrated for occupational distress, depressive symptoms, work ability, job demands and job resources. Surgeons showed consistently the highest levels of perceived distress but also the highest levels of work ability and lowest scores for depression. Depressive symptoms were rated with the highest levels by anaesthesiologists. Significant associations between physicians' working conditions, occupational distress and mental health-related aspects are illustrated. Study results demonstrated significant differences in specific job stressors, demands and resources. Relevant relations between work factors and physicians' health and work ability are discussed. These findings should be reinvestigated in further studies, especially with a longitudinal study design. This work suggests that to ensure physicians' health, hospital management should plan and implement suitable mental health promotion strategies. In addition, operational efficiency through resource planning optimisation and work process improvements should be focused by hospital management. Published by the BMJ Publishing Group

  1. The Value of Specialty Oncology Drugs

    Science.gov (United States)

    Goldman, Dana P; Jena, Anupam B; Lakdawalla, Darius N; Malin, Jennifer L; Malkin, Jesse D; Sun, Eric

    2010-01-01

    Objective To estimate patients' elasticity of demand, willingness to pay, and consumer surplus for five high-cost specialty medications treating metastatic disease or hematologic malignancies. Data Source/Study Setting Claims data from 71 private health plans from 1997 to 2005. Study Design This is a revealed preference analysis of the demand for specialty drugs among cancer patients. We exploit differences in plan generosity to examine how utilization of specialty oncology drugs varies with patient out-of-pocket costs. Data Collection/Extraction Methods We extracted key variables from administrative health insurance claims records. Principal Findings A 25 percent reduction in out-of-pocket costs leads to a 5 percent increase in the probability that a patient initiates specialty cancer drug therapy. Among patients who initiate, a 25 percent reduction in out-of-pocket costs reduces the number of treatments (claims) by 1–3 percent, depending on the drug. On average, the value of these drugs to patients who use them is about four times the total cost paid by the patient and his or her insurer, although this ratio may be lower for oral specialty therapies. Conclusions The decision to initiate therapy with specialty oncology drugs is responsive to price, but not highly so. Among patients who initiate therapy, the amount of treatment is equally responsive. The drugs we examine are highly valued by patients in excess of their total costs, although oral agents warrant further scrutiny as copayments increase. PMID:19878344

  2. Nursing specialty and burnout.

    Science.gov (United States)

    Browning, Laura; Ryan, Carey S; Thomas, Scott; Greenberg, Martin; Rolniak, Susan

    2007-03-01

    We examined the relationship between perceived control and burnout among three nursing specialties: nurse practitioners, nurse managers, and emergency nurses. Survey data were collected from 228 nurses from 30 states. Findings indicated that emergency nurses had the least control and the highest burnout, whereas nurse practitioners had the most control and the least burnout. Mediational analyses showed that expected control, hostility, and stressor frequency explained differences between specialties in burnout. The implications of these findings for interventions that reduce burnout and promote nursing retention are discussed.

  3. Preferencias de los estudiantes de medicina de la Universidad de Buenos Aires en la elección de la especialidad Medical students' preferences on specialty selection in Buenos Aires University

    Directory of Open Access Journals (Sweden)

    Raúl A. Borracci

    2012-09-01

    Full Text Available Introducción. Los factores que influyen en la elección de una especialidad son la demanda laboral, la remuneración, el prestigio, el tiempo de formación y la posibilidad de tener un estilo de vida 'controlable'. Sin embargo, la influencia de la cultura podría modificar el peso de estas variables a la hora de elegir una especialidad. Objetivo. Analizar los factores que influían sobre la elección de la especialidad médica por parte de los estudiantes. Sujetos y métodos. Entre marzo y mayo de 2010 se encuestaron 125 estudiantes que cursaban quinto año o el internado. Por medio de una encuesta anónima se recogió información sobre los factores que podrían influir en la elección futura de la especialidad. Resultados. La pediatría fue la especialidad más elegida, pero se la consideró entre las menos lucrativas, con más tiempo de formación y prestigio moderado, aunque con una adecuada demanda laboral. La cirugía fue la segunda más elegida y considerada como la de mayor prestigio y mejor remunerada. La clínica médica requeriría más tiempo de formación, con más oportunidades laborales, pero peor remuneradas. Tanto la clínica médica como la cirugía se eligieron como las de estilo de vida menos 'controlable', hallándose en tercer lugar la pediatría. Conclusión. Las características de remuneración, prestigio, estilo de vida, tiempo de formación y demanda laboral, en general, parecen no haber influido significativamente en la elección de la especialidad.Introduction. Factors associated with medical students' specialty choice are work market opportunities, expected income, prestige, length of training and controllable life style possibility. However, cultural influence may modify the weight of these variables at time of choosing a specialty. Aim. To analyze the factors influencing on medical students' specialty preferences. Subjects and methods. From March to May of 2010, 125 medical students' from 5th and 6th year were

  4. Fostering clinical engagement and medical leadership and aligning cultural values: an evaluation of a general practice specialty trainee integrated training placement in a primary care trust.

    Science.gov (United States)

    Ruston, Annmarie; Tavabie, Abdol

    2010-01-01

    To report on the extent to which a general practice specialty trainee integrated training placement (ITP) developed the leadership skills and knowledge of general practice specialty trainees (GPSTRs) and on the potential of the ITP to improve clinical engagement. A case study method was used in a Kent primary care trust (PCT). Sources of data included face-to-face and telephone interviews (three GPSTRs, three PCT clinical supervisors, three general practitioner (GP) clinical supervisors and three Deanery/PCT managers), reflective diaries, documentary sources and observation. Interview data were transcribed and analysed using the constant comparative method. All respondents were positive about the value and success of the ITP in developing the leadership skills of the GPSTRs covering three dimensions: leadership of self, leadership of teams and leadership of organisations within systems. The ITP had enabled GP trainees to understand the context for change, to develop skills to set the direction for change and to collect and apply evidence to decision making. The ITP was described as an effective means of breaking down cultural barriers between general practice and the PCT and as having the potential for improving clinical engagement. The ITP provided a model to enable the effective exchange of knowledge and understanding of differing cultures between GPSTRs, general practice and the PCT. It provided a sound basis for effective, dispersed clinical engagement and leadership.

  5. Personality traits and career choices among physicians in Finland: employment sector, clinical patient contact, specialty and change of specialty.

    Science.gov (United States)

    Mullola, Sari; Hakulinen, Christian; Presseau, Justin; Gimeno Ruiz de Porras, David; Jokela, Markus; Hintsa, Taina; Elovainio, Marko

    2018-03-27

    Personality influences an individual's adaptation to a specific job or organization. Little is known about personality trait differences between medical career and specialty choices after graduating from medical school when actually practicing different medical specialties. Moreover, whether personality traits contribute to important career choices such as choosing to work in the private or public sector or with clinical patient contact, as well as change of specialty, have remained largely unexplored. In a nationally representative sample of Finnish physicians (N = 2837) we examined how personality traits are associated with medical career choices after graduating from medical school, in terms of employment sector, patient contact, medical specialty and change of specialty. Personality was assessed using the shortened version of the Big Five Inventory (S-BFI). An analysis of covariance with posthoc tests for pairwise comparisons was conducted, adjusted for gender and age with confounders (employment sector, clinical patient contact and medical specialty). Higher openness was associated with working in the private sector, specializing in psychiatry, changing specialty and not practicing with patients. Lower openness was associated with a high amount of patient contact and specializing in general practice as well as ophthalmology and otorhinolaryngology. Higher conscientiousness was associated with a high amount of patient contact and specializing in surgery and other internal medicine specialties. Lower conscientiousness was associated with specializing in psychiatry and hospital service specialties. Higher agreeableness was associated with working in the private sector and specializing in general practice and occupational health. Lower agreeableness and neuroticism were associated with specializing in surgery. Higher extraversion was associated with specializing in pediatrics and change of specialty. Lower extraversion was associated with not practicing with

  6. Admission Factors Predicting Family Medicine Specialty Choice: A Literature Review and Exploratory Study among Students in the Rural Medical Scholars Program

    Science.gov (United States)

    Avery, Daniel M., Jr.; Wheat, John R.; Leeper, James D.; McKnight, Jerry T.; Ballard, Brent G.; Chen, Jia

    2012-01-01

    Purpose: The Rural Medical Scholars Program (RMSP) was created to increase production of rural family physicians in Alabama. Literature review reveals reasons medical students choose careers in family medicine, and these reasons can be categorized into domains that medical schools can address through admission, curriculum, and structural…

  7. Awareness and perception of the specialty of family medicine ...

    African Journals Online (AJOL)

    Background: Family Medicine is the medical specialty that provides ... the World Health Organization (WHO) has acknowledged the critical importance and positive ... This study evaluated the awareness, knowledge and perception of Family ...

  8. The impact of clerkships on students' specialty preferences: what do undergraduates learn for their profession?

    NARCIS (Netherlands)

    Maiorova, T.; Stevens, F.; Scherpbier, A.; Zee, J. van der

    2008-01-01

    OBJECTIVE: Clinical experiences and gender have been shown to influence medical students' specialty choices. It remains unclear, however, which aspects of experiences make students favour some specialties and reject others. This study aimed to clarify the effects of clerkships on specialty choice

  9. Psychiatric specialty training in Greece.

    Science.gov (United States)

    Margariti, M; Kontaxakis, V; Ploumpidis, D

    2017-01-01

    The reform and development of psychiatric services require, in addition to financial resources, reserves in specialized human resources. The role of psychiatrists in this process, and at reducing the consequences of mental morbidity is evident. Psychiatrists are required to play a multifaceted role as clinicians, as experts in multidisciplinary team environments and as advisors in the recognition of public needs in mental health issues, as teachers and mentors for students and other health professionals, as researchers in order to enrich our knowledge in the scientific field of psychiatry, and as public health specialists in the development of the mental health services system. This multifaceted role requires the continuous education of modern psychiatrists, but above all a broad, substantial and comprehensive training regime in the initial stage of their professional career, that is to say during specialization. Training in Psychiatry, as indeed has happened in all other medical specialties, has evolved considerably in recent decades, both in the content of education due to scientific advances in the fields of neurobiology, cognitive neuroscience, genetics, psychopharmacology, epidemiology and psychiatric nosology, and also because of advances in the educational process itself. Simple apprenticeship next to an experienced clinician, despite its importance in the clinical training of young psychiatrists, is no longer sufficient to meet the increased demands of the modern role of psychiatrists, resulting in the creation of educational programs defined by setting and pursuing minimum, though comprehensive educational objectives. This development has created the global need to develop organizations intended to supervise training programs. These organizations have various forms worldwide. In the European Union, the competent supervising body for medical specialties is the UEMS (European Union of Medical Specialities) and particularly in the case of the psychiatric

  10. Physician wages across specialties: informing the physician reimbursement debate.

    Science.gov (United States)

    Leigh, J Paul; Tancredi, Daniel; Jerant, Anthony; Kravitz, Richard L

    2010-10-25

    Disparities in remuneration between primary care and other physician specialties may impede health care reform by undermining the sustainability of a primary care workforce. Previous studies have compared annual incomes across specialties unadjusted for work hours. Wage (earnings-per-hour) comparisons could better inform the physician payment debate. In a cross-sectional analysis of data from 6381 physicians providing patient care in the 2004-2005 Community Tracking Study (adjusted response rate, 53%), we compared wages across broad and narrow categories of physician specialties. Tobit and linear regressions were run. Four broad specialty categories (primary care, surgery, internal medicine and pediatric subspecialties, and other) and 41 specific specialties were analyzed together with demographic, geographic, and market variables. In adjusted analyses on broad categories, wages for surgery, internal medicine and pediatric subspecialties, and other specialties were 48%, 36%, and 45% higher, respectively, than for primary care specialties. In adjusted analyses for 41 specific specialties, wages were significantly lower for the following than for the reference group of general surgery (wage near median, $85.98): internal medicine and pediatrics combined (-$24.36), internal medicine (-$24.27), family medicine (-$23.70), and other pediatric subspecialties (-$23.44). Wage rankings were largely impervious to adjustment for control variables, including age, race, sex, and region. Wages varied substantially across physician specialties and were lowest for primary care specialties. The primary care wage gap was likely conservative owing to exclusion of radiologists, anesthesiologists, and pathologists. In light of low and declining medical student interest in primary care, these findings suggest the need for payment reform aimed at increasing incomes or reducing work hours for primary care physicians.

  11. The predictive validity of a situational judgement test, a clinical problem solving test and the core medical training selection methods for performance in specialty training .

    Science.gov (United States)

    Patterson, Fiona; Lopes, Safiatu; Harding, Stephen; Vaux, Emma; Berkin, Liz; Black, David

    2017-02-01

    The aim of this study was to follow up a sample of physicians who began core medical training (CMT) in 2009. This paper examines the long-term validity of CMT and GP selection methods in predicting performance in the Membership of Royal College of Physicians (MRCP(UK)) examinations. We performed a longitudinal study, examining the extent to which the GP and CMT selection methods (T1) predict performance in the MRCP(UK) examinations (T2). A total of 2,569 applicants from 2008-09 who completed CMT and GP selection methods were included in the study. Looking at MRCP(UK) part 1, part 2 written and PACES scores, both CMT and GP selection methods show evidence of predictive validity for the outcome variables, and hierarchical regressions show the GP methods add significant value to the CMT selection process. CMT selection methods predict performance in important outcomes and have good evidence of validity; the GP methods may have an additional role alongside the CMT selection methods. © Royal College of Physicians 2017. All rights reserved.

  12. Distinct attitudes of professionals from different medical specialties toward autonomy and legal instruments in the assessment of patients with Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Ana Beatriz Maringolo Pioltini

    Full Text Available Abstract The evaluation of competence of Alzheimer's disease (AD patients to assume personal or collective responsibilities and the resulting legal implications is a relevant issue. Objectives: The aim of this study was to evaluate the attitudes of different medical specialists towards the disability of patients with Alzheimer's disease and practitioners' competence to interfere with decision-making autonomy. Methods: Professionals from different areas (Neurology, Psychiatry, Geriatrics, and General Practice were interviewed by one of the authors, after being presented a fictitious clinical case which raised several topics, namely: [1] Critical judgment and capacity of the patient to take decisions related to daily activities; [2] The role of family physicians in nominating trustees and caregivers. Results: Answers to the first question did not differ regarding degree of preservation of awareness but at least 25% stressed that the patient must be carefully listened to, independent of caregiver or legal representative opinion. There were significant knowledge gaps in responses to the second question. Half of the physicians interviewed did not have adequate information about the legal aspects of caring for patients with Alzheimer's disease. Conclusions: Legal aspects is a topic that must be incorporated into professional training in order to improve attitudes toward the long-term management of patients with dementia.

  13. Opioid Prescriptions by Specialty in Ohio, 2010-2014.

    Science.gov (United States)

    Weiner, Scott G; Baker, Olesya; Rodgers, Ann F; Garner, Chad; Nelson, Lewis S; Kreiner, Peter W; Schuur, Jeremiah D

    2018-05-01

    The current US opioid epidemic is attributed to the large volume of prescribed opioids. This study analyzed the contribution of different medical specialties to overall opioids by evaluating the pill counts and morphine milligram equivalents (MMEs) of opioid prescriptions, stratified by provider specialty, and determined temporal trends. This was an analysis of the Ohio prescription drug monitoring program database, which captures scheduled medication prescriptions filled in the state as well as prescriber specialty. We extracted prescriptions for pill versions of opioids written in the calendar years 2010 to 2014. The main outcomes were the number of filled prescriptions, pill counts, MMEs, and extended-released opioids written by physicians in each specialty, and annual prescribing trends. There were 56,873,719 prescriptions for the studied opioids dispensed, for which 41,959,581 (73.8%) had prescriber specialty type available. Mean number of pills per prescription and MMEs were highest for physical medicine/rehabilitation (PM&R; 91.2 pills, 1,532 mg, N = 1,680,579), anesthesiology/pain (89.3 pills, 1,484 mg, N = 3,261,449), hematology/oncology (88.2 pills, 1,534 mg, N = 516,596), and neurology (84.4 pills, 1,230 mg, N = 573,389). Family medicine (21.8%) and internal medicine (17.6%) wrote the most opioid prescriptions overall. Time trends in the average number of pills and MMEs per prescription also varied depending on specialty. The numbers of pills and MMEs per opioid prescription vary markedly by prescriber specialty, as do trends in prescribing characteristics. Pill count and MME values define each specialty's contribution to overall opioid prescribing more accurately than the number of prescriptions alone.

  14. Padrões éticos adotados pelas revistas científicas brasileiras das especialidades médicas Ethical standards adopted by brazilian journals of medical specialties

    Directory of Open Access Journals (Sweden)

    Marcos Rassi Fernandes

    2011-06-01

    Full Text Available OBJETIVO: Analisar os padrões éticos contidos nas instruções aos autores das revistas científicas brasileiras de diversas especialidades médicas e verificar se existe alguma padronização. MÉTODOS: Trata-se de um estudo exploratório em que se avaliaram as revistas científicas brasileiras, catalogadas no "Portal de Revistas em Ciências da Saúde" da Biblioteca Virtual de Saúde de todas as especialidades médicas, com relação às orientações aos autores no envio dos manuscritos, quanto aos padrões éticos em pesquisa de seres humanos. Os dados foram coletados e categorizados quanto à presença das variáveis: aprovação do Comitê de Ética; Declaração de Helsinque e/ou Resolução 196/96, consentimento informado; padrões éticos; requisitos uniformes; sigilo dos pacientes e sem referências éticas. Verificou-se, também, se existia associação entre elas. RESULTADOS: De um total de 8.701 periódicos, 95 foram incluídos no presente estudo. As variáveis foram pesquisadas, verificando a frequência de cada uma delas. Foram referenciados 80% de aprovação do Comitê de Ética; 43,15% da Declaração de Helsinque; 43,15% do consentimento informado; 9,47% dos padrões éticos; 32,63% dos requisitos uniformes e 15,78% do sigilo dos pacientes. Em toda a amostragem, 9,47% das revistas não mencionam qualquer referência ética como orientação aos autores no envio de manuscritos. A associação entre as variáveis ocorreu em 61% da amostra. CONCLUSÃO: Os aspectos éticos no envio de manuscritos foram citados em mais de 90% das instruções aos autores das revistas científicas nacionais, e não existe qualquer tipo de padronização.OBJECTIVE: To review ethical standards contained in guidelines to authors of Brazilian scientific journals in several medical specialties and see if there is any standardization available. METHODS: This is an exploratory study evaluating Brazilian scientific journals classified on the Portal of

  15. Orthopedic specialty hospitals: centers of excellence or greed machines?

    Science.gov (United States)

    Badlani, Neil; Boden, Scott; Phillips, Frank

    2012-03-07

    Orthopedic specialty hospitals have recently been the subject of debate. They are patient-centered, physician-friendly health care alternatives that take advantage of the economic efficiencies of specialization. Medically, they provide a higher quality of care and increase patient and physician satisfaction. Economically, they are more efficient and profitable than general hospitals. They also positively affect society through the taxes they pay and the beneficial aspects of the competition they provide to general hospitals. Their ability to provide a disruptive innovation to the existing hospital industry will lead to lower costs and greater access to health care. However, critics say that physician ownership presents potential conflicts of interest and leads to overuse of medical care. Some general hospitals are suffering as a result of unfair specialty hospital practices, and a few drastic medical complications have occurred at specialty hospitals. Specialty hospitals have been scrutinized for increasing the inequality of health care and continue to be a target of government regulations. In this article, the pros and cons are examined, and the Emory Orthopaedics and Spine Hospital is analyzed as an example. Orthopedic specialty hospitals provide excellent care and are great assets to society. Competition between specialty and general hospitals has provided added value to patients and taxpayers. However, physicians must take more responsibility in their appropriate and ethical leadership. It is critical to recognize financial conflicts of interest, disclose ownership, and act ethically. Patient care cannot be compromised. With thoughtful and efficient leadership, specialty hospitals can be an integral part of improving health care in the long term. Copyright 2012, SLACK Incorporated.

  16. The general practitioner and the surgeon: stereotypes and medical specialties O clínico e o cirurgião: esteriótipos e especialidades médicas

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    Patrícia Lacerda Bellodi

    2004-02-01

    Full Text Available OBJECTIVE: To investigate and characterize the professional stereotypes associated with general medicine and surgery among Brazilian medical residents. METHODS: A randomized sample of residents of the General Medicine and Surgery Residence Programs were interviewed and their perceptions and views of general and surgical doctors were compared. RESULTS: The general practitioner was characterized by the residents in general to be principally a sensitive and concerned doctor with a close relationship with the patient; (45%; calm, tranquil, and balanced (27%; with intellectual skills (25%; meticulous and attentive to details (23%; slow to resolve problems and make decisions (22%; and working more with probabilities and hypotheses (20%. The surgeon was considered to be practical and objective (40%; quickly resolving problems (35%; technical with manual skills (23%; omnipotent, arrogant, and domineering (23%; anxious, stressed, nervous, and temperamental (23%; and more decided, secure, and courageous (20%. Only the residents of general medicine attributed the surgeon with less knowledge of medicine and only the surgeons attributed gender characteristics to their own specialty. CONCLUSION: There was considerable similarity in the description of a typical general practitioner and surgeon among the residents in general, regardless of the specialty they had chosen. It was interesting to observe that these stereotypes persist despite the transformations in the history of medicine, i.e. the first physicians (especially regarding the valorization of knowledge and the first surgeons, so-called "barber surgeons" in Brazil (associated with less knowledge and the performance of high-risk procedures.OBJETIVOS: Investigar e caracterizar entre residentes brasileiros os estereótipos profissionais associados ao médico clínico e ao cirurgião. METODOLOGIA: uma amostra randomizada de residentes dos programas de Clínica Médica e Cirurgia foi entrevistada e suas

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

    Science.gov (United States)

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

    2012-04-01

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

  18. Specialty Guidelines for Forensic Psychology

    Science.gov (United States)

    American Psychologist, 2013

    2013-01-01

    In the past 50 years forensic psychological practice has expanded dramatically. Because the practice of forensic psychology differs in important ways from more traditional practice areas (Monahan, 1980) the "Specialty Guidelines for Forensic Psychologists" were developed and published in 1991 (Committee on Ethical Guidelines for Forensic…

  19. Knowledge silos: assessing knowledge sharing between specialties through the vestibular schwannoma literature.

    Science.gov (United States)

    Schnurman, Zane; Golfinos, John G; Roland, J Thomas; Kondziolka, Douglas

    2017-12-01

    OBJECTIVE It is common for a medical disorder to be managed or researched by individuals who work within different specialties. It is known that both neurosurgeons and neurotologists manage vestibular schwannoma (VS) patients. While overlap in specialty focus has the potential to stimulate multidisciplinary collaboration and innovative thinking, there is a risk of specialties forming closed-communication loops, called knowledge silos, which may inhibit knowledge diffusion. This study quantitatively assessed knowledge sharing between neurosurgery and otolaryngology on the subject of VS. METHODS A broad Web of Science search was used to download details for 4439 articles related to VS through 2016. The publishing journal's specialty and the authors' specialties (based on author department) were determined for available articles. All 114,647 of the article references were categorized by journal specialty. The prevalence of several VS topics was assessed using keyword searches of titles. RESULTS For articles written by neurosurgeons, 44.0% of citations were from neurosurgery journal articles and 23.4% were from otolaryngology journals. The citations of otolaryngology authors included 11.6% neurosurgery journals and 56.5% otolaryngology journals. Both author specialty and journal specialty led to more citations of the same specialty, though author specialty had the largest effect. Comparing the specialties' literature, several VS topics had significantly different levels of coverage, including radiosurgery and hearing topics. Despite the availability of the Internet, there has been no change in the proportions of references for either specialty since 1997 (the year PubMed became publicly available). CONCLUSIONS Partial knowledge silos are observed between neurosurgery and otolaryngology on the topic of VS, based on the peer-reviewed literature. The increase in access provided by the Internet and searchable online databases has not decreased specialty reference bias

  20. Organizational readiness in specialty mental health care.

    Science.gov (United States)

    Hamilton, Alison B; Cohen, Amy N; Young, Alexander S

    2010-01-01

    Implementing quality improvement efforts in clinics is challenging. Assessment of organizational "readiness" for change can set the stage for implementation by providing information regarding existing strengths and deficiencies, thereby increasing the chance of a successful improvement effort. This paper discusses organizational assessment in specialty mental health, in preparation for improving care for individuals with schizophrenia. To assess organizational readiness for change in specialty mental health in order to facilitate locally tailored implementation strategies. EQUIP-2 is a site-level controlled trial at nine VA medical centers (four intervention, five control). Providers at all sites completed an organizational readiness for change (ORC) measure, and key stakeholders at the intervention sites completed a semi-structured interview at baseline. At the four intervention sites, 16 administrators and 43 clinical staff completed the ORC, and 38 key stakeholders were interviewed. The readiness domains of training needs, communication, and change were the domains with lower mean scores (i.e., potential deficiencies) ranging from a low of 23.8 to a high of 36.2 on a scale of 10-50, while staff attributes of growth and adaptability had higher mean scores (i.e., potential strengths) ranging from a low of 35.4 to a high of 41.1. Semi-structured interviews revealed that staff perceptions and experiences of change and decision-making are affected by larger structural factors such as change mandates from VA headquarters. Motivation for change, organizational climate, staff perceptions and beliefs, and prior experience with change efforts contribute to readiness for change in specialty mental health. Sites with less readiness for change may require more flexibility in the implementation of a quality improvement intervention. We suggest that uptake of evidence-based practices can be enhanced by tailoring implementation efforts to the strengths and deficiencies of the

  1. Emergency medicine as a specialty in Asia.

    Science.gov (United States)

    Pek, Jen Heng; Lim, Swee Han; Ho, Hiu Fai; Ramakrishnan, T V; Jamaluddin, Sabariah Faizah; Mesa-Gaerlan, Faith Joan C; Tiru, Mohan; Hwang, Sung Oh; Choi, Wai-Mau; Kanchanasut, Somchai; Khruekarnchana, Pairoj; Avsarogullari, Levent; Shimazu, Takeshi; Hori, Shingo

    2016-04-01

    We aim to examine the similarities and differences in areas of EM development, workload, workforce, and capabilities and support in the Asia region. Emerging challenges faced by our EM community are also discussed. The National Societies for Emergency Medicine of Hong Kong, India, Japan, Malaysia, Philippines, Singapore, South Korea, Taiwan, Thailand and Turkey participated in the joint Japanese Association of Acute Medicine (JAAM) and Asian Conference of Emergency Medicine (ACEM) Special Symposium held in October 2013 at Tokyo, Japan. The findings are reviewed in this paper. Emergency medicine (EM) has over the years evolved into a distinct and recognized medical discipline requiring a unique set of cognitive, administrative and technical skills for managing all types of patients with acute illness or injury. EM has contributed to healthcare by providing effective, safe, efficient and cost-effective patient care. Integrated systems have developed to allow continuity of emergency care from the community into emergency departments. Structured training curriculum for undergraduates, and specialty training programs for postgraduates are in place to equip trainees with the knowledge and skills required for the unique practice of EM. The practice of EM still varies among the Asian countries. However, as a region, we strive to continue in our efforts to develop the specialty and improve the delivery of EM.

  2. The Impact of HIV/AIDS Epidemic on the Choice of Specialties ...

    African Journals Online (AJOL)

    The Impact of HIV/AIDS Epidemic on the Choice of Specialties among Medical ... satisfaction and favourable work schedule respectively. ... We recommend improvements in the work environment and adherence to universal precautions to

  3. A survey of sub-specialty preferences of radiography students of the University of Lagos, Nigeria

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    E T Namah

    2013-01-01

    Full Text Available Background: Technological advances and computing have expanded both the scope and capacity of diagnostic medical imaging (the radiography profession. This has created many diverse imaging modalities which in turn, have culminated in different sub-specialties in the profession. Objective: The aims of the study were to determine the level of awareness of imaging sub-specialties, preferred sub specialties and reasons for preferences of sub-specialties in senior level radiography students of the University of Lagos. Methods: The study was a prospective cross-sectional survey. Consents were obtained before the students were recruited for the study. Data Collection and Analysis: A questionnaire semi-structured in line with objectives of the study was used in data collection. A computer software Epi Info version 3.3 was used to analyze data while results were expressed as percentages of responses and were presented in tables and pie charts. Results : Greater than 90% showed awareness of sub-specialties in the radiography profession whereas 35% preferred ultrasonography to other sub-specialties. The least preferred sub-specialty was conventional radiography (4.3%. Remuneration (73.3% and less physical exertion (73.3% were major attractors to preferred sub-specialties whereas concerns over radiation hazard were major detractors (58.3%. Conclusion : Awareness of sub-specialties in the radiography profession was high amongst students studied. Furthermore, ultrasonography was the most preferred sub-specialty among the respondents. Remuneration was the main attractor to sub-specialties whereas fears over effects of ionizing radiation were the major detractors to some sub-specialties.

  4. DETERMINANTS OF SPECIALTY CHOICE OF RESIDENT DOCTORS; CASE STUDY--AMONG RESIDENT DOCTORS IN NIGERIA.

    Science.gov (United States)

    Osuoji, Roland I; Adebanji, Atinuke; Abdulsalam, Moruf A; Oludara, Mobolaji A; Abolarinwa, Abimbola A

    2015-01-01

    This study examined medical specialty selection by Nigerian resident doctors using a marketing research approach to determine the selection criteria and the role of perceptions, expected remuneration, and job placement prospects of various specialties in the selection process. Data were from the Community of residents from April 2014 to July 2014. The cohort included 200 residents, but only 171 had complete information. Data were obtained from a cross section of resident doctors in the Lagos State University Teaching Hospital and at the 2014 Ordinary General Meeting of the National Association of Resident Doctors(NARD) where representatives from over 50 Teaching hospitals in Nigeria attended. Using a client behaviour model as a framework, a tripartite questionnaire was designed and administered to residents to deduce information on their knowledge about and interests in various specialties, their opinions of sixteen specialties, and the criteria they used in specialty selection. A total of 171 (85.5%) questionnaires were returned. ln many instances, consistency between selection criteria and perceptions of a specialty were accompanied by interest in pursuing the specialty. Job security, job availability on completion of programme, duration of training and qualifying examinations were highly correlated with p value marketing research concepts for medical specialty selection (Weissmanet al 2012) stipulates that choice of speciality is influenced by criteria and perception. This study shows that job security expected financial remuneration, and examination requirements for qualification are major determinants of the choice of speciality for residents.

  5. How are the different specialties represented in the major journals in general medicine?

    Science.gov (United States)

    Gehanno, Jean-Francois; Ladner, Joel; Rollin, Laetitia; Dahamna, Badisse; Darmoni, Stefan J

    2011-01-21

    General practitioners and medical specialists mainly rely on one "general medical" journal to keep their medical knowledge up to date. Nevertheless, it is not known if these journals display the same overview of the medical knowledge in different specialties. The aims of this study were to measure the relative weight of the different specialties in the major journals of general medicine, to evaluate the trends in these weights over a ten-year period and to compare the journals. The 14,091 articles published in The Lancet, the NEJM, the JAMA and the BMJ in 1997, 2002 and 2007 were analyzed. The relative weight of the medical specialities was determined by categorization of all the articles, using a categorization algorithm which inferred the medical specialties relevant to each article MEDLINE file from the MeSH terms used by the indexers of the US National Library of Medicine to describe each article. The 14,091 articles included in our study were indexed by 22,155 major MeSH terms, which were categorized into 81 different medical specialties. Cardiology and Neurology were in the first 3 specialties in the 4 journals. Five and 15 specialties were systematically ranked in the first 10 and first 20 in the four journals respectively. Among the first 30 specialties, 23 were common to the four journals. For each speciality, the trends over a 10-year period were different from one journal to another, with no consistency and no obvious explanatory factor. Overall, the representation of many specialties in the four journals in general and internal medicine included in this study may differ, probably due to different editorial policies. Reading only one of these journals may provide a reliable but only partial overview.

  6. The value of independent specialty designation for interventional cardiology.

    Science.gov (United States)

    Blankenship, James C; Powell, Wayne A; Gray, Dawn R; Duffy, Peter L

    2017-01-01

    Interventional cardiology has finally completed, after 26 years of advocacy, a professional hat trick: independent board certification, membership as a unique specialty in the American Medical Association House of Delegates (AMA HOD), and recognition by the Centers for Medicaid and Medicare Services (CMS) as a separate medical specialty. This article points out how these distinctions for interventional cardiology and its professional society, the Society for Cardiovascular Angiography and Interventions (SCAI), have led to clear and definite benefits for interventional cardiologists and their patients. We focus on the least understood of these three-recognition by CMS and its implications for reimbursement and quality assessment for interventional cardiologists. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  7. Resident and program director gender distribution by specialty.

    Science.gov (United States)

    Long, Timothy R; Elliott, Beth A; Warner, Mary Ellen; Brown, Michael J; Rose, Steven H

    2011-12-01

    Although enrollment of women in U.S. medical schools has increased, women remain less likely to achieve senior academic rank, lead academic departments, or be appointed to national leadership positions. The purpose of this paper is to compare the gender distribution of residency program directors (PDs) with residents and faculty in the 10 largest specialties. The gender distribution of residents training in the 10 specialties with the largest enrollment was obtained from the annual education issue of Journal of the American Medical Association. The gender distribution of the residents was compared with the gender distribution of PDs and medical school faculty. The number of programs and the names of the PDs were identified by accessing the Accreditation Council for Graduate Medical Education web site. Gender was confirmed through electronic search of state medical board data, program web sites, or by using internet search engines. The gender distribution of medical school faculty was determined using the Association of American Medical Colleges faculty roster database (accessed June 15, 2011). The correlation between female residents and PDs was assessed using Pearson's product-moment correlation. The gender distribution of female PDs appointed June 1, 2006, through June 1, 2010, was compared with the distribution appointed before June 1, 2006, using chi square analysis. Specialties with higher percentages of female PDs had a higher percentage of female residents enrolled (r=0.81, p=0.005). The number of female PDs appointed from July 1, 2006, through June 30, 2010, was greater than the number appointed before July 1, 2006, in emergency medicine (pWomen remain underrepresented in PD appointments relative to the proportion of female medical school faculty and female residents. Mechanisms to address gender-based barriers to advancement should be considered.

  8. Care coordination and unmet specialty care among children with special health care needs.

    Science.gov (United States)

    Boudreau, Alexy Arauz; Perrin, James M; Goodman, Elizabeth; Kurowski, Daniel; Cooley, W Carl; Kuhlthau, Karen

    2014-06-01

    Care coordination and the medical home may ensure access to specialty care. Children with special health care needs (CSHCN) have higher rates of specialty care use and unmet need compared with the general pediatric population. We hypothesized that care coordination, regardless of whether it was provided in a medical home, would decrease unmet specialty care needs among CSHCN and that the effect of care coordination would be greater among low-income families. Secondary data analysis of participants in the 2009–2010 National Survey of CSHCN who reported unmet specialty care needs and for whom care coordination and medical home status could be determined (n = 18 905). Logistic regression models explored the association of unmet need with care coordination and medical home status adjusting for household income. Approximately 9% of CSHCN reported having unmet specialty care needs. Care coordination was associated with reduced odds of unmet specialty care need (without a medical home, odds ratio: 0.63, 95% confidence interval: 0.47–0.86; within a medical home, odds ratio: 0.22, 95% confidence interval: 0.16–0.29) with a greater reduction among those receiving care coordination within a medical home versus those receiving care coordination without a medical home. We did not find differences in the impact of care coordination by percentage of the federal poverty level. Care coordination is associated with family report of decreased unmet specialty care needs among CSHCN independent of household income. The effect of care coordination is greater when care is received in a medical home.

  9. Health plan utilization and costs of specialty drugs within 4 chronic conditions.

    Science.gov (United States)

    Gleason, Patrick P; Alexander, G Caleb; Starner, Catherine I; Ritter, Stephen T; Van Houten, Holly K; Gunderson, Brent W; Shah, Nilay D

    2013-09-01

    Drugs are most typically defined as specialty because they are expensive; however, other criteria used to define a drug as specialty include biologic drugs, the need to inject or infuse the drug, the requirement for special handling, or drug availability only via a limited distribution network. Specialty drugs play an increasingly important role in the treatment of chronic conditions such as multiple sclerosis (MS), rheumatoid arthritis (RA), psoriasis, and inflammatory bowel disease (IBD), yet little is known regarding the comprehensive medical and pharmacy benefit utilization and cost trends for these conditions. To describe MS, RA, psoriasis, and IBD trends for condition prevalence, treatment with specialty drugs, specialty costs, nonspecialty costs, and total direct costs of care within the medical and pharmacy benefits. This was a descriptive analysis of a commercially insured population made up of 1 million members, using integrated medical and pharmacy administrative claims data from 2008 to 2010. Analyses were limited to continuously enrolled commercially insured individuals less than 65 years of age. Condition-specific cohorts for MS, RA, psoriasis, and IBD were defined using standardized criteria. Trends in condition prevalence, specialty drug use for the conditions, and direct total cost of care were analyzed. The direct costs were subcategorized into the following: medical benefit specialty drug costs, medical benefit all other costs, pharmacy benefit specialty drug costs, and pharmacy benefit all other costs. Trends and compound annual growth rates were calculated for the total cost of care and subcategory costs from 2008 through 2010. Condition prevalence ranged from a low of 1,720 per million members for MS to a high of 4,489 per million members for RA. Psoriasis and MS condition prevalence rates were unchanged over the 3 years; however, IBD prevalence increased 7.0%, and RA prevalence increased 9.7%. The rate of specialty drug use was lowest for IBD

  10. Synthetic Biology for Specialty Chemicals.

    Science.gov (United States)

    Markham, Kelly A; Alper, Hal S

    2015-01-01

    In this review, we address recent advances in the field of synthetic biology and describe how those tools have been applied to produce a wide variety of chemicals in microorganisms. Here we classify the expansion of the synthetic biology toolbox into three different categories based on their primary function in strain engineering-for design, for construction, and for optimization. Next, focusing on recent years, we look at how chemicals have been produced using these new synthetic biology tools. Advances in producing fuels are briefly described, followed by a more thorough treatment of commodity chemicals, specialty chemicals, pharmaceuticals, and nutraceuticals. Throughout this review, an emphasis is placed on how synthetic biology tools are applied to strain engineering. Finally, we discuss organism and host strain diversity and provide a future outlook in the field.

  11. Specialty pharmaceuticals care management in an integrated health care delivery system with electronic health records.

    Science.gov (United States)

    Monroe, C Douglas; Chin, Karen Y

    2013-05-01

    The specialty pharmaceuticals market is expanding more rapidly than the traditional pharmaceuticals market. Specialty pharmacy operations have evolved to deliver selected medications and associated clinical services. The growing role of specialty drugs requires new approaches to managing the use of these drugs. The focus, expectations, and emphasis in specialty drug management in an integrated health care delivery system such as Kaiser Permanente (KP) can vary as compared with more conventional health care systems. The KP Specialty Pharmacy (KP-SP) serves KP members across the United States. This descriptive account addresses the impetus for specialty drug management within KP, the use of tools such as an electronic health record (EHR) system and process management software, the KP-SP approach for specialty pharmacy services, and the emphasis on quality measurement of services provided. Kaiser Permanente's integrated system enables KP-SP pharmacists to coordinate the provision of specialty drugs while monitoring laboratory values, physician visits, and most other relevant elements of the patient's therapy. Process management software facilitates the counseling of patients, promotion of adherence, and interventions to resolve clinical, logistic, or pharmacy benefit issues. The integrated EHR affords KP-SP pharmacists advantages for care management that should become available to more health care systems with broadened adoption of EHRs. The KP-SP experience may help to establish models for clinical pharmacy services as health care systems and information systems become more integrated.

  12. Oferta y demanda de médicos especialistas en los establecimientos de salud del Ministerio de Salud: brechas a nivel nacional, por regiones y tipo de especialidad Supply and demand of medical specialists in the health facilities of the Ministry of Health: national, regional and by type of specialty gaps

    Directory of Open Access Journals (Sweden)

    Leslie Zevallos

    2011-06-01

    medical specialists in facilities of the Ministry of Health of Peru (MINSA at the national, regional and specialty type levels. Materials and methods. Observational, descriptive study through which we calculated the supply of medical specialists using secondary sources of MINSA. The analysis of the demand for medical specialists was based on two methodologies: the need for specialists according to the guidelines of classification of the health facilities and according to the epidemiological and demographic profile. The arithmetic difference between the estimated demand and the supply was the procedure used to calculate the gap of medical specialists. Results. The Ministry of Health has a total supply at the national level of 6,074 medical specialists of which 61.5% belong to the clinical specialties, 33.2% to the surgical specialties, 4.9% specialities related to aid to diagnosis and treatment and 0.4% to public health specialties. According to the categorization guideline there is a total demand of 11,176 medical specialists and according to the epidemiological and demographic profile of 11,738. The national estimated gaps found are similar in both methods, although they differ widely across regions and by type of specialty. At the regional level, the gaps are greater in Loreto, Piura, Puno and Madre de Dios when estimating the defficit in relation to the supply. Regarding the speciality, the gap is greater in the four basic specialties: gynecology and obstetrics, pediatrics, internal medicine and general surgery. Conclusions. There is a waid gap between supply and demand of medical specialists at the national and regional levels, as a whole representing approximately 45% of the current offer, regardless of the estimation method.

  13. Specialties differ in which aspects of doctor communication predict overall physician ratings.

    Science.gov (United States)

    Quigley, Denise D; Elliott, Marc N; Farley, Donna O; Burkhart, Q; Skootsky, Samuel A; Hays, Ron D

    2014-03-01

    Effective doctor communication is critical to positive doctor-patient relationships and predicts better health outcomes. Doctor communication is the strongest predictor of patient ratings of doctors, but the most important aspects of communication may vary by specialty. To determine the importance of five aspects of doctor communication to overall physician ratings by specialty. For each of 28 specialties, we calculated partial correlations of five communication items with a 0-10 overall physician rating, controlling for patient demographics. Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS®) 12-month Survey data collected 2005-2009 from 58,251 adults at a 534-physician medical group. CG-CAHPS includes a 0 ("Worst physician possible") to 10 ("Best physician possible") overall physician rating. Five doctor communication items assess how often the physician: explains things; listens carefully; gives easy-to-understand instructions; shows respect; and spends enough time. Physician showing respect was the most important aspect of communication for 23/28 specialties, with a mean partial correlation (0.27, ranging from 0.07 to 0.44 across specialties) that accounted for more than four times as much variance in the overall physician rating as any other communication item. Three of five communication items varied significantly across specialties in their associations with the overall rating (p importance of other aspects of communication varied significantly by specialty. Quality improvement efforts by all specialties should emphasize physicians showing respect to patients, and each specialty should also target other aspects of communication that matter most to their patients. The results have implications for improving provider quality improvement and incentive programs and the reporting of CAHPS data to patients. Specialists make important contributions to coordinated patient care, and thus customized approaches to measurement

  14. El currículo oculto en la formación del médico: El caso de la subespecialidad en Cirugía Plástica, Estética y Reconstructiva The hidden curriculum in medical training: The case of sub-specialty in Plastic, Reconstructive and Aesthetic Surgery

    Directory of Open Access Journals (Sweden)

    M. Candaudap-Ortega

    2010-06-01

    Full Text Available Introducción. La formación médica es una necesidad pues serán los profesionales que resolverán nuestros problemas de salud. En 1994, el Consejo Universitario aprobó el Plan Único de Especializaciones Médicas (PUEM, pero desde los años treinta la subespecialidad en Cirugía Plástica, Estética y Reconstructiva fue introducida en los hospitales de salud pública. El PUEM ha establecido propósitos que son influidos por prácticas informales que están inmersas en cualquier proceso educativo, permitiendo aprendizajes reglamentados por el currículo oculto. Sujetos y métodos. Para saber cómo influyen las prácticas informales en la subespecialidad, se realizó un estudio descriptivo a un grupo de residentes de la especialidad. Resultados y conclusiones. Después de un año de observación de los residentes, charlas y una encuesta de nueve preguntas, conocimos algunas de las prácticas que se establecen más allá del currículo formal y el plan de estudios y que dan cuenta de las prácticas y acciones cotidianas que vive el médico, las cuales nada tienen que ver con lo establecido formalmente o de forma 'explicita'; sin embargo, aun estando ocultas o no contempladas en el currículo, dan cuenta también de la formación de los médicos. Los estudios de posgrado se ven afectados por los efectos de este currículo, que desempeña un papel importante en el desarrollo de los estudiantes y sus destinos, como son los recorridos educativos de las especializaciones médicas.Introduction. The medical education is a necessity because they are the professionals who will solve our problems. Therefore, the physician must choose a specialty, the study became more prominent postgraduate training in medicine. In 1994 the University Council approved the Single Plan for Medical Specializations (PUEM, but since the thirties the sub-specialty in Plastic Surgery, Cosmetic and Reconstructive was introduced in public health hospitals. The PUEM established

  15. Dental students' perceptions of dental specialties and factors influencing specialty and career choices.

    Science.gov (United States)

    Dhima, Matilda; Petropoulos, Vicki C; Han, Rita K; Kinnunen, Taru; Wright, Robert F

    2012-05-01

    The goals of this study were to 1) evaluate dental students' perceptions of dental specialties, 2) identify factors that play an important role in students' decision to pursue specialty training or career choices, and 3) establish a baseline of students' perceptions of the dental fields with the best future in terms of salary, personal and patient quality of life, and overall impact on the dental profession. Surveys were distributed to 494 students at the University of Pennsylvania School of Dental Medicine. Data were collected from 380 traditional four-year students and thirty advanced standing students. Chi-square tests, multivariate analysis, and logistic regressions were used to determine associations and independent contributions of student demographics to their perceptions of dental specialties and factors influencing specialty training or career choices. Debt was a statistically significant factor (p<0.001) in choosing specialty training or career independent of gender, age, or class year. Enjoyment of providing care in a specialty or field was identified as the single most important factor in choosing a specialty career. Half of the respondents had decided not to specialize. Pursuing postdoctoral general dentistry training and private practice in general dentistry were the most commonly reported plans after completion of dental school. Suggestions are made for ways to inform students about specialty training.

  16. Factors affecting membership in specialty nursing organizations.

    Science.gov (United States)

    White, Mary Joe; Olson, Rhonda S

    2004-01-01

    A discouraging trend in many specialty nursing organizations is the stagnant or declining membership. The research committee of the Southeast Texas Chapter of the Association of Rehabilitation Nurses (ARN) collected data and studied this trend to determine what changes would be necessary to increase membership. Using Herzberg's motivational theory as a framework, a review of the literature was initiated. There were few current studies on this issue, but relevant information was found about nursing's emerging workforce, as well as implications of the growth of magnet hospitals, which affect whether nurses join specialty nursing organizations. A multifaceted data-collection approach using convenience samples was designed. First, relevant literature was reviewed. Second, a survey was sent by e-mail to other ARN chapters. Third, a telephone survey on other specialty organizations in the geographic region was completed. Finally, members of the local ARN chapter and four other specialty organizations, as well staff nurses in the geographic area, were given questionnaires to complete. Descriptive statistics and cross tabulations were used to determine why nurses do and do not join specialty organizations (N = 81). The most frequent reasons for joining an organization were to increase knowledge, benefit professionally, network, and earn continuing education units. Reasons for choosing not to participate were family responsibilities, lack of information about these organizations, and lack of time. Ways to reverse the decline in membership are discussed.

  17. [Infectious diseases - a specialty of internal medicine].

    Science.gov (United States)

    Fätkenheuer, G; Jung, N; Kern, W V; Fölsch, U R; Salzberger, B

    2018-04-01

    Infectious diseases have recently gained wide public interest. Emerging infections and rising rates of antibiotic resistance are determining this trend. Both challenges will need to be addressed in international and local collaborations between different specialties in medicine and basic science. Infectious diseases as a clinical specialty in this scenario is directly responsible for the care of patients with infectious diseases. Its involvement in the care of patients with complicated infections has proved to be highly effective. Antibiotic stewardship programmes are effective measures in slowing the development of antibiotic resistance and have been widely implemented. But antibiotic stewardship specialists should not be confused with or taken as an alternative to infectious disease experts. Infectious diseases requires appropriate and specific training. It mainly uses the instrumentarium of internal medicine. With the current challenges in modern medicine, infectious diseases in Germany should thus be upgraded from a subspecialty to a clinical specialty, ideally within Internal Medicine.

  18. Physician attitudes toward industry: a view across the specialties

    Science.gov (United States)

    Korenstein, Deborah; Keyhani, Salomeh; Ross, Joseph S.

    2010-01-01

    Objectives Physician relationships with industry are receiving attention as government and professional organizations move toward restrictive policies and financial transparency. Our objective was to explore attitudes of physicians from all specialties toward gifts from and interactions with the pharmaceutical and device industries. Design Anonymous cross sectional survey. Setting Hospitals in the Mount Sinai School of Medicine consortium, in the New York City metro area Participants Faculty and trainee physicians from all clinical departments Main Outcome Measures Attitudes toward industry interactions and gifts and their appropriateness, measured on 4-point Likert scales. Results Five hundred ninety physicians and medical students completed the survey (response rate=67%); 59% were male, 39% were attendings, and 24% were from surgical specialties. Attitudes toward industry and gifts were generally positive. More than 65% found educational materials and sponsored lunches appropriate, whereas fewer than 25% considered vacations or large gifts appropriate. Surgeons, trainees, and those unfamiliar with institutional policies on industry interactions held more positive attitudes than others and were more likely to deem some gifts appropriate, including industry funding of residency programs and, among surgeons, receiving meals, travel expenses, and payments for attending lectures. Non-attendings held more positive attitudes toward meals in clinical settings, textbooks and samples. Conclusions Physicians continue to hold positive attitudes toward marketing-oriented activities of the pharmaceutical and device industries. Changes in medical culture and physician education focused on surgeons and trainees may align physician attitudes with current policy trends. PMID:20566978

  19. Medical Total Force Management

    Science.gov (United States)

    2014-05-01

    Facilities (MTFs). For specialties that are common in civilian labor markets , civilian providers generally cost less than military providers. While the...produced in Military Treatment Facilities (MTFs). For specialties that are common in civilian labor markets , civilian providers generally cost less...Attracting Fully Trained Medical Personnel,” CRM D0013237.A2 (Alexandria, VA: CNA Corporation, 2006). 66

  20. Access to specialty care in autism spectrum disorders-a pilot study of referral source

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    West Therese

    2011-05-01

    Full Text Available Abstract Background In the United States, a medical home model has been shown to improve the outcomes for children with special health care needs. As part of this model, primary care physicians provide comprehensive medical care that includes identification of delayed and/or atypical development in children and coordination of care with specialists. However, it is not clear if families of children with Autism Spectrum Disorder (ASD rely on the medical home model for care of their child to the same extent as families of children with other special health care needs. This study aims to add to the understanding of medical care for children with ASD by examining the referral source for specialty care. Methods This retrospective study was accomplished by evaluating parent completed intake data for children with ASD compared to those with other neurological disorders in a single physician Pediatric Neurology Practice at a major urban medical center in Northern New Jersey. To account for referral bias, a similar comparison study was conducted using a multispecialty ASD practice at the same medical center. Parent reported "source of referral" and "reason for the referral" of 189 ASD children and 108 non-ASD neurological disordered children were analyzed. Results The specialty evaluations of ASD were predominantly parent initiated. There were significantly less referrals received from primary care physicians for children with ASD compared to children with other neurodevelopmental disorders. Requirement of an insurance referral was not associated with a primary care physician prompted specialty visit.We identified different patterns of referral to our specialty clinics for children with ASD vs. children with other neurolodevelopmental disorders. Conclusion The majority of the families of children with ASD evaluated at our autism center did not indicate that a primary care physician initiated the specialty referral. This study suggests that families of

  1. The assessment of clinical skills is imperative in postgraduate specialty training

    DEFF Research Database (Denmark)

    Tolsgaard, Martin G; Ostergaard, Doris; Konge, Lars

    2014-01-01

    According to the Danish Ministry of Health recommendations, workplace-based assessment (WPBA) should be a central component in postgraduate specialty training. In this review the potential impact of WPBA with regard to patient safety, medical licensing and effects on doctors' learning is explored...

  2. Calculations of doses for the personnel wrapped up in the radiological accident of the Specialties Hospital of the National Medical Center ''Siglo XXI''; Calculos de dosis para el personal involucrado en el accidente radiologico del Hospital de Especialidades del Centro Medico Nacional ''Siglo XXI''

    Energy Technology Data Exchange (ETDEWEB)

    Cortes C, A. [CNSNS, Dr. Barragan 779, Col Narvarte, Mexico D.F. (Mexico)]. e-mail: acortes@cnsns.gob.mx

    2004-07-01

    In this work the methodology used by the National Commission of Nuclear Safety and Safeguards for the determination of the internal dose due to the ingestion of coffee with I-131 for the personnel of the service of nuclear medicine of the Hospital of Specialties of the National Medical Center ''Siglo XXI'' of the Mexican Institute of the Social Insurance (IMSS), that was poured in the coffeepot of the service by a deliberate act before mentioned, is presented. Three different techniques were used to determine the initial activity incorporated starting from the measurements of retained activity in thyroid for 6 people of the service of nuclear medicine; the techniques employee provided consistent results. Using the results of the technique of the best estimator, it was applied the proposed methodology by the International Commission of Radioprotection in its publication 30 to determine the absorbed doses by the personnel involved in the accident, with which the Commission determines the administrative consequences to those that it should be held the personnel and the directive of the service of nuclear medicine of the one nosocome. (Author)

  3. Recent trends in specialty pharma business model

    Directory of Open Access Journals (Sweden)

    Mannching Sherry Ku

    2015-12-01

    Full Text Available The recent rise of specialty pharma is attributed to its flexible, versatile, and open business model while the traditional big pharma is facing a challenging time with patent cliff, generic threat, and low research and development (R&D productivity. These multinational pharmaceutical companies, facing a difficult time, have been systematically externalizing R&D and some even establish their own corporate venture capital so as to diversify with more shots on goal, with the hope of achieving a higher success rate in their compound pipeline. Biologics and clinical Phase II proof-of-concept (POC compounds are the preferred licensing and collaboration targets. Biologics enjoys a high success rate with a low generic biosimilar threat, while the need is high for clinical Phase II POC compounds, due to its high attrition/low success rate. Repurposing of big pharma leftover compounds is a popular strategy but with limitations. Most old compounds come with baggage either in lackluster clinical performance or short in patent life. Orphan drugs is another area which has gained popularity in recent years. The shorter and less costly regulatory pathway provides incentives, especially for smaller specialty pharma. However, clinical studies on orphan drugs require a large network of clinical operations in many countries in order to recruit enough patients. Big pharma is also working on orphan drugs starting with a small indication, with the hope of expanding the indication into a blockbuster status. Specialty medicine, including orphan drugs, has become the growth engine in the pharmaceutical industry worldwide. Big pharma is also keen on in-licensing technology or projects from specialty pharma to extend product life cycles, in order to protect their blockbuster drug franchises. Ample opportunities exist for smaller players, even in the emerging countries, to collaborate with multinational pharmaceutical companies provided that the technology platforms or

  4. Recent trends in specialty pharma business model.

    Science.gov (United States)

    Ku, Mannching Sherry

    2015-12-01

    The recent rise of specialty pharma is attributed to its flexible, versatile, and open business model while the traditional big pharma is facing a challenging time with patent cliff, generic threat, and low research and development (R&D) productivity. These multinational pharmaceutical companies, facing a difficult time, have been systematically externalizing R&D and some even establish their own corporate venture capital so as to diversify with more shots on goal, with the hope of achieving a higher success rate in their compound pipeline. Biologics and clinical Phase II proof-of-concept (POC) compounds are the preferred licensing and collaboration targets. Biologics enjoys a high success rate with a low generic biosimilar threat, while the need is high for clinical Phase II POC compounds, due to its high attrition/low success rate. Repurposing of big pharma leftover compounds is a popular strategy but with limitations. Most old compounds come with baggage either in lackluster clinical performance or short in patent life. Orphan drugs is another area which has gained popularity in recent years. The shorter and less costly regulatory pathway provides incentives, especially for smaller specialty pharma. However, clinical studies on orphan drugs require a large network of clinical operations in many countries in order to recruit enough patients. Big pharma is also working on orphan drugs starting with a small indication, with the hope of expanding the indication into a blockbuster status. Specialty medicine, including orphan drugs, has become the growth engine in the pharmaceutical industry worldwide. Big pharma is also keen on in-licensing technology or projects from specialty pharma to extend product life cycles, in order to protect their blockbuster drug franchises. Ample opportunities exist for smaller players, even in the emerging countries, to collaborate with multinational pharmaceutical companies provided that the technology platforms or specialty medicinal

  5. Urology – a specialty that will be faced by all future doctors

    Directory of Open Access Journals (Sweden)

    Miah S

    2016-01-01

    Full Text Available Saiful Miah,1 Karl H Pang2 1Department of Urology, Royal Hallamshire Hospital, 2Academic Urology Unit, School of Medicine and Biomedical Sciences at the University of Sheffield, Sheffield, UKWe read with great interest the articles by Shah, and Ah-kee and Khan regarding the various potential methods that could increase the exposure of undergraduate medical students to smaller specialties.1,2 We would like to draw attention to a small but high clinical volume specialty, ie, urology.Read the original article by ShahRead the original article by Ah-kee and Khan 

  6. [A scintillating specialty. Excerpts from the history of nuclear medicine in Denmark].

    Science.gov (United States)

    Hess, Søren

    2010-01-01

    Nuclear medicine is among the youngest medical specialties but its history spans more than a century. From the earliest discoveries of radioactivity and the establishment of the novel field of nuclear physics at the turn of the twentieth century and via the developments in radiochemistry set in motion by George de Hevesy from his base in Copenhagen to the specialty of today offering a multitude of diagnostic procedures. The present work is not intended to cover the entire history of nuclear medicine exhaustively but focus on pivotal events in the development of the field with special reference to Denmark.

  7. Impact of a national specialty e-consultation implementation project on access.

    Science.gov (United States)

    Kirsh, Susan; Carey, Evan; Aron, Dacid C; Cardenas, Omar; Graham, Glenn; Jain, Rajiv; Au, David H; Tseng, Chin-Lin; Franklin, Heather; Ho, P Michael

    2015-12-01

    To assess the early impact of implementation of the electronic consults (e-consults) initiative by the Veterans Health Administration (VHA), designed to improve specialty care access. Observational cohort study exploiting a natural experiment begun in May 2011 at 12 VHA medical centers and expanded to 122 medical centers by December 2013. The following were assessed: 1) growth of e-consults by VHA regional networks, medical centers, and specialty; 2) location of patient's primary care provider (medical center vs community-based outpatient clinic [CBOC]); 3) potential patient miles needed to travel for a specialty care face-to-face consult in place of the observed e-consults using estimated geodesic distance; 4) use of specialty care subsequent to the e-consult. Of 11,270,638 consults completed in 13 clinics of interest, 217,014 were e-consults (adjusted rate, 1.93 e-consults per 100 consults). The e-consult rate was highest in endocrinology (5.0 per 100), hematology (3.0 per 100), and gastroenterology (3.0 per 100). The percentage of e-consult patients with CBOC-based primary care grew from 28.5% to 44.4% in the first year of implementation and to 45.6% at year 3. Of those e-consult patients from community clinics, the average potential miles needed to travel was 72.1 miles per patient (SD = 72.6; median = 54.6; interquartile range = 17.1-108), translating to a potential savings of 6,875,631 total miles and travel reimbursement costs of $2,853,387. E-consult volume increased significantly since inception within many medical and surgical specialties. For patients receiving primary care at one of more than 800 CBOCs, e-consults may decrease travel burden and direct travel costs for patients.

  8. Specialty choice among dental students in Ibadan, Nigeria ...

    African Journals Online (AJOL)

    The majority of dental students at the University of Ibadan preferred the oral and maxillofacial surgery (OMS) specialty above all other dental specialties, while prosthetic dentistry was least preferred. Of all the factors to take into consideration when choosing a dental specialty, personal interest was the only factor considered ...

  9. Lessons Learned in Pilot Testing Specialty Consultations to Benefit Individuals with Lower Limb Loss

    Directory of Open Access Journals (Sweden)

    Christine Elnitsky

    2012-12-01

    Full Text Available Telerehabilitation technologies enable the delivery of rehabilitation services from providers to people with disabilities as well as specialty care consultations. This article discusses the barriers experienced when planning and pilot testing a telerehabilitation multi-site specialty consultation for specialists in their medical centers, and the lessons learned. The barriers included integration and participation, coordination across organizational units, and privacy and information security. Lessons learned included the need for collaboration across multiple departments, telerehabilitation equipment back-ups, and anonymous and private communication protocols. Despite delays resulting from coordination at multiple levels of a national organization, we developed a program plan and successfully implemented a pilot test of the southeast region program.  Specialty consultation using telerehabilitation delivery methods requires identifying provider preferences for technological features. Lessons learned could inform development of outpatient telerehabilitation for patients with amputations and studies of patients and providers involved in telerehabilitation.

  10. [A new specialty is born: Vascular medicine].

    Science.gov (United States)

    Laroche, J-P

    2016-05-01

    On the 4th of December 2015, the French authorities officially recognized the birth of a specialty in vascular medicine entitled CO-DES cardiology-vascular/vascular Medicine. France is the 7th country to obtain this specialty after Switzerland, Germany, Austria, Czech Republic, Slovakia and Slovenia, six countries in the EEC. It has taken years to achieve a long but exciting experience: we went from hopes to disappointments, sometimes with the blues, but lobbying helping… with sustained confidence. This article tells the story of 30 years of struggle to achieve this vascular medicine specialty. Gaston Bachelard wrote: "Nothing is obvious, nothing is given, all is built." For the construction of vascular medicine, we had to overcome many obstacles, nothing was given to us, everything was conquered. Beware "The specialist is one who knows more and more things about an increasingly restricted field, up to 'knowing everything about nothing"' recalled Ralph Barton Ferry, philosopher; so there is room for modesty and humility but also convictions. The physical examination will remain the basis of our exercise. But let us recall the contributions of all those vascular physicians who practiced in the past, together with those currently active, who built day after day, year after year, a vascular medicine of quality. It is because of the trust of our colleagues and our patients that we can occupy the place that is ours today. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  11. Questionnaire survey on the process of specialty training in neurology in Japan.

    Science.gov (United States)

    Sonoo, Masahiro; Nishiyama, Kazutoshi; Ando, Tetsuo; Shindo, Katsuro; Kanda, Takashi; Aoki, Masashi; Kamei, Satoshi; Kikuchi, Seiji; Kusunoki, Susumu; Suzuki, Norihiro; Sobue, Gen; Nakashima, Kenji; Hara, Hideo; Hirata, Koichi; Mizusawa, Hidehiro; Murai, Hiroyuki; Murata, Miho; Mochizuki, Hideki; Takahashi, Ryosuke; Kira, Jun-Ichi

    2017-07-29

    Documentation of the current status of specialty training to become a neurologist in Japan would represent an important basis for constructing better neurology training program in the planned reform of the specialty training system in Japan. The committee for future neurology specialty system of Japanese Society of Neurology (JSN) conducted a questionnaire survey on the process of specialty training of each trainee for neurology in board-certified educational facilities and semi-educational facilities throughout Japan. The response rate was 46.2% in all facilities and 87.5% in medical universities. The training process of 905 trainees over 5 grades was clarified, which was estimated to be about 80% of all the relevant subjects. Specialty training dedicated to neurology was started at the 3rd year of residency in 87.8% of subjects. During the 3 years following junior residency, 51.3% of subjects ran the rotation training between university and city hospital, whereas 36.5% was trained within the same institution throughout the 3 years of training period.

  12. Theoretical Model of Professional Competence Development in Dual-Specialty Students (On the Example of the "History, Religious Studies" Specialty)

    Science.gov (United States)

    Karimova, A. E.; Amanova, A. S.; Sadykova, A. M.; Kuzembaev, N. E.; Makisheva, A. T.; Kurmangazina, G. Zh.; Sakenov, Janat

    2016-01-01

    The article explores the significant problem of developing a theoretical model of professional competence development in dual-specialty students (on the example of the "History, Religious studies" specialty). In order to validate the specifics of the professional competence development in dual-specialty students (on the example of the…

  13. Amaurosis fugax – delay between symptoms and surgery by specialty

    Directory of Open Access Journals (Sweden)

    Kvickström P

    2016-11-01

    Full Text Available Pia Kvickström,1 Bertil Lindblom,2,3 Göran Bergström,4,5 Madeleine Zetterberg2,3 1Department of Ophthalmology, Skaraborg Hospital, Skövde, 2Department of Clinical Neuroscience/Ophthalmology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, 3Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, 4Department of Molecular and Clinical Medicine, The Sahlgrenska Academy at University of Gothenburg, 5Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden Purpose: To describe the time course of management of patients with amaurosis fugax and analyze differences in management by different specialties.Methods: Patients diagnosed with amaurosis fugax and subjected to carotid ultrasound in 2004–2010 at the Sahlgrenska University Hospital, Gothenburg, Sweden (n=302 were included in this retrospective cohort study, and data were collected from medical records.Results: The prevalence of significant carotid stenosis was 18.9%, and 14.2% were subjected to carotid endarterectomy. A trend of longer delay for surgery was noted for patients first consulting a general practitioner (P=0.069 as compared to hospital-based specialties. For 46.3% of the patients, an ophthalmologist was their first medical contact. No significant difference in time interval to endarterectomy was seen between ophthalmologists and neurologists/internists. Only 31.8% of the patients with significant carotid stenosis had carotid endarterectomy within 2 weeks from the debut of symptoms, and this proportion was smaller for patients residing outside the Gothenburg city area (P=0.038.Conclusion: Initially consulting an ophthalmologist does not delay the time to ultrasound or carotid endarterectomy. The overall time from symptoms to surgery is longer than recommended for a majority of the patients, especially for patients from rural areas and for patients initially consulting a general

  14. Best practices across surgical specialties relating to simulation-based training.

    Science.gov (United States)

    Gardner, Aimee K; Scott, Daniel J; Pedowitz, Robert A; Sweet, Robert M; Feins, Richard H; Deutsch, Ellen S; Sachdeva, Ajit K

    2015-11-01

    Simulation-based training is playing an increasingly important role in surgery. However, there is insufficient discussion among the surgical specialties regarding how simulation may best be leveraged for training. There is much to be learned from one another as we all strive to meet new requirements within the context of Undergraduate Medical Education, Graduate Medical Education, and Continuing Medical Education. To address this need, a panel was convened at the 6th Annual Meeting of the Consortium of the American College of Surgeons-Accredited Education Institutes consisting of key leaders in the field of simulation from 4 surgical subspecialties, namely, general surgery, orthopedic surgery, cardiothoracic surgery, urology, and otolaryngology. An overview of how the 5 surgical specialties are using simulation-based training to meet a wide array of educational needs for all levels of learners is presented. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Experience with DICOM for the clinical specialties in the healthcare enterprise

    Science.gov (United States)

    Kuzmak, Peter M.; Dayhoff, Ruth E.

    2003-05-01

    DICOM is a success for radiology and cardiology and it is now beginning to be used for other clinical specialties. The US Department of Veterans Affairs has been instrumental in promoting this technological advancement. We have worked with a number of non-radiology imaging vendors over the past several years, encouraging them to support DICOM, providing requirement specifications, validating their implementations, installing their products, and integrating their systems with the VA healthcare enterprise. We require each new non-radiology vendor to support the DICOM Modality Worklist and Storage services, as specified in the IHE Technical Framework, and insist that they perform validation testing with us over the Internet before installing at a VA site. Three years ago we began working with commercial DICOM image acquisition applications in ophthalmology and endoscopy. Today we are interfacing with six vendors in ophthalmology, six in dental, and two in endoscopy. Getting imaging modality vendors to support DICOM is only part of the story, however. We have also developed the capabilities of the VistA hospital information system to properly handle DICOM interfaces to the different clinical specialties. The workflow in the clinical specialties is different than that of radiology, and is much more diverse. We designed the VistA DICOM image acquisition and display interface to use the generic order entry, result entry, result reporting, and appointment scheduling applications of our hospital information system, which are common to other hospital information systems, in order to maintain existing clinical workflow, minimize operational disruptions, simplify training, and win user acceptance. This software is now being field tested with dental and ophthalmology systems at a large number of VA medical centers. We have learned several things from this field test. The DICOM Modality Worklist and Storage services can be successfully used for image acquisition in the clinical

  16. Patient-Centered Specialty Practice: Defining the Role of Specialists in Value-Based Health Care.

    Science.gov (United States)

    Ward, Lawrence; Powell, Rhea E; Scharf, Michael L; Chapman, Andrew; Kavuru, Mani

    2017-04-01

    Health care is at a crossroads and under pressure to add value by improving patient experience and health outcomes and reducing costs to the system. Efforts to improve the care model in primary care, such as the patient-centered medical home, have enjoyed some success. However, primary care accounts for only a small portion of total health-care spending, and there is a need for policies and frameworks to support high-quality, cost-efficient care in specialty practices of the medical neighborhood. The Patient-Centered Specialty Practice (PCSP) model offers ambulatory-based specialty practices one such framework, supported by a formal recognition program through the National Committee for Quality Assurance. The key elements of the PCSP model include processes to support timely access to referral requests, improved communication and coordination with patients and referring clinicians, reduced unnecessary and duplicative testing, and an emphasis on continuous measurement of quality, safety, and performance improvement for a population of patients. Evidence to support the model remains limited, and estimates of net costs and value to practices are not fully understood. The PCSP model holds promise for promoting value-based health care in specialty practices. The continued development of appropriate incentives is required to ensure widespread adoption. Copyright © 2017. Published by Elsevier Inc.

  17. Interventional radiology as clinical specialty and how this affects the radiology specialty as a whole

    International Nuclear Information System (INIS)

    Tsetis, D.

    2015-01-01

    maintain high quality clinical standards, Radiology departments must carry out regular audit and where available submitting data to national or international registries. Furthermore, IRs have a duty of care to ensure that the IR procedures are safe and effective which can only be demonstrated by high quality research. For IR to survive as clinical specialty, IR training must be adapted in order to ensure that future IR’s will acquire both clinical knowledge and confidence in the disease processes as well as in dealing with patients. Core IR training must include communication skills, clinical assessment and knowledge of the various alternative treatments to IR both surgical and medical. In order to fulfill these expectations, IR training must move to a certified residency program; an attractive format would be one year of internship, three years of Diagnostic Radiology, and then two years of IR. this IR certification will hopefully have a huge impact on local organizational issues so that at a local institution the IR service will be listed next to surgery and medicine. towards this direction, appropriate curricula and formal assessment of the appropriate skills such as the european Board of Interventional Radiology (eBIR) examination are available to ensure the high standards of the future IR workforce. the CIRSe Clinical Practice in IR Manual provides a comprehensive approach to patient care, including numerous well-structured forms for gathering data on patient or social history and conducting examinations are part of its content (www.cirse.org/Clinical_Practice) In my opinion the continuous effort to upgrade IR practice, also points to the only direction for the entire Radiology specialty to survive: the radiologist should be part of clinical decision-making, a true active clinical partner, with up-to-date clinical knowledge about a medical subspecialty. the reality is that clinicians have started to learn about the images in their subspecialty territory, and through

  18. Medical tourism

    OpenAIRE

    Abbas Ghanbari; Khadijeh Zirak Moradlu; Morteza Ramazani

    2014-01-01

    Medical tourism is considered as one of the tourism dimensions and it can contribute to the stabilized and dynamic development of a country's economy. Since it is cost-effective industry, most developing countries have focused on this industry and they are planning to develop this industry. Not only does Zanjan province, as the central region in medicine services, enjoy different kinds of variety and acceptable medical specialties but also it has historical, natural, and religious tourism pot...

  19. Improving the communication between teams managing boarded patients on a surgical specialty ward.

    Science.gov (United States)

    Puvaneswaralingam, Shobitha; Ross, Daniella

    2016-01-01

    Transferring patients from the ward of their specialty or consultant is described as boarding. 1 Boarding patients is becoming increasingly prevalent due to greater pressure on hospital capacity. This practice compromises patient safety through delayed investigations, prolonged hospital stays, and increased risk of hospital-acquired infections. 1 2 We evaluated how regularly boarded patients were reviewed, and how effectively information regarding their management was communicated from their primary specialty to ward staff. We aimed to improve the frequency of patient reviews by ensuring that each patient was reviewed every weekday and increase communication between primary specialty, and medical and nursing teams by 20% from baseline during the data collection period. The project was based in the Otolaryngology ward in Ninewells Hospital, Dundee, where there was a high prevalence of boarded patients. Baseline data showed a clear deficit in communication between the primary specialty and ward staff with only 31% of patient reviews being communicated to ward doctors. We designed and implemented a communication tool, in the form of a sticker, to be inserted into patients' medical notes for use by the primary specialty. Implementation of the sticker improved communication between teams as stickers were completed in 93% of instances. In 88% of patient reviews, the junior doctor was informed of the management plan, showing a large increase from baseline. Through PDSA cycles, we aimed to increase the sustainability and reliability of the sticker; however, we faced challenges with sustainability of sticker insertion. We aim to engage more stakeholders to raise awareness of the problem, brainstorm solutions together, and review the production and implementation of stickers with senior hospital management to discuss the potential use of this tool within practice. There is potentially a large scope for utilisation of this communication tool on a local level, which we hope

  20. Sampling and farm stories prompt consumers to buy specialty cheeses

    OpenAIRE

    Reed, Barbara A.; Bruhn, Christine M.

    2003-01-01

    California specialty cheese makers need information on what drives product sales so they can effectively market their products. Focus group and telephone research revealed that specialty cheese consumers have a strong preference for sampling cheese before making a purchase. Consumers also rely heavily on staff recommendations to select cheese. They appreciate unlimited sampling in an unhurried, low-pressure environment. Specialty cheese consumers consider themselves “food experimenters”; they...

  1. [Reinventing specialty training of physicians? Principles and challenges].

    Science.gov (United States)

    Morán-Barrios, J; Ruiz de Gauna Bahillo, P

    2010-01-01

    In a world undergoing constant change, in the era of globalisation, the training of medical professionals should be under constant review so that it can be tailored to meet the needs of this society in transition. This is all the more true at times of economic uncertainty, such as the current conditions, which have a direct impact on health services. Professionals need new Competencies for new times. Over the last decade initiatives have emerged in various Anglo-Saxon countries which have defined a framework of basic Competencies that all medical specialists should demonstrate in their professional practice. In addition to this, we must respond to the creation of the European Higher Education Area which has implications for specialised training. In Spain, training for medical specialists was in need of an overhaul and the recently passed law (Real Decreto 183/2008) will allow us to move forward and implement, in medical education, initiatives and innovations required in our medical centres, to respond to the new society and bring us in line with international professional education and practice. The way forward is a Competency-based model for medical education with assessment of these Competencies using simple instruments, validated and accepted by all the stakeholders. The institutions involved (hospitals, medical centres and other health care services) should trial different approaches within the general framework established by the current legislation and be conscious of the duty they have to society as accredited training organisations. Accordingly, they should consolidate their teaching and learning structures and the various different educational roles (Director of Studies, Tutors, and other teaching positions), showing the leadership necessary to allow proper implementation of their training programmes. For this, the Spanish Autonomous Regions must develop their own legislation regulating Medical Specialty Training. So, medical professionals should receive

  2. BUSINESS DEVELOPMENT STRATEGY FOR SPECIALTY COFFEE

    Directory of Open Access Journals (Sweden)

    Vharessa Aknesia

    2015-01-01

    Full Text Available Specialty coffee is a coffee of premium quality that has been made through various stages of post-harvest processing and strictly controlled to produce distinctive taste of origins. PT Sinar Mayang Lestari is one of the companies that currently produce and develop specialty coffee type, Arabica Java Preanger. The objectives of the study are to examine competitive advantages and develop an alternative strategy that need to be done by PT Sinar Mayang Lestari for their business development. The research methods used are value chain analysis and VRIO framework to explore competitive advantage owned by the company. The result shows the company currently has a temporary competitive advantage of the technological resources and reputation. By using SWOT-AHP technique, the alternative strategies that can be done by company are as follows: 1 increasing the production of natural and honey coffee  type; 2 building coffee center in plantation site for sharing knowledge and innovation media to the farmers; 3 improving the competency of human resource in plantation, post harvest, and promoting area; 4 building management system gradually 5 forwarding integration by building roast and ground coffee business; and 6 maximizing the ability of the land and human resources through research and development.Keywords: competitive advantage, specialty coffee, SWOT-AHP, value chain, VRIOABSTRAKKopi special merupakan kopi dengan kualitas premium yang sudah melalui berbagai tahapan pengolahan pascapanen yang diawasi dengan ketat sehingga menghasilkan cita rasa yang khas sesuai dengan daerah asalnya. PT Sinar Mayang Lestari adalah salah satu perusahaan yang saatini memproduksi dan mengembangkan kopi spesial jenis Arabika Java Preanger. Tujuan dari penelitian ini adalah menganalisis keunggulan bersaing yang dimiliki dan mengembangkan alternative strategi yang perlu dilakukanoleh PT Sinar Mayang Lestari untuk pengembangan usahanya. Penelitian ini menggunakan analisis rantai

  3. Trigeminal neuralgia--a coherent cross-specialty management program.

    Science.gov (United States)

    Heinskou, Tone; Maarbjerg, Stine; Rochat, Per; Wolfram, Frauke; Jensen, Rigmor Højland; Bendtsen, Lars

    2015-01-01

    Optimal management of patients with classical trigeminal neuralgia (TN) requires specific treatment programs and close collaboration between medical, radiological and surgical specialties. Organization of such treatment programs has never been described before. With this paper we aim to describe the implementation and feasibility of an accelerated cross-speciality management program, to describe the collaboration between the involved specialties and to report the patient flow during the first 2 years after implementation. Finally, we aim to stimulate discussions about optimal management of TN. Based on collaboration between neurologists, neuroradiologists and neurosurgeons a standardized program for TN was implemented in May 2012 at the Danish Headache Center (DHC). First out-patient visit and subsequent 3.0 Tesla MRI scan was booked in an accelerated manner. The MRI scan was performed according to a special TN protocol developed for this program. Patients initially referred to neurosurgery were re-directed to DHC for pre-surgical evaluation of diagnosis and optimization of medical treatment. Follow-up was 2 years with fixed visits where medical treatment and indication for neurosurgery was continuously evaluated. Scientific data was collected in a structured and prospective manner. From May 2012 to April 2014, 130 patients entered the accelerated program. Waiting time for the first out-patient visit was 42 days. Ninety-four percent of the patients had a MRI performed according to the special protocol after a mean of 37 days. Within 2 years follow-up 35% of the patients were referred to neurosurgery after a median time of 65 days. Five scientific papers describing demographics, clinical characteristics and neuroanatomical abnormalities were published. The described cross-speciality management program proved to be feasible and to have acceptable waiting times for referral and highly specialized work-up of TN patients in a public tertiary referral centre for headache

  4. Dental student perceptions of oral and maxillofacial surgery as a specialty.

    Science.gov (United States)

    Jarosz, Krystian F; Ziccardi, Vincent B; Aziz, Shahid R; Sue-Jiang, Shuying

    2013-05-01

    The specialty of oral and maxillofacial surgery (OMS) encompasses the diagnosis and surgical management of a variety of pathologic, functional, and esthetic conditions of the oral and maxillofacial region. Despite the specialty's prominent role in the field of dentistry, a lack of complete understanding still remains among dental and medical health professionals as to the exact scope and expertise of the oral and maxillofacial surgeon. The present study aimed to analyze a population of dental students' perceptions of OMS as a specialty with respect to treatment rendered, referral patterns, and a general opinion of the specialty as a whole. A survey consisting of 10 multiple-choice questions was compiled and distributed to dental students through an on-line polling service (SurveyMonkey). A total of 5 dental student classes at a single dental school were polled using school-based electronic mail, including the graduating seniors. All answers were kept confidential, and no individual students were identified. The students were not able to retake the survey once completed. The final tallies of the survey results were compiled and submitted for statistical analysis. Statistically significant associations between the year of dental education and student perceptions of OMS were determined. As dental students progress through their undergraduate studies, their perceptions change with regard to the referral of dental implants. Periodontists were found to have statistically significantly greater rates of referral than oral and maxillofacial surgeons from dental students in the fourth year and recent graduates compared with younger dental students from the first, second, and third years for placement of dental implants. Statistically insignificant in terms of a changing dental student perception was the finding that third molar removal was within the domain of the oral and maxillofacial surgeon, as well as the management of cleft lip and palate deformities and mandibular

  5. Dentistry's oldest specialty: orthodontics and dentofacial orthopedics.

    Science.gov (United States)

    George, Raymond

    2009-01-01

    The American Association of Orthodontists (AAO) has 15,500 members worldwide and is the oldest and largest of the recognized dental specialties. A strategic planning process has identified six key challenges, and this article describes the progress that is being made in the areas of (a) consumer education, (b) volunteer leadership development, (c) recruitment and retention of orthodontic educators, (d) relationships with ADA and other healthcare organizations, (e) the AAO's role in international orthodontics, and (f) advocacy. The AAO is working for freedom of choice in dental healthcare providers; fee-for-service dental care; orthodontic insurance coverage as a benefit of employment, with direct reimbursement as the preferred plan; self-referred access to specialists; private and public funding that promote quality orthodontic care; and the retention of tax deductibility of dental healthcare benefits, including orthodontic care.

  6. Artificial intelligence in radiation oncology: A specialty-wide disruptive transformation?

    Science.gov (United States)

    Thompson, Reid F; Valdes, Gilmer; Fuller, Clifton D; Carpenter, Colin M; Morin, Olivier; Aneja, Sanjay; Lindsay, William D; Aerts, Hugo J W L; Agrimson, Barbara; Deville, Curtiland; Rosenthal, Seth A; Yu, James B; Thomas, Charles R

    2018-06-12

    Artificial intelligence (AI) is emerging as a technology with the power to transform established industries, and with applications from automated manufacturing to advertising and facial recognition to fully autonomous transportation. Advances in each of these domains have led some to call AI the "fourth" industrial revolution [1]. In healthcare, AI is emerging as both a productive and disruptive force across many disciplines. This is perhaps most evident in Diagnostic Radiology and Pathology, specialties largely built around the processing and complex interpretation of medical images, where the role of AI is increasingly seen as both a boon and a threat. In Radiation Oncology as well, AI seems poised to reshape the specialty in significant ways, though the impact of AI has been relatively limited at present, and may rightly seem more distant to many, given the predominantly interpersonal and complex interventional nature of the specialty. In this overview, we will explore the current state and anticipated future impact of AI on Radiation Oncology, in detail, focusing on key topics from multiple stakeholder perspectives, as well as the role our specialty may play in helping to shape the future of AI within the larger spectrum of medicine. Published by Elsevier B.V.

  7. Predictors of Final Specialty Choice by Internal Medicine Residents

    Science.gov (United States)

    Diehl, Andrew K; Kumar, Vineeta; Gateley, Ann; Appleby, Jane L; O'Keefe, Mary E

    2006-01-01

    BACKGROUND Sociodemographic factors and personality attributes predict career decisions in medical students. Determinants of internal medicine residents' specialty choices have received little attention. OBJECTIVE To identify factors that predict the clinical practice of residents following their training. DESIGN Prospective cohort study. PARTICIPANTS Two hundred and four categorical residents from 2 university-based residency programs. MEASUREMENTS Sociodemographic and personality inventories performed during residency, and actual careers 4 to 9 years later. RESULTS International medical school graduates (IMGs) were less likely to practice general medicine than U.S. graduates (33.3% vs 70.6%, Pinternal medicine was observed among those who perceived General Internists to have lower potential incomes (69.0% vs 53.3%, P = .08). There was a trend for generalists to have lower scores on scales measuring authoritarianism, negative orientation to psychological problems, and Machiavellianism (0.05medicine, with trends apparent for higher debt (P = .05) and greater comfort caring for patients with psychological problems (P = .07). CONCLUSION Recruitment of IMGs may not increase the supply of General Internists. Prospects of lower income, even in the face of large debt, may not discourage residents from becoming generalists. If increasing generalist manpower is a goal, residencies should consider weighing applicants' personal attributes during the selection process. PMID:16836624

  8. Gendered Perceptions of Typical Engineers across Specialties for Engineering Majors

    Science.gov (United States)

    Kelley, Margaret S.; Bryan, Kimberley K.

    2018-01-01

    Young women do not choose to be engineers nearly as often as young men, and they tend to cluster in particular specialties when they do. We examine these patterns and the role of gender schemas as applied to perceptions of typical engineers in understanding the choices that women make in terms of engineering specialties. We use Part 1 of two waves…

  9. 75 FR 42431 - Onyx Specialty Papers, Inc; Notice Soliciting Applications

    Science.gov (United States)

    2010-07-21

    ... Papers, Inc; Notice Soliciting Applications July 14, 2010. On April 29, 2009, Onyx Specialty Papers, Inc... is located in the basement of MeadWestvaco's paper mill. There are no transmission lines associated... information from the licensee, please contact Mr. John Clements, Counsel for Onyx Specialty Papers, Inc., Van...

  10. The Orientation and Development of the Public Affair Management Specialty

    Science.gov (United States)

    Li, Chenghui; Fu, Yongxian; Chen, Rongxiang; Hu, Xueqi

    2010-01-01

    Though the specialty of the public affair management has been developed for ten years, but it is still facing the actuality that the orientation and development are difficult. Only by confirming the cultivation target and the development orientation, the development of the specialty could find the development approach and method. According to the…

  11. Integration of specialties: An institutional and organizational view.

    Science.gov (United States)

    Gerson, Elihu M

    2013-12-01

    By what mechanisms of organizational and institutional change do different specialties succeed in accommodating and working with one another? How do these mechanisms function over time to support and retard the emergence and stability of new knowledge? This paper considers two such mechanisms, metawork (work that determines the organization of work) and common knowledge (knowledge that participants know is known by all participants). These mechanisms integrate specialties by making the activities of multiple specialties dependent upon one another, and by segmenting the common effort from the parent specialties. Integration of specialties can lead to the development of new specialties. Integration is facilitated and impeded by the anchoring of specialties in the system of institutions that participate in research. Host organizations, degree programs, sponsors, associations, regulators, and other organizations provide resources and impose demands that shape research. Some of these impacts are obvious and direct; others are indirect and more subtle. The research specialties form a network (not a hierarchy) in which connections constantly form and reform, and in which the influence of different anchoring institutions are constantly waxing and waning. The complexity of connections and their pattern of change are especially obvious in the life sciences, which are an especially good place to study problems of integration. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. The implementation of a quality system in the Dutch GP specialty training: barriers and facilitators; a qualitative study

    NARCIS (Netherlands)

    Buwalda, N.; Braspenning, J.C.; Roosmalen, S. van; Dijk, N. van; Visser, Machteld

    2017-01-01

    BACKGROUND: Quality assurance programs in medical education are introduced to gain insight into the quality of such programs and to trigger improvements. Although of utmost importance, research on the implementation of such programs is scarce. The Dutch General Practice (GP) specialty training

  13. The implementation of a quality system in the Dutch GP specialty training: barriers and facilitators; a qualitative study

    NARCIS (Netherlands)

    Buwalda, Nienke; Braspenning, Jozé; van Roosmalen, Sanne; van Dijk, Nynke; Visser, Mechteld

    2017-01-01

    Quality assurance programs in medical education are introduced to gain insight into the quality of such programs and to trigger improvements. Although of utmost importance, research on the implementation of such programs is scarce. The Dutch General Practice (GP) specialty training institutes used

  14. Nurse specialty subcultures and patient outcomes in acute care hospitals: A multiple-group structural equation modeling.

    Science.gov (United States)

    Mallidou, Anastasia A; Cummings, Greta G; Estabrooks, Carole A; Giovannetti, Phyllis B

    2011-01-01

    Hospital organizational culture is widely held to matter to the delivery of services, their effectiveness, and system performance in general. However, little empirical evidence exists to support that culture affects provider and patient outcomes; even less evidence exists to support how this occurs. To explore causal relationships and mechanisms between nursing specialty subcultures and selected patient outcomes (i.e., quality of care, adverse patient events). Martin's differentiation perspective of culture (nested subcultures within organizations) was used as a theoretical framework to develop and test a model. Hospital nurse subcultures were identified as being reflected in formal practices (i.e., satisfactory salary, continuing education, quality assurance program, preceptorship), informal practices (i.e., autonomy, control over practice, nurse-physician relationships), and content themes (i.e., emotional exhaustion). A series of structural equation models were assessed using LISREL on a large nurse survey database representing four specialties (i.e., medical, surgical, intensive care, emergency) in acute care hospitals in Alberta, Canada. Nursing specialty subcultures differentially influenced patient outcomes. Specifically, quality of care (a) was affected by nurses' control over practice, (b) was better in intensive care than in medical specialty, and (c) was related to lower adverse patient events; nurses in intensive care and emergency specialties reported fewer adverse events than did their counterparts in medical specialties. Understanding the meaning of subcultures in clinical settings would influence nurses and administrators efforts to implement clinical change and affect outcomes. More research is needed on nested subcultures within healthcare organizations for better understanding differentiated subspecialty effects on complexity of care and outcomes in hospitals. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. Senior medical students' appraisal of CanMEDS competencies.

    NARCIS (Netherlands)

    Rademakers, J.; Rooy, N. de; Cate, O.T.J. ten

    2007-01-01

    CONTEXT: In 2003 the Dutch Central College of Medical Specialties presented guidelines for the modernisation of all medical specialty training programmes in the Netherlands. These guidelines are based to a large extent on the CanMEDS (Canadian Medical Education Directives for Specialists) 2000

  16. Specialty Practice and Cost Considerations in the Management of Uveitis Associated With Juvenile Idiopathic Arthritis.

    Science.gov (United States)

    Palestine, Alan G; Singh, Jasleen K; Kolfenbach, Jason R; Ozzello, Daniel J

    2016-07-01

    To evaluate whether cost, prior insurance authorization concerns, and subspecialty practice influence therapeutic decisions in the treatment of uveitis associated with juvenile idiopathic arthritis. A total of 2,965 pediatric ophthalmologists, uveitis specialists, retina specialists, and rheumatologists across the United States were surveyed via e-mail regarding their choice in long-term therapy for a hypothetical patient with uveitis associated with juvenile idiopathic arthritis. Outcomes of interest were differences in therapy choice based on cost/prior authorization and specialty practice. There were significant differences in the use of methotrexate and biologics among specialists, both with and without consideration for cost and prior authorization. Physicians in four different specialties who treat uveitis associated with juvenile idiopathic arthritis agree on methotrexate as a first-line treatment choice and a biologic immunosuppressive medication as a second choice, but there are significant differences between the specialties in their use of these medications. Cost and insurance considerations did not affect therapy selection. [J Pediatr Ophthalmol Strabismus. 2016;53(4):246-251.]. Copyright 2016, SLACK Incorporated.

  17. Variability in Resident Operative Hand Experience by Specialty.

    Science.gov (United States)

    Silvestre, Jason; Lin, Ines C; Levin, L Scott; Chang, Benjamin

    2018-01-01

    Recent attention has sought to standardize hand surgery training in the United States. This study analyzes the variability in operative hand experience for orthopedic and general surgery residents. Case logs for orthopedic and general surgery residency graduates were obtained from the American Council of Graduate Medical Education (2006-2007 to 2014-2015). Plastic surgery case logs were not available for comparison. Hand surgery case volumes were compared between specialties with parametric tests. Intraspecialty variation in orthopedic surgery was assessed between the bottom and top 10th percentiles in procedure categories. Case logs for 9605 general surgery residents and 5911 orthopedic surgery residents were analyzed. Orthopedic surgery residents performed a greater number of hand surgery cases than general surgery residents ( P < .001). Mean total hand experience ranged from 2.5 ± 4 to 2.8 ± 5 procedures for general surgery residents with no reported cases of soft tissue repairs, vascular repairs, and replants. Significant intraspecialty variation existed in orthopedic surgery for all hand procedure categories (range, 3.3-15.0). As the model for hand surgery training evolves, general surgeons may represent an underutilized talent pool to meet the critical demand for hand surgeon specialists. Future research is needed to determine acceptable levels of training variability in hand surgery.

  18. Commercial production of specialty chemicals and pharmaceuticals from biomass

    Energy Technology Data Exchange (ETDEWEB)

    McChesney, J.D. [Univ. of Mississippi, University, MS (United States)

    1993-12-31

    The chemical substances utilized in consumer products, and for pharmaceutical and agricultural uses are generally referred to as specialty chemicals. These may be flavor or fragrance substances, intermediates for synthesis of drugs or agrochemicals or the drugs or agrochemicals themselves, insecticides or insect pheromones or antifeedants, plant growth regulators, etc. These are in contrast to chemicals which are utilized in large quantities for fuels or preparation of plastics, lubricants, etc., which are usually referred to as industrial chemicals. The specific utilization of specialty chemicals is associated with a specific important physiochemical or biological property. They may possess unique properties as lubricants or waxes or have a very desirable biological activity such as a drug, agrochemical or perfume ingredient. These unique properties convey significant economic value to the specific specialty chemical. The economic commercial production of specialty chemicals commonly requires the isolation of a precursor or the specialty chemical itself from a natural source. The discovery, development and commercialization of specialty chemicals is presented and reviewed. The economic and sustainable production of specialty chemicals is discussed.

  19. Migraine-preventive prescription patterns by physician specialty in ambulatory care settings in the United States.

    Science.gov (United States)

    Takaki, Hiroko; Onozuka, Daisuke; Hagihara, Akihito

    2018-03-01

    Many adults with migraine who require preventive therapy are often not prescribed the proper medications. The most likely reason is that primary care physicians are unacquainted with preventive medications for migraine. The present study assessed the migraine-preventive prescription patterns in office visits using data from the National Ambulatory Medical Care Survey from 2006 to 2009 in the United States. Patients who were 18 years or older and diagnosed with migraine were included in the analysis. In accordance with the recommendations of the headache guidelines, we included beta-blockers, antidepressants, triptans for short-term prevention of menstrual migraine, and other triptans for acute treatment. Weighted visits of adults with migraine prescribed with preventive medication ranged from 32.8% in 2006 to 38.6% in 2009. Visits to primary care physicians accounted for 72.6% of the analyzed adult migraine visits. Anticonvulsants (odds ratio [OR] 0.29, 95% confidence interval [CI] 0.14-0.57, p  < 0.001) and triptans for menstrual migraine (OR 0.50, 95% CI 0.28-0.91, p  = 0.025) were less frequently prescribed by primary care physicians compared with specialty care physicians, such as neurologists and psychiatrists. There were no significant differences in the prescription patterns of antidepressants and beta-blockers between primary and specialty care physicians. Beta-blockers were prescribed to patients with comorbidity of hypertension, and antidepressants were used by patients with comorbidity of depression. There are differences in the prescription patterns of certain type of preventive medications between primary care physicians and specialty care physicians.

  20. Migraine-preventive prescription patterns by physician specialty in ambulatory care settings in the United States

    Directory of Open Access Journals (Sweden)

    Hiroko Takaki

    2018-03-01

    Full Text Available Many adults with migraine who require preventive therapy are often not prescribed the proper medications. The most likely reason is that primary care physicians are unacquainted with preventive medications for migraine. The present study assessed the migraine-preventive prescription patterns in office visits using data from the National Ambulatory Medical Care Survey from 2006 to 2009 in the United States. Patients who were 18 years or older and diagnosed with migraine were included in the analysis. In accordance with the recommendations of the headache guidelines, we included beta-blockers, antidepressants, triptans for short-term prevention of menstrual migraine, and other triptans for acute treatment. Weighted visits of adults with migraine prescribed with preventive medication ranged from 32.8% in 2006 to 38.6% in 2009. Visits to primary care physicians accounted for 72.6% of the analyzed adult migraine visits. Anticonvulsants (odds ratio [OR] 0.29, 95% confidence interval [CI] 0.14–0.57, p < 0.001 and triptans for menstrual migraine (OR 0.50, 95% CI 0.28–0.91, p = 0.025 were less frequently prescribed by primary care physicians compared with specialty care physicians, such as neurologists and psychiatrists. There were no significant differences in the prescription patterns of antidepressants and beta-blockers between primary and specialty care physicians. Beta-blockers were prescribed to patients with comorbidity of hypertension, and antidepressants were used by patients with comorbidity of depression. There are differences in the prescription patterns of certain type of preventive medications between primary care physicians and specialty care physicians.

  1. 75 FR 39664 - Grant of Authority For Subzone Status Materials Science Technology, Inc. (Specialty Elastomers...

    Science.gov (United States)

    2010-07-12

    ... Status Materials Science Technology, Inc. (Specialty Elastomers and Fire Retardant Chemicals) Conroe... specialty elastomer manufacturing and distribution facility of Materials Science Technology, Inc., located... and distribution of specialty elastomers and fire retardant chemicals at the facility of Materials...

  2. Two interesting cases highlighting an oblivious specialty of psychoneuroendocrinology.

    Science.gov (United States)

    Hari Kumar, K V S; Dhull, Pawan; Somasekharan, Manoj; Seshadri, K

    2012-01-01

    Psychoneuroendocrinology deals with the overlap disorders pertaining to three different specialties. Awareness about the somatic manifestations of psychiatric diseases and vice versa is a must for all the clinicians. The knowledge of this interlinked specialty is essential because of the obscure presentation of certain disorders. Our first case was treated as depressive disorder, whereas the diagnosis was hypogonadism with empty sella. Our second patient was managed as schizophrenia and the evaluation revealed bilateral basal ganglia calcification and a diagnosis of Fahr's disease. We report these cases for their unusual presentation and to highlight the importance of this emerging specialty.

  3. A Associação Brasileira de Medicina do Trabalho: locus do processo de constituição da especialidade medicina do trabalho no Brasil na década de 1940 The Brazilian Association of Workers' Medicine: a space for the constitution of occupational health as a medical specialty in Brazil in the 1940s

    Directory of Open Access Journals (Sweden)

    Anna Beatriz de Sá Almeida

    2008-06-01

    Full Text Available O artigo analisa a Associação Brasileira de Medicina do Trabalho (ABMT, criada em fins de 1944 como lócus de consolidação do campo da medicina do trabalho no Brasil. O grupo dos primeiros especialistas no campo da higiene e medicina do trabalho que trabalhavam no Ministério do Trabalho, Indústria e Comércio (MTIC foi o responsável pela fundação da ABMT, nas próprias dependências do Ministério. Contando com um núcleo inicial de 35 médicos e cinco engenheiros, todos oriundos do MTIC, a ABMT destacava como seu objetivo primordial, o estudo, a discussão e a divulgação dos assuntos referentes à medicina do trabalho. Entre as principais atividades promovidas pela ABMT, destacavam-se as reuniões científicas mensais (palestras de médicos convidados e de médicos e engenheiros do próprio MTIC, a organização de eventos científicos e a publicação de um periódico especializado. Logo após a sua criação, já em 1945, a ABMT passou a integrar o Bureau Internacional de Segurança do Trabalho, com sede em Montreal, Canadá e o Bureau Internacional do Trabalho, da Organização Internacional do Trabalho. Em dezembro de 1945, no momento da eleição da nova diretoria, criou-se a Revista Médica do Trabalho, cuja primeira publicação foi em 1946.This article analyzes the Brazilian Association of Workers' Medicine, created in the end of 1944 as a space for consolidating occupational health as a medical specialty in Brazil. The Association was founded by the first group of specialists in the field of occupational hygiene and medicine with seat at the facilities of the proper Ministry of Work, Industry and Commerce, where the founders were working. Counting on an initial core group of 35 physicians and five engineers, all of them coming from the Ministry, the main objective of the Association was to study, discuss and promote the issues related to workers' medicine. Among the most relevant activities promoted by the Association were

  4. Evaluation of the educational climate for specialty trainees in dermatology.

    Science.gov (United States)

    Goulding, J M R; Passi, V

    2016-06-01

    Dermatology specialty trainees (STs) in the United Kingdom (UK) are few in number and will join a thinly spread national consultant body. It is of paramount importance to deliver training programmes of the highest quality for these doctors, central to which is the establishment and maintenance of an educational climate conducive to learning. To conduct a pilot study to evaluate the educational climate for dermatology STs in one UK deanery (West Midlands). Secondary analysis of published data was performed, from the UK's General Medical Council (GMC) national training survey, and the Job Evaluation Survey Tool (JEST) administered by the West Midlands deanery. A modified online version of the Postgraduate Hospital Educational Environment Measure (PHEEM) was circulated among dermatology STs. The GMC's survey data show that UK dermatology STs rated their training highly in comparison with undifferentiated UK postgraduate trainees. West Midlands dermatology STs (n = 22) scored very similarly to UK dermatology STs. The JEST gave broadly encouraging results, with 21/22 (95%) happy to recommend their posts to colleagues. The modified PHEEM yielded a global mean score of 96.5/152, attracting the descriptor 'more positive than negative but room for improvement'. Despite inherent methodological limitations, the GMC, JEST and modified PHEEM surveys have revealed useful comparative triangulated data which allows the conclusion that West Midlands dermatology STs seem to be training in a favourable educational climate. This represents an important facet of the quality assurance process for medical education, and allows insight into areas which may require improvement. © 2015 European Academy of Dermatology and Venereology.

  5. 15 CFR 2011.204 - Entry of specialty sugars.

    Science.gov (United States)

    2010-01-01

    ... UNITED STATES TRADE REPRESENTATIVE ALLOCATION OF TARIFF-RATE QUOTA ON IMPORTED SUGARS, SYRUPS AND... present a certificate to the appropriate customs official at the date of entry of specialty sugars. Entry...

  6. Fiber Fabrication Facility for Non-Oxide and Specialty Glasses

    Data.gov (United States)

    Federal Laboratory Consortium — FUNCTION: Unique facility for the research, development, and fabrication of non-oxide and specialty glasses and fibers in support of Navy/DoD programs.DESCRIPTION:...

  7. Challenges in referral communication between VHA primary care and specialty care.

    Science.gov (United States)

    Zuchowski, Jessica L; Rose, Danielle E; Hamilton, Alison B; Stockdale, Susan E; Meredith, Lisa S; Yano, Elizabeth M; Rubenstein, Lisa V; Cordasco, Kristina M

    2015-03-01

    Poor communication between primary care providers (PCPs) and specialists is a significant problem and a detriment to effective care coordination. Inconsistency in the quality of primary-specialty communication persists even in environments with integrated delivery systems and electronic medical records (EMRs), such as the Veterans Health Administration (VHA). The purpose of this study was to measure ease of communication and to characterize communication challenges perceived by PCPs and primary care personnel in the VHA, with a particular focus on challenges associated with referral communication. The study utilized a convergent mixed-methods design: online cross-sectional survey measuring PCP-reported ease of communication with specialists, and semi-structured interviews characterizing primary-specialty communication challenges. 191 VHA PCPs from one regional network were surveyed (54% response rate), and 41 VHA PCPs and primary care staff were interviewed. PCP-reported ease of communication mean score (survey) and recurring themes in participant descriptions of primary-specialty referral communication (interviews) were analyzed. Among PCPs, ease-of-communication ratings were highest for women's health and mental health (mean score of 2.3 on a scale of 1-3 in both), and lowest for cardiothoracic surgery and neurology (mean scores of 1.3 and 1.6, respectively). Primary care personnel experienced challenges communicating with specialists via the EMR system, including difficulty in communicating special requests for appointments within a certain time frame and frequent rejection of referral requests due to rigid informational requirements. When faced with these challenges, PCPs reported using strategies such as telephone and e-mail contact with specialists with whom they had established relationships, as well as the use of an EMR-based referral innovation called "eConsults" as an alternative to a traditional referral. Primary-specialty communication is a continuing

  8. Specialty training and the personal use of benzodiazepines by physicians affect their proneness to prescribe tranquilizers.

    Science.gov (United States)

    Linden, M; Gothe, H

    1998-03-01

    The decision on how to treat a patient does not depend on clinical matters or illness characteristics alone, but also on patient, physician and setting variables such as personality, training, or reimbursement. No research has yet been carried out to answer the question whether personal experience with medications also influences prescribing behavior. In this study, 124 physicians stratified according to specialty (neuropsychiatrists vs. general practitioners), type of institution (private practice vs. hospital), years of professional experience (young vs. old), and region (rural vs. urban) participated in a structured interview to evaluate their proneness to prescribe benzodiazepines for sleep disorders as well as their personal experience in taking benzodiazepines for their own sleep problems. Both specialty and personal experience were significantly related to proneness to prescribe. Other variables tested (region, institution, age, gender) did not help to explain the variance in benzodiazepine prescribing practice. Thus physician variables and, importantly, their own personal experience in taking the medication significantly influence treatment choice. Rational medical decision making and treatment guidelines must therefore take into account medical knowledge as well as knowledge of personal treatment preferences and professional biases.

  9. Gender in clinical neuropsychology: practice survey trends and comparisons outside the specialty.

    Science.gov (United States)

    Sweet, Jerry J; Lee, Catherine; Guidotti Breting, Leslie M; Benson, Laura M

    2018-02-01

    This paper describes gender-related trends within clinical neuropsychology, based primarily on recurrent practice surveys within the specialty and, to a lesser extent, job-related information from medical specialties and the general U.S. labor market. Chronological and cross-sectional analyses of professional practice survey data from 2005, 2010, and 2015 relevant to gender. As is common with survey data, descriptive analysis and independent samples t-tests were conducted. Longitudinal data allowed for examination of gender trends, as well as observations of change and stability of factors associated with gender, over time. Women have become dominant in number in clinical neuropsychology, and also comprise a vast majority of practitioners entering the specialty. Gender differences are noted in professional identity, work status, work settings, types of career satisfaction, and retirement expectations. Women are more likely to identify work environment and personal/family obstacles to aspects of career satisfaction. A gender pay gap was found at all time points and is not narrowing. As is true nationally, multiple factors appear related to the gender pay gap in clinical neuropsychology. Women in neuropsychology are now dominant in number, and their presence is strongly associated with specific practice patterns, such as greater institutional employment, less involvement in forensic practice, and strong involvement in pediatric practice, which may be maintaining the sizeable gender pay gap in neuropsychology. As the proportion of women neuropsychologists continues to increase, flexible work hours, and alternative means of remuneration may be needed to offset current disproportionate family-related responsibilities.

  10. Operational experience with DICOM for the clinical specialties in the healthcare enterprise

    Science.gov (United States)

    Kuzmak, Peter M.; Dayhoff, Ruth E.

    2004-04-01

    A number of clinical specialties routinely use images in treating patients, for example ophthalmology, dentistry, cardiology, endoscopy, and surgery. These images are captured by a variety of commercial digital image acquisition systems. The US Department of Veterans Affairs has been working for several years on advancing the use of the Digital Imaging and Communications in Medicine (DICOM) Standard in these clinical specialties. This is an effort that has involved several facets: (1) working with the vendors to ensure that they satisfy existing DICOM requirements, (2) developing interface software to the VistA hospital information system (HIS), (3) field testing DICOM systems, (4) deploying these DICOM interfaces nation-wide to all VA medical centers, (5) working with the healthcare providers using the system, and (6) participating in the DICOM working groups to improve the standard. The VA is now beginning to develop clinical applications that make use of the DICOM interfaces in the clinical specialties. The first of these will be in ophthalmology to remotely screen patients for diabetic retinopathy.

  11. rural medicine as a sub-specialty

    African Journals Online (AJOL)

    hospital for a year can be regarded as a rural medical specialist. Most often they realise ... of them, that they leave the public service for ever, for a situation that is ... So for rural medicine, it is an extremely wide set of skills that best describes ...

  12. Burnout among Dutch medical residents

    NARCIS (Netherlands)

    Prins, J.T.; Hoekstra-Weebers, J.E.; Van De Wiel, H.B.; Gazendam-Donofrio, S.M.; Sprangers, F.; Jaspers, F.C.; van der Heijden, F.M.

    2007-01-01

    We examined levels of burnout and relationships between burnout, gender, age, years in training, and medical specialty in 158 medical residents working at the University Medical Center Groningen, the Netherlands. Thirteen percent of the residents met the criteria for burnout, with the highest

  13. Detecting clinically relevant new information in clinical notes across specialties and settings.

    Science.gov (United States)

    Zhang, Rui; Pakhomov, Serguei V S; Arsoniadis, Elliot G; Lee, Janet T; Wang, Yan; Melton, Genevieve B

    2017-07-05

    Automated methods for identifying clinically relevant new versus redundant information in electronic health record (EHR) clinical notes is useful for clinicians and researchers involved in patient care and clinical research, respectively. We evaluated methods to automatically identify clinically relevant new information in clinical notes, and compared the quantity of redundant information across specialties and clinical settings. Statistical language models augmented with semantic similarity measures were evaluated as a means to detect and quantify clinically relevant new and redundant information over longitudinal clinical notes for a given patient. A corpus of 591 progress notes over 40 inpatient admissions was annotated for new information longitudinally by physicians to generate a reference standard. Note redundancy between various specialties was evaluated on 71,021 outpatient notes and 64,695 inpatient notes from 500 solid organ transplant patients (April 2015 through August 2015). Our best method achieved at best performance of 0.87 recall, 0.62 precision, and 0.72 F-measure. Addition of semantic similarity metrics compared to baseline improved recall but otherwise resulted in similar performance. While outpatient and inpatient notes had relatively similar levels of high redundancy (61% and 68%, respectively), redundancy differed by author specialty with mean redundancy of 75%, 66%, 57%, and 55% observed in pediatric, internal medicine, psychiatry and surgical notes, respectively. Automated techniques with statistical language models for detecting redundant versus clinically relevant new information in clinical notes do not improve with the addition of semantic similarity measures. While levels of redundancy seem relatively similar in the inpatient and ambulatory settings in the Fairview Health Services, clinical note redundancy appears to vary significantly with different medical specialties.

  14. Specialty Training's Organizational Readiness for curriculum Change (STORC): development of a questionnaire in a Delphi study.

    Science.gov (United States)

    Bank, Lindsay; Jippes, Mariëlle; van Luijk, Scheltus; den Rooyen, Corry; Scherpbier, Albert; Scheele, Fedde

    2015-08-05

    In postgraduate medical education (PGME), programs have been restructured according to competency-based frameworks. The scale and implications of these adjustments justify a comprehensive implementation plan. Organizational Readiness for Change (ORC) is seen as a critical precursor for a successful implementation of change initiatives. Though, ORC in health care settings is mostly assessed in small scale settings and in relation to new policies and practices rather than educational change. Therefore our aim with this work was to develop an instrument to asses Specialty Training's Organizational Readiness for curriculum Change (STORC). A Delphi procedure was conducted to examine the applicability of a preliminary questionnaire in PGME, which was based on existing instruments designed for business and health care organizations. The 41 panellists (19 trainees and 22 supervisors from 6 specialties) from four different countries who were confronted with an apparent curriculum change, or would be in the near future, were asked to rate the relevance of a 89-item web-based questionnaire with regard to changes in specialty training on a 5-point Likert scale. Furthermore, they were invited to make qualitative comments on the items. In two rounds the 89-item preliminary questionnaire was reduced to 44 items. Items were either removed, kept, adapted or added based on individual item scores and qualitative comments. In the absence of a gold standard, this Delphi procedure was considered complete when the overall questionnaire rating exceeded 4.0 (scale 0-5). The overall item score reached 4.1 in the second round, meeting our criteria for completion of this Delphi procedure. This Delphi study describes the initial validating step in the development of an instrument to asses Specialty Training's Organisational Readiness for curriculum Change (STORC). Since ORC is measured on various subscales and presented as such, its strength lies in analysing these subscales. The latter makes

  15. Specialty and full-service hospitals: a comparative cost analysis.

    Science.gov (United States)

    Carey, Kathleen; Burgess, James F; Young, Gary J

    2008-10-01

    To compare the costs of physician-owned cardiac, orthopedic, and surgical single specialty hospitals with those of full-service hospital competitors. The primary data sources are the Medicare Cost Reports for 1998-2004 and hospital inpatient discharge data for three of the states where single specialty hospitals are most prevalent, Texas, California, and Arizona. The latter were obtained from the Texas Department of State Health Services, the California Office of Statewide Health Planning and Development, and the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Additional data comes from the American Hospital Association Annual Survey Database. We identified all physician-owned cardiac, orthopedic, and surgical specialty hospitals in these three states as well as all full-service acute care hospitals serving the same market areas, defined using Dartmouth Hospital Referral Regions. We estimated a hospital cost function using stochastic frontier regression analysis, and generated hospital specific inefficiency measures. Application of t-tests of significance compared the inefficiency measures of specialty hospitals with those of full-service hospitals to make general comparisons between these classes of hospitals. Results do not provide evidence that specialty hospitals are more efficient than the full-service hospitals with whom they compete. In particular, orthopedic and surgical specialty hospitals appear to have significantly higher levels of cost inefficiency. Cardiac hospitals, however, do not appear to be different from competitors in this respect. Policymakers should not embrace the assumption that physician-owned specialty hospitals produce patient care more efficiently than their full-service hospital competitors.

  16. Primary Care Resident Perceived Preparedness to Deliver Cross-cultural Care: An Examination of Training and Specialty Differences

    Science.gov (United States)

    Park, Elyse R.; Green, Alexander R.; Betancourt, Joseph R.; Weissman, Joel S.

    2007-01-01

    Objective Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents’ perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Design Cross-sectional, national mail survey of resident physicians in their last year of training. Participants Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Results Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Conclusions Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents’ preparedness to provide cross-cultural care. PMID:17516107

  17. Primary care resident perceived preparedness to deliver cross-cultural care: an examination of training and specialty differences.

    Science.gov (United States)

    Greer, Joseph A; Park, Elyse R; Green, Alexander R; Betancourt, Joseph R; Weissman, Joel S

    2007-08-01

    Previous research has shown that resident physicians report differences in training across primary care specialties, although limited data exist on education in delivering cross-cultural care. The goals of this study were to identify factors that relate to primary care residents' perceived preparedness to provide cross-cultural care and to explore the extent to which these perceptions vary across primary care specialties. Cross-sectional, national mail survey of resident physicians in their last year of training. Eleven hundred fifty primary care residents specializing in family medicine (27%), internal medicine (23%), pediatrics (26%), and obstetrics/gynecology (OB/GYN) (24%). Male residents as well as those who reported having graduated from U.S. medical schools, access to role models, and a greater cross-cultural case mix during residency felt more prepared to deliver cross-cultural care. Adjusting for these demographic and clinical factors, family practice residents were significantly more likely to feel prepared to deliver cross-cultural care compared to internal medicine, pediatric, and OB/GYN residents. Yet, when the quantity of instruction residents reported receiving to deliver cross-cultural care was added as a predictor, specialty differences became nonsignificant, suggesting that training opportunities better account for the variability in perceived preparedness than specialty. Across primary care specialties, residents reported different perceptions of preparedness to deliver cross-cultural care. However, this variation was more strongly related to training factors, such as the amount of instruction physicians received to deliver such care, rather than specialty affiliation. These findings underscore the importance of formal education to enhance residents' preparedness to provide cross-cultural care.

  18. The database for aggregate analysis of ClinicalTrials.gov (AACT and subsequent regrouping by clinical specialty.

    Directory of Open Access Journals (Sweden)

    Asba Tasneem

    Full Text Available BACKGROUND: The ClinicalTrials.gov registry provides information regarding characteristics of past, current, and planned clinical studies to patients, clinicians, and researchers; in addition, registry data are available for bulk download. However, issues related to data structure, nomenclature, and changes in data collection over time present challenges to the aggregate analysis and interpretation of these data in general and to the analysis of trials according to clinical specialty in particular. Improving usability of these data could enhance the utility of ClinicalTrials.gov as a research resource. METHODS/PRINCIPAL RESULTS: The purpose of our project was twofold. First, we sought to extend the usability of ClinicalTrials.gov for research purposes by developing a database for aggregate analysis of ClinicalTrials.gov (AACT that contains data from the 96,346 clinical trials registered as of September 27, 2010. Second, we developed and validated a methodology for annotating studies by clinical specialty, using a custom taxonomy employing Medical Subject Heading (MeSH terms applied by an NLM algorithm, as well as MeSH terms and other disease condition terms provided by study sponsors. Clinical specialists reviewed and annotated MeSH and non-MeSH disease condition terms, and an algorithm was created to classify studies into clinical specialties based on both MeSH and non-MeSH annotations. False positives and false negatives were evaluated by comparing algorithmic classification with manual classification for three specialties. CONCLUSIONS/SIGNIFICANCE: The resulting AACT database features study design attributes parsed into discrete fields, integrated metadata, and an integrated MeSH thesaurus, and is available for download as Oracle extracts (.dmp file and text format. This publicly-accessible dataset will facilitate analysis of studies and permit detailed characterization and analysis of the U.S. clinical trials enterprise as a whole. In

  19. Awareness of family medicine discipline among clinical medical ...

    African Journals Online (AJOL)

    Introduction: Undergraduate medical education requires the studying of a wide range of medical specialties to produce the future workforce of the healthcare system. Family medicine (FM), a relatively new specialty in Nigeria, aims at supplying doctors capable of providing comprehensive healthcare for the majority of the ...

  20. Integration of outpatient infectious diseases clinic pharmacy services and specialty pharmacy services for patients with HIV infection.

    Science.gov (United States)

    Gilbert, Elise M; Gerzenshtein, Lana

    2016-06-01

    The integration of specialty pharmacy services and existing outpatient clinical pharmacy services within an infectious diseases (ID) clinic to optimize the care of patients with human immunodeficiency virus (HIV) infection is described. The management of HIV-infected patients is a highly specialized area of practice, often requiring use of complex medication regimens for reduction of HIV-associated morbidity and mortality prophylaxis and treatment of opportunistic infections, and prevention of HIV transmission. To maximize the effectiveness and safety of treatment with antiretroviral agents and associated pharmacotherapies, an interdisciplinary team is often involved in patient care. At Chicago-based Northwestern Medicine (NM), the outpatient ID clinic has long worked with an interdisciplinary care team including physicians, clinical pharmacists, nurses, and social workers to care for patients with HIV infection. In April 2014, specialty pharmacy services for patients with HIV infection were added to the NM ID clinic's care model to help maintain continuity of care and enhance patient follow-up. The care model includes well-defined roles for clinical pharmacists, pharmacy residents and students on rotation, and licensed pharmacy technicians. Specialty pharmacy services, including medication education, prescription fulfillment, assistance with medication access (e.g., navigation of financial assistance programs, completion of prior-authorization requests), and treatment monitoring, allow for closed-loop medication management of the HIV-infected patient population. Integration of specialty pharmacy services with the interdisciplinary care provided in the outpatient NM ID clinic has enhanced continuity of care for patients with HIV infection in terms of prescription filling, medication counseling, and adherence monitoring. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  1. Seashell specialties and food handling in Slovene Istria restaurants

    Directory of Open Access Journals (Sweden)

    Tamara POKLAR VATOVEC

    2015-11-01

    Full Text Available The purpose of the research was to evaluate the offer of seashell specialties in Slovene Istria restaurants, and to assess food safety knowledge (gained through formal and informal education as well as to assess the behaviour of food handlers in preparing shell dishes. A self-administered questionnaire was designed that included four sections: a demographic section, a general section, a restaurant menu offer, and a food safety section related to preparation of seashell specialties. Seashell specialties were offered in 41 restaurants, of which the employed food handlers 24 attended formal education and 17 informal education. Seashells specialties and seashell menus are commonly part of the culinary and gastronomic specialties along the Slovene coast, with the most frequently offered main dish being “Blue Mussels alla Busara”. Results the questionnaire indicated poor food safety knowledge and poor behaviour regardless of the (informal education of those who prepared the dishes. We propose that formal education for catering workers preparing shell dishes should be much more emphasized.

  2. Attrition during graduate medical education: medical school perspective.

    Science.gov (United States)

    Andriole, Dorothy A; Jeffe, Donna B; Hageman, Heather L; Klingensmith, Mary E; McAlister, Rebecca P; Whelan, Alison J

    2008-12-01

    To identify predictors of attrition during graduate medical education (GME) in a single medical school cohort of contemporary US medical school graduates. Retrospective cohort study. Single medical institution. Recent US allopathic medical school graduates. Attrition from initial GME program. Forty-seven of 795 graduates (6%) did not complete the GME in their initial specialty of choice. At bivariate analysis, attrition was associated with election to the Alpha Omega Alpha Honor Medical Society, being an MD-PhD degree holder, and specialty choice (all P PhD degree holder (odds ratio, 3.43; 95% confidence interval, 1.27-9.26; P = .02), election to Alpha Omega Alpha (2.19; 1.04-4.66; P = .04), choice of general surgery for GME (5.32; 1.98-14.27; P < .001), and choice of 5-year surgical specialty including those surgical specialties with a GME training requirement of 5 years or longer (2.74; 1.16-6.44; P = .02) each independently predicted greater likelihood of attrition. Academically highly qualified graduates and graduates who chose training in general surgery or in a 5-year surgical specialty were at increased risk of attrition during GME.

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

    Science.gov (United States)

    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.

  4. Veterans Affairs general surgery service: the last bastion of integrated specialty care.

    Science.gov (United States)

    Poteet, Stephen; Tarpley, Margaret; Tarpley, John L; Pearson, A Scott

    2011-11-01

    In a time of increasing specialization, academic training institutions provide a compartmentalized learning environment that often does not reflect the broad clinical experience of general surgery practice. This study aimed to evaluate the contribution of the Veterans Affairs (VA) general surgery surgical experience to both index Accreditation Council for Graduate Medical Education (ACGME) requirements and as a unique integrated model in which residents provide concurrent care of multiple specialty patients. Institutional review board approval was obtained for retrospective analysis of electronic medical records involving all surgical cases performed by the general surgery service from 2005 to 2009 at the Nashville VA. Over a 5-year span general surgery residents spent an average of 5 months on the VA general surgery service, which includes a postgraduate year (PGY)-5, PGY-3, and 2 PGY-1 residents. Surgeries involved the following specialties: surgical oncology, endocrine, colorectal, hepatobiliary, transplant, gastrointestinal laparoscopy, and elective and emergency general surgery. The surgeries were categorized according to ACGME index requirements. A total of 2,956 surgeries were performed during the 5-year period from 2005 through 2009. Residents participated in an average of 246 surgeries during their experience at the VA; approximately 50 cases are completed during the chief year. On the VA surgery service alone, 100% of the ACGME requirement was met for the following categories: endocrine (8 cases); skin, soft tissue, and breast (33 cases); alimentary tract (78 cases); and abdominal (88 cases). Approximately 50% of the ACGME requirement was met for liver, pancreas, and basic laparoscopic categories. The VA hospital provides an authentic, broad-based, general surgery training experience that integrates complex surgical patients simultaneously. Opportunities for this level of comprehensive care are decreasing or absent in many general surgery training

  5. Contingent Valuation Analysis of an Otolaryngology and Ophthalmology Emergency Department: The Value of Acute Specialty Care.

    Science.gov (United States)

    Naunheim, Matthew R; Kozin, Elliot D; Sethi, Rosh K; Ota, H G; Gray, Stacey T; Shrime, Mark G

    2017-03-01

    Specialty emergency departments (EDs) provide a unique mechanism of health care delivery, but the value that they add to the medical system is not known. Evaluation of patient preferences to determine value can have a direct impact on resource allocation and direct-to-specialist care. To assess the feasibility of contingent valuation (CV) methodology using a willingness-to-pay (WTP) survey to evaluate specialty emergency services, in the context of an ophthalmology- and otolaryngology-specific ED. Contingent valuation analysis of a standalone otolaryngology and ophthalmology ED. Participants were English-speaking adults presenting to a dedicated otolaryngology and ophthalmology ED. The WTP questions were assessed using a payment card format, with reference to an alternative modality of treatment (ie, general ED), and were analyzed with multivariate regression. Validated WTP survey administered from October 14, 2014, through October 1, 2015. Sociodemographic data, level of distress, referral data, income, and WTP. A total of 327 of 423 (77.3%) ED patients responded to the WTP survey, with 116 ophthalmology and 211 otolaryngology patients included (52.3% female; mean [range] age, 46 [18-90] years). The most common reason for seeking care at this facility was a reputation for specialty care for both ear, nose, and throat (80 [37.9%]) and ophthalmology (43 [37.1%]). Mean WTP for specialty-specific ED services was $377 for ophthalmology patients, and $321 for otolaryngology patients ($340 overall; 95% CI, $294 to $386), without significant difference between groups (absolute difference, $56; 95% CI, $-156 to $43). Self-reported level of distress was higher among ear, nose, and throat vs ophthalmology patients (absolute difference, 0.47 on a Likert scale of 1-7; 95% CI, 0.10 to 0.84). Neither level of distress, income, nor demographic characteristics influenced WTP, but patients with higher estimates of total visit cost were more likely to have higher WTP (β coefficient

  6. Women otolaryngologist representation in specialty society membership and leadership positions.

    Science.gov (United States)

    Choi, Sukgi S; Miller, Robert H

    2012-11-01

    To determine the proportion of female otolaryngologists in leadership positions relative to their number in the specialty, their membership in various otolaryngology organizations, and age. Cross-sectional analyses of otolaryngology organization membership with a subgroup analysis on female membership and leadership proportion comparing 5-year male/female cohort groups. Information on the number of members and leaders was obtained from various specialty societies by direct communication and from their Web sites between June and December 2010. The number of female and male otolaryngologists and their age distribution in 5-year age groups was obtained from the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). Statistical analyses were used to determine whether women had proportional membership and leadership representation in various specialty societies. Additionally, female representation in other leadership roles was analyzed using the male/female ratio within the 5-year cohort groups. Female otolaryngologists were found to constitute approximately 11% of practicing otolaryngologists. The American Society of Pediatric Otolaryngology had a higher proportion of female members (22%) compared to five other societies. When the gender composition within each organization was taken into account, female representation in specialty society leadership positions was proportionate to their membership across all societies. When gender and age were considered, women have achieved proportionate representation in each of the specialty societies' leadership positions. There was also proportionate representation of females as program directors, American Board of Otolaryngology directors, Residency Review Committee members, and journal editors/editorial board members. Finally, fewer female chairs or chiefs of departments/divisions were seen, but when age was taken into consideration, this difference was no longer significant. Women have achieved parity in

  7. ORIGINAL ARTICLES Changing gender profile of medical schools ...

    African Journals Online (AJOL)

    2008-06-23

    Jun 23, 2008 ... Changing gender profile of medical schools in South Africa. Mignonne ... The Higher Education Management Information System. (HEMIS) ..... specialty and gender: A study of teachers at a Swedish medical school. BMC Med ...

  8. Career preference and medical students' biographical characteristics and academic achievement

    NARCIS (Netherlands)

    Soethout, M.B.M.; Heijmans, M.W.; ten Cate, O.T.J.

    2008-01-01

    Background: We know that medical students' biographical characteristics and academic achievement influence career preference. Less is known about the differential association of these characteristics with preference for distinct specialties at different stages of medical training. Aim: To

  9. Physician' entrepreneurship explained: a case study of intra-organizational dynamics in Dutch hospitals and specialty clinics.

    Science.gov (United States)

    Koelewijn, Wout T; de Rover, Matthijs; Ehrenhard, Michel L; van Harten, Wim H

    2014-05-19

    Challenges brought about by developments such as continuing market reforms and budget reductions have strained the relation between managers and physicians in hospitals. By applying neo-institutional theory, we research how intra-organizational dynamics between physicians and managers induce physicians to become entrepreneurs by starting a specialty clinic. In addition, we determine the nature of this change by analyzing the intra-organizational dynamics in both hospitals and clinics. For our research, we interviewed a total of fifteen physicians and eight managers in four hospitals and twelve physicians and seven managers in twelve specialty clinics. We found evidence that in becoming entrepreneurs, physicians are influenced by intra-organizational dynamics, including power dependence, interest dissatisfaction, and value commitments, between physicians and managers as well as among physicians' groups. The precise motivation for starting a new clinic can vary depending on the medical or business logic in which the entrepreneurs are embedded, but also the presence of an entrepreneurial nature or nurture. Finally we found that the entrepreneurial process of starting a specialty clinic is a process of sedimented change or hybridized professionalism in which elements of the business logic are added to the existing logic of medical professionalism, leading to a hybrid logic. These findings have implications for policy at both the national and hospital level. Shared ownership and aligned incentives may provide the additional cement in which the developing entrepreneurial values are 'glued' to the central medical logic.

  10. Physician’ entrepreneurship explained: a case study of intra-organizational dynamics in Dutch hospitals and specialty clinics

    Science.gov (United States)

    2014-01-01

    Background Challenges brought about by developments such as continuing market reforms and budget reductions have strained the relation between managers and physicians in hospitals. By applying neo-institutional theory, we research how intra-organizational dynamics between physicians and managers induce physicians to become entrepreneurs by starting a specialty clinic. In addition, we determine the nature of this change by analyzing the intra-organizational dynamics in both hospitals and clinics. Methods For our research, we interviewed a total of fifteen physicians and eight managers in four hospitals and twelve physicians and seven managers in twelve specialty clinics. Results We found evidence that in becoming entrepreneurs, physicians are influenced by intra-organizational dynamics, including power dependence, interest dissatisfaction, and value commitments, between physicians and managers as well as among physicians’ groups. The precise motivation for starting a new clinic can vary depending on the medical or business logic in which the entrepreneurs are embedded, but also the presence of an entrepreneurial nature or nurture. Finally we found that the entrepreneurial process of starting a specialty clinic is a process of sedimented change or hybridized professionalism in which elements of the business logic are added to the existing logic of medical professionalism, leading to a hybrid logic. Conclusions These findings have implications for policy at both the national and hospital level. Shared ownership and aligned incentives may provide the additional cement in which the developing entrepreneurial values are ‘glued’ to the central medical logic. PMID:24885912

  11. [Medical specialization in Chile. A centralized vision].

    Science.gov (United States)

    Clouet-Huerta, Diego E; González, Bárbara; Correa, Katherine

    2017-11-01

    Medical graduates face different postgraduate training options, but their priority is to obtain a primary medical specialty, defined as a specialty that does not derive from other. There are different specialty training programs in Chile, which can be dependent or independent of the Ministry of Health. The information about these programs is available in different Internet sites. However a centralized information service that groups and synthetize these programs is lacking, hampering graduate choice decisions. This article aims to review all specialization program modalities, providing a general vision of the institutional structure and implications that govern the specialization process in Chile.

  12. The recognition of radiation protection training as a professional specialty

    International Nuclear Information System (INIS)

    Touzet, R. E.

    2003-01-01

    After Chernobyl accident, the radiation protection training was recognized as a professional specialty. To improve this training we focussed the project in 3 points: - The recognition of radiation protective in the legislation. - Stablishment of minimum programs - Different categories: nuclear facilities, radioisotopes and radiopharmaceuticals

  13. IPM of specialty crops and community gardens in north Florida

    Science.gov (United States)

    Insect pests post serious challenges to specialty crops (vegetables, fruits and nut crops) and community gardens in North Florida. The major vegetable pests include silverleaf whitefly, Bemisia argentifolii; the green peach aphid, Myzus persicae; southeastern green stinkbug, Nezara viridula; brown s...

  14. Assessing Student Interest and Familiarity with Professional Psychology Specialty Areas

    Science.gov (United States)

    Stark-Wroblewski, Kimberly; Wiggins, Tina L.; Ryan, Joseph J.

    2006-01-01

    The present study examined undergraduate psychology students' (N = 83) self-reported interest in and familiarity with five specialty areas in professional psychology: counseling psychology, clinical psychology, school psychology, forensic psychology, and criminal profiling. Results suggest that although students are quite interested in careers…

  15. 76 FR 22733 - Cable Statutory License: Specialty Station List

    Science.gov (United States)

    2011-04-22

    ... Counsel, Copyright GC/I&R, P.O. Box 70400, Southwest Station, Washington, DC 20024. Telephone: (202) 707... foreign- language, religious, and/or automated programming in one-third of the hours of an average... programming comports with the 1981 FCC definition, and hence, qualifies it as a specialty station. 55 FR 40021...

  16. This Specialty Line of Clothing Really Is the "Bee's Knees"

    Science.gov (United States)

    Hollingsworth, Jan Carter

    2009-01-01

    This article features "Bee's Knees," a specialty line of clothing. While not the typical product one would think of when considering mobility equipment, this line of clothing certainly does aid in helping those with disabilities access their world more safely and comfortably. "Bee's Knees" offers pint-sized pants made of kid-friendly, durable…

  17. 76 FR 42112 - Specialty Crop Committee Stakeholder Listening Sessions

    Science.gov (United States)

    2011-07-18

    ... Specialty Crop Committee Stakeholder Listening Sessions AGENCY: Research, Education, and Economics, USDA. ACTION: Notice of stakeholder listening sessions. SUMMARY: In accordance with the Federal Advisory Committee Act, 5 U.S.C. App 2, the United States Department of Agriculture announces two stakeholder...

  18. Medical tourism

    Directory of Open Access Journals (Sweden)

    Abbas Ghanbari

    2014-08-01

    Full Text Available Medical tourism is considered as one of the tourism dimensions and it can contribute to the stabilized and dynamic development of a country's economy. Since it is cost-effective industry, most developing countries have focused on this industry and they are planning to develop this industry. Not only does Zanjan province, as the central region in medicine services, enjoy different kinds of variety and acceptable medical specialties but also it has historical, natural, and religious tourism potentials. In this survey, the researcher investigated the existing potentials of Zanjan province based on descriptive - analytical tourism in offering and providing medical services and accommodation. The survey reports that offered services in tourism were not acceptable and satisfactory.

  19. Cost consideration in the clinical guidance documents of physician specialty societies in the United States.

    Science.gov (United States)

    Schwartz, Jennifer A T; Pearson, Steven D

    2013-06-24

    Despite increasing concerns regarding the cost of health care, the consideration of costs in the development of clinical guidance documents by physician specialty societies has received little analysis. To evaluate the approach to consideration of cost in publicly available clinical guidance documents and methodological statements produced between 2008 and 2012 by the 30 largest US physician specialty societies. Qualitative document review. Whether costs are considered in clinical guidance development, mechanism of cost consideration, and the way that cost issues were used in support of specific clinical practice recommendations. Methodological statements for clinical guidance documents indicated that 17 of 30 physician societies (57%) explicitly integrated costs, 4 (13%) implicitly considered costs, 3 (10%) intentionally excluded costs, and 6 (20%) made no mention. Of the 17 societies that explicitly integrated costs, 9 (53%) consistently used a formal system in which the strength of recommendation was influenced in part by costs, whereas 8 (47%) were inconsistent in their approach or failed to mention the exact mechanism for considering costs. Among the 138 specific recommendations in these guidance documents that included cost as part of the rationale, the most common form of recommendation (50 [36%]) encouraged the use of a specific medical service because of equal effectiveness and lower cost. Slightly more than half of the largest US physician societies explicitly consider costs in developing their clinical guidance documents; among these, approximately half use an explicit mechanism for integrating costs into the strength of recommendations. Many societies remain vague in their approach. Physician specialty societies should demonstrate greater transparency and rigor in their approach to cost consideration in documents meant to influence care decisions.

  20. Holes in the safety net: a case study of access to prescription drugs and specialty care.

    Science.gov (United States)

    Stanley, Ava; Cantor, Joel C; Guarnaccia, Peter

    2008-07-01

    The health care safety net in the United States is intended to fill gaps in health care services for uninsured and other vulnerable populations. This paper presents a case study of New Brunswick, NJ, a small city rich in safety net resources, to examine the adequacy of the American model of safety net care. We find substantial gaps in access to care despite the presence of a medical school, an abundance of primary care and specialty physicians, two major teaching hospitals, a large federally qualified health center and other safety net resources in this community of about 50,000 residents. Using a blend of random-digit-dial and area probability sampling, a survey of 595 households was conducted in 2001 generating detailed information about the health, access to care, demographic and other characteristics of 1,572 individuals. Confirming the great depth of the New Brunswick health care safety net, the survey showed that more than one quarter of local residents reported a hospital or community clinic as their usual source of care. Still, barriers to prescription drugs were reported for 11.0% of the area population and more than two in five (42.8%) local residents who perceived a need for specialty care reported difficulty getting those services. Bivariate analyses show significantly elevated risk of access problems among Hispanic and black residents, those in poor health, those relying on hospital and community clinics or with no usual source of care, and those living at or below poverty. In multivariate analysis, lack of health insurance was the greatest risk factor associated with both prescription drug and specialty access problems. Few local areas can claim the depth of safety net resources as New Brunswick, NJ, raising serious concerns about the adequacy of the American safety net model, especially for people with complex and chronic health care needs.

  1. 75 FR 34418 - Notice of the Specialty Crop Committee's Stakeholder Listening Session

    Science.gov (United States)

    2010-06-17

    ... Notice of the Specialty Crop Committee's Stakeholder Listening Session AGENCY: Research, Education, and Economics, USDA. ACTION: Notice of stakeholder listening session. SUMMARY: The notice announces the Specialty Crop Committee's Stakeholder Listening Session. The document contained the wrong date for the...

  2. Higher specialty training in genitourinary medicine: A curriculum competencies-based approach.

    Science.gov (United States)

    Desai, Mitesh; Davies, Olubanke; Menon-Johansson, Anatole; Sethi, Gulshan Cindy

    2018-01-01

    Specialty trainees in genitourinary medicine (GUM) are required to attain competencies described in the GUM higher specialty training curriculum by the end of their training, but learning opportunities available may conflict with service delivery needs. In response to poor feedback on trainee satisfaction surveys, a four-year modular training programme was developed to achieve a curriculum competencies-based approach to training. We evaluated the clinical opportunities of the new programme to determine: (1) Whether opportunity cost of training to service delivery is justifiable; (2) Which competencies are inadequately addressed by direct clinical opportunities alone and (3) Trainee satisfaction. Local faculty and trainees assessed the 'usefulness' of the new modular programme to meet each curriculum competence. The annual General Medical Council (GMC) national training survey assessed trainee satisfaction. The clinical opportunities provided by the modular training programme were sufficiently useful for attaining many competencies. Trainee satisfaction as captured by the GMC survey improved from two reds pre- to nine greens post-intervention on a background of rising clinical activity in the department. The curriculum competencies-based approach to training offers an objective way to balance training with service provision and led to an improvement in GMC survey satisfaction.

  3. The management of gout in different clinical specialties in Turkey: a patient-based survey.

    Science.gov (United States)

    Öztürk, Mehmet Akif; Mercan, Rıdvan; Gök, Kevser; Onat, Ahmet Mesut; Kısacık, Bünyamin; Kimyon, Gezmiş; Balkarlı, Ayşe; Kaya, Arif; Çobankara, Veli; Balcı, Mehmet Ali; Pamuk, ÖmerNuri; Yıldırım Çetin, Gözde; Sayarlıoğlu, Mehmet; Şenel, Soner; Tezcan, Mehmet Engin; Küçük, Adem; Üreten, Kemal; Şahin, Şafak; Tufan, Abdurrahman

    2016-12-01

    Although gout is potentially curable, the management of this disease is often suboptimal. In this study, we investigated the treatment of gout in Turkey and also compared the management approaches to gout in different clinical specialties. Three hundred and nineteen consecutive patients (mean age 58.60 ± 12.8 years; 44 females, 275 males) were included in this multicenter study. A standardized form was generated to collect data about the patient's first admission to health care, the specialty of the doctor first diagnosed the gout, the treatment options for gout including attack management, patient referral, chronic treatment including medical treatment, and life style modifications. Forty patients were referred to another center without any treatment (12.8 %), and referral rate is most common among the primary care physicians (28.8 %). Colchicine was more commonly used for attack prophylaxis than allopurinol. Ninety-two patients had never been treated with allopurinol (28.8 %). Allopurinol prescription was less common among the primary care physicians and orthopedists, and highest among the rheumatologists. Recommendation of diet and life style modifications was less common among the primary care physicians and orthopedists, and highest among the rheumatologists. The rates of life style modification recommendation and long-term allopurinol prescription were 83.7 and 77.6 %, respectively, among the rheumatologists. Both acute and chronic management of gout is suboptimal in Turkey especially among the primary care physicians and orthopedists. Moreover, chronic treatment is even suboptimal among rheumatologists.

  4. The popularity of neurology in Spain: An analysis of specialty selection.

    Science.gov (United States)

    Curbelo, J; Romeo, J M; Galván-Román, J M; Vega-Villar, J; Martinez-Lapiscina, E H; Jiménez-Fonseca, P; Villacampa, T; Sánchez-Lasheras, F; Fernández-Somoano, A; Baladrón, J

    2017-12-23

    Neurology is one of the medical specialties offered each year to residency training candidates. This project analyses the data associated with candidates choosing neurology residency programmes in recent years. Data related to specialty selection were obtained from official reports by the Spanish Ministry of Health, Social Services, and Equality. Information was collected on several characteristics of teaching centres: availability of stroke units, endovascular intervention, national reference clinics for neurology, specific on-call shifts for neurology residents, and links with medical schools or national research networks. The median selection list position of candidates selecting neurology training has been higher year on year; neurology was among the 4 most popular residency programmes in 2016. Potential residents were mainly female, Spanish, and had good academic results. The median number of hospitals with higher numbers of beds, endovascular intervention, stroke units, and national reference clinics for neurology is significantly lower. This is also true when centers are analysed by presence of specific on-call shifts for neurology residents and association with medical schools or national research networks. The centres selected by candidates with the highest median selection list position in 2012-2016 were the Clínico San Carlos, 12 de Octubre, and Vall d'Hebron university hospitals. Neurology has gradually improved in residency selection choices and is now one of the 4 most popular options. Potential residents prefer larger centres which are more demanding in terms of patient care and which perform more research activity. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Specialty Drug Spending Trends Among Medicare And Medicare Advantage Enrollees, 2007–11

    OpenAIRE

    Trish, Erin; Joyce, Geoffrey; Goldman, Dana P.

    2014-01-01

    Specialty pharmaceuticals include most injectable and biologic agents used to treat complex conditions such as rheumatoid arthritis, multiple sclerosis, and cancer. We analyzed trends in specialty drug spending among Medicare beneficiaries ages sixty-five and older using 2007–11 pharmacy claims data from a 20 percent sample of Medicare beneficiaries. Annual specialty drug spending per beneficiary who used specialty drugs increased considerably during the study period, from $2,641 to $8,976. H...

  6. Implementation of a Cross-specialty Training Program in Basic Laparoscopy

    DEFF Research Database (Denmark)

    Bjerrum, Flemming; Sorensen, Jette Led; Thinggaard, Jette

    2015-01-01

    BACKGROUND AND OBJECTIVES: Several surgical specialties use laparoscopy and share many of the same techniques and challenges, such as entry approaches, equipment, and complications. However, most basic training programs focus on a single specialty. The objective of this study was to describe the ...... laparoscopy is feasible. There are several logistic benefits of using a cross-specialty approach; however, it is important that local departments include specialty-specific components, together with clinical departmental follow-up....

  7. [A historical view of the specialty of clinical microbiology].

    Science.gov (United States)

    Pérez, Evelio Perea; Álvarez, Rogelio Martín

    2010-10-01

    Clinical microbiology today is a well established specialty in Spain whose development has necessarily been linked to improvements in the diagnosis, treatment and prevention of infectious diseases. Over time, clinical, teaching, and research structures have been organized around these diseases. In addition, a scientific society for specialists in infectious diseases (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica) has been set up, which in turn, publishes the journal ENFERMEDADES INFECCIOSAS Y MICROBIOLOGÍA CLÍNICA, and organizes congresses, meetings, working groups and a quality control program, etc. Clinical microbiologists will continue to be needed to meet future challenges (identification of new pathogenic microorganisms, methodological changes, diagnostic quality and speed, nosocomial infections, the development of antimicrobial resistance, etc.), which constitute a well-defined area of knowledge specific to our specialty. Copyright © 2010 Elsevier España S.L. All rights reserved.

  8. Report of the ASHP Task Force on Caring for Patients Served by Specialty Suppliers.

    Science.gov (United States)

    Caselnova, Dominick; Donley, Kathy; Ehlers, Diane; Hyduk, Amy E; Koontz, Susannah E; Nowobilski-Vasilios, Anna; Pawlicki, Kathleen S; Poikonen, John C; Poremba, Art C; Sasser, Cathy L; Schell, Kenneth H; Schwab, Jay L; Swinarski, Dave; Chen, David; Kirschenbaum, Bonnie; Armitstead, John

    2010-10-01

    Task Force recommendations are discussed in more detail in eAppendix A (available at www.ajhp.org). What follows is a brief summary of those recommendations. In very abbreviated terms, the Task Force suggested that ASHP: 1. Consider creating and maintaining a Web resource center on ASHP's website to provide information about restricted drug distributions systems (RDDSs), risk evaluation and mitigation strategies (REMSs), risk assessment and minimization plans (RiskMAPs), and specialty suppliers and products. 2. Provide comprehensive education to members, other health professionals, regulators, third-party payers, patients, and other stakeholders about RDDSs, REMSs, RiskMAPs, and specialty suppliers and products. 3. Develop policies to advocate that a. Pharmacists serve as the institutional leaders in compliance and utilization challenges of safely managing externally supplied medications and related drug administration devices, b. Agencies, organizations, and associations that influence the distribution, sale, and dispensing of medications under these alternative distribution models address issues these models create in continuity of care, reimbursement, and patient safety, c. The Centers for Medicare and Medicaid Services and the Joint Commission develop standards and interpretations that accommodate hospital use of these products and devices when currently available technology (e.g., cold-chain storage, e-pedigree) is used to ensure patient safety, d. Group purchasing organizations negotiate contractual arrangements for specialty pharmaceuticals for both acquisition costs and distribution arrangements, and e. Information technology (IT) be used to resolve issues created by alternative distribution models and that ASHP work with IT vendors to ensure that programs are designed to meet the needs of these evolving models. 4. Quantify through research, perhaps in cooperation with entities such as the Agency for Healthcare Research and Quality, the Institute of

  9. Maximising harm reduction in early specialty training for general practice: validation of a safety checklist.

    Science.gov (United States)

    Bowie, Paul; McKay, John; Kelly, Moya

    2012-06-21

    Making health care safer is a key policy priority worldwide. In specialty training, medical educators may unintentionally impact on patient safety e.g. through failures of supervision; providing limited feedback on performance; and letting poorly developed behaviours continue unchecked. Doctors-in-training are also known to be susceptible to medical error. Ensuring that all essential educational issues are addressed during training is problematic given the scale of the tasks to be undertaken. Human error and the reliability of local systems may increase the risk of safety-critical topics being inadequately covered. However adherence to a checklist reminder may improve the reliability of task delivery and maximise harm reduction. We aimed to prioritise the most safety-critical issues to be addressed in the first 12-weeks of specialty training in the general practice environment and validate a related checklist reminder. We used mixed methods with different groups of GP educators (n=127) and specialty trainees (n=9) in two Scottish regions to prioritise, develop and validate checklist content. Generation and refinement of checklist themes and items were undertaken on an iterative basis using a range of methods including small group work in dedicated workshops; a modified-Delphi process; and telephone interviews. The relevance of potential checklist items was rated using a 4-point scale content validity index to inform final inclusion. 14 themes (e.g. prescribing safely; dealing with medical emergency; implications of poor record keeping; and effective & safe communication) and 47 related items (e.g. how to safety-net face-to-face or over the telephone; knowledge of practice systems for results handling; recognition of harm in children) were judged to be essential safety-critical educational issues to be covered. The mean content validity index ratio was 0.98. A checklist was developed and validated for educational supervisors to assist in the reliable delivery of

  10. 77 FR 40644 - Specialty Bar Products Company; A Subsidiary of Doncasters, Inc., Blairsville, PA; Notice of...

    Science.gov (United States)

    2012-07-10

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-80,511] Specialty Bar Products... Application for Reconsideration for the workers and former workers of Specialty Bar Products Company, a... resulted in reduction of work force within Specialty Bar Products.'' Information obtained during the...

  11. 76 FR 2148 - Specialty Minerals, Inc., Franklin, VA; Notice of Revised Determination on Reconsideration

    Science.gov (United States)

    2011-01-12

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,057] Specialty Minerals, Inc...) applicable to workers of Specialty Minerals, Inc., Franklin, Virginia (the subject firm). The Notice was... workers of Specialty Minerals, Inc., Franklin, Virginia, who are engaged in employment related to the...

  12. 76 FR 45397 - Export Inspection and Weighing Waiver for High Quality Specialty Grain Transported in Containers

    Science.gov (United States)

    2011-07-29

    ...-AB18 Export Inspection and Weighing Waiver for High Quality Specialty Grain Transported in Containers... permanent a waiver due to expire on July 31, 2012, for high quality specialty grain exported in containers... of high quality specialty grain exported in containers are small entities that up until recently...

  13. The Price Elasticity of Specialty Drug Use: Evidence from Cancer Patients in Medicare Part D.

    Science.gov (United States)

    Jung, Jeah Kyoungrae; Feldman, Roger; McBean, A Marshall

    2017-12-01

    Specialty drugs can bring substantial benefits to patients with debilitating conditions, such as cancer, but their costs are very high. Insurers/payers have increased patient cost-sharing for specialty drugs to manage specialty drug spending. We utilized Medicare Part D plan formulary data to create the initial price (cost-sharing in the initial coverage phase in Part D), and estimated the total demand (both on- and off-label uses) for specialty cancer drugs among elderly Medicare Part D enrollees with no low-income subsidies (non-LIS) as a function of the initial price. We corrected for potential endogeneity associated with plan choice by instrumenting the initial price of specialty cancer drugs with the initial prices of specialty drugs in unrelated classes. We report three findings. First, we found that elderly non-LIS beneficiaries with cancer were less likely to use a Part D specialty cancer drug when the initial price was high: the overall price elasticity of specialty cancer drug spending ranged between -0.72 and -0.75. Second, the price effect in Part D specialty cancer drug use was not significant among newly diagnosed patients. Finally, we found that use of Part B-covered cancer drugs was not responsive to the Part D specialty cancer drug price. As the demand for costly specialty drugs grows, it will be important to identify clinical circumstances where specialty drugs can be valuable and ensure access to high-value treatments.

  14. Information Security: A Scientometric Study of the Profile, Structure, and Dynamics of an Emerging Scholarly Specialty

    Science.gov (United States)

    Olijnyk, Nicholas Victor

    2014-01-01

    The central aim of the current research is to explore and describe the profile, dynamics, and structure of the information security specialty. This study's objectives are guided by four research questions: 1. What are the salient features of information security as a specialty? 2. How has the information security specialty emerged and evolved from…

  15. 78 FR 60766 - Clarification on Fireworks Policy Regarding Approvals or Certifications for Specialty Fireworks...

    Science.gov (United States)

    2013-10-02

    ... 173 [Docket No. PHMSA-2013-0206; Notice No. 13-15] Clarification on Fireworks Policy Regarding Approvals or Certifications for Specialty Fireworks Devices AGENCY: Pipeline and Hazardous Materials Safety... applications for specialty fireworks devices. Specialty fireworks devices are fireworks devices in various...

  16. Lipid components and oxidative status of selected specialty oils

    Energy Technology Data Exchange (ETDEWEB)

    Madawala, S. R. P.; Kochhar, S. P.; Dutta, P. C.

    2012-11-01

    Many vegetable oils are marketed as specialty oils because of their retained flavors, tastes and distinct characteristics. Specialty oil samples which were commercially produced and retailed were purchased from local superstores in Reading, UK, and Uppsala, Sweden and profiled for detailed lipid composition and oxidative status. These oil samples include: almond, hazelnut, walnut, macadamia nut, argan, avocado, grape seed, roasted sesame, rice bran, cold pressed, organic and cold pressed, warm pressed and refined rapeseed oils. The levels of PV were quite low (0.5-1.3mEq O{sub 2}/kg) but AV and Rancimat values at 100 degree centigrade (except for rapeseed oils) varied considerably at (0.5-15.5) and (4.2-37.0 h) respectively. Macadamia nut oil was found to be the most stable oil followed by argan oil, while walnut oil was the least stable. Among the specialty oils, macadamia nut oil had the lowest (4%) and walnut oil had the highest (71%) level of total PUFA. The organic cold pressed rapeseed oil had considerably lower PUFA (27%) compared with other rapeseed oils (28- 35%). In all the samples, {alpha}- and {gamma}- tocopherols were the major tocopherols; nut oils had generally lower levels. Total sterols ranged from 889 to 15,106 {mu}g/g oil. The major sterols were {beta}-sitosterol (61-85%) and campesterol (6-20%). Argan oil contained schottenol (35%) and spinasterol (32%). Compared with literature values, no marked differences were observed among the differently processed, organically grown or cold pressed rapeseed oils and other specialty oils in this study. (Author) 33 refs.

  17. Benchmarking specialty hospitals, a scoping review on theory and practice.

    Science.gov (United States)

    Wind, A; van Harten, W H

    2017-04-04

    Although benchmarking may improve hospital processes, research on this subject is limited. The aim of this study was to provide an overview of publications on benchmarking in specialty hospitals and a description of study characteristics. We searched PubMed and EMBASE for articles published in English in the last 10 years. Eligible articles described a project stating benchmarking as its objective and involving a specialty hospital or specific patient category; or those dealing with the methodology or evaluation of benchmarking. Of 1,817 articles identified in total, 24 were included in the study. Articles were categorized into: pathway benchmarking, institutional benchmarking, articles on benchmark methodology or -evaluation and benchmarking using a patient registry. There was a large degree of variability:(1) study designs were mostly descriptive and retrospective; (2) not all studies generated and showed data in sufficient detail; and (3) there was variety in whether a benchmarking model was just described or if quality improvement as a consequence of the benchmark was reported upon. Most of the studies that described a benchmark model described the use of benchmarking partners from the same industry category, sometimes from all over the world. Benchmarking seems to be more developed in eye hospitals, emergency departments and oncology specialty hospitals. Some studies showed promising improvement effects. However, the majority of the articles lacked a structured design, and did not report on benchmark outcomes. In order to evaluate the effectiveness of benchmarking to improve quality in specialty hospitals, robust and structured designs are needed including a follow up to check whether the benchmark study has led to improvements.

  18. Meta-Analysis of Surgeon Burnout Syndrome and Specialty Differences.

    Science.gov (United States)

    Bartholomew, Alex J; Houk, Anna K; Pulcrano, Marisa; Shara, Nawar M; Kwagyan, John; Jackson, Patrick G; Sosin, Michael

    2018-02-27

    Surgeon burnout compromises the quality of life of physicians and the delivery of care to patients. Burnout rates and interpretation of the Maslach Burnout Inventory (MBI) complicates the interpretation of surgeon burnout. The purpose of this study is to apply a standardized interpretation of severe surgeon burnout termed, "burnout syndrome" to analyze inherent variation within surgical specialties. A systematic literature search was performed using MEDLINE, PsycINFO, and EMBASE to identify studies reporting MBI data by surgical specialty. Data extraction was performed to isolate surgeon specific data. A meta-analysis was performed. A total of 16 cross-sectional studies were included in this meta-analysis, totaling 3581 subjects. A random effects model approximated burnout syndrome at 3.0% (95% CI: 2.0%-5.0%; I 2 = 78.1%). Subscale analysis of emotional exhaustion, depersonalization, and personal accomplishment indicated subscale burnout in 30.0% (CI: 25.0%-36.0%; I 2 = 93.2%), 34.0% (CI: 25.0%-43.0%; I 2 = 96.9%), and 25.0% (CI: 18.0%-32.0%; I 2 = 96.5%) of surgeons, respectively. Significant differences (p burnout termed "burnout syndrome," although surgeon burnout may occur in up to 34% of surgeons, characterized by high burnout in 1 of 3 subscales. Surgical specialties have significantly different rates of burnout subscales. Future burnout studies should target the specialty-specific level to understand inherent differences in an effort to better understand methods of improving surgeon burnout. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. Topical anaesthesia in children: reducing the need for specialty referral.

    LENUS (Irish Health Repository)

    O'Connor, Gabrielle

    2012-01-31

    OBJECTIVE: The management of wounds in children is stressful, not only for the child, but also for parents and staff. In our Emergency Department (ED), we currently do not have a paediatric sedation policy, and thus children requiring suturing, not amenable to distraction and infiltrative anaesthesia, are referred to specialty teams for general anaesthesia. We proposed that the introduction of a topical anaesthetic gel (lidocaine, adrenaline, tetracaine - LAT) might help to reduce the number of referrals, by allowing the ED staff to perform the procedures, in combination with nonpharmacological approaches. METHODS: We carried out a retrospective review of ED records of all children aged 14 years or less attending with wounds, over an 8-month period, from 01 May 2007 to 31 January 2008. RESULTS: Two hundred and one (50.6%) patients presented before the introduction of LAT gel, whereas 196 (49.3%) patients presented afterwards. A total of 39 (19.4%) patients were referred for specialty review pre-LAT, whereas only 19 (9.7%) patients were referred in the LAT group. Of these, 31 (15.4%) pre-LAT and 15 (7.7%) LAT group required general anaesthesia. There is a significant difference between these two groups, using Fischer\\'s exact test, P=0.018. CONCLUSION: We have found that the introduction of topical anaesthetic gel in ED has significantly reduced the number of children with wounds referred to specialty teams for general anaesthesia. This has important implications for patient safety and hospital resources.

  20. Shale oil specialty markets: Screening survey for United States applications

    Energy Technology Data Exchange (ETDEWEB)

    1987-12-01

    EG and G requested J. E. Sinor Consultants Inc. to carry out an initial screening study on the possibilities for producing specialty chemicals from oil shale. Raw shale oil is not an acceptable feedstock to refineries and there are not enough user of heavy fuel oil in the western oil shale region to provide a dependable market. The only alternatives are to hydrotreat the oil, or else ship it long distances to a larger market area. Either of these alternatives results in a cost penalty of several dollars per barrel. Instead of attempting to enter the large-volume petroleum products market, it was hypothesized that a small shale oil facility might be able to produce specialty chemicals with a high enough average value to absorb the high costs of shipping small quantities to distant markets and still provide a higher netback to the plant site than sales to the conventional petroleum products market. This approach, rather than attempting to refine shale oil or to modify its characteristics to satisfy the specifications for petroleum feedstocks or products, focuses instead on those particular characteristics which distinguish shale oil from petroleum, and attempts to identify applications which would justify a premium value for those distinctive characteristics. Because byproducts or specialty chemicals production has been a prominent feature of oil shale industries which have flourished for periods of time in various countries, a brief review of those industries provides a starting point for this study. 9 figs., 32 tabs.

  1. ACE up the sleeve - are vascular patients medically optimized?

    LENUS (Irish Health Repository)

    Coveney, A P

    2011-03-01

    To examine the current medical management of arteriopathic patients attending a vascular surgical service at a university teaching hospital over a 6-month period. The prescribing of antiplatelets, statins, angiotensin-converting enzyme (ACE) inhibitors, or angiotensin receptor blockers and beta-blockers was specifically examined. Vascular patients are often under the care of multiple specialties, and therefore the influence of different medical specialties on the patients\\' medical management was also examined.

  2. Trends in American Board of Psychiatry and Neurology specialties and neurologic subspecialties

    Science.gov (United States)

    Faulkner, L.R.; Juul, D.; Pascuzzi, R.M.; Aminoff, M.J.; Crumrine, P.K.; DeKosky, S.T.; Jozefowicz, R.F.; Massey, J.M.; Pirzada, N.; Tilton, A.

    2010-01-01

    Objective: To review the current status and recent trends in the American Board of Psychiatry and Neurology (ABPN) specialties and neurologic subspecialties and discuss the implications of those trends for subspecialty viability. Methods: Data on numbers of residency and fellowship programs and graduates and ABPN certification candidates and diplomates were drawn from several sources, including ABPN records, Web sites of the Accreditation Council for Graduate Medical Education and the American Medical Association, and the annual medical education issues of the Journal of the American Medical Association. Results: About four-fifths of neurology graduates pursue fellowship training. While most recent neurology and child neurology graduates attempt to become certified by the ABPN, many clinical neurophysiologists elect not to do so. There appears to have been little interest in establishing fellowships in neurodevelopmental disabilities. The pass rate for fellowship graduates is equivalent to that for the “grandfathers” in clinical neurophysiology. Lower percentages of clinical neurophysiologists than specialists participate in maintenance of certification, and maintenance of certification pass rates are high. Conclusion: The initial enthusiastic interest in training and certification in some of the ABPN neurologic subspecialties appears to have slowed, and the long-term viability of those subspecialties will depend upon the answers to a number of complicated social, economic, and political questions in the new health care era. PMID:20855855

  3. Physician Opinions about an Anatomy Core Curriculum: A Case for Medical Imaging and Vertical Integration

    Science.gov (United States)

    Orsbon, Courtney P.; Kaiser, Rebecca S.; Ross, Callum F.

    2014-01-01

    Pre-clinical anatomy curricula must provide medical students with the knowledge needed in a variety of medical and surgical specialties. But do physicians within specialties agree about what anatomical knowledge is most important in their practices? And, what is the common core of anatomical knowledge deemed essential by physicians in different…

  4. Intensive care nurses' perceptions of Inter Specialty Trauma Nursing Rounds to improve trauma patient care-A quality improvement project.

    Science.gov (United States)

    Jennings, Fiona L; Mitchell, Marion

    2017-06-01

    Trauma patient management is complex and challenging for nurses in the Intensive Care Unit. One strategy to promote quality and evidence based care may be through utilising specialty nursing experts both internal and external to the Intensive Care Unit in the form of a nursing round. Inter Specialty Trauma Nursing Rounds have the potential to improve patient care, collaboration and nurses' knowledge. The purpose of this quality improvement project was to improve trauma patient care and evaluate the nurses perception of improvement. The project included structured, weekly rounds that were conducted at the bedside. Nursing experts and others collaborated to assess and make changes to trauma patients' care. The rounds were evaluated to assess the nurse's perception of improvement. There were 132 trauma patients assessed. A total of 452 changes to patient care occurred. On average, three changes per patient resulted. Changes included nursing management, medical management and wound care. Nursing staff reported an overall improvement of trauma patient care, trauma knowledge, and collaboration with colleagues. Inter Specialty Trauma Nursing Rounds utilizes expert nursing knowledge. They are suggested as an innovative way to address the clinical challenges of caring for trauma patients and are perceived to enhance patient care and nursing knowledge. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Effectiveness of hospital-wide methicillin-resistant Staphylococcus aureus (MRSA infection control policies differs by ward specialty.

    Directory of Open Access Journals (Sweden)

    Rosemarie Sadsad

    Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA is a major cause of preventable nosocomial infections and is endemic in hospitals worldwide. The effectiveness of infection control policies varies significantly across hospital settings. The impact of the hospital context towards the rate of nosocomial MRSA infections and the success of infection control is understudied. We conducted a modelling study to evaluate several infection control policies in surgical, intensive care, and medical ward specialties, each with distinct ward conditions and policies, of a tertiary public hospital in Sydney, Australia. We reconfirm hand hygiene as the most successful policy and find it to be necessary for the success of other policies. Active screening for MRSA, patient isolation in single-bed rooms, and additional staffing were found to be less effective. Across these ward specialties, MRSA transmission risk varied by 13% and reductions in the prevalence and nosocomial incidence rate of MRSA due to infection control policies varied by up to 45%. Different levels of infection control were required to reduce and control nosocomial MRSA infections for each ward specialty. Infection control policies and policy targets should be specific for the ward and context of the hospital. The model we developed is generic and can be calibrated to represent different ward settings and pathogens transmitted between patients indirectly through health care workers. This can aid the timely and cost effective design of synergistic and context specific infection control policies.

  6. Perceptions of organizational justice among nurses working in university hospitals of shiraz: a comparison between general and specialty settings.

    Science.gov (United States)

    Hatam, Nahid; Fardid, Mozhgan; Kavosi, Zahra

    2013-12-01

    Justice has gained much attention in social and human studies and has many consequences on employees and the organizations, especially on health system workers such as nurses who are among the key factors in health care systems. The purpose of this study was to investigate perception of organizational justice among nurses in educational hospitals of Shiraz University of Medical Sciences (SUMS), and to compare the results of general and specialty hospitals. In this research, 400 nurses at SUMS hospitals were selected by random sampling method. A 19-item questionnaire was applied to measure distributive, procedural and interactional justice. Data analysis was performed using descriptive statistics, including percentage, frequency, mean, and standard deviation. Also, the t-test and one way ANOVA were used to measure the differences between different hospitals and wards. Of 400 nurses, 66% perceived a high level of organizational justice. In this study the mean scores of total perceived organizational justice (P = 0.035), procedural justice (P = 0.031), and interactional justice (P = 0.046) in specialty hospitals were higher than general ones. Furthermore, the mean score of interactional justice was higher than the other components of organizational justice, respectively 3.58 ± 1.02 for general and 3.76 ± 0.86 for specialty hospitals. Significant differences were observed between overall perceived justice (P = 0.013) and its components (P = 0.024, P = 0.013, and P = 0.036) in different wards. Most nurses who participated in this study had a high perception of organizational justice. The mean score of organizational justice was higher in specialty hospitals. Health care policy makers and hospital managers should support their employees, especially nurses through fairness in distributions, procedures, and interactions.

  7. Specialty-specific admission: a cost-effective intervention?

    LENUS (Irish Health Repository)

    Slattery, E

    2012-02-01

    INTRODUCTION: Cost effectiveness of healthcare has become an important component in its delivery. Current practices need to be assessed and measured for variations that may lead to financial savings. Speciality specific admission is known not only to lead improved clinical outcomes but also to lead important cost reductions. METHODS: All patients admitted to an Irish teaching hospital via the emergency department over a 2-year period with a gastroenterology (GI) related illness were included in this analysis.GI illness was classified using the Disease related grouping (DRG) system. Mean length of stay (LOS) and patient level costing (PLC) were calculated. Differences between DRGs with respect to speciality (i.e. specialist vs. non-specialist) were calculated for the five commonest DRGs. RESULTS: Significant variations in LOS and PLC were demonstrated in the DRGs. Mean LOS varied with increasing complexity, from 3.2 days for non-complex GI haemorrhage to 14.4 days for complex alcohol related cirrhosis as expected. A substantial difference in LOS within DRG groups was demonstrated by large standard deviations in the mean (up to 8.1 days in some groups) and was independent of complexity of cases. PLC also varied widely in both complex and non-complex cases with standard deviations of up to 17,342 noted. Specialty-specific admission was associated with shorter LOS for most GI admissions. CONCLUSION: Significant disparity exists for both LOS and PLC for most GI diagnoses. Specialty-specific admissions are associated with reduced LOS. Specialty-specific admission would appear to be cost-effective which may also lead to improved clinical outcomes.

  8. Access to specialty mental health services among women in California.

    Science.gov (United States)

    Kimerling, Rachel; Baumrind, Nikki

    2005-06-01

    The Anderson behavioral model was used to investigate racial and ethnic disparities in access to specialty mental health services among women in California as well as factors that might account for such disparities. The study was a cross-sectional examination of a probability sample of 3,750 California women. The main indicators of access to services were perceived need, service seeking, and service use. Multivariate models were constructed that accounted for need and enabling and demographic variables. Significant racial and ethnic variations in access to specialty mental health services were observed. African-American, Hispanic, and Asian women were significantly less likely to use specialty mental health services than white women. Multivariate analyses showed that Hispanic and Asian women were less likely than white women to report perceived need, even after frequent mental distress had been taken into account. Among women with perceived need, African-American and Asian women were less likely than white women to seek mental health services after differences in insurance status had been taken into account. Among women who sought services, Hispanic women were less likely than white women to obtain services after adjustment for the effects of poverty. Need and enabling factors did not entirely account for the observed disparities in access to services. Additional research is needed to identify gender- and culture-specific models for access to mental health services in order to decrease disparities in access. Factors such as perceived need and decisions to seek services are important factors that should be emphasized in future studies.

  9. Surgical resident perceptions of trauma surgery as a specialty.

    Science.gov (United States)

    Hadzikadic, Lejla; Burke, Peter A; Esposito, Thomas J; Agarwal, Suresh

    2010-05-01

    Presenting the opinions of surgical residents about the appeal of trauma surgery as a specialty may influence current reform. Survey study. Academic research. General surgery residents (postgraduate years 1-5 and recent graduates) registered with the American College of Surgeons. A 22-item survey. Career plans and perceptions about trauma surgery as a specialty. Of 6006 mailed surveys, we had a 20.1% response rate. Midlevel residents comprised most of the respondents, and most were undecided about their career choice or planned to enter general surgical private practice. The typical residency programs represented were academic (81.7%), urban (90.6%), and level I trauma centers (78.7%), and included more than 6 months of trauma experience (77.6%). Most respondents (70.6%) thought that trauma surgery was unappealing. The most important deterrents to entering the field were lifestyle, poor reimbursement, and limited operating room exposure, while increased surgical critical care was not seen as a restriction. When questioned about the future of trauma surgery, they believed that trauma surgeons should perform elective (86.8%) and nontrauma emergency (91.5%) cases and would benefit from active association with an outpatient clinic (76.0%). Intellectual challenge and exciting nature of the field were listed as the most appealing aspects, and ideal practice characteristics included guaranteed salary and time away from work. As demand for trauma surgeons increases, resident interest has dwindled. As a specialty, trauma surgery must undergo changes that reflect the needs of the incoming generation. We present a sampling of current surgical resident opinion and offer these data to assist the changing discipline and the evolving field of acute care surgery.

  10. Strategies for Introducing Outpatient Specialty Palliative Care in Gynecologic Oncology.

    Science.gov (United States)

    Hay, Casey M; Lefkowits, Carolyn; Crowley-Matoka, Megan; Bakitas, Marie A; Clark, Leslie H; Duska, Linda R; Urban, Renata R; Creasy, Stephanie L; Schenker, Yael

    2017-09-01

    Concern that patients will react negatively to the idea of palliative care is cited as a barrier to timely referral. Strategies to successfully introduce specialty palliative care to patients have not been well described. We sought to understand how gynecologic oncologists introduce outpatient specialty palliative care. We conducted a national qualitative interview study at six geographically diverse academic cancer centers with well-established palliative care clinics between September 2015 and March 2016. Thirty-four gynecologic oncologists participated in semistructured telephone interviews focusing on attitudes, experiences, and practices related to outpatient palliative care. A multidisciplinary team analyzed interview transcripts using constant comparative methods to inductively develop and refine a coding framework. This analysis focuses on practices for introducing palliative care. Mean participant age was 47 years (standard deviation, 10 years). Mean interview length was 25 minutes (standard deviation, 7 minutes). Gynecologic oncologists described the following three main strategies for introducing outpatient specialty palliative care: focus initial palliative care referral on symptom management to dissociate palliative care from end-of-life care and facilitate early relationship building with palliative care clinicians; use a strong physician-patient relationship and patient trust to increase acceptance of referral; and explain and normalize palliative care referral to address negative associations and decrease patient fear of abandonment. These strategies aim to decrease negative patient associations and encourage acceptance of early referral to palliative care specialists. Gynecologic oncologists have developed strategies for introducing palliative care services to alleviate patient concerns. These strategies provide groundwork for developing system-wide best practice approaches to the presentation of palliative care referral.

  11. Residents' views about family medicine specialty education in Turkey

    Directory of Open Access Journals (Sweden)

    Uzuner Arzu

    2010-04-01

    Full Text Available Abstract Background Residents are one of the key stakeholders of specialty training. The Turkish Board of Family Medicine wanted to pursue a realistic and structured approach in the design of the specialty training programme. This approach required the development of a needs-based core curriculum built on evidence obtained from residents about their needs for specialty training and their needs in the current infrastructure. The aim of this study was to obtain evidence on residents' opinions and views about Family Medicine specialty training. Methods This is a descriptive, cross-sectional study. The board prepared a questionnaire to investigate residents' views about some aspects of the education programme such as duration and content, to assess the residents' learning needs as well as their need for a training infrastructure. The questionnaire was distributed to the Family Medicine Departments (n = 27 and to the coordinators of Family Medicine residency programmes in state hospitals (n = 11 by e-mail and by personal contact. Results A total of 191 questionnaires were returned. The female/male ratio was 58.6%/41.4%. Nine state hospitals and 10 university departments participated in the study. The response rate was 29%. Forty-five percent of the participants proposed over three years for the residency duration with either extensions of the standard rotation periods in pediatrics and internal medicine or reductions in general surgery. Residents expressed the need for extra rotations (dermatology 61.8%; otolaryngology 58.6%; radiology 52.4%. Fifty-nine percent of the residents deemed a rotation in a private primary care centre necessary, 62.8% in a state primary care centre with a proposed median duration of three months. Forty-seven percent of the participants advocated subspecialties for Family Medicine, especially geriatrics. The residents were open to new educational methods such as debates, training with models, workshops and e

  12. Factors influencing junior doctors' choices of future specialty: trends over time and demographics based on results from UK national surveys.

    Science.gov (United States)

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

    2015-10-01

    To study trends in factors influencing junior doctors' choice of future specialty. Respondents were asked whether each of 15 factors had a great deal of influence on their career choice, a little influence or no influence on it. Percentages are reported of those who specified that a factor had a great deal of influence on their career choice. UK. A total of 15,765 UK-trained doctors who graduated between 1999 and 2012. Questions about career choices and factors which may have influenced those choices, in particular comparing doctors who qualified in 2008-2012 with those who qualified in 1999-2002. Enthusiasm for and commitment to the specialty was a greater influence on career choice in the 2008-2012 qualifiers (81%) than those of 1999-2002 (64%), as was consideration of their domestic circumstances (43% compared with 20%). Prospects for promotion were less important to recent cohorts (16%) than older cohorts (21%), as were financial prospects (respectively, 10% and 14%). Domestic circumstances and working hours were considered more important, and financial prospects less important, by women than men. Inclination before medical school was rated as important by 41% of doctors who were over 30 years old, compared with 13% of doctors who were under 21, at the time of starting medical school. The increasing importance of both domestic circumstances and enthusiasm for their specialty choice in recent cohorts suggest that today's young doctors prize both work-life balance and personal fulfilment at work more highly than did their predecessors. The differences in motivations of older and younger generations of doctors, men and women, and doctors who start medical school relatively late are worthy of note. © The Royal Society of Medicine.

  13. Exodus of male physicians from primary care drives shift to specialty practice.

    Science.gov (United States)

    Tu, Ha T; O'Malley, Ann S

    2007-06-01

    An exodus of male physicians from primary care is driving a marked shift in the U.S. physician workforce toward medical-specialty practice, according to a national study by the Center for Studying Health System Change (HSC). Two factors have helped mask the severity of the shift--a growing proportion of female physicians, who disproportionately choose primary care, and continued reliance on international medical graduates (IMGs), who now account for nearly a quarter of all U.S. primary care physicians. Since 1996-97, a 40 percent increase in the female primary care physician supply has helped to offset a 16 percent decline in the male primary care physician supply relative to the U.S. population. At the same time, primary care physicians' incomes have lost ground to both inflation and medical and surgical specialists' incomes. And women in primary care face a 22 percent income gap relative to men, even after accounting for differing characteristics. If real incomes for primary care physicians continue to decline, there is a risk that the migration of male physicians will intensify and that female physicians may begin avoiding primary care--trends that could aggravate a predicted shortage of primary care physicians.

  14. Trust and memory: organizational strategies, institutional conditions and trust negotiations in specialty clinics for Alzheimer's disease.

    Science.gov (United States)

    Beard, Renée L

    2008-03-01

    Clinicians aim to establish trust during medical encounters because, without it, health consumers may not seek medical care, consider their diagnoses legitimate, or adhere to treatment regimens. This paper examines the identification and treatment of memory loss within two specialty clinics to understand how cultural dynamics, such as organizational ethos and work practices, influence the social fabric of cognitive evaluations. Ethnographic data suggest important historical and cultural differences in the approaches to Alzheimer's disease (AD). Organizational routines, however, support a common goal, that of moving individuals from "potential patients" to patients, and ultimately research subjects, through establishing trust. Although the processes through which trust is potentially achieved, or the social conditions of trust, were similar at the sites, the object of trust was different. Whereas one clinic encouraged trust in collective medical expertise, the other focused on trust in specific clinicians. These conditions affect the clinical consequences of trust, particularly how and when the diagnosis is delivered, use of the AD label and other terminology, and the level of standardization. The individual consequences include perceptions of patients and depictions of the prognosis. Whether cognitive impairment is viewed as a scientific puzzle to be solved or is seen as a chronic illness significantly shapes the organizational processes of clinical evaluation. Alzheimer's disease, as a cultural object, is a particularly salient exemplar of the clinical negotiation of ambiguous diagnostic categorizations and the unpredictable patient in daily biomedical practice.

  15. Pan African Medical Journal - Vol 5, No 1 (2010)

    African Journals Online (AJOL)

    Specialty preferences among medical students in a Kenyan university · EMAIL FREE ... Current knowledge, attitudes and practices of women on breast cancer and ... Knowledge and practice of prevention of mother-to-child transmission of HIV ...

  16. assessment of emergency medical services in the ashanti region of ...

    African Journals Online (AJOL)

    2015-09-01

    Sep 1, 2015 ... trauma and burn care, and various medical and surgical sub-specialties. The mission ..... equipment (bag valve mask, face mask, nasal cannu- lae), an .... which legally empowered the publicly-operated Na- tional Ambulance ...

  17. Prevalence of dry eye syndrome in residents of surgical specialties.

    Science.gov (United States)

    Castellanos-González, José Alberto; Torres-Martínez, Verónica; Martínez-Ruiz, Adriana; Fuentes-Orozco, Clotilde; Rendón-Félix, Jorge; Irusteta-Jiménez, Leire; Márquez-Valdez, Aída Rebeca; Cortés-Lares, José Antonio; González-Ojeda, Alejandro

    2016-07-16

    The aim of this study was to determine the prevalence and severity of dry eye syndrome in a group of Mexican residents of different surgical specialties. A cross-sectional descriptive study where the residents were studied using the Ocular Surface Disease Index, together with diagnostic tests for dry eye syndrome, such as tear breakup time, Oxford Schema, Schirmer's test I, and meibomian gland dysfunction testing. Statistical analyses were performed by Pearson's chi-squared test for categorical variables and student's t-test for quantitative variables. Any P value eyes); 90 (73 %) were male and 33 (27 %) were female. The mean age was 27.8 ± 2.1 years. A higher number of residents with dry eye syndrome was found in the cardiothoracic surgery (75 %) and otorhinolaryngology (71 %) specialties; 70 % of them reported ocular symptoms, with teardrop quality involvement in >50 % of them. We found a prevalence of 56 % for mild-to-moderate/severe stages of the condition. Their presence in the operating room predisposes surgical residents to dry eye syndrome because of environmental conditions.

  18. Oral health in Brazil - Part II: Dental Specialty Centers (CEOs

    Directory of Open Access Journals (Sweden)

    Vinícius Pedrazzi

    2008-08-01

    Full Text Available The concepts of health promotion, self-care and community participation emerged during the 1970s and, since then, their application has grown rapidly in the developed world, showing evidence of effectiveness. In spite of this, a major part of the population in the developing countries still has no access to specialized dental care such as endodontic treatment, dental care for patients with special needs, minor oral surgery, periodontal treatment and oral diagnosis. This review focuses on a program of the Brazilian Federal Government named CEOs (Dental Specialty Centers, which is an attempt to solve the dental care deficit of a population that is suffering from oral diseases and whose oral health care needs have not been addressed by the regular programs offered by the SUS (Unified National Health System. Literature published from 2000 to the present day, using electronic searches by Medline, Scielo, Google and hand-searching was considered. The descriptors used were Brazil, Oral health, Health policy, Health programs, and Dental Specialty Centers. There are currently 640 CEOs in Brazil, distributed in 545 municipal districts, carrying out dental procedures with major complexity. Based on this data, it was possible to conclude that public actions on oral health must involve both preventive and curative procedures aiming to minimize the oral health distortions still prevailing in developing countries like Brazil.

  19. The demand for ambulatory mental health services from specialty providers.

    Science.gov (United States)

    Horgan, C M

    1986-01-01

    A two-part model is used to examine the demand for ambulatory mental health services in the specialty sector. In the first equation, the probability of having a mental health visit is estimated. In the second part of the model, variations in levels of use expressed in terms of visits and expenditures are examined in turn, with each of these equations conditional on positive utilization of mental health services. In the second part of the model, users are additionally grouped into those with and without out-of-pocket payment for services. This specification accounts for special characteristics regarding the utilization of ambulatory mental health services: (1) a large part of the population does not use these services; (2) of those who use services, the distribution of use is highly skewed; and (3) a large number of users have zero out-of-pocket expenditures. Cost-sharing does indeed matter in the demand for ambulatory mental health services from specialty providers; however, the decision to use mental health services is affected by the level of cost-sharing to a lesser degree than is the decision regarding the level of use of services. The results also show that price is only one of several important factors in determining the demand for services. The lack of significance of family income and of being female is notable. Evidence is presented for the existence of bandwagon effects. The importance of Medicaid in the probability of use equations is noted. PMID:3721874

  20. High prevalence of sexual dysfunction in a vulvovaginal specialty clinic

    Science.gov (United States)

    Gordon, Dina; Gardella, Carolyn; Eschenbach, David; Mitchell, Caroline M.

    2014-01-01

    Objective Our study evaluated the presence and predictors of sexual dysfunction in a vulvovaginal specialty clinic population. Materials & Methods Women who presented to a vulvovaginal specialty clinic were eligible to enroll. Participants completed a questionnaire, including Female Sexual Function Index (FSFI) to assess sexual dysfunction and Patient Health Questionnaire (PHQ)-9 depression screen, and underwent a standardized physical exam, with vaginal swabs collected for wet mount and culture. Logistic regression assessed the relationship between sexual dysfunction and clinical diagnosis. Results We enrolled 161 women, aged 18–80 years (median = 36), presenting with vulvovaginal complaints. Median symptom duration was 24 months; 131 women (81%) reported chronic symptoms (≥12 months). By PHQ-9, 28 (17%) women met depression criteria. In the month prior to assessment, 86 (53%) women experienced sexual dysfunction. Women were primarily diagnosed with vaginitis (n = 46, 29%), vestibulodynia/vulvitis (n = 70; 43%), lichen planus or lichen sclerosus (n = 24; 15%). Controlling for age, sexual dysfunction did not correlate with chronic symptoms (IRR 0.86, 95% CI 0.50–1.48), depression (IRR 1.24; 95% CI 0.59, 2.58), or presence of any of the three main diagnoses (IRR 1.16, 95% CI 0.47, 2.88). Discussion Sexual dysfunction is present in over half of women presenting to a vulvovaginitis referral clinic, more than twice the rate in the wider population. PMID:25259664

  1. Specialty Training's Organizational Readiness for curriculum Change (STORC): validation of a questionnaire.

    Science.gov (United States)

    Bank, Lindsay; Jippes, Mariëlle; Leppink, Jimmie; Scherpbier, Albert Jja; den Rooyen, Corry; van Luijk, Scheltus J; Scheele, Fedde

    2018-01-01

    The field of postgraduate medical education (PGME) is continuously evolving as a result of social demands and advancing educational insights. Change experts contend that organizational readiness for change (ORC) is a critical precursor for successful implementation of change initiatives. However, in PGME, assessing change readiness is rarely considered while it could be of great value for managing educational change such as curriculum change. Therefore, in a previous Delphi study the authors developed an instrument for assessing ORC in PGME: Specialty Training's Organizational Readiness for curriculum Change (STORC). In this study, the psychometric properties of this questionnaire were further explored. In 2015, STORC was distributed among clinical teaching teams in the Netherlands. The authors conducted a confirmatory factor analysis on the internal factor structure of STORC. The reliability of the measurements was estimated by calculating Cronbach's alpha for all sub-scales. Additionally, a behavioral support-for-change measure was distributed as well to assess correlations with change-related behavior. In total, the STORC questionnaire was completed by 856 clinical teaching team members from 39 specialties. Factor analysis led to the removal of 1 item but supported the expected factor structure with very good fit for the other 43 items. Supportive behavior was positively correlated to a higher level of ORC. In this study, additional steps to collect validity evidence for the STORC questionnaire were taken successfully. The final subscales of STORC represent the core components of ORC in the literature. By breaking down this concept into multiple measurable aspects, STORC could help to enable educational leaders to diagnose possible hurdles in implementation processes and to perform specifically targeted interventions when needed.

  2. FEATURES OF THE HIGHEST QUALIFICATION IN THE SPECIALTY «INFORMATION AND COMMUNICATION TECHNOLOGIES IN EDUCATION»

    OpenAIRE

    O.M. Spirin; A.V. Iatsyshyn

    2013-01-01

    The paper analyzes the prerequisites for developing and becoming of new specialty 13.00.10 – information and communication technology in education. The features of training of the high-qualified specialists at the Institute of information technologies and learning tools of NAPS of Ukraine are examined. The subjects of dissertations on new specialty, are studied the respective research directions in new specialty are defined. The features of the formulation of scientific and categorical appara...

  3. Abstracts of the Canadian Society for Civil Engineering annual conference including the general conference, the 1. international structural specialty conference, the 1. international construction specialty conference, and the 1. specialty conference on disaster mitigation : towards a sustainable future

    International Nuclear Information System (INIS)

    El-Badry, M.; Loov, R.E.; Ruwanpura, J.; El-Hacha, R.; Kroman, J.; Rankin, J.

    2006-01-01

    This conference provided a forum for national and international practicing engineers, researchers and technical experts to discuss sustainable solutions to infrastructure development. Discussions focused on recent developments in new technologies for building more economic and sustainable infrastructure, while improving the safety of buildings, bridges, roads, water supply and sewage treatment systems. The conference was held in conjunction with associated specialty conferences, including a first international structures specialty conference, a first international construction specialty conference, and a first specialty conference on disaster mitigation. This book of abstracts highlights all the specialty conferences and accompanies a CD-ROM that has the full text of all the papers. Manuscripts of the full papers submitted to the specialty conferences were peer-reviewed by international scientific committees. The general conference provided a forum to learn about new technologies and future directions in various areas of civil engineering. It included a special theme session on sustainable development and a special session on innovation and information technology. Other technical sessions focused on topics such as civil engineering history and education; infrastructure management and renewal; asset management; risk assessment and management; engineering materials and mechanics; environmental engineering and science; hydrotechnical engineering; cold region engineering; and, transportation engineering. The general conference featured 88 presentations, of which 15 have been catalogued separately for inclusion in this database

  4. [The scientometric analysis of dissertation studies in the field of specialty public health and health care concerning children population].

    Science.gov (United States)

    Albitskiy, V S; Ustinova, N V; Antonova, Ye V

    2014-01-01

    The article considers trends and priority directions of research studies of the field of public health and health care of children population. The interpretative content analysis was applied to study dissertations in the field of public health and health care in 1991-2012. The sampling included 4194 units of information. The first stage of study established that problems of children population are considered in 14.8% dissertations defended on the mentioned specialty. The next stage the categories of content-analysis were examined. They were divided on the following axes: axis I "Main problem of study", axis II "Localization of study", axis III "Examined age groups", axis IV "Distribution of studies on gender of examined contingent", axis V "Examined contingent", axis VI "Additional medical specialty". It is established that in dissertations on public health and health care of children population on axis I prevails organizational subject matter (27.2%). The health condition of various contingents of children population (16.8%), preventive aspects of pediatrics (12.2%), examination of particular conditions/diseases/classes of diseases (10.8%) are fixed as priority directions. In the most dissertations the regional character of studies is presented (98.2%). The prevailing age group in studies is the adolescent group (19.9%). The inter-disciplinary relationships of dissertations on problems of public health and health care of children population are revealed with such specialties as "Pediatrics" (16.2%), "Obstetrics and gynecology" (3.8%) and "Hygiene" (3.4%). With consideration for recognition of health promotion and optimization of health care of children population as priority directions of public health policy amount of research studies in this field is to be admitted as inadequate. With purpose of optimization of scientific knowledge and development of system of medical social care to children population it is needed to promote research studies of problems of

  5. 40 CFR 407.80 - Applicability; description of the canned and miscellaneous specialties subcategory.

    Science.gov (United States)

    2010-07-01

    ... ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS CANNED AND PRESERVED FRUITS AND VEGETABLES PROCESSING POINT SOURCE CATEGORY Canned and Miscellaneous Specialties Subcategory § 407.80...

  6. The research on teaching reformation of photoelectric information science and engineering specialty experiments

    Science.gov (United States)

    Zhu, Zheng; Yang, Fan; Zhang, Yang; Geng, Tao; Li, Yuxiang

    2017-08-01

    This paper introduced the idea of teaching reformation of photoelectric information science and engineering specialty experiments. The teaching reformation of specialty experiments was analyzed from many aspects, such as construction of specialized laboratory, experimental methods, experiment content, experiment assessing mechanism, and so on. The teaching of specialty experiments was composed of four levels experiments: basic experiments, comprehensive and designing experiments, innovative research experiments and engineering experiments which are aiming at enterprise production. Scientific research achievements and advanced technology on photoelectric technology were brought into the teaching of specialty experiments, which will develop the students' scientific research ability and make them to be the talent suitable for photoelectric industry.

  7. Design and Implementation of the Automatic Assessment System for the Command and Control Specialty in Ships

    Directory of Open Access Journals (Sweden)

    Zhang Hao

    2017-01-01

    Full Text Available On the basis of analyzing the actual demand of automated assessment system for the command and control specialty in ships, the thought of the overall design of automated assessment system for the command and control specialty in ships is given, and the concrete realization methods of the user login module, test paper operation module and system maintenance module are studied and demonstrated. The proposed design idea and implementation method of automated assessment system for the command and control specialty in ships is scientific, efficient and practical, and provides reference for the exploitation of automated assessment system for the command and control specialty in ships.

  8. Medical radiation physics in Bulgaria

    International Nuclear Information System (INIS)

    Todorov, V.; Vasileva, G.

    1999-01-01

    In Bulgaria medical radiation physics in not yet on a world level. The number of medical physicists working in diagnostic and therapeutic centres is low. Comparatively good is the situation of medical physics in the areas of therapy and radiation protection. But the role of physics in medicine is underestimated as a whole, because of subjective reasons. At the other hand the education in this area is good and very professional. Since 1992 there has been established a specialty 'medical physics' in University of Shoumen and since 1997 the same specialty exists in Sofia University. The situation is expected to be approved with reorganization of the Health System in Bulgaria with compliance with the European standards

  9. The taste transformation ritual in the specialty coffee market

    Directory of Open Access Journals (Sweden)

    Ronan Torres Quintão

    2017-10-01

    Full Text Available Although the consumer culture field has addressed the role of ritual processes in consumption, no research has yet identified how connoisseur consumers, through ritual practices, establish and manipulate their distinction from other consumers. Drawing on key concepts from ritual theory, this research addresses the role played by ritual in connoisseurship consumption and consumers’ taste. In conducting an ethnographic study on connoisseurship consumption, the first author immersed himself in the North American specialty coffee context—Toronto, Montreal, Seattle, and New York—from August 2013 to July 2014. He used long interviews and participant observation to collect data, which was then interpreted using a hermeneutic approach. We introduce the taste transformation ritual, theorizing the process that converts regular consumers into connoisseur consumers by establishing and reinforcing differences between mass and connoisseurship consumption. We develop a broader theoretical account that builds on consumption ritual and taste formation.

  10. Veteran satisfaction and treatment preferences in response to a posttraumatic stress disorder specialty clinic orientation group.

    Science.gov (United States)

    Schumm, Jeremiah A; Walter, Kristen H; Bartone, Anne S; Chard, Kathleen M

    2015-06-01

    To maximize accessibility to evidence-based treatments for posttraumatic stress disorder (PTSD), the United States Department of Veterans Affairs (VA) has widely disseminated cognitive processing therapy (CPT) and prolonged exposure (PE) therapy to VA clinicians. However, there is a lack of research on veteran preferences when presented with a range of psychotherapy and medication options. This study uses a mixed-method approach to explore veteran satisfaction with a VA PTSD specialty clinic pre-treatment orientation group, which provides education about available PTSD treatment options. This study also tested differences in treatment preference in response to the group. Participants were 183 US veterans. Most were White, male, and referred to the clinic by a VA provider. Results indicated high satisfaction with the group in providing an overview of services and helping to inform treatment choice. Most preferred psychotherapy plus medications (63.4%) or psychotherapy only (30.1%). Participants endorsed a significantly stronger preference for CPT versus other psychotherapies. PE was significantly preferred over nightmare resolution therapy and present-centered therapy, and both PE and cognitive-behavioral conjoint therapy were preferred over virtual reality exposure therapy. Results suggest that by informing consumers about evidence-based treatments for PTSD, pre-treatment educational approaches may increase consumer demand for these treatment options. Published by Elsevier Ltd.

  11. Consumer interest in specialty beers in three European markets.

    Science.gov (United States)

    Donadini, G; Fumi, M D; Kordialik-Bogacka, E; Maggi, L; Lambri, M; Sckokai, P

    2016-07-01

    This study explores the quality perception of specialty beers (SBs) in Italy, Spain and Poland. Five-hundred and fifty mainstream beer consumers were enrolled in this study (two-hundred and thirty Italians, one hundred and sixty Poles and Spaniards respectively). The authors adopted a conjoint rating experiment in which the respondents were given forty SB profiles to evaluate. Each profile was described on six attributes (malt type, adjuncts, alternative source of sugars, characterizing ingredients, sensory characteristics, and retail price) varied at different levels and were asked to state his/her preference for each profile on a 9-point scale of interest. The results of this study showed that the ideal SB: (1) for the aggregate Polish panel is brewed from malted wheat, raw wheat, honey, and tropical fruits, is alcoholic and is priced below 2.00 Euros; (2) for the aggregate Italian panel consists of a beer brewed from malted wheat, maize, honey, and vanilla, is blonde and costs a maximum of 2.00 Euros; (3) for the aggregate Spanish panel is brewed from malted wheat, rye or maize, vanilla, is fruity and is priced below 2.00 Euros. The heterogeneity of interest in specialty beers observed in the three countries under test requires for the adaptation of a SB specifically to each culture in which it is sold. In this process of customization, brewers must take into account that gender modulates the effect of culture on consumer interest in SB sensory characteristics and ingredient formulation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Role of emergency department of a super specialty government hospital during a seasonal dengue epidemic in a developing country: A conundrum

    Directory of Open Access Journals (Sweden)

    Hem Chandra

    2013-01-01

    Full Text Available Main objectives of this study were to establish the role of the emergency department of an exclusive super specialty tertiary care hospital during a seasonal epidemic such as dengue and to further estimate the opportunity cost involved in treating such dengue patients. Retro-prospective six months study at the Emergency Receiving Station of a Super Specialty Government Hospital was done in India. 294 dengue patients were managed during the study period. 38% of these were cured in the Emergency Department itself where the treatment was given by an Emergency Medical Officer, a plain medical graduate. The average retention period of the dengue patients was significantly higher than that of the rest of the patients visiting the emergency (p=0.001. Treatment of the 294 dengue patients was achieved at an opportunity cost of 8 genuine super- specialty emergency patients per day. Dengue, being a seasonal epidemic in the developing world, assiduous measures are imperative to prevent any such recurrence. Health authorities should be more proactive to preclude such a situation, detrimental to the very concepts of regionalization of the healthcare delivery system and should disseminate correct timely information to the public vis-à-vis availability and requirement of medical services during such seasonal epidemics.

  13. Role of emergency department of a super specialty government hospital during a seasonal dengue epidemic in a developing country: A conundrum

    Directory of Open Access Journals (Sweden)

    Hem Chandra

    2013-11-01

    Full Text Available Main objectives of this study were to establish the role of the emergency department of an exclusive super specialty tertiary care hospital during a seasonal epidemic such as dengue and to further estimate the opportunity cost involved in treating such dengue patients. Retro-prospective six months study at the Emergency Receiving Station of a Super Specialty Government Hospital was done in India. 294 dengue patients were managed during the study period. 38% of these were cured in the Emergency Department itself where the treatment was given by an Emergency Medical Officer, a plain medical graduate. The average retention period of the dengue patients was significantly higher than that of the rest of the patients visiting the emergency (p=0.001. Treatment of the 294 dengue patients was achieved at an opportunity cost of 8 genuine super-specialty emergency patients per day. Dengue, being a seasonal epidemic in the developing world, assiduous measures are imperative to prevent any such recurrence. Health authorities should be more proactive to preclude such a situation, detrimental to the very concepts of regionalization of the healthcare delivery system and should disseminate correct timely information to the public vis-à-vis availability and requirement of medical services during such seasonal epidemics.

  14. Medical school type and physician income.

    Science.gov (United States)

    Weeks, William B; Wallace, Tanner A

    2008-01-01

    We wanted to determine whether the type of medical school attended--private US, public US, or foreign medical school--is associated with practice characteristics or incomes of physicians. Therefore, we used survey responses obtained during the 1990s from 10,436 actively practicing white male physicians who worked in one of 13 medical specialties and who graduated from a public US (5,702), private US (3,797), or international (937) medical school. We used linear regression modeling to determine the association between type of medical school attended and physicians' annual incomes after controlling for specialty, work hours, provider characteristics, and practice characteristics. We found that, for most specialties, international medical school graduates worked longer hours, were less likely to be board certified, had practiced medicine for fewer years, and were less likely to work in rural settings than US medical school graduates. After controlling for key variables, international medical school graduates' annual incomes were 2.6 percent higher (95% CI: 0.1%, 4.4%, p = .043) and public US medical school graduates' were 2.2 percent higher (95% CI: -0.9% -6.1%, p = 0.2) than private US medical school graduates' incomes. Because of their lower tuition expenses, international and public US medical school graduates may experience higher returns on educational investment than their counterparts who graduated from private US medical schools.

  15. In-gap discounts in Medicare Part D and specialty drug use.

    Science.gov (United States)

    Jung, Jeah; Xu, Wendy Yi; Cheong, Chelim

    2017-09-01

    Specialty drugs can bring significant benefits to patients, but they can be expensive. Medicare Part D plans charge relatively high cost-sharing costs for specialty drugs. A provision in the Affordable Care Act reduced cost sharing in the Part D coverage gap phase in an attempt to mitigate the financial burden of beneficiaries with high drug spending. We examined the early impact of the Part D in-gap discount on specialty cancer drug use and patients' out-of-pocket (OOP) spending. Natural experimental design. We compared changes in outcomes before and after the in-gap discount among beneficiaries with and without low-income subsidies (LIS). Beneficiaries with LIS, who were not affected by the in-gap discount, made up the control group. We studied a random sample of elderly standalone prescription drug plan enrollees with relatively uncommon cancers (eg, leukemia, skin, pancreas, kidney, sarcomas, and non-Hodgkin lymphoma) between 2009 and 2013. We constructed 4 outcome variables annually: 1) use of any specialty cancer drug, 2) the number of specialty cancer drug fills, 3) total specialty drug spending, and 4) OOP spending for specialty cancer drugs. The in-gap discount did not influence specialty cancer drug use, but reduced annual OOP spending for specialty cancer drugs among users without LIS by $1108. In-gap discounts in Part D decreased patients' financial burden to some extent, but resulted in no change in specialty drug use. As demand for specialty drugs increases, it will be important to ensure patients' access to needed drugs, while simultaneously reducing their financial burden.

  16. Tacit knowledge and visual expertise in medical diagnostic reasoning: implications for medical education

    DEFF Research Database (Denmark)

    Heiberg Engel, Peter Johan

    2008-01-01

    BACKGROUND: Much education--especially at the university level--has been criticized for having primarily dealt with explicit knowledge, i.e. those aspects of mental activities, which are verbal and conscious. Furthermore, research in medical diagnostic reasoning has been criticized for having...... focused on the specialty of intern medicine, while specialties with other skills, i.e. perceptive skills within pathology and radiology, have been ignored. AIMS: To show that the concept of tacit knowledge is important in medical education-at all levels and in medical diagnostic reasoning. METHODS...... such as "non-analytical reasoning" and "dual process of reasoning." CONCLUSION: It is important that educators are trained in how explicit and implicit knowledge is attained and that tacit knowledge is included in educational programmes of all medical specialties....

  17. A network of Pediatric Environmental Health Specialty Units (PEHSUs: Filling a critical gap in the health care system

    Directory of Open Access Journals (Sweden)

    Christine M. Zachek

    2012-09-01

    Full Text Available A network of pediatric environmental health specialty units (PEHSUs in the United States was formed in 1998 out of a recognized need for clinical expertise in children’s environmental health. Documented trends in a rise of pediatric diseases caused or exacerbated by environmental conditions, coupled with the failure of medical schools and residency programs to cover these issues in a significant way, leaves health care providers, parents, communities, and governments at a loss for this specialized knowledge. The PEHSUs fill this gap by providing: 1 medical education, 2 general outreach and communications, and 3 consultative services to communities and health care professionals. This paper presents examples of key situations where PEHSU involvement was instrumental in improved patient outcomes or advancing clinical expertise in children’s environmental health. Challenges and opportunities for future directions for the program are also discussed.

  18. Specialized consulting in radiological safety to the south central hospital of high specialty, PEMEX. VI. December of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J.A.; Garcia A, J.; Rodriguez A, F.

    2002-01-01

    It is a report of a specialized consulting in radiological safety that to be carried the ININ to PEMEX for the South Central Hospital of High Specialty, to maintain the sanitary license for the use of X-ray equipment of medical diagnostic, and guarantee these services with a program of quality assurance. To give fulfilment to that requests it is programmed a technical assistance monthly, with reports of results during the development of the service. In this document it is carried a report of the advances and results in the month of december of the 2001, where the following documents are analyzed: Manual of radiological safety, program of quality assurance, operation procedures, procedure of maintenance team, procedure of medical radiological control of the specialized personnel; also are annotate the obtained results and their observations. (Author)

  19. Specialized consulting in radiological safety to the North Central Hospital of high specialty, PEMEX. V. November of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F.

    2002-01-01

    It is a report of a specialized consulting in radiological safety that to be carried the ININ to PEMEX for the North Central Hospital of High Specialty, to maintain the sanitary license for the use of X ray equipment of medical diagnostic, and guarantee these services with a program of quality assurance. To give fulfilment to that requests it is programmed a technical assistance monthly, with reports of results during the development of the service. In this document it is carried a report of the advances and results in the month of November of the 2001, where the following documents are analyzed: Manual of radiological safety, program of quality assurance, operation procedures, procedure of maintenance team, procedure of medical radiological control of the specialized personnel; also are annotate the obtained results and their observations. (Author)

  20. An overview of medical informatics education in China.

    Science.gov (United States)

    Hu, Dehua; Sun, Zhenling; Li, Houqing

    2013-05-01

    To outline the history of medical informatics education in the People's Republic of China, systematically analyze the current status of medical informatics education at different academic levels (bachelor's, master's, and doctoral), and suggest reasonable strategies for the further development of the field in China. The development of medical informatics education was divided into three stages, defined by changes in the specialty's name. Systematic searches of websites for material related to the specialty of medical informatics were then conducted. For undergraduate education, the websites surveyed included the website of the Ministry of Education of the People's Republic of China (MOE) and those of universities or colleges identified using the baidu.com search engine. For postgraduate education, the websites included China's Graduate Admissions Information Network (CGAIN) and the websites of the universities or their schools or faculties. Specialties were selected on the basis of three criteria: (1) for undergraduate education, the name of specialty or program was medical informatics or medical information or information management and information system; for postgraduate education, medical informatics or medical information; (2) the specialty was approved and listed by the MOE; (3) the specialty was set up by a medical college or medical university, or a school of medicine of a comprehensive university. The information abstracted from the websites included the year of program approval and listing, the university/college, discipline catalog, discipline, specialty, specialty code, objectives, and main courses. A total of 55 program offerings for undergraduate education, 27 for master's-level education, and 5 for PhD-level education in medical informatics were identified and assessed in China. The results indicate that medical informatics education, a specialty rooted in medical library and information science education in China, has grown significantly in that

  1. Study on the Higher Vocational and Professional Specialty Ability Module of "Construction Management"

    Science.gov (United States)

    Gao, Qun

    2008-01-01

    The higher vocational and professional specialty of "construction management" of China begun late, and the talent training mode of various colleges are different, especially the analysis to the specialty ability modules on the higher vocational and professional layer is not mature. In this article, combining with the practice of Manjing…

  2. Formation of Professional Competence of Legal Specialty Students in the Elective Courses Studying

    Science.gov (United States)

    Akhmejanova, Gulnara; Olzhabayev, Bulat; Grigoryeva, Roza; Karibaeva, Zhanara; Avilkhan, Akmamyk; Sakenov, Janat

    2016-01-01

    This article examines the scientific problem of the formation of professional competence of legal specialty students in the elective courses studying. The analysis has been conducted and the content of professional competence of legal specialty students has been substantiated. This work substantiates the role of elective courses in the formation…

  3. The impact of endovascular repair on specialties performing abdominal aortic aneurysm repair

    NARCIS (Netherlands)

    K.H.J. Ultee (Klaas); R. Hurks (Rob); D.B. Buck (Dominique B.); G.S. Dasilva (George S.); P.A. Soden (Peter A.); J.A. van Herwaarden (Joost); H.J.M. Verhagen (Hence); M.L. Schermerhorn (Marc)

    2015-01-01

    textabstractBackground Abdominal aortic aneurysm (AAA) repair has been performed by various surgical specialties for many years. Endovascular aneurysm repair (EVAR) may be a disruptive technology, having an impact on which specialties care for patients with AAA. Therefore, we examined the proportion

  4. 27 CFR 6.84 - Point of sale advertising materials and consumer advertising specialties.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Point of sale advertising materials and consumer advertising specialties. 6.84 Section 6.84 Alcohol, Tobacco Products and Firearms....84 Point of sale advertising materials and consumer advertising specialties. (a) General. The act by...

  5. 77 FR 40353 - Onyx Specialty Papers, Inc; Notice of Availability of Environmental Assessment

    Science.gov (United States)

    2012-07-09

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 2985-008 Massachusetts] Onyx Specialty Papers, Inc; Notice of Availability of Environmental Assessment In accordance with the...), Commission staff has reviewed the Onyx Specialty Papers, Inc.'s application for surrender of project license...

  6. Embracing a competency-based specialty curriculum for community-based nursing roles.

    Science.gov (United States)

    Levin, Pamela F; Swider, Susan M; Breakwell, Susan; Cowell, Julia M; Reising, Virginia

    2013-01-01

    The Quad Council competencies for public health nursing (PHN) provide guidance in developing curricula at both the generalist and specialist level. However, these competencies are based on nursing roles in traditional public health agencies and community/public health is defined more broadly than official agency practice. The question arises as to whether community-based specialties require largely the same knowledge and skill set as PHN. The purpose of the competency cross-mapping project reported here was to (a) assess the intersection of the Quad Council competencies with four community-based specialties and (b) ensure the appropriateness of a Quad Council-based curriculum to prepare graduates across these four specialties (home health, occupational health, environmental health, and school nursing). This article details the multistep cross-mapping process, including validation with practice leaders. Results indicate strong alignment of community-based specialty competencies with Quad Council competencies. Community-based specialty-specific content that did not align well is identified, along with examples of didactic and clinical strategies to address gaps. This work indicates that a Quad Council-based curriculum is appropriate to prepare graduates in community-based specialties when attention to the specialty-specific competencies in the clinical setting is included. This work guides the development of a doctorate of nursing practice curriculum in PHN, encompassing the four additional community-based specialties. © 2013 Wiley Periodicals, Inc.

  7. The impact of endovascular repair on specialties performing abdominal aortic aneurysm repair

    NARCIS (Netherlands)

    Ultee, Klaas H J; Hurks, Rob; Buck, Dominique B.; Dasilva, George S.; Soden, Peter A.; Van Herwaarden, Joost A.; Verhagen, Hence J M; Schermerhorn, Marc L.

    2015-01-01

    Background Abdominal aortic aneurysm (AAA) repair has been performed by various surgical specialties for many years. Endovascular aneurysm repair (EVAR) may be a disruptive technology, having an impact on which specialties care for patients with AAA. Therefore, we examined the proportion of AAA

  8. Dental specialty, career preferences and their influencing factors among final year dental students in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Hassan Suliman Halawany

    2017-01-01

    Conclusion: The results of this study show the top preferred specialties and career choices which can be a baseline for establishing national policies and for the improvement of graduate programs. There seems to be a need to promote mentoring activities and provide guidance and encouragement to pre-doctoral dental students in selecting the most appropriate specialty within their capability domain.

  9. Do financial incentives linked to ownership of specialty hospitals affect physicians' practice patterns?

    Science.gov (United States)

    Mitchell, Jean M

    2008-07-01

    Although physician-owned specialty hospitals have become increasingly prevalent in recent years, little research has examined whether the financial incentives linked to ownership influence physicians' referral rates for services performed at the specialty hospital. We compared the practice patterns of physician owners of specialty hospitals in Oklahoma, before and after ownership, to the practice patterns of physician nonowners who treated similar cases over the same time period in Oklahoma markets without physician-owned specialty hospitals. We constructed episodes of care for injured workers with a primary diagnosis of back/spine disorders. We used pre-post comparisons and difference-in-differences analysis to evaluate changes in practice patterns for physician owners and nonowners over the time period spanned by the entry of the specialty hospital. Findings suggest the introduction of financial incentives linked to ownership coincided with a significant change in the practice patterns of physician owners, whereas such changes were not evident among physician nonowners. After physicians established ownership interests in a specialty hospital, the frequency of use of surgery, diagnostic, and ancillary services used in the treatment of injured workers with back/spine disorders increased significantly. Physician ownership of specialty hospitals altered the frequency of use for an array of procedures rendered to patients treated at these hospitals. Given the growth in physician-owned specialty hospitals, these findings suggest that health care expenditures will be substantially greater for patients treated at these institutions relative to persons who obtain care from nonself-referral providers.

  10. 75 FR 27536 - Notice of the Specialty Crop Committee's Stakeholder Listening Session

    Science.gov (United States)

    2010-05-17

    ... Stakeholder Listening Session AGENCY: Research, Education, and Economics, USDA. ACTION: Notice of stakeholder... United States Department of Agriculture announces a stakeholder listening session of the Specialty Crop... Advisory Board (NAREEE). DATES: The Specialty Crop Committee will hold the stakeholder listening session on...

  11. 75 FR 32735 - Notice of the Specialty Crop Committee's Stakeholder Listening Session

    Science.gov (United States)

    2010-06-09

    ... Stakeholder Listening Session AGENCY: Research, Education, and Economics, USDA. ACTION: Notice of stakeholder... United States Department of Agriculture announces a stakeholder listening session of the Specialty Crop... Advisory Board (NAREEE). DATES: The Specialty Crop Committee will hold the stakeholder listening session on...

  12. Marketing of specialty forest products in the southeast: opportunities for research, education and outreach (poster abstract)

    Science.gov (United States)

    A.L. Hammett; J.L. Chamberlain

    1999-01-01

    The specialty forest products sector in the Southeast is growing rapidly - perhaps faster than in other sections of the country. In 1993, the state of Virginia exported almost 10 percent of the national total of wild harvested ginseng. On a yearly basis, the value of the specialty forest products extracted from Virginia?s forests has been estimated at $35 million. The...

  13. Careers in medicine at Vanderbilt University School of Medicine: an innovative approach to specialty exploration and selection.

    Science.gov (United States)

    Sweeney, Kyle R; Fritz, Ryan A; Rodgers, Scott M

    2012-07-01

    Research on resident attrition rates suggests that medical students would benefit from more comprehensive career advising programs during medical school. Responding to this need, students and administrators at the Vanderbilt University School of Medicine (Vanderbilt) introduced a broad Careers in Medicine (CiM) program in 2005 to complement the CiM resources offered by the Association of American Medical Colleges (AAMC). In this article, the authors detail the Vanderbilt CiM program's four core components: career-related events, an elective course, specialty interest groups, and career advising. The authors discuss the program's implementation and its student-led organizational structure, and they provide a critical assessment of important lessons learned. Using data from internal satisfaction surveys and the AAMC's Medical School Graduation Questionnaire (GQ), they demonstrate the success of Vanderbilt's career counseling efforts. According to recent GQ data, Vanderbilt ranks above the U.S. medical school average on graduating students' ratings of overall satisfaction with career services and of the usefulness of key programming. The authors present this description of the Vanderbilt CiM model as a framework for other medical schools to consider adopting or adapting as they explore options for expanding their own career counseling services.

  14. Educational debt: does it have an influence on initial job location and specialty choice?

    Science.gov (United States)

    Snyder, Jennifer; Nehrenz, Guy; Danielsen, Randy; Pedersen, Donald

    2014-01-01

    This study applied a quantitative design and analyzed the impact of educational debt on initial specialty and location choices for physician assistant (PA) graduates in Indiana. PAs who graduated between January 1, 2000, and December 31, 2010, and actively practice in Indiana were surveyed. Descriptive statistics and chi-square analyses were performed to determine whether any significant relationships existed among practice specialty, location, and gender. 157 participants (33%) responded to the survey and were considered in the final analysis. Males were more likely than females to be influenced by debt in choosing their specialty and the location of their initial job. A majority of PAs would have reconsidered rural practice if they had received federal and or state loan forgiveness for educational debt. This study provides evidence that debt may influence practice specialty and location choice. Further studies are needed to determine how gender might account for decisions to practice in certain specialties and location.

  15. Perception of final year medical students about the choice of ...

    African Journals Online (AJOL)

    Background: In Nigeria and many other countries, many specialties had problems with recruitment of medical teachers outside the core clinical departments. Objective: We aim at determining the factors that influence the choice of medical microbiology as a speciality among final year medical students in University of ...

  16. Becoming a general practitioner - Which factors have most impact on career choice of medical students?

    OpenAIRE

    Loh Andreas; Hermann Katja; Miksch Antje; Kiolbassa Kathrin; Szecsenyi Joachim; Joos Stefanie; Goetz Katja

    2011-01-01

    Abstract Background In Germany, there is a shortage of young physicians in several specialties, the situation of general practitioners (GP) being especially precarious. The factors influencing the career choice of German medical students are poorly understood. This study aims to identify factors influencing medical students' specialty choice laying a special focus on general practice. Methods The study was designed as a cross-sectional survey. In 2010, students at the five medical schools in ...

  17. Summer anesthesiology externship: Demonstrating the ability of early clinical involvement to educate and increase specialty interest.

    Science.gov (United States)

    Baker, Kevin S; Cormican, Daniel; Seidman, Peggy A

    2012-01-01

    We describe the influence of a 6-week "Summer Anesthesiology Externship" featuring didactic, procedure, and simulation education on formation of medical students' specialty choice. Eighteen months after externship completion, externs were sent a questionnaire with Likert scale agreement ratings of subspecialties/simulations and yes/no questions about student career interests before/after the program, stipend importance, and procedural skill performance during/after the program. General anesthesiology had the highest subspecialty approval rating (9.0). Externs strongly agreed that simulations successfully progressed at first year student understanding levels (9.2 mean agreement rating), increased confidence in being part of a care team (9.4 mean agreement rating), and provided personal/interpersonal development. Externs unanimously agreed that the program introduced them to the breadth of anesthesiology, and that practicing clinical/procedural skills improved confidence when performing the procedures later in medical school. Four of 14 students applied for the externship with some focus on anesthesiology as a career choice. After the externship, a significantly higher number of students (12 of 14) were strongly considering applying to the field (prate than our general medical student classes (p<0.0001). Both CA1 and CA3 resident post-test scores improved at the end of the ultrasound guided regional workshop. Our study showed a 68% improvement in test scores, which is larger than the 50% improvement previously reported. These results show that fast learning can occur in this type of setting. Furthermore, knowledge acquired during the workshop was retained when CA1 residents were re-tested one year after the workshop. The ultrasound-guided regional anesthesia workshop will become part of the didactic series for our CA1 residents and will be a required learning activity. Additional work still needs to be done to find out the best way to test knowledge and skill

  18. Footprint and imprint: an ecologic time-trend analysis of cardiovascular publications in general and specialty journals.

    Science.gov (United States)

    Baldridge, Abigail S; Huffman, Mark D; Bloomfield, Gerald S; Prabhakaran, Dorairaj

    2014-06-01

    Studies have demonstrated strong associations between publication source and citations, as well as investigatory analysis of collaboration effects, in general and medical literature, but are limited to specific journals or short duration of time. This study sought to analyze time trends in cardiovascular research publications in leading general and specialty journals and to determine the association between collaboration and citation index. Cardiovascular publications were retrieved from Web of Knowledge by a cardiovascular bibliometric filter, and annual publication volumes in 8 general and specialty journals were compared. Univariable linear regression models were used to determine global and journal-specific trends for overall publication, cardiovascular publication, proportion of cardiovascular publication, collaboration, and citations. Cardiovascular publications increased (1999 to 2008) by 36% and number of sources by 74%. Volume increased in European Heart Journal (beta: 18.4, 95% confidence interval [CI]: 10.6 to 26.3) and decreased in Circulation (beta: -42.9, 95% CI: -79.3 to -6.5), Annals of Internal Medicine (beta: -1.9, 95% CI: -3.5 to -0.3), and Lancet (beta: -11.2, 95% CI: -14.7 to -7.8). Number of contributing countries increased in 3 journals: BMJ (beta: 0.8, 95% CI: 0.2 to 1.5), European Heart Journal (beta: -1.2, 95% CI: 0.8 to 1.7), and New England Journal of Medicine (beta: 1.6, 95% CI: 0.6 to 2.7). Fraction of collaborative publications increased (beta: 1.1 to 2.9) in all but Annals of Internal Medicine. Collaboration was associated with a higher median actual citation index (p general and specialty journals. Contribution by country in selected journals was disproportionate and under-represents total cardiovascular research in low- and middle-income countries. Copyright © 2014 World Heart Federation (Geneva). Published by Elsevier B.V. All rights reserved.

  19. Rapid Development of Specialty Population Registries and Quality Measures from Electronic Health Record Data.

    Science.gov (United States)

    Kannan, Vaishnavi; Fish, Jason S; Mutz, Jacqueline M; Carrington, Angela R; Lai, Ki; Davis, Lisa S; Youngblood, Josh E; Rauschuber, Mark R; Flores, Kathryn A; Sara, Evan J; Bhat, Deepa G; Willett, DuWayne L

    2017-01-01

    Creation of a new electronic health record (EHR)-based registry often can be a "one-off" complex endeavor: first developing new EHR data collection and clinical decision support tools, followed by developing registry-specific data extractions from the EHR for analysis. Each development phase typically has its own long development and testing time, leading to a prolonged overall cycle time for delivering one functioning registry with companion reporting into production. The next registry request then starts from scratch. Such an approach will not scale to meet the emerging demand for specialty registries to support population health and value-based care. To determine if the creation of EHR-based specialty registries could be markedly accelerated by employing (a) a finite core set of EHR data collection principles and methods, (b) concurrent engineering of data extraction and data warehouse design using a common dimensional data model for all registries, and (c) agile development methods commonly employed in new product development. We adopted as guiding principles to (a) capture data as a byproduct of care of the patient, (b) reinforce optimal EHR use by clinicians, (c) employ a finite but robust set of EHR data capture tool types, and (d) leverage our existing technology toolkit. Registries were defined by a shared condition (recorded on the Problem List) or a shared exposure to a procedure (recorded on the Surgical History) or to a medication (recorded on the Medication List). Any EHR fields needed - either to determine registry membership or to calculate a registry-associated clinical quality measure (CQM) - were included in the enterprise data warehouse (EDW) shared dimensional data model. Extract-transform-load (ETL) code was written to pull data at defined "grains" from the EHR into the EDW model. All calculated CQM values were stored in a single Fact table in the EDW crossing all registries. Registry-specific dashboards were created in the EHR to display both

  20. International Medical Graduates in the US Physician Workforce and Graduate Medical Education: Current and Historical Trends.

    Science.gov (United States)

    Ahmed, Awad A; Hwang, Wei-Ting; Thomas, Charles R; Deville, Curtiland

    2018-04-01

    Data show that international medical graduates (IMGs), both US and foreign born, are more likely to enter primary care specialties and practice in underserved areas. Comprehensive assessments of representation trends for IMGs in the US physician workforce are limited. We reported current and historical representation trends for IMGs in the graduate medical education (GME) training pool and US practicing physician workforce. We compared representation for the total GME and active practicing physician pools with the 20 largest residency specialties. A 2-sided test was used for comparison, with P  < .001 considered significant. To assess significant increases in IMG GME trainee representation for the total pool and each of the specialties from 1990-2015, the slope was estimated using simple linear regression. IMGs showed significantly greater representation among active practicing physicians in 4 specialties: internal medicine (39%), neurology (31%), psychiatry (30%), and pediatrics (25%). IMGs in GME showed significantly greater representation in 5 specialties: pathology (39%), internal medicine (39%), neurology (36%), family medicine (32%), and psychiatry (31%; all P  < .001). Over the past quarter century, IMG representation in GME has increased by 0.2% per year in the total GME pool, and 1.1% per year for family medicine, 0.5% for obstetrics and gynecology and general surgery, and 0.3% for internal medicine. IMGs make up nearly a quarter of the total GME pool and practicing physician workforce, with a disproportionate share, and larger increases over our study period in certain specialties.

  1. ENGINEERING SPECIALTY ASSESSMENT OF TANK WASTE COMPATIBILITY REPORTING

    International Nuclear Information System (INIS)

    KNIGHT, M.A.

    2003-01-01

    This Engineering Specialty Assessment was conducted to review the Tank Farm Waste Transfer Compatibility Program to assess whether the program meets the needs of accelerated retrieval and closure and waste feed delivery and to identify areas and methods for streamlining the program. The assessment was conducted in June 2003 and resulted in two findings and thirteen observations. The assessment results indicate that significant opportunities exist for streamlining the program by reducing the number of criteria requiring evaluation from 21 to 11, with only six of the criteria requiring evaluation for the majority of transfers. The assessment identified areas where existing criteria require strengthening to ensure that the risks of undesirable solids precipitation, from either waste mixing or waste transfer, are minimized. The assessment further identified opportunities for using existing engineering tools to simplify the calculations involved with preparation of waste compatibility assessments. The need to ensure that a revision to the waste compatibility program is prepared to align the program criteria with those that will be implemented with the DSA approval was also identified. Finally, the assessment identified that corrective actions are required to implement a tank-by-tank PCB inventory within the Best Basis Inventory and to ensure that sample data from external waste generators is entered into the TWINS database

  2. Lipid components and oxidative status of selected specialty oils

    Directory of Open Access Journals (Sweden)

    P. Madawala, S. R.

    2012-06-01

    Full Text Available Many vegetable oils are marketed as specialty oils because of their retained flavors, tastes and distinct characteristics. Specialty oil samples which were commercially produced and retailed were purchased from local superstores in Reading, UK, and Uppsala, Sweden and profiled for detailed lipid composition and oxidative status. These oil samples include: almond, hazelnut, walnut, macadamia nut, argan, avocado, grape seed, roasted sesame, rice bran, cold pressed, organic and cold pressed, warm pressed and refined rapeseed oils. The levels of PV were quite low (0.5-1.3mEq O₂/kg but AV and Rancimat values at 100 °C (except for rapeseed oils varied considerably at (0.5-15.5 and (4.2-37.0 h respectively. Macadamia nut oil was found to be the most stable oil followed by argan oil, while walnut oil was the least stable. Among the specialty oils, macadamia nut oil had the lowest (4% and walnut oil had the highest (71% level of total PUFA. The organic cold pressed rapeseed oil had considerably lower PUFA (27% compared with other rapeseed oils (28- 35%. In all the samples, α- and γ- tocopherols were the major tocopherols; nut oils had generally lower levels. Total sterols ranged from 889 to 15,106 μg/g oil. The major sterols were β-sitosterol (61-85% and campesterol (6-20%. Argan oil contained schottenol (35% and spinasterol (32%. Compared with literature values, no marked differences were observed among the differently processed, organically grown or cold pressed rapeseed oils and other specialty oils in this study.

    Muchos aceites vegetales se venden como aceites especiales debido a su flavor, gusto y características distintas. Muestras de aceites especiales de almendra, avellana, nuez, nuez de macadamia, argán, aguacate, semillas de uva, de sésamo tostadas, salvado de arroz, y aceites orgánico de semillas de colza prensado en frío y, prensado caliente, y refinados que se producen y comercializan al por menor, se obtuvieron en

  3. Development of nurses with specialties: the nurse administrators' perspective.

    Science.gov (United States)

    Onishi, Mami; Sasaki, Minako; Nagata, Ayako; Kanda, Katsuya

    2008-10-01

    This study clarified how Japanese nurse administrators consider the current status and future prospects of development and utilization of nurses with specialties. The demand for specialized nurses is not satisfied throughout the country. Nine nurse administrators participated in three focus-group discussions. Data were analyzed using qualitative content analysis technique. On development of specialized nurses, four categories were abstracted: offering opportunities for career development; establishing an environment of life-term continuous learning; providing well-balanced support for the needs of organizations and individual nurses; and support for career development as a specialist. To develop specialized nurses effectively it is important to focus more attention on qualitative aspects of nurses' professional experience in in-service education and to support appropriate personnel for strategic human resource development. Facilitating frequent contacts between specialized and general nurses should be highly valued as making an environment where nurses can face career goals daily leads to steady preservation of human resources. It is necessary for nurse administrators to keep human resources quantitatively and to clarify the developmental process after nurses obtain special roles to plan for continuous education.

  4. Opinion On Drug Information Services Provided In A Multi- Specialty Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Vijayakumar TM, Poovi G & Dhanaraju MD

    2011-05-01

    Full Text Available Objective: To evaluate the various drug information queriesreceived, and to access the drug information services providedby the pharmacy practice department.Method: Drug information queries received during wardrounds, direct communication, telephone or internet etc. weredocumented in the drug information request anddocumentation forms prepared by the department over theperiod of January 2010 to June 2010. Various parameters likestatus of enquirer, their specialty, mode of receipt of query,purpose of query, type of query etc. were consider forevaluation.Results: Out of 208 queries received, major 56 (26.9% frommale medical ward. Maximum [82 (39.4 %] queries were fromthe physicians. 73 (35.0 % of the queries were about therecent advances and the updating of the information, It wasfound that mostly the mode of request was during wardrounds 85 (40.9%. Most of the queries [126 (60.6%] wereanswered by written or printout format. Majority of thequeries [195 (93.8 %] were answered directly to theenquirers through direct access. Most of the queries wereanswered through books in the department [86 (41.3 %].Conclusion: Results of the external auditing revealed thatrequestors were generally satisfied with the service provided.The drug information services provided by clinical pharmacistsat the hospital were found to be useful and beneficial to thehealthcare professionals and patients.

  5. Can the transition process from foundation doctor to neurosurgical specialty trainee be improved through “learner-centered induction programs”?

    Directory of Open Access Journals (Sweden)

    Acharya V

    2015-10-01

    Full Text Available Vikas Acharya,1 Sami Mansour,2 Samuel M Amis,3 Amir Reyahi3 1Department of Neurosurgery, University Hospitals Coventry and Warwickshire, 2Warwick Medical School, University of Warwick, Coventry, 3Luton and Dunstable University Hospital, Luton, UK Abstract: The transition period from foundation program doctor to specialty trainee can be difficult for junior doctors. This difficult period often acts as a major obstacle for learning in the workplace. Existing induction programs are commonly seen as inadequate at easing this transition, and therefore, a pilot study intervention was undertaken to assess if the initiation of “learner-centered induction programs” could help improve the confidence, knowledge acquisition, and satisfaction of junior doctors as they begin specialty training in neurosurgery. Ethnographic and anecdotal evidences were collated from junior doctors, specialty trainees, and consultants in order to investigate if further work on this subject would be beneficial. All participants were working in the Department of Neurosurgery at University Hospital Coventry and Warwickshire, Coventry, UK, over a 4-week period in March/April 2015. A review of the relevant literature was also undertaken. This report found that despite the reservations around the increased organizational demands of induction programs of this nature, as well as concerns around a single junior doctor covering the ward alone during the induction period, feedback following the intervention was largely positive. Junior doctors appreciated being taught about their roles and responsibilities from their predecessors as well as deciding among themselves what topics they wanted covering. As a result, the induction sessions tended to focus on clinical skills rather than theoretical knowledge, which most of the junior doctors believed they could cover adequately in their own time. The junior doctors felt that they benefited from learning/refreshing their relevant practical

  6. Impact of the site specialty of a continuity practice on students' clinical skills: performance with standardized patients.

    Science.gov (United States)

    Pfeiffer, Carol A; Palley, Jane E; Harrington, Karen L

    2010-07-01

    The assessment of clinical competence and the impact of training in ambulatory settings are two issues of importance in the evaluation of medical student performance. This study compares the clinical skills performance of students placed in three types of community preceptors' offices (pediatrics, medicine, family medicine) on yearly clinical skills assessments with standardized patients. Our goal was to see if the site specialty impacted on clinical performance. The students in the study were completing a 3-year continuity preceptorship at a site representing one of the disciplines. Their performance on the four clinical skills assessments was compared. There was no significant difference in history taking, physical exam, communication, or clinical reasoning in any year (ANOVA p< or = .05) There was a small but significant difference in performance on a measure of interpersonal and interviewing skills during Years 1 and 2. The site specialty of an early clinical experience does not have a significant impact on performance of most of the skills measured by the assessments.

  7. Doing the Same and Earning Less: Male and Female Physicians in a New Medical Specialty

    Directory of Open Access Journals (Sweden)

    Timothy J. Hoff

    2004-09-01

    Full Text Available This study presents findings from a national survey of physicians working in the emerging career of hospital medicine. It finds that female hospitalists earn significantly less annually than male hospitalists, despite similar work schedules and commitments; that these similarities in work and differences in pay remain even for male and female hospitalists who are married and have children; and that female hospitalists maintain positive feelings toward their work careers despite assuming multiple work and nonwork roles simultaneously. The results present a unique picture of female physicians career experiences in toto. They have implications for how health care organizations and managers should think about the contemporary female physician (e.g., her career development needs and workplace challenges; for female physicians need to gain greater equity vis-à-vis men within the profession; and for the kinds of questions researchers should raise around physician gender in their work.

  8. Providing Specialty Care for the Poor and Underserved at Student-Run Free Clinics in the San Francisco Bay Area.

    Science.gov (United States)

    Liu, Max Bolun; Xiong, Grace; Boggiano, Victoria Lynn; Ye, Patrick Peiyong; Lin, Steven

    2017-01-01

    This report describes the model of specialty clinics implemented at Stanford University's two student-run free clinics, Arbor Free Clinic and Pacific Free Clinic, in the San Francisco Bay Area. We describe our patient demographic characteristics and the specialty services provided. We discuss challenges in implementing specialty care at student-run free clinics.

  9. Satellite Estimation of Fractional Cover in Several California Specialty Crops

    Science.gov (United States)

    Johnson, L.; Cahn, M.; Rosevelt, C.; Guzman, A.; Lockhart, T.; Farrara, B.; Melton, F. S.

    2016-12-01

    Past research in California and elsewhere has revealed strong relationships between satellite NDVI, photosynthetically active vegetation fraction (Fc), and crop evapotranspiration (ETc). Estimation of ETc can support efficiency of irrigation practice, which enhances water security and may mitigate nitrate leaching. The U.C. Cooperative Extension previously developed the CropManage (CM) web application for evaluation of crop water requirement and irrigation scheduling for several high-value specialty crops. CM currently uses empirical equations to predict daily Fc as a function of crop type, planting date and expected harvest date. The Fc prediction is transformed to fraction of reference ET and combined with reference data from the California Irrigation Management Information System to estimate daily ETc. In the current study, atmospherically-corrected Landsat NDVI data were compared with in-situ Fc estimates on several crops in the Salinas Valley during 2011-2014. The satellite data were observed on day of ground collection or were linearly interpolated across no more than an 8-day revisit period. Results will be presented for lettuce, spinach, celery, broccoli, cauliflower, cabbage, peppers, and strawberry. An application programming interface (API) allows CM and other clients to automatically retrieve NDVI and associated data from NASA's Satellite Irrigation Management Support (SIMS) web service. The SIMS API allows for queries both by individual points or user-defined polygons, and provides data for individual days or annual timeseries. Updates to the CM web app will convert these NDVI data to Fc on a crop-specific basis. The satellite observations are expected to play a support role in Salinas Valley, and may eventually serve as a primary data source as CM is extended to crop systems or regions where Fc is less predictable.

  10. Specialty Payment Model Opportunities and Assessment: Oncology Model Design Report.

    Science.gov (United States)

    Huckfeldt, Peter J; Chan, Chris; Hirshman, Samuel; Kofner, Aaron; Liu, Jodi L; Mulcahy, Andrew W; Popescu, Ioana; Stevens, Clare; Timbie, Justin W; Hussey, Peter S

    2015-07-15

    This article describes research related to the design of a payment model for specialty oncology services for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services (CMS). Cancer is a common and costly condition. Episode-based payment, which aims to create incentives for high-quality, low-cost care, has been identified as a promising alternative payment model for oncology care. Episode-based payment systems can provide flexibility to health care providers to select among the most effective and efficient treatment alternatives, including activities that are not currently reimbursed under Medicare payment policies. However, the model design also needs to ensure that high-quality care is delivered and that beneficial treatments are not withheld from patients. CMS asked MITRE and RAND to conduct analyses to inform design decisions related to an episode-based oncology model for Medicare beneficiaries undergoing chemotherapy treatment for cancer. In particular, this study focuses on analyses of Medicare claims data related to the definition of the initiation of an episode of chemotherapy, patterns of spending during and surrounding episodes of chemotherapy, and attribution of episodes of chemotherapy to physician practices. We found that the time between the primary cancer diagnosis and chemotherapy initiation varied widely across patients, ranging from one day to over seven years, with a median of 2.4 months. The average level of total monthly payments varied considerably across cancers, with the highest spending peak of $9,972 for lymphoma, and peaks of $3,109 for breast cancer and $2,135 for prostate cancer.

  11. Specialty Payment Model Opportunities and Assessment: Oncology Simulation Report.

    Science.gov (United States)

    White, Chapin; Chan, Chris; Huckfeldt, Peter J; Kofner, Aaron; Mulcahy, Andrew W; Pollak, Julia; Popescu, Ioana; Timbie, Justin W; Hussey, Peter S

    2015-07-15

    This article describes the results of a simulation analysis of a payment model for specialty oncology services that is being developed for possible testing by the Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services (CMS). CMS asked MITRE and RAND to conduct simulation analyses to preview some of the possible impacts of the payment model and to inform design decisions related to the model. The simulation analysis used an episode-level dataset based on Medicare fee-for-service (FFS) claims for historical oncology episodes provided to Medicare FFS beneficiaries in 2010. Under the proposed model, participating practices would continue to receive FFS payments, would also receive per-beneficiary per-month care management payments for episodes lasting up to six months, and would be eligible for performance-based payments based on per-episode spending for attributed episodes relative to a per-episode spending target. The simulation offers several insights into the proposed payment model for oncology: (1) The care management payments used in the simulation analysis-$960 total per six-month episode-represent only 4 percent of projected average total spending per episode (around $27,000 in 2016), but they are large relative to the FFS revenues of participating oncology practices, which are projected to be around $2,000 per oncology episode. By themselves, the care management payments would increase physician practices' Medicare revenues by roughly 50 percent on average. This represents a substantial new outlay for the Medicare program and a substantial new source of revenues for oncology practices. (2) For the Medicare program to break even, participating oncology practices would have to reduce utilization and intensity by roughly 4 percent. (3) The break-even point can be reduced if the care management payments are reduced or if the performance-based payments are reduced.

  12. An analysis of moderate sedation protocols used in dental specialty programs: a retrospective observational study.

    Science.gov (United States)

    Setty, Madhavi; Montagnese, Thomas A; Baur, Dale; Aminoshariae, Anita; Mickel, Andre

    2014-09-01

    Pain and anxiety control is critical in dental practice. Moderate sedation is a useful adjunct in managing a variety of conditions that make it difficult or impossible for some people to undergo certain dental procedures. The purpose of this study was to analyze the sedation protocols used in 3 dental specialty programs at the Case Western Reserve University School of Dental Medicine, Cleveland, OH. A retrospective analysis was performed using dental school records of patients receiving moderate sedation in the graduate endodontic, periodontic, and oral surgery programs from January 1, 2010, to December 31, 2012. Information was gathered and the data compiled regarding the reasons for sedation, age, sex, pertinent medical conditions, American Society of Anesthesiologists physical status classifications, routes of administration, drugs, dosages, failures, complications, and other information that was recorded. The reasons for the use of moderate sedation were anxiety (54%), local anesthesia failures (15%), fear of needles (15%), severe gag reflex (8%), and claustrophobia with the rubber dam (8%). The most common medical conditions were hypertension (17%), asthma (15%), and bipolar disorder (8%). Most patients were classified as American Society of Anesthesiologists class II. More women (63.1%) were treated than men (36.9%). The mean age was 45 years. Monitoring and drugs varied among the programs. The most common tooth treated in the endodontic program was the mandibular molar. There are differences in the moderate sedation protocols used in the endodontic, periodontic, and oral surgery programs regarding monitoring, drugs used, and record keeping. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  13. Do diabetes-specialty clinics differ in management approach and ...

    African Journals Online (AJOL)

    2016-06-02

    Jun 2, 2016 ... Diabetes Study Group recommended target for intensive ... and documented accordingly for individual participant. ... frequency of verbal instructions and counseling from ... >4 versus ≤4 medications (as cut-off) to indicate.

  14. [Monitoring evaluation system for high-specialty hospitals].

    Science.gov (United States)

    Fajardo Dolci, Germán; Aguirre Gas, Héctor G; Robledo Galván, Héctor

    2011-01-01

    Hospital evaluation is a fundamental process to identify medical units' objective compliance, to analyze efficiency of resource use and allocation, institutional values and mission alignment, patient safety and quality standards, contributions to research and medical education, and the degree of coordination among medical units and the health system as a whole. We propose an evaluation system for highly specialized regional hospitals through the monitoring of performance indicators. The following are established as base thematic elements in the construction of indicators: safe facilities and equipment, financial situation, human resources management, policy management, organizational climate, clinical activity, quality and patient safety, continuity of care, patients' and providers' rights and obligations, teaching, research, social responsibility, coordination mechanisms. Monitoring refers to the planned and systematic evaluation of valid and reliable indicators, aimed at identifying problems and opportunity areas. Moreover, evaluation is a powerful tool to strengthen decision-making and accountability in medical units.

  15. The Emergence and Development of the Sociology of Sport as an Academic Specialty.

    Science.gov (United States)

    Loy, John W.; And Others

    1980-01-01

    Sport sociology as an academic specialty and its stages of development are described. Problems confronting future developments in sport sociology include critical mass, academic status, and ideological orientation, both in physical education and in sociology. (CJ)

  16. CLASSIFICATION OF SPECIALTIES AND QUALIFICATIONS IN REPUBLIC OF BELARUS: TENDENCIES AND PROSPECTS

    Directory of Open Access Journals (Sweden)

    O. A. Oleks

    2016-01-01

    Full Text Available In the present publication short data on the system of specialties and qualifications functioning in Republic of Belarus, her features, scope of application are given. The purpose and problems of the revision of the National classifier of the Republic of Belarus «Specialties and qualifications», its orientation to reduce the gap between the content of education and content of activity of graduates of establishments of education are described. The main tendencies of change of the operating classification – on the basis of types of economic activity and international standard classification of education taking into account requirements of employers, minimization of economic expenses for education, including due to minimization of classification units, rapprochement of positions with educational systems of other states are revealed. Prospects of development of national system of specialties and qualifications are disclosed. Tendencies and prospects of the expected changes are shown on the examples of the certain specialties offered by BNTU (Belarusian National Technical University.

  17. Forecasting U.S. Marine Corps Reenlistments by Military Occupational Specialty and Grade

    National Research Council Canada - National Science Library

    Conatser, Dean G

    2006-01-01

    .... Currently the First Term Alignment Plan (FTAP) Model and Subsequent Term Alignment Plan (STAP) Model are used to determine the number of required reenlistments by Marine military occupational specialty...

  18. Social media in the mentorship and networking of physicians: Important role for women in surgical specialties.

    Science.gov (United States)

    Luc, Jessica G Y; Stamp, Nikki L; Antonoff, Mara B

    2018-04-01

    Social media may be a useful supplement to physician and trainee interactions; however, its role in enhancing mentorship has not been described. A 35-item survey investigating trainee and physician social media use was distributed. Responses were analyzed using descriptive statistics. 282 respondents completed the survey, among whom 136 (48.2%) reported careers in surgical specialties. Women in surgical specialties were more likely to describe the specialty as being dominated by the opposite sex (p media to build a network of same-sex mentorship (p = 0.031). Social media serves as a valuable tool to enhance the networking and mentorship of surgeons, particularly for women in surgical specialties who may lack exposure to same-sex mentors at their own institution. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Application-specific specialty microstructured optical fibers for mid-IR and THz photonics (Invited)

    DEFF Research Database (Denmark)

    Pal, Bishnu P.; Barh, Ajanta; Varshney, Ravi K.

    2016-01-01

    A review of several of our designed specialty microstructured optical fibers (MOFs) for mid-IR and THz generation and transmission including high power transmission is presented. Extensive results on performance of the designed MOFs are described....

  20. THE SPECIALTY OF EMERGENCY MEDICINE IN CHILE: 20 YEARS OF HISTORY

    Directory of Open Access Journals (Sweden)

    WK Mallon

    2017-03-01

    Full Text Available Chile is uniquely situated to be a leader in South American development of the specialty of Emergency Medicine. Chilean emergency medicine has successfully transitioned from a novelty training idea to a nationally and internationally recognized entity with serious public health goals. There are more residency training programs in Chile than in any other South American or Latin American country, and the specialty is formally recognized by the Ministry of Health. Chilean emergency medicine thought leaders have networked internationally with multiple groups, intelligently used outside resources, and created durable academic relationships. While focusing on locally important issues and patient care they have successfully advanced their agenda. Despite this, the specialty faces many new challenges and remains fragile but sustainable. Policy makers and the Chilean MOH need to be acutely aware of this fragility to preserve the progress achieved so far, and support ongoing maturation of the specialty of Emergency Medicine.

  1. 48 CFR 252.225-7008 - Restriction on Acquisition of Specialty Metals.

    Science.gov (United States)

    2010-10-01

    ... CLAUSES Text of Provisions And Clauses 252.225-7008 Restriction on Acquisition of Specialty Metals. As... more of the following limits: Manganese, 1.65 percent; silicon, 0.60 percent; or copper, 0.60 percent...

  2. 8. Seminar of the IMP-IIE-ININ on technological specialties. Topic 10: Earth Sciences

    International Nuclear Information System (INIS)

    1996-01-01

    The document contains two papers within INIS subject scope which were presented at the 8th Seminar of the IMP-IIE-ININ on technological specialties. Topic 10: Earth Sciences. A separate abstract was prepared for each paper

  3. Routine Prenatal Care Visits by Provider Specialty in the United States, 2009-2010

    Science.gov (United States)

    ... and are not in the specialties of anesthesiology, pathology, or radiology. The NAMCS physician response rate was ... last reviewed: November 6, 2015 Page last updated: March 13, 2014 Content source: Email Recommend Tweet YouTube ...

  4. Herbert Rackow and Ernest Salanitre: the emergence of pediatric anesthesia as a specialty in the United States.

    Science.gov (United States)

    Friesen, Robert H

    2015-07-01

    Herbert Rackow and Ernest Salanitre were pediatric anesthesiologists at Babies Hospital at the Columbia-Presbyterian Medical Center in New York whose work spanned three decades beginning in the early 1950s. Their pioneering research included studies of the uptake and elimination of inhalational anesthetics and of the risk of cardiac arrest in infants and children. They were actively involved in the development of pediatric anesthesia as a specialty, and their efforts contributed to inter-disciplinary collaboration and to the formation of the Section on Anesthesiology of the American Academy of Pediatrics. Their 1969 review article, 'Modern Concepts in Pediatric Anesthesiology', provides a fascinating view of pediatric anesthesia 50 years ago. In 1990, they were jointly awarded the Robert M. Smith award by the Section on Anesthesiology of the American Academy of Pediatrics. © 2015 John Wiley & Sons Ltd.

  5. The dynamics of physical and mental health of students of economic specialties in the course of employment aqua

    Directory of Open Access Journals (Sweden)

    N. V. Petrenko

    2013-11-01

    Full Text Available The objective was to determine the effect of fitness classes for aqua to physical and mental fitness of students of economic specialties. The volume of the experimental sample consisted of 69 female students basic medical group aged 17-18 years. Analysis of the results was carried out according to the Harvard step test, and the results of the speed and accuracy of processing visual information using alphabetical table Anfimova. Comparative analysis of the data showed the trend more pronounced positive changes in the physical and mental health of students of the experimental group 1 and experimental group 2. The low level of the index of physical performance within 42.39 was observed in the control group. Increase speed and accuracy of processing visual information in the control group not observed.

  6. [The Problems with Domestic Introduction of rTMS from the Three Viewpoints of Scientific Evidence, Specialty and Social Responsibility].

    Science.gov (United States)

    Shinosaki, Kazuhiro

    2015-01-01

    The domestic introduction of rTMS is expected as a new treatment option for treatment-resistant depression. I discussed some problems with the introduction from three viewpoints : scientific evidence, specialty, and social responsibility. I surveyed scientific evidence for rTMS regarding the action mechanism, effectiveness, side effects, and its positioning in the treatment guidelines. To secure the quality of rTMS treatment, I proposed rTMS guidelines, nurturing of the specialists, and a center hospital plan, and pointed out some medium-term problems after its introduction and the consistency of rTMS treatment and standard depression treatment. From the viewpoint of social responsibility, rTMS treatment should be a medical service covered by health insurance to avoid its misuse. We should prepare to overcome the public suspicion of brain stimulation treatment for mental disease.

  7. Some theoretic elements about vocational guidance in the specialty Carpintería

    Directory of Open Access Journals (Sweden)

    Odelmi Miló García

    2016-03-01

    Full Text Available Presently article the methodological conceptual theoretical bases are presented that sustain in an essential way the cultural historical theory, The objective of the same one is to elaborate a methodological strategy for the development of the professional orientation toward the specialty carpentry in students of the first year of the Polytechnic Leonides Blanco González, being given the problem that the students are not motivated by the specialty.

  8. Current and future funding sources for specialty mental health and substance abuse treatment providers.

    Science.gov (United States)

    Levit, Katharine R; Stranges, Elizabeth; Coffey, Rosanna M; Kassed, Cheryl; Mark, Tami L; Buck, Jeffrey A; Vandivort-Warren, Rita

    2013-06-01

    Goals were to describe funding for specialty behavioral health providers in 1986 and 2005 and examine how the recession, parity law, and Affordable Care Act (ACA) may affect future funding. Numerous public data sets and actuarial methods were used to estimate spending for services from specialty behavioral health providers (general hospital specialty units; specialty hospitals; psychiatrists; other behavioral health professionals; and specialty mental health and substance abuse treatment centers). Between 1986 and 2005, hospitals-which had received the largest share of behavioral health spending-declined in importance, and spending shares trended away from specialty hospitals that were largely funded by state and local governments. Hospitals' share of funding from private insurance decreased from 25% in 1986 to 12% in 2005, and the Medicaid share increased from 11% to 23%. Office-based specialty providers continued to be largely dependent on private insurance and out-of-pocket payments, with psychiatrists receiving increased Medicaid funding. Specialty centers received increased funding shares from Medicaid (from 11% to 29%), and shares from other state and local government sources fell (from 64% to 46%). With ACA's full implementation, spending on behavioral health will likely increase under private insurance and Medicaid. Parity in private plans will also push a larger share of payments for office-based professionals from out-of-pocket payments to private insurance. As ACA provides insurance for formerly uninsured individuals, funding by state behavioral health authorities of center-based treatment will likely refocus on recovery and support services. Federal Medicaid rules will increase in importance as more people needing behavioral health treatment become covered.

  9. Ideal versus real conditions for type 2 diabetes care : diabetes specialty nurses’ perspectives

    OpenAIRE

    Jutterström, Lena; Hällgren Graneheim, Ulla; Isaksson, Ulf; Hörnsten, Åsa

    2012-01-01

    Background: Since diabetes specialty nurses are the professionals who spend the most time with patients living with diabetes, they probably have the greatest influence on the quality of diabetes care. Therefore, their personal perceptions about what constitutes “good care” in type 2 diabetes care are important to explore. Aim: The aim of this study was to describe conditions for “good care” in type 2-diabetes as perceived by diabetes specialty nurses. Method: Twenty-one experienced diabetes s...

  10. Surgical specialty procedures in rural surgery practices: implications for rural surgery training.

    Science.gov (United States)

    Sticca, Robert P; Mullin, Brady C; Harris, Joel D; Hosford, Clint C

    2012-12-01

    Specialty procedures constitute one eighth of rural surgery practice. Currently, general surgeons intending to practice in rural hospitals may not get adequate training for specialty procedures, which they will be expected to perform. Better definition of these procedures will help guide rural surgery training. Current Procedural Terminology codes for all surgical procedures for 81% of North Dakota and South Dakota rural surgeons were entered into the Dakota Database for Rural Surgery. Specialty procedures were analyzed and compared with the Surgical Council on Resident Education curriculum to determine whether general surgery training is adequate preparation for rural surgery practice. The Dakota Database for Rural Surgery included 46,052 procedures, of which 5,666 (12.3%) were specialty procedures. Highest volume specialty categories included vascular, obstetrics and gynecology, orthopedics, cardiothoracic, urology, and otolaryngology. Common procedures in cardiothoracic and vascular surgery are taught in general surgical residency, while common procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology are usually not taught in general surgery training. Optimal training for rural surgery practice should include experience in specialty procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Factors influencing the implementation, adoption, use, sustainability and scalability of eLearning for family medicine specialty training: a systematic review protocol.

    Science.gov (United States)

    Cotič, Živa; Rees, Rebecca; Wark, Petra A; Car, Josip

    2016-10-19

    In 2013, there was a shortage of approximately 7.2 million health workers worldwide, which is larger among family physicians than among specialists. eLearning could provide a potential solution to some of these global workforce challenges. However, there is little evidence on factors facilitating or hindering implementation, adoption, use, scalability and sustainability of eLearning. This review aims to synthesise results from qualitative and mixed methods studies to provide insight on factors influencing implementation of eLearning for family medicine specialty education and training. Additionally, this review aims to identify the actions needed to increase effectiveness of eLearning and identify the strategies required to improve eLearning implementation, adoption, use, sustainability and scalability for family medicine speciality education and training. A systematic search will be conducted across a range of databases for qualitative studies focusing on experiences, barriers, facilitators, and other factors related to the implementation, adoption, use, sustainability and scalability of eLearning for family medicine specialty education and training. Studies will be synthesised by using the framework analysis approach. This study will contribute to the evaluation of eLearning implementation, adoption, use, sustainability and scalability for family medicine specialty training and education and the development of eLearning guidelines for postgraduate medical education. PROSPERO http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016036449.

  12. Do diabetes-specialty clinics differ in management approach and ...

    African Journals Online (AJOL)

    Objectives: To evaluate management approach and outcome in two endocrinologist-managed clinics using data on treatment adherence, diabetes specific parameters, prescribed medications and self-management practices among ambulatory type 2 diabetes patients. Opinion on cause(s) and perceived fear about ...

  13. Evaluation of adolescent medicine sub-specialty training in Nigeria ...

    African Journals Online (AJOL)

    Objective: To evaluate the extent of coverage of curriculum contents pertinent to Adolescent Medicine, as well as the adequacy of facilities and professionals in Nigeria using residents' viewpoint. Design: A descriptive cross-sectional study. Setting: The Intensive Course in Paediatrics of the National Post-graduate Medical ...

  14. Psychiatric Morbidity Patterns in Referred Inpatients of Other Specialties

    Directory of Open Access Journals (Sweden)

    Ajay Risal

    2013-03-01

    Conclusions: Psychiatric consultation was sought mostly by medical ward that had maximum number of patients presenting with self-poisoning. The commonest diagnosis seen in the referred in-patients was depression and anxiety disorder. Keywords: consultation-liaison psychiatry; in-patient referral; psychiatric morbidity.

  15. [How does our specialty present itself on the Internet?].

    Science.gov (United States)

    Rechenberg, U; Josten, C; Grüner, S; Klima, S

    2013-08-01

    The huge amount of information on the internet about orthopaedic and trauma surgical issues is very often unclear and hard to control in reliability, autonomy and expertise. The aim of this work is to evaluate German-speaking internet sites with orthopaedic and trauma surgical contents. Over a period of two months (from May to June) in 2012 different websites about 20 common orthopaedic and trauma surgical diseases were analysed on the internet by Google search engine. The first ten search results were evaluated for the HON code principles (Health On the Net Foundation). Furthermore there was an evaluation about qualification of the first 50 websites. The best 1,000 placed websites on Google were analysed for the authoritative value: academic, commercial, media, non-medical, physicians, non-profit and miscellaneous. Only 194 from 200 websites could be evaluated by the HON code principles. Overall 188 websites complied the principle of transparency, followed by privacy with 150 sites and authoritative with 134 sites. Only 90 websites give information about financial disclosure. Medical articles of the website Wikipedia appear most frequently. In the second part of this work it is shown that non-profit sites and sites by physicians are the most frequent. The fewest results are given by academic and commercial sites with 93 and 85 online hits. In summary, it is shown that most of the websites about medical information have inadequate quality. This statement is in accord with some U. S. American publications. It is clear that Wikipedia has a top-ranking on the internet when it is about medical information. Wikipedia almost achieves all of the HON code principles. It is possible to give better medical online information about orthopaedic and trauma surgical issues published by professionals. Georg Thieme Verlag KG Stuttgart · New York.

  16. Gender differences in motives and career choice of medical students.

    NARCIS (Netherlands)

    Heiligers, P.J.M.; Emmerik, H. van

    2009-01-01

    Introduction: Insight in the choices of medical students concerning their future career is an actual issue, since the population is changing towards a majority of female students. We focus here on insight in the effect of gender and life-stage on students’ preferences concerning a medical specialty,

  17. Foreign Medical Graduates in the 1980s: Trends in Specialization.

    Science.gov (United States)

    Mick, Stephen S.; Worobey, Jacqueline Lowe

    1984-01-01

    Despite predictions of a physician surplus by 1990, graduates of foreign medical schools (both aliens and U.S. citizens) continue to flow into the United States. Secondary analysis of 1980 data suggests that graduates of foreign schools may secure their presence within the American medical system by selecting specialties where shortages exist. (KH)

  18. Gendered career considerations consolidate from the start of medical education

    NARCIS (Netherlands)

    Alers, M.; Verdonk, P.; Bor, H.; Hamberg, K.; Lagro-Janssen, A.

    2014-01-01

    OBJECTIVE: To explore changes in specialty preferences and work-related topics during the theoretical phase of Dutch medical education and the role of gender. METHODS: A cohort of medical students at Radboudumc, the Netherlands, was surveyed at start (N=612, 69.1% female) and after three years

  19. Sexual Dysfunction 1 - Sexual sequelae of general medical disorders

    NARCIS (Netherlands)

    Basson, Rosemary; Schultz, Willibrord Weijmar

    2007-01-01

    That sexual symptoms can signal serious underlying disease confirms the importance of sexual enquiry as an integral component of medical assessment. Data on sexual function are sparse in some medical specialties. However, increased scientific understanding of the central and peripheral physiology of

  20. The Mathematics of Medical Imaging in the Classroom.

    Science.gov (United States)

    Funkhouser, Charles P.; Jafari, Farhad; Eubank, William B.

    2002-01-01

    Presents an integrated exposition of aspects of secondary school mathematics and a medical science specialty. Reviews clinical medical practice and theoretical and empirical literature in mathematics education and radiology to develop and pilot model integrative classroom topics and activities. Suggests mathematical applications in numeration and…

  1. Recognized focused practice: Does sub-specialty designation offer value to the neurosurgeon?

    Directory of Open Access Journals (Sweden)

    Maya A Babu

    Full Text Available Vehicles for life-long assessment such as Maintenance of Certification tend to focus on generalist neurosurgical knowledge. However, as neurosurgeons advance in their careers, they tend to narrow their practice and increase volumes in certain specific types of operations. Failing to test the type of procedures most relevant to the practitioner is a lost opportunity to improve the knowledge and practice of the individual neurosurgeon. In this study, we assess the neurosurgical community's appetite for designations of board-recognized Recognized Focused Practice (RFP. We administered a validated, online, confidential survey to 4,899 neurosurgeons (2,435 American Board of Neurological Surgery (ABNS Diplomates participating in MOC, 1,440 Diplomates certified prior to 1999 (grandfathered, and 1,024 retired Diplomates. We received 1,449 responses overall (30% response rate. A plurality of respondents were in practice 11-15 years (18.5%, in private practice (40% and participate in MOC (61%. 49% of respondents felt that a RFP designation would not be helpful. For the 30% who felt that RFP would be helpful, 61.3% felt that it would support recognition by their hospital or practice, it would motivate them to stay current on medical knowledge (53.4%, or it would help attract patients (46.4%;. The most popular suggestions for RFP were Spine (56.2%, Cerebrovascular (62.9%, Pediatrics (64.1%, and Functional/Stereotactic (52%. A plurality of neurosurgeons (35.7% felt that RFP should recognize neurosurgeons with accredited and non-accredited fellowship experience and sub-specialty experience. Ultimately, Recognized Focused Practice may provide value to individual neurosurgeons, but the neurosurgical community shows tepid interest for pursuing this designation.

  2. Recognized focused practice: Does sub-specialty designation offer value to the neurosurgeon?

    Science.gov (United States)

    Babu, Maya A; Liau, Linda M; Meyer, Fredric B

    2017-01-01

    Vehicles for life-long assessment such as Maintenance of Certification tend to focus on generalist neurosurgical knowledge. However, as neurosurgeons advance in their careers, they tend to narrow their practice and increase volumes in certain specific types of operations. Failing to test the type of procedures most relevant to the practitioner is a lost opportunity to improve the knowledge and practice of the individual neurosurgeon. In this study, we assess the neurosurgical community's appetite for designations of board-recognized Recognized Focused Practice (RFP). We administered a validated, online, confidential survey to 4,899 neurosurgeons (2,435 American Board of Neurological Surgery (ABNS) Diplomates participating in MOC, 1,440 Diplomates certified prior to 1999 (grandfathered), and 1,024 retired Diplomates). We received 1,449 responses overall (30% response rate). A plurality of respondents were in practice 11-15 years (18.5%), in private practice (40%) and participate in MOC (61%). 49% of respondents felt that a RFP designation would not be helpful. For the 30% who felt that RFP would be helpful, 61.3% felt that it would support recognition by their hospital or practice, it would motivate them to stay current on medical knowledge (53.4%), or it would help attract patients (46.4%;). The most popular suggestions for RFP were Spine (56.2%), Cerebrovascular (62.9%), Pediatrics (64.1%), and Functional/Stereotactic (52%). A plurality of neurosurgeons (35.7%) felt that RFP should recognize neurosurgeons with accredited and non-accredited fellowship experience and sub-specialty experience. Ultimately, Recognized Focused Practice may provide value to individual neurosurgeons, but the neurosurgical community shows tepid interest for pursuing this designation.

  3. Professional burnout and work satisfaction in Spanish allergists: analysis of working conditions in the specialty.

    Science.gov (United States)

    Chivato Pérez, T; Campos Andreu, A; Negro Alvarez, J M; Caballero Martínez, F

    2011-01-01

    Burnout is a worrying problem in the medical profession and has proven to be highly prevalent in all the care settings and specialty areas in which it has been studied.We applied 2 widely used questionnaires to analyze the working conditions of Spanish allergists in terms of quality of professional life and degree of burnout perceived. Participants completed 2 questionnaires: the 22-item Maslach scale, a structured questionnaire covering different aspects of the feelings and attitudes of professionals toward their work and patients; and the Spanish Quality of Professional Life Questionnaire (CPV-35), a 35-item questionnaire evaluating job satisfaction and perceived quality of life at work. We received 404 questionnaires from throughout Spain. The main sources of motivation were better pay (94.4%), more available resources/technology (85.1%), access to research activities (81%), and promotion in one's professional career (80.1%). Analysis of the scores from the Maslach scale revealed that two-thirds of the allergists interviewed experienced medium and high levels of negative burnout (67.9% and 66.2%, respectively, for emotional exhaustion and depersonalization). This situation was in part compensated for by the fact that a slightly lower proportion of the group (59.2%) obtained very high scores on personal accomplishment in their work. Analysis of the scores from the CPV-35 questionnaire revealed 3 complementary aspects of job satisfaction: perceptions of the workload borne (5.8), management support available to cope with daily patient workload (5.6), and levels of intrinsic motivation for work (7.7), which was the highest value. The score for the item summarizing self-perceived overall quality of working life was acceptable (6.4). Promoting intrinsic motivation of Spanish allergists using the motivating factors identified in this study could protect against professional burnout.

  4. Choosing a career in paediatrics: do trainees' views change over the first year of specialty training?

    Science.gov (United States)

    Goodyear, Helen M; Lakshminarayana, Indumathy; Wall, David; Bindal, Taruna

    2014-09-01

    To look at why a regional cohort of UK doctors chose a paediatric career and to ascertain views on their career near the end of training year one. A 20-item questionnaire was sent to all new regional paediatric specialty trainees. Three focus groups were held with trainees near the end of year one to elicit key themes. West Midlands Deanery, UK. Twenty-nine new regional paediatric specialty trainees in year one completed the questionnaire. A total of 15 trainees participated in the focus groups near the end of year one training. Reasons for choosing a paediatric career and factors which further influence career choice for trainees during their first specialty training year. Key influencing factors for choosing paediatrics were enjoying working with children and positive undergraduate experience of the specialty. All trainees had paediatrics as their first choice specialty and undertook a paediatric Foundation post. Near the end of year one, doubts were cast on career aspirations due to seeing middle grade colleagues struggling with work-life balance and a growing feeling that family came first. Senior trainees need to be aware that they act as powerful role models for their more junior colleagues and therefore have an influential role on how juniors perceive a paediatric career. Family friendly flexible working patterns in paediatrics are vital to retain junior trainees. All paediatric staff are role models and need to be enthusiastic, keen to teach and to promote a positive working environment.

  5. Much ado about nothing? The financial impact of physician-owned specialty hospitals.

    Science.gov (United States)

    Chakravarty, Sujoy

    2016-06-01

    The U.S. hospital industry has recently witnessed a number of policy changes aimed at aligning hospital payments to costs and these can be traced to significant concerns regarding selection of profitable patients and procedures by physician-owned specialty hospitals. The policy responses to specialty hospitals have alternated between payment system reforms and outright moratoriums on hospital operations including one in the recently enacted Affordable Care Act. A key issue is whether physician-owned specialty hospitals pose financial strain on the larger group of general hospitals through cream-skimming of profitable patients, yet there is no study that conducts a systematic analysis relating such selection behavior by physician-owners to financial impacts within hospital markets. The current paper takes into account heterogeneity in specialty hospital behavior and finds some evidence of their adverse impact on profit margins of competitor hospitals, especially for-profit hospitals. There is also some evidence of hospital consolidation in response to competitive pressures by specialty hospitals. Overall, these findings underline the importance of the payment reforms aimed at correcting distortions in the reimbursement system that generate incentives for risk-selection among providers groups. The identification techniques will also inform empirical analysis on future data testing the efficacy of these payment reforms.

  6. Advanced specialty fiber designs for high power fiber lasers

    Science.gov (United States)

    Gu, Guancheng

    The output power of fiber lasers has increased rapidly over the last decade. There are two major limiting factors, namely nonlinear effects and transverse mode instability, prohibiting the power scaling capability of fiber lasers. The nonlinear effects, originating from high optical intensity, primarily limit the peak power scaling. The mode instability, on the other hand, arises from quantum-defect driven heating, causing undesired mode coupling once the power exceeds the threshold and degradation of beam quality. The mode instability has now become the bottleneck for average output power scaling of fiber lasers. Mode area scaling is the most effective way to mitigate nonlinear effects. However, the use of large mode area may increase the tendency to support multiple modes in the core, resulting in lower mode instability threshold. Therefore, it is critical to maintain single mode operation in a large mode area fiber. Sufficient higher order mode suppression can lead to effective single-transverse-mode propagation. In this dissertation, we explore the feasibility of using specialty fiber to construct high power fiber lasers with robust single-mode output. The first type of fiber discussed is the resonantly-enhanced leakage channel fiber. Coherent reflection at the fiber outer boundary can lead to additional confinement especially for highly leaky HOM, leading to lower HOM losses than what are predicted by conventional finite element mothod mode solver considering infinite cladding. In this work, we conducted careful measurements of HOM losses in two leakage channel fibers (LCF) with circular and rounded hexagonal boundary shapes respectively. Impact on HOM losses from coiling, fiber boundary shapes and coating indexes were studied in comparison to simulations. This work demonstrates the limit of the simulation method commonly used in the large-mode-area fiber designs and the need for an improved approach. More importantly, this work also demonstrates that a

  7. The implementation of a quality system in the Dutch GP specialty training: barriers and facilitators; a qualitative study.

    Science.gov (United States)

    Buwalda, Nienke; Braspenning, Jozé; van Roosmalen, Sanne; van Dijk, Nynke; Visser, Mechteld

    2017-07-21

    Quality assurance programs in medical education are introduced to gain insight into the quality of such programs and to trigger improvements. Although of utmost importance, research on the implementation of such programs is scarce. The Dutch General Practice (GP) specialty training institutes used an implementation strategy to implement a quality system (QS), and we aimed to study the success of this strategy and to learn about additional facilitators and barriers. Seventeen structured interviews were conducted with the directors and quality coordinators (QCs) of the eight Dutch GP training institutes. A five-stage process model of implementation was used to structure these interviews and analyze the data. Two researchers analyzed the data with a framework approach. The strategy supported the institutes in implementing the QS. However, after the introduction of the QS, staff experienced the QS as demanding, although they noticed almost no concrete short-term results. Moreover, they experienced difficulties in integrating the QS into their local situation. Collectively working with the QS and following common deadlines did create a sense of commitment towards each other that appeared to be a true stimulus to the introduction of the QS. The implementation strategy focused mainly on the introduction of the QS in the GP specialty training, and it was, as such, rather successful. An important barrier concerned the acceptance of the QS and the integration of the QS into local structures, which suggests that there is a need for guidance on the translation of the QS to local contexts. All in all, we recommend more focus on the benefits of a QS.

  8. Factors affecting cardiac rehabilitation referral by physician specialty.

    Science.gov (United States)

    Grace, Sherry L; Grewal, Keerat; Stewart, Donna E

    2008-01-01

    Cardiac rehabilitation (CR) is widely underutilized because of multiple factors including physician referral practices. Previous research has shown CR referral varies by type of provider, with cardiologists more likely to refer than primary care physicians. The objective of this study was to compare factors affecting CR referral in primary care physicians versus cardiac specialists. A cross-sectional survey of a stratified random sample of 510 primary care physicians and cardiac specialists (cardiologists or cardiovascular surgeons) in Ontario identified through the Canadian Medical Directory Online was administered. One hundred four primary care physicians and 81 cardiac specialists responded to the 26-item investigator-generated survey examining medical, demographic, attitudinal, and health system factors affecting CR referral. Primary care physicians were more likely to endorse lack of familiarity with CR site locations (P negatively impacting CR referral practices than cardiac specialists. Cardiac specialists were significantly more likely to perceive that their colleagues and department would regularly refer patients to CR than primary care physicians (P Marketing CR site locations, provision of standardized referral forms, and ensuring discharge summaries are communicated to primary care physicians may improve their willingness to refer to CR.

  9. The microbiological safety of ready-to-eat specialty meats from markets and specialty food shops: a UK wide study with a focus on Salmonella and Listeria monocytogenes.

    Science.gov (United States)

    Gormley, F J; Little, C L; Grant, K A; de Pinna, E; McLauchlin, J

    2010-04-01

    From 2359 specialty meats (continental sausages, cured/fermented, dried meats) sampled from markets and specialty food shops, 98.9% of samples were of satisfactory or acceptable microbiological quality. However, 16 (0.7%) were unsatisfactory as a result of Escherichia coli, Staphylococcus aureus or Listeria spp. contamination (>or=10(2) CFU/g), and nine (0.4%) were unacceptable due to presence of Salmonella spp. or Listeria monocytogenes (>10(2) CFU/g). Meats with unacceptable levels of L. monocytogenes were within shelf life (range: 8-143 days remaining). Nine different subtypes of L. monocytogenes were detected with sero/AFLP type 1/2c VII predominating (37%), although this subtype was not overrepresented in any particular meat type (P > 0.05). Ninety-six percent of continental sausages and cured/fermented products were stored at potential for L. monocytogenes to be present at levels hazardous to health at the point of sale.

  10. BIOCHEMISTRY IN THE SPECIALTY IN VISUAL FUNCTION, AND VIRTUAL ENVIRONMENTS IN THE CICS UMA-IPN

    Directory of Open Access Journals (Sweden)

    Blanca Elisa Pérez-Magaña

    2014-07-01

    Full Text Available The higher education and postgraduate in Mexico." delivered at the National Polytechnic Institute is located in a period of constant modification and sustained that has led to the creation of new pedagogical proposals aimed at the promotion of learning emphasizing virtual education. The development of ICT (Information Technologies and Communication in the last few years has favored the emergence and consolidation of degrees, diplomas, Specialties, Master's Degrees among other, using the distance learning based on a web environment. This work analyzes the importance that had the Biochemistry course taught in the specialty of Visual Function in the CICS and UMA that allowed both to the students as the teachers try to virtually eliminate the disadvantages theoretical to traditional teaching. The results obtained in addition to the skills and competences acquired the students were highly successful, and it is hoped to be able to continue implementing such environments in other specialties and master's degrees.

  11. Does a single specialty intensive care unit make better business sense than a multi-specialty intensive care unit? A costing study in a trauma center in India.

    Science.gov (United States)

    Kumar, Parmeshwar; Jithesh, Vishwanathan; Gupta, Shakti Kumar

    2015-01-01

    Though intensive care units (ICUs) only account for 10% of hospital beds, they consume nearly 22% of hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. To evaluate and compare the cost of intensive care delivery between multi-specialty and neurosurgery ICU in an apex trauma care facility in India. The study was conducted in a polytrauma and neurosurgery ICU at a 203 bedded level IV trauma care facility in New Delhi, India from May, 2012 to June 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Fisher's two-tailed t-test. Total cost/bed/day for the multi-specialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU was Rs. 14,306.7/-, manpower constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Quantification of expenditure in running an ICU in a trauma center would assist healthcare decision makers in better allocation of resources. Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed.

  12. Does Specialty Bias Trump Evidence in the Management of High-risk Prostate Cancer?

    Science.gov (United States)

    Kishan, Amar U; Duchesne, Gillian; Wang, Pin-Chieh; Rwigema, Jean-Claude M; Saigal, Christopher; Rettig, Matthew; Steinberg, Michael L; King, Christopher R

    2018-06-01

    The objective was to query how specialty influences treatment recommendations for high-risk prostate cancer in 3 clinical settings: upfront management, postoperative management, and management of biochemical recurrences (BCRs) after radiotherapy (RT). We hypothesized that specialty bias would manifest in all settings, trumping available evidence. A survey of practicing urologists and radiation oncologists was distributed through electronic mail. Questions pertained to upfront management, postoperative treatment, and local salvage for postradiation BCRs. The associations between 26 selected categorical responses and specialty were assessed using multivariate logistic regression. Training level/expertise, practice setting, percentage of consultation caseload consisting of prostate cancer, and nationality were set as effect modifiers. One thousand two hundred fifty-three physicians (846 radiation oncologists and 407 urologists) completed the survey. Radiation oncologists were more likely to recommend adjuvant RT and consider it to be underutilized, and more likely to recommend salvage RT at lower prostate-specific antigen thresholds (P<0.0001). Urologists were more likely to recommend salvage radical prostatectomy or cryoablation for local salvage after RT, whereas radiation oncologists were more likely to recommend RT-based modalities and more likely to report that local salvage was underutilized after RT (P<0.0001). Urologists were more likely to report that upfront radical prostatectomy was a better definitive treatment (P<0.0001), whereas radiation oncologists were more likely to report the opposite (P=0.005). Specialty biases permeate recommendations for upfront management and management in the postoperative and post-RT BCR setting, irrespective of available evidence. These data reveal the critical need for multidisciplinary clinics and cross-specialty training as potential solutions for overcoming specialty bias.

  13. Comparison of Women in Department Leadership in Obstetrics and Gynecology With Those in Other Specialties.

    Science.gov (United States)

    Hofler, Lisa G; Hacker, Michele R; Dodge, Laura E; Schutzberg, Rose; Ricciotti, Hope A

    2016-03-01

    To compare the representation of women in obstetrics and gynecology department-based leadership to other clinical specialties while accounting for proportions of women in historical residency cohorts. This was a cross-sectional observational study. The gender of department-based leaders (chair, vice chair, division director) and residency program directors was determined from websites of 950 academic departments of anesthesiology, diagnostic radiology, general surgery, internal medicine, neurology, obstetrics and gynecology, pathology, pediatrics, and psychiatry. Each specialty's representation ratio-proportion of leadership roles held by women in 2013 divided by proportion of residents in 1990 who were women-and 95% confidence interval (CI) were calculated. A ratio of 1 indicates proportionate representation. Women were significantly underrepresented among chairs for all specialties (ratios 0.60 or less, P≤.02) and division directors for all specialties except anesthesiology (ratio 1.13, 95% CI 0.87-1.46) and diagnostic radiology (ratio 0.97, 95% CI 0.81-1.16). The representation ratio for vice chair was below 1.0 for all specialties except anesthesiology; this finding reached statistical significance only for pathology, pediatrics, and psychiatry. Women were significantly overrepresented as residency program directors in general surgery, anesthesiology, obstetrics and gynecology, and pediatrics (ratios greater than 1.19, P≤.046). Obstetrics and gynecology and pediatrics had the highest proportions of residents in 1990 and department leaders in 2013 who were women. Despite having the largest proportion of leaders who were women, representation ratios demonstrate obstetrics and gynecology is behind other specialties in progression of women to departmental leadership. Women's overrepresentation as residency program directors raises concern because education-based academic tracks may not lead to major leadership roles.

  14. Comparison of Burnout among Medical Residents before and after the Implementation of Work Hours Limits

    Science.gov (United States)

    Martini, Shahm; Arfken, Cynthia L.; Balon, Richard

    2006-01-01

    Objective: The authors assess whether implementation of work hour limits is associated with a lower prevalence of medical resident burnout. Method: A survey was mailed to medical residents in different medical specialties at one university. Results: Somewhat lower burnout prevalence was reported among residents after implementation of work hour…

  15. Going Through Medical School and Considering the Choice of Family Medicine: Prescription or Antidote?

    Science.gov (United States)

    Mauksch, Hans O.; And Others

    A study of the choice of specialty by medical students suggests that Family Medicine depends on students whose choice predates medical school; the number of those interested diminishes significantly over the four years. Interviews suggest several characteristics of the medical school that mitigate against the choice of family medicine and steer…

  16. Roadmap for a Smart Factory: A Modular, Intelligent Concept for the Production of Specialty Chemicals.

    Science.gov (United States)

    Reitze, Arnulf; Jürgensmeyer, Nikolas; Lier, Stefan; Kohnke, Marco; Riese, Julia; Grünewald, Marcus

    2018-04-09

    Digitalization and increasing the flexibility of production concepts offer the possibility to react to market challenges in the field of specialty chemicals. Shorter product lifetimes, increasing product individualization, and the resulting market volatility impose new requirements on plant operators. Novel concepts such as modular production plants and developments in digitalization (Industry 4.0) are able to assist the implementation of smart factories in specialty chemicals. These essential concepts will be presented in this Minireview. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  17. Medical photography: principles for orthopedics.

    Science.gov (United States)

    Uzun, Metin; Bülbül, Murat; Toker, Serdar; Beksaç, Burak; Kara, Adnan

    2014-04-05

    Medical photography is used clinically for patient evaluation, treatment decisions, and scientific documentation. Although standards for medical photography exist in many branches of medicine, we have not encountered such criteria in publications in the area of orthopedics. This study aims to (1) assess the quality of medical images used in an orthopedic publication and (2) to propose standards for medical photography in this area. Clinical photographs were reviewed from all issues of a journal published between the years 2008 and 2012. A quality of clinical images was developed based on the criteria published for the specialties of dermatology and cosmetic surgery. All images were reviewed on the appropriateness of background, patient preparation, and technique. In this study, only 44.9% of clinical images in an orthopedic publication adhered to the proposed conventions. Standards have not been established for medical photography in orthopedics as in other specialty areas. Our results suggest that photographic clinical information in orthopedic publications may be limited by inadequate presentation. We propose that formal conventions for clinical images should be established.

  18. Physician self-referral and physician-owned specialty facilities.

    Science.gov (United States)

    Casalino, Lawrence P

    2008-06-01

    Physician self-referral ranges from suggesting a follow-up appointment, to sending a patient to a facility in which the doctor has an ownership interest or financial relationship. Physician referral to facilities in which the physicians have an ownership interest is becoming increasingly common and not always medically appropriate. This Synthesis reviews the evidence on physician self-referral arrangements, their effect on costs and utilization, and their effect on general hospitals. Key findings include: the rise in self-referral is sparked by financial, regulatory and clinical incentives, including patient convenience and doctors trying to preserve their income in the changing health care landscape. Strong evidence suggests self-referral leads to increased usage of health care services; but there is insufficient evidence to determine whether this increased usage reflects doctors meeting an unmet need or ordering clinically inappropriate care. The more significant a physician's financial interest in a facility, the more likely the doctor is to refer patients there. Arrangements through which doctors receive fees for patient referrals to third-party centers, such as "pay-per-click," time-share, and leasing arrangements, do not seem to offer benefits beyond increasing physician income. So far, the profit margins of general hospitals have not been harmed by the rise in doctor-owned facilities.

  19. The Integration of Medical Toxicology and Addiction Medicine: a New Era in Patient Care.

    Science.gov (United States)

    Laes, JoAn R

    2016-03-01

    Medical toxicologists are frequently called upon to treat patients who are addicted to alcohol, tobacco, or other substances across many care settings. Medical toxicologists provide service to their patients through the identification, treatment, and prevention of addiction and its co-morbidities, and practice opportunities are quite varied. Training in addiction medicine can be obtained during or after medical toxicology fellowship through resources offered by the American Society of Addiction Medicine. Additionally, the American Board of Addiction Medicine offers certification in the specialty of addiction medicine to candidates across a wide range of medical specialties.

  20. 6. Seminar of the IIE-ININ-IMP on technological specialties. Topic 8: computation

    International Nuclear Information System (INIS)

    1992-01-01

    The document includes 10 papers presented at the 6. Seminar of the IIE-ININ-IMP (Mexico) on technological specialties in the field of computation. (Topic 8). Three items were in INIS subject scope and a separate abstract was prepared for each of them

  1. 6. Seminar of the IIE-ININ-IMP on technological specialties. Topic 4: dynamics

    International Nuclear Information System (INIS)

    1992-01-01

    The document includes 7 papers presented at the 6. Seminar of the IIE-ININ-IMP (Mexico) on technological specialties in the field of dynamics. (Topic 4). One item was in INIS subject scope and a separate abstract was prepared for it

  2. The professional orientation to the masonry specialty: a system of activities

    Directory of Open Access Journals (Sweden)

    Jóse Andrés Gómez Torres

    2018-03-01

    Full Text Available The specialty Masonry in Technical and Vocational Education is of great importance given the mission that has to train workers who have to use the most efficient and updated techniques and technologies for the construction of buildings and other construction works. In the pedagogical practice manifested a contradiction expressed in the need to raise the quality of the professional training of the workers in the specialty Masonry, however, there were inadequacies in the work of professional guidance with students who attend the first year in the Polytechnical center "Leonides Blanco", reflected in the insufficient inclination towards the study profile, which led to the failure of a percentage of students. The objective of the work was to elaborate a system of activities that perfected the process of professional orientation towards the specialty Albañilería the first year at the "Leonides Blanco" PolytechnicCenter. In the investigative process, the dialectical-materialist method was assumed as the general method, which supported the theoretical methods, the application of statistical techniques that made possible the study and systematization of the theoretical and methodological foundations of the process under investigation. The practical significance is expressed in a system of activities that contributed to the professional orientation of the first-year students of the specialty Masonry, which guarantees a relevant initial training process, depending on the demands of the professional model and the needs educational and social

  3. Purple Pelisse: A specialty fingerling potato with purple skin and flesh and medium specific gravity

    Science.gov (United States)

    Purple Pelisse is a specialty fingerling potato with purple skin and dark purple flesh. It has medium maturity and sets a large number of smooth, small, fingerling-shaped tubers. The tubers have medium specific gravity and high levels of antioxidants. This potato variety is mainly intended for the f...

  4. Personality Patterns of Physicians in Person-Oriented and Technique-Oriented Specialties

    Science.gov (United States)

    Borges, Nicole J.; Gibson, Denise D.

    2005-01-01

    This study investigated differences in personality patterns between person-oriented and technique-oriented physicians. It tested an integrative framework by converting the scores on the Personality Research Form (PRF) to the Big-Five factors and built a predictive model of group membership in clinical specialty area. PRF scores from 238 physicians…

  5. On the Development of Professional Competence in Students of Creative Pedagogical Specialties

    Science.gov (United States)

    Makhashova, Patima; Meirmanov, Asylbek; Zhunusbekov, Zhaxybek; Makasheva, Orynkul; Mirzaliyeva, Elmira; Ermuratova, Almagul; Sakenov, Janat

    2016-01-01

    The relevance of the topic revealed is caused by necessity to update the organization of professional activity for pedagogical higher education institution on a competence-based basis, creating conditions for developing the corresponding professional competences in students of creative pedagogical specialties. The paper addresses the structure,…

  6. 75 FR 52989 - Specialty Minerals, Inc., Franklin, VA; Notice of Negative Determination Regarding Application...

    Science.gov (United States)

    2010-08-30

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,057] Specialty Minerals, Inc., Franklin, VA; Notice of Negative Determination Regarding Application for Reconsideration By applications dated July 9, 2010 and July 16, 2010 (filed by a company official and a worker, respectively...

  7. 76 FR 2290 - TRICARE; Reimbursement for Travel for Specialty Care Under Exceptional Circumstances

    Science.gov (United States)

    2011-01-13

    ... or TRICARE Prime Remote. The Director, TRICARE Management Activity, shall issue procedures and... from members of the public is to make these submissions available for viewing on the Internet at http... live in certain more remote areas where there are insufficient numbers or types of specialty or...

  8. 6. Seminar of the IIE-ININ-IMP on technological specialties. Topic 3: thermal fluids

    International Nuclear Information System (INIS)

    1992-01-01

    The document includes 10 papers presented at the 6. Seminar of the IIE-ININ-IMP (Mexico) on technological specialties in the field of thermal fluids. (Topic 3). From these, 4 papers were in INIS subject scope and a separate abstract was prepared for each of them

  9. 6. Seminar of the IIE-ININ-IMP on technological specialties. Topic 13: earth sciences

    International Nuclear Information System (INIS)

    1992-01-01

    The document includes 12 papers presented at the 6. Seminar of the IIE-ININ-IMP (Mexico) on technological specialties in the field of earth sciences. (Topic 13). Four items were in INIS subject scope and a separate abstract was prepared for each of them

  10. 75 FR 41693 - Export Inspection and Weighing Waiver for High Quality Specialty Grains Transported in Containers

    Science.gov (United States)

    2010-07-19

    ... Specialty Grains Transported in Containers AGENCY: Grain Inspection, Packers and Stockyards Administration... rule to potentially make permanent the current waiver for high quality grain exported in containers... exported in containers that was established by a final rule on December 13, 2005 (70 FR 73556). This...

  11. 75 FR 6377 - Onyx Specialty Papers, Inc.; Notice of Availability of Draft Environmental Assessment

    Science.gov (United States)

    2010-02-09

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 2985-006] Onyx Specialty Papers, Inc.; Notice of Availability of Draft Environmental Assessment February 2, 2010. In accordance... lieu of paper. The Commission strongly encourages electronic filings. See 18 CFR 385.2001(a)(1)(iii...

  12. 76 FR 19467 - Mueller Steam Specialty Formerly Known As Core Industries Including Workers Whose Unemployment...

    Science.gov (United States)

    2011-04-07

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-73,851] Mueller Steam Specialty... to Apply for Worker Adjustment Assistance on October 7, 2010, applicable to workers of Mueller Steam... shows that workers separated from employment at the St. Pauls, North Carolina location of Mueller Steam...

  13. 75 FR 5152 - Ancor Specialties: A Division of Hoeganaes Corporation Ridgway, PA; Notice of Revised...

    Science.gov (United States)

    2010-02-01

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-71,251] Ancor Specialties: A..., resulted in a negative determination issued on October 15, 2009, was based on the finding that imports of... certification, and all workers in the group threatened with total or partial separation from employment on date...

  14. Mapping change in scientific specialties: a scientometric case study of the development or artificial intelligence

    NARCIS (Netherlands)

    van den Besselaar, P.; Leydesdorff, L.

    1996-01-01

    Has an identifiable core of activities called AI been established, during the AI-boom in the eighties? Is AI already in a “paradigmatic” phase? There has been a lot of disagreement among commentators and specialists about the nature of Artificial Intelligence as a specialty. This makes AI an

  15. 6. Seminar of the IIE-ININ-IMP on technological specialties. Topic 7: energy savings

    International Nuclear Information System (INIS)

    1992-01-01

    The document includes 6 papers presented at the 6. Seminar of the IIE-ININ-IMP (Mexico) on technological specialties in the field of energy savings. (Topic 7). One item was in INIS subject scope and a separate abstract was prepared for it

  16. Oral speech teaching to students of mathematic specialties: a grammatical aspect

    Directory of Open Access Journals (Sweden)

    Ibragimov I.I.

    2016-08-01

    Full Text Available the paper considers teaching features of English speech grammar aspects. The case studies include undergraduates of mathematical specialties. The content of students’ educational activity at the final stage of language teaching is pointed out. Besides the structure of grammar section, a special didactic training unit in which framework mastering grammar phenomena used in oral speech takes place is described.

  17. Construction and Practice of the New Business Specialty Talent Cultivation Mode

    Science.gov (United States)

    Xiao, Xiaokong

    2009-01-01

    The vocational education of business should actively adapt the demands of the domestic and foreign business development to cultivate high-quality applicable talents with international knowledge. The traditional business specialty teaching and the talent cultivation mode have not followed the domestic and foreign market demands, and are difficult…

  18. A patient group based business planning model for a surgical specialty

    NARCIS (Netherlands)

    Adan, I.J.B.F.; Vissers, J.M.H.; van den Heuvel, M.N.; Wiersema, K.; Vissers, J.M.H.; Beech, R.

    2005-01-01

    In this contribution we present an approach for a business planning model for a surgical specialty, based on modelling of all patient processes as well as of the dynamics involved in planning and managing resources. An important basis of the model is the description of the processes of all patient

  19. Vulnerability of California specialty crops to projected mid-century temperature changes

    Science.gov (United States)

    Increasing global temperatures are likely to have major impacts on agriculture, but the effects will vary by crop and location. This paper describes the temperature sensitivity and exposure of selected specialty crops in California. We used literature synthesis to create several sensitivity indices ...

  20. 78 FR 79658 - Okanagan Specialty Fruits, Inc.; Availability of Plant Pest Risk Assessment and Environmental...

    Science.gov (United States)

    2013-12-31

    ..., DC, this 20th day of December 2013. Kevin Shea, Administrator, Animal and Plant Health Inspection... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service [Docket No. APHIS-2012-0025] Okanagan Specialty Fruits, Inc.; Availability of Plant Pest Risk Assessment and Environmental Assessment...

  1. Toward the establishment of a forensic nursing specialty in Brazil: an integrative literature review.

    Science.gov (United States)

    Esteves, Rafael Braga; Lasiuk, Gerri C; Cardoso, Lucilene; Kent-Wilkinson, Arlene

    2014-01-01

    Over the past two decades, Brazil has made progress in bringing political and community attention to issues related to violence. The recognition of links between violence and health has intensified calls to accelerate the development of a forensic nursing specialty in Brazil. The aim of this study was to systematically examine and synthesize the literature on the development of the forensic nursing specialty around the globe and to extract important lessons for the establishment of a forensic nursing specialty in Brazil. An integrative review was conducted according to the method described by Whittmore and Knafl (2005). Electronic searches of the following databases were conducted between December 2012 and March 2013: CINAHL Plus with Full Text, Criminal Justice, Index to Legal periodicals, MEDLINE, Soc Index with Full Text, Social Work Abstracts, SCOPUS, and PsycINFO. The search terms used were: [(TI nurs* or SU nurs*) and [TI (forensic* or penal or prison*) or SU (forensic* or penal or prison*)] and (sexual assault nurse examiner*). Preestablished inclusion/exclusion criteria were used to select published articles for review. Twenty-three articles met inclusion criteria and were included in the full review. Important lessons for Brazil are discussed in terms of education and curricular issues and forensic psychiatric nursing. In Brazil, there is a window of opportunity to contribute the theoretical foundations of forensic nursing science and to advance nursing specialty practice in the areas of Sexual Assault Nurse Examiners and forensic psychiatric nurses.

  2. The relation between specialty choice of psychology students and their interests, personality, and cognitive abilities

    NARCIS (Netherlands)

    Wicherts, J.M.; Vorst, H.C.M.

    2010-01-01

    The aim of this longitudinal study was to investigate differences in interests, personality, and cognitive abilities between students majoring in the six specialties of psychology at the University of Amsterdam. Results show that students at Social Psychology and Work and Organizational Psychology

  3. The Relation between Specialty Choice of Psychology Students and Their Interests, Personality, and Cognitive Abilities

    Science.gov (United States)

    Wicherts, Jelte M.; Vorst, Harrie C. M.

    2010-01-01

    The aim of this longitudinal study was to investigate differences in interests, personality, and cognitive abilities between students majoring in the six specialties of psychology at the University of Amsterdam. Results show that students at Social Psychology and Work and Organizational Psychology were on average more extraverted than students of…

  4. "Medical writing" and ghostwriting as ethical challenges in medical communication.

    Science.gov (United States)

    Górski, A; Letkiewicz, S

    2010-10-01

    In the past years, it has become increasingly apparent that ghostwriting may erode the public trust in medical science and scientific publishing. It is estimated that approximately 10% of articles published in reputed journals are ghostwritten, and this rate may be even higher in some medical specialties. Although this practice is rather universally condemned, the propriety of participation of professional writers in producing papers remains an open question. Although some believe this practice should also be banned, others argue that such stringent policy would increase nonpublication and rather encourage disclosure; but should medical writers be included as authors on the final version of manuscripts? These and other questions should be solved to maintain the high scientific and ethical standards of medical communication and public trust in medicine. Copyright © 2010 Elsevier Inc. All rights reserved.

  5. Influences on Intentions to Place Long-Acting Reversible Contraceptives: A Pilot Study Comparing According to Provider Specialty in Ohio.

    Science.gov (United States)

    Thompson, Charee M; Broecker, Jane; Dade, Maggie; Nottingham, Kelly

    2018-03-23

    According to the American Academy of Pediatrics, pediatricians are to counsel and provide long-acting reversible contraceptives (LARCs) as first line of defense contraceptives because they are the most effective. We wanted to explore positive influences on LARC placement for pediatricians, particularly compared with providers in other specialties who care for women. Survey methods with data analyzed using analyses of variance and general linear models in statistical software SPSS version 24.0 (IBM Corp). Online survey. Participants were 224 providers across the state of Ohio who specialize in family medicine (51.8%), obstetrics/gynecology (17.9%), pediatrics (16.5%), and internal medicine (13.8%). Most of the sample was female (50.9%) and Caucasian (74.6%). The most frequent provider types were Doctors of Osteopathic Medicine (42.0%), followed by Doctors of Medicine (37.9%), and Certified Nurse Practitioners (8.5%). None. Attitudes about LARCs, perceived norms about placing LARCs, perceived behavioral control over placing LARCs, intentions to place LARCs. Means for all of the variables (attitudes, perceived norms, perceived behavioral control, and intentions to place) differed according to provider specialty. A pattern emerged across these variables in which internal medicine and pediatric practitioners reported lower attitudes, perceived norms, perceived behavioral control, and intentions to place LARCs than family medicine and obstetrics/gynecology practitioners, in that order. To increase positive attitudes and perceived norms about LARCs, professional organizations should increase communication to providers about the importance and expectations to place, counsel about, and facilitate placement of LARCs, and medical schooling can improve LARC counseling and procedural training to medical students, interns, and residents. Because perceived behavioral control is linked to intentions to place LARCs, perhaps providers would feel more confident to place them if they

  6. Perceived Health Status and Utilization of Specialty Care: Racial and Ethnic Disparities in Patients with Chronic Diseases

    Science.gov (United States)

    Glover, Saundra; Bellinger, Jessica D.; Bae, Sejong; Rivers, Patrick A.; Singh, Karan P.

    2010-01-01

    Objective: The objective of this study is to determine racial and ethnic variations in specialty care utilization based on (a) perceived health status and (b) chronic disease status. Methods: Variations in specialty care utilization, by perceived health and chronic disease status, were examined using the Commonwealth Fund Health Care Quality…

  7. 77 FR 6584 - Specialty Bar Products Company,a Subsidiary of Doncasters, Inc., Blairsville, PA; Notice of...

    Science.gov (United States)

    2012-02-08

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-80,511] Specialty Bar Products Company,a Subsidiary of Doncasters, Inc., Blairsville, PA; Notice of Affirmative Determination Regarding... Assistance (TAA) applicable to workers and former workers of Specialty Bar Products Company, a subsidiary of...

  8. The dynamics of triads in aggregated journal-journal citation relations: specialty developments at the above-journal level

    NARCIS (Netherlands)

    de Nooy, W.; Leydesdorff, L.

    2015-01-01

    Dyads of journals—related by citations—can agglomerate into specialties through the mechanism of triadic closure. Using the Journal Citation Reports 2011, 2012, and 2013, we analyze triad formation as indicators of integration (specialty growth) and disintegration (restructuring). The strongest

  9. 76 FR 50285 - Fiscal Year 2012 Tariff-Rate Quota Allocations for Raw Cane Sugar, Refined and Specialty Sugar...

    Science.gov (United States)

    2011-08-12

    ... for Raw Cane Sugar, Refined and Specialty Sugar and Sugar-Containing Products AGENCY: Office of the... quantity of the tariff-rate quotas for imported raw cane sugar, refined and specialty sugar and sugar...), the United States maintains tariff-rate quotas (TRQs) for imports of raw cane sugar and refined sugar...

  10. 77 FR 57180 - Fiscal Year 2013 Tariff-rate Quota Allocations for Raw Cane Sugar, Refined and Specialty Sugar...

    Science.gov (United States)

    2012-09-17

    ... Sugar, Refined and Specialty Sugar, and Sugar-Containing Products AGENCY: Office of the United States... quantity of the tariff-rate quotas for imported raw cane sugar, refined and specialty sugar, and sugar... imports of raw cane sugar and refined sugar. Pursuant to Additional U.S. Note 8 to Chapter 17 of the HTS...

  11. The Effect of Teaching Experience and Specialty (Vocal or Instrumental) on Vocal Health Ratings of Music Teachers

    Science.gov (United States)

    Hackworth, Rhonda S.

    2010-01-01

    The current study sought to determine the relationship among music teachers' length of teaching experience, specialty (vocal or instrumental), and ratings of behaviors and teaching activities related to vocal health. Participants (N = 379) were experienced (n = 208) and preservice (n = 171) music teachers, further categorized by specialty, either…

  12. Agile Model Driven Development of Electronic Health Record-Based Specialty Population Registries

    Science.gov (United States)

    Kannan, Vaishnavi; Fish, Jason C.; Willett, DuWayne L.

    2018-01-01

    The transformation of the American healthcare payment system from fee-for-service to value-based care increasingly makes it valuable to develop patient registries for specialized populations, to better assess healthcare quality and costs. Recent widespread adoption of Electronic Health Records (EHRs) in the U.S. now makes possible construction of EHR-based specialty registry data collection tools and reports, previously unfeasible using manual chart abstraction. But the complexities of specialty registry EHR tools and measures, along with the variety of stakeholders involved, can result in misunderstood requirements and frequent product change requests, as users first experience the tools in their actual clinical workflows. Such requirements churn could easily stall progress in specialty registry rollout. Modeling a system’s requirements and solution design can be a powerful way to remove ambiguities, facilitate shared understanding, and help evolve a design to meet newly-discovered needs. “Agile Modeling” retains these values while avoiding excessive unused up-front modeling in favor of iterative incremental modeling. Using Agile Modeling principles and practices, in calendar year 2015 one institution developed 58 EHR-based specialty registries, with 111 new data collection tools, supporting 134 clinical process and outcome measures, and enrolling over 16,000 patients. The subset of UML and non-UML models found most consistently useful in designing, building, and iteratively evolving EHR-based specialty registries included User Stories, Domain Models, Use Case Diagrams, Decision Trees, Graphical User Interface Storyboards, Use Case text descriptions, and Solution Class Diagrams. PMID:29750222

  13. High and specialty-related musculoskeletal disorders afflict dental professionals even since early training years

    Directory of Open Access Journals (Sweden)

    Jianru YI

    2013-07-01

    Full Text Available OBJECTIVE: To determine how early musculoskeletal disorders (MSDs develop in dental professionals and to explore the potential differences among distinct dental specialties. MATERIAL AND METHODS: 271 dental postgraduates majoring in five dental specialties were recruited, i.e., orthodontics, prosthodontics, endodontics, periodontics and alveolar surgery. 254 age-matched non-dental postgraduates served as the control. The standardized Nordic questionnaire on MSDs and a self-report questionnaire regarding correlative factors (only for dental postgraduates were answered through emails. Reliability of responses was assessed applying test-retest method. RESULTS: The intraclass correlation coefficient of participants' answers ranged from 0.89 to 0.96. Dental postgraduates had significantly higher prevalence of MSDs than the control group, especially at neck, upper back and lower back. In all dental specialties included, high prevalence of MSDs was reported at neck (47.5%-69.8%, shoulders (50.8%-65.1%, lower back (27.1%-51.2% and upper back (25.6%-46.5%, with lower prevalence at elbows (5.1%-18.6%, hips (3.4%-16.3% and ankles (5.1%-11.6%. Periodontics students reported the worst MSDs in most body regions except wrists and knees, which were more prevalent for prosthodontic and alveolar surgery students, respectively. Furthermore, year of clinical work, clinical hours per week and desk hours per week were found as risk factors for MSDs, whereas physical exercise and rest between patients as protective factors. CONCLUSIONS: High and specialty-related MSDs afflict dental professionals even since very early stage of careers. Prevention aimed at the specialty-related characteristics and the risk/protective factors revealed in this study should be introduced to dental personnel as early as possible.

  14. Radiation physics for medical physicists

    CERN Document Server

    Podgorsak, Ervin B

    2016-01-01

    This textbook summarizes the basic knowledge of atomic, nuclear, and radiation physics that professionals working in medical physics and biomedical engineering need for efficient and safe use of ionizing radiation in medicine. Concentrating on the underlying principles of radiation physics, the textbook covers the prerequisite knowledge for medical physics courses on the graduate and post-graduate levels in radiotherapy physics, radiation dosimetry, imaging physics, and health physics, thus providing the link between elementary undergraduate physics and the intricacies of four medical physics specialties: diagnostic radiology physics, nuclear medicine physics, radiation oncology physics, and health physics. To recognize the importance of radiation dosimetry to medical physics three new chapters have been added to the 14 chapters of the previous edition. Chapter 15 provides a general introduction to radiation dosimetry. Chapter 16 deals with absolute radiation dosimetry systems that establish absorbed dose or ...

  15. Interest in neurology during medical clerkship in three Nigerian medical schools

    Directory of Open Access Journals (Sweden)

    Olanrewaju Timothy O

    2010-05-01

    Full Text Available Abstract Background This study sought to ascertain perception of Nigerian medical students of neurology in comparison with 7 other major medical specialties. To also determine whether neurology was the specialty students consider most difficult and the reasons for this and to appraise their opinion on how neurosciences and neurology were taught in their different universities. Methods Self-administered questionnaires were used to obtain information from randomly selected clinical students from 3 medical colleges in Nigeria (University of Ibadan, Ibadan; University of Ilorin, Ilorin; Ladoke Akintola University of Technology, Osogbo. Results Of 320 questionnaires sent out, 302 were returned given 94% response rate. Students felt they knew neurology least of all the 8 medical specialties, and were not confident of making neurological diagnoses. About 82% of the students indicated they learnt neurology best from bedside teaching, followed by use of medical textbooks. Close to 15% found online resources very useful for learning neurology and 6% indicated that group discussion was quite useful in the acquisition of knowledge on neurology. Histology and biochemistry were the preclinical subjects participants opined were least useful in learning neurology. The most frequent reasons students felt neurology was difficult were problems with understanding neuroanatomy (49%, insufficient exposure to neurological cases (41%, too many complex diagnoses (32% and inadequate neurology teachers (32%. Conclusions Nigerian medical students perceived neurology as the most difficult medical specialty and are not interested in specializing in it. Neurology education could be improved upon by provision of more bedside tutorials and increased availability of online resources to enhance learning. There is need to emphasize increased frequency of small group discussions amongst students so that they will be used to teamwork after graduation.

  16. Workplace Violence and Self-reported Psychological Health: Coping with Post-traumatic Stress, Mental Distress, and Burnout among Physicians Working in the Emergency Departments Compared to Other Specialties in Pakistan.

    Science.gov (United States)

    Zafar, Waleed; Khan, Uzma R; Siddiqui, Shakeel A; Jamali, Seemin; Razzak, Junaid A

    2016-01-01

    Little is known about the mental health impact of workplace violence (WPV) among emergency physicians (EPs) working in emergency departments (EDs) in Pakistan and whether this impact varies across specialties. Our aim was to measure the prevalence of WPV among EPs in 4 of the largest hospitals in Karachi, Pakistan; to measure the association between the experience of WPV and self-report of post-traumatic stress disorder (PTSD), depression, anxiety, and burnout; to compare the same factors across medical specialties; and to explore the coping strategies used by physicians in dealing with job-related stressors. A cross-sectional survey was conducted among 179 physicians from 5 specialties (response rate, 92.2%) using standard questionnaires for WPV, PTSD, burnout, current mental distress, and methods of coping. One in 6 physicians reported experiencing a physical attack and 3 in 5 verbal abuse on the job in the previous 12 months. Pathologists were less likely to report any form of WPV compared to all other specialties. There was, however, no difference in experience of WPV between EPs and internists, surgeons, or pediatricians. One in 6 physicians screened positive for PTSD, and 2 in 5 for current anxiety and depression. There was significant comorbidity of mental distress with PTSD. Those who reported experiencing physical attack were 6.7 times more likely to report PTSD symptoms. We also found high rates of burnout (42.4% emotional exhaustion; 72.9% depersonalization) among physicians. Experience of WPV was not uniform across specialties but was generally high among Pakistani physicians. Prevention of WPV should be a high priority for health care policy makers. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Does a single specialty intensive care unit make better business sense than a multi-specialty intensive care unit? A costing study in a trauma center in India

    Science.gov (United States)

    Kumar, Parmeshwar; Jithesh, Vishwanathan; Gupta, Shakti Kumar

    2015-01-01

    Context: Though intensive care units (ICUs) only account for 10% of hospital beds, they consume nearly 22% of hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. Aim: To evaluate and compare the cost of intensive care delivery between multi-specialty and neurosurgery ICU in an apex trauma care facility in India. Materials and Methods: The study was conducted in a polytrauma and neurosurgery ICU at a 203 bedded level IV trauma care facility in New Delhi, India from May, 2012 to June 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Statistical Analysis: Fisher's two-tailed t-test. Results: Total cost/bed/day for the multi-specialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU was Rs. 14,306.7/-, manpower constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Conclusions: Quantification of expenditure in running an ICU in a trauma center would assist healthcare decision makers in better allocation of resources. Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed. PMID:25829909

  18. Does a single specialty intensive care unit make better business sense than a multi-specialty intensive care unit? A costing study in a trauma center in India

    Directory of Open Access Journals (Sweden)

    Parmeshwar Kumar

    2015-01-01

    Full Text Available Context: Though intensive care units (ICUs only account for 10% of hospital beds, they consume nearly 22% of hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. Aim: To evaluate and compare the cost of intensive care delivery between multi-specialty and neurosurgery ICU in an apex trauma care facility in India. Materials and Methods: The study was conducted in a polytrauma and neurosurgery ICU at a 203 bedded level IV trauma care facility in New Delhi, India from May, 2012 to June 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Statistical Analysis: Fisher′s two-tailed t-test. Results: Total cost/bed/day for the multi-specialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU was Rs. 14,306.7/-, manpower constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Conclusions: Quantification of expenditure in running an ICU in a trauma center would assist healthcare decision makers in better allocation of resources. Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed.

  19. Publication of research projects for certification as medical specialists at a peruvian university, 2007-2010

    OpenAIRE

    Ticse, Ray; Hospital Nacional Cayetano Heredia. Lima, Perú. Facultad de Medicina, Universidad Peruana Cayetano Heredia. Lima, Perú. Médico internista endocrinólogo; magíster en Epidemiología Clínica.; Ygreda, Patricia; Facultad de Medicina, Universidad Peruana Cayetano Heredia. Lima, Perú. Médico cirujano.; Samalvides, Frine; Hospital Nacional Cayetano Heredia. Lima, Perú. Facultad de Medicina, Universidad Peruana Cayetano Heredia. Lima, Perú. Médico infectólogo.

    2014-01-01

    In order to determine the frequency of publication in a scientific journal of the research projects done for medical specialty certification, a search was conducted in Google Scholar, Pubmed, biomedical databases and Peruvian medical society journals. These publications were research projects carried out by medical residents graduated from the Faculty of Medicine at the Universidad Peruana Cayetano Heredia, to obtain the certification of medical specialist. Of 351 medical residents graduated ...

  20. Female medical leadership: cross sectional study.

    Science.gov (United States)

    Kvaerner, K J; Aasland, O G; Botten, G S

    1999-01-09

    To assess the relation between male and female medical leadership. Cross sectional study on predictive factors for female medical leadership with data on sex, age, specialty, and occupational status of Norwegian physicians. Oslo, Norway. 13 844 non-retired Norwegian physicians. Medical leaders, defined as physicians holding a leading position in hospital medicine, public health, academic medicine, or private health care. 14.6% (95% confidence interval 14.0% to 15.4%) of the men were leaders compared with 5.1% (4.4% to 5.9%) of the women. Adjusted for age men had a higher estimated probability of leadership in all categories of age and job, the highest being in academic medicine with 0.57 (0.42 to 0.72) for men aged over 54 years compared with 0.39 (0.21 to 0.63) for women in the same category. Among female hospital physicians there was a positive relation between the proportion of women in their specialty and the probability of leadership. Women do not reach senior positions as easily as men. Medical specialties with high proportions of women have more female leaders.

  1. One-year incidence and predictors of homelessness among 300,000 U.S. Veterans seen in specialty mental health care.

    Science.gov (United States)

    Tsai, Jack; Hoff, Rani A; Harpaz-Rotem, Ilan

    2017-05-01

    The Department of Veterans Affairs (VA) is committed to preventing and ending homelessness among U.S. veterans, but there have been few estimates of the incidence of veteran homelessness and prospective studies to identify predictors of homelessness. This study examines the 1-year incidence of homelessness among veterans seen in VA specialty mental health clinics and identified sociodemographic and clinical predictors of homelessness. Using a retrospective cohort study design, data were extracted from the VA medical records of 306,351 veterans referred to anxiety and posttraumatic stress disorder clinics across 130 VA facilities from 2008-2012 and followed for 1 year after referral. Homeless incidence was defined as new use of any VA homeless services or a documented International Classification of Diseases (9th rev.) V60.0 (lack of housing) code during the year. Of the total sample, 5.6% (7.8% for women and 5.4% for men) experienced homelessness within 1 year after referral to VA specialty mental health care. Veterans who were unmarried or diagnosed with a drug use disorder were more than twice as likely to become homeless; those who were Black or had annual incomes less than $25,000 were more than one and a half times as likely to become homeless. Together, these findings suggest a notable and important percentage of veterans seen in VA specialty mental health clinics newly experience homelessness annually. Monitoring early signs of housing vulnerability and preventing homelessness in this vulnerable but treatment-engaged population may be important in the VA's efforts to end veteran homelessness. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. Rapid Development of Specialty Population Registries and Quality Measures from Electronic Health Record Data*. An Agile Framework.

    Science.gov (United States)

    Kannan, Vaishnavi; Fish, Jason S; Mutz, Jacqueline M; Carrington, Angela R; Lai, Ki; Davis, Lisa S; Youngblood, Josh E; Rauschuber, Mark R; Flores, Kathryn A; Sara, Evan J; Bhat, Deepa G; Willett, DuWayne L

    2017-06-14

    Creation of a new electronic health record (EHR)-based registry often can be a "one-off" complex endeavor: first developing new EHR data collection and clinical decision support tools, followed by developing registry-specific data extractions from the EHR for analysis. Each development phase typically has its own long development and testing time, leading to a prolonged overall cycle time for delivering one functioning registry with companion reporting into production. The next registry request then starts from scratch. Such an approach will not scale to meet the emerging demand for specialty registries to support population health and value-based care. To determine if the creation of EHR-based specialty registries could be markedly accelerated by employing (a) a finite core set of EHR data collection principles and methods, (b) concurrent engineering of data extraction and data warehouse design using a common dimensional data model for all registries, and (c) agile development methods commonly employed in new product development. We adopted as guiding principles to (a) capture data as a byproduct of care of the patient, (b) reinforce optimal EHR use by clinicians, (c) employ a finite but robust set of EHR data capture tool types, and (d) leverage our existing technology toolkit. Registries were defined by a shared condition (recorded on the Problem List) or a shared exposure to a procedure (recorded on the Surgical History) or to a medication (recorded on the Medication List). Any EHR fields needed - either to determine registry membership or to calculate a registry-associated clinical quality measure (CQM) - were included in the enterprise data warehouse (EDW) shared dimensional data model. Extract-transform-load (ETL) code was written to pull data at defined "grains" from the EHR into the EDW model. All calculated CQM values were stored in a single Fact table in the EDW crossing all registries. Registry-specific dashboards were created in the EHR to display

  3. Medical students' preparation for the transition to postgraduate training through final year elective rotations.

    Science.gov (United States)

    van den Broek, W E Sjoukje; Wijnen-Meijer, Marjo; Ten Cate, Olle; van Dijk, Marijke

    2017-01-01

    Objectives: This study adds to the ongoing discussion on how to ease the transition from undergraduate medical training to postgraduate training. In the Netherlands there is no central matching system for admission to residency. Medical school graduates just apply for a position in an open job market. Many choose to acquire general or specialty-specific clinical experiences after the medical degree before residency, to further explore career opportunities and to increase their chances to get into their preferred specialty. To shorten this gap between undergraduate and the start of postgraduate training, the sixth and final year of most Dutch medical schools is designed as a "transitional year". Students work with more clinical responsibilities than in the earlier clerkships, and this year includes many elective options. Our study focuses on these elective options and explores how medical students use these transitional year electives to prepare for transition to postgraduate training. Methods: In 2012-2013 we asked all 274 graduating students at one Dutch medical school to complete an open-answer questionnaire with the following topics: their preferred specialty at the start of the transitional year, electives they chose during this year and reasons for these choices, and whether the transitional year electives changed their career considerations. Questionnaire results were coded by two researchers and were discussed with all members of the research team. Results: A total of 235 students responded (86%). Answers about motivation for choices revealed that most electives where chosen for career orientation and to optimize chances to get into a residency program. Students also focused on additional experiences in specialties related to their preferred specialty. Many students chose electives logically related to each other, e.g. combinations of surgery and radiology. About two-thirds of the respondents stated that their elective experiences did confirm their specialty

  4. Tacit knowledge and visual expertise in medical diagnostic reasoning: implications for medical education.

    Science.gov (United States)

    Heiberg Engel, Peter Johan

    2008-01-01

    Much education--especially at the university level--has been criticized for having primarily dealt with explicit knowledge, i.e. those aspects of mental activities, which are verbal and conscious. Furthermore, research in medical diagnostic reasoning has been criticized for having focused on the specialty of intern medicine, while specialties with other skills, i.e. perceptive skills within pathology and radiology, have been ignored. To show that the concept of tacit knowledge is important in medical education-at all levels and in medical diagnostic reasoning. Describing how tacit knowledge according to Michael Polany, is experienced and expressed in day-to-day life, it is shown that there is a tacit dimension to all knowledge. Reviewing recent literature on medical diagnostic reasoning, it is shown that tacit knowledge is recognized in connection with concepts such as "non-analytical reasoning" and "dual process of reasoning." It is important that educators are trained in how explicit and implicit knowledge is attained and that tacit knowledge is included in educational programmes of all medical specialties.

  5. A Comparative Analysis of Patient Access Modes at Wilford Hall United States Air Force Medical Center and Selected Civilian Medical Centers

    Science.gov (United States)

    1983-12-01

    In A COMPARATIVE ANALYSIS OF PATIENT ACCESS MODES AT WILFORD HALL UNITED STATES AIR FORCE MEDICAL CENTER N AND SELECTED CIVILIAN MEDICAL CENTERS0 N...current patient access modes at WHMC and several civilian medical centers of comparable size. This project has pursued the subject of patient access in...selected civilian medical centers which are comparable to WHMC in size, specialty mix, workload, and mission, providing responsive and efficient patient

  6. Influence of inpatient service specialty on care processes and outcomes for patients with non ST-segment elevation acute coronary syndromes.

    Science.gov (United States)

    Roe, Matthew T; Chen, Anita Y; Mehta, Rajendra H; Li, Yun; Brindis, Ralph G; Smith, Sidney C; Rumsfeld, John S; Gibler, W Brian; Ohman, E Magnus; Peterson, Eric D

    2007-09-04

    Since the broad dissemination of practice guidelines, the association of specialty care with the treatment of patients with acute coronary syndromes has not been studied. We evaluated 55 994 patients with non-ST-segment elevation acute coronary syndromes (ischemic ST-segment changes and/or positive cardiac markers) included in the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines) Quality Improvement Initiative from January 2001 through September 2003 at 301 tertiary US hospitals with full revascularization capabilities. We compared baseline characteristics, the use of American College of Cardiology/American Heart Association guidelines class I recommendations, and in-hospital outcomes by the specialty of the primary in-patient service (cardiology versus noncardiology). A total of 35 374 patients (63.2%) were primarily cared for by a cardiology service, and these patients had lower-risk clinical characteristics, but they more commonly received acute (processes were improved when care was provided by a cardiology service regardless of the propensity to receive cardiology care. The adjusted risk of in-hospital mortality was lower with care provided by a cardiology service (adjusted odds ratio 0.80, 95% confidence interval 0.73 to 0.88), and adjustment for differences in the use of acute medications and invasive procedures partially attenuated this mortality difference (adjusted odds ratio 0.92, 95% confidence interval 0.83 to 1.02). Non-ST-segment elevation acute coronary syndrome patients primarily cared for by a cardiology inpatient service more commonly received evidence-based treatments and had a lower risk of mortality, but these patients had lower-risk clinical characteristics. Results from the present analysis highlight the difficulties with accurately determining how specialty care is associated with treatment patterns and clinical outcomes for patients with acute

  7. Medical safety in boxing: administrative, ethical, legislative, and legal considerations.

    Science.gov (United States)

    Schwartz, Michael B

    2009-10-01

    The roles and responsibilities of the ringside physician are complex and have evolved into a unique specialty in sport medicine. In addition to the medical aspects of ringside medicine, the doctor is now responsible for many administrative, ethical, and legal considerations. This article reviews and details the numerous roles the ringside physician plays in the sport of boxing.

  8. Faculty of Radiation Oncology 2012 trainee survey: perspectives on choice of specialty training and future work practice preferences.

    Science.gov (United States)

    Leung, John; Le, Hien; Turner, Sandra; Munro, Philip; Vukolova, Natalia

    2014-02-01

    This paper reports the key findings of the first Faculty of Radiation Oncology survey of trainees dealing with experiences and perceptions on work practices and choice of specialty. The survey was conducted in mid 2012 using a 37-question instrument. This was distributed by email to 159 current trainees and advertised through the Radiation Oncology Trainees Committee and other channels. There were six email reminders. Respondents were reassured that their responses were anonymous. The overall response rate was 82.8%. Gender was balanced among respondents with 67 (51.5%) being male and 63 (48.5%) being female. The most common age bracket was the 31 to 35 years range. There were similar proportions of trainee responders in each of the five years of training. A substantial number of trainees held other degrees besides medical degrees. The large majority were satisfied with radiation oncology as a career choice and with the Training Network within which they were training. Interest in oncology patients, lifestyle after training and work hours were given as the major reasons for choosing radiation oncology as a career. Nearly half of trainees were interested in undertaking some of their training in a part-time capacity and working part time as a radiation oncologist in the future. Over 70% of trainees stated they were working 36-55 clinical hours per week with additional non-clinical tasks, after-hours work and on-call duties. Nearly half of all trainees reported having one or less hours of protected time per week. Nonetheless, 40% of respondents indicated they had enough time to pursue outside interests. Radiation treatment planning and maintaining currency in general medicine were considered the most difficult aspects of training in radiation oncology. Most respondents were keen on the concept of fostering a research mentor. In terms of views on practice after completion of training, the majority were interested in pursuing a fellowship, and nearly all expressed an

  9. Evaluation of HIV testing recommendations in specialty guidelines for the management of HIV indicator conditions

    DEFF Research Database (Denmark)

    Lord, E; Stockdale, A J; Malek, R

    2017-01-01

    OBJECTIVES: European guidelines recommend HIV testing for individuals presenting with indicator conditions (ICs) including AIDS-defining conditions (ADCs). The extent to which non-HIV specialty guidelines recommend HIV testing in ICs and ADCs is unknown. Our aim was to pilot a methodology in the UK...... are piloting methods to engage with guideline development groups to ensure that patients diagnosed with ICs/ADCs are tested for HIV. We then plan to apply our methodology in other European settings as part of the Optimising Testing and Linkage to Care for HIV across Europe (OptTEST) project....... to review specialty guidelines and ascertain if HIV was discussed and testing recommended. METHODS: UK and European HIV testing guidelines were reviewed to produce a list of 25 ADCs and 49 ICs. UK guidelines for these conditions were identified from searches of the websites of specialist societies...

  10. Specialty pharmaceuticals: policy initiatives to improve assessment, pricing, prescription, and use.

    Science.gov (United States)

    Robinson, James C; Howell, Scott

    2014-10-01

    The value of "specialty pharmaceuticals" for cancer and other complex conditions depends not merely on their molecular structures but also on the manner in which the drugs are assessed, insured, priced, prescribed, and used. This article analyzes the five principal stages through which a specialty drug must pass on its journey from the laboratory to the bedside. These include regulatory approval by the Food and Drug Administration for market access, insurance coverage, pricing and payment, physician prescription, and patient engagement. If structured appropriately, each stage improves performance and supports continued research and development. If structured inappropriately, however, each stage adds to administrative burdens, distorts clinical decision making, and weakens incentives for innovation. Cautious optimism is in order, but neither the continued development of breakthrough products nor their use according to evidence-based guidelines can be taken for granted. Project HOPE—The People-to-People Health Foundation, Inc.

  11. Specialty resident perceptions of the impact of a distributed education model on practice location intentions.

    Science.gov (United States)

    Myhre, Douglas L; Adamiak, Paul J; Pedersen, Jeanette S

    2015-01-01

    There is an increased focus internationally on the social mandate of postgraduate training programs. This study explores specialty residents' perceptions of the impact of the University of Calgary's (UC) distributed education rotations on their self-perceived likelihood of practice location, and if this effect is influenced by resident specialty or stage of program. Residents participating in the UC Distributed Royal College Initiative (DistRCI) between July 2010 and June 2013 completed an online survey following their rotation. Descriptive statistics and student's t-test were employed to analyze quantitative survey data, and a constant comparative approach was used to analyze free text qualitative responses. Residents indicated they were satisfied with the program (92%), and that the distributed rotations significantly increased their self-reported likelihood of practicing in smaller centers (p education program in contributing to future practice and career development, and its relevance in the social accountability of postgraduate programs.

  12. The role of emergency medicine physicians in trauma care in North America: evolution of a specialty

    Directory of Open Access Journals (Sweden)

    Grossman Michael D

    2009-08-01

    Full Text Available Abstract The role of Emergency Medicine Physicians (EMP in the care of trauma patients in North America has evolved since the advent of the specialty in the late 1980's. The evolution of this role in the context of the overall demands of the specialty and accreditation requirements of North American trauma centers will be discussed. Limited available data published in the literature examining the role of EMP's in trauma care will be reviewed with respect to its implications for an expanded role for EMPs in trauma care. Two training models currently in the early stages of development have been proposed to address needs for increased manpower in trauma and the critical care of trauma patients. The available information regarding these models will be reviewed along with the implications for improving the care of trauma patients in both Europe and North America.

  13. Investigation on the learning interest of senior undergraduate students in optoelectronics specialty

    Science.gov (United States)

    Wu, Shenjiang; Wang, Na; Li, Dangjuan; Liu, Chanlao

    2017-08-01

    With the increasing number of the graduate students, many of them have some troubles in job finding. This situation make a huge pressure on the senior students and loss them the interesting in study. This work investigate the reasons by questionnaire survey, panel discussion, interview, etc. to achieve the factors influence their learning interesting. The main reason of students do not have the motivation on study is that they do not understand the development and competition of photoelectric specialty, lack of innovation and entrepreneurship training, hysteresis of the learning knowledge and practical application. Finally, the paper gives some suggestions through teaching reform on how to improve students' learning enthusiasm. This work will contribute to the teaching and training of senior undergraduate students of optoelectronics specialty.

  14. Medical physics 1981

    International Nuclear Information System (INIS)

    Bunde, E.

    1982-01-01

    This volume continues the series of congress publications with which the Deutsche Gesellschaft fuer Medizinische Physik has been completely documenting its annual meetings for some years. The meeting was aimed to show the complexity not only of the scientific specialty medical physics but also of the practical activities of medical physicists, or at least give some idea of it. The conference was centred on the following points: Possibilities of optimization and methods for re-examination of techniques used in X-ray diagnostics, nuclear diagnostics and ultrasonographic diagnostics; bases of dosimetry in practical radiotherapy, especially with a view to the plans to make gauging of therapeutical dosemeters compulsory; current state of neutron therapy and dosimetry; safety and constancy of irradiation devices in operation; planning and equipment of modern radiotherapy departments. Furthermore topics from medical optics and nuclearbiological research were dealt with. Reports were given on the clinical use of whole-body counters. Climatology and surgical research were marginally dealt with in two synoptical papers. Short reports on work currently under way completed the subject groups given and allowed insight into further topical fields of work of medical physicists in science and practice. Finally, the question of education received particular interest. (orig./MG) [de

  15. Prediction of specialty coffee cup quality based on near infrared spectra of green coffee beans.

    Science.gov (United States)

    Tolessa, Kassaye; Rademaker, Michael; De Baets, Bernard; Boeckx, Pascal

    2016-04-01

    The growing global demand for specialty coffee increases the need for improved coffee quality assessment methods. Green bean coffee quality analysis is usually carried out by physical (e.g. black beans, immature beans) and cup quality (e.g. acidity, flavour) evaluation. However, these evaluation methods are subjective, costly, time consuming, require sample preparation and may end up in poor grading systems. This calls for the development of a rapid, low-cost, reliable and reproducible analytical method to evaluate coffee quality attributes and eventually chemical compounds of interest (e.g. chlorogenic acid) in coffee beans. The aim of this study was to develop a model able to predict coffee cup quality based on NIR spectra of green coffee beans. NIR spectra of 86 samples of green Arabica beans of varying quality were analysed. Partial least squares (PLS) regression method was used to develop a model correlating spectral data to cupping score data (cup quality). The selected PLS model had a good predictive power for total specialty cup quality and its individual quality attributes (overall cup preference, acidity, body and aftertaste) showing a high correlation coefficient with r-values of 90, 90,78, 72 and 72, respectively, between measured and predicted cupping scores for 20 out of 86 samples. The corresponding root mean square error of prediction (RMSEP) was 1.04, 0.22, 0.27, 0.24 and 0.27 for total specialty cup quality, overall cup preference, acidity, body and aftertaste, respectively. The results obtained suggest that NIR spectra of green coffee beans are a promising tool for fast and accurate prediction of coffee quality and for classifying green coffee beans into different specialty grades. However, the model should be further tested for coffee samples from different regions in Ethiopia and test if one generic or region-specific model should be developed. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Beyond yields: Climate change effects on specialty crop quality and agroecological management

    Directory of Open Access Journals (Sweden)

    Selena Ahmed

    2016-03-01

    Full Text Available Abstract Climate change is impacting the sustainability of food systems through shifts in natural and human dimensions of agroecosystems that influence farmer livelihoods, consumer choices, and food security. This paper highlights the need for climate studies on specialty crops to focus not only on yields, but also on quality, as well as the ability of agroecological management to buffer climate effects on quality parameters. Crop quality refers to phytonutrient and secondary metabolite profiles and associated health and sensory properties that influence consumer buying decisions. Through two literature reviews, we provide examples of specialty crops that are vulnerable to climate effects on quality and examples of climate-resilient agroecological strategies. A range of specialty crops including fruits, vegetables, tree nuts, stimulants, and herbs were identified to respond to climate variables with changes in quality. The review on climate-resilient strategies to mitigate effects on crop quality highlighted a major gap in the literature. However, agricultural diversification emerged as a promising strategy for climate resilience more broadly and highlights the need for future research to assess the potential of diversified agroecosystems to buffer climate effects on crop quality. We integrate the concepts from our literature review within a socio-ecological systems framework that takes into account feedbacks between crop quality, consumer responses, and agroecosystem management. The presented framework is especially useful for two themes in agricultural development and marketing, nutrition-sensitive agriculture and terroir, for informing the design of climate-change resilient specialty crop systems focused on management of quality and other ecosystem services towards promoting environmental and human wellbeing.

  17. About training of Kazakh students of not language specialties basis of scientific speech

    OpenAIRE

    Ospanova D.

    2016-01-01

    The article discusses the process of written scientific speech training should include two components: teaching understanding and evaluating texts that make the scientific speech in all its substantive and problematic species and learning the rules of creating texts in the chosen specialty. The idea about functional languages develops in the theory vernaculars among which numerous languages of science take essentially important place; studying of these languages represents the theory and prac...

  18. Investigation of Science Faculty with Education Specialties within the Largest University System in the United States

    OpenAIRE

    Bush, Seth D; Pelaez, Nancy; Rudd, James A, II; Stevens, Michael T; Tanner, Kimberly D; Williams, Kathy, PhD

    2011-01-01

    Efforts to improve science education include university science departments hiring Science Faculty with Education Specialties (SFES), scientists who take on specialized roles in science education within their discipline. Although these positions have existed for decades and may be growing more common, few reports have investigated the SFES approach to improving science education. We present comprehensive data on the SFES in the California State University (CSU) system, the largest university ...

  19. VOCATIONAL AND PATRIOTIC EDUCATION OF STUDENTS OF DEFENSE SPECIALTIES AT A TECHNICAL UNIVERSITY

    Directory of Open Access Journals (Sweden)

    N. P. Ustinova

    2016-01-01

    Full Text Available The aim of the publication is an experimental research of patriotic qualities of students – future engineers of the defense industry. Methods. The study is conducted with the use of system-based analysis methods, teacher modeling, observation, interviews, pedagogical testing, and questionnaires. Diagnosis and evaluation of personal qualities of students are carried out using morphological life values test (modified by I. G. Senin, and questionnaire «The need for achieving the goal» (modified by Y. M. Orlov. The reliability of the results is granted by the use of statistical processing of empirical methods. Results. The average empirical values have been obtained concerning the level of professional and patriotic education of students of defence specialties at technical universities. It has been shown that targeted educational activities carried out on the basis of the identified organizational and pedagogical conditions, contributes to the level of professional and patriotic education of students of defense specialties at a Technical University.Scientific novelty. In relation to students – future professionals of defense industry, the concept of «professional – patriotic education» is clarified, which appears to be an integrative quality of a person, including cognitive, emotion-andvalue component and rational-activity components. The organizational and pedagogical conditions of vocational patriotic education of students of defense specialties are identified; the conditions are united into two groups: the creation of professional-oriented educative environment and creating the opportunities for active participation of students in educational and professional activities. Practical significance. Designed criterion-evaluation units are used to evaluate the current level of professional and patriotic education of students. Identified set of organizational and pedagogical conditions has been implemented in the process of patriotic education

  20. Information Security: A Scientometric Study of the Profile, Structure, and Dynamics of an Emerging Scholarly Specialty

    Science.gov (United States)

    2014-03-01

    analysis to study biotechnology research and development. Co-classification, according to McCain, relies on the interpretation of subject analysts...difficulties when mapping higher levels entities (e.g., specialties). Chen and Guan (2011) argued that nanotechnology, biotechnology , and pharmaceuticals... Magazine Communications of the ACM 56 (6): 48-53. Georgi, Christoph, Inga-Lena Darkow, and Herbert Kotzab. 2010. “The Intellectual Foundation of the

  1. The educational impact of the Specialty Care Access Network-Extension of Community Healthcare Outcomes program.

    Science.gov (United States)

    Salgia, Reena J; Mullan, Patricia B; McCurdy, Heather; Sales, Anne; Moseley, Richard H; Su, Grace L

    2014-11-01

    With the aging hepatitis C cohort and increasing prevalence of fatty liver disease, the burden on primary care providers (PCPs) to care for patients with liver disease is growing. In response, the Veterans Administration implemented initiatives for primary care-specialty referral to increase PCP competency in complex disease management. The Specialty Care Access Network-Extension of Community Healthcare Outcomes (SCAN-ECHO) program initiative was designed to transfer subspecialty knowledge to PCPs through case-based distance learning combined with real-time consultation. There is limited information regarding the initiative's ability to engage PCPs to learn and influence their practice. We surveyed PCPs to determine the factors that led to their participation in this program and the educational impact of participation. Of 51 potential participants, 24 responded to an anonymous survey. More than 75% of respondents participated more than one time in a SCAN-ECHO clinic. Providers were motivated to participate by a desire to learn more about liver disease, to apply the knowledge gained to future patients, and to save their patients time traveling to another center for specialty consultation. Seventy-one percent responded that the didactic component and case-based discussion were equally important. It is important that participation changed clinical practice: 75% of providers indicated they had personally discussed the information they learned from the case presentations with their colleague(s), and 42% indicated they helped a colleague care for their patient with the knowledge learned during discussions of other participants' cases. This study shows that the SCAN-ECHO videoconferencing program between PCPs and specialists can educate providers in the delivery of specialty care from a distance and potentially improve healthcare delivery.

  2. E-cigarette specialty retailers: Data to assess the association between retail environment and student e-cigarette use

    OpenAIRE

    Georgiana Bostean; Catherine M. Crespi; Patsornkarn Vorapharuek; William J. McCarthy

    2017-01-01

    The retail environment is a major social determinant of health, yet little is known about the e-cigarette specialty retailer environment. The e-cigarette specialty retail environment may be associated with e-cigarette use by middle and high school students, an issue that was addressed in a recent article entitled, ?E-cigarette use among students and e-cigarette specialty retailer presence near schools,? by Bostean and colleagues (G. Bostean, C.M. Crespi, P. Vorapharuek, W.J. McCarthy, 2016 [1...

  3. Becoming a general practitioner--which factors have most impact on career choice of medical students?

    Science.gov (United States)

    Kiolbassa, Kathrin; Miksch, Antje; Hermann, Katja; Loh, Andreas; Szecsenyi, Joachim; Joos, Stefanie; Goetz, Katja

    2011-05-09

    In Germany, there is a shortage of young physicians in several specialties, the situation of general practitioners (GP) being especially precarious. The factors influencing the career choice of German medical students are poorly understood. This study aims to identify factors influencing medical students' specialty choice laying a special focus on general practice. The study was designed as a cross-sectional survey. In 2010, students at the five medical schools in the federal state of Baden-Wuerttemberg (Germany) filled out an online-questionnaire. On 27 items with 5-point Likert scales, the students rated the importance of specified individual and occupational aspects. Furthermore, students were asked to assign their intended medical specialty. 1,299 students participated in the survey. Thereof, 1,114 students stated a current choice for a specialty, with 708 students choosing a career in one of the following 6 specialties: internal medicine, surgery, gynaecology and obstetrics, paediatrics, anaesthetics and general practice. Overall, individual aspects ('Personal ambition', 'Future perspective', 'Work-life balance') were rated as more important than occupational aspects (i.e. 'Variety in job', 'Job-related ambition') for career choice. For students favouring a career as a GP individual aspects and the factor 'Patient orientation' among the occupational aspects were significantly more important and 'Job-related ambition' less important compared to students with other specialty choices. This study confirms that future GPs differ from students intending to choose other specialties particularly in terms of patient-orientation and individual aspects such as personal ambition, future perspective and work-life balance. Improving job-conditions in terms of family compatibility and work-life balance could help to increase the attractiveness of general practice. Due to the shortage of GPs those factors should be made explicit at an early stage at medical school to increase

  4. Becoming a general practitioner - Which factors have most impact on career choice of medical students?

    Directory of Open Access Journals (Sweden)

    Loh Andreas

    2011-05-01

    Full Text Available Abstract Background In Germany, there is a shortage of young physicians in several specialties, the situation of general practitioners (GP being especially precarious. The factors influencing the career choice of German medical students are poorly understood. This study aims to identify factors influencing medical students' specialty choice laying a special focus on general practice. Methods The study was designed as a cross-sectional survey. In 2010, students at the five medical schools in the federal state of Baden-Wuerttemberg (Germany filled out an online-questionnaire. On 27 items with 5-point Likert scales, the students rated the importance of specified individual and occupational aspects. Furthermore, students were asked to assign their intended medical specialty. Results 1,299 students participated in the survey. Thereof, 1,114 students stated a current choice for a specialty, with 708 students choosing a career in one of the following 6 specialties: internal medicine, surgery, gynaecology and obstetrics, paediatrics, anaesthetics and general practice. Overall, individual aspects ('Personal ambition', 'Future perspective', 'Work-life balance' were rated as more important than occupational aspects (i.e. 'Variety in job', 'Job-related ambition' for career choice. For students favouring a career as a GP individual aspects and the factor 'Patient orientation' among the occupational aspects were significantly more important and 'Job-related ambition' less important compared to students with other specialty choices. Conclusions This study confirms that future GPs differ from students intending to choose other specialties particularly in terms of patient-orientation and individual aspects such as personal ambition, future perspective and work-life balance. Improving job-conditions in terms of family compatibility and work-life balance could help to increase the attractiveness of general practice. Due to the shortage of GPs those factors should

  5. [Prosthodontic specialty training in the United States: what can we learn].

    Science.gov (United States)

    Qing, H

    2017-12-09

    Prosthodontics is one of the nine recognized specialties by American Dental Association. The postgraduate prosthodontic program used to train prosthodontic specialists in U S A started about 70 years ago. Compared to China which just launched the dental residency programs, the programs in U S A have more developed and relatively more mature education system. It is worthwhile for China to study and learn the U S A prosthodontic residency education program. Prosthodontics is a specialty to diagnose and treat complex dental problems, and is often considered as the 'orchestrator' directing and coordinating all the other dental specialists to manage complex situations. This specialty plays an important role in a nation's oral health system. The present article is aimed to introduce the history of US prosthodontic residency program, initial accreditation, curriculum, education standards and mechanisms of the residency program, and how the program is monitored and managed post initial accreditation, with the hope that this system can serve as a reference for China's developing its own residency program.

  6. Mapping Direct Observations From Objective Structured Clinical Examinations to the Milestones Across Specialties.

    Science.gov (United States)

    Baker-Genaw, Kimberly; Kokas, Maria S; Ahsan, Syed F; Darnley-Fisch, Deborah; Drake, Sean; Goyal, Nikhil; Inamdar, Kedar; Moutzouros, Vasilios; Prabhakar, Deepak; Rolland, Laurie; Sangha, Roopina; Shreve, Maria; Woodward, Ann

    2016-07-01

    Little is known about residents' performance on the milestones at the institutional level. Our institution formed a work group to explore this using an institutional-level curriculum and residents' evaluation of the milestones. We assessed whether beginner-level milestones for interpersonal and communication skills (ICS) related to observable behaviors in ICS-focused objective structured clinical examinations (OSCEs) for postgraduate year (PGY) 1 residents across specialties. The work group compared ICS subcompetencies across 12 programs to identify common beginner-level physician-patient communication milestones. The selected ICS milestone sets were compared for common language with the ICS-OSCE assessment tool-the Kalamazoo Essential Elements of Communication Checklist-Adapted (KEECC-A). To assess whether OSCE scores related to ICS milestone scores, all PGY-1 residents from programs that were part of Next Accreditation System Phase 1 were identified; their OSCE scores from July 2013 to June 2014 and ICS subcompetency scores from December 2014 were compared. The milestones for 10 specialties and the transitional year had at least 1 ICS subcompetency that related to physician-patient communication. The language of the ICS beginner-level milestones appears similar to behaviors outlined in the KEECC-A. All 60 residents with complete data received at least a beginner-level ICS subcompetency score and at least a satisfactory score on all 3 OSCEs. The ICS-OSCE scores for PGY-1 residents appear to relate to beginner-level milestones for physician-patient communication across multiple specialties.

  7. Specialty glass development for radiation shielding windows and nuclear waste immobilization

    International Nuclear Information System (INIS)

    Mandal, S.; Ghorui, S.; Roy Chowdhury, A.; Sen, R.; Chakraborty, A.K.; Sen, S.; Maiti, H.S.

    2015-01-01

    The technology of two important varieties of specialty glasses, namely high density Radiation Shielding Window (RSW) glass and specialty glass beads of borosilicate composition have been successfully developed in CGCRI with an aim to meet the countries requirement. Radiation Shielding Windows used in nuclear installations, are viewing devices, which allow direct viewing into radioactive areas while still providing adequate protection to the operating personnel. The glass blocks are stabilized against damage from radiation by introducing cerium in definite proportions. Considering the essentially of developing an indigenous technology to make the country self-sufficient for this critical item, CGCRI has taken up a major programme to develop high lead containing glasses required for RSWs under a MoD with BARC. On the other hand, the specialty glass bead of specific composition and properties is a critical material required for management of radioactive waste in a closed nuclear fuel cycle that is followed by India. During reprocessing of the spent nuclear fuel, high level radio-active liquid waste (HLW) is produced containing unwanted radio isotopes some of which remain radioactive for thousands of years. The need is to immobilize them within a molecular structure so that they will not come out and be released to the ambience and thereby needs to be resolved if nuclear power is to make a significant contribution to the country's power requirement. Borosilicate glass has emerged as the material of choice for immobilization due to its unique random network structure

  8. Radiation Physics for Medical Physicists

    CERN Document Server

    Podgorsak, Ervin B

    2010-01-01

    This well-received textbook and reference summarizes the basic knowledge of atomic, nuclear, and radiation physics that professionals working in medical physics and biomedical engineering need for efficient and safe use of ionizing radiation. Concentrating on the underlying principles of radiation physics, it covers the prerequisite knowledge for medical physics courses on the graduate and post-graduate levels in radiotherapy physics, radiation dosimetry, imaging physics, and health physics, thus providing the link between elementary physics on the one hand and the intricacies of the medical physics specialties on the other hand. This expanded and revised second edition offers reorganized and expanded coverage. Several of the original chapters have been split into two with new sections added for completeness and better flow. New chapters on Coulomb scattering; on energy transfer and energy absorption in photon interactions; and on waveguide theory have been added in recognition of their importance. Others tra...

  9. Specialty magnets

    International Nuclear Information System (INIS)

    Halbach, K.

    1986-07-01

    A number of basic conceptual designs are explained for magnet systems that use permanent magnet materials. Included are iron free multipoles and hybrid magnets. Also appended is a discussion of the manufacturing process and magnetic properties of some permanent magnet materials

  10. Attitudes toward Psychiatry among Final-Year Medical Students in Kumasi, Ghana

    Science.gov (United States)

    Laugharne, Richard; Appiah-Poku, John; Laugharne, Jon; Shankar, Rohit

    2009-01-01

    Objective: Most sub-Saharan African countries have fewer psychiatrists than one per one million people. One possible reason could be that medical students have a negative attitude toward the specialty. The authors evaluated the attitudes toward a career in psychiatry of final-year medical students in Kumasi, Ghana, and compare these with attitudes…

  11. Emergency Contraception: A multi-specialty survey of clinician knowledge and practices

    Science.gov (United States)

    Batur, Pelin; Cleland, Kelly; McNamara, Megan; Wu, Justine; Pickle, Sarah

    2015-01-01

    Objectives To assess knowledge and provision of emergency contraception (EC), particularly the most effective methods. Study Design A web-based survey was distributed to a cross-sectional convenience sample of healthcare providers across specialties treating reproductive-aged women. The survey was sent to 3,260 practicing physicians and advanced practice clinicians in 14 academic centers between February 2013 and April 2014. We analyzed responses by provider specialty using multivariable logistic regression. Results The final sample included 1,684 providers (response rate = 51.7%). Ninety-five percent of the respondents had heard of levonorgestrel (LNG) EC. Among reproductive health specialists, 81% provide levonorgestrel EC in their practice, although only half (52%) had heard of ulipristal acetate (UPA) and very few provide it (14%). The majority in family medicine (69%) and emergency medicine (74%) provide levonorgestrel, in contrast to 42% of internists and 55% of pediatricians. However, the more effective methods (UPA and copper IUD) were little known and rarely provided outside of reproductive health specialties; 18% of internists and 14% of emergency medicine providers had heard of UPA and 4% provide it. Only 22% of emergency providers and 32% of pediatricians had heard of the copper IUD used as EC. Among reproductive health specialists, only 36% provide copper IUD as EC in their practice. Specialty, provider type and proportion of women of reproductive age in the practice were related to knowledge and provision of some forms of EC. Conclusions Awareness and provision of the most effective EC methods, UPA and the copper IUD (which are provider-dependent), are substantially lower than for LNG EC, especially among providers who do not focus on reproductive health. Implications In our sample of 1,684 healthcare providers from diverse specialties who treat reproductive-aged women, knowledge and provision of the most effective forms of emergency contraception

  12. 78 FR 44922 - Vegetable and Specialty Crop Marketing Orders; Notice of Request for Extension and Revision of a...

    Science.gov (United States)

    2013-07-25

    ... Approved Information Collection AGENCY: Agricultural Marketing Service, USDA. ACTION: Notice and request... assured of consideration. Additional Information or Comments: Contact Andrew Hatch, Supervisory Marketing....regulations.gov . SUPPLEMENTARY INFORMATION: Title: Vegetable and Specialty Crop Marketing Orders. OMB Number...

  13. 6. Seminar of the IIE-ININ-IMP on technological specialties. Topic 10: industrial applications of radiation and control

    International Nuclear Information System (INIS)

    1992-01-01

    The document includes 7 papers presented at the 6. Seminar of the IIE-ININ-IMP (Mexico) on technological specialties in the field of industrial applications of radiation and control. (Topic 10). A separate abstract was prepared for each paper

  14. Survey results show that adults are willing to pay higher insurance premiums for generous coverage of specialty drugs.

    Science.gov (United States)

    Romley, John A; Sanchez, Yuri; Penrod, John R; Goldman, Dana P

    2012-04-01

    Generous coverage of specialty drugs for cancer and other diseases may be valuable not only for sick patients currently using these drugs, but also for healthy people who recognize the potential need for them in the future. This study estimated how healthy people value insurance coverage of specialty drugs, defined as high-cost drugs that treat cancer and other serious health conditions like multiple sclerosis, by quantifying willingness to pay via a survey. US adults were estimated to be willing to pay an extra $12.94 on average in insurance premiums per month for generous specialty-drug coverage--in effect, $2.58 for every dollar in out-of-pocket costs that they would expect to pay with a less generous insurance plan. Given the value that people assign to generous coverage of specialty drugs, having high cost sharing on these drugs seemingly runs contrary to what people value in their health insurance.

  15. Specialty pharmacies and other restricted drug distribution systems: financial and safety considerations for patients and health-system pharmacists.

    Science.gov (United States)

    Kirschenbaum, Bonnie E

    2009-12-15

    To discuss the role of restricted drug distribution systems in the implementation of risk evaluation and mitigation strategies (REMS), health-system pharmacists' concerns associated with the use of specialty pharmacies and other restricted drug distribution systems, reimbursement policies for high-cost specialty drugs, supply chain models for traditional and specialty drugs, and emerging trends in the management of and reimbursement for specialty pharmaceuticals. Restricted drug distribution systems established by pharmaceutical manufacturers, specialty pharmacies, or other specialty suppliers may be a component of REMS, which are required by the Food and Drug Administration for the management of known or potential serious risks from certain drugs. Concerns of health-system pharmacists using specialty suppliers include access to pharmaceuticals, operational challenges, product integrity, financial implications, continuity of care, and patient safety. An ambulatory care patient taking a specialty drug product from home to a hospital outpatient clinic or inpatient setting for administration, a practice known as "brown bagging," raises concerns about product integrity and institutional liability. An institution's finances, tolerance for liability, and ability to skillfully manage the processes involved often determine its choice between an approach that prohibits brown bagging but is costly and one that permits the practice under certain conditions and is less costly. The recent shift from a traditional supply chain model to a specialty pharmacy supply chain model for high-cost pharmaceuticals has the potential to increase pharmaceutical costs for health systems. A dialogue is needed between health-system pharmacists and group purchasing organizations to address the latter's role in mitigating the financial implications of this change and to help clarify the safety issues. Some health plans have shifted part of the cost of expensive drugs to patients by establishing a

  16. Medical students' preparation for the transition to postgraduate training through final year elective rotations

    Directory of Open Access Journals (Sweden)

    van den Broek, W. E. Sjoukje

    2017-11-01

    Full Text Available Objectives: This study adds to the ongoing discussion on how to ease the transition from undergraduate medical training to postgraduate training. In the Netherlands there is no central matching system for admission to residency. Medical school graduates just apply for a position in an open job market. Many choose to acquire general or specialty-specific clinical experiences after the medical degree before residency, to further explore career opportunities and to increase their chances to get into their preferred specialty. To shorten this gap between undergraduate and the start of postgraduate training, the sixth and final year of most Dutch medical schools is designed as a “transitional year”. Students work with more clinical responsibilities than in the earlier clerkships, and this year includes many elective options. Our study focuses on these elective options and explores how medical students use these transitional year electives to prepare for transition to postgraduate training.Methods: In 2012-2013 we asked all 274 graduating students at one Dutch medical school to complete an open-answer questionnaire with the following topics: Questionnaire results were coded by two researchers and were discussed with all members of the research team. Results: A total of 235 students responded (86%. Answers about motivation for choices revealed that most electives where chosen for career orientation and to optimize chances to get into a residency program. Students also focused on additional experiences in specialties related to their preferred specialty. Many students chose electives logically related to each other, e.g. combinations of surgery and radiology. About two-thirds of the respondents stated that their elective experiences did confirm their specialty preferences or resulted in a more clear insight.Conclusion: We conclude that students use the transitional year electives to focus on their future postgraduate training program, i.e. for

  17. A Call to Action to Address Gender Equity Within Our Specialty: Time's Up on Waiting for Change.

    Science.gov (United States)

    Baecher-Lind, Laura; Abbott, Jodi; Atkins, Katharyn Meredith; Nijjar, J Biba; Royce, Celeste; Schiff, Lauren; Ricciotti, Hope A

    2018-06-01

    Although national attention has been focused on sexual harassment and gender inequity in the United States, leaders within the obstetrics and gynecology community have remained relatively silent. Sexual harassment and gender inequity remain pervasive in our specialty. This article serves as a call to action for leadership as well as physicians within obstetrics and gynecology to implement ethical and evidence-based approaches to reduce gender inequity and improve workplace culture within our specialty.

  18. What factors influence UK medical students' choice of foundation school?

    Science.gov (United States)

    Miah, Saiful; Pang, Karl H; Rebello, Wayne; Rubakumar, Zoe; Fung, Victoria; Venugopal, Suresh; Begum, Hena

    2017-01-01

    We aimed to identify the factors influencing UK medical student applicants' choice of foundation school. We also explored the factors that doctors currently approaching the end of their 2-year program believe should be considered. A cross-sectional study was conducted during the 2013-2014 academic year. An online questionnaire was distributed to 2092 final-year medical students from nine UK medical schools and 84 foundation year-2 (FY2) doctors from eight foundation schools. Participants were asked to rank their top 3 from a list of 12 factors that could potentially influence choice of foundation school on a 5-point Likert scale. Collated categorical data from the two groups were compared using a chi-square test with Yates correction. Geographic location was overwhelmingly the most important factor for medical students and FY2 doctors with 97.2% and 98.8% in agreement, respectively. Social relationships played a pivotal role for medical student applicants. Clinical specialties within the rotations were of less importance to medical students, in comparison to location and social relationships. In contrast, FY2 doctors placed a significantly greater importance on the specialties undertaken in their 2-year training program, when compared to medical students (chi-square; p =0.0001). UK medical schools should make their foundation program applicants aware of the importance of choosing rotations based on specialties that will be undertaken. Individual foundation schools could provide a more favorable linked application system and greater choice and flexibility of specialties within their 2-year program, potentially making their institution more attractive to future applicants.

  19. What factors influence UK medical students’ choice of foundation school?

    Science.gov (United States)

    Miah, Saiful; Pang, Karl H; Rebello, Wayne; Rubakumar, Zoe; Fung, Victoria; Venugopal, Suresh; Begum, Hena

    2017-01-01

    Background We aimed to identify the factors influencing UK medical student applicants’ choice of foundation school. We also explored the factors that doctors currently approaching the end of their 2-year program believe should be considered. Methods A cross-sectional study was conducted during the 2013–2014 academic year. An online questionnaire was distributed to 2092 final-year medical students from nine UK medical schools and 84 foundation year-2 (FY2) doctors from eight foundation schools. Participants were asked to rank their top 3 from a list of 12 factors that could potentially influence choice of foundation school on a 5-point Likert scale. Collated categorical data from the two groups were compared using a chi-square test with Yates correction. Results Geographic location was overwhelmingly the most important factor for medical students and FY2 doctors with 97.2% and 98.8% in agreement, respectively. Social relationships played a pivotal role for medical student applicants. Clinical specialties within the rotations were of less importance to medical students, in comparison to location and social relationships. In contrast, FY2 doctors placed a significantly greater importance on the specialties undertaken in their 2-year training program, when compared to medical students (chi-square; p=0.0001). Conclusion UK medical schools should make their foundation program applicants aware of the importance of choosing rotations based on specialties that will be undertaken. Individual foundation schools could provide a more favorable linked application system and greater choice and flexibility of specialties within their 2-year program, potentially making their institution more attractive to future applicants. PMID:28458589

  20. Medical Institutions and Twitter: A Novel Tool for Public Communication in Japan

    Science.gov (United States)

    Sugawara, Yuya; Tsuya, Atsushi; Tanaka, Atsushi; Fukao, Akira

    2016-01-01

    Background Twitter is a free social networking and microblogging service on the Internet. Medical professionals and patients have started to use Twitter in medicine. Twitter use by medical institutions can interactively and efficiently provide public health information and education for laypeople. Objective This study examined Twitter usage by medical institutions. Methods We reviewed all Japanese user accounts in which the names of medical institutions were described in the user’s Twitter profile. We then classified medical institutions’ tweets by content. Results We extracted 168 accounts for medical institutions with ≥500 followers. The medical specialties of those accounts were dentistry and oral surgery (n=73), dermatology (n=12), cosmetic surgery (n=10), internal medicine (n=10), ophthalmology (n=6), obstetrics and gynecology (n=5), plastic surgery (n=2), and others (n=50). Of these, 21 accounts tweeted medical knowledge and 45 accounts tweeted guidance about medical practice and consultation hours, including advertisements. In the dentistry and oral surgery accounts, individual behavior or thinking was the most frequent (22/71, 31%) content. On the other hand, consultation including advertisements was the most frequent (14/23, 61%) in cosmetic surgery, plastic surgery, and dermatology. Conclusions Some medical specialties used Twitter for disseminating medical knowledge or guidance including advertisements. This indicates that Twitter potentially can be used for various purposes by different medical specialties. PMID:27227154

  1. Medical Institutions and Twitter: A Novel Tool for Public Communication in Japan.

    Science.gov (United States)

    Sugawara, Yuya; Narimatsu, Hiroto; Tsuya, Atsushi; Tanaka, Atsushi; Fukao, Akira

    2016-01-01

    Twitter is a free social networking and microblogging service on the Internet. Medical professionals and patients have started to use Twitter in medicine. Twitter use by medical institutions can interactively and efficiently provide public health information and education for laypeople. This study examined Twitter usage by medical institutions. We reviewed all Japanese user accounts in which the names of medical institutions were described in the user's Twitter profile. We then classified medical institutions' tweets by content. We extracted 168 accounts for medical institutions with ≥500 followers. The medical specialties of those accounts were dentistry and oral surgery (n=73), dermatology (n=12), cosmetic surgery (n=10), internal medicine (n=10), ophthalmology (n=6), obstetrics and gynecology (n=5), plastic surgery (n=2), and others (n=50). Of these, 21 accounts tweeted medical knowledge and 45 accounts tweeted guidance about medical practice and consultation hours, including advertisements. In the dentistry and oral surgery accounts, individual behavior or thinking was the most frequent (22/71, 31%) content. On the other hand, consultation including advertisements was the most frequent (14/23, 61%) in cosmetic surgery, plastic surgery, and dermatology. Some medical specialties used Twitter for disseminating medical knowledge or guidance including advertisements. This indicates that Twitter potentially can be used for various purposes by different medical specialties.

  2. Medical informatics in morocco.

    Science.gov (United States)

    Bouhaddou, O; Bennani Othmani, M; Diouny, S

    2013-01-01

    Informatics is an essential tool for helping to transform healthcare from a paper-based to a digital sector. This article explores the state-of-the-art of health informatics in Morocco. Specifically, it aims to give a general overview of the Moroccan healthcare system, the challenges it is facing, and the efforts undertaken by the informatics community and Moroccan government in terms of education, research and practice to reform the country's health sector. Through the experience of establishing Medical Informatics as a medical specialty in 2008, creating a Moroccan Medical Informatics Association in 2010 and holding a first national congress took place in April 2012, the authors present their assessment of some important priorities for health informatics in Morocco. These Moroccan initiatives are facilitating collaboration in education, research, and implementation of clinical information systems. In particular, the stakeholders have recognized the need for a national coordinator office and the development of a national framework for standards and interoperability. For developing countries like Morocco, new health IT approaches like mobile health and trans-media health advertising could help optimize scarce resources, improve access to rural areas and focus on the most prevalent health problems, optimizing health care access, quality, and cost for Morocco population.

  3. Practice transition in graduate medical education.

    Science.gov (United States)

    Shaffer, Robyn; Piro, Nancy; Katznelson, Laurence; Gephart, Melanie Hayden

    2017-10-01

    Debt repayment, professional negotiation and practice management skills are vital to a successful medical practice, yet are undervalued and seldom taught in graduate medical education. Medical residents need additional training to confidently transition to independent practice, requiring the development of novel curricula. Medical residents need additional training to confidently transition to independent practice METHODS: We developed a trial practice management curriculum to educate senior residents and fellows through voluntary workshops. Topics discussed in the workshops included debt repayment, billing compliance, medical malpractice, contract negotiations, and lifestyle and financial management. Resident self-confidence was assessed, and feedback was obtained through voluntary survey responses before and after attendance at a workshop, scored using a Likert scale. Twenty-five residents from 20 specialties attended a 1-day session incorporating all lectures; 53 residents from 17 specialties attended a re-designed quarterly session with one or two topics per session. Survey evaluations completed before and after the workshop demonstrated an improvement in residents' self-assessment of confidence in contract negotiations (p practice (p practice. One hundred per cent of respondents agreed that the presentation objectives were relevant to their needs as residents. Participant responses indicated a need for structured education in practice management for senior trainees. Senior residents and fellows will benefit most from curricula, but have high familial and professional demands on their schedules. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  4. Associations between medical school and career preferences in Year 1 medical students in Scotland.

    Science.gov (United States)

    Cleland, Jennifer; Johnston, Peter W; French, Fiona H; Needham, Gillian

    2012-05-01

    Little is known about the relationship between the career preferences of medical students and the medical schools at which they are enrolled. Our aim was to explore this relationship early in students' medical training. Year 1 (2009-2010) medical students at the five Scottish medical schools were invited to take part in a career preference questionnaire survey. Questions were asked about demographic factors, career preferences and influencing factors. The response rate was 87.9% (883/1005). No significant differences were found among medical schools with regard to first-choice specialty. Surgery (22.5%), medicine (19.0%), general practice (17.6%) and paediatrics (16.1%) were the top career choices. Work-life balance, perceived aptitude and skills, intellectual satisfaction, and amount of patient contact were rated as the most important job-related factors by most respondents. Few differences were found among schools in terms of the impact of job-related factors on future career preferences. Students for whom the work-life balance was extremely important (odds ratio [OR]=0.6) were less likely to prefer surgery. Students for whom the work-life balance (OR=2.2) and continuity of care (OR=2.1) were extremely important were more likely to prefer general practice. Students' early career preferences were similar across the five medical schools. These preferences result from the interplay among demographic factors and the perceived characteristics of the various specialties. Maintaining a satisfactory work-life balance is very important to tomorrow's doctors, and the data hint that this may be breaking down some of the traditional gender differences in specialty choice. Longitudinal work is required to explore whether students' career preferences change as they progress through medical school and training. © Blackwell Publishing Ltd 2012.

  5. [Education on medical anthropology and intercultural health in Mexico: from the 20th century cultural indigenism to the 21st century interculturality].

    Science.gov (United States)

    Campos-Navarro, Roberto

    2010-03-01

    The study of the health/disease/healthcare process from the socio-medical aspect is the field of the medical anthropology. In Mexico, this medical specialty had its origins at the end of the 19th century. Since then, many educational reforms occurred associated to the political processes and the recognition and better understanding of Mexican pluricultural society; allowing expansion, diversification and consolidation of medical anthropology as an specialty. This review presents the historical evolution of the academic courses on this field, the educators that influenced its consolidation, and the current situation of the available academic programs on medical anthropology. The diversity of specialties from those health sciences that are associated to medical anthropology is emphasized.

  6. U.S. Dental Specialty Residents' Expectations and Anticipated Benefits of Academic Employment.

    Science.gov (United States)

    Nazarova, Elena; Martin-Peele, Melanie; Fifield, Judith

    2016-10-01

    The aims of this study were to assess features of an academic career that dental specialty residents, as a group and by gender, find most attractive and to identify what determines their expectations for responsibilities and professional growth in academic employment. In November 2013, an invitation to participate in the study along with a link to an online survey was sent to the 407 U.S. program directors of six of the dental specialties (endodontics, oral and maxillofacial surgery, pediatric dentistry, periodontics, prosthodontics, and orthodontics), asking them to forward the survey to their residents. A total of 287 residents responded (112 [41.3%] female and 159 [58.7%] male) out of 4,400 enrolled in these specialty training programs (6.5% response rate). The female respondents were significantly more interested in joining academia than were the male respondents (female 48%; male 31.5%; pgenders were attracted to academic dentistry by opportunities for intellectual and professional stimulation, but the lifestyle of academicians was significantly more important for the female respondents. The most important feature of a successful academic career for the female respondents was the ability to have a good balance between career and personal life. While opportunity to conduct research was a positive feature for all residents interested in academia and both male and female respondents agreed strongly on the need for collaboration between faculty members for productive research, male respondents agreed significantly more than female respondents that faculty members should conduct independent research. Faculty members' feedback about academic employment were a significantly positive influence on those planning an academic career compared to those planning to enter private practice. This study found that the female and male residents differed in their expectations of responsibilities and professional growth in academic employment. These results may be useful for

  7. The role of the national general medical journal: surveys of which journals UK clinicians read to inform their clinical practice.

    Science.gov (United States)

    Jones, Teresa H; Hanney, Stephen; Buxton, Martin J

    2008-12-01

    For biomedical research findings to contribute toward health gains they must reach clinicians. Academic journals have historically been considered important information sources. Birken and Parkin found seven journals to most consistently contain the best pediatric evidence and, of these seven, four were general medical journals. We surveyed clinicians in three UK medical specialties (psychiatry, surgery and pediatrics), asking which journals they read and which they considered important to inform their clinical practice. The readership of general medical journals, in comparison to specialty and sub-specialty journals, is widespread across the three UK medical specialties, although the importance of general medical journals varies widely. The BMJ is the most prominent general medical journal in terms of readership and importance but a dominant specialty or sub-specialty journal was usually more important for most groups. The Lancet is less widely read and less important, although more academics than non-academics consider it important. Overall, key general medical journals play an important role. Journal availability and cost, particularly in relation to membership for UK clinicians, and the position of academics and non-academics have to be considered in any analysis. Three of the four general medical journals containing the best pediatric evidence were found to be widely read by UK pediatricians and two UK-based general medical journals, the BMJ and The Lancet, were also considered important in our survey. Further investigation of the reasons for the importance of a journal and studies that would allow international comparisons would provide greater input to the discussion.

  8. Trends in hospital-physician integration in medical oncology.

    Science.gov (United States)

    Clough, Jeffrey D; Dinan, Michaela A; Schulman, Kevin A

    2017-10-01

    Hospitals have rapidly acquired medical oncology practices in recent years. Experts disagree as to whether these trends are related to oncology-specific market factors or reflect a general trend of hospital-physician integration. The objective of this study was to compare the prevalence, geographic variation, and trends in physicians billing from hospital outpatient departments in medical oncology with other specialties. Retrospective analysis of Medicare claims data for 2012 and 2013. We calculated the proportion of physicians and practitioners in the 15 highest-volume specialties who billed the majority of evaluation and management visits from hospital outpatient departments in each year, nationally and by state. We included 338,998 and 352,321 providers in 2012 and 2013, respectively, of whom 9715 and 9969 were medical oncologists. Among the 15 specialties examined, medical oncology had the highest proportion of hospital outpatient department billing in 2012 and 2013 (35.0% and 38.3%, respectively). Medical oncology also experienced the greatest absolute change (3.3%) between the years, followed by thoracic surgery (2.4%) and cardiology (2.0%). There was marked state-level variation, with the proportion of medical oncologists based in hospital outpatient departments ranging from 0% in Nevada to 100% in Idaho. Hospital-physician integration has been more pronounced in medical oncology than in other high-volume specialties and is increasing at a faster rate. Policy makers should take these findings into consideration, particularly with respect to recent proposals that may continue to fuel these trends.

  9. The professional orientation in the specialty Administration of the Human Capital

    Directory of Open Access Journals (Sweden)

    Amelia Milagro López Martínez

    2016-03-01

    Full Text Available In the article it is approached one of the most significant problems in the Technical Education and Professional (ETP: the orientation toward the professions, to form a professional in correspondence to the current social and labor demands. Is carried out an approach to the historical evolution of the referred process, as well as antecedents and theoretical foundations of the phenomenon are examined in the ETP and in the Administration of the Human Capital specialty, on bases of the Dialectical-Materialistic one, the General Pedagogy, the Pedagogy of the ETP in particular and the situation of the process in the Polytechnic Center Rigoberto Fuentes Pérez.

  10. Specialty and Associate Specialist doctors: still the dependable backbone of genitourinary medicine.

    Science.gov (United States)

    Lee, J D; Carlin, E M; Robinson, A

    2013-05-01

    Workforce planning is an inexact science. Specialty and Associate Specialist (SAS) doctors are rarely included in workforce analyses. Past studies have shown that SAS doctors are significant contributors to the work in genitourinary (GU) medicine clinics. This survey confirms the large amount of clinical work undertaken by SAS doctors. It appears that 51% of SAS doctors in GU plan to retire in the next 15 years and it is uncertain what effect the 2008 SAS contract will have on SAS recruitment. This information should be taken into consideration in future GUM workforce planning.

  11. Specialty Store and Multi-Brand Store loyalty: An Indian consumer perspective

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    Sarabjot Singh

    2013-12-01

    Full Text Available In the competitive era of retailing, retailers need to understand the importance of store format preferences. The study aimed to understand consumer store loyalty; in-depth interview was conducted to examine consumer store loyalty antecedents for two retail formats: specialty stores and multi brand stores. The study conceptualizes store loyalty factors like program loyalty, trust and brand commitment. Trust and brand commitment act as mediating factors between store image and store loyalty formats, and also between brand image and store loyalty formats. The findings highlight how consumer store loyalty preference differ for these two formats.

  12. Professional technical plantar ability in students of 1er year of the Agricultural specialty

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    Yonel Areces Mireles

    2015-09-01

    Full Text Available The present article which approaches on the problems as to the development of professional technical plantar ability in the Agricultural Specialty Polytechnic Leonides Blanco González. Splitting of a dialectic materialistic focus various methods were utilized and techniques: Theorists and empiricists, the ones that permitted going into the background and conception assumed for the treatment of professional technical ability like formation of the personality of the future agricultural worker, as well as determining the needs of developmental students of technical plantar ability.

  13. Professionally-oriented teaching of foreign language to postgraduates of technical specialties

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    Gramma D.V.

    2017-04-01

    Full Text Available the practice of professionally-oriented teaching at English classes of Surgut State University is described in the article. The structure and content of the course for postgraduates of non-linguistic specialties is analyzed. Foreign language teaching in modern conditions is a priority direction and an essential component of professional activity of engineers. Particular attention is paid to such linguistic aspects as reading technical literature, writing activities and project work. The developed system of tasks is aimed at the activation of lexical and grammatical material.

  14. Discrimination of several Indonesian specialty coffees using Fluorescence Spectroscopy combined with SIMCA method

    Science.gov (United States)

    Suhandy, D.; Yulia, M.

    2018-03-01

    Indonesia is one of the important producers of several specialty coffees, which have a particularly high economic value, including Civet coffee (‘kopi luwak’ in Indonesian language) and Peaberry coffee (‘kopi lanang’ in Indonesian language). The production of Civet and Peaberry coffee is very limited. In order to provide authentication of Civet and Peaberry coffee and protect consumers from adulteration, a robust and easy method for evaluating ground Civet and Peaberry coffee and detection of its adulteration is needed. In this study, we investigate the use of fluorescence spectroscopy combined with SIMCA (soft independent modelling of class analogies) method to discriminate three Indonesian specialty coffee: ground Peaberry, Civet and Pagar Alam coffee. Total 90 samples were used (30 samples for Civet, Peaberry and Pagar Alam coffee, respectively). All coffee samples were ground using a home-coffee-grinder. Since particle size in coffee powder has a significant influence on the spectra obtained, we sieved all coffee samples through a nest of U. S. standard sieves (mesh number of 40) on a Meinzer II sieve shaker for 10 minutes to obtain a particle size of 420 µm. The experiments were performed at room temperature (around 27-29°C). All samples were extracted with distilled water and then filtered. For each samples, 3 mL of extracted sample then was pipetted into 10 mm cuvettes for spectral data acquisition. The EEM (excitation-emission matrix) spectral data of coffee samples were acquired using JASCO FP-8300 Fluorescence Spectrometer. The principal component analysis (PCA) result shows that it is possible to discriminate types of coffee based on information from EEM (excitation-emission matrix) spectral data. Using SIMCA method, the discrimination model of Indonesian specialty coffee was successfully developed and resulted in high performance of discrimination with 100% of sensitivity and specificity for Peaberry, Civet and Pagar Alam coffee. This research

  15. Geotechnologies for the Characterization of Specialty Coffee Environments of Mantiqueira de Minas in Brazil

    Science.gov (United States)

    Alves, H. M. R.; Vieira, T. G. C.; Volpato, M. M. L.; Lacerda, M. P. C.; Borém, F. M.

    2016-06-01

    Land-use/land-cover change (LUCC) is a major cause of environmental transformation. Distant drivers, often associated with emerging markets for specific products, are now being considered one of the main factors of LUCC and are gaining attention in land change science. Consumers show an increasing interest in local and quality food, certified for its origin and its environmental production standards. A kind of agricultural product certification, Geographic Indication, identifies a product as originating from a specific region where a given quality, reputation or characteristic is attributed to its geographical origin. Sustainable land use is potentially an indirect effect of Geographic Indication, as it requires better land management in order to preserve the natural resources associated with the unique characteristics of the certified product. Located in the southern region of the state of Minas Gerais in Brazil is the region of Mantiqueira de Minas, considered one of the most important regions for the production of specialty coffees in Brazil. In 2011, the region's tradition and reputation were recognized with a Geographic Indication, the second given for coffee regions in the country. To explore the full potential of this area for producing coffees with higher quality and meet the growing demand of this new international market, which aggregates value at specialty coffees, it became fundamental to understand the coffee environments of the region, the "terroirs" where these coffees are obtained. Geotechnology can give a significant contribution in filling this gap. This work is part of a research project that made a detailed characterization of the region's coffee agroecosystems. Geotechnologies were employed to map the areas occupied by coffee plantations by using RapidEye satellite images and SPRING and ArcGIS software. All the segments of the environment were characterized and mapped in detail and the relations with coffee quality were evaluated. The results

  16. GEOTECHNOLOGIES FOR THE CHARACTERIZATION OF SPECIALTY COFFEE ENVIRONMENTS OF MANTIQUEIRA DE MINAS IN BRAZIL

    Directory of Open Access Journals (Sweden)

    H. M. R. Alves

    2016-06-01

    Full Text Available Land-use/land-cover change (LUCC is a major cause of environmental transformation. Distant drivers, often associated with emerging markets for specific products, are now being considered one of the main factors of LUCC and are gaining attention in land change science. Consumers show an increasing interest in local and quality food, certified for its origin and its environmental production standards. A kind of agricultural product certification, Geographic Indication, identifies a product as originating from a specific region where a given quality, reputation or characteristic is attributed to its geographical origin. Sustainable land use is potentially an indirect effect of Geographic Indication, as it requires better land management in order to preserve the natural resources associated with the unique characteristics of the certified product. Located in the southern region of the state of Minas Gerais in Brazil is the region of Mantiqueira de Minas, considered one of the most important regions for the production of specialty coffees in Brazil. In 2011, the region’s tradition and reputation were recognized with a Geographic Indication, the second given for coffee regions in the country. To explore the full potential of this area for producing coffees with higher quality and meet the growing demand of this new international market, which aggregates value at specialty coffees, it became fundamental to understand the coffee environments of the region, the “terroirs” where these coffees are obtained. Geotechnology can give a significant contribution in filling this gap. This work is part of a research project that made a detailed characterization of the region’s coffee agroecosystems. Geotechnologies were employed to map the areas occupied by coffee plantations by using RapidEye satellite images and SPRING and ArcGIS software. All the segments of the environment were characterized and mapped in detail and the relations with coffee quality