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.

Building Imaging Institutes of Patient Care Outcomes: Imaging as a Nidus for Innovation in Clinical Care, Research, and Education.

Science.gov (United States)

Petrou, Myria; Cronin, Paul; Altaee, Duaa K; Kelly, Aine M; Foerster, Bradley R

2018-05-01

Traditionally, radiologists have been responsible for the protocol of imaging studies, imaging acquisition, supervision of imaging technologists, and interpretation and reporting of imaging findings. In this article, we outline how radiology needs to change and adapt to a role of providing value-based, integrated health-care delivery. We believe that the way to best serve our specialty and our patients is to undertake a fundamental paradigm shift in how we practice. We describe the need for imaging institutes centered on disease entities (eg, lung cancer, multiple sclerosis) to not only optimize clinical care and patient outcomes, but also spur the development of a new educational focus, which will increase opportunities for medical trainees and other health professionals. These institutes will also serve as unique environments for testing and implementing new technologies and for generating new ideas for research and health-care delivery. We propose that the imaging institutes focus on how imaging practices-including new innovations-improve patient care outcomes within a specific disease framework. These institutes will allow our specialty to lead patient care, provide the necessary infrastructure for state-of-the art-education of trainees, and stimulate innovative and clinically relevant research. Copyright © 2018 The Association of University Radiologists. All rights reserved.

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

2017 Census Test

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/Programs Latest Information Are you in a Survey? 2020 Census 2018 Census Test 2010 Census American Information Surveys/Programs Main Are you in a Survey? 2020 Census 2018 Census Test If you have received a Census. Latest Information The 2018 Census Test will take place in Pierce County, Wash.; Providence

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.

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

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.

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.

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.

2020 Census

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What We Do Our Research Business Opportunities Census Careers Field Jobs by State Regional Offices /Programs Respond, Survey Data Newsroom News, Blogs About Us Our Research Search Population Economy Business ., area. 2017 Census Test The 2017 Census Test provided the opportunity to research new methods and

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.

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

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

Qualified Census Tracts

Data.gov (United States)

Department of Housing and Urban Development — A Qualified Census Tract (QCT) is any census tract (or equivalent geographic area defined by the Census Bureau) in which at least 50% of households have an income...

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.

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 ...

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.

Collaboration between paediatric surgery and other medical specialties in Nigeria

Directory of Open Access Journals (Sweden)

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.

Census Data

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Department of Housing and Urban Development — The Bureau of the Census has released Census 2000 Summary File 1 (SF1) 100-Percent data. The file includes the following population items: sex, age, race, Hispanic...

[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.

The 1941 villages census – an important source for studying local history

Directory of Open Access Journals (Sweden)

Sergiu Tabuncic

2014-12-01

Full Text Available The 1941 census is an important source for studying the history of the settlements from the present-time districts of Soldanesti and Rezina in the Republic of Moldova. In 1941, those localities were part of Bessarabia’s Orhei County. The materials of that census are stored at the National Archives of the Republic of Moldova, the fund No 2069, inventory 1, part 1, file 450-a. Villages Census 1941 – this is the title of the questionnaire used to collect data. The census was conducted under the auspices of the Central Institute of Statistics subordinate to the Council of Ministers of Romania. The census questionnaire contained 28 sections, each containing questions aimed to clarify the status of settlements in terms of administrative, social, economic, ethnographic, cultural, medical and religious aspects. Many questions pertained to the duration and continuity of the population’s residing in villages listed in the census and villages’ foundation years, to description of rural settlements, permanent and temporary dwellings. Also, the census results show some elements of relations between Romanians and Roma people. The 1941 census is the most significant and representative component of local history, substantially enriching the sources of this domain of research.

Time Series Analysis for Forecasting Hospital Census: Application to the Neonatal Intensive Care Unit.

Science.gov (United States)

Capan, Muge; Hoover, Stephen; Jackson, Eric V; Paul, David; Locke, Robert

2016-01-01

Accurate prediction of future patient census in hospital units is essential for patient safety, health outcomes, and resource planning. Forecasting census in the Neonatal Intensive Care Unit (NICU) is particularly challenging due to limited ability to control the census and clinical trajectories. The fixed average census approach, using average census from previous year, is a forecasting alternative used in clinical practice, but has limitations due to census variations. Our objectives are to: (i) analyze the daily NICU census at a single health care facility and develop census forecasting models, (ii) explore models with and without patient data characteristics obtained at the time of admission, and (iii) evaluate accuracy of the models compared with the fixed average census approach. We used five years of retrospective daily NICU census data for model development (January 2008 - December 2012, N=1827 observations) and one year of data for validation (January - December 2013, N=365 observations). Best-fitting models of ARIMA and linear regression were applied to various 7-day prediction periods and compared using error statistics. The census showed a slightly increasing linear trend. Best fitting models included a non-seasonal model, ARIMA(1,0,0), seasonal ARIMA models, ARIMA(1,0,0)x(1,1,2)7 and ARIMA(2,1,4)x(1,1,2)14, as well as a seasonal linear regression model. Proposed forecasting models resulted on average in 36.49% improvement in forecasting accuracy compared with the fixed average census approach. Time series models provide higher prediction accuracy under different census conditions compared with the fixed average census approach. Presented methodology is easily applicable in clinical practice, can be generalized to other care settings, support short- and long-term census forecasting, and inform staff resource planning.

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.

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

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...

Census Videos

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Employment and Payroll Survey of Business Owners Work from Home Our statistics highlight trends in household statistics from multiple surveys. Data Tools & Apps Main American FactFinder Census Business Builder My Classification Codes (i.e., NAICS) Economic Census Economic Indicators Economic Studies Industry Statistics

Census Photos

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Employment and Payroll Survey of Business Owners Work from Home Our statistics highlight trends in household statistics from multiple surveys. Data Tools & Apps Main American FactFinder Census Business Builder My Classification Codes (i.e., NAICS) Economic Census Economic Indicators Economic Studies Industry Statistics

Census.gov

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Employment and Payroll Survey of Business Owners Work from Home Our statistics highlight trends in household statistics from multiple surveys. Data Tools & Apps Main American FactFinder Census Business Builder My Classification Codes (i.e., NAICS) Economic Census Economic Indicators Economic Studies Industry Statistics

Census Audio

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Employment and Payroll Survey of Business Owners Work from Home Our statistics highlight trends in household statistics from multiple surveys. Data Tools & Apps Main American FactFinder Census Business Builder My Classification Codes (i.e., NAICS) Economic Census Economic Indicators Economic Studies Industry Statistics

High energy physicists and graduate students. 1985 Census

International Nuclear Information System (INIS)

1985-10-01

An alphabetical listing is given of high energy physicists and graduate students, providing the person's name, rank, and institution. Another listing gives the faculty (or permanent staff) and graduate students for each institution, listing for each person the date of birth, year and institution of highest degree, the rank and institutional affiliation with starting dates, up to three items selected from a list of research specialties, and their sources of federal support. For the graduate students, there is also indicated an estimated date for their degree. Where appropriate, a person may be listed at more than one institution. Except as noted, the information is intended to indicate the situation as of January 1, 1985

Census of mental hospital patients and life expectancy of those unlikely to be discharged.

Science.gov (United States)

Bewley, T; Bland, J M; Ilo, M; Walch, E; Willington, G

1975-12-20

A census in a London mental hospital was performed so that the numbers of patients requiring permanent care for the next 20 to 40 years could be estimated. Of 1467 resident patients 20% had been admitted in the preceding five months and 15% in the year before that. Of the 65% who had been in hospital for over 17 months 1% (16 patients) had been in hospital for over 5o years. Altogether 257 (18%) patients would probably be discharged, 339 (23%) might possibly be discharged if there were adequate community facilities, but 871 (59%) were not likely to be discharged; 239 patients under the age of 65 who had been admitted between 1950 and 1973 were unlikely to be discharged. There were about 10 new younger long-stay patients from each year's admissions. Three conditions--schizophrenia, organic brain syndrome, and affective illness--affected 79% of the population. Fourteen per cent had been employed on admission and 28% were considered employable or possibly employable. Half of those who might be considered for discharge (296) would need a hostel. No rehabilitation was needed or possible for 40% of the patients; 299 (20%) patients were chairbound or bedridden and 400 (27%) were totally dependent on nursing and 587 (40%) partly dependent. Twenty months after the census 361 (25%) patients had left (59 had been readmitted), 284 (19%) had died, and 822 (56%) had remained as inpatients. The most realistic future prediction was that 210 (14%) of these patients would still be in the hospital in 20 years and 43 (3%) in 40 years. In the light of these findings and the scarceness of resources current Department of Health and Social Security plans for phasing out mental hospitals must be challenged.

Institutional Repositories: The Experience of Master's and Baccalaureate Institutions

Science.gov (United States)

Markey, Karen; St. Jean, Beth; Soo, Young Rieh; Yakel, Elizabeth; Kim, Jihyun

2008-01-01

In 2006, MIRACLE Project investigators censused library directors at all U.S. academic institutions about their activities planning, pilot testing, and implementing the institutional repositories on their campuses. Out of 446 respondents, 289 (64.8 percent) were from master's and baccalaureate institutions (M&BIs) where few operational…

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

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

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.

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.

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.

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.

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.

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.

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.

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.

Region 9 Census Block 2010

Science.gov (United States)

Geography:The TIGER Line Files are feature classes and related database files (.) that are an extract of selected geographic and cartographic information from the U.S. Census Bureau's Master Address File / Topologically Integrated Geographic Encoding and Referencing (MAF/TIGER) Database (MTDB). The MTDB represents a seamless national file with no overlaps or gaps between parts, however, each TIGER Line File is designed to stand alone as an independent data set, or they can be combined to cover the entire nation. Census Blocks are statistical areas bounded on all sides by visible features, such as streets, roads, streams, and railroad tracks, and/or by non visible boundaries such as city, town, township, and county limits, and short line-of-sight extensions of streets and roads. Census blocks are relatively small in area; for example, a block in a city bounded by streets. However, census blocks in remote areas are often large and irregular and may even be many square miles in area. A common misunderstanding is that data users think census blocks are used geographically to build all other census geographic areas, rather all other census geographic areas are updated and then used as the primary constraints, along with roads and water features, to delineate the tabulation blocks. As a result, all 2010 Census blocks nest within every other 2010 Census geographic area, so that Census Bureau statistical data can be tabulated at the block level and aggregated up t

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

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.

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

Census 2001: issues and perspectives.

Science.gov (United States)

1998-01-01

This article discusses the Census of India for 2001 and gender issues such as the sex ratio, undercounts of girls, tribe and scheduled caste data, and the data users' conference. The April 1998 conference was attended by representatives of government planning and development departments, research institutions, and statisticians and researchers. Under consideration was a government Ministry of Welfare proposal to reintroduce, after a 60-year hiatus, data by scheduled caste and tribe. This issue is complicated by criteria that vary by state and includability. Quotas for backward classes in educational institutions, government jobs, and in decision-making bodies are the reason for designations by caste. Some groups are distressed because of lack of inclusion as backward classes. M.N. Srinivas strongly advises that counting by caste will create problems for enumerators and will result in lawsuits and violent disturbances. G. Shah argues that caste counts will not weaken the caste system nor expand their political power, but will intensify internal conflicts between the Dalit and Bahujan movements. One other issue is the reintroduction of the 1961 Household schedule which provides family composition by landholding size and household enterprise. Krishnaji advises that this data would help analyze sex ratio imbalances. In 1997, the Core Group examined gender equity issues and operational issues about increasing the scope without increasing costs. The Core Group recommended caste data at the district and sub-district level. Undercounting of the female work force is a continuing issue from the 1991 Census. Suggestions by the Core Group are indicated in brief.

Census Infographics & Visualizations

Science.gov (United States)

Employment and Payroll Survey of Business Owners Work from Home Our statistics highlight trends in household statistics from multiple surveys. Data Tools & Apps Main American FactFinder Census Business Builder My statistics that relate to current events, observances, holidays, and anniversaries. Census Business Builder

Special Census Program

Science.gov (United States)

Employment and Payroll Survey of Business Owners Work from Home Our statistics highlight trends in household statistics from multiple surveys. Data Tools & Apps Main American FactFinder Census Business Builder My Classification Codes (i.e., NAICS) Economic Census Economic Indicators Economic Studies Industry Statistics

500 Cities: Census Tract Boundaries

Data.gov (United States)

U.S. Department of Health & Human Services — This census tract shapefile for the 500 Cities project was extracted from the Census 2010 Tiger/Line database and modified to remove portions of census tracts that...

Colfax County 2000 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Otero County 2000 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Socorro County 2000 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Catron County 2000 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Sierra County 2000 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Curry County 2000 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Harding County 2000 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Bernalillo County 2000 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Eddy County 2000 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

The Aggregate Dutch Historical Censuses

NARCIS (Netherlands)

Ashkpour, Ashkan; Meroño-Peñuela, Albert; Mandemakers, Kees

2015-01-01

Historical censuses have an enormous potential for research. In order to fully use this potential, harmonization of these censuses is essential. During the last decades, enormous efforts have been undertaken in digitizing the published aggregated outcomes of the Dutch historical censuses

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

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

The Aggregate Dutch Historical Censuses

NARCIS (Netherlands)

A. Ashkpour (Ashkan); A. Meronõ-Peñuela (Albert); C.A. Mandemakers (Kees)

2015-01-01

textabstractHistorical censuses have an enormous potential for research. In order to fully use this potential, harmonization of these censuses is essential. During the last decades, enormous efforts have been undertaken in digitizing the published aggregated outcomes of the Dutch historical censuses

Census County Subdivisions for the United States Virgin Islands (CENSUS.COUNTY_SUBDIV_USVI)

Data.gov (United States)

U.S. Environmental Protection Agency — County subdivisions are the primary divisions of counties and statistically equivalent entities for the reporting of decennial census data. They include census...

High energy physicists and graduate students. 1978 census

Energy Technology Data Exchange (ETDEWEB)

None

1978-11-01

This listing of physicists and students associated with the U.S. high-energy physics program was obtained by asking the research groups, laboratories, and other agencies involved to update previous information. The first part of this volume is an alphabetical listing and includes only the name, rank, and institution of high-energy physicists and graduate students. The second part of the volume is arranged by institution. Within each institution, the faculty (or permanent staff) and the graduate students are presented in separate alphabetical lists. For each person the entry indicates the year and institution of highest degree, rank and institutional affiliation with starting dates, up to three items selected from a list of research specialties, and sources of federal support. For the graduate students, there is also indicated an estimated date for their degree. Where appropriate, a person is listed at more than one institution. Except as noted in the headings, the information is intended to indicate the situation as of January 1, 1978. (RWR)

High energy physicists and graduate students. 1978 census

International Nuclear Information System (INIS)

1978-11-01

This listing of physicists and students associated with the U.S. high-energy physics program was obtained by asking the research groups, laboratories, and other agencies involved to update previous information. The first part of this volume is an alphabetical listing and includes only the name, rank, and institution of high-energy physicists and graduate students. The second part of the volume is arranged by institution. Within each institution, the faculty (or permanent staff) and the graduate students are presented in separate alphabetical lists. For each person the entry indicates birthdate, the year and institution of highest degree, rank and institutional affiliation with starting dates, up to three items selected from a list of research specialties, and sources of federal support. For the graduate students, there is also indicated an estimated date for their degree. Where appropriate, a person is listed at more than one institution. Except as noted in the headings, the information is intended to indicate the situation as of January 1, 1978

2015 Census Blocks Geodatabase

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US Census Bureau, Department of Commerce — The 2015 TIGER Geodatabases are extracts of selected nation based and state based geographic and cartographic information from the U.S. Census Bureau's Master...

Declining average daily census. Part 1: Implications and options.

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Weil, T P

1985-12-01

A national trend toward declining average daily (inpatient) census (ADC) started in late 1982 even before the Medicare prospective payment system began. The decrease in total days will continue despite an increasing number of aged persons in the U.S. population. This decline could have been predicted from trends during 1978 to 1983, such as increasing available beds but decreasing occupancy, 100 percent increases in hospital expenses, and declining lengths of stay. Assuming that health care costs will remain as a relatively fixed part of the gross national product and no major medical advances will occur in the next five years, certain implications and options exist for facilities experiencing a declining ADC. This article discusses several considerations: Attempts to improve market share; Reduction of full-time equivalent employees; Impact of greater acuity of illness among remaining inpatients; Implications of increasing the number of physicians on medical staffs; Option of a closed medical staff by clinical specialty; Unbundling with not-for-profit and profit-making corporations; Review of mergers, consolidations, and multihospital systems to decide when this option is most appropriate; Sale of a not-for-profit hospital to an investor-owned chain, with implications facing Catholic hospitals choosing this option; Impact and difficulty of developing meaningful alternative health care systems with the hospital's medical staff; Special problems of teaching hospitals; The social issue of the hospital shifting from the community's health center to a cost center; Increased turnover of hospital CEOs; With these in mind, institutions can then focus on solutions that can sometimes be used in tandem to resolve this problem's impact. The second part of this article will discuss some of them.

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

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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.

Impact of physician specialty on quality care for patients hospitalized with decompensated cirrhosis.

Directory of Open Access Journals (Sweden)

Nicholas Lim

Full Text Available Decompensated cirrhosis is a common precipitant for hospitalization, and there is limited information concerning factors that influence the delivery of quality care in cirrhotic inpatients. We sought to determine the relation between physician specialty and inpatient quality care for decompensated cirrhosis.We reviewed 247 hospital admissions for decompensated cirrhosis, managed by hospitalists or intensivists, between 2009 and 2013. The primary outcome was quality care delivery, defined as adherence to all evidence-based specialty society practice guidelines pertaining to each specific complication of cirrhosis. Secondary outcomes included new complications, length-of-stay, and in-hospital death.Overall, 147 admissions (59.5% received quality care. Quality care was given more commonly by intensivists, compared with hospitalists (71.7% vs. 53.1%, P = .006, and specifically for gastrointestinal bleeding (72% vs. 45.8%, P = .03 and hepatic encephalopathy (100% vs. 63%, P = .005. Involvement of gastroenterology consultation was also more common in admissions in which quality care was administered (68.7% vs. 54.0%, P = .023. Timely diagnostic paracentesis was associated with reduced new complications in admissions for refractory ascites (9.5% vs. 46.6%, P = .02, and reduced length-of-stay in admissions for spontaneous bacterial peritonitis (5 days vs. 13 days, P = .02.Adherence to quality indicators for decompensated cirrhosis is suboptimal among hospitalized patients. Although quality care adherence appears to be higher among cirrhotic patients managed by intensivists than by hospitalists, opportunities for improvement exist in both groups. Rational and cost-effective strategies should be sought to achieve this end.

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

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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

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.

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

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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

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 ...

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

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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.

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

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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.

Lifetime earnings for physicians across specialties.

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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.

Primary Care Research in the Patient-Centered Outcomes Research Institute's Portfolio.

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Selby, Joe V; Slutsky, Jean R

2016-04-01

In their article in this issue, Mazur and colleagues analyze the characteristics of early recipients of funding from the Patient-Centered Outcomes Research Institute (PCORI). Mazur and colleagues note correctly that PCORI has a unique purpose and mission and suggest that it should therefore have a distinct portfolio of researchers and departments when compared with other funders such as the National Institutes of Health (NIH). Responding on behalf of PCORI, the authors of this Commentary agree with the characterization of PCORI's mission as distinct from that of NIH and others. They agree too that data found on PCORI's Web site demonstrate that PCORI's portfolio of researchers and departments is more diverse and more heavily populated with clinician researchers, as would be expected. The authors take issue with Mazur and colleagues' suggestion that because half of clinical visits occur within primary care settings, half of PCORI's funded research should be based in primary care departments. PCORI's portfolio reflects what patients and others tell PCORI are the critical questions. Many of these do, in fact, occur with more complex conditions in specialty care. The authors question whether the research of primary care departments is too narrowly focused and whether it sufficiently considers study of these complex conditions. Research on more complex conditions including heart failure, coronary artery disease, and multiple comorbid conditions could be highly valuable when approached from the primary care perspective, where many of the comparative effectiveness questions first arise.

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

Social media in the mentorship and networking of physicians: Important role for women in surgical specialties.

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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.

Santa Fe County 2000 Census Blocks

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Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

McKinley County 2000 Census Tracts

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Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Sandoval County 2000 Census Block Groups

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Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Lea County 2000 Census Block Groups

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Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Bernalillo County 2000 Census Block Groups

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Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Taos County 2000 Census Block Groups

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Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

2000 Census Urban Areas and Clusters

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Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

San Miguel County 2000 Census Blocks

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Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Catron County 2000 Census Block Groups

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Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Santa Fe County 2000 Census Tracts

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Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Los Alamos County 2000 Census Blocks

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Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Otero County 2000 Census Block Groups

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Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Much ado about nothing? The financial impact of physician-owned specialty hospitals.

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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.

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

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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.

Census Business Builder (CBB)

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Employment and Payroll Survey of Business Owners Work from Home Our statistics highlight trends in household statistics from multiple surveys. Data Tools & Apps Main American FactFinder Census Business Builder My Classification Codes (i.e., NAICS) Economic Census Economic Indicators Economic Studies Industry Statistics

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

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

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,…

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

1st college of physicians lecture: the role of internal medicine as a specialty in the era of subspecialisation.

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Chee, Y C

2004-11-01

This paper is divided into 4 parts. The first deals with the definition of specialties and traces its roots from the early 20th century in the United States of America with the formation and growth of Specialty Boards. The second is a reflection on the scene in Singapore from the 1960s to the present, describing the change from public healthcare institutions run by the civil service to the autonomous restructured public service hospitals towards the end of the 20th century. The third section deals with what the 4ps have expressed about changes necessary to the Singapore system in the 21st century. The 4ps are the politicians, the payers, the patients and the public. It is about value for money, better coordination and better communication. Finally, just what is Internal Medicine - its competencies and its practice. A review of the systems in Australia, New Zealand, and the USA is presented. The idea of the "hospitalist" is discussed. Concluding remarks deal with the viability of Internal Medicine because of low reimbursement, administrative burdens and brief patient visits.

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.

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…

CDC WONDER: Population (from Census)

Data.gov (United States)

U.S. Department of Health & Human Services — The Population online databases contain data from the US Census Bureau. The Census Estimates online database contains contains county-level population counts for...

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.

CDC WONDER: Population (from Census)

Data.gov (United States)

U.S. Department of Health & Human Services — The Population online databases contain data from the US Census Bureau. The Census Estimates online database contains county-level population counts for years 1970 -...

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.

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.

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.

Academic specialties in U.S. are shifting; hiring of women geoscientists is stagnating

Science.gov (United States)

Holmes, Mary Anne; O'Connell, Suzanne; Frey, Connie; Ongley, Lois K.

Women have been receiving a greater proportion of the bachelor's and master's degrees in the geosciences over the last 10 years, reaching near 40% in 2000 (latest data available), while receiving only 28% of the Ph.D.s that year. Women are now only 20% of assistant professors at Ph.D.-granting institutions, a proportion that has not changed in the last 4 years. As part of a larger study to find what key barriers continue to prevent larger numbers of women geoscientists from becoming academics, data have been compiled from the National Science Board [NSB, 2002] and the American Geological Institute's (AGI) Directory of Geoscience Departments [Claudy, 2001] on geoscience specialty by gender.The data are broken down by the specialty of the Ph.D., and compared to hiring rates at Ph.D.-granting institutions over the last 10 years. These institutions are the focus because they are the source of future Ph.D.s, and diversity of their faculty is critical to assuring diversity and consequent intellectual vigor and strength of our future academic workforce. The data reveal both a slight shift in the subdisciplines of all geoscientists employed in tenure-track positions at Ph.D.-granting institutions, and that hiring of women into tenure-track positions in specific subdisciplines has not kept pace with their Ph.D. production during that time.

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.

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.

Census Blockgroups for the United States Virgin Islands

Data.gov (United States)

U.S. Environmental Protection Agency — A census block group (BG) is a cluster of census blocks having the same first digit of their four-digit identifying numbers within a census tract. (See also Census...

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.

New Mexico, 2010 Census Census Tract State-based

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

High energy physicists and graduate students: 1981 census

International Nuclear Information System (INIS)

1982-02-01

This listing of physicists and students associated with the US high energy physics program has been compiled in the Division of High Energy Physics of the Office of Energy Research of the US Department of Energy. This listing has been obtained by asking the research groups, laboratories, and other agencies involved to update previous information. This volume is in two parts. The first part is an alphabetical listing and includes only the name, rank, and institution of high energy physicists and graduate students. The second part of the volume is arranged by institution. Within each institution, the faculty (or permanent staff) and the graduate students are presented in separate alphabetical lists. For each person the entry indicates their birthdate, the year and institution of their highest degree, their rank and institutional affiliation with starting dates, up to three items selected from a list of research specialties, and their sources of federal support. For the graduate students, there is also indicated an estimated date for their degree. Where appropriate, a person is listed at more than one institution. Except as noted in the headings, the information is intended to indicate the situation as of January 1, 1981

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.

De Baca County 2000 Census Block Groups

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

Rio Arriba County 2000 Census Block Groups

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — TIGER, TIGER/Line, and Census TIGER are registered trademarks of the Bureau of the Census. The Redistricting Census 2000 TIGER/Line files are an extract of selected...

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.

77 FR 39678 - Census Bureau

Science.gov (United States)

2012-07-05

... and small businesses. While these Exchanges are still in development and states have broad flexibility... DEPARTMENT OF COMMERCE Census Bureau Proposed Information Collection; Comment Request; 2013 Current Population Survey Annual Social and Economic Supplement Content Test AGENCY: U.S. Census Bureau...

75 FR 75452 - Proposed Information Collection; Comment Request; 2012 Economic Census General Classification Report

Science.gov (United States)

2010-12-03

... System (NAICS) code. New businesses are assigned NAICS codes by the Social Security Administration (SSA.... Affected Public: Businesses or Other for Profit Institutions, Small Businesses or Organizations, Non-profit... DEPARTMENT OF COMMERCE U.S. Census Bureau Proposed Information Collection; Comment Request; 2012...

Length of stay for patients undergoing invasive electrode monitoring with stereoelectroencephalography and subdural grids correlates positively with increased institutional profitability.

Science.gov (United States)

Chan, Alvin Y; Kharrat, Sohayla; Lundeen, Kelly; Mnatsakanyan, Lilit; Sazgar, Mona; Sen-Gupta, Indranil; Lin, Jack J; Hsu, Frank P K; Vadera, Sumeet

2017-06-01

Lowering the length of stay (LOS) is thought to potentially decrease hospital costs and is a metric commonly used to manage capacity. Patients with epilepsy undergoing intracranial electrode monitoring may have longer LOS because the time to seizure is difficult to predict or control. This study investigates the effect of economic implications of increased LOS in patients undergoing invasive electrode monitoring for epilepsy. We retrospectively collected and analyzed patient data for 76 patients who underwent invasive monitoring with either subdural grid (SDG) implantation or stereoelectroencephalography (SEEG) over 2 years at our institution. Data points collected included invasive electrode type, LOS, profit margin, contribution margins, insurance type, and complication rates. LOS correlated positively with both profit and contribution margins, meaning that as LOS increased, both the profit and contribution margins rose, and there was a low rate of complications in this patient group. This relationship was seen across a variety of insurance providers. These data suggest that LOS may not be the best metric to assess invasive monitoring patients (i.e., SEEG or SDG), and increased LOS does not necessarily equate with lower or negative institutional financial gain. Further research into LOS should focus on specific specialties, as each may differ in terms of financial implications. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

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.

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.

Trends and Predictors of National Institutes of Health Funding to Plastic Surgery Residency Programs.

Science.gov (United States)

Silvestre, Jason; Abbatematteo, Joseph M; Chang, Benjamin; Serletti, Joseph M

2017-12-01

Recent studies have demonstrated low levels of National Institutes of Health funding for surgical research. The authors compared the funding in plastic surgery with the funding for other surgical specialties. A query of National Institutes of Health grants awarded to departments of surgical specialties was performed using the National Institutes of Health RePORTER database (2008 to 2016). Trends in funding were compared by specialty and adjusted for the number of active physicians in each specialty. Plastic surgery residency program characteristics were correlated with funding procurement. Eight hundred eighty-nine faculty at 94 plastic surgery residency programs were queried. Forty-eight investigators (5.4 percent) at 23 programs (24.4 percent) had National Institutes of Health funding. From 2008 to 2016, a total of $84,142,138 was awarded through 81 grants. Funding supported translational (44.6 percent), clinical (26.4 percent), basic science (27.2 percent), and educational (1.7 percent) research. In 2016, plastic surgery received the least amount of National Institutes of Health funding per active physician ($1,530) relative to orthopedic surgery ($3124), obstetrics and gynecology ($3885), urology ($5943), otolaryngology ($9999), general surgery ($11,649), ophthalmology ($11,933), and neurologic surgery ($20,874). Plastic surgery residency program characteristics associated with National Institutes of Health funding were high ranking and had more than 10 clinical faculty (p < 0.05). Plastic surgery receives the least National Institutes of Health funding among the surgical specialties. Departments and divisions of plastic surgery should support investigators applying for research grants to increase future National Institutes of Health funding.

Sustainability in Canadian Post-Secondary Institutions: The Interrelationships among Sustainability Initiatives and Geographic and Institutional Characteristics

Science.gov (United States)

Beveridge, Dan; McKenzie, Marcia; Vaughter, Philip; Wright, Tarah

2015-01-01

Purpose: This paper aims to report on a census of high-level sustainability initiatives at all accredited post-secondary institutions in Canada by documenting the institutions that have undertaken sustainability assessments, have signed one or more sustainability declarations, have sustainability offices or officers or have sustainability…

Ethnicity in censuses: Changeable and inconstant category

Directory of Open Access Journals (Sweden)

Mrđen Snježana

2002-01-01

Full Text Available The issue of ethnicity was set in all censuses of SFRY, as well as in the first censuses in countries that were created after its disintegration. When analyzing the censuses it can be concluded that it is a changeable category. Not only was the manner of forming the question in censuses changing, but also the number of categories of nationality and their order in published census' results. It depended on state policy and the political situation preceding the censuses. Since the answer on the issues of ethnicity is a subjective criterion, and it was written down according to the freely declared statement of the residents, guaranteed by the Constitution. It has often happened that same individuals have declared themselves differently from one census to another, and also some categories of ethnicity have vanished and some others were created. Although in SFRY nations and ethnicities were equal, still indirectly in published results, existence of these two categories was indicated. But, in newly created countries, the manner of forming the question of ethnicity was changed, their number and order were also changed and the notion of 'minority' was again introduced, indicating, beyond doubt, a different status of nationality (except the majority from the one in the former Yugoslavia.

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…

Census Careers

Science.gov (United States)

Indicators Economic Studies Industry Statistics Portal Other Economic Programs Business is a large part of Classification Codes (i.e., NAICS) Economic Census Economic Indicators Economic Studies Industry Statistics Portal Other Economic Programs Business Latest Information Business Characteristics Classification Codes

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.

Experience with DICOM for the clinical specialties in the healthcare enterprise

Science.gov (United States)

Kuzmak, Peter M.; Dayhoff, Ruth E.

2003-05-01

specialties, although the specifications for some of the clinical specialty image types need to be enhanced. Special consideration needs to be given to the healthcare provider workflow in order to support DICOM requirements and to minimize change. The clinical specialties handle a large number of different kinds of requests, and imaging procedures may comprise only a small subset, which may need to be isolated out for efficient operation of DICOM Modality Worklist. The clinical specialties will acquire a large volume of images. Our goal is to incorporate all of the patient"s data into the electronic medical record and DICOM is making this easier for everyone. The work involved in extending DICOM to the clinical specialties and integrating them with the hospital information systems continues to be an ongoing and worthwhile challenge.

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.

The Central Research Institute of Electric Power Industry and nuclear energy. Real images and views for compatibility of specialty and sociality

International Nuclear Information System (INIS)

Sato, Motohide

2004-01-01

The Central Research Institute of Electric Power Industry (CRIEPI) has been a motive power supporting electric energy and rich society in Japan as a center of electric power field in Japan under always challenging technologies advancing at a step since beginning of business as a special research institute on electrical power technology in Japan. And, on today receiving whole of liberalization on electric business, CRIEPI plans to carry out new development closer to society and nationals under a flag of 'contribution to society' by making its specialty and sociality compatible. Therefore, when social discussion on nuclear energy constructing basis of electric energy in Japan is noisy, here were summarized efforts, actual results, and topics for individual researching subjects shown as follows under showing basic attitude of CRIEPI to the nuclear energy: maintenance and administration techniques to rationally secure soundness of the light water reactor apparatuses; intermediate storage technique on spent fuels (concrete cask storage); survey, design and safety evaluation techniques supporting landfill disposal business of high level radioactive wastes; dry recycle technique and metal fuel fast reactors applicable to spent fuel processing at light water reactors; and small size fast reactors (4S reactors) usable for diverse applications. (G.K.)

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.

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.

Do Women Work Less Than Men in Urology: Data From the American Urological Association Census.

Science.gov (United States)

Porten, Sima P; Gaither, Thomas W; Greene, Kirsten L; Baradaran, Nima; Anger, Jennifer T; Breyer, Benjamin N

2018-04-30

To further explore the issue of work parity between male and female urologists in the context of demographics, practice characteristics, subspecialty affiliation, and planned retirement. We analyzed data from the 2014 American Urological Association census, which is a specialty wide survey distributed to the entire urology community in the United States. A total of 2204 census samples were weighted to represent 11,703 urologists who practiced in the United States in 2014. We compared clinical and nonclinical hours worked by gender after adjusting for age, practice setting, fellowship type, and whether or not the urologist performed inpatient operations. Of the 11,703 practicing urologists in the United States, female urologists make up approximately 7.7% of the workforce (n ~ 897). Female practicing urologists were younger (66.4%, women were fellowship-trained in a urologic subspecialty (54.9% vs 34.9%, P hours worked between women and men (beta-coefficient -2.8, 95% confidence interval -6.4 to 0.7, P = .12). Gender does not appear to drive the number of hours urologists work per week. There is work hour parity between women and men practicing urologists in both clinical and nonclinical hours. Women are proportionately more likely to pursue fellowship training and hold academic positions. Copyright © 2018 Elsevier Inc. All rights reserved.

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

Breaking down the silos to decrease internal diversions and patient flow delays.

Science.gov (United States)

Driscoll, Molly; Tobis, Kristen; Gurka, David; Serafin, Frederick; Carlson, Elizabeth

2015-01-01

Hospitals strive to admit patients to the units where caregiver competencies align with the patient's condition. When the hospital's census peaks, internal diversions and the associated risks increase, which are intensified when silos exist, as segregated care negatively impacts collaboration and patient safety. In this study, a 600+-bed academic, tertiary care specialty hospital experienced an increase in internal diversions. Within the neuroscience service line, emergent neuroscience transfers from outside hospitals had been declined or internally diverted because of capacity limitations. Formalized processes for improving collaboration between health care providers related to capacity issues were required to decrease internal diversions and improve patient flow and patient safety. A pilot project was conducted on neuroscience units during a process improvement initiative. A hospital-wide internal diversion plan was developed, identifying primary and secondary placement options for all patients requiring hospitalization to support patient flow and patient safety. Forecasting tools were developed to provide units' leadership with current information on expected admissions. Daily capacity huddles were instituted to increase collaboration between patient care units. The interventions trialed during the pilot decreased internal diversions and improved patient flow. The improved collaboration resulted in an 80% decrease in declinations of emergent intensive care unit transfers from outside hospitals due to capacity limitations and a 50% decrease in the number of these patients being internally diverted to alternate intensive care units. The interventions implemented minimized internal diversions and improved patient flow. The transparency of the patient placement process led to an increased collaboration between all participants.

Comparison of 2010 Census Nonresponse Follow-Up Proxy Responses with Administrative Records Using Census Coverage Measurement Results

Directory of Open Access Journals (Sweden)

Mulry Mary H.

2017-06-01

Full Text Available The U.S. Census Bureau is currently conducting research on ways to use administrative records to reduce the cost and improve the quality of the 2020 Census Nonresponse Followup (NRFU at addresses that do not self-respond electronically or by mail. Previously, when a NRFU enumerator was unable to contact residents at an address, he/she found a knowledgeable person, such as a neighbor or apartment manager, who could provide the census information for the residents. This was called a proxy response. The Census Bureau’s recent advances in merging federal and third-party databases raise the question: Are proxy responses for NRFU addresses more accurate than the administrative records available for the housing unit? Our study attempts to answer this question by comparing the quality of proxy responses and the administrative records for those housing units in the same timeframe using the results of 2010 Census Coverage Measurement (CCM Program. The assessment of the quality of the proxy responses and the administrative records in the CCM sample of block clusters takes advantage of the extensive fieldwork, processing, and clerical matching conducted for the CCM.

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.

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.

Psychiatric specialty training in Greece.

Science.gov (United States)

Margariti, M; Kontaxakis, V; Ploumpidis, D

2017-01-01

specialty, the European Board of Psychiatry. In the US, the supervising bodies are the Accreditation Council on Graduate Medical Education (ACGME) and the American Board of Psychiatry and Neurology, in the United Kingdom the Royal College of Psychiatrists, in Canada the Royal College of Physicians and Surgeons, etc. In our country, the debate on the need to reform the institutional framework for Psychiatric training has been underway since the mid-90s, with initiatives especially by the Hellenic Psychiatric Association, aiming to raise awareness and concern among psychiatrists while responding to requests from competent central bodies of the state, as well as establishing Panhellenic training programs for psychiatric trainees and continuing education programs. But what is the situation of the educational map in the country today, what would be the objectives, and how might we proceed? These questions we will try to answer in an effort initiated by Hellenic Psychiatric Association (HPA) and the journal "Psychiatriki" with the publication of thematic articles starting by presenting in the next issue of "Psychiatriki"a comparative study of the training in the specialty of psychiatry at two distinct periods of time (2000 and 2014). These time-frames are of great importance, since the first is a period that in retrospect can be considered as wealthier yet missing robust priorities, while the second, at the peak of the economic crisis, constitutes a difficult environment with limited resources. Already in the year 2000, psychiatric residency training in our country had major difficulties due to its outdated framework and its fragmentation. All areas in which training is assessed (clinical experience, theoretical training and training in psychotherapy exhibited inadequacies and limited convergence with European golden standards, in the absence of a plan and the implementation of a national education curriculum. Certain university clinics constituted an important exception, though

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

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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.

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.

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…

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.

Census 2000 Places (cen00pl02)

Data.gov (United States)

California Natural Resource Agency — Census 2000 Place Names provides a seamless statewide GIS layer of places, including census designated places (CDP), consolidated cities, and incorporated places,...

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...

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.

75 FR 17835 - Census Day, 2010

Science.gov (United States)

2010-04-07

... Since our Nation's earliest days, the census has played an important role in identifying where resources... receive adequate funding for schools, hospitals, senior centers, and other public works projects. The 2010 Census will also aid employers in selecting locations for new factories and businesses as our economy...

39th annual Reed rig census

International Nuclear Information System (INIS)

Crowhurst, M.E.; Fitts, R.L.

1991-01-01

This paper reports on cutbacks in U.S. exploration and development drilling during the first half of 1991 which squeezed most of the optimism out of the drilling industry. Just how rough the year has been is underscored by the results of this year's rig census. The number of rotary rigs available for U.S. drilling declined by only 69 units (3%) during the past 12 months. But despite those withdrawals from competition, only 66% of the remaining rigs were working at the time the census was taken. Results of the 1991 census contrasted sharply with the stability and optimism that seemed apparent a year ago when 72% of the available rig fleet met the census definition of active. At that time, the mini-boom in horizontal drilling coupled with tax-credit- driven gas drilling led to a relatively high rig utilization rate and suggested that rig supply and demand might be close to an economically acceptable balance. However, it quickly became apparent in early 1991 that industry optimism was unjustified. Horizontal drilling began to drop and the lowest natural gas prices in 12 years triggered rapid declines in gas drilling. Although oil prices have been relatively stable and above $18 per bbl since January 1989, most major operators have concluded that a better return on investment can be had outside the U.S. and have drastically cut their domestic drilling budgets. These factors, combined with softened energy demand from the worldwide recession, further slowed U.S. drilling. The long awaited balance between rig supply and demand has seemingly slipped away. The 1991 Reed rig census describes an industry facing several more rough years. Details of this year's census include: The available U.S. fleet now stands at 2,251 rigs, down by 69 from the 2,320-unit total in 1990, and the lowest since 1976. Rigs meeting the census definition of active numbered 1,485, down 192 (11.4%) from the 1,677 active rigs counted a year earlier

[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.

Census Model Transition: Contributions to its Implementation in Portugal

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Dias Carlos A.

2016-03-01

Full Text Available Given the high cost and complexity of traditional censuses, some countries have started to change the census process. Following this trend, Portugal is also evaluating a new census model as an alternative to an exhaustive collection of all statistical units. The main motivations for the implementation of this census model transition in Portugal are related to the decrease in statistical burden on citizens, improvements in the frequency of outputs, and the reduction of collection costs associated with census operations. This article seeks to systematise and critically review all alternatives to the traditional census methodologies, presenting their advantages and disadvantages and the countries that use them. As a result of the comparison, we conclude that the methods that best meet these objectives are those that use administrative data, either in whole or in part. We also present and discuss the results of an inventory and evaluation of administrative registers in Portugal with the potential to produce statistical census information.

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 ...

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.

Statistical Model of the 2001 Czech Census for Interactive Presentation

Czech Academy of Sciences Publication Activity Database

Grim, Jiří; Hora, Jan; Boček, Pavel; Somol, Petr; Pudil, Pavel

Vol. 26, č. 4 (2010), s. 1-23 ISSN 0282-423X R&D Projects: GA ČR GA102/07/1594; GA MŠk 1M0572 Grant - others:GA MŠk(CZ) 2C06019 Institutional research plan: CEZ:AV0Z10750506 Keywords : Interactive statistical model * census data presentation * distribution mixtures * data modeling * EM algorithm * incomplete data * data reproduction accuracy * data mining Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.492, year: 2010 http://library.utia.cas.cz/separaty/2010/RO/grim-0350513.pdf

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.

A Nationwide Census of ICU Capacity and Admissions in Mongolia.

Directory of Open Access Journals (Sweden)

Naranpurev Mendsaikhan

Full Text Available In Mongolia, a Central Asian lower-middle income country, intensive care medicine is an under-resourced and-developed medical specialty. The burden of critical illness and capacity of intensive care unit (ICU services in the country is unknown. In this nationwide census, we collected data on adult and pediatric/neonatal ICU capacities and the number of ICU admissions in 2014. All hospitals registered to run an ICU service in Mongolia were surveyed. Data on the availability of an adult and/or pediatric/neonatal ICU service, the number of available ICU beds, the number of available functional mechanical ventilators, the number of patients admitted to the ICU, and the number of patients admitted to the study hospital were collected. In total, 70 ICUs with 349 ICU beds were counted in Mongolia (11.7 ICU beds/100,000 inhabitants; 1.7 ICU beds/100 hospital beds. Of these, 241 (69% were adult and 108 (31% pediatric/neonatal ICU beds. Functional mechanical ventilators were available for approximately half of the ICU beds (5.1 mechanical ventilators/100,000 inhabitants. While all provincial hospitals ran a pediatric/neonatal ICU, only dedicated pediatric hospitals in Ulaanbaatar did so. The number of adult and pediatric/neonatal ICU admissions varied between provinces. The number of adult ICU beds and adult ICU admissions per 100,000 inhabitants correlated (r = 0.5; p = 0.02, while the number of pediatric/neonatal ICU beds and pediatric/neonatal ICU admissions per 100,000 inhabitants did not (r = 0.25; p = 0.26. In conclusion, with 11.7 ICU beds per 100,000 inhabitants the ICU capacity in Mongolia is higher than in other low- and lower-middle-income countries. Substantial heterogeneities in the standardized ICU capacity and ICU admissions exist between Mongolian provinces. Functional mechanical ventilators are available for only half of the ICU beds. Pediatric/neonatal ICU beds make up one third of the national ICU capacity and appear to meet or even

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...

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.

New Mexico Census Tracts, Total Population (2010)

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The once-a-decade decennial census was conducted in April 2010 by the U.S. Census Bureau. This count of every resident in the United States was mandated by Article...

Arrival time pattern and waiting time distribution of patients in the emergency outpatient department of a tertiary level health care institution of North India

Directory of Open Access Journals (Sweden)

Yogesh Tiwari

2014-01-01

Full Text Available Background: Emergency Department (ED of tertiary health care institute in India is mostly overcrowded, over utilized and inappropriately staffed. The challenges of overcrowded EDs and ill-managed patient flow and admission processes result in excessively long waits for patients. Aim: The objective of the present study was to analyze the patient flow system by assessing the arrival and waiting time distribution of patients in an Emergency out Patient Department (EOPD. Materials and Methods: This short cross-sectional descriptive study was conducted in the EOPD of a Tertiary level health care Institution in North India in the month of May, 2011. The data was obtained from 591 patients, who were present in the EOPD during the month of May, 2011. The waiting time, inter arrival time between two consecutive patients were calculated in addition to the daily census data (discharge rate, admission rate and transfer out rates etc. of the emergency. Results: Arrival time pattern of patients in the EOPD was highly stochastic with the peak arrival hours to be "9.00-12.00 h" in which around 26.3% patients arrived in the EOPD. The primary waiting areas of patients included patients "under observation" (29.6%; "waiting for routine diagnostic tests" (16.4% and "waiting for discharge" (14.6%. Around 71% patients were waiting due to reasons within emergency complex. Conclusion: The patient flow of the ED could only be addressed by multifaceted, multidisciplinary and hospital wide approach.

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

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

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.

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

Recruitment of patients into head and neck clinical trials: acceptability of studies to patients from perspective of the research team.

Science.gov (United States)

Ho, M W; Pick, A S; Sutton, D N; Dyker, K; Cardale, K; Gilbert, K; Johnson, J; Quantrill, J; McCaul, J A

2018-05-01

We reviewed longitudinal recruitment data to assess recruitment into head and neck cancer trials, and to identify factors that could influence this and affect their acceptability to patients. We retrieved data from the prospective computerised database (2009-2016) to measure acceptability to patients using the recruitment:screening ratio, and compared observational with interventional studies, single specialty (or site) with multispecialty (or site) studies, and "step-up" randomisation with "non-inferiority" randomisation designs. A total of 1283 patients were screened and 583 recruited. The recruitment:screening ratio for all National Institute for Health Research (NIHR) portfolio studies combined was 0.47 (486/1133). Studies that involved treatment by several specialties or at several sites had a significantly adverse impact on acceptability (p=0.01). Recruitment into non-inferiority randomised controlled studies was lower than that into step-up randomised studies (p=0.06). The complexity of a study's design did not compromise recruitment. Treatment across several specialties or several sites and perceived non-inferiority designs, reduced the acceptability of some trials. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

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.

Identifying Telemedicine Services to Improve Access to Specialty Care for the Underserved in the San Francisco Safety Net

Directory of Open Access Journals (Sweden)

Ken Russell Coelho

2011-01-01

Full Text Available Safety-net settings across the country have grappled with providing adequate access to specialty care services. San Francisco General Hospital and Trauma Center, serving as the city's primary safety-net hospital, has also had to struggle with the same issue. With Healthy San Francisco, the City and County of San Francisco's Universal Healthcare mandate, the increased demand for specialty care services has placed a further strain on the system. With the recent passage of California Proposition 1D, infrastructural funds are now set aside to assist in connecting major hospitals with primary care clinics in remote areas all over the state of California, using telemedicine. Based on a selected sample of key informant interviews with local staff physicians, this study provides further insight into the current process of e-referral which uses electronic communication for making referrals to specialty care. It also identifies key services for telemedicine in primary and specialty care settings within the San Francisco public health system. This study concludes with proposals for a framework that seek to increase collaboration between the referring primary care physician and specialist, to prioritize institution of these key services for telemedicine.

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.

Census in North Vietnam

National Research Council Canada - National Science Library

1960-01-01

This population census decree aims at collecting the most fundamental and accurate data on the population situation of North Vietnam to lay the foundation for all plans and public administration policies...

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.

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....

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…

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.

Food Desert Census Tract Polygons, Region 9, 2000, US EPA Region 9

Data.gov (United States)

U.S. Environmental Protection Agency — Census Tract Data - Census 2000 This data layer represents Census 2000 demographic data derived from the PL94-171 redistricting files and SF3. Census geographic...

Faculty of Radiation Oncology 2014 workforce census.

Science.gov (United States)

Leung, John; Munro, Philip L; James, Melissa

2015-12-01

This paper reports the key findings of the Faculty of Radiation Oncology 2014 workforce census and compares the results with earlier surveys. The census was conducted in mid-2014 with distribution to all radiation oncologists, educational affiliates and trainees listed on the college database. There were six email reminders and responses were anonymous. The overall response rate was 76.1%. The age range of fellows was 32-96 (mean = 49 years, median = 47 years). The majority of the radiation oncologists were male (n = 263, 63%). The minority of radiation oncologists were of Asian descent (n = 43, 13.4%). Radiation oncologists graduated from medical school on average 23 years ago (median = 22 years). A minority of fellows (n = 66, 20%) held another postgraduate qualification. Most radiation oncologists worked, on average, at two practices (median = 2, range 1-7). Practising radiation oncologists worked predominantly in the public sector (n = 131, 49%), but many worked in both the public and private sectors (n = 94, 37%), and a minority worked in the private sector only (n = 38, 14%). The largest proportion of the workforce was from New South Wales accounting for 29% of radiation oncologists. Radiation oncologists worked an average of 43 h/week (median = 43 h, range 6-80). Radiation oncologists who worked in the private sector worked less hours than their public sector or public/private sector colleagues. (38.3 vs. 42.9 vs. 44.3 h, P = 0.042). Victorians worked the fewest average hours per week at 38 h and West Australians the most at 46 h/week. Radiation oncologists averaged 48 min for each new case, 17 min per follow up and 11 min for a treatment review. Radiation oncologists averaged 246 new patients per year (median = 250, range = 20-600) with men (average = 268), Western Australians (average = 354) and those in private practice seeing more (average = 275). Most radiation

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.

New Mexico Census Tracts, Households by Type (2010)

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The once-a-decade decennial census was conducted in April 2010 by the U.S. Census Bureau. This count of every resident in the United States was mandated by Article...

New Mexico Census Tracts, Housing Vacancy Status (2010)

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The once-a-decade decennial census was conducted in April 2010 by the U.S. Census Bureau. This count of every resident in the United States was mandated by Article...

Privacy protection for patients with substance use problems

OpenAIRE

Hu, Lianne Lian; Sparenborg, Steven; Tai, Betty

2011-01-01

Lianne Lian Hu1, Steven Sparenborg2, Betty Tai21Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, 2Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MDAbstract: Many Americans with substance use problems will have opportunities to receive coordinated health care through the integration of primary care and specialty care for substance use disorders under the Patient Protection...

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.

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

Compassion satisfaction, burnout, and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties.

Science.gov (United States)

Hooper, Crystal; Craig, Janet; Janvrin, David R; Wetsel, Margaret A; Reimels, Elaine

2010-09-01

Today the proportion of acute patients entering the health care system through emergency departments continues to grow, the number of uninsured patients relying primarily on treatment in the emergency department is increasing, and patients' average acuities are rising. At the same time, support resources are constrained, while reimbursement and reputation depends increasingly on publicly available measures of patient satisfaction. It is important to understand the potential effect of these pressures on direct care staff. This study explores the prevalence of compassion satisfaction, burnout, and compassion fatigue among emergency nurses and nurses in other selected inpatient specialties. Emergency nurses and nurses from 3 other specialty units self-selected participation in a cross-sectional survey. Participants completed a sociodemographic profile and the Professional Quality of Life: Compassion Satisfaction and Fatigue Subscales, R-IV. Scale scores were summed for compassion satisfaction, burnout, and compassion fatigue for emergency nurses and compared with those of nurses in other specialties. Approximately 82% of emergency nurses had moderate to high levels of burnout, and nearly 86% had moderate to high levels of compassion fatigue. Differences between emergency nurses and those working in 3 other specialty areas, that is, oncology, nephrology, and intensive care, on the subscales for compassion satisfaction, burnout, or compassion fatigue did not reach the level of statistical significance. However, the scores of emergency nurses evidenced a risk for less compassion satisfaction, while intensive care nurses demonstrated a higher risk for burnout and oncology nurses reflected a risk for higher compassion fatigue. ED nurse managers, along with other nurse leaders, are faced with the competing demands of managing the satisfaction of patients, recruitment and retention of experienced nurses, and provision of quality and safe care customized to patients' needs

1980 Census Tracts (TIGER)

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — This data set is a vector polygon digital data structure taken from Census Bureau's TIGER/Line Files, 1994, for New Mexico. The source software used was ARC/INFO...

Awkward Questions: Language Issues in the 2011 Census in England

Science.gov (United States)

Sebba, Mark

2018-01-01

The 2011 Census in England broke new ground, as a question about language had never previously been asked. After stakeholder consultations and a series of trials, the census authority decided on two questions based on earlier censuses in the USA: one about the respondent's "main language" and another about proficiency in English. This…

15 CFR 50.10 - Fee structure for special population censuses.

Science.gov (United States)

2010-01-01

... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Fee structure for special population... § 50.10 Fee structure for special population censuses. The Bureau of the Census is authorized to conduct special population censuses at the request of and at the expense of the community concerned. To...

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.

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.

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.

Computer-based literature search in medical institutions in India

Directory of Open Access Journals (Sweden)

Kalita Jayantee

2007-01-01

Full Text Available Aim: To study the use of computer-based literature search and its application in clinical training and patient care as a surrogate marker of evidence-based medicine. Materials and Methods: A questionnaire comprising of questions on purpose (presentation, patient management, research, realm (site accessed, nature and frequency of search, effect, infrastructure, formal training in computer based literature search and suggestions for further improvement were sent to residents and faculty of a Postgraduate Medical Institute (PGI and a Medical College. The responses were compared amongst different subgroups of respondents. Results: Out of 300 subjects approached 194 responded; of whom 103 were from PGI and 91 from Medical College. There were 97 specialty residents, 58 super-specialty residents and 39 faculty members. Computer-based literature search was done at least once a month by 89% though there was marked variability in frequency and extent. The motivation for computer-based literature search was for presentation in 90%, research in 65% and patient management in 60.3%. The benefit of search was acknowledged in learning and teaching by 80%, research by 65% and patient care by 64.4% of respondents. Formal training in computer based literature search was received by 41% of whom 80% were residents. Residents from PGI did more frequent and more extensive computer-based literature search, which was attributed to better infrastructure and training. Conclusion: Training and infrastructure both are crucial for computer-based literature search, which may translate into evidence based medicine.

Archive of Census Related Products (ACRP): 1992 Boundary Files

Data.gov (United States)

National Aeronautics and Space Administration — The 1992 Boundary Files portion of the Archive of Census Related Products (ACRP) consists of 1992 boundary data from the U.S. Census Bureau's Topologically...

Census 2000 Urbanized Areas (CEN00UA02_2)

Data.gov (United States)

California Natural Resource Agency — For Census 2000, the Census Bureau classifies as 'urban' all territory, population, and housing units located within an urbanized area (UA) or an urban cluster (UC)....

Census Tracts & Block Groups, 2004, East Baton Rouge, Louisiana

Data.gov (United States)

Louisiana Geographic Information Center — This is a graphical polygon dataset depicting the polygon boundaries of 107 semi-permanent census tracts and the census blocks within the Parish of East Baton Rouge....

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

Decennial Censuses: Historical Data on Enumerator Productivity Are Limited

National Research Council Canada - National Science Library

2001-01-01

... it. These factors-used to calculate productivity-are some of the largest drivers of census costs, and the Bureau developed its budget for the 2000 Census using a model that contained key assumptions...

Spatial analyses identify the geographic source of patients at a National Cancer Institute Comprehensive Cancer Center.

Science.gov (United States)

Su, Shu-Chih; Kanarek, Norma; Fox, Michael G; Guseynova, Alla; Crow, Shirley; Piantadosi, Steven

2010-02-01

We examined the geographic distribution of patients to better understand the service area of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, a designated National Cancer Institute (NCI) comprehensive cancer center located in an urban center. Like most NCI cancer centers, the Sidney Kimmel Comprehensive Cancer Center serves a population beyond city limits. Urban cancer centers are expected to serve their immediate neighborhoods and to address disparities in access to specialty care. Our purpose was to learn the extent and nature of the cancer center service area. Statistical clustering of patient residence in the continental United States was assessed for all patients and by gender, cancer site, and race using SaTScan. Primary clusters detected for all cases and demographically and tumor-defined subpopulations were centered at Baltimore City and consisted of adjacent counties in Delaware, Pennsylvania, Virginia, West Virginia, New Jersey and New York, and the District of Columbia. Primary clusters varied in size by race, gender, and cancer site. Spatial analysis can provide insights into the populations served by urban cancer centers, assess centers' performance relative to their communities, and aid in developing a cancer center business plan that recognizes strengths, regional utility, and referral patterns. Today, 62 NCI cancer centers serve a quarter of the U.S. population in their immediate communities. From the Baltimore experience, we might project that the population served by these centers is actually more extensive and varies by patient characteristics, cancer site, and probably cancer center services offered.

75 FR 52173 - Proposed Urban Area Criteria for the 2010 Census

Science.gov (United States)

2010-08-24

... avoid confusion with the Census Bureau's official urban- rural classifications. I. History Over the... been possible previously. Rather than delineating urban areas in an interactive and manual fashion, the... consistent fashion. For example, the Census Bureau split large agglomerations for Census 2000 by using...

Local censuses in the 18th century.

Science.gov (United States)

Law, C M

1969-03-01

Abstract Recent work on the population problems of the eighteenth century has been mainly based on the use of parish records. Another source, and one which, surprisingly, has received little attention is the local census. These are more numerous than is generally realised; and can be of great use in demographic studies. This paper examines 125 local censuses mainly taken in urban areas. They are discussed in terms of how they come to be taken, their reliability, extant manuscript material and their contents. Whilst most of the censuses confine themselves to the basic facts such as total population, number of houses and number of families, some give details of sex, age, marital status and occupation. Generally the information is given for the parish or local administrative unit, but in a few instances it is available by streets.

40th annual Reed rig census

International Nuclear Information System (INIS)

Fitts, R.L.; Stokes, T.A.

1992-01-01

This paper reports that declines characterize the 1992 rig census-in the number of available drilling rigs, in the number of active rigs, in rig utilization rate, in the number of rig owners and in industry optimism. The number of rotary rigs available for U.S. drilling fell by 255 units (11.3%) during the past 12 months, an attrition rate almost four times greater than in 1991. But despite the high attrition, only 59.7% of remaining rigs were working during the time the census was taken. Results of the 1992 census bring emphasis to an industry trend that became apparent in early 1991. The major oil companies, and many independents, continued their exodus form the U.S., and the remaining independents, which were hurt by low natural gas prices and unfavorable tax treatment of intangible drilling costs, were not able to pick u the drilling slack. Consequently, the past year has been disastrous for many U.S. drilling contractors, and the outlook for this industry segment remains bleak

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.

Consent: an event or a memory in lumbar spinal surgery? A multi-centre, multi-specialty prospective study of documentation and patient recall of consent content.

Science.gov (United States)

Lo, William B; McAuley, Ciaran P; Gillies, Martin J; Grover, Patrick J; Pereira, Erlick A C

2017-11-01

Prospective, multi-centre, multi-specialty medical notes review and patient interview. The consenting process is an important communication tool which also carries medico-legal implications. While written consent is a pre-requisite before spinal surgery in the UK, the standard and effectiveness of the process have not been assessed previously. This study assesses standard of written consent for elective lumbar decompressive surgery for degenerative disc disease across different regions and specialties in the UK; level of patient recall of the consent content; and identifies factors which affect patient recall. Consent forms of 153 in-patients from 4 centres a, b, c, d were reviewed. Written documentation of intended benefits, alternative treatments and operative risks was assessed. Of them, 108 patients were interviewed within 24 h before or after surgeries to assess recall. The written documentation rates of the operative risks showed significant inter-centre variations in haemorrhage and sphincter disturbance (P = 0.000), but not for others. Analysis of pooled data showed variations in written documentation of risks (P recall of these risks, there was no inter-centre variation. Patients' recall of paralysis as a risk was highest (50.9%) and that of recurrence was lowest (6.5%). Patients recalled risks better than those ≥65, significantly so for infection (29.9 vs 9.7%, P = 0.027). Patients consented >14 days compared to recall for paralysis (65.2 vs 43.7%) and recurrence (17.4 vs 2.8%). Patient recall was independent of consenter grade. Overall, the standard of written consent for elective lumbar spinal decompressive surgery was sub-optimal, which was partly reflected in the poor patient recall. While consenter seniority did not affect patient recall, younger age and longer consent-to-surgery time improved it.

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.

Pediatric emergency department census during major sporting events.

Science.gov (United States)

Kim, Tommy Y; Barcega, Besh B; Denmark, T Kent

2012-11-01

Our study attempted to evaluate the effects of major sporting events on the census of a pediatric emergency department (ED) in the United States specifically related to the National Football League Super Bowl, National Basketball Association (NBA) Finals, and Major League Baseball World Series. We performed a retrospective data analysis of our pediatric ED census on the number of visits during major sporting events over a 5-year period. Data during the same period 1 week after the major sporting event were collected for comparison as the control. We evaluated the medians of 2-hour increments around the event start time. Subgroup analysis was performed for games involving the local sporting teams. Our results showed no significant difference in ED census during the sporting events, except in the post 6 to 8 hours of the NBA finals. Subgroup analysis of the Los Angeles Lakers showed the same significant findings in the post 6 to 8 hours of the NBA finals. No major difference in pediatric ED census is observed during the most major sporting events in the United States.

New Mexico Census Tracts, Race and Hispanic Ethnicity (2010)

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The once-a-decade decennial census was conducted in April 2010 by the U.S. Census Bureau. This count of every resident in the United States was mandated by Article...

New Mexico Census Tracts, Median Age by Sex (2010)

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The once-a-decade decennial census was conducted in April 2010 by the U.S. Census Bureau. This count of every resident in the United States was mandated by Article...

The Register-based Census in Germany: Historical Context and Relevance for Population Research

Directory of Open Access Journals (Sweden)

Rembrandt Scholz

2016-08-01

Full Text Available In 2011, Germany carried out its first census after a 20-year break. In light of the United Nations’ recommendations that countries initiate a population census at least every 10 years, the census was long overdue. Moreover, demographers had for some time been demanding a new enumeration that would enable them to place the calculation of demographic indicators on a reliable basis. With the 2011 census, Germany not only met the demand for a current population census, but also broke new ground by using a register-based approach. Unlike the Scandinavian countries, which have a long tradition of performing register-based data analyses, the linking of administrative data in Germany is restricted by the country’s legal framework. Thus, the 2011 census was an ambitious project. After contextualising the 2011 census historically, we discuss in this contribution the census’ relevance for generating central demographic data. Specifically, we compare the updated population estimates of the 1987 census to the results of the 2011 census in order to identify possible systematic sources of error that distort demographic indicators and analyses.

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

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.

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...

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

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...

Impact of Cost-Sharing Increases on Continuity of Specialty Drug Use: A Quasi-Experimental Study.

Science.gov (United States)

Li, Pengxiang; Hu, Tianyan; Yu, Xinyan; Chahin, Salim; Dahodwala, Nabila; Blum, Marissa; Pettit, Amy R; Doshi, Jalpa A

2017-07-24

To examine the impact of cost-sharing increases on continuity of specialty drug use in Medicare beneficiaries with multiple sclerosis (MS) or rheumatoid arthritis (RA). Five percent Medicare claims data (2007-2010). Quasi-experimental study examining changes in specialty drug use among a group of Medicare Part D beneficiaries without low-income subsidies (non-LIS) as they transitioned from a 5 percent cost-sharing preperiod to a ≥25 percent cost-sharing postperiod, as compared to changes among a disease-matched contemporaneous control group of patients eligible for full low-income subsidies (LIS), who faced minor cost sharing (≤$6.30 copayment) in both the pre- and postperiods. Key variables were extracted from Medicare data. Relative to the LIS group, the non-LIS group had a greater increase in incidence of 30-day continuous gaps in any Part D treatment from the lower cost-sharing period to the higher cost-sharing period (MS, absolute increase = 10.1 percent, OR = 1.61, 95% CI 1.19-2.17; RA, absolute increase = 21.9 percent, OR = 2.75, 95% CI 2.15-3.51). The increase in Part D treatment gaps was not offset by increased Part B specialty drug use. Cost-sharing increases due to specialty tier-level cost sharing were associated with interruptions in MS and RA specialty drug treatments. © Health Research and Educational Trust.

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.

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

Nazareth College: Specialty Preparation for Speech-Language Pathologists to Work with Children Who Are Deaf and Hard of Hearing

Science.gov (United States)

Brown, Paula M.; Quenin, Cathy

2010-01-01

The specialty preparation program within the speech-language pathology master's degree program at Nazareth College in Rochester, New York, was designed to train speech-language pathologists to work with children who are deaf and hard of hearing, ages 0 to 21. The program is offered in collaboration with the Rochester Institute of Technology,…

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.

Tortugas Reef Fish Census (CRCP)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This is a long term data set collecting visual census transect data on reef fishes at staions located at Rileys Hump, Tortugas South Ecological Reservee.

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

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.

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

fracture repair. Almost all the dental classes believed that the specialty of OMS was both medical and dental in nature and that it is a very important dental specialty. Dental student perceptions of OMS change throughout their undergraduate training. The reasons for such a change are multivariate and might include factors such as the amount of didactic training and clinical exposure. It is vital to both recognize and address this change at an undergraduate level of training in an effort to increase educated referrals to a surgeon who might provide the best treatment options for the patient. A stronger understanding of the dental students' perception of OMS provides an opportunity for the oral and maxillofacial academic faculty to better educate students and, ultimately, strengthen our specialty. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Mora County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Bernalillo County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Chaves County 2010 Census Roads

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Lea County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Guadalupe County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Lincoln County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Bernalillo County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Torrance County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Sierra County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Grant County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Luna County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

New Mexico, 2010 Census Place

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Otero County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Quay County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Union County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Sandoval County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Socorro County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Valencia County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Taos County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Sandoval County 2010 Census Tracts

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Eddy County 2010 Census Tracts

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Socorro County 2010 Census Tracts

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Harding County 2010 Census Tracts

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Grant County 2010 Census Tracts

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Roosevelt County 2010 Census Tracts

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Cibola County 2010 Census Tracts

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Lincoln County 2010 Census Tracts

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Lincoln County 2010 Census Edges

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Harding County 2010 Census Edges

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Union County 2010 Census Edges

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Taos County 2010 Census Edges

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Guadalupe County 2010 Census Edges

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Luna County 2010 Census Edges

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Catron County 2010 Census Edges

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Hidalgo County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Otero County 2010 Census Edges

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Curry County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Chaves County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Sierra County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Chaves County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Union County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Lea County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Otero County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Valencia County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Curry County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Quay County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Quay County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Luna County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Union County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Bernalillo County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Guadalupe County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Catron County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Cibola County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Sandoval County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Colfax County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Roosevelt County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Grant County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Sierra County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Otero County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Lea County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Lincoln County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Curry County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Eddy County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Valencia County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Hidalgo County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Harding County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Mora County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Socorro County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Quay County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Luna County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Chaves County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Taos County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Torrance County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Taos County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Hidalgo County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Mora County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Torrance County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Colfax County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Bernalillo County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Torrance County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Socorro County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Sierra County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Lea County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Cibola County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Roosevelt County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Sandoval County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Hidalgo County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Valencia County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Grant County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Eddy County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Colfax County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Mora County 2010 Census Roads

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Catron County 2010 Census Roads

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

The Armstrong Institute: An Academic Institute for Patient Safety and Quality Improvement, Research, Training, and Practice.

Science.gov (United States)

Pronovost, Peter J; Holzmueller, Christine G; Molello, Nancy E; Paine, Lori; Winner, Laura; Marsteller, Jill A; Berenholtz, Sean M; Aboumatar, Hanan J; Demski, Renee; Armstrong, C Michael

2015-10-01

Academic medical centers (AMCs) could advance the science of health care delivery, improve patient safety and quality improvement, and enhance value, but many centers have fragmented efforts with little accountability. Johns Hopkins Medicine, the AMC under which the Johns Hopkins University School of Medicine and the Johns Hopkins Health System are organized, experienced similar challenges, with operational patient safety and quality leadership separate from safety and quality-related research efforts. To unite efforts and establish accountability, the Armstrong Institute for Patient Safety and Quality was created in 2011.The authors describe the development, purpose, governance, function, and challenges of the institute to help other AMCs replicate it and accelerate safety and quality improvement. The purpose is to partner with patients, their loved ones, and all interested parties to end preventable harm, continuously improve patient outcomes and experience, and eliminate waste in health care. A governance structure was created, with care mapped into seven categories, to oversee the quality and safety of all patients treated at a Johns Hopkins Medicine entity. The governance has a Patient Safety and Quality Board Committee that sets strategic goals, and the institute communicates these goals throughout the health system and supports personnel in meeting these goals. The institute is organized into 13 functional councils reflecting their behaviors and purpose. The institute works daily to build the capacity of clinicians trained in safety and quality through established programs, advance improvement science, and implement and evaluate interventions to improve the quality of care and safety of patients.

Algorithmic Approach With Clinical Pathology Consultation Improves Access to Specialty Care for Patients With Systemic Lupus Erythematosus.

Science.gov (United States)

Chen, Lei; Welsh, Kerry J; Chang, Brian; Kidd, Laura; Kott, Marylee; Zare, Mohammad; Carroll, Kelley; Nguyen, Andy; Wahed, Amer; Tholpady, Ashok; Pung, Norin; McKee, Donna; Risin, Semyon A; Hunter, Robert L

2016-09-01

Harris Health System (HHS) is a safety net system providing health care to the underserved of Harris County, Texas. There was a 6-month waiting period for a rheumatologist consult for patients with suspected systemic lupus erythematosus (SLE). The objective of the intervention was to improve access to specialty care. An algorithmic approach to testing for SLE was implemented initially through the HHS referral center. The algorithm was further offered as a "one-click" order for physicians, with automated reflex testing, interpretation, and case triaging by clinical pathology. Data review revealed that prior to the intervention, 80% of patients did not have complete laboratory workups available at the first rheumatology visit. Implementation of algorithmic testing and triaging of referrals by pathologists resulted in decreasing the waiting time for a rheumatologist by 50%. Clinical pathology intervention and case triaging can improve access to care in a county health care system. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Archive of Census Related Products (ACRP): 1990 Standard Extract Files

Data.gov (United States)

National Aeronautics and Space Administration — The 1990 Standard Extract Files portion of the Archive of Census Related Products (ACRP) contains population and housing data derived from the U.S. Census Bureau's...

Counting nurses: the power of historical census data.

Science.gov (United States)

D'Antonio, Patricia; Whelan, Jean C

2009-10-01

This study used census data to construct a demographic profile of early 20th century nurses in the United States. Census data are recognised as a rich source of quantitative information on long-term changes. However, difficulties in retrieving census data dissuade researchers from exploiting this source. Integrated Public Use Microdata Series, a standardised and digitialised version of census data, enables greater ease in retrieving and analysing data. A sample of respondents identifying as 'professional nurses' for the years 1900-1950 was extracted from Integrated Public Use Microdata Series categorised by the variables of race, sex and marital status. The resulting data were analysed for simple frequency statistics using SPSS software. Results revealed a tremendous increase in the number of nurses over the five decades under study. Nurses were increasingly young, female, single and white until 1930. After 1930, white and African-American women nurses began to reflect trends towards more diversity. This study is the first systematic attempt to trace the demographic trajectory of professional nurses in the United States in the early 20th century. It also demonstrates the possibilities of using digital technologies to restructure the asking and answering of historical questions. The use of quantitative methods of social history has trans-national applications which can facilitate global investigations into the demographic composition of the nursing occupation. RELEVANCE TO POLICY: This way of using digitalisation of census data provides a way to examine historical trans-national workforce trends. Such trends provide a firmer base upon which to construct workforce and practice strategies for a future global workforce.

Bernalillo County Transportation Analysis Zones, Census 2000 from TIGER 2008

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Shapefiles are an extract of selected geographic and cartographic information from the Census MAF/TIGER database. The Census MAF/TIGER database...

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

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.

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.

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.

[Automated processing of data from the 1985 population and housing census].

Science.gov (United States)

Cholakov, S

1987-01-01

The author describes the method of automated data processing used in the 1985 census of Bulgaria. He notes that the computerization of the census involves decentralization and the use of regional computing centers as well as data processing at the Central Statistical Office's National Information Computer Center. Special attention is given to problems concerning the projection and programming of census data. (SUMMARY IN ENG AND RUS)

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.

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

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.

Allegheny County Jail Daily Census

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — A daily census of the inmates at the Allegheny County Jail (ACJ). Includes gender, race, age at booking, and current age. The records for each month contain a...

77 FR 38634 - Request for Information: Collection and Use of Patient Work Information in the Clinical Setting...

Science.gov (United States)

2012-06-28

... (specialty) health care: At your clinical facility, how is the patient's work information collected... the Clinical Setting: Electronic Health Records AGENCY: The National Institute for Occupational Safety... Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention (CDC), Department of...

76 FR 13980 - Proposed Information Collection; Comment Request; 2012 Economic Census Covering the Information...

Science.gov (United States)

2011-03-15

... essential information for government, business, and the general public. Economic data are the Census Bureau... Economic Census Covering the Information, etc. AGENCY: U.S. Census Bureau, Commerce. ACTION: Notice... ). SUPPLEMENTARY INFORMATION: I. Abstract The economic census, conducted under authority of Title 13, United States...

Implementation and quality assessment of a pharmacy services call center for outpatient pharmacies and specialty pharmacy services in an academic health system.

Science.gov (United States)

Rim, Matthew H; Thomas, Karen C; Chandramouli, Jane; Barrus, Stephanie A; Nickman, Nancy A

2018-05-15

The implementation and quality assessment of a pharmacy services call center (PSCC) for outpatient pharmacies and specialty pharmacy services within an academic health system are described. Prolonged wait times in outpatient pharmacies or hold times on the phone affect the ability of pharmacies to capture and retain prescriptions. To support outpatient pharmacy operations and improve quality, a PSCC was developed to centralize handling of all outpatient and specialty pharmacy calls. The purpose of the PSCC was to improve the quality of pharmacy telephone services by (1) decreasing the call abandonment rate, (2) improving the speed of answer, (3) increasing first-call resolution, (4) centralizing all specialty pharmacy and prior authorization calls, (5) increasing labor efficiency and pharmacy capacities, (6) implementing a quality evaluation program, and (7) improving workplace satisfaction and retention of outpatient pharmacy staff. The PSCC centralized pharmacy calls from 9 pharmacy locations, 2 outpatient clinics, and a specialty pharmacy. Since implementation, the PSCC has achieved and maintained program goals, including improved abandonment rate, speed of answer, and first-call resolution. A centralized 24-7 support line for specialty pharmacy patients was also successfully established. A quality calibration program was implemented to ensure service quality and excellent patient experience. Additional ongoing evaluations measure the impact of the PSCC on improving workplace satisfaction and retention of outpatient pharmacy staff. The design and implementation of the PSCC have significantly improved the health system's patient experiences, efficiency, and quality. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

[The need to develop demographic census systems for Latin America].

Science.gov (United States)

Silva, A

1987-01-01

The author presents the case for developing new software packages specifically designed to process population census information for Latin America. The focus is on the problems faced by developing countries in handling vast amounts of data in an efficient way. First, the basic methods of census data processing are discussed, then brief descriptions of some of the available software are included. Finally, ways in which data processing programs could be geared toward and utilized for improving the accuracy of Latin American censuses in the 1990s are proposed.

Who is Hmong? Questions and Evidence from the U.S. Census

Directory of Open Access Journals (Sweden)

Victoria Udalova

2006-01-01

Full Text Available This paper explores the boundaries of the Hmong community as measured by different categories in 2000 U.S. census data. Following careful assessment of detailed Census data, the authors conclude that theusual criterion used to identify a person in the data as Hmong is too narrow, and that a broader, more inclusive definition more accurately delineates the Hmong ethnic group. The authors propose that anyonewho reported in the Census that his or her race, ancestry, or language was Hmong should be included in the Hmong community. This more inclusive method provides evidence that the Hmong populationenumerated by the 2000 U.S. census was about 18% larger than the figure that is usually reported.

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.

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.

Results of the 2000 census of wild reindeer on the Taimyr Peninsula

Directory of Open Access Journals (Sweden)

Leonid A. Kolpashchikov

2003-04-01

Full Text Available We conducted a census of wild reindeer (Rangifer tarandus on the Taimyr Peninsula during 21-25 July 2000. This was the eighteenth aerial population census of wild reindeer on the Taimyr since counts began in 1959. Prior to the census, we conducted reconnaissance flights to identify areas of reindeer concentration. After the reindeer became aggregated, we estimated group size both visually and by photographing the larger groups. Unusually hot and dry weather (temperatures of 25-30 °C and a high density of mosquitoes during the census likely forced the reindeer to group into unusually large concentrations. In late July most of the reindeer in the Taimyr population were distributed in two groupings that contained at least 450 000 animals, and one area that contained about 110 000. Smaller groups found during the census and the estimated 43 000 resident wild reindeer that were not counted during the census brought the total minimum population estimate to about 1 040 000. The maximum number of wild reindeer present could have been as high as about 1 100 000.

Census Bureau Regional Office Boundaries : New Structure as of January 2013

Data.gov (United States)

US Census Bureau, Department of Commerce — The Census Bureau has six regional offices to facilitate data collection, data dissemination and geographic operations within their boundary. The surveys these...

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.

‎ Factors Affecting the Choice of Psychiatry as a Specialty in ‎Psychiatry Residents in Iran

Science.gov (United States)

Sadr, Seyed Saeed; Nayerifard‎‎, Razieh; Samimi Ardestani, Seyed Mehdi; Namjoo, Massood

2016-01-01

Objective: The aim of this study was to investigate the current factors affecting the choice of ‎psychiatry as a specialty and to detect the main factors in their choice.‎ Method: This descriptive study included 75 first year psychiatry residents in the academic year of ‎‎2014/2015. A Likert-type anonymous questionnaire consisting of academic and ‎demographic data with 43 questions, which evaluated the reason for choosing ‎psychiatry as a specialty, was given to the residents.‎ Results: The participants had a positive opinion about 28 items of the questionnaire, meaning that ‎these items had a positive effect in choosing psychiatry as a specialty (questions with P ‎value less than 0.05 and a positive mean). More than 80% of the residents had a positive ‎opinion about six items of the questionnaire (amount of intellectual challenge, variety of ‎knowledge fields relevant to psychiatry, emphasis on the patient as a whole person, the ‎importance of treating mental illnesses in the future, work pressure and stress of the ‎field during residency and coordinating with the person's life style). The participants ‎had a negative opinion about two items of the questionnaire (questions with a P value ‎less than 0.05 and a negative mean). They included experiencing mental illness ‎personally through relatives or close friends as well as the income in psychiatry. ‎Moreover, 36% of the residents with a more definite opinion mentioned that they chose ‎psychiatry as a specialty because of the limitations in residency exam.‎ Conclusion: Assistants had a positive opinion about most of the questions and this positive attitude ‎seemed to be an important factor in their specialty choice. However, attending to the ‎preventing factors may increase the selection of psychiatry as a specialty.‎ PMID:27928251

[Statement of the board of directors of the German Sociological Society on the population census].

Science.gov (United States)

1983-10-01

This statement concerning population censuses has been prepared at the request of the board of directors of the German Sociological Society in light of the controversy surrounding the 1983 census in the Federal Republic of Germany. It is suggested that sample surveys cannot replace a census, a census is indispensable as a data source for regional analyses and studies of small population groups, a census must be carried out in a way that preserves the confidentiality of data, and census data must be accessible to scientific research.

75 FR 29508 - The 2010 Census Count Question Resolution Program

Science.gov (United States)

2010-05-26

... hundreds of square miles. Census blocs are the smallest geographic entities for which the Census Bureau... information on total population, sex, age, race, Hispanic or Latino origin, household relationship, group... housing units. This information includes age, sex, race, Hispanic or Latino origin, household relationship...

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...

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.

77 FR 50082 - Notice of Opportunity To Submit Content Request for the 2013 Census of Aquaculture

Science.gov (United States)

2012-08-20

... Content Request for the 2013 Census of Aquaculture AGENCY: National Agricultural Statistics Service... requests for the 2013 Census of Aquaculture. This census is required by law under the ``Census of... results of the 2005 Census of Aquaculture were released in October 2006. For more information, visit...

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

Institutional discourses and ascribed disability identities

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Mukta Kulkarni

2017-09-01

Full Text Available In the present study we asked: how do institutional discourses, as represented in mass media such as newspapers, confer identities upon a traditionally marginalised collective such as those with a disability? To answer our question, we examined Indian newspaper discourse from 2001 to 2010, the time period between two census counts. We observed that disability identities—that of a welfare recipient, a collective with human rights, a collective that is vulnerable, and that engages in miscreancy—were ascribed through selective highlighting of certain aspects of the collective, thereby socially positioning the collective, and through the associated signalling of institutional subject positions. Present observations indicate that identities of a collective can be governed by institutional discourse, that those “labelled” can themselves reinforce institutionally ascribed identities, and that as institutional discourses confer identities onto the marginalised, they simultaneously also signal who the relatively more powerful institutional actors are.

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…

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.

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...

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

Directory of Open Access Journals (Sweden)

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.

[Census of the renal and dialysis units by Italian Society of Nephrology: structure and organization for renal patient assistance in Italy (2014-2015)].

Science.gov (United States)

Quintaliani, Giuseppe; Di Luca, Marina; Di Napoli, Anteo; Viglino, Giusto; Postorino, Maurizio; Amore, Alessandro; Andrulli, Simeone; Bellasi, Antonio; Brunori, Giuliano; Buongiorno, Erasmo; Castellino, Santina; D'Amelio, Alessandro; De Nicola, Luca; Gesualdo, Loreto; Di Landro, Domenico; Feriozzi, Sandro; Strippoli, Giovanni; Teatini, Ugo; Santoro, Antonio

2016-01-01

Given the public health challenge and burden of chronic kidney disease, the Italian Society of Nephrology (SIN) promoted a census of the renal and dialysis units to analyse structural and human resources, organizational aspects, activities and workload referring to the year 2014. An online questionnaire, including 64 items exploring structural and human resources, organization aspects, activities and epidemiological data referred to 2014, was sent to chiefs of any renal or dialysis unit. 615 renal units were identified. From these 615 units, 332 were public renal centres (of which 318 centres answered to the census) and 283 were private dialysis centres (of which 113 centres answered to the census). The results show 6 public renal units pmp. Renal biopsies were 4624 (81 pmp). The nephrology beds are about 41 pmp. There are 7.304 nurses working in HD wards, 1.692 in the nephrology wards and only 613 for outpatients clinics. The benchmark data derived from this census show interesting comparisons between centres, regions and groups of regions. These data realised the clinical management of renal disease in Italy.

New Mexico County Boundaries (2010 Census)

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Dona Ana County 2010 Census Roads

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Santa Fe County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Curry County 2010 Census Block Groups

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Union County 2010 Census Block Groups

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Rio Arriba County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Dona Ana County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Los Alamos County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

San Miguel County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

San Juan County 2010 Census Tracts

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Rio Arriba County 2010 Census Tracts

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Valencia County 2010 Census Block Groups

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Socorro County 2010 Census Block Groups

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Sandoval County 2010 Census Block Groups

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Eddy County 2010 Census Block Groups

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Dona Ana County 2010 Census Edges

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Los Alamos County 2010 Census Edges

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

McKinley County 2010 Census Edges

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

San Juan County 2010 Census Roads

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

McKinley County 2010 Census Tracts

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Los Alamos County 2010 Census Tracts

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

San Miguel County 2010 Census Tracts

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Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

De Baca County 2010 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

McKinley County 2010 Census Roads

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

De Baca County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Dona Ana County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Los Alamos County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

San Juan County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Santa Fe County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

McKinley County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Rio Arriba County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

San Miguel County 2010 Census Blocks

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Mora County 2010 Census Block Groups

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Otero County 2010 Census Block Groups

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Harding County 2010 Census Block Groups

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Torrance County 2010 Census Block Groups

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Catron County 2010 Census Block Groups

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

San Juan County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Santa Fe County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

San Miguel County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

De Baca County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Rio Arriba County 2010 Census Edges

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Bernalillo County 2010 Census Block Groups

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Taos County 2010 Census Block Groups

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Grant County 2010 Census Block Groups

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

New Mexico, 2010 Census American Indian

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Clinical and socio-demographic characteristics of college students exposed to traumatic experiences: a census of seven college institutions in Northeastern Brazil.

Directory of Open Access Journals (Sweden)

Liana R Netto

Full Text Available BACKGROUND: Epidemiological studies show that most of the adult population will be exposed to at least one potentially traumatic event in the course of his/her life; adolescence and early adulthood are the most vulnerable periods of life for exposure to traumatic experiences (70% of their deaths are due to external causes. Posttraumatic Stress Disorder is characterized by the development of dysfunctional symptoms that cause distress or social, academic, or occupational impairment, as result of exposure to a traumatic event. The aim of this multicentric study is to establish the proportion of college students, within seven institutions in Northeastern Brazil, who were exposed to traumatic experience and met PTSD criteria. METHODS/DESIGN: A one-phase census protocol of seven college institutions in three metropolitan regions in Northeastern Brazil was performed (April to July 2011. All students aged 18 years or older, matriculated and attending their first or final semester were eligible. The self-applied protocol consisted of a socio-demographic questionnaire and the following scales adjusted to Brazilian Portuguese standards Trauma History Questionnaire (THQ, PTSD Checklist-Civilian (PCL-C, Impulsivity Scale (BIS-11. Data were entered into SPSS 17.0. RESULTS: 2213 (85.5% students consented to participate, and completely filled in the protocols. Of these, 66.1% were woman, mean age 23.9 (SD 6.3, 82.7% were single, and 57.3% attended university outside their native cities. The total PTSD prevalence was 14%, and the median for frequency of trauma exposure was 5 events. CONCLUSION: A high frequency of exposure to violence, as well as a high rate of PTSD, suicide attempts, and high-risk sexual behavior was found in Brazilian college students. This highlights the importance of effective public health actions in relation to the prevention and treatment of PTSD and other dysfunctional behaviors resulting from traumatic exposure in young individuals

International and internal migration measured from the School Census in England.

Science.gov (United States)

Simpson, Ludi; Marquis, Naomi; Jivraj, Stephen

2010-01-01

The School Census is the only regularly updated dataset covering almost all of the population of a specific age, which records changes of address along with ethnicity and some family economic circumstances. It can be used to measure internal and international family migration as shown in this report. The School Census is suited to identify and quantify new local migration streams between censuses, successfully identifying the local distribution of Eastern European immigration in the decade since 2000. The measures do not provide a complete measure of migration, either internally or internationally. The exclusion of those outside the state school system means that internal migration is under-estimated, and international migration is approximately measured. The advantages of the School Census are its frequent updates, its fine geographical information, and its indicators of ethnicity and low family income, which powerfully complement other sources.

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…

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…

A Global Perspective on Drinking-Water and Sanitation Classification: An Evaluation of Census Content.

Science.gov (United States)

Yu, Weiyu; Wardrop, Nicola A; Bain, Robert E S; Lin, Yanzhao; Zhang, Ce; Wright, Jim A

2016-01-01

Following the recent expiry of the United Nations' 2015 Millennium Development Goals (MDGs), new international development agenda covering 2030 water, sanitation and hygiene (WASH) targets have been proposed, which imply new demands on data sources for monitoring relevant progress. This study evaluates drinking-water and sanitation classification systems from national census questionnaire content, based upon the most recent international policy changes, to examine national population census's ability to capture drinking-water and sanitation availability, safety, accessibility, and sustainability. In total, 247 censuses from 83 low income and lower-middle income countries were assessed using a scoring system, intended to assess harmonised water supply and sanitation classification systems for each census relative to the typology needed to monitor the proposed post-2015 indicators of WASH targets. The results signal a lack of international harmonisation and standardisation in census categorisation systems, especially concerning safety, accessibility, and sustainability of services in current census content. This suggests further refinements and harmonisation of future census content may be necessary to reflect ambitions for post-2015 monitoring.

A Global Perspective on Drinking-Water and Sanitation Classification: An Evaluation of Census Content.

Directory of Open Access Journals (Sweden)

Weiyu Yu

Full Text Available Following the recent expiry of the United Nations' 2015 Millennium Development Goals (MDGs, new international development agenda covering 2030 water, sanitation and hygiene (WASH targets have been proposed, which imply new demands on data sources for monitoring relevant progress. This study evaluates drinking-water and sanitation classification systems from national census questionnaire content, based upon the most recent international policy changes, to examine national population census's ability to capture drinking-water and sanitation availability, safety, accessibility, and sustainability. In total, 247 censuses from 83 low income and lower-middle income countries were assessed using a scoring system, intended to assess harmonised water supply and sanitation classification systems for each census relative to the typology needed to monitor the proposed post-2015 indicators of WASH targets. The results signal a lack of international harmonisation and standardisation in census categorisation systems, especially concerning safety, accessibility, and sustainability of services in current census content. This suggests further refinements and harmonisation of future census content may be necessary to reflect ambitions for post-2015 monitoring.

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.

Negotiating Race and Ethnicity: exploring the implications of the 1991 Census

OpenAIRE

Ballard, Roger

1996-01-01

This paper explores the way in which the concepts of 'Ethnic group' and 'Race' were operationalised in the 1991 Census of the UK, and explores the far-reaching impact which these conceptualization have had on the character of published Census data.

Institutional contexts and mortality: the case of Peru.

Science.gov (United States)

Andes, N

1992-10-01

"This analysis examines the institutional context of infant mortality in Peru using economic, social, health care, and public health measures as indicators of development and equity. Using linked data from population and economic censuses, government agencies, and health surveys on twenty-four Peruvian provinces, I explore how economic development and institutional contexts influence health outcomes. Regional inequities based on rural population, subsistence activity, women's illiteracy, monthly income, Gross Domestic Product, medical care, and health facilities are compared. Then a cluster analysis identifies institutional contexts that have internal similarities.... My conclusion is that understanding regional inequities--defined in terms of economic development, social institutions, and health services--leads to enhanced explanations of disparities in health outcomes."

76 FR 321 - Proposed Information Collection; Comment Request; 2012 Economic Census Covering the Utilities...

Science.gov (United States)

2011-01-04

... Economic Census Covering the Utilities, Transportation and Warehousing, Finance and Insurance, and Real... nondecennial census years. The 2012 Economic Census covering Utilities, Transportation and Warehousing, Finance... basic statistics by kind of business on the number of establishments, revenue, payroll, and employment...

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.

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

Los Alamos County 1990 Census Tracts

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — This data set is a vector polygon digital data structure taken from the Census Bureau's TIGER/Line Files, 1994, for New Mexico. The source software used was ARC/INFO...

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...

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.

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

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

A global census of marine microbes

Digital Repository Service at National Institute of Oceanography (India)

Amaral-Zettler, L.; Artigas, L.F.; Baross, J.; LokaBharathi, P.A; Boetius, A; Chandramohan, D.; Herndl, G.; Kogure, K.; Neal, P.; Pedros-Alio, C.; Ramette, A; Schouten, S.; Stal, L.; Thessen, A; De Leeuw, J.; Sogin, M.

In this chapter we provide a brief history of what is known about marine microbial diversity, summarize our achievements in performing a global census of marine microbes, and reflect on the questions and priorities for the future of the marine...

Demographic Data - TIGER/Line Shapefile, 2010, 2010 county, Miami-Dade County, FL, 2010 Census Census Tract County-based

Data.gov (United States)

NSGIC Local Govt | GIS Inventory — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Medical narratives and patient analogs: the ethical implications of electronic patient records.

Science.gov (United States)

Kluge, E H

1999-12-01

An electronic patient record consists of electronically stored data about a specific patient. It therefore constitutes a data-space. The data may be combined into a patient profile which is relative to a particular specialty as well as phenomenologically unique to the specific professional who constructs the profile. Further, a diagnosis may be interpreted as a path taken by a health care professional with a certain specialty through the data-space relative to the patient profile constructed by that professional. This way of looking at electronic patient records entails certain ethical implications about privacy and accessibility. However, it also permits the construction of artificial intelligence and competence algorithms for health care professionals relative to their specialties.

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.

TIGER/Line Shapefile, 2017, nation, U.S., Current Tribal Census Tract National

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line shapefiles and related database files (.dbf) are an extract of selected geographic and cartographic information from the U.S. Census Bureau's Master...

TIGER/Line Shapefile, 2016, nation, U.S., Current Tribal Census Tract National

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line shapefiles and related database files (.dbf) are an extract of selected geographic and cartographic information from the U.S. Census Bureau's Master...

76 FR 13981 - Proposed Information Collection; Comment Request; 2012 Economic Census Covering the Construction...

Science.gov (United States)

2011-03-15

... essential information for government, business and the general public. The 2012 Economic Census covering the... Economic Census Covering the Construction Sector AGENCY: U.S. Census Bureau. ACTION: Notice. SUMMARY: The... provider of timely, relevant and quality data about the people and economy of the United States. Economic...

76 FR 13978 - Proposed Information Collection; Comment Request; 2012 Economic Census Covering the Manufacturing...

Science.gov (United States)

2011-03-15

... essential information for government, business and the general public. The 2012 Economic Census covering the... Economic Census Covering the Manufacturing Sector AGENCY: U.S. Census Bureau. ACTION: Notice. SUMMARY: The... provider of timely, relevant and quality data about the people and economy of the United States. Economic...

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...

Patient loyalty in a mature IDS market: is population health management worth it?

Science.gov (United States)

Carlin, Caroline S

2014-06-01

To understand patient loyalty to providers over time, informing effective population health management. Patient care-seeking patterns over a 6-year timeframe in Minnesota, where care systems have a significant portion of their revenue generated by shared-saving contracts with public and private payers. Weibull duration and probit models were used to examine patterns of patient attribution to a care system and the continuity of patient affiliation with a care system. Clustering of errors within family unit was used to account for within-family correlation in unobserved characteristics that affect patient loyalty. The payer provided data from health plan administrative files, matched to U.S. Census-based characteristics of the patient's neighborhood. Patients were retrospectively attributed to health care systems based on patterns of primary care. I find significant patient loyalty, with past loyalty a very strong predictor of future relationship. Relationships were shorter when the patient's health status was complex and when the patient's care system was smaller. Population health management can be beneficial to the care system making this investment, particularly for patients exhibiting prior continuity in care system choice. The results suggest that co-located primary and specialty services are important in maintaining primary care loyalty. © Health Research and Educational Trust.

TIGER/Line Shapefile, 2010, 2010 state, California, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Virginia, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Texas, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Tennessee, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Georgia, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Hawaii, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Indiana, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Michigan, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Delaware, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Idaho, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Montana, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Oregon, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Kansas, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Ohio, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Mississippi, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Colorado, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Kentucky, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Washington, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Maryland, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Wisconsin, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Missouri, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Illinois, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Alabama, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Minnesota, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Connecticut, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Wyoming, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

TIGER/Line Shapefile, 2010, 2010 state, Vermont, 2010 Census Block State-based

Data.gov (United States)

US Census Bureau, Department of Commerce — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

Provincial migration in China : Preliminary insights from the 2010 population census

NARCIS (Netherlands)

A.M. Fischer (Andrew Martín)

2012-01-01

textabstractIn anticipation of the forthcoming release of the 2010 national population census of China, this paper compares the limited population data that have been released so far with annual data on natural population increase since the 2000 census in order to construct a rough but robust

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…

Real-world Clinical Outcomes Among Patients With Type 2 Diabetes Receiving Canagliflozin at a Specialty Diabetes Clinic: Subgroup Analysis by Baseline HbA1c and Age.

Science.gov (United States)

Johnson, June Felice; Parsa, Rahul; Bailey, Robert A

2017-06-01

Canagliflozin, a sodium glucose co-transporter 2 inhibitor developed for the treatment of type 2 diabetes mellitus (T2DM), has demonstrated effectiveness in patients with T2DM receiving care at a specialty diabetes clinic. We report the outcomes in these patients in subgroups classified by baseline hemoglobin A 1c (HbA 1c ) and age. This subgroup analysis was based on a review of data from the electronic health records of adults with T2DM who were prescribed canagliflozin at a specialty diabetes clinic and who returned for ≥1 follow-up office visit. Mean changes from baseline to the first and second follow-up office visits in HbA 1c , body weight, and systolic and diastolic blood pressure (BP) were calculated in each subgroup classified by baseline HbA 1c (≥7.0%, ≥8.0%, and >9.0%) and age (baseline HbA 1c ≥7.0%, ≥8.0%, and >9.0%, respectively; 396 and 66 patients were aged baseline HbA 1c and age experienced clinically and statistically significant reductions from baseline in HbA 1c , body weight, and systolic BP that were sustained over 2 office visits; diastolic BP was also reduced across baseline HbA 1c and age subgroups. Greater reductions in HbA 1c were seen among the canagliflozin-treated patients with higher baseline HbA 1c and among younger versus older patients. These findings from clinical practice demonstrate real-world effectiveness of canagliflozin in lowering HbA 1c , body weight, and systolic BP among patients with T2DM, regardless of baseline HbA 1c levels or age. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

History of census in the Czech Republic and in France (or in Germany, in the USA)

OpenAIRE

Šťastný, Jan

2016-01-01

Principal objective of this bachelor thesis is comparing census in the Czech Republic, in France and in the USA. In introductory section concerns on history of census in particular countries, mainly on detailed describe of census during 20th century. This is followed by chapters which attend to methodology and last census in selected countries where illustrated different access in variable parts of the world is. The last part is concerned about following census and perspective to the future, ...

AFSC/NMML/CCEP: Channel Islands Pinniped Census

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The National Marine Mammal Laboratories' California Current Ecosystem Program (AFSC/NOAA) initiated and maintains census programs for California sea lions (Zalophus...

The state, statistics, minorities and power: Ethnic "others" in the Duchy and Kingdom of Serbia as viewed through the lens of national census

Directory of Open Access Journals (Sweden)

Pavlović Mirjana

2015-01-01

Full Text Available In this paper we deal with ethnically diverse categories of residents of the Duchy and the Kingdom of Serbia in national censuses conducted between 1834 and 1910, with an accent on those conducted from 1862 - the period when official state statistics institutions were established. We do not deal foremost with numbers and statistical analyses, but with censuses as such - as we consider censuses to be an important instrument in the hands of the state which has the power to count, delineate and categorize the population. In this paper we give special attention to the relationship between the census officials and (ethnic minorities: when and in what measure the interest in counting and documenting “others” emerges in Serbia, how they are categorized, which terms are used for minorities as such or various groups specifically, and how the data on these is interpreted. From this a certain image emerges - an image of the relationship between the state and ethnic “others”. This research displays a prominent tendency in this historical period to view minorities not as an integral part of the state and society, but as an alien, foreign body in it. Also, the meaning of the existence of ethnically diverse groups is often minimized, due to their alleged small numbers. Even though valid conclusions on the position of minorities in the state and society would require more thorough research and more sources, we consider the way in which ethnically diverse groups of citizens were treated in state censuses as very indicative in this sense.

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.

Rethinking informal payments by patients in Europe: An institutional approach.

Science.gov (United States)

Williams, Colin C; Horodnic, Adrian V

2017-10-01

The aim of this paper is to explain informal payments by patients to healthcare professionals for the first time through the lens of institutional theory as arising when there are formal institutional imperfections and asymmetry between norms, values and practices and the codified formal laws and regulations. Reporting a 2013 Eurobarometer survey of the prevalence of informal payments by patients in 28 European countries, a strong association is revealed between the degree to which formal and informal institutions are unaligned and the propensity to make informal payments. The association between informal payments and formal institutional imperfections is then explored to evaluate which structural conditions might reduce this institutional asymmetry, and thus the propensity to make informal payments. The paper concludes by exploring the implications for tackling such informal practices. Copyright © 2017 Elsevier B.V. All rights reserved.

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.

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.

Closed medical negligence claims can drive patient safety and reduce litigation.

Science.gov (United States)

Pegalis, Steven E; Bal, B Sonny

2012-05-01

Medical liability reform is viewed by many physician groups as a means of reducing medical malpractice litigation and lowering healthcare costs. However, alternative approaches such as closed medical negligence claims data may also achieve these goals. We asked whether information gleaned from closed claims related to medical negligence could promote patient safety and reduce costs related to medical liability. Specifically, we investigated whether physician groups have examined such data to identify error patterns and to then institute specific patient treatment protocols. We searched for medical societies that have systematically examined closed medical negligence claims in their specialty to develop specific standards of physician conduct. We then searched the medical literature for published evidence of the efficacy, if any, related to the patient safety measures thus developed. Anesthesia and obstetric physician societies have successfully targeted costs and related concerns arising from medical malpractice lawsuits by using data from closed claims to develop patient safety and treatment guidelines. In both specialties, after institution of safety measures derived from closed medical negligence claims, the incidence and costs related to medical malpractice decreased and physician satisfaction improved. Tort reform, in the form of legislatively prescribed limits on damages arising from lawsuits, is not the only means of addressing the incidence and costs related to medical malpractice litigation. As the experience of anesthesia and obstetric physicians has demonstrated, safety guidelines derived from analyzing past medical malpractice litigation can achieve the same goals while also promoting patient safety.

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

[The impact of technological change on census taking: some thoughts on implications for the 1990 round of censuses and on the statistical use of administrative records].

Science.gov (United States)

Brackstone, G J

1984-01-01

The author presents some general thoughts on the implications of technological change for the 1990 round of censuses and for the statistical use of administrative records. Consideration is also given to alternative methods of obtaining the type of data traditionally collected in a population census, by using these new technologies in association with administrative record systems.

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.

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...

Use of aerial photograph to enhance dog population census in Ilorin ...

African Journals Online (AJOL)

The ground survey method for dog population census is considered to be prone to error in enumeration. As a result, use of aerial photography has been suggested as capable of enhancing ground survey methods for more accurate results. Dog population census was carried out within llorin city in October 2010 using direct ...

[The measurement of data quality in censuses of population and housing].

Science.gov (United States)

1980-01-01

The determination of data quality in population and housing censuses is discussed. Principal types of errors commonly found in census data are reviewed, and the parameters used to evaluate data quality are described. Various methods for measuring data quality are outlined and possible applications of the methods are illustrated using Canadian examples

P02.05 Peripheral Nerve Sheath Tumor Epidemiology in the South Central Hospital of High Specialty from PEMEX in Mexico

Science.gov (United States)

Guerra Mora, J.; Cordoba Mosqueda, M.; Hernandez Resendiz, R.; Loya Aguilar, I.; Vicuña Gonzalez, R.; Garcia Gonzalez, U.

2016-01-01

Abstract Introduction: The peripheral sheath tumors are part of a large group of neoplasms that range from biologically benign with minimal disorders in life quality to highly malign with life quality deterioration and high mortality. There are subtypes with high prevalence like Schwannomas and some much rarer like the intracranial peripheral nerve sheath tumor which happen to have very bad prognosis. The aim of this study is to describe the epidemiologic and clinical characteristics of patients with peripheral nerve sheat tumors in a hospital of high specialty. Method and materials: Observational study with patients from March 1999 to March 2016 with confirmed diagnosis of peripheral nerve sheath tumor in the electronic files of the South Central Hospital of High Specialty PEMEX. A statistical analysis is made through the SPSS Statistics of the disease in this Institution program. Results: There were 84 patients with the diagnosis of peripheral nerve sheath tumor with a median age of 48.04 years, 65.5% were males, the most common histological type found was the Schwannoma with a 72.6%, followed by senescent Schwannoma 13.1%, neurofibroma 8.3%, and malign peripheral nerve sheath tumor 2.4%. The most frequent location was at the site of cranial nerves, followed by cervical level 27.4%, lumbar 16.7% and thoracic 9.5%. The most common initial symptom was pain in 23.8% of the patients, and the time of the onset of symptoms to the diagnosis was 31.6 months. From the total of patients 8.3% had neurofibromatosis type 1, 6.0% neurofibromatosis type 2. Conclusions: We realized in our series of reported cases that the frequency is similar to those reported in worldwide population; nevertheless the time between the onset of symptoms and the diagnosis is much higher in our cases as well as the population of patients with neurofibromatosis. This study justifies the need of attention quality improvement and the knowledge of this information the medical doctor of first

Variability in abundance of temperate reef fishes estimated by visual census.

Directory of Open Access Journals (Sweden)

Alejo J Irigoyen

Full Text Available Identifying sources of sampling variation and quantifying their magnitude is critical to the interpretation of ecological field data. Yet, most monitoring programs of reef fish populations based on underwater visual censuses (UVC consider only a few of the factors that may influence fish counts, such as the diver or census methodology. Recent studies, however, have drawn attention to a broader range of processes that introduce variability at different temporal scales. This study analyzes the magnitude of different sources of variation in UVCs of temperate reef fishes off Patagonia (Argentina. The variability associated with time-of-day, tidal state, and time elapsed between censuses (minutes, days, weeks and months was quantified for censuses conducted on the five most conspicuous and common species: Pinguipes brasilianus, Pseudopercis semifasciata, Sebastes oculatus, Acanthistius patachonicus and Nemadactylus bergi. Variance components corresponding to spatial heterogeneity and to the different temporal scales were estimated using nested random models. The levels of variability estimated for the different species were related to their life history attributes and behavior. Neither time-of-day nor tidal state had a significant effect on counts, except for the influence of tide on P. brasilianus. Spatial heterogeneity was the dominant source of variance in all but one species. Among the temporal scales, the intra-annual variation was the highest component for most species due to marked seasonal fluctuations in abundance, followed by the weekly and the instantaneous variation; the daily component was not significant. The variability between censuses conducted at different tidal levels and time-of-day was similar in magnitude to the instantaneous variation, reinforcing the conclusion that stochastic variation at very short time scales is non-negligible and should be taken into account in the design of monitoring programs and experiments. The present

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...

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.

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.

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

Institutional Variation in Traumatic Brain Injury Acute Rehabilitation Practice.

Science.gov (United States)

Seel, Ronald T; Barrett, Ryan S; Beaulieu, Cynthia L; Ryser, David K; Hammond, Flora M; Cullen, Nora; Garmoe, William; Sommerfeld, Teri; Corrigan, John D; Horn, Susan D

2015-08-01

To describe institutional variation in traumatic brain injury (TBI) inpatient rehabilitation program characteristics and evaluate to what extent patient factors and center effects explain how TBI inpatient rehabilitation services are delivered. Secondary analysis of a prospective, multicenter, cohort database. TBI inpatient rehabilitation programs. Patients with complicated mild, moderate, or severe TBI (N=2130). Not applicable. Mean minutes; number of treatment activities; use of groups in occupational therapy, physical therapy, speech therapy, therapeutic recreation, and psychology inpatient rehabilitation sessions; and weekly hours of treatment. A wide variation was observed between the 10 TBI programs, including census size, referral flow, payer mix, number of dedicated beds, clinician experience, and patient characteristics. At the centers with the longest weekday therapy sessions, the average session durations were 41.5 to 52.2 minutes. At centers with the shortest weekday sessions, the average session durations were approximately 30 minutes. The centers with the highest mean total weekday hours of occupational, physical, and speech therapies delivered twice as much therapy as the lowest center. Ordinary least-squares regression modeling found that center effects explained substantially more variance than patient factors for duration of therapy sessions, number of activities administered per session, use of group therapy, and amount of psychological services provided. This study provides preliminary evidence that there is significant institutional variation in rehabilitation practice and that center effects play a stronger role than patient factors in determining how TBI inpatient rehabilitation is delivered. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Rio Arriba County 2010 Census Block Groups

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — The TIGER/Line Files are shapefiles and related database files (.dbf) that are an extract of selected geographic and cartographic information from the U.S. Census...

McKinley County 2010 Census Block Groups