3rd International School and Conference “Saint Petersburg OPEN 2016” on Optoelectronics, Photonics, Engineering and Nanostructures

International Nuclear Information System (INIS)

2016-01-01

Dear Colleagues, 3rd International School and Conference “Saint Petersburg OPEN 2016” on Optoelectronics, Photonics, Engineering and Nanostructures was held on March 28 - 30, 2016 at St. Petersburg Academic University of the Russian Academy of Sciences. The School and Conference included a series of invited talks given by leading professors with the aim of introducing young scientists to the actual problems and major advances in modern physics and technology. The keynote speakers were Mircea Guina (Tampere University of Technology, Finland) Evgeny I. Terukov (Ioffe Institute RAS, Russia) Victor M. Ustinov (Ioffe Institute RAS, Russia) Peter G. Kazansky (University of Southampton, UK) Alexander O. Golubok (ITMO University, Russia) Georgy E. Cirlin (St Petersburg Academic University RAS, Russia) Levon V. Asryan (Virginia Polytechnic Institute and State University, USA) Andrey A. Lipovskii (Peter the Great St.Petersburg Polytechnic University, Russia) During the poster session all undergraduate and graduate students attending the conference presented their works. A large number of participants with more than 280 student attendees from all over the world allowed the Conference to provide a fertile ground for the fruitful discussions between the young scientists as well as to become a perfect platform for the valuable discussions between student authors and highly experienced scientists. The best student papers, which were selected by the Program Committee and by the invited speakers based on the theses and their poster presentation, were awarded with diplomas of the conference - see the photos. This year “Saint Petersburg OPEN 2016” is organized by St. Petersburg Academic University in cooperation with Peter the Great St. Petersburg Polytechnic University. The School and Conference is supported by the Russian Foundation for Basic Research (Project N 16-32-10060) , Russian Science Foundation, SPIE (The International Society for Optics and Photonics) and OSA (The

Russian Muslims: History and Modern Age (Case of Establishing and Developing of Islamic Community in Saint Petersburg

Directory of Open Access Journals (Sweden)

Marina A. Sapronova

2016-01-01

Full Text Available Book review: Renat Bekkin, Almira Tagirdzhanova. Muslim Petersburg. Historical guide-book. The life of Muslims in St. Petersburg and its suburbs. - Moscow, St. Petersburg: Institute for African Studies, 2016. - 640p.

76 FR 44531 - Safety Zone; Fourth Annual Chillounge Night St. Petersburg Fireworks Display, Tampa Bay, St...

Science.gov (United States)

2011-07-26

...-AA00 Safety Zone; Fourth Annual Chillounge Night St. Petersburg Fireworks Display, Tampa Bay, St... proposes to establish a temporary safety zone on the waters of Tampa Bay in St. Petersburg, Florida during the Fourth Annual Chillounge Night St. Petersburg Fireworks Display on Saturday, November 19, 2011...

76 FR 68098 - Safety Zone; Fourth Annual Chillounge Night St. Petersburg Fireworks Display, Tampa Bay, St...

Science.gov (United States)

2011-11-03

...-AA00 Safety Zone; Fourth Annual Chillounge Night St. Petersburg Fireworks Display, Tampa Bay, St... Guard is establishing a temporary safety zone on the waters of Tampa Bay in St. Petersburg, Florida during the Fourth Annual Chillounge Night St. Petersburg Fireworks Display on Saturday, November 19, 2011...

Changes in the Population Distribution and Transport Network of Saint Petersburg

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Xiaoling Li

2016-12-01

Full Text Available The authors explores the interdependence between demographic changes and transport network centrality, using Saint Petersburg as an example. The article describes the demographic data for the period 2002—2015 and the transportation network data of 2006. The authors employ several methods of demographic research; they identified the centre of gravity of the population, produce the standard deviational ellipsis and use the kernel density estimation. The street network centrality of Saint Petersburg was analyzed using the Multiple Centrality Assessment Model (MCA and the Urban Network Analysis Tool for ArcGIS. The analysis of the population distribution in Saint Petersburg shows that each area of the city has seen their population grow over the last thirteen years. However, it is the population of suburban areas that increased the most. The core area of the city has the tendency of outward diffusion, and the population gravity centre has been moving northwards. Spatial characteristics of the population growth, changes in the population gravity centre, the standard deviational ellipse and characteristics of the street network centrality show that Saint Petersburg is at the final stage of urbanization and its development pattern is similar to that of other major cities.

The macroeconomic factors impact on the Level of Food Expenditure of St. Petersburg Residents

OpenAIRE

Bulatova Anastasiia

2016-01-01

The topic of this research is the impact of the macroeconomic factors on food spending residents of St. Petersburg. The problem of the study is the ambiguity of the food sanctions impact on the consumer spending on food. The aim of the work are the trend analyze in the level of food spending in St. Petersburg since the first quarter of 2007 to the third quarter 2015, and the identifying of factors influencing these food waste. St. Petersburg was chosen because it is a city with a large popula...

Nursing specialty and burnout.

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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.

77 FR 19970 - Security Zones; 2012 Republican National Convention, Captain of the Port St. Petersburg Zone...

Science.gov (United States)

2012-04-03

... Marine Science Technician First Class Nolan L. Ammons, Sector St. Petersburg Prevention Department, Coast... Science Technician First Class Nolan L. Ammons, Sector St. Petersburg Prevention Department, Coast Guard...

Radionuclide diagnostics in St. Petersburg: сurrent status and development challenges

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I. A. Zvonova

2015-01-01

Full Text Available This work aims at radionuclide diagnostics analyses in the Russian Federation city of St. Petersburg over 2005–2014. The study covers trends and development challenges , availability of radionuclide diagnostics for population needs, exposure doses for patients.This work aims at radionuclide diagnostics analyses in the Russian Federation city of St. Petersburg over 2005–2014. The study covers trends and development challenges , availability of radionuclide diagnostics for population needs, exposure doses for patients.Materials and methods. The radionuclide diagnostics temporal and structural changes’ analysis was based on Federal state statistical observation forms No.3-DOZ for St. Petersburg and on the results of radionuclide diagnostics subdivision surveys with radiology physicians’ questionnaires on the amount and composition of conducted examinations, dosages of introduced radioactivity of radiopharmaceticals and patients’ doses.The results. Since the end of 1990s until 2012 the amount of radionuclide diagnostics procedures had been steadily reducing. 74000 procedures were conducted in 2005 and 35500 in 2012. The number of radionuclide diagnostics procedures per one thousand residents reduced from 16 to 7.2. Both indicators slightly grew in 2013. In 2014 the total number of radiodiagnostic proceduress amounted up to 42000 and 8.2 tests per 1000 residents. Since 2011 the diagnostic equipment was upgraded. Four medical institutions received SPECT (single photon emission computed tomography or SPECT/CT, two new PET ( positron emission tomographs – centers were set up, three medical institutions had acquired positron emission tomographs (PET and are conducting PET – diagnostics receiving radiofarmaceuticals from external PET – center. At the same time one a third of radiodiagnostic units still has been operating obsolete and depreciated equipment dating back to 1980–1990 .Inspection results indicated that St. Petersburg

A second level of the Saint Petersburg skyline

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Krasnopolsky, Andrey; Bolotin, Sergey

2018-03-01

The article considers the history of the residential development in Saint Petersburg and states corresponding landmark dates. In recent years, changes in the altitude range of the residential development are noted, the influence of this factor on the formation of the city's silhouette is assessed. Reasons for such changes are identified. Attractiveness of high-rise residential complexes for living is assessed. Conclusions are made of tendencies in further housing construction development in terms of its altitude range. It is noted that it is possible to locate multi-storied buildings in the periphery of the city, taking into account specific visual characteristics of the construction site and silhouette of erected buildings; as for central districts, strict regulations regarding the altitude range are needed.

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

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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.

The development of the housing market in Russian regions by the example of Saint Petersburg

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Romaniuk Georgii Daniilovich

2014-06-01

Full Text Available This article analyses the state and development of housing market in St. Petersburg during 2000-2013. Reveals the stages of the real estate market in this period, its characteristic features and trends of today. There is the growing role of the primary market in the structure of the housing market and shows its modern features and problems.

The use of local natural stone in construction of St. Petersburg region and south-east Finland

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Luodes, Hannu; Härmä, Paavo; Panova, Elena; Pirinen, Heikki; Selonen, Olavi

2013-04-01

A three-year project, started in 2012, "Efficient use of natural stone in the Leningrad region and South-East Finland", studies the use and durability of natural stone in the city environments in the Nordic climate and especially along the Eastern Baltic Sea coastline between Helsinki and St. Petersburg. The project is lead by the Geological Survey of Finland (GTK) and the partners in the project are Saimaa University of Applied Sciences from Finland and Federal State Unitary Enterprise "Petersburg Complex Geological Expedition" Russian together with Saint-Petersburg State University from the Russian Federation. As associates in this project are also natural stone companies from Finland, Ylämaa Group Oy and Palin Granit Oy. The project is co-funded by the European Union, the Russian Federation and the Republic of Finland through the European Neighbourhood and Partnership Instrument (ENPI). A great potential of natural stone that can be used in construction is located in the border zone between South-East Finland and the Leningrad region. Rapakivi granite from that area has been utilized for several important buildings worldwide since 18th century and the area holds still potential for future economic growth. The use of the stone particularly from this area is based on its visual expression and good properties with high durability and long life cycle that can be used as arguments in the future development. Strengthening of the knowledge of the material reserves in the area gives a long term basement for economic development. Special aim of the project is to promote the use of natural stone in the city construction, especially the use of left-over stone generated in the production. In the project the use of natural stone in larger cities from the 18th century until today including the towns St. Petersburg, Vyborg, Helsinki, Kuopio and Kotka will be reported. Also an analysis of the near future needs of natural stone (qualities and quantities) in reconstruction and

A qualitative study on physicians' perceptions of specialty characteristics.

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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.

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.

Mercury pollution in the ground of Saint-Petersburg

Energy Technology Data Exchange (ETDEWEB)

Malov, A.M. [FSSI Inst. of Toxicology FMBA of Russia, Saint-Petersburg (Russian Federation)

2008-07-01

The problem of mercury poisoning in St-Petersburg's industrial centre was investigated. First, mercury content was directly measured in ground samples taken at various depths. Mushrooms, which are abundant in every district of the city, were then collected from lawns, yards and parks. Mushrooms provide an accurate indication of mercury distribution in the upper layer of the ground because they get their nutrients from the environment. As such, the chemical composition of mushrooms depends on the composition of the substrate on which they grow, notably the composition of the ground soil and its mercury content. The purpose of the study was to determine the mercury content of the mushrooms growing in the centre of St-Petersburg and its suburbs. The mercury content of the samples was measured by using the cold vapor atomic absorption spectrometry method. The mercury content of the mushrooms collected ranged from 1.29 mg/kg to 0.010 mg/kg. There was some correlation of the 2 data sets for territorial mercury impurity. The mercury content in the blood of 2 comparable groups of women living in the central part of St-Petersburg and its suburbs was also compared. Although there was no one single patterns of mercury distribution in the ground of the city, the depth of 1.0 to 2.0 m was found to be the most polluted. It was concluded that both measuring methods could be used to determine mercury contamination, but each reflects the situation from a different perspective. 20 refs., 3 tabs.

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.

77 FR 45332 - Wrangell-Petersburg Resource Advisory Committee

Science.gov (United States)

2012-07-31

... North Nordic Drive in Petersburg, Alaska. Interested persons may attend in person at either location, or... 12 North Nordic Drive or the Wrangell Ranger District office at 525 Bennett Street during regular... language interpreting, assistive listening devices or other reasonable accommodation for access to the...

Analysis of the incidence of syphilis in the Leningrad region and St. Petersburg: the current state

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R. A. Agaev

2011-01-01

Full Text Available In 1996–2009, the incidence of syphilis in the North-West region of Russia has declined and changed its structure. The frequency of neurosyphilis and latent forms increased, especially of late and unspecified latent syphilis. Differences in the structure of syphilis between the Leningrad region and St. Petersburg have been identified, which consisted in the reduction of primary syphilis and an increase in early latent syphilis in comparison with the city.

Joint analysis of air pollution in street canyons in St. Petersburg and Copenhagen

Science.gov (United States)

Genikhovich, E. L.; Ziv, A. D.; Iakovleva, E. A.; Palmgren, F.; Berkowicz, R.

The bi-annual data set of concentrations of several traffic-related air pollutants, measured continuously in street canyons in St. Petersburg and Copenhagen, is analysed jointly using different statistical techniques. Annual mean concentrations of NO 2, NO x and, especially, benzene are found systematically higher in St. Petersburg than in Copenhagen but for ozone the situation is opposite. In both cities probability distribution functions (PDFs) of concentrations and their daily or weekly extrema are fitted with the Weibull and double exponential distributions, respectively. Sample estimates of bi-variate distributions of concentrations, concentration roses, and probabilities of concentration of one pollutant being extreme given that another one reaches its extremum are presented in this paper as well as auto- and co-spectra. It is demonstrated that there is a reasonably high correlation between seasonally averaged concentrations of pollutants in St. Petersburg and Copenhagen.

Pooling strategies for St Petersburg gamblers

OpenAIRE

Csörgö, Sandor; Simons, Gordon

2006-01-01

Peter offers to play exactly one St Petersburg game with each of [math] players, Paul [math] , [math] , Paul [math] , whose conceivable pooling strategies are described by all possible probability distributions [math] . Comparing infinite expectations, we characterize among all [math] those admissible strategies for which the pooled winnings, each distributed as [math] , yield a finite added value for each and every one of Paul [math] , [math] , Paul [math] in comparison with their individual...

MARKETING STRATEGY FOR THE FINNISH TOURIST COMPANY BASED ON SAINT PETERSBURG MARKET RESEARCH

OpenAIRE

Miroshnichenko, Julia

2014-01-01

The goal of this thesis is to get a marketing strategy for proposed tourist business through the field-work marketing research. The purpose of this marketing research was to investigate the attitudes of Russian tourists in Saint Pe-tersburg towards Finland as a destination. The research examines the respondents’ own evaluation of the Finnish tourism possibilities, as well as the expert evaluation (made by the professionals of tourist agencies in Saint Petersburg) of the Finnish tourist ma...

Flood-inundation maps for White River at Petersburg, Indiana

Science.gov (United States)

Fowler, Kathleen K.

2015-08-20

Digital flood-inundation maps for a 7.7-mile reach of the White River at Petersburg, Indiana, were created by the U.S. Geological Survey (USGS), in cooperation with the Indiana Office of Community and Rural Affairs. The inundation maps, which can be accessed through the USGS Flood Inundation Mapping Science Web site at http://water.usgs.gov/osw/flood_inundation/, depict estimates of the areal extent and depth of flooding corresponding to selected water levels (stages) at the USGS streamgage at White River at Petersburg, Ind. (03374000). Near-real-time stages at this streamgage may be obtained from the USGS National Water Information System at http://waterdata.usgs.gov/ or the National Weather Service (NWS) Advanced Hydrologic Prediction Service at http:/water.weather.gov/ahps/, which also forecasts flood hydrographs at this site (PTRI3).

New optical museum at Saint-Petersburg for education and training

Science.gov (United States)

Vasil'ev, V. N.; Stafeef, S. K.; Tomilin, M. G.

2009-06-01

Nowadays the educational problem of teaching optics and photonics is to attract the young generation to the wonderful and magic world of light, optical science, technology and systems. The main issue is to explain that in the course of last several hundred years optics has been representing the most clear world view for humanity. In fact, the optics itself is a multidisciplinary complex of independent scientific directions, and, moreover, it has always been a generator of new fields of knowledge. Besides, optics and photonics are the fields within which the most fundamental problems of today's reality are to be resolved. It is absolutely necessary to encourage our scholars in getting optics and photonics education as an alternative physical basis to gaining solely computer knowledge. The main obstacle is the poor connection between program of optical education and the real optical researches, disintegration of different branches of the optical science, the demographic situation, some problems with teaching mathematics and physics at schools, and the collision between traditional educational methods and the mentality of the new generation. In Russia the Saint-Petersburg State University of Information Technologies, Mechanics and Optics offers partial solution to these problems: the organization of a real place for interactive optical science in a form of a new museum of optics, intended for education and training, seems to be the most effective way. This was the main reason for establishing such a museum in Saint-Petersburg at the end of 2008.

Sales of Forestry-Related Specialty License Plates in the Southern United States: A County Level Empirical Analysis

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Shaun M. Tanger

2016-07-01

Full Text Available In recent years, specialty license plates have become an increasingly popular way to raise awareness and show support for a myriad of issues with which the plate is linked. Several states and various organizations that provide forestry education have developed forestry license plates. Vehicle owners can purchase the plates to show their support towards forestry by buying the forestry license plates, which generates revenue for the provider organization. Using county-level data from five states in the Southeastern United States, a statistical model was developed to examine explanatory factors of forestry-based specialty license plate sales in 2014. Using linear count regression modeling, we observed that the significant predictor variables of plate sales were income per capita, population density, the percentage of acres that are forested in the county, acres of forest in the county that are privately owned, percentage of people who are 65 or older, and presence of the forest industry in the county. Plate sales were positively correlated with the presence of the forest industry in the county.

78 FR 54445 - Wrangell-Petersburg Resource Advisory Committee; Meeting

Science.gov (United States)

2013-09-04

... Nordic Drive in Petersburg, Alaska. Interested persons may attend in person at either location, or by... Nordic Drive or the Wrangell Ranger District office at 525 Bennett Street during regular office hours... advance for sign language interpreting, assistive listening devices or other reasonable accomodation for...

An Empirical Approach to the St. Petersburg Paradox

Science.gov (United States)

Klyve, Dominic; Lauren, Anna

2011-01-01

The St. Petersburg game is a probabilistic thought experiment. It describes a game which seems to have infinite expected value, but which no reasonable person could be expected to pay much to play. Previous empirical work has centered around trying to find the most likely payoff that would result from playing the game n times. In this paper, we…

Der monströse Fouleuze: Eine philosophische Lektüre von Andrej Belyjs Petersburg

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Simon Ganahl

2017-01-01

Full Text Available This paper deals critically with the posthumous interpretation of Foucault's work by Gilles Deleuze. The inquiry begins with Deleuze's claim that the late Foucault was a topologist like Andrei Bely in his modernist novel 'Petersburg'. In order to illuminate this Deleuzian perspective, the author discusses the concepts of dispositif and chronotope. By analyzing a key scene from 'Petersburg', the paper concludes that Deleuze's notion of topology is closer to his own philosophical system than to Foucault's historical research.

[Prosthodontic specialty training in the United States: what can we learn].

Science.gov (United States)

Qing, H

2017-12-09

Prosthodontics is one of the nine recognized specialties by American Dental Association. The postgraduate prosthodontic program used to train prosthodontic specialists in U S A started about 70 years ago. Compared to China which just launched the dental residency programs, the programs in U S A have more developed and relatively more mature education system. It is worthwhile for China to study and learn the U S A prosthodontic residency education program. Prosthodontics is a specialty to diagnose and treat complex dental problems, and is often considered as the 'orchestrator' directing and coordinating all the other dental specialists to manage complex situations. This specialty plays an important role in a nation's oral health system. The present article is aimed to introduce the history of US prosthodontic residency program, initial accreditation, curriculum, education standards and mechanisms of the residency program, and how the program is monitored and managed post initial accreditation, with the hope that this system can serve as a reference for China's developing its own residency program.

The International Scientific-Practical Conference XIII Faizkhanov Readings “The Heritage of the Golden Horde in the Nationhood and Cultural Traditions of the Peoples of Eurasia” (St. Petersburg, May 4–6, 2016

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R.Yu. Pochekaev

2017-03-01

Full Text Available XIII Faizkhanov Readings have been held in St. Petersburg on May 4–6, 2016. This year the conference was devoted to the Golden Horde and its heritage in Eurasia on occasion of the 750 years from foundation of this state. The conference was organized by the Spiritual Administration of Moslems of the Russian Federation, State Hermitage, Moscow State University, St. Petersburg State University, Institute of Oriental Studies, Institute of Oriental Manuscripts and others. There were two plenary sessions and four sections with about 100 speakers from different regions of Russia as well as from Finland, France, Kazakhstan, Ukraine, Uzbekistan. Most part of presentations caused questions and debates. The proceeding of the conference is to be published this year.

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.

EPIDEMIOLOGICAL, SOCIAL AND ECONOMIC EVIDENCES OF VACCINATION AGAINST HUMAN PAPILLOMAVIRUS INFECTION IN SAINT-PETERSBURG

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L. V. Lyalina

2014-01-01

Full Text Available Abstract. Analysis of anogenital warts morbidity in St. Petersburg and Russian Federation in 2000–2013 has been carried out. The incidence rate in the population of St. Petersburg during the observation period was found to be 1.4–2.3 times higher. In 2011–2013, 3310 pregnant women were tested for high carcinogenic risk HPV by PCR. Prevalence rate of HPV genotype 16 was 11.0 per 100 tested persons. Other genotypes (31, 52, 33, 45, 58, 39, 18, 59, 35were determined less often (p < 0.001 6.3; 6.3; 5.1; 4.02; 3.7; 3.4; 2.9; 2.8 and 2.7 per 100 persons, respectively. An increased morbidity of cervical cancer in women aging from 25 to 49 years old was established. Assessment of the economic burden of diseases associated with HPV has shown that in 2012 in St. Petersburg expenses were more than one billion rubles. In the structure of economic lost the largest proportion was associated with premature mortality of women with cervical cancer.

Petersburg Builds a Health Program. Bulletin, 1949, No. 9

Science.gov (United States)

Bathurst, Effie G.

1949-01-01

This bulletin is about an invasion that was welcomed. It tells how boys and girls of Petersburg, West Virginia, invaded their town to learn and to serve. Hotels, school lunchroom, alleys, creeks and swamps, unused park area, and other resources were utilized. The young invaders were welcomed by the adult citizens of the town because the principal…

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.

Shale oil specialty markets: Screening survey for United States applications

Energy Technology Data Exchange (ETDEWEB)

1987-12-01

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

Investigation of Science Faculty with Education Specialties within the Largest University System in the United States

OpenAIRE

Bush, Seth D; Pelaez, Nancy; Rudd, James A, II; Stevens, Michael T; Tanner, Kimberly D; Williams, Kathy, PhD

2011-01-01

Efforts to improve science education include university science departments hiring Science Faculty with Education Specialties (SFES), scientists who take on specialized roles in science education within their discipline. Although these positions have existed for decades and may be growing more common, few reports have investigated the SFES approach to improving science education. We present comprehensive data on the SFES in the California State University (CSU) system, the largest university ...

St Petersburg Business Information Centres and Their Role in Increasing the Efficiency of International Business Activities

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Bazhenov Yu.

2014-08-01

Full Text Available The Ministry of Foreign Affairs of the Russian Federation acknowledges the significant contribution of regions to the development of the state’s foreign policy. An increase in innovative production, a commitment to achieve complete import substitution, and the development of measures to promote non-raw material export are the principal objectives established by the state for its regions. The current trends in world economy and the geopolitical situation formulate new goals and objectives for regions and suggest the creation of innovative and universal mechanisms to increase the efficiency of international economic activities, promotion of a positive image of Saint Petersburg and other regions of the Russian Northwest. The article analyses the activities of Saint Petersburg business information centres abroad, similar experience of other Russian regions, and prerequisites for reforming the institution of regional offices abroad. In the course of the study, new theoretical and methodological questions as to improving the regulatory framework for development and functioning of Russian regional offices abroad, the use of public-private partnership mechanism in foreign economic activities and information technologies of positive image promotion were formulated.

Die Soldatenmütter Sankt Petersburg The Soldiers’ Mothers of St. Petersburg

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Frauke Wetzel

2001-03-01

Full Text Available Eine wachsende Zahl von Frauen in Rußland schafft es, gegen die tragende Rolle des Militärs zu rebellieren. Sie leisten Widerstand gegen die undemokratischen Streitkräfte, in denen Wehrdienstleistende mißhandelt und gefoltert werden. Eva Maria Hinterhuber, selbst für einige Zeit Mitarbeiterin der Soldatenmütter Sankt Petersburg, schreibt in ihrer nun veröffentlichten Diplomarbeit über eine Gruppe von Widerständigen, ihre Rolle im Transformationsprozeß und ihre Bedeutung für das Entstehen einer Zivilgesellschaft in Rußland.An increasing number of women is successfully rebelling against the Russian army. They try to resist an undemocratic military force where soldiers are ill-treated and tortured. Eva Maria Hinterhuber, a former employee at the St. Peterburg Soldiers’ Mothers, writes in her recently published thesis about one group of opposers, their role in the process of transformation and their importance for the development of a civil society in Russia.

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

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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.

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.

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

Science.gov (United States)

2010-05-17

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

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

Science.gov (United States)

2010-06-09

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

15 CFR 2011.204 - Entry of specialty sugars.

Science.gov (United States)

2010-01-01

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

Neivelti juhitav Bank St. Petersburg korraldas täiendava IPO / Hetlin Villak

Index Scriptorium Estoniae

Villak, Hetlin

2007-01-01

Bank Saint Petersburg müüs täiendava aktsiaemissiooni käigus 50,68 miljonit aktsiat hinnaga 58,37 krooni aktsia, panga esimehele Indrek Neiveltile kuulub nüüd üle 100 miljoni krooni väärtuses panga aktsiaid

Moulds and profiles of the building facades of St. Petersburg of the 18th century

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Voznyak Ekaterina Ryurikovna

2015-12-01

Full Text Available In the article the author underlines the importance of details (moulds and profiles for the architects of previous times. The architects of the 17th-19th centuries expressed their creative and filosofic position choosing some concrete example of the great theorists of the past when constructing moulds and orders. We should note that the negative attitude to Classicism theory reasoned in the lack of investigations of the architectural details of the buildings of the 18th-19th centuries, in particular the ones in Saint Petersburg. At the present moment the interest to studying the architectural theories and forms is reappearing both in Russia and in Europe. The article considers the architectural moulds of the eighteenth century buildings of St. Petersburg, examples of their construction in each stylistic period. The analysis shows the significant differences of the Russian moulds drawings from the recommendations of classical treatises of the Renaissance and educational counterparts. The author offers the basic analysis of the characteristic features and data elements for each stylistic period in the architecture of St. Petersburg of the 18th century, as well as a unique handwriting of the architects who worked in that era.

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.

Lifetime earnings for physicians across specialties.

Science.gov (United States)

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

2012-12-01

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

Business plan of a food truck in Saint Petersburg

OpenAIRE

Zavyalova, Ekaterina

2017-01-01

The purpose of the thesis was to investigate how to write a proper business plan and then implement gained knowledge in creating a business plan of a food truck in Saint Petersburg. A business plan serves as a guide for an entrepreneur in the process of company establishment and enables to gain funding from potential investors. The primary objective was to study essential components of a business plan. The theoretical framework comprises of core issues on company establishment and desc...

Physician career satisfaction within specialties

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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

Childhood victimization experiences of young adults in St. Petersburg, Russia.

Science.gov (United States)

Bogolyubova, Olga; Skochilov, Roman; Smykalo, Lyubov

2015-04-01

The purpose of this study was to assess the prevalence of childhood victimization experiences in a sample of young adults in St. Petersburg, Russia. The study sample included 743 students aged 19 to 25 from 15 universities in St. Petersburg, Russia. All of the study participants completed a reliable questionnaire assessing the following types of childhood victimization: conventional crime, child maltreatment, peer victimization, sexual victimization, and witnessing violence. Participation in the study was anonymous. High rates of victimization and exposure to violence were reported by the study participants. The majority of the sample experienced at least one type of victimization during childhood or adolescence, and poly-victimization was reported frequently. The most common type of victimization reported was peer or sibling assault (66.94%), followed by witnessing an assault without weapon (63.91%), personal theft (56.19%), vandalism (56.06%), and emotional bullying (49.99%). Sexual assault by a known adult was reported by 1.45% males and 5.16% of females. This study provides new information on the scope of childhood victimization experiences in Russia. Further research is warranted, including epidemiological research with representative data across the country and studies of the impact of trauma and victimization on mental health and well-being of Russian adults and children. © The Author(s) 2014.

Dynamics and forecast of morbidity and mortality from prostate cancer in St. Petersburg

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N. G. Petrova

2015-01-01

Full Text Available The paper presents the characteristics of primary disease incidence, prevalence and mortality from prostate cancer among men's population of St. Petersburg (normal and age-standardized rates; analyzed their dynamics for 20 years; shows the calculated trend of these indicators up to 2020.

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…

US Department of Energy (DOE)/Gosatomnadzor (GAN) of Russia project at the Petersburg Nuclear Physics Institute (PNPI)

International Nuclear Information System (INIS)

Baranov, I.A.; Konoplev, K.A.; Hauser, G.C.

1997-01-01

This paper presents a summary of work accomplished within the scope of the DOE-Gosatomnadzor (GAN) Agreement to reduce vulnerability to theft of direct-use nuclear materials in Russia. The DOE-GAN agreement concerns the Russian Academy of Science B.P. Konstantinov Petersburg Nuclear Physics Institute (PNPI), located 45 kilometers from St. Petersburg. The PNPI operates facilities to research basic nuclear physics. Current world conditions require particular attention to the issue of Material Protection, Control, and Accounting (MPC ampersand A) of nuclear materials. The long-term plan to increase security at the facility is outlined, including training, physical protection upgrades, and material control and accountability. 4 figs

Sankt Petersburg : Bedeutungswandel und Entwicklungsperspektiven einer osteuropäischen Metropole

OpenAIRE

Brade, Isolde

1994-01-01

St. Petersburg is one of the few metropolitan centres of Europe the development of which was consequently planned and carried through right from its foundation. Its development can be divided into three important phases: (1) Its development into a world-famous city of culture and trade until the beginning of the 20th century; (2) its development into the second largest industrial centre of the Soviet Union; (3) its transformation into an modern multi-functional busi...

Test facility of transport packagings for radioactive materials in the St. Petersburg region (Russia)

International Nuclear Information System (INIS)

Guskov, V.D.; Korotkov, G.V.; Drozdov, V.P.; Ershov, V.N.; Yanovskaya, N.S.

2001-01-01

The paper describes the test facility located near St. Petersburg (Russia) where test of packagings of mass up to 140 tons are carried out. The results of tests of some new designs of packaging for irradiated nuclear fuel are briefly considered. (author)

Residents' views about family medicine specialty education in Turkey

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Uzuner Arzu

2010-04-01

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

76 FR 42112 - Specialty Crop Committee Stakeholder Listening Sessions

Science.gov (United States)

2011-07-18

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

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

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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.

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

Science.gov (United States)

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

2018-03-27

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

Routine Prenatal Care Visits by Provider Specialty in the United States, 2009-2010

Science.gov (United States)

... and are not in the specialties of anesthesiology, pathology, or radiology. The NAMCS physician response rate was ... last reviewed: November 6, 2015 Page last updated: March 13, 2014 Content source: Email Recommend Tweet YouTube ...

CLASSIFICATION OF SPECIALTIES AND QUALIFICATIONS IN REPUBLIC OF BELARUS: TENDENCIES AND PROSPECTS

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O. A. Oleks

2016-01-01

Full Text Available In the present publication short data on the system of specialties and qualifications functioning in Republic of Belarus, her features, scope of application are given. The purpose and problems of the revision of the National classifier of the Republic of Belarus «Specialties and qualifications», its orientation to reduce the gap between the content of education and content of activity of graduates of establishments of education are described. The main tendencies of change of the operating classification – on the basis of types of economic activity and international standard classification of education taking into account requirements of employers, minimization of economic expenses for education, including due to minimization of classification units, rapprochement of positions with educational systems of other states are revealed. Prospects of development of national system of specialties and qualifications are disclosed. Tendencies and prospects of the expected changes are shown on the examples of the certain specialties offered by BNTU (Belarusian National Technical University.

The prevalence of drug use among university students in St. Petersburg, Russia

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Tsvetkova L. A.

2013-01-01

Full Text Available Over the last decade, the problem of young people's health has been among the most important and complicated ones for Russian society; these problems affect not only young children but also students in higher education institutions. The low level of physical and psychological health of young people has become an alarming characteristic of the demographic situation in modern Russia.This study was carried out at the State University of St. Petersburg, which is one of the largest higher education institutions in Russia. The university consists of many academic departments, and thus it is possible to study the health-related behavior of students with different professional backgrounds.The results show that drug use among students in Russia still remains relatively rare and episodic; in most cases, students use "light" drugs and thus have both slow rates of developing an addiction and an alternative but successful socialization in modern youth subculture. Such drugs are also not generally associated with significant health risks.

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

Science.gov (United States)

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

2014-01-01

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

Air Quality Side Event Proposal November 2016 GEO XIII Plenary in St. Petersburg, Russia

Science.gov (United States)

The Group on Earth Observations (GEO), which EPA has participated in since 2003, has put out a call for Side Events for its thirteenth annual international Plenary Meeting which is in St. Petersburg, Russia this year during November, 2016. EPA has put on Side Events on Air Quali...

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…

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

Science.gov (United States)

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

2018-06-12

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

Biofouling of granite-rapakivi in St. Petersburg monuments and in the quarry in Russia and Finland

Science.gov (United States)

Vlasov, Dmitry; Panova, Elena; Alampieva, Elena; Olhovaya, Elena; Popova, Tatyana; Vlasov, Alexey; Zelenskaya, Marina

2013-04-01

Granite-rapakivi was widely used in the architecture of St. Petersburg: the facades of buildings, embankments of rivers and canals, bridges, sculptural monuments, pedestals, facing the metro stations. This stone is rapidly destroyed due to the peculiarities of its structure. Biofouling of granite is insufficiently studied. Cause the destruction of granite can be bacteria, microscopic algae, fungi, mosses, lichens, higher plants, invertebrates and vertebrates. They often form specific lithobiotic communities that contribute to the destruction of granite-rapakivi. The objects of research were monuments of St. Petersburg (granite sculpture, facades, facing embankments) as well as granite-rapakivi quarries in Russia and Finland, where the stone was quarried for use in St. Petersburg. Sampling was carried out from the most typical biofouling sites. Different methods were applied for the study of damaged granite: petrographic analysis, light and scanning electron microscopy, methods for detection and identification of microorganisms, X-ray microprobe analysis. As result the main forms of granite destruction were described: fractures, ovoid weathering, granular disintegration, surface films, crusts and layers, pitting and fouling. Lichens, mosses, herbaceous and micromycetes were dominated on the granite-rapakivi in quarries. For example, in a Monferran quarry (Virolahti region) the complicated lithobiotic community was revealed. It included 30 species of micromycetes, 31 species of lichens, 10 species of moss. Bacteriological analysis showed the dominance of bacteria Bacillus, and actinomycetes in microbial biofilms. More than 100 species of plants were found on the granite embankments in St. Petersburg. They were confined to the cracks, seams of granite blocks. Plants and mosses were common to the granite embankments of rivers and canals in the central (historical) part of the city. Dimensions of mosses depend on the area of the deepening which they occupy. The most

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.

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

Science.gov (United States)

Monroe, C Douglas; Chin, Karen Y

2013-05-01

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

Ending the myth of the St Petersburg Paradox

Directory of Open Access Journals (Sweden)

Robert Vivian

2013-09-01

Full Text Available Nicolas Bernoulli suggested the St Petersburg game, nearly 300 years ago, which is widely believed to produce a paradox in decision theory. This belief stems from a long standing mathematical error in the original calculation of the expected value of the game. This article argues that, in addition to the mathematical error, there are also methodological considerations which gave rise to the paradox. This article explains these considerations and why because of the modern computer, the same considerations, when correctly applied, also demonstrate that no paradox exists. Because of the longstanding belief that a paradox exists it is unlikely the mere mathematical correction will end the myth. The article explains why it is the methodological correction which will dispel the myth.

The Value of Specialty Oncology Drugs

Science.gov (United States)

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

2010-01-01

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

Integration of specialties: An institutional and organizational view.

Science.gov (United States)

Gerson, Elihu M

2013-12-01

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

High-rise construction in the Saint Petersburg agglomeration in 1703-1950s

Science.gov (United States)

Sementsov, Sergey; Akulova, Nadezhda; Kurakina, Severina

2018-03-01

Regularities of high-rise construction (implemented projects and developments) in Saint Petersburg and the Saint Petersburg agglomeration since the foundation of the city in 1703 till the 1950s are considered. Based on these regularities, a single spatially developed system of vertical dominants is formed. High-rise construction in the city and its suburbs started in the 1710s and continues up to the present time. In the considered decades (1703-1950s), high-rise construction mostly performed urban-planning functions (with vertical and symbolic dominants), relying on patterns of the visual perception of man-made landscapes under development. Since the 1710s, the construction of vertical dominants (mainly temples, spires of towers, lighthouses, etc.) of five ranks (depending on the altitude range and in relation to the background development) was conducted in territories of the entire agglomeration. These dominants were arranged in landscapes of the city and suburbs with almost mathematically precise accuracy and according to special regulations. Such dominants obtained particular descriptive and silhouette characteristics in accordance with the conditions of spatial perception. In some periods of city development, attempts were made to create monuments (symbolic dominants) of specific height and include those in the spatial system of high-rise dominants as significant elements of the city silhouette.

Identifying Key Stakeholder Groups for Implementing a Place Branding Policy in Saint Petersburg

Directory of Open Access Journals (Sweden)

Kulibanova V. V.

2017-10-01

Full Text Available Regional brands have become a valuable intangible asset and a crucial competitive resource for forging partnerships. An effective place branding policy is impossible without a precise understanding of the interests of stakeholder groups. It is essential to realize that each region is unique in its own way. Territories differ in the structure of stakeholders, their influence on regional development, and the range of leverages over regional decision-makers. This study aims to give a more precise definition of key groups of stakeholders in Saint Petersburg place branding, and to identify them. The authors employ the method of theoretical and empirical typology of a territory’s stakeholders within a theoretical framework proposed by E. Freeman, P. Kotler, S. Zenker, and E. Brown. The article defines the concept of key regional stakeholders and identifies them. The proposed target audience (stakeholder group model for a place branding policy is tested on the case of Saint Petersburg. The authors show that each target audience of place marketing requires an individual policy. This is explained by the fact that each group enjoys its unique features that should be taken into account when creating and transmitting messages.

Principles of soil mapping of a megalopolis with St. Petersburg as an example

Science.gov (United States)

Aparin, B. F.; Sukhacheva, E. Yu.

2014-07-01

For the first time, a soil map of St. Petersburg has been developed on a scale of 1 : 50000 using MicroStation V8i software. The legend to this map contains more than 60 mapping units. The classification of urban soils and information on the soil cover patterns are principally new elements of this legend. New concepts of the urbanized soil space and urbopedocombinations have been suggested for soil mapping of urban territories. The typification of urbopedocombinations in St. Petersburg has been performed on the basis of data on the geometry and composition of the polygons of soils and nonsoil formations. The ratio between the areas of soils and nonsoil formations and their spatial distribution patterns have been used to distinguish between six types of the urbanized soil space. The principles of classification of the soils of urban territories have been specified, and a separate order of pedo-allochthonous soils has been suggested for inclusion into the Classification and Diagnostic System of Russian Soils (2004). Six types of pedo-allochthonous soils have been distinguished on the basis of data on their humus and organic horizons and the character of the underlying mineral substrate.

An Investigation into the Current State and Direction of the Development of the Russian Language as a Specialty in China’s Comprehensive Universities

Directory of Open Access Journals (Sweden)

Guo Lijun

2014-06-01

Full Text Available Chinese comprehensive universities will face the stern tenet of the development of Russian as a specialty. Connecting this specialty with the advantage of the development of university disciplines and taking one’s own path of building the Russian language specialty using one’s own know-hows and accomplishments is an important issue instructors of Russians are going to have to tackle. This article analyzes the major tenet of the development of the Russian language specialty in comprehensive universities. The article provides the author’s speculations and proposes a countermeasure in respect of the development of the Russian language specialty in comprehensive universities, which, the author hopes, will help the cause of the development of the Russian language specialty in comprehensive universities.

76 FR 68101 - Safety Zone; Art Gallery Party St. Pete 2011 Fireworks Display, Tampa Bay, St. Petersburg, FL

Science.gov (United States)

2011-11-03

... questions on this temporary final rule, call or email Marine Science Technician First Class Nolan L. Ammons, Sector St. Petersburg Prevention Department, Coast Guard; telephone (813) 228-2191, email Nolan.L.Ammons...

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.

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 ...

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

Science.gov (United States)

A.L. Hammett; J.L. Chamberlain

1999-01-01

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

Demonetization: did India face the St. Petersburg paradox and lose?

Directory of Open Access Journals (Sweden)

Rajaram Gana

2017-12-01

Full Text Available In 2016, India demonetized 24% of its currency notes (viz. 86% in cash value in circulation presuming this will remove “black” (illicit and counterfeit cash holdings, and combat money laundering. This was the largest demonetization experiment in recent history. Although demonetization has occurred several times before, no unambiguous economic argument for, or against, it exists. This was a key enabler for demonetization, yet again. This paper argues that the St. Petersburg Paradox (SPP provides a compelling argument against demonetization. Assuming the distribution of cash is lognormal, it is shown that the probability of black cash holdings will be small. If not, the holders would: a be irrational because they are willing to accept, contrary to the SPP, the small probability of a large loss, by effectively perceiving it as zero, without using all means to immunize themselves against it; or b be sure their cash can be legitimized via collusion with the State; or c be sure they can incentivize law-abiding citizens to act as agents to legitimize the cash for a reasonable fee. Assuming rationality and no bureaucratic support, large probabilities of black cash holdings imply that many more law-abiding patriotic citizens have to be corruptible than seems rational.

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

Science.gov (United States)

2013-02-14

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

Methods of sociological diagnostics in the assessment of staff's competencies: a case of a state museum (St. Petersburg, Russia

Directory of Open Access Journals (Sweden)

Asiia Usiaeva

2016-01-01

Full Text Available The study is dedicated to research of methods of sociological diagnostics, which can be used in the assessment of staff's competencies. Theoretical framework of this survey is T. Parson’s structural functionalism, the approach that sees the society as a complex system. The research questions were how we can analyze competencies by using sociological diagnostics and what the features of sociological diagnostics are. In order to achieve the target, it was analyzed the assessment of staff's competencies in the museum complex “The Cathedral”, Saint-Petersburg, Russia. Methodology of the research was structured observation, data collected by using “Mystery shopper” method. As a result, it was showed which techniques were applied in the staff’s assessment in this museum. Besides, the researcher discovered the level of museum staff’s competencies and revealed that the least developed employees’ competence was communication with visitors.

76 FR 50285 - Fiscal Year 2012 Tariff-Rate Quota Allocations for Raw Cane Sugar, Refined and Specialty Sugar...

Science.gov (United States)

2011-08-12

... for Raw Cane Sugar, Refined and Specialty Sugar and Sugar-Containing Products AGENCY: Office of the... quantity of the tariff-rate quotas for imported raw cane sugar, refined and specialty sugar and sugar...), the United States maintains tariff-rate quotas (TRQs) for imports of raw cane sugar and refined sugar...

High-rise construction in the Saint Petersburg agglomeration in 1703–1950s

Directory of Open Access Journals (Sweden)

Sementsov Sergey

2018-01-01

Full Text Available Regularities of high-rise construction (implemented projects and developments in Saint Petersburg and the Saint Petersburg agglomeration since the foundation of the city in 1703 till the 1950s are considered. Based on these regularities, a single spatially developed system of vertical dominants is formed. High-rise construction in the city and its suburbs started in the 1710s and continues up to the present time. In the considered decades (1703–1950s, high-rise construction mostly performed urban-planning functions (with vertical and symbolic dominants, relying on patterns of the visual perception of man-made landscapes under development. Since the 1710s, the construction of vertical dominants (mainly temples, spires of towers, lighthouses, etc. of five ranks (depending on the altitude range and in relation to the background development was conducted in territories of the entire agglomeration. These dominants were arranged in landscapes of the city and suburbs with almost mathematically precise accuracy and according to special regulations. Such dominants obtained particular descriptive and silhouette characteristics in accordance with the conditions of spatial perception. In some periods of city development, attempts were made to create monuments (symbolic dominants of specific height and include those in the spatial system of high-rise dominants as significant elements of the city silhouette.

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.

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.

The St.Petersburg school of oncogynecology, certain results and perspectives

International Nuclear Information System (INIS)

Bokhman, Ya.V.; Bishnevskij, A.S.; Maksimov, S.Ya.

1997-01-01

Basic results on studies, accomplished at the St.Petersburg school of oncogynecology, relative to the most frequent cases of Timor process localization (uterus cervix cancer, endometritis cancer, ovary cancer). It is shown that results of improved gynecological cancer treatment and decrease in mortality cases may be achieved not because of improving the surgical and radiation methods, the possibilities whereof are to a certain degree exhausted, but due to introduction of screening programs, enabling identification of early preclinical forms of cancer. Computerized and magnetoresonance tomography, USI and mammography are among the most efficient diagnostical methods. The perspectives of chemiohormone therapy and immunotherapy are also noted

77 FR 57180 - Fiscal Year 2013 Tariff-rate Quota Allocations for Raw Cane Sugar, Refined and Specialty Sugar...

Science.gov (United States)

2012-09-17

... Sugar, Refined and Specialty Sugar, and Sugar-Containing Products AGENCY: Office of the United States... quantity of the tariff-rate quotas for imported raw cane sugar, refined and specialty sugar, and sugar... imports of raw cane sugar and refined sugar. Pursuant to Additional U.S. Note 8 to Chapter 17 of the HTS...

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.

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

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

African Journals Online (AJOL)

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

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.

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

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.

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.

RESULTS OF ACUTE LYMPHOBLASTIC LEUKEMIA TREATMENT WITH INTENSIVE CHEMOTHERAPY IN CHILDREN IN ST.-PETERSBURG: RETROSPECTIVE EVALUATION OF TWO VERSIONS OF COALL-92 PROTOCOL

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E.G. Boichenko

2011-01-01

Full Text Available Regardless the success gained in treatment of acute lymphoblastic leukaemia, several problems still remain to be solved, such as: overcoming primary drug resistance and minimizing the amount of relapses as well as decreasing of chemotherapy toxicity without detriment to the final outcome of the treatment. Development of an optimal chemotherapeutical strategy still remains a hot issue. Objective: to evaluate an efficacy of two modifications of German protocol COALL-92 in treatment of ALL in children in St.-Petersburg. Methods: the retrospective analysis of results of treatment in patients under 18 years old with ALL was performed. The diagnosis was confirmed according to international criteria. The treatment was performed via protocols PECO-92 and COALL-St.-Petersburg-92. Results: 438 initial patients with ALL were treated in St.-Petersburg clinics during the period from 01.01.1993 to 01.01.2007. At the time of analysis the probability of event-free survival (pEFS was 60% in group of PECO-92 protocol and 70% — in COALL group (plog-rank = 0,048, probability of relapse-free survival (рRFS was 65 and 74% (plog-rank = 0,002, probability of overall survival was (pOS 78 and 70%, correspondingly (plog-rank = 0,079. Conclusion: inclusion of protocol treatment in practice of St.-Petersburg hospitals resulted in significant improvement of treatment results in children with ALL. The problem of both versions of COALL protocol is high rate of postremission mortality due to high toxicity of intensive stage if chemotherapy.Key words: children, acute lymphoblastic leukemia, intensive chemotherapy.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3: 33–42

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.

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.

Factors Influencing Medical Students' Choice of Specialty

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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.

VOCATIONAL AND PATRIOTIC EDUCATION OF STUDENTS OF DEFENSE SPECIALTIES AT A TECHNICAL UNIVERSITY

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N. P. Ustinova

2016-01-01

of students of defense specialties at Izhevsk State Technical University named after M. T. Kalashnikov (Izhevsk, Tula State University (Tula, Kovrov State Technological Academy named after V. A. Degtjarjov (Kovrov, Ryazan Higher Airborne Command School named after V. F. Margelov (Ryazan.

Collaboration between paediatric surgery and other medical specialties in Nigeria

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Philemon E Okoro

2012-01-01

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

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

Science.gov (United States)

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

2017-01-09

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

A Call to Action to Address Gender Equity Within Our Specialty: Time's Up on Waiting for Change.

Science.gov (United States)

Baecher-Lind, Laura; Abbott, Jodi; Atkins, Katharyn Meredith; Nijjar, J Biba; Royce, Celeste; Schiff, Lauren; Ricciotti, Hope A

2018-06-01

Although national attention has been focused on sexual harassment and gender inequity in the United States, leaders within the obstetrics and gynecology community have remained relatively silent. Sexual harassment and gender inequity remain pervasive in our specialty. This article serves as a call to action for leadership as well as physicians within obstetrics and gynecology to implement ethical and evidence-based approaches to reduce gender inequity and improve workplace culture within our specialty.

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

Science.gov (United States)

Schwartz, Jennifer A T; Pearson, Steven D

2013-06-24

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

Seashell specialties and food handling in Slovene Istria restaurants

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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.

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

Science.gov (United States)

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

2017-12-01

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

Retrofit flue gas desulfurization system at Indianapolis Power and Light Co. Petersburg Station Units 1 and 2

International Nuclear Information System (INIS)

Watson, W.K.; Wolsiffer, S.R.; Youmans, J.; Martin, J.E.; Wedig, C.P.

1992-01-01

This paper briefly describes the status of the retrofit wet limestone flue gas desulfurization system (FGDS) project at Indianapolis Power and Light Company (IPL), Petersburg Units 1 and 2. This project was initiated by IPL in response to the Clean Air Act of 1990 and is intended to treat the flue gas from two base load units with a combined capacity of approximately 700 MW gross electrical output. IPL is the owner and operator of the Petersburg Station located in southwestern Indiana. Stone and Webster Engineering Corporation (Stone and Webster) is the Engineer and Constructor for the project. Radian Corporation is a subcontractor to Stone and Webster in the area of flue gas desulfurization (FGD) process. General Electric Environmental Systems, Inc. (GEESI) is the supplier of the FGDS. The project is organized as a team with each company providing services. The supplier of the new stack is scheduled to be selected and join the team in early 1992. Other material suppliers and field contractors will be selected in 1992

Antibiotic use practices of pharmacy staff: a cross-sectional study in Saint Petersburg, the Russian Federation.

Science.gov (United States)

Belkina, Tatiana; Duvanova, Natalia; Karbovskaja, Julia; Tebbens, Jurjen Duintjer; Vlcek, Jiri

2017-02-14

Non-prescription access to antimicrobials is common, and self-prescribing is increasingly popular in Russian society. The aim of this study was to assess the attitudes of community pharmacists regarding antibiotic use and self-medication. We conducted a cross-sectional study from September-December 2015 of community pharmacists in the Saint-Petersburg and Leningrad region, Russia. A self-administered questionnaire was used to assess antibiotic use and self-medication practices. The data were analysed using logistic regression and Pearson chi-squared tests. Of the 316 pharmacists (77.07%) who completed the questionnaire, 230 (72.8%) self-medicated with antibiotics. Antibiotics were mostly used to self-treat upper (53.3%) and lower respiratory tract infections (19.3%), relying on their own knowledge (81.5%), previous treatment experience (49%) and patients' prescriptions (17%). The most commonly used antibiotics were macrolides (33.2%). Characteristics such as age, education and experience were related to antibiotic use and self-medication. The study confirmed that self-prescription of antibiotics is a common practice amongst pharmacists in Saint Petersburg and also identified personal and professional characteristics of pharmacists strongly associated with self-medication.

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.

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.

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.

Investigation of science faculty with education specialties within the largest university system in the United States.

Science.gov (United States)

Bush, Seth D; Pelaez, Nancy J; Rudd, James A; Stevens, Michael T; Tanner, Kimberly D; Williams, Kathy S

2011-01-01

Efforts to improve science education include university science departments hiring Science Faculty with Education Specialties (SFES), scientists who take on specialized roles in science education within their discipline. Although these positions have existed for decades and may be growing more common, few reports have investigated the SFES approach to improving science education. We present comprehensive data on the SFES in the California State University (CSU) system, the largest university system in the United States. We found that CSU SFES were engaged in three key arenas including K-12 science education, undergraduate science education, and discipline-based science education research. As such, CSU SFES appeared to be well-positioned to have an impact on science education from within science departments. However, there appeared to be a lack of clarity and agreement about the purpose of these SFES positions. In addition, formal training in science education among CSU SFES was limited. Although over 75% of CSU SFES were fulfilled by their teaching, scholarship, and service, our results revealed that almost 40% of CSU SFES were seriously considering leaving their positions. Our data suggest that science departments would likely benefit from explicit discussions about the role of SFES and strategies for supporting their professional activities.

Recent trends in specialty pharma business model

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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

Medical specialty considerations by medical students early in their clinical experience

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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

Microbiological safety and quality control of poultry products sold in retail chains of Saint Petersburg and Leningrad region.

Directory of Open Access Journals (Sweden)

A. K. Alieva

2017-01-01

Full Text Available Food safety and food raw materials is an important task which needs to be under government’s and public associations’ control, under enterprises which produce and sale them, and other economy departments. Nutrition is one of the most important factors influencing human health. To 70% alien substances of chemical and microbiological origin get into the human body with food. The heavy metals, nitrates, nitrites, pesticides, nitrosescomounds, mycotoxins, antibiotics, radionuclides and others are xenobiotics of chemical origin. The poultry products represented in commercial networks by poultry plants located in Saint-Petersburg and Leningrad region: “Roskar”, “Sinyavinskaya”, “North”, “Lebyazhye” were picked up for analysis. We used the bacteriological, virological, immunological, mycological, and statistical methods of research. Sanitary -hygienic or microbiological safety of food products was evaluated for the contenting of disease-causing (pathogenic microorganisms such as bacteria groups, coliforms, Staphylococcus, Salmonella and etc. in them. The poultry products sold in commercial networks of St. Petersburg were picked up for analysis. After processing the statistical were revealed 6 nosological forms where the leading position has finding colibacillosis – 27%. The number of positive samples for streptococcosis – 18%, staphylococcus – 8%, aspergillosis–2.6%, salmonellosis – 1.8%, pasteurellosis–1.6 %. The microbiological control of food products which can be the sources of infections should be regular for providing inhabitants with harmless poultry products. It is necessary to adopt and to use the modern microbiological criteria of food safety that will allow to realize the monitoring of their conformity with sanitary norms. The results of these analysis shows that the quality of poultry products sold in commercial networks of Saint Petersburg and the Leningrad region meet the standards.

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.

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.

Resident and program director gender distribution by specialty.

Science.gov (United States)

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

2011-12-01

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

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

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

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 ...

[Jan Kusberg, Kleine Geschichte St. Petersburgs. (Regensburg, 2009) ; Ingrid Bohn. Kleine Geschichte Stockholms. (Regensburg, 2008) ; Konrad Dittrich. Kleine Lübecker Stadtgeschichte. (Regensburg, 2007)] / Dennis Hortmuth

Index Scriptorium Estoniae

Hormuth, Dennis

2011-01-01

Arvustus: Jan Kusberg, Kleine Geschichte St. Petersburgs. (Regensburg, 2009) ; Ingrid Bohn. Kleine Geschichte Stockholms. (Regensburg, 2008) ; Konrad Dittrich. Kleine Lübecker Stadtgeschichte. (Regensburg, 2007)

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...

Evolution of high-rise construction in Leningrad - Saint Petersburg in the middle of the 20th - Early 21st centuries: projects and Implementation

Science.gov (United States)

Vaytens, Andrey; Rusanov, Gennadiy; Skryabin, Pavel

2018-03-01

One of the most important issues in national urban planning is arrangement of high-rise buildings in the largest cities of Russia. This issue becomes especially acute in such cities as Saint Petersburg, which has unique architectural and urban-planning heritage preserved to a great extent. In this regard, it seems important to trace the evolution of high-rise construction development and arrangement in Leningrad - Saint Petersburg in the middle of the 20th — early 21st centuries. The goal of the article is to consider high-rise construction development regarding both public and residential buildings in comparison of project ideas and results of their implementation in the 1940s-2000s. Prerequisites and issues of high-rise construction of that period are considered. Particular attention is paid to changes in the official urban-planning policy, regulatory framework and attitude of city authorities to high-rise construction. The study was carried out with the consideration of the following historic periods differing in their urban-planning policy: the late 1940s-1950s; 1960s; 1970-1980s; 1990s; 2000s-2010s. Economical prerequisites of high-rise construction and their influence on the modern urban-planning policy during the post-Soviet period are considered. In conclusion, an attempt is made to determine tendencies of high-rise construction development in Saint Petersburg.

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.

[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.

Contributions to 30th European Physical Society conference on controlled fusion and plasma physics (St. Petersburg, Russia, 7-11 July 2003) from NIFS

International Nuclear Information System (INIS)

2003-08-01

25 contributed papers to the 30th European Physical Society Conference on Controlled Fusion and Plasma Physics (St. Petersburg, Russia, 7-11 July 2003) from the activity of NIFS are collected in this report. (author)

A tale of two cities: stigma and health outcomes among people with HIV who inject drugs in St. Petersburg, Russia and Kohtla-Järve, Estonia.

Science.gov (United States)

Burke, Sara E; Calabrese, Sarah K; Dovidio, John F; Levina, Olga S; Uusküla, Anneli; Niccolai, Linda M; Abel-Ollo, Katri; Heimer, Robert

2015-04-01

Experiences of stigma are often associated with negative mental and physical health outcomes. The present work tested the associations between stigma and health-related outcomes among people with HIV who inject drugs in Kohtla-Järve, Estonia and St. Petersburg, Russia. These two cities share some of the highest rates of HIV outside of sub-Saharan Africa, largely driven by injection drug use, but Estonia has implemented harm reduction services more comprehensively. People who inject drugs were recruited using respondent-driven sampling; those who indicated being HIV-positive were included in the present sample (n = 381 in St. Petersburg; n = 288 in Kohtla-Järve). Participants reported their health information and completed measures of internalized HIV stigma, anticipated HIV stigma, internalized drug stigma, and anticipated drug stigma. Participants in both locations indicated similarly high levels of all four forms of stigma. However, stigma variables were more strongly associated with health outcomes in Russia than in Estonia. The St. Petersburg results were consistent with prior work linking stigma and health. Lower barriers to care in Kohtla-Järve may help explain why social stigma was not closely tied to negative health outcomes there. Implications for interventions and health policy are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Tale of Two Cities: Stigma and Health Outcomes Among People with HIV who Inject Drugs in St. Petersburg, Russia and Kohtla-Järve, Estonia

Science.gov (United States)

Burke, Sara E.; Calabrese, Sarah K.; Dovidio, John F.; Levina, Olga S.; Uusküla, Anneli; Niccolai, Linda M.; Abel-Ollo, Katri; Heimer, Robert

2015-01-01

Experiences of stigma are often associated with negative mental and physical health outcomes. The present work tested the associations between stigma and health-related outcomes among people with HIV who inject drugs in Kohtla-Järve, Estonia and St. Petersburg, Russia. These two cities share some of the highest rates of HIV outside of sub-Saharan Africa, largely driven by injection drug use, but Estonia has implemented harm reduction services more comprehensively. People who inject drugs were recruited using respondent-driven sampling; those who indicated being HIV-positive were included in the present sample (n=381 in St. Petersburg; n=288 in Kohtla-Järve). Participants reported their health information and completed measures of internalized HIV stigma, anticipated HIV stigma, internalized drug stigma, and anticipated drug stigma. Participants in both locations indicated similarly high levels of all four forms of stigma. However, stigma variables were more strongly associated with health outcomes in Russia than in Estonia. The St. Petersburg results were consistent with prior work linking stigma and health. Lower barriers to care in Kohtla-Järve may help explain why social stigma was not closely tied to negative health outcomes there. Implications for interventions and health policy are discussed. PMID:25703668

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.

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.

A Very General Overview of the Development Pediatric Emergency Medicine as a Specialty in the United States and Advocacy for Pediatric Healthcare; the Charge to Other Countries

Directory of Open Access Journals (Sweden)

Ron D. Waldrop

2017-12-01

Full Text Available One of the first noted instances regarding awareness of pediatric specific illnesses in the United States came from the writings of Dr. Benjamin Rush during the late 1700’s where he titled a section in his medical text “Diseases Specific to Children”. Throughout the 1700’s and 1800’s and even early 1900’s medicine was primarily a generalist profession where all ages were cared for by a personal family physician and there were virtually no subspecialties for adults or children.  At that time in American history children were the great neglected segment of society in families, labor, and healthcare and were often treated more as property than valued life. There were a few pediatric advocates of note. Abraham Jacobi is considered the father of modern pediatrics and advocated for pediatrics being separated from the field of obstetrics.  His actions were fundamental in the formation of the Section on Diseases of Children within the American Medical Association (AMA. In the 1930s there was a recognized need for separate pediatric specialty care advocacy organization and hence the development of the American Academy of Pediatrics (AAP occurred. This was primarily born out of the lack of and need for federal funding to support pregnant women and children as well as the need for a foundational organization for the development of pediatrics as a specialty in the United States in the future. In the 1950’s pediatric poisonings became commonplace due to chemicals available after the end of World War II. As a result, the first poison control center was formed in Chicago and a manual was published by the AAP on pediatric poisonings. Similarly, the first cardiac surgeries for congenital heart disease were occurring and the specialty of pediatric cardiology was arising. The rising nuclear threat in the 1950’s and 1960’s also raised concern for disaster planning meeting specific pediatric needs and led to further committees, interest groups

INFORMATIVE SYSTEM OF EDUCATIONAL PURPOSE FROM MATHEMATICS AS A WAY OF PROFESSIONAL ORIENTATION OF TEACHING STUDENTS IT SPECIALTIES

Directory of Open Access Journals (Sweden)

Lyudmyla Shishko

2016-01-01

Full Text Available The current state of formation of mathematical knowledge in universities insufficiently focused on their further use in professional activities. Students not formed the ability to apply mathematical knowledge to study general professional and special disciplines. In this article: –\tconsidered features of formation of a professional orientation of teaching mathematics using structured content multimedia information system for educational purposes (MISEP; –\tfound psychologo-pedagogical features of teaching mathematics of students IT specialties; –\tconsidered methodical aspects of MISEP in teaching the course "Discrete Mathematics" for students of IT specialties

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.

H-index and academic rank in general surgery and surgical specialties in the United States.

Science.gov (United States)

Ashfaq, Awais; Kalagara, Roshini; Wasif, Nabil

2018-09-01

H-index serves as an alternative to measure academic achievement. Our objective is to study the h-index as a measure of academic attainment in general surgery and surgical specialties. A database of all surgical programs in the United States was created. Publish or Perish software was used to determine surgeons h-index. A total of 134 hospitals and 3712 surgeons (79% male) were included. Overall, mean h-index was 14.9 ± 14.8. H-index increased linearly with academic rank: 6.8 ± 6.4 for assistant professors (n = 1557, 41.9%), 12.9 ± 9.3 for associate professors (n = 891, 24%), and 27.9 ± 17.4 for professors (n = 1170, 31.5%); P h-indices (18.7 ± 16.7 and 18.4 ± 17.6, respectively). Surgeons with additional postgraduate degrees, university affiliations and male had higher mean h-indices; P h-index and the number of publications (R2 = 0.817) and citations (R2 = 0.768). The h-index of academic surgeons correlates with academic rank and serves a potential tool to measure academic productivity. Copyright © 2018 Elsevier Inc. All rights reserved.

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

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

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

Directory of Open Access Journals (Sweden)

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.

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...

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

Science.gov (United States)

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

2017-12-01

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

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

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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.

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…

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

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

2018-04-01

Training in the medical specialty of sport and exercise medicine is now available in many, but not all countries. Lack of resources may be a barrier to the development of this important specialty field and the International Syllabus in Sport and Exercise Medicine Group was convened to reduce one potential barrier, the need to develop a syllabus. The group is composed of 17 sport and exercise medicine specialists residing in 12 countries (Australia, Canada, India, Ireland, Malaysia, the Netherlands, Qatar, South Africa, Sweden, Switzerland, the UK and USA). This paper presents the first phase of this project covering the domains and general learning areas of a specialist training syllabus in sport and exercise medicine. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Surgical specialty procedures in rural surgery practices: implications for rural surgery training.

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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

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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

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E T Namah

2013-01-01

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

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

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Mitchell, Jean M

2008-07-01

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

The Orientation and Development of the Public Affair Management Specialty

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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…

Professionally-oriented teaching of foreign language to postgraduates of technical specialties

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Gramma D.V.

2017-04-01

Full Text Available the practice of professionally-oriented teaching at English classes of Surgut State University is described in the article. The structure and content of the course for postgraduates of non-linguistic specialties is analyzed. Foreign language teaching in modern conditions is a priority direction and an essential component of professional activity of engineers. Particular attention is paid to such linguistic aspects as reading technical literature, writing activities and project work. The developed system of tasks is aimed at the activation of lexical and grammatical material.

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

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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.

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

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West Therese

2011-05-01

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

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

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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.

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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

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.

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...

Online examiner calibration across specialties.

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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

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

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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...

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

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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.

Gendered Perceptions of Typical Engineers across Specialties for Engineering Majors

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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…

THE SPECIALTY OF EMERGENCY MEDICINE IN CHILE: 20 YEARS OF HISTORY

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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.

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

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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.

Evaluating the impact of a partnership for creating change in substance misuse practice in St. Petersburg, Russia.

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Green, Anita J; Holloway, David G

2005-11-01

This paper reports on an evaluation of an innovative education and training programme for nurses and narcologists in St. Petersburg, Russia. The aims of the evaluation were: first, to evaluate the effect of the education and training programme on the clinical practice of doctors and nurses who have had direct contact with the programme and, second, to evaluate the influence of the education and training programme on city-wide drug and alcohol policy and practice. Brief contextual information regarding the programme is provided prior to an account of the qualitative methodology. Particular attention was paid to the work of Patton [Utilisation-focused evaluation, second ed., Sage, London, 1986; Qualitative research and evaluation methods, third ed., Sage, London, 2002] for the theoretical framework and to Hantais and Mangen [Cross-national research methods in the social sciences, Pinter, London, 1996] regarding the methodological issues that surround international and cross-cultural research projects. Data collection was carried out in St. Petersburg and in the United Kingdom, which involved key participants in the programme. The data analysis followed Miles and Huberman [Qualitative data analysis. An expanded sourcebook, second ed. Sage, Thousand Oaks, 1994] which yielded six major themes: rehabilitation, the role and continuing professional development of the trained nurse; the status of the nurse training-college and the staff, small scale projects and their significance; sharing experiences/networking/face-to-face meetings; and, lack of resistance. The findings are discussed and recommendations for further involvement are identified.

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

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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

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

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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...

Constancy and cover of plants in the Petersburg and Wrangell Districts, Tongass National Forest and associated private and other public lands, southeast Alaska.

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Bert R. Mead

2002-01-01

This study provides a comprehensive and inclusive description and inventory of the vegetation within the Stikine area of southeast Alaska. Private and other public lands were included as well as Tongass National Forest lands contained in the Petersburg and Wrangell Ranger Districts. Previous inventories have concentrated almost exclusively on tree species within forest...

DIET OF ST. PETERSBURG INFANTS AND PRE-SCHOOL CHILDREN AS A FACTOR MAINTAINING NEGATIVE INFLUENCE OF THE REGION NATURE AND ECOLOGY

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E. M. Bulatova

2013-01-01

Full Text Available Aim: to study defects of infants and pre-school children diet, which negative consequences are aggravated by unfavorable nature and ecological conditions of St. Petersburg region. Patients and methods: diet of 119 children (53 — aged from 2 to 3 years old and 66 — from 4 to 6 years old visiting St. Petersburg pre-school institutions of 12-hours stay (including all additional food outside the institution was analyzed.  Analysis of diet was formed by assessment of actual nutrition and supply of nutrients. Results: actual diet of infants and pre-school children was found to deviate significantly from recommended standards which lead to long-standing imbalance of the main nutrients intake. Many defects of the diet are maintained by specific negative factors of the habitat. Combined influence of such influence causes disturbances in development and increase of ecology-dependent disorders in children. Conclusions: in organization of nutrition of children living in unfavorable nature and ecology conditions account must be taken not only of age standards of nutrients and calories intake, but weather, nature biological rhythms and specific geological characteristics.

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...

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

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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

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

[St. Petersburg und Livland - und die Entwicklung der estnischen Literatur : Anton Schiefner (1817-1879) und Friedrich R. Kreutzwald (1803-1882) im Briefwechsel (1853-1879)] / Felix Köther

Index Scriptorium Estoniae

Köther, Felix

2015-01-01

Arvustus: St. Petersburg und Livland - und die Entwicklung der estnischen Literatur : Anton Schiefner (1817-1879) und Friedrich R. Kreutzwald (1803-1882) im Briefwechsel (1853-1879) / bearbeitet von Hartmut Walravens. Wiesbaden : Harrassowitz, 2013. (Orientalistik-Bibliographien und Dokumentationen ; Bd. 22)

Specificity of high-rise construction and real estate markets in the regional economy: an analysis of Russian practice (example of St. Petersburg)

Science.gov (United States)

Vilken, Viktoriya; Kalinina, Olga; Dubgorn, Alissa

2018-03-01

In paper features of the regional markets of construction the commercial and residential real estate on the example of St. Petersburg are defined. The current situation is analysed, the specific features of branch are revealed. The major factors influencing investors making decisions on construction of various types of objects are defined. The main methods of advance of real estate objects are considered.

Factors affecting future specialty choice among medical students in Kuwait

OpenAIRE

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

2012-01-01

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

Internalized HIV and Drug Stigmas: Interacting Forces Threatening Health Status and Health Service Utilization Among People with HIV Who Inject Drugs in St. Petersburg, Russia

Science.gov (United States)

Burke, Sara E.; Dovidio, John F.; Levina, Olga S.; Uusküla, Anneli; Niccolai, Linda M.; Heimer, Robert

2016-01-01

Marked overlap between the HIV and injection drug use epidemics in St. Petersburg, Russia, puts many people in need of health services at risk for stigmatization based on both characteristics simultaneously. The current study examined the independent and interactive effects of internalized HIV and drug stigmas on health status and health service utilization among 383 people with HIV who inject drugs in St. Petersburg. Participants self-reported internalized HIV stigma, internalized drug stigma, health status (subjective rating and symptom count), health service utilization (HIV care and drug treatment), sociodemographic characteristics, and health/behavioral history. For both forms of internalized stigma, greater stigma was correlated with poorer health and lower likelihood of service utilization. HIV and drug stigmas interacted to predict symptom count, HIV care, and drug treatment such that individuals internalizing high levels of both stigmas were at elevated risk for experiencing poor health and less likely to access health services. PMID:26050155

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

Science.gov (United States)

Rodriguez Santana, Idaira; Chalkley, Martin

2017-08-11

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

Experience with DICOM for the clinical specialties in the healthcare enterprise

Science.gov (United States)

Kuzmak, Peter M.; Dayhoff, Ruth E.

2003-05-01

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

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

Science.gov (United States)

Chakravarty, Sujoy

2016-06-01

The U.S. hospital industry has recently witnessed a number of policy changes aimed at aligning hospital payments to costs and these can be traced to significant concerns regarding selection of profitable patients and procedures by physician-owned specialty hospitals. The policy responses to specialty hospitals have alternated between payment system reforms and outright moratoriums on hospital operations including one in the recently enacted Affordable Care Act. A key issue is whether physician-owned specialty hospitals pose financial strain on the larger group of general hospitals through cream-skimming of profitable patients, yet there is no study that conducts a systematic analysis relating such selection behavior by physician-owners to financial impacts within hospital markets. The current paper takes into account heterogeneity in specialty hospital behavior and finds some evidence of their adverse impact on profit margins of competitor hospitals, especially for-profit hospitals. There is also some evidence of hospital consolidation in response to competitive pressures by specialty hospitals. Overall, these findings underline the importance of the payment reforms aimed at correcting distortions in the reimbursement system that generate incentives for risk-selection among providers groups. The identification techniques will also inform empirical analysis on future data testing the efficacy of these payment reforms.

[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.

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

Directory of Open Access Journals (Sweden)

Ligia Correia Lima de Souza

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

Specialty Choices: Patterns and Determinants among Medical ...

African Journals Online (AJOL)

2017-07-18

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

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

Science.gov (United States)

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

2016-11-10

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

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.

Lipid components and oxidative status of selected specialty oils

Energy Technology Data Exchange (ETDEWEB)

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

2012-11-01

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

Perinatal HIV-infection in Sankt Petersburg and Modern Therapy Concomitant Viral Infections

Directory of Open Access Journals (Sweden)

V. N. Timchenko

2016-01-01

Full Text Available The study included 338 HIV-infected children (B-23 and 350 children with perinatal contact HIV infection (R-75, consisting on the dispensary in the department of maternal and child the St. Petersburg City AIDS Center. In 32 persons (9.5% diagnosed with secondary infections. In the structure of viral opportunistic infections (herpesvirus, SARS amounted to 39.8%, bacterial (bronchitis, tonsillitis, pyoderma, tuberculosis — 34.8%, fungal and parasitic (candidiasis of the oral mucosa, PCP — 25.4 %. Combined therapy (causal, pathogenetic, symptomatic SARS in children with B-23 and R-75, allows you to get in early (6th d. Treatment regress the main symptoms of acute respiratory diseases. Modern therapy of congenital cytomegalovirus infection (VTSMI in children with B-23 and R-75 of the first year of life with antitsitomegalovirusnogo immunoglobulin and preparation of human recombinant interferon alfa-2b in the form of rectal suppositories — VIFERON, causes persistent normalization of clinical and laboratory parameters.

Archive of Geosample Data and Information from the U.S. Geological Survey (USGS) Coastal and Marine Geology Program (CMGP) St. Petersburg Coastal and Marine Science Center (SPCMSC) Samples Repository

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The U.S. Geological Survey Coastal and Marine Geology Program (CMGP) St. Petersburg Coastal and Marine Science Center (SPCMSC) Samples Repository is a partner in the...

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

Science.gov (United States)

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

2015-03-01

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

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

Science.gov (United States)

2012-07-10

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

Consumer interest in specialty beers in three European markets.

Science.gov (United States)

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

2016-07-01

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

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.

Risk-communication issues in radiation safety: еvaluation of public awareness in St. Petersburg and the Leningrad region on the activities of the nuclear industry and public understanding of the hazards

Directory of Open Access Journals (Sweden)

G. V. Arkhangelskaya

2017-01-01

Full Text Available In 2016, St. Petersburg Research Institute of Radiation Hygiene named after Professor P.V. Ramzaev developed a Program for the radiation risk communication management for the adequate perception risks associated with the use of various technologies in the nuclear industry by the public. Carrying out sociological research is one of the stages of this program. The aim of the analysis presented in the article is to study the population’s awareness of radiation safety issues and its attitude to further development of the nuclear industry. The data used in this analysis is a part of a large sociological survey conducted in St. Petersburg and the Leningrad Region The sociological research was conducted by the method of a selective questionnaire survey among the adult population permanently residing in the territory of St. Petersburg and the Leningrad Region. The volume of the sample studied was 2369 respondents: 1006 in St. Petersburg and 1363 in the Leningrad Region, including Sosnovy Bor – 401. The analysis showed that the population of all the studied territories estimates the environmental situation as being mainly favorable. The residents consider the main environmental problems in all areas studied to be a collection, removal, storage, disposal of garbage, as well as air and water pollution. The population of the region is relatively poorly informed about the current projects in the nuclear industry. One-third of the inhabitants of the region perceives the Leningrad nuclear power plant as a source of danger. Respondents see the main danger in the possibility of an accident on it. There is a sharply negative attitude of the population towards the construction of radioactive waste disposal sites anywhere in the region. According to the results of the study, it can be concluded that the population of the studied region is poorly informed about the existing radiation situation and the nuclear industry projects. It requires an optimization of the

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

Science.gov (United States)

2012-07-09

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

Evaluation of feedback given to trainees in medical specialties.

Science.gov (United States)

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

2017-07-01

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

Risk factors for developing tuberculosis in remand prisons in St. Petersburg, Russia - a case-control study.

Science.gov (United States)

Lobacheva, Tatiana; Asikainen, Tommi; Giesecke, Johan

2007-01-01

Detainees have a substantial risk to develop tuberculosis (TB) due to a higher incidence of TB in remand prison compared to the civil community. They develop TB during incarceration not only due to poor living conditions in remand prison, but also due to some factors affecting their life before imprisonment. Prevention measures against TB spread from penitentiary institutions to society include study of factors, which contribute to TB development. Current study aims at identification of important risk factors of TB development in remand prison in St. Petersburg, Russia. A retrospective matched case-control study was performed from May 2002 to May 2003 in two remand prisons in St. Petersburg. One hundred and fourteen prisoners (57 cases, 57 controls) were interviewed by using standardised questionnaire. Logistic regression analysis was performed to identify risk factors. Six factors were significantly linked to the risk of developing TB: narcotic drug use (odds ratio (OR): 2.6, 95% confidence interval (CI): 1.0-6.9), low income (OR: 3.2, CI: 1.2-8.6), high ratio of prisoners per available bed (OR: 4.0, CI: 1.1-15.0), not having own bed clothes (OR: 13.0, CI: 2.7-61.6), and little time outdoors (OR: 3.3, CI: 1.3-8.5). However, good housing before imprisonment (OR: 4.2, CI: 1.1-15.7) was a separate risk factor for TB. Three of the risk factors (high number of prisoners per bed, not having own bed clothes, and little time outdoors) are certainly possible to approach by improvement of conditions in remand prisons. The remaining three factors (narcotic drug use, good housing before imprisonment, and low income) provide knowledge about study population, but cannot be intervened by prison's medical staff.

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

Science.gov (United States)

2011-07-29

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

Investigation of the potential of wind energy applications in the Sct. Petersburg region. Pre-feasibility study report. Phase 1

International Nuclear Information System (INIS)

1995-11-01

It was proposed to initiate an investigation and, if found to be viable, a feasibility study of the possibilities for partly substituting and supplementing the existing nuclear and fossil fuel based energy supply of the St. Petersburg region with environmentally benign wind energy. The feasibility study is expected to lead to one or more pilot projects. The proposal outlines a three-phased project including an investigation, a feasibility study and a full scale demonstration of wind energy in this region. A 4th phase is envisaged, and this will include the large scale introduction of wind energy applications using national and international financing and resulting in increased local production. The report covers the first phase, the investigation which includes data acquisition and desk studies. It is shown that technically exploitable wind potential exists in the St. Petersburg region, that local production of wind turbine equipment will reduce wind turbine costs due to decreased transport costs and lower local salaries, that suitable sites for the demonstration of both grid-connected wind farms and wind-diesel systems have been preliminarily identified and that the demonstration plants investigated have exhibited reasonable economic parameters - IRR in the range of 9 - 15%. But a feasibility study phase (2) including engineering and economic analyses must be carried out in order to reach the necessary detailed understanding of the technical and economic implications of full scale demonstration projects. (EG)

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

Science.gov (United States)

Boyle, Veronica; Shulruf, Boaz; Poole, Phillippa

2014-09-12

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

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

Science.gov (United States)

Kwon, Oh Young; Park, So Youn

2016-03-01

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

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

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Oh Young Kwon

2016-03-01

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

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

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

Science.gov (United States)

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

2014-12-01

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

[Management of medical care for the victims of road accidents in traumatology centers of Saint-Petersburg].

Science.gov (United States)

Tulupov, A N; Afonchikov, V Iu; Chikin, A E; Taniia, S Sh; Ganin, A S

2014-01-01

The number of road accidents, fatal outcomes and victims exceeded in 1.5 times in Saint-Petersburg in comparison with Moscow. At the average, 600 victims were treated in each of 6 first-level traumatology centers every year. The quantity of patients, who were admitted to 3 second-level traumatology centers, numbered 10 times less. About 300 people entered to others hospitals. The lethality consisted of 15%, 20% and 37%, respectively. There are a lot of matters, that should be discussed, such as an importance of better treatment financing of multitrauma by using compulsory medical insurance system, an optimization of pre-admission treatment and a necessity of patient delivery by mobile medical team using the anaesthesiology and resuscitation.

Encapsulated specialty oils commercialized in São Paulo state, Brazil: evaluation of identity (fatty acid profile and compliance of fatty acids and Vitamin E contents with nutrition labeling

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Karen Hirashima

2013-03-01

Full Text Available Encapsulated specialty oils commercialized in São Paulo state, Brazil, were evaluated for their identity (fatty acids profile and compliance with nutrition labeling (fatty acids and Vitamin E (alpha tocopherol contents. Twenty one samples [flaxseed oil (6, evening primrose (5, safflower (8, borage (1, and black currant (1] purchased from local markets or collected by the health surveillance agency were analyzed. The fatty acids and vitamin E contents were analyzed by gas chromatography with flame ionization detector and liquid chromatography with UV detector, respectively. Nine samples were adulterated (5 samples of safflower oil, 3 of flaxseed oil, and one of evening primrose. Among them, 3 flaxseed and 2 safflower oil samples were probably adulterated by the addition of soybean oil. Conjugated linoleic acid (CLA was found in two safflower oils samples although the sale of oils with conjugated linoleic acid (CLA is not permitted by the National Health Surveillance Agency in Brazil (ANVISA. Only two samples presented all values in compliance with nutrition labeling (one safflower oil sample and one borage oil sample. The results show that a continuous monitoring of encapsulated specialty oils commercialized in Brazil is necessary including a greater number of samples and sanitary surveillance.

Declaration of the G8 of Saint Petersburg, the 16 July 2006 on the world energy security

International Nuclear Information System (INIS)

2006-01-01

This document presents in a first part the energy problems which the G8 is confronted with, the response of the international community and the declaration on the principles of the world energy security. The second part is devoted to the action plan of Saint Petersburg, actions in the following domains: reinforcement of the world energy markets transparency and stability, improvement of the investments climate in the energy sector, reinforcement of the energy efficiency and the energy conservation, diversification of the energies resources, security of the vital energy infrastructures, decrease of the energy dearth, fight against the climatic change and help to the sustainable development. (A.L.B.)

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

Science.gov (United States)

Olijnyk, Nicholas Victor

2014-01-01

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

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

Science.gov (United States)

2010-04-01

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

Does Specialty Bias Trump Evidence in the Management of High-risk Prostate Cancer?

Science.gov (United States)

Kishan, Amar U; Duchesne, Gillian; Wang, Pin-Chieh; Rwigema, Jean-Claude M; Saigal, Christopher; Rettig, Matthew; Steinberg, Michael L; King, Christopher R

2018-06-01

The objective was to query how specialty influences treatment recommendations for high-risk prostate cancer in 3 clinical settings: upfront management, postoperative management, and management of biochemical recurrences (BCRs) after radiotherapy (RT). We hypothesized that specialty bias would manifest in all settings, trumping available evidence. A survey of practicing urologists and radiation oncologists was distributed through electronic mail. Questions pertained to upfront management, postoperative treatment, and local salvage for postradiation BCRs. The associations between 26 selected categorical responses and specialty were assessed using multivariate logistic regression. Training level/expertise, practice setting, percentage of consultation caseload consisting of prostate cancer, and nationality were set as effect modifiers. One thousand two hundred fifty-three physicians (846 radiation oncologists and 407 urologists) completed the survey. Radiation oncologists were more likely to recommend adjuvant RT and consider it to be underutilized, and more likely to recommend salvage RT at lower prostate-specific antigen thresholds (P<0.0001). Urologists were more likely to recommend salvage radical prostatectomy or cryoablation for local salvage after RT, whereas radiation oncologists were more likely to recommend RT-based modalities and more likely to report that local salvage was underutilized after RT (P<0.0001). Urologists were more likely to report that upfront radical prostatectomy was a better definitive treatment (P<0.0001), whereas radiation oncologists were more likely to report the opposite (P=0.005). Specialty biases permeate recommendations for upfront management and management in the postoperative and post-RT BCR setting, irrespective of available evidence. These data reveal the critical need for multidisciplinary clinics and cross-specialty training as potential solutions for overcoming specialty bias.

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.

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.

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

Science.gov (United States)

Gao, Qun

2008-01-01

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

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

Science.gov (United States)

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

2016-01-01

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

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...

“And You, Vampire, Admiral Napier, Don’t Expect the Banquet”. The Case on the Surveillance of the British Vice-Admiral Sir Charles Napier in St. Petersburg in 1856

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Aleksandr A. Orlov

2016-12-01

Full Text Available The Crimean War of 1853-1856 provoked the hostility between the Russian and the English peoples. This had contributed to the confrontational thinking in the consciousness of the two peoples. The changes in mentality had for a long time been anchored through the efforts of the authorities and the media of that time (newspapers, magazines and cartoons. Military operations had led to the fact that their members had realized the disparity of the imposed stereotypes. Disappointment with propaganda clichés prompted some British to think over the reason for their personal failure, to get acquainted closer with the life of former enemies and to inform the public of their country about truth. The author carries out the analysis of unpublished archival documents from the State Archive of the Russian Federation (GA RF, which allow talking about the visit of former commander of the Baltic squadron of the English fleet, Vice-Admiral Ch.J. Napier to St. Petersburg in July 1856, and the surveillance of him by the Russian security police. Ch. J. Napier, motivated by the concepts of personal honour, aimed to get the Russian authorities’ confirmation of the correctness of his actions in the maritime campaign of 1854. He partially succeeded, but the Emperor Alexander II was not willing to meet with him. Ch.J. Napier had not succeeded in gaining justification from the British authorities either. Apparently, neither Russian nor British government no longer needed a positive image of the other country. The Russian-British relations had been tense (or worse throughout the rest part of the 19th century. Russia reoriented to France and (to a lesser extent to the United States, while Britain found itself at the threshold of the “splendid isolation” era. Only the appearance of Germany as a dangerous enemy, which had established at the borders of the British colonial possessions in different parts of the world and had finally broken the “balance of powers” in

Fiber Fabrication Facility for Non-Oxide and Specialty Glasses

Data.gov (United States)

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

Correlates of Lifetime History of Purchasing Sex Services by Men in Saint Petersburg and Leningrad Oblast, Russia.

Science.gov (United States)

Girchenko, P; Ompad, D C; Kulchynska, R; Bikmukhametov, D; Dugin, S; Gensburg, L

2015-12-01

Commercial sex workers (CSWs) in the Russian Federation are at high risk of HIV infection and transmission as a result of unsafe sexual and injecting behaviors. Their clients might be at increased risk of acquiring HIV; however, little is known about the population of men purchasing sex services. This study aims to investigate factors associated with a history of purchasing sex services by men in Saint Petersburg and Leningrad Oblast, Russian Federation. Data were collected as part of a cross-sectional study offering free anonymous rapid HIV testing in Saint Petersburg and Leningrad Oblast in 2014; in total, 3565 men aged 18 years and older provided information about their behaviors associated with risk of acquiring HIV during face-to-face interviews. Prevalence of CSW use in our study was 23.9%. Multivariable analyses using log-binomial regression were stratified by self-reported HIV testing during the 12 months preceding the study interview. In both strata, older age, multiple sex partners, and a history of sex with an injection drug user (IDU) were associated with an elevated prevalence ratio (PR) for history of purchasing sex services, although the strength of the association differed by strata. Among men who reported recent HIV testing, condom use (PR = 1.22, 90% confidence interval (CI) 1.0, 1.48) was associated with a history of purchasing sex services, and among men who did not report recent HIV testing, having a consistent sex partner was associated with purchasing sex services (PR = 1.23, 90% CI 1.1, 1.37). The high prevalence of CSW service use and associations found in this study raise serious concerns about potential for sexual HIV transmission and should be investigated more closely.

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

Directory of Open Access Journals (Sweden)

Zhang Hao

2017-01-01

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

Organizational readiness in specialty mental health care.

Science.gov (United States)

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

2010-01-01

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

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

Science.gov (United States)

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

2013-05-01

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

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

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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

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

The professional orientation to the masonry specialty: a system of activities

Directory of Open Access Journals (Sweden)

Jóse Andrés Gómez Torres

2018-03-01

Full Text Available The specialty Masonry in Technical and Vocational Education is of great importance given the mission that has to train workers who have to use the most efficient and updated techniques and technologies for the construction of buildings and other construction works. In the pedagogical practice manifested a contradiction expressed in the need to raise the quality of the professional training of the workers in the specialty Masonry, however, there were inadequacies in the work of professional guidance with students who attend the first year in the Polytechnical center "Leonides Blanco", reflected in the insufficient inclination towards the study profile, which led to the failure of a percentage of students. The objective of the work was to elaborate a system of activities that perfected the process of professional orientation towards the specialty Albañilería the first year at the "Leonides Blanco" PolytechnicCenter. In the investigative process, the dialectical-materialist method was assumed as the general method, which supported the theoretical methods, the application of statistical techniques that made possible the study and systematization of the theoretical and methodological foundations of the process under investigation. The practical significance is expressed in a system of activities that contributed to the professional orientation of the first-year students of the specialty Masonry, which guarantees a relevant initial training process, depending on the demands of the professional model and the needs educational and social

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

African Journals Online (AJOL)

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

Some theoretic elements about vocational guidance in the specialty Carpintería

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Odelmi Miló García

2016-03-01

Full Text Available Presently article the methodological conceptual theoretical bases are presented that sustain in an essential way the cultural historical theory, The objective of the same one is to elaborate a methodological strategy for the development of the professional orientation toward the specialty carpentry in students of the first year of the Polytechnic Leonides Blanco González, being given the problem that the students are not motivated by the specialty.

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

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Harada Tadanari

2010-02-01

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

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

Science.gov (United States)

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

2012-11-01

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

Emergency Contraception: A multi-specialty survey of clinician knowledge and practices

Science.gov (United States)

Batur, Pelin; Cleland, Kelly; McNamara, Megan; Wu, Justine; Pickle, Sarah

2015-01-01

Objectives To assess knowledge and provision of emergency contraception (EC), particularly the most effective methods. Study Design A web-based survey was distributed to a cross-sectional convenience sample of healthcare providers across specialties treating reproductive-aged women. The survey was sent to 3,260 practicing physicians and advanced practice clinicians in 14 academic centers between February 2013 and April 2014. We analyzed responses by provider specialty using multivariable logistic regression. Results The final sample included 1,684 providers (response rate = 51.7%). Ninety-five percent of the respondents had heard of levonorgestrel (LNG) EC. Among reproductive health specialists, 81% provide levonorgestrel EC in their practice, although only half (52%) had heard of ulipristal acetate (UPA) and very few provide it (14%). The majority in family medicine (69%) and emergency medicine (74%) provide levonorgestrel, in contrast to 42% of internists and 55% of pediatricians. However, the more effective methods (UPA and copper IUD) were little known and rarely provided outside of reproductive health specialties; 18% of internists and 14% of emergency medicine providers had heard of UPA and 4% provide it. Only 22% of emergency providers and 32% of pediatricians had heard of the copper IUD used as EC. Among reproductive health specialists, only 36% provide copper IUD as EC in their practice. Specialty, provider type and proportion of women of reproductive age in the practice were related to knowledge and provision of some forms of EC. Conclusions Awareness and provision of the most effective EC methods, UPA and the copper IUD (which are provider-dependent), are substantially lower than for LNG EC, especially among providers who do not focus on reproductive health. Implications In our sample of 1,684 healthcare providers from diverse specialties who treat reproductive-aged women, knowledge and provision of the most effective forms of emergency contraception

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.

A briefing paper for the status of the flue gas desulfurization system at Indianapolis Power ampersand Light Company Petersburg Station Units 1 and 2

International Nuclear Information System (INIS)

Rutledge, C.K.; Wolsiffer, S.R.; Gray, S.M.; Martin, J.E.; Wedig, C.P.

1992-01-01

This paper presents a brief description of the status of the retrofit wet limestone flue gas desulfurization system project at Indianapolis Power ampersand Light Company (IPL) Petersburg Units 1 and 2. This project was initiated by IPL in response to the Clean Air Act of 1990 and is intended to treat the flue gas from two base load units with a combined capacity of approximately 700 MW gross electrical output

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

, 0.27; SE, 0.05; adjusted R2 = 0.17 for model). Patients with eye and ear, nose, and throat complaints place a mean explicit value on specialty emergency services of $340 per visit, relative to general emergency care. Ultimately, CV data using WTP methodology are useful in valuing patient preferences in monetary terms and can help inform state-wide resource allocation and the availability of direct-to-specialist care.

An analysis of the medical specialty training system in Spain.

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

2015-06-02

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-07-15

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

Warm Mix Asphalt

Science.gov (United States)

2009-04-17

State of Alaska State of Alaska - Warm Mix Project Warm Mix Project: Location - Petersburg, Alaska which is Petersburg, Alaska which is located in the heart of Southeast Alaska located in the heart of Southeast Alaska's Inside Passage at the tip of M...

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

Science.gov (United States)

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

2016-01-01

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

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 ...

Burnout Comparison among Residents in Different Medical Specialties

Science.gov (United States)

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

2004-01-01

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

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

Science.gov (United States)

Luc, Jessica G Y; Stamp, Nikki L; Antonoff, Mara B

2018-04-01

Social media may be a useful supplement to physician and trainee interactions; however, its role in enhancing mentorship has not been described. A 35-item survey investigating trainee and physician social media use was distributed. Responses were analyzed using descriptive statistics. 282 respondents completed the survey, among whom 136 (48.2%) reported careers in surgical specialties. Women in surgical specialties were more likely to describe the specialty as being dominated by the opposite sex (p media to build a network of same-sex mentorship (p = 0.031). Social media serves as a valuable tool to enhance the networking and mentorship of surgeons, particularly for women in surgical specialties who may lack exposure to same-sex mentors at their own institution. Copyright © 2018 Elsevier Inc. All rights reserved.

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.

Specialty pharmacies and other restricted drug distribution systems: financial and safety considerations for patients and health-system pharmacists.

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Kirschenbaum, Bonnie E

2009-12-15

To discuss the role of restricted drug distribution systems in the implementation of risk evaluation and mitigation strategies (REMS), health-system pharmacists' concerns associated with the use of specialty pharmacies and other restricted drug distribution systems, reimbursement policies for high-cost specialty drugs, supply chain models for traditional and specialty drugs, and emerging trends in the management of and reimbursement for specialty pharmaceuticals. Restricted drug distribution systems established by pharmaceutical manufacturers, specialty pharmacies, or other specialty suppliers may be a component of REMS, which are required by the Food and Drug Administration for the management of known or potential serious risks from certain drugs. Concerns of health-system pharmacists using specialty suppliers include access to pharmaceuticals, operational challenges, product integrity, financial implications, continuity of care, and patient safety. An ambulatory care patient taking a specialty drug product from home to a hospital outpatient clinic or inpatient setting for administration, a practice known as "brown bagging," raises concerns about product integrity and institutional liability. An institution's finances, tolerance for liability, and ability to skillfully manage the processes involved often determine its choice between an approach that prohibits brown bagging but is costly and one that permits the practice under certain conditions and is less costly. The recent shift from a traditional supply chain model to a specialty pharmacy supply chain model for high-cost pharmaceuticals has the potential to increase pharmaceutical costs for health systems. A dialogue is needed between health-system pharmacists and group purchasing organizations to address the latter's role in mitigating the financial implications of this change and to help clarify the safety issues. Some health plans have shifted part of the cost of expensive drugs to patients by establishing a

Comparison of Women in Department Leadership in Obstetrics and Gynecology With Those in Other Specialties.

Science.gov (United States)

Hofler, Lisa G; Hacker, Michele R; Dodge, Laura E; Schutzberg, Rose; Ricciotti, Hope A

2016-03-01

To compare the representation of women in obstetrics and gynecology department-based leadership to other clinical specialties while accounting for proportions of women in historical residency cohorts. This was a cross-sectional observational study. The gender of department-based leaders (chair, vice chair, division director) and residency program directors was determined from websites of 950 academic departments of anesthesiology, diagnostic radiology, general surgery, internal medicine, neurology, obstetrics and gynecology, pathology, pediatrics, and psychiatry. Each specialty's representation ratio-proportion of leadership roles held by women in 2013 divided by proportion of residents in 1990 who were women-and 95% confidence interval (CI) were calculated. A ratio of 1 indicates proportionate representation. Women were significantly underrepresented among chairs for all specialties (ratios 0.60 or less, P≤.02) and division directors for all specialties except anesthesiology (ratio 1.13, 95% CI 0.87-1.46) and diagnostic radiology (ratio 0.97, 95% CI 0.81-1.16). The representation ratio for vice chair was below 1.0 for all specialties except anesthesiology; this finding reached statistical significance only for pathology, pediatrics, and psychiatry. Women were significantly overrepresented as residency program directors in general surgery, anesthesiology, obstetrics and gynecology, and pediatrics (ratios greater than 1.19, P≤.046). Obstetrics and gynecology and pediatrics had the highest proportions of residents in 1990 and department leaders in 2013 who were women. Despite having the largest proportion of leaders who were women, representation ratios demonstrate obstetrics and gynecology is behind other specialties in progression of women to departmental leadership. Women's overrepresentation as residency program directors raises concern because education-based academic tracks may not lead to major leadership roles.

Effect of surface geometry and insolation on temperature profile of green roof in Saint-Petersburg environment

Directory of Open Access Journals (Sweden)

С. А. Игнатьев

2016-08-01

Full Text Available The paper addresses an issue of creating an environment favorable for the life in megacities by planting vegetation on the rooftops. It also provides information about rooftop greening practices adopted in other countries. The issues of ‘green roof’ building in climatic conditions of Saint Petersburg and roof vegetation impact on the urban ecosystem are examined. Vegetation composition quality- and quantity-wise has been proposed for the roof under research and a 3D model of this roof reflecting its geometric properties has been developed. A structure of roof covering and substrate qualitative composition is presented. An effect of rooftop geometry on the substrate temperature is explored. The annual substrate temperature and moisture content in different parts of the roof have been analyzed. Results of thermal imaging monitoring and insolation modelling for different parts of green roof surface are presented.

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

Science.gov (United States)

Pérez, Evelio Perea; Álvarez, Rogelio Martín

2010-10-01

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

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...

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.

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

Science.gov (United States)

Puvaneswaralingam, Shobitha; Ross, Daniella

2016-01-01

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

77 FR 6584 - Specialty Bar Products Company,a Subsidiary of Doncasters, Inc., Blairsville, PA; Notice of...

Science.gov (United States)

2012-02-08

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-80,511] Specialty Bar Products Company,a Subsidiary of Doncasters, Inc., Blairsville, PA; Notice of Affirmative Determination Regarding... Assistance (TAA) applicable to workers and former workers of Specialty Bar Products Company, a subsidiary of...

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.

State of emergency medicine in Azerbaijan

OpenAIRE

Sule, Harsh; Kazimov, Shirin; Shahmaliyev, Oktay; Sirois, Adam

2008-01-01

Background There has been no previous study into the state of emergency medicine in Azerbaijan. As a legacy of the Soviet Semashko system, the ?specialty? model of emergency medicine and integrated emergency departments do not exist here. Instead, pre-hospital emergency care is delivered by ambulance physicians and in-hospital care by individual departments, often in specialty hospitals. Emergency care is therefore fragmented, highly specialized and inefficient. Aims The Emergency Medicine De...

In vitro toxicity of FemOn, FemOn-SiO2 composite, and SiO2-FemOn core-shell magnetic nanoparticles

Directory of Open Access Journals (Sweden)

Toropova YG

2017-01-01

Full Text Available Yana G Toropova,1 Alexey S Golovkin,2 Anna B Malashicheva,3,4 Dmitry V Korolev,5,6 Andrey N Gorshkov,7 Kamil G Gareev,8 Michael V Afonin,9 Michael M Galagudza10,11 1Laboratory of Cardioprotection, Institute of Experimental Medicine, Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russian Federation; 2Gene and Cell Engineering Group, Institute of Molecular Biology and Genetics, Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russian Federation; 3Laboratory of Molecular Cardiology, Institute of Molecular Biology and Genetics, Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russian Federation; 4Department of Embryology, Faculty of Biology, Saint Petersburg State University, Saint Petersburg, Russian Federation; 5Laboratory of Nanotechnology, Institute of Experimental Medicine, Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russian Federation; 6Department of Photonics and Optical Information Technology ITMO University, Saint Petersburg, Russian Federation; 7Laboratory of Intracellular Signaling and Transport Research Institute of Influenza, Saint Petersburg, Russian Federation; 8Department of Micro and Nanoelectronics, Faculty of Electronics, Saint Petersburg Electrotechnical University LETI, Saint Petersburg, Russian Federation; 9Department of Inorganic Chemistry Saint Petersburg State Technological Institute (Technical University, Saint Petersburg, Russian Federation; 10Institute of Experimental Medicine, Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russian Federation; 11Departament of Pathophysiology, First Pavlov State Medical University of Saint Petersburg, Saint Petersburg, Russian Federation Abstract: Over the last decade, magnetic iron oxide nanoparticles (IONPs have drawn much attention for their potential biomedical applications. However, serious in vitro and in vivo safety concerns continue to exist. In this study, the effects

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

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Ryuichi Kawamoto

2016-11-01

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

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.

Hepatitis C virus infection among drug injectors in St Petersburg, Russia: social and molecular epidemiology of an endemic infection.

Science.gov (United States)

Paintsil, Elijah; Verevochkin, Sergei V; Dukhovlinova, Elena; Niccolai, Linda; Barbour, Russell; White, Edward; Toussova, Olga V; Alexander, Louis; Kozlov, Andrei P; Heimer, Robert

2009-11-01

To understand the epidemiology and transmission patterns of hepatitis C virus (HCV), the predominant blood borne-pathogen infecting injection drug users (IDUs), in a part of the former Soviet Union. Cross-sectional respondent-driven sample of IDUs. St Petersburg, Russia. A total of 387 IDUs were recruited in late 2005 and throughout 2006. Participants were surveyed to collect demographic, medical and both general and dyad-specific drug injection and sexual behaviors. A blood sample was collected to detect antibodies to hepatitis C and to amplify viral RNA for molecular analysis. The molecular data, including genotypes, were analyzed spatially and linkage patterns were compared to the social linkages obtained by respondent-driven sampling (RDS) for chains of respondents and among the injection dyads. HCV infection was all but ubiquitous: 94.6% of IDUs were HCV-seropositive. Among the 209 viral sequences amplified, genotype 3a predominated (n = 119, 56.9%), followed by 1b (n = 61, 29.2%) and 1a (n = 25, 11.9%). There was no significant clustering of genotypes spatially. Neither genotypes nor closely related sequences were clustered within RDS chains. Analysis of HCV sequences from dyads failed to find associations of genotype or sequence homology within pairs. Genotyping reveals that there have been at least five unique introductions of HCV genotypes into the IDU community in St Petersburg. Analysis of prevalent infections does not appear to correlate with the social networks of IDUs, suggesting that simple approaches to link these networks to prevalent infections, rather than incident transmission, will not prove meaningful. On a more positive note, the majority of IDUs are infected with 3a genotype that is associated with sustained virological response to antiviral therapy.

E-cigarette specialty retailers: Data to assess the association between retail environment and student e-cigarette use

OpenAIRE

Georgiana Bostean; Catherine M. Crespi; Patsornkarn Vorapharuek; William J. McCarthy

2017-01-01

The retail environment is a major social determinant of health, yet little is known about the e-cigarette specialty retailer environment. The e-cigarette specialty retail environment may be associated with e-cigarette use by middle and high school students, an issue that was addressed in a recent article entitled, ?E-cigarette use among students and e-cigarette specialty retailer presence near schools,? by Bostean and colleagues (G. Bostean, C.M. Crespi, P. Vorapharuek, W.J. McCarthy, 2016 [1...

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.

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

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

2011-01-01

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

Beyond yields: Climate change effects on specialty crop quality and agroecological management

Directory of Open Access Journals (Sweden)

Selena Ahmed

2016-03-01

Full Text Available Abstract Climate change is impacting the sustainability of food systems through shifts in natural and human dimensions of agroecosystems that influence farmer livelihoods, consumer choices, and food security. This paper highlights the need for climate studies on specialty crops to focus not only on yields, but also on quality, as well as the ability of agroecological management to buffer climate effects on quality parameters. Crop quality refers to phytonutrient and secondary metabolite profiles and associated health and sensory properties that influence consumer buying decisions. Through two literature reviews, we provide examples of specialty crops that are vulnerable to climate effects on quality and examples of climate-resilient agroecological strategies. A range of specialty crops including fruits, vegetables, tree nuts, stimulants, and herbs were identified to respond to climate variables with changes in quality. The review on climate-resilient strategies to mitigate effects on crop quality highlighted a major gap in the literature. However, agricultural diversification emerged as a promising strategy for climate resilience more broadly and highlights the need for future research to assess the potential of diversified agroecosystems to buffer climate effects on crop quality. We integrate the concepts from our literature review within a socio-ecological systems framework that takes into account feedbacks between crop quality, consumer responses, and agroecosystem management. The presented framework is especially useful for two themes in agricultural development and marketing, nutrition-sensitive agriculture and terroir, for informing the design of climate-change resilient specialty crop systems focused on management of quality and other ecosystem services towards promoting environmental and human wellbeing.

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.

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

Science.gov (United States)

Turan, Sevgi; Üner, Sarp

2015-01-01

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

Specialty education in periodontics in Japan and the United States: comparison of programs at Nippon Dental University Hospital and the University of Texas Health Science Center at San Antonio.

Science.gov (United States)

Osawa, Ginko; Nakaya, Hiroshi; Mealey, Brian L; Kalkwarf, Kenneth; Cochran, David L

2014-03-01

Japan has institutions that train qualified postdoctoral students in the field of periodontics; however, Japan does not have comprehensive advanced periodontal programs and national standards for these specialty programs. To help Japanese programs move toward global standards in this area, this study was designed to describe overall differences in periodontics specialty education in Japan and the United States and to compare periodontics faculty members and residents' characteristics and attitudes in two specific programs, one in each country. Periodontal faculty members and residents at Nippon Dental University (NDU) and the University of Texas Health Science Center at San Antonio (UTHSCSA) Dental School participated in the survey study: four faculty members and nine residents at NDU; seven faculty members and thirteen residents at UTHSCSA. Demographic data were collected as well as respondents' attitudes toward and assessment of their programs. The results showed many differences in curriculum structure and clinical performance. In contrast to the UTHSCSA respondents, for example, the residents and faculty members at NDU reported that they did not have enough subject matter and time to learn clinical science. Although the residents at NDU reported seeing more total patients in one month than those at UTHSCSA, they were taught fewer varieties of periodontal treatments. To provide high-quality and consistent education for periodontal residents, Japan needs to establish a set of standards that will have positive consequences for those in Japan who need periodontal treatment.

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

African Journals Online (AJOL)

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

Methods used by accredited dental specialty programs to advertise faculty positions: results of a national survey.

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Ballard, Richard W; Hagan, Joseph L; Armbruster, Paul C; Gallo, John R

2011-01-01

The various reasons for the current and projected shortages of dental faculty members in the United States have received much attention. Dental school deans have reported that the top three factors impacting their ability to fill faculty positions are meeting the requirements of the position, lack of response to position announcement, and salary/budget limitations. An electronic survey sent to program directors of specialty programs at all accredited U.S. dental schools inquired about the number of vacant positions, advertised vacant positions, reasons for not advertising, selection of advertising medium, results of advertising, and assistance from professional dental organizations. A total of seventy-three permanently funded full-time faculty positions were reported vacant, with 89.0 percent of these positions having been advertised in nationally recognized professional journals and newsletters. Networking or word-of-mouth was reported as the most successful method for advertising. The majority of those responding reported that professional dental organizations did not help with filling vacant faculty positions, but that they would utilize the American Dental Association's website or their specialty organization's website to post faculty positions if they were easy to use and update.

Communities Are Becoming "SolSmart" (With Some Help From Their States)

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Associated Areas of Regulation Code PV related area National Electric Code Electrical safety, wiring building in the event of a fire (see 2010 Oregon Solar Installation Specialty Code and Commentary) (Figure Installation Specialty Code and Commentary Ensuring Solar Access States have also set policies to ensure

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

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Hess, Søren

2010-01-01

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

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

Directory of Open Access Journals (Sweden)

Miah S

2016-01-01

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

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.

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

African Journals Online (AJOL)

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

High and specialty-related musculoskeletal disorders afflict dental professionals even since early training years

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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.

The Problem Analysis of Existing FSES of Higher Education for the Enlarged Group of Specialties"the Service and Tourism"

OpenAIRE

Marina A. Maznichenko; Nataliya I. Neskoromnykh

2016-01-01

The article presents the results of aspect analysis of the current federal state educational standards of higher education for the enlarged group of specialties"Service and tourism". There are analyzed the conformity of educational standards of higher education to the requirements of employers, the requirements for development results, to the structure and terms of realization of educational programs of undergraduate/graduate. The authors outline the key problems for each aspect, also identif...

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

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

2017-04-01

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

Surgical resident perceptions of trauma surgery as a specialty.

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

2010-05-01

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

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.

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

Science.gov (United States)

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

2011-01-01

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

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

Science.gov (United States)

Harendza, Sigrid; Pyra, Martin

2017-07-26

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

The dynamics of triads in aggregated journal-journal citation relations: specialty developments at the above-journal level

NARCIS (Netherlands)

de Nooy, W.; Leydesdorff, L.

2015-01-01

Dyads of journals—related by citations—can agglomerate into specialties through the mechanism of triadic closure. Using the Journal Citation Reports 2011, 2012, and 2013, we analyze triad formation as indicators of integration (specialty growth) and disintegration (restructuring). The strongest

76 FR 22733 - Cable Statutory License: Specialty Station List

Science.gov (United States)

2011-04-22

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

Personality and Values as Predictors of Medical Specialty Choice

Science.gov (United States)

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

2011-01-01

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

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.

IPM of specialty crops and community gardens in north Florida

Science.gov (United States)

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

BUSINESS DEVELOPMENT STRATEGY FOR SPECIALTY COFFEE

Directory of Open Access Journals (Sweden)

Vharessa Aknesia

2015-01-01

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

Child morbidity of salmonellosis and the level of resistance of clinical isolates of salmonella to antibacterial preparations in saint Petersburg

Directory of Open Access Journals (Sweden)

N. V. Gonchar

2015-01-01

Full Text Available The aim of the study was to study the dynamics of the incidence of salmonellosis children in St. Petersburg and phenotypic resistance of clinical isolates of S. Enteritidis and S. Typhimurium to antibiotics in recent years. Materials and methods. The incidence of salmonellosis children studied according to the report for the first nine months of Rospotrebnadzor in 2013–2014. Incidence of salmonellosis in the structure of bacterial intestinal infections caused by pathogens in children hospitalized in the Department of intestinal infections in 2013–2014, studied according to annual reports. Antibiotic sensitivity was studied 86 Salmonella isolates (S. Enteritidis strain 64 and strain 22 S. Typhimurium, isolated from patients in children 2010–2014. Used the method of serial microdilution broth. Salmonella isolates were divided into sensitive, resistant, intermediate sensitivity to antibiotics. The Results. Analysis of the incidence of salmonellosis children of St. Petersburg has revealed its decline in 2014 (109.2 compared to 2013 (123,9 but relatively long-term average level was an increase in incidence (107,6. In the structure of salmonellosis in children prevailed salmonellosis Group D. In hospitalized children in the structure of bacterial intestinal infections detected Excess of share of salmonellosis in 2014 (36,9±3,4% compared to 2013 (24,5±2,4%; p <0,01. A reduction in the frequency sensitivity of S. Enteritidis to ampicillin, cefepime, ceftazidime and chloramphenicol. Compared to S. Enteritidis S. Typhimurium isolates were more resistant to ceftazidime and ampicillin, but more sensitive to ciprofloxacin. Conclusion. Morbidity of salmonellosis in recent years characterized by a relatively long-term average increase of the level. In the structure of salmonellosis in children prevailed salmonellosis Group D. There was a reduction of sensitivity S. Enteritidis isolates to cephalosporins new generations, and S. Typhimurium isolates

A Cohort Approach to Real-Time Detection of Acute HIV Infections Among People Who Inject Drugs in St. Petersburg, Russia.

Science.gov (United States)

Toussova, Olga V; Kozlov, Andrei P; Verevochkin, Sergei V; Lancaster, Kathryn E; Shaboltas, Alla V; Masharsky, Alexei; Dukhovlinova, Elena; Miller, William C; Hoffman, Irving F

2018-03-01

To detect acute HIV infections (AHIs) in real time among people who inject drugs (PWID) in St. Petersburg, Russia and to test the feasibility of this approach. Prospective cohort study. One hundred seronegative or acutely HIV-infected at screening PWID were enrolled and followed until the end of the 12-month pilot period. Each participant was evaluated, tested, and counseled for HIV monthly. Two HIV tests were used: HIV antibody and HIV RNA PCR. If diagnosed with AHI, participants were followed weekly for a month; then, monthly for 3 months; and then, quarterly for the duration of the follow-up period. HIV risk behavior was assessed at each study visit. Most enrolled PWID were 30-39 years old, male, completed high school or more, not employed full-time, heroin users, and frequently shared injection paraphernalia. AHI prevalence at screening was 1.8% [95% confidence interval (CI): 0.4, 5.5]. Three participants with AHI at enrollment represented 3% (95% CI: 0.6, 8.5) of the 100 participants who consented to enroll. Among the HIV-uninfected participants (n = 97), the AHI incidence over time was 9.3 per 100 person-years. Persons with AHI were more likely to report alcohol intoxication within the prior 30 days. This was the first study to detect AHI using a cohort approach. The approach proved to be feasible: recruitment, retention, AHI detection, and virological endpoints were successfully reached. A cost analysis in a real-world setting would be required to determine if this strategy could be brought to scale. The study revealed continued high HIV incidence rate among PWID in St. Petersburg, Russia and the importance of prevention and treatment programs for this group.

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

Directory of Open Access Journals (Sweden)

Christine Elnitsky

2012-12-01

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

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

Science.gov (United States)

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

2007-08-01

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

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

Science.gov (United States)

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

2016-05-21

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

‎ 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

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

Science.gov (United States)

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

2008-07-01

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

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

African Journals Online (AJOL)

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

The recognition of radiation protection training as a professional specialty

International Nuclear Information System (INIS)

Touzet, R. E.

2003-01-01

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

Assessing Student Interest and Familiarity with Professional Psychology Specialty Areas

Science.gov (United States)

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

2006-01-01

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

Geotechnologies for the Characterization of Specialty Coffee Environments of Mantiqueira de Minas in Brazil

Science.gov (United States)

Alves, H. M. R.; Vieira, T. G. C.; Volpato, M. M. L.; Lacerda, M. P. C.; Borém, F. M.

2016-06-01

Land-use/land-cover change (LUCC) is a major cause of environmental transformation. Distant drivers, often associated with emerging markets for specific products, are now being considered one of the main factors of LUCC and are gaining attention in land change science. Consumers show an increasing interest in local and quality food, certified for its origin and its environmental production standards. A kind of agricultural product certification, Geographic Indication, identifies a product as originating from a specific region where a given quality, reputation or characteristic is attributed to its geographical origin. Sustainable land use is potentially an indirect effect of Geographic Indication, as it requires better land management in order to preserve the natural resources associated with the unique characteristics of the certified product. Located in the southern region of the state of Minas Gerais in Brazil is the region of Mantiqueira de Minas, considered one of the most important regions for the production of specialty coffees in Brazil. In 2011, the region's tradition and reputation were recognized with a Geographic Indication, the second given for coffee regions in the country. To explore the full potential of this area for producing coffees with higher quality and meet the growing demand of this new international market, which aggregates value at specialty coffees, it became fundamental to understand the coffee environments of the region, the "terroirs" where these coffees are obtained. Geotechnology can give a significant contribution in filling this gap. This work is part of a research project that made a detailed characterization of the region's coffee agroecosystems. Geotechnologies were employed to map the areas occupied by coffee plantations by using RapidEye satellite images and SPRING and ArcGIS software. All the segments of the environment were characterized and mapped in detail and the relations with coffee quality were evaluated. The results

GEOTECHNOLOGIES FOR THE CHARACTERIZATION OF SPECIALTY COFFEE ENVIRONMENTS OF MANTIQUEIRA DE MINAS IN BRAZIL

Directory of Open Access Journals (Sweden)

H. M. R. Alves

2016-06-01

Full Text Available Land-use/land-cover change (LUCC is a major cause of environmental transformation. Distant drivers, often associated with emerging markets for specific products, are now being considered one of the main factors of LUCC and are gaining attention in land change science. Consumers show an increasing interest in local and quality food, certified for its origin and its environmental production standards. A kind of agricultural product certification, Geographic Indication, identifies a product as originating from a specific region where a given quality, reputation or characteristic is attributed to its geographical origin. Sustainable land use is potentially an indirect effect of Geographic Indication, as it requires better land management in order to preserve the natural resources associated with the unique characteristics of the certified product. Located in the southern region of the state of Minas Gerais in Brazil is the region of Mantiqueira de Minas, considered one of the most important regions for the production of specialty coffees in Brazil. In 2011, the region’s tradition and reputation were recognized with a Geographic Indication, the second given for coffee regions in the country. To explore the full potential of this area for producing coffees with higher quality and meet the growing demand of this new international market, which aggregates value at specialty coffees, it became fundamental to understand the coffee environments of the region, the “terroirs” where these coffees are obtained. Geotechnology can give a significant contribution in filling this gap. This work is part of a research project that made a detailed characterization of the region’s coffee agroecosystems. Geotechnologies were employed to map the areas occupied by coffee plantations by using RapidEye satellite images and SPRING and ArcGIS software. All the segments of the environment were characterized and mapped in detail and the relations with coffee quality

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.

Association of State Access Standards With Accessibility to Specialists for Medicaid Managed Care Enrollees.

Science.gov (United States)

Ndumele, Chima D; Cohen, Michael S; Cleary, Paul D

2017-10-01

Medicaid recipients have consistently reported less timely access to specialists than patients with other types of coverage. By 2018, state Medicaid agencies will be required by the Center for Medicare and Medicaid Services (CMS) to enact time and distance standards for managed care organizations to ensure an adequate supply of specialist physicians for enrollees; however, there have been no published studies of whether these policies have significant effects on access to specialty care. To compare ratings of access to specialists for adult Medicaid and commercial enrollees before and after the implementation of specialty access standards. We used Consumer Assessment of Healthcare Providers and Systems survey data to conduct a quasiexperimental difference-in-differences (DID) analysis of 20 163 nonelderly adult Medicaid managed care (MMC) enrollees and 54 465 commercially insured enrollees in 5 states adopting access standards, and 37 290 MMC enrollees in 5 matched states that previously adopted access standards. Reported access to specialty care in the previous 6 months. Seven thousand six hundred ninety-eight (69%) Medicaid enrollees and 28 423 (75%) commercial enrollees reported that it was always or usually easy to get an appointment with a specialist before the policy implementation (or at baseline) compared with 11 889 (67%) of Medicaid enrollees in states that had previously implemented access standards. Overall, there was no significant improvement in timely access to specialty services for MMC enrollees in the period following implementation of standard(s) (adjusted difference-in-differences, -1.2 percentage points; 95% CI, -2.7 to 0.1), nor was there any impact of access standards on insurance-based disparities in access (0.6 percentage points; 95% CI, -4.3 to 5.4). There was heterogeneity across states, with 1 state that implemented both time and distance standards demonstrating significant improvements in access and reductions in disparities

Access to specialty mental health services among women in California.

Science.gov (United States)

Kimerling, Rachel; Baumrind, Nikki

2005-06-01

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

Strategies for Introducing Outpatient Specialty Palliative Care in Gynecologic Oncology.

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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.

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

Science.gov (United States)

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

2018-03-07

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

48 CFR 252.225-7008 - Restriction on Acquisition of Specialty Metals.

Science.gov (United States)

2010-10-01

... CLAUSES Text of Provisions And Clauses 252.225-7008 Restriction on Acquisition of Specialty Metals. As... more of the following limits: Manganese, 1.65 percent; silicon, 0.60 percent; or copper, 0.60 percent...

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

Science.gov (United States)

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

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

Science.gov (United States)

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

2016-01-01

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

Choosing a career in paediatrics: do trainees' views change over the first year of specialty training?

Science.gov (United States)

Goodyear, Helen M; Lakshminarayana, Indumathy; Wall, David; Bindal, Taruna

2014-09-01

To look at why a regional cohort of UK doctors chose a paediatric career and to ascertain views on their career near the end of training year one. A 20-item questionnaire was sent to all new regional paediatric specialty trainees. Three focus groups were held with trainees near the end of year one to elicit key themes. West Midlands Deanery, UK. Twenty-nine new regional paediatric specialty trainees in year one completed the questionnaire. A total of 15 trainees participated in the focus groups near the end of year one training. Reasons for choosing a paediatric career and factors which further influence career choice for trainees during their first specialty training year. Key influencing factors for choosing paediatrics were enjoying working with children and positive undergraduate experience of the specialty. All trainees had paediatrics as their first choice specialty and undertook a paediatric Foundation post. Near the end of year one, doubts were cast on career aspirations due to seeing middle grade colleagues struggling with work-life balance and a growing feeling that family came first. Senior trainees need to be aware that they act as powerful role models for their more junior colleagues and therefore have an influential role on how juniors perceive a paediatric career. Family friendly flexible working patterns in paediatrics are vital to retain junior trainees. All paediatric staff are role models and need to be enthusiastic, keen to teach and to promote a positive working environment.

Specialty satisfaction, positive psychological capital, and nursing professional values in nursing students: A cross-sectional survey.

Science.gov (United States)

Woo, Chung Hee; Park, Ju Young

2017-10-01

Ideally, college majors should be chosen to achieve self-realization and correspond to self-concept. However, some students select a major based on extrinsic factors, rather than aptitude or interests, because of a lack of employment opportunities. If they have negative college experiences with an unsatisfactory major, they might not engage fully in their occupation following graduation. This study aimed to identify factors affecting specialty satisfaction in preclinical practice nursing-college students. A cross-sectional descriptive survey. A nonprobability convenience sample of 312 nursing-college students at colleges in Deajeon City, South Korea. The survey questionnaire was distributed to those who agreed to participate. Freshmen and sophomore nursing students (n=312). Participants were 312 students at colleges in Deajeon City. A structured questionnaire was used to collect data, which were analyzed using SPSS/WIN. Positive psychological capital and nursing professional values were positively correlated with specialty satisfaction. Significant predictors for specialty satisfaction included hope and optimism (as components of positive psychological capital), the roles of nursing service and originality of nursing (as nursing professional values), and aptitude/interests and job value (as motives for selecting a major). The findings suggested that nursing students' specialty satisfaction was partially linked to positive psychological capital and professional values. Therefore, the promotion of positive factors should be useful in enhancing specialty satisfaction in preclinical-practice nursing-college students. Copyright © 2017 Elsevier Ltd. All rights reserved.

Herbert Rackow and Ernest Salanitre: the emergence of pediatric anesthesia as a specialty in the United States.

Science.gov (United States)

Friesen, Robert H

2015-07-01

Herbert Rackow and Ernest Salanitre were pediatric anesthesiologists at Babies Hospital at the Columbia-Presbyterian Medical Center in New York whose work spanned three decades beginning in the early 1950s. Their pioneering research included studies of the uptake and elimination of inhalational anesthetics and of the risk of cardiac arrest in infants and children. They were actively involved in the development of pediatric anesthesia as a specialty, and their efforts contributed to inter-disciplinary collaboration and to the formation of the Section on Anesthesiology of the American Academy of Pediatrics. Their 1969 review article, 'Modern Concepts in Pediatric Anesthesiology', provides a fascinating view of pediatric anesthesia 50 years ago. In 1990, they were jointly awarded the Robert M. Smith award by the Section on Anesthesiology of the American Academy of Pediatrics. © 2015 John Wiley & Sons Ltd.

The Effect of Teaching Experience and Specialty (Vocal or Instrumental) on Vocal Health Ratings of Music Teachers

Science.gov (United States)

Hackworth, Rhonda S.

2010-01-01

The current study sought to determine the relationship among music teachers' length of teaching experience, specialty (vocal or instrumental), and ratings of behaviors and teaching activities related to vocal health. Participants (N = 379) were experienced (n = 208) and preservice (n = 171) music teachers, further categorized by specialty, either…

Porphyry of Russian Empires in Paris

Science.gov (United States)

Bulakh, Andrey

2014-05-01

Porphyry of Russian Empires in Paris A. G. Bulakh (St Petersburg State University, Russia) So called "Schokhan porphyry" from Lake Onega, Russia, belongs surely to stones of World cultural heritage. One can see this "porphyry" at facades of a lovely palace of Pavel I and in pedestal of the monument after Nicolas I in St Petersburg. There are many other cases of using this stone in Russia. In Paris, sarcophagus of Napoleon I Bonaparte is constructed of blocks of this stone. Really, it is Proterozoic quartzite. Geology situation, petrography and mineralogical characteristic will be reported too. Comparison with antique porphyre from the Egyptian Province of the Roma Empire is given. References: 1) A.G.Bulakh, N.B.Abakumova, J.V.Romanovsky. St Petersburg: a History in Stone. 2010. Print House of St Petersburg State University. 173 p.

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.

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

Science.gov (United States)

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

2007-01-01

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

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

Science.gov (United States)

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.

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

Directory of Open Access Journals (Sweden)

Hassan Suliman Halawany

2017-01-01

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

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…

Synthetic Biology for Specialty Chemicals.

Science.gov (United States)

Markham, Kelly A; Alper, Hal S

2015-01-01

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

'In different situations, in different ways': male sex work in St. Petersburg, Russia.

Science.gov (United States)

Niccolai, Linda M; King, Elizabeth J; Eritsyan, Ksenia U; Safiullina, Liliya; Rusakova, Maia M

2013-01-01

We conducted a qualitative study of male sex work in St. Petersburg Russia with a focus on social vulnerabilities, HIV-risk perception and HIV-related behaviours. In-depth interviews were conducted with individuals knowledgeable about male sex work through their profession and with male sex workers themselves. Male sex work involves a variety of exchanges, including expensive vacations, negotiated monetary amounts or simply access to food. Methods of finding clients included the Internet, social venues (e.g. gay clubs and bars) and public places (e.g. parks). Use of the Internet greatly facilitated male sex work in a variety of ways. It was used by both individuals and agencies to find clients, and appeared to be increasing. Men often reported not being professionally connected to other male sex workers and limited disclosure about their work. Many were aware of the work-related risks to personal safety, including violence and robbery by clients. Perceived risk for HIV was mostly abstract and several exceptions to condom use with clients were noted. Alcohol use was reported as moderate but alcohol was consumed frequently in association with work. These data suggest that the most salient risks for male sex workers include professional isolation, threats to personal safety, limited perceived HIV risk and sub-optimal levels of condom use.

Toward the establishment of a forensic nursing specialty in Brazil: an integrative literature review.

Science.gov (United States)

Esteves, Rafael Braga; Lasiuk, Gerri C; Cardoso, Lucilene; Kent-Wilkinson, Arlene

2014-01-01

Over the past two decades, Brazil has made progress in bringing political and community attention to issues related to violence. The recognition of links between violence and health has intensified calls to accelerate the development of a forensic nursing specialty in Brazil. The aim of this study was to systematically examine and synthesize the literature on the development of the forensic nursing specialty around the globe and to extract important lessons for the establishment of a forensic nursing specialty in Brazil. An integrative review was conducted according to the method described by Whittmore and Knafl (2005). Electronic searches of the following databases were conducted between December 2012 and March 2013: CINAHL Plus with Full Text, Criminal Justice, Index to Legal periodicals, MEDLINE, Soc Index with Full Text, Social Work Abstracts, SCOPUS, and PsycINFO. The search terms used were: [(TI nurs* or SU nurs*) and [TI (forensic* or penal or prison*) or SU (forensic* or penal or prison*)] and (sexual assault nurse examiner*). Preestablished inclusion/exclusion criteria were used to select published articles for review. Twenty-three articles met inclusion criteria and were included in the full review. Important lessons for Brazil are discussed in terms of education and curricular issues and forensic psychiatric nursing. In Brazil, there is a window of opportunity to contribute the theoretical foundations of forensic nursing science and to advance nursing specialty practice in the areas of Sexual Assault Nurse Examiners and forensic psychiatric nurses.

Specialty glass development for radiation shielding windows and nuclear waste immobilization

International Nuclear Information System (INIS)

Mandal, S.; Ghorui, S.; Roy Chowdhury, A.; Sen, R.; Chakraborty, A.K.; Sen, S.; Maiti, H.S.

2015-01-01

The technology of two important varieties of specialty glasses, namely high density Radiation Shielding Window (RSW) glass and specialty glass beads of borosilicate composition have been successfully developed in CGCRI with an aim to meet the countries requirement. Radiation Shielding Windows used in nuclear installations, are viewing devices, which allow direct viewing into radioactive areas while still providing adequate protection to the operating personnel. The glass blocks are stabilized against damage from radiation by introducing cerium in definite proportions. Considering the essentially of developing an indigenous technology to make the country self-sufficient for this critical item, CGCRI has taken up a major programme to develop high lead containing glasses required for RSWs under a MoD with BARC. On the other hand, the specialty glass bead of specific composition and properties is a critical material required for management of radioactive waste in a closed nuclear fuel cycle that is followed by India. During reprocessing of the spent nuclear fuel, high level radio-active liquid waste (HLW) is produced containing unwanted radio isotopes some of which remain radioactive for thousands of years. The need is to immobilize them within a molecular structure so that they will not come out and be released to the ambience and thereby needs to be resolved if nuclear power is to make a significant contribution to the country's power requirement. Borosilicate glass has emerged as the material of choice for immobilization due to its unique random network structure

Forecasting U.S. Marine Corps Reenlistments by Military Occupational Specialty and Grade

National Research Council Canada - National Science Library

Conatser, Dean G

2006-01-01

.... Currently the First Term Alignment Plan (FTAP) Model and Subsequent Term Alignment Plan (STAP) Model are used to determine the number of required reenlistments by Marine military occupational specialty...

Variability in Resident Operative Hand Experience by Specialty.

Science.gov (United States)

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

2018-01-01

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

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

OpenAIRE

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

2016-01-01

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

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

Does a single specialty intensive care unit make better business sense than a multi-specialty intensive care unit? A costing study in a trauma center in India.

Science.gov (United States)

Kumar, Parmeshwar; Jithesh, Vishwanathan; Gupta, Shakti Kumar

2015-01-01

Though intensive care units (ICUs) only account for 10% of hospital beds, they consume nearly 22% of hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. To evaluate and compare the cost of intensive care delivery between multi-specialty and neurosurgery ICU in an apex trauma care facility in India. The study was conducted in a polytrauma and neurosurgery ICU at a 203 bedded level IV trauma care facility in New Delhi, India from May, 2012 to June 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Fisher's two-tailed t-test. Total cost/bed/day for the multi-specialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU was Rs. 14,306.7/-, manpower constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Quantification of expenditure in running an ICU in a trauma center would assist healthcare decision makers in better allocation of resources. Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed.

Investigation on the learning interest of senior undergraduate students in optoelectronics specialty

Science.gov (United States)

Wu, Shenjiang; Wang, Na; Li, Dangjuan; Liu, Chanlao

2017-08-01

With the increasing number of the graduate students, many of them have some troubles in job finding. This situation make a huge pressure on the senior students and loss them the interesting in study. This work investigate the reasons by questionnaire survey, panel discussion, interview, etc. to achieve the factors influence their learning interesting. The main reason of students do not have the motivation on study is that they do not understand the development and competition of photoelectric specialty, lack of innovation and entrepreneurship training, hysteresis of the learning knowledge and practical application. Finally, the paper gives some suggestions through teaching reform on how to improve students' learning enthusiasm. This work will contribute to the teaching and training of senior undergraduate students of optoelectronics specialty.

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.

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

Science.gov (United States)

Hollingsworth, Jan Carter

2009-01-01

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

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...

Vulnerability of California specialty crops to projected mid-century temperature changes

Science.gov (United States)

Increasing global temperatures are likely to have major impacts on agriculture, but the effects will vary by crop and location. This paper describes the temperature sensitivity and exposure of selected specialty crops in California. We used literature synthesis to create several sensitivity indices ...

Leslie Cemetery and Francisco distributary fluvial channels in the Petersburg Formation (Pennsylvanian) of Gibson County, Indiana, USA

Energy Technology Data Exchange (ETDEWEB)

Eggert, D L

1984-01-01

The Leslie Cemetery Channel is a small distributary fluvial channel that is partly contemporaneous with the Springfield Coal member of the Petersburg Formation (Pennsylvanian) and splits the seam into two seams. This channel is 1-6 miles (1.6-10 km) wide and extends 30 miles (48 km) in the subsurface. Overbank and channel fill deposits consisting of sandstone, siltstone, and mudstone split the coal into two seams up to 40-50 ft (12-15 m) apart in places. The lower seam is a low-sulphur coal. Adjacent to this channel is the unsplit coal, which is as much as 9 ft (3 m) thick. Beneath the Leslie Cemetery Channel and the Springfield coal is the slightly older Francisco Channel (new name), which is younger than the next lower coal. This channel is filled with a fining-upward sandstone as much as 75 ft (23 m) thick. The positions of these stacked channels were determined by the differential compaction of earlier sediments. 20 references.

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.

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.

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

Science.gov (United States)

2010-07-01

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

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

Science.gov (United States)

Baldini, Christopher G; Culley, Eric J

2011-01-01

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

The microbiological safety of ready-to-eat specialty meats from markets and specialty food shops: a UK wide study with a focus on Salmonella and Listeria monocytogenes.

Science.gov (United States)

Gormley, F J; Little, C L; Grant, K A; de Pinna, E; McLauchlin, J

2010-04-01

From 2359 specialty meats (continental sausages, cured/fermented, dried meats) sampled from markets and specialty food shops, 98.9% of samples were of satisfactory or acceptable microbiological quality. However, 16 (0.7%) were unsatisfactory as a result of Escherichia coli, Staphylococcus aureus or Listeria spp. contamination (>or=10(2) CFU/g), and nine (0.4%) were unacceptable due to presence of Salmonella spp. or Listeria monocytogenes (>10(2) CFU/g). Meats with unacceptable levels of L. monocytogenes were within shelf life (range: 8-143 days remaining). Nine different subtypes of L. monocytogenes were detected with sero/AFLP type 1/2c VII predominating (37%), although this subtype was not overrepresented in any particular meat type (P > 0.05). Ninety-six percent of continental sausages and cured/fermented products were stored at potential for L. monocytogenes to be present at levels hazardous to health at the point of sale.

Roadmap for a Smart Factory: A Modular, Intelligent Concept for the Production of Specialty Chemicals.

Science.gov (United States)

Reitze, Arnulf; Jürgensmeyer, Nikolas; Lier, Stefan; Kohnke, Marco; Riese, Julia; Grünewald, Marcus

2018-04-09

Digitalization and increasing the flexibility of production concepts offer the possibility to react to market challenges in the field of specialty chemicals. Shorter product lifetimes, increasing product individualization, and the resulting market volatility impose new requirements on plant operators. Novel concepts such as modular production plants and developments in digitalization (Industry 4.0) are able to assist the implementation of smart factories in specialty chemicals. These essential concepts will be presented in this Minireview. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Prevalence of dry eye syndrome in residents of surgical specialties.

Science.gov (United States)

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

2016-07-16

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

United States Air Force Research Initiation Program for 1987. Volume 4.

Science.gov (United States)

1989-04-01

University of - 7 N. Carolina A&T State Univ. - I Dillard University - 1 N. Carolina-Greensboro, Univ - I Drury College - 1 Northwestern University - 1...Specialty: Educational Psychology Specialty: Management Science Dr. Michael Matthews Dr. Charles Lance (1986) Drury College University of Georgia...Molecular Biology of the Cell, pp 611-668, 918-947, Garland Publishing Company, Inc. New York, 1983. 2. Anderson, Colin , Manual for the Examination of

Does a single specialty intensive care unit make better business sense than a multi-specialty intensive care unit? A costing study in a trauma center in India

Science.gov (United States)

Kumar, Parmeshwar; Jithesh, Vishwanathan; Gupta, Shakti Kumar

2015-01-01

Context: Though intensive care units (ICUs) only account for 10% of hospital beds, they consume nearly 22% of hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. Aim: To evaluate and compare the cost of intensive care delivery between multi-specialty and neurosurgery ICU in an apex trauma care facility in India. Materials and Methods: The study was conducted in a polytrauma and neurosurgery ICU at a 203 bedded level IV trauma care facility in New Delhi, India from May, 2012 to June 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Statistical Analysis: Fisher's two-tailed t-test. Results: Total cost/bed/day for the multi-specialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU was Rs. 14,306.7/-, manpower constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Conclusions: Quantification of expenditure in running an ICU in a trauma center would assist healthcare decision makers in better allocation of resources. Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed. PMID:25829909

Does a single specialty intensive care unit make better business sense than a multi-specialty intensive care unit? A costing study in a trauma center in India

Directory of Open Access Journals (Sweden)

Parmeshwar Kumar

2015-01-01

Full Text Available Context: Though intensive care units (ICUs only account for 10% of hospital beds, they consume nearly 22% of hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. Aim: To evaluate and compare the cost of intensive care delivery between multi-specialty and neurosurgery ICU in an apex trauma care facility in India. Materials and Methods: The study was conducted in a polytrauma and neurosurgery ICU at a 203 bedded level IV trauma care facility in New Delhi, India from May, 2012 to June 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Statistical Analysis: Fisher′s two-tailed t-test. Results: Total cost/bed/day for the multi-specialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU was Rs. 14,306.7/-, manpower constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Conclusions: Quantification of expenditure in running an ICU in a trauma center would assist healthcare decision makers in better allocation of resources. Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed.

Pain is associated with risky drinking over time among HIV-infected persons in St. Petersburg, Russia.

Science.gov (United States)

Tsui, Judith I; Cheng, Debbie M; Coleman, Sharon M; Lira, Marlene C; Blokhina, Elena; Bridden, Carly; Krupitsky, Evgeny; Samet, Jeffrey H

2014-11-01

Pain is highly prevalent among persons with HIV. Alcohol may be used to "self-medicate" pain. This study examined the association between pain and risky alcohol use over time in a cohort of HIV-infected Russian drinkers. This secondary analysis utilized longitudinal data from a randomized trial of a behavioral intervention. Subjects included HIV-infected adults who reported past 6-month risky drinking and unprotected sex and were recruited from HIV and addiction treatment sites in St. Petersburg, Russia. The main independent variable was pain that at least moderately interfered with daily living. The primary outcome was past month risky drinking amounts based on NIAAA guidelines. General estimating equations (GEE) logistic regression models were used to calculate odds ratios and 95% confidence intervals for the association between pain and risky drinking over time (i.e., baseline, 6 and 12 months), adjusting for potential confounders. Baseline characteristics of participants (n=699) were mean age of 30 (SD ±5) years, 41% female, and 22% time. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Factors affecting consumers' preferences for and purchasing decisions regarding pasteurized and raw milk specialty cheeses.

Science.gov (United States)

Colonna, A; Durham, C; Meunier-Goddik, L

2011-10-01

Eight hundred ninety consumers at a local food festival were surveyed about their specialty cheese purchasing behavior and asked to taste and rate, through nonforced choice preference, 1 of 4 cheese pairs (Cheddar and Gouda) made from pasteurized and raw milks. The purpose of the survey was to examine consumers' responses to information on the safety of raw milk cheeses. The associated consumer test provided information about specialty cheese consumers' preferences and purchasing behavior. Half of the consumers tested were provided with cheese pairs that were identified as being made from unpasteurized and pasteurized milk. The other half evaluated samples that were identified only with random 3-digit codes. Overall, more consumers preferred the raw milk cheeses than the pasteurized milk cheeses. A larger portion of consumers indicated preferences for the raw milk cheese when the cheeses were labeled and thus they knew which samples were made from raw milk. Most of the consumers tested considered the raw milk cheeses to be less safe or did not know if raw milk cheeses were less safe. After being informed that the raw milk cheeses were produced by a process approved by the FDA (i.e., 60-d ripening), most consumers with concerns stated that they believed raw milk cheeses to be safe. When marketing cheese made from raw milk, producers should inform consumers that raw milk cheese is produced by an FDA-approved process. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Labor recruitment and economic freedoms in Europe

NARCIS (Netherlands)

Cremers, Jan; Rozanova, Marya S.

2016-01-01

In the spring of 2015, Jan Cremers (UvT-TLS) contributed to an international congress in Saint Petersburg dedicated to labor migration. The conference was organized by the state university of Saint Petersburg, the Friedrich-Ebert-Foundation in the Russian Federation, the Center for Civil, Social,

Caveats on tomographic images

DEFF Research Database (Denmark)

Foulger, Gillian R.; Panza, Giuliano F.; Artemieva, Irina

2014-01-01

)CNR – Istituto di Geologia Ambientale e Geoingegneria (IGAG) c/o Dipartimento di Scienze della Terra, Università degliStudi di Roma La Sapienza, Rome, Italy, (10) Dept. Physics of the Earth, Sankt-Petersburg State University, Sankt-Petersburg,RussiaGeological models of the mantle and its geodynamic...

Foreign economic activity of Saint Petersburg, the Leningrad Region, and the Republic of Karelia: problems and opportunities for development

Directory of Open Access Journals (Sweden)

Bazhenov Yuri

2012-03-01

Full Text Available In this paper, we look at the interregional cooperation in adjacent areas. Specifically, we focus our attention on the cluster of regions formed by the city of St. Petersburg, the Leningrad region and the Republic of Karelia. All three areas face a number of challenges when it comes to international trade: challenges that are shared and that require strategic coordinated solutions from regional decisionmakers. One of such solutions, for example, could require pooling of competitive advantages of these areas. The analysis of strategic documents of regional development, however, shows that the issue of interregional cooperation has not been duly addressed at any level, theoretical or practical. It is important to strengthen international trade capacity and to increase cooperation in other areas of cross-border relations, since these processes are crucial for Russia’s integration into the global markets.

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

Construction and Practice of the New Business Specialty Talent Cultivation Mode

Science.gov (United States)

Xiao, Xiaokong

2009-01-01

The vocational education of business should actively adapt the demands of the domestic and foreign business development to cultivate high-quality applicable talents with international knowledge. The traditional business specialty teaching and the talent cultivation mode have not followed the domestic and foreign market demands, and are difficult…

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

Science.gov (United States)

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

2012-01-01

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

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

Science.gov (United States)

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

2018-01-01

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

Adherence of randomized trials within children's surgical specialties published during 2000 to 2009 to standard reporting guidelines.

Science.gov (United States)

Blakely, Martin L; Kao, Lillian S; Tsao, Kuojen; Huang, Eunice Y; Tsai, Anthony; Tanaka, Stacy; Younas, Shiraz; Lu, Zengqi; Lally, Kevin P

2013-09-01

Randomized clinical trials (RCTs) are uncommon in pediatric surgical specialties and the quality of reporting is unknown. Our primary purpose was to analyze published surgical RCTs involving children to measure adherence to the Consolidated Standards of Reporting Trials (CONSORT) guidelines. Published RCTs from January 1, 2000 through December 31, 2009 were reviewed. The trials were evaluated for the presence of 7 CONSORT guidelines and also graded according to the Jadad scale. Two hundred and twenty-eight trials were included. Five trials met all 7 CONSORT criteria (2%) and 53 had a Jadad score of ≥3 (23%). Slightly more than 50% of all trials specified primary outcomes and guidelines for allocation concealment, randomization description, and attrition details was even lower. There were significant differences between surgical specialties with regard to CONSORT adherence to the majority of the guidelines. Pediatric general surgery had the largest number of published RCTs. Pediatric orthopaedic surgery had the highest proportion of trials with a Jadad score ≥3 (40%). Adherence to CONSORT guidelines is low across the spectrum of children's surgical specialties, although significant differences do exist. Future RCTs in children's surgical specialties should specifically focus on areas of low adherence to reporting guidelines. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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.

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

African Journals Online (AJOL)

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

Personality Patterns of Physicians in Person-Oriented and Technique-Oriented Specialties

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Borges, Nicole J.; Gibson, Denise D.

2005-01-01

This study investigated differences in personality patterns between person-oriented and technique-oriented physicians. It tested an integrative framework by converting the scores on the Personality Research Form (PRF) to the Big-Five factors and built a predictive model of group membership in clinical specialty area. PRF scores from 238 physicians…

A patient group based business planning model for a surgical specialty

NARCIS (Netherlands)

Adan, I.J.B.F.; Vissers, J.M.H.; van den Heuvel, M.N.; Wiersema, K.; Vissers, J.M.H.; Beech, R.

2005-01-01

In this contribution we present an approach for a business planning model for a surgical specialty, based on modelling of all patient processes as well as of the dynamics involved in planning and managing resources. An important basis of the model is the description of the processes of all patient

Laparoscopic Upper Urinary System Surgery After Specialty Training: Presentation of 50 Cases

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Alper Gok

2014-03-01

Full Text Available Aim: Results of first 50 laparoscopic upper urinary tractus surgeries which were performed in Adiyaman State Hospital during compulsory duty after specialty training are presented. Material and Method: Fifty patients who underwent laparoscopic upper urinary tractus surgeries in our clinic between February 2012 and January 2013 were retrospectively evaluated. All of the laparoscopic procedures were performed using transperitoneal method. Results: Mean age of the patients was 42,6±13,6 (17-74, and mean operation duration was 96,8±12,4 minutes (28-165. Thirty two patients were males and 18 were females. Intraoperative complications were not seen in any of the patients and operations didn%u2019t proceed to open surgeries. All patients were mobilized at first day after the operation. No patient needed opioids as painkillers at postoperative period. Decrease in hematocrit level was obseved in a patient at early postoperative period and this patient was followed conservatively with 6 units of erythrocyte suspension. Herniation from the port area was observed in a patient who had cortical cyst excision at postoperative 3rd month. No major complication was observed. Discussion: Laparoscopic surgery which is becoming more commonly used nowadays can be safely applied in state hospitals if appropriate infrastructure is provided.

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

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KVS Hari Kumar

2012-01-01

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

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

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

2005-04-01

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

Effect of electromagnetic fields of natural and man-made origin on the incidence of various pathologies in St. Petersburg

International Nuclear Information System (INIS)

Tyasto, M.I.; Ptitsyna, N.G.; Kopytenko, Yu.A.; Voronov, P.M.; Kopntenko, E.A.; Villorezi, Dzh.; Yuchchi, N.

1995-01-01

The effect on man-made electromagnetic fluctuations and strong geomagnetic disturbances on human pathology-data from St.Petersburg (Russia, 1981) is analyzed. The most remarkable effect is the 7-day variation of the ambulance-call data for myocardial infarction, that show a decrease in pathology-rate (70%) during weak-ends and public holidays. Results of measurement of man-made electromagnetic fluctuations in the frequency range 0,005-10 Hz in 1991 and 1994 show a big decrease in electromagnetic noise during week-ends. We suggest that very big 7-day variation in infarction rates is connected with the decrease of electromagnetic noise during Saturdays-Sundays. This phenomenon is responsible for the very big 7-day variation in infarction rate. The myocardial infarction rate cleaned up by meteorological and social effects show whit increasing by a factor 1,14 during geomagnetic storsm. 13 refs., 6 figs

Discrimination of several Indonesian specialty coffees using Fluorescence Spectroscopy combined with SIMCA method

Science.gov (United States)

Suhandy, D.; Yulia, M.

2018-03-01

Indonesia is one of the important producers of several specialty coffees, which have a particularly high economic value, including Civet coffee (‘kopi luwak’ in Indonesian language) and Peaberry coffee (‘kopi lanang’ in Indonesian language). The production of Civet and Peaberry coffee is very limited. In order to provide authentication of Civet and Peaberry coffee and protect consumers from adulteration, a robust and easy method for evaluating ground Civet and Peaberry coffee and detection of its adulteration is needed. In this study, we investigate the use of fluorescence spectroscopy combined with SIMCA (soft independent modelling of class analogies) method to discriminate three Indonesian specialty coffee: ground Peaberry, Civet and Pagar Alam coffee. Total 90 samples were used (30 samples for Civet, Peaberry and Pagar Alam coffee, respectively). All coffee samples were ground using a home-coffee-grinder. Since particle size in coffee powder has a significant influence on the spectra obtained, we sieved all coffee samples through a nest of U. S. standard sieves (mesh number of 40) on a Meinzer II sieve shaker for 10 minutes to obtain a particle size of 420 µm. The experiments were performed at room temperature (around 27-29°C). All samples were extracted with distilled water and then filtered. For each samples, 3 mL of extracted sample then was pipetted into 10 mm cuvettes for spectral data acquisition. The EEM (excitation-emission matrix) spectral data of coffee samples were acquired using JASCO FP-8300 Fluorescence Spectrometer. The principal component analysis (PCA) result shows that it is possible to discriminate types of coffee based on information from EEM (excitation-emission matrix) spectral data. Using SIMCA method, the discrimination model of Indonesian specialty coffee was successfully developed and resulted in high performance of discrimination with 100% of sensitivity and specificity for Peaberry, Civet and Pagar Alam coffee. This research

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.

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

Science.gov (United States)

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

2010-08-01

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

The Emergence and Development of the Sociology of Sport as an Academic Specialty.

Science.gov (United States)

Loy, John W.; And Others

1980-01-01

Sport sociology as an academic specialty and its stages of development are described. Problems confronting future developments in sport sociology include critical mass, academic status, and ideological orientation, both in physical education and in sociology. (CJ)

Application-specific specialty microstructured optical fibers for mid-IR and THz photonics (Invited)

DEFF Research Database (Denmark)

Pal, Bishnu P.; Barh, Ajanta; Varshney, Ravi K.

2016-01-01

A review of several of our designed specialty microstructured optical fibers (MOFs) for mid-IR and THz generation and transmission including high power transmission is presented. Extensive results on performance of the designed MOFs are described....

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.

Comparison of activation cross section measurements and experimental techniques for fusion reactor technology. Summary report of the IAEA specialists' meeting held in St. Petersburg, Russia, 7 to 9 September 1994

International Nuclear Information System (INIS)

Pashchenko, A.B.

1995-02-01

The report contains the Summary of the IAEA Specialists' Meeting on ''Comparison of Activation Cross Section Measurements and Experimental Techniques for Fusion Reactor Technology''. The meeting was organized by the IAEA Nuclear Data Section (NDS) with co-operation and assistance of local organizers from the V.G. Khlopin Radium Institute, KRI, and held in St. Petersburg, Russia, from 7 to 9 September 1994. The aim of the meeting was to discuss and evaluate the preliminary results of the researches carried out in the framework of the international programme on Comparison of Activation Cross Section Measurements and Experimental Techniques for Fusion Reactor Technology coordinated by the IAEA Nuclear Data Section and to identify further measurements and actions of participating laboratories. The detailed conclusions and recommendations of the meeting are presented in Attachment 1 of the summary report. It was confirmed that for further comparison of experimental techniques the experimental groups at JAERI (Tokai, Japan), KRI (St. Petersburg, Russia), IPPE (Obninsk, Russia) and IEP (Debrecen, Hungary) will join in a collaborative program on comparing their measurement techniques and do measurements for reactions where discrepancies between their previous measurements exist. In cases where the JAERI results are the only existing data or deviate strongly from previous measurements, collaboration between KRI, IEP, IPPE and other institutions can consider measurements of these cross sections in order to clarify the situation. (author)

The results of virological surveillance for intrauterine infections in Saint-Petersburg

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E. A. Murina

2014-01-01

Full Text Available The purpose of researchis the determiningthe etiological structure ofintrauterine infections in Saint-Petersburg pediatric patients, pregnant women andinfants born to them using a variety of virological methods.Methods: serum from 164 children aged from 1 month to 14 years with diagnosis of «intrauterine infection». Serum from 80 pregnant women, collected in each trimester (total – 240 samples, their 42 children (at the age of 1–2 and 4–6  months of life, total – 82 samples. Immunoglobulin Mand G (IgM and IgGto herpes virus type 1, cytomegalovirus (CMV, Toxoplasma gondii, mycoplasma and chlamydia, rubella, Epstein-Barr virus (EBV and parvovirus B19, as well as IgG avidity,were determined by ELISA in all these samples. Theimmunoblot (Western blot, using the «Immunoblot2000» with test kits from «Euroimmun AG» (Germany, was applied to confirm cases. Statistical analysis wasperformed with theprograms Microsoft Excel, Statistica6.Results: cytomegalovirus, herpes virus 1st type and Epstein-Barr virus infections are dominate in the structure of intrauterine ones (45%, 23% and 14%, respectively. Laboratory evidence ofreactivationof cytomegalovirus (35% ofpregnant womenin the 2nd and/or 3rd trimesters and acuteparvovirus infection (15% of cases were found. Specific IgM to cytomegalovirus were detected in 6,2% ofchildren in the firstsix months of life.Conclusions: with the aim of early detection of cytomegalovirus reactivation and acute parvovirus infection it isnecessary to monitor pregnant women with the definition of specific IgM, IgG and avidity IgG. The procedure to using immunoblotting in the diagnosis of intrauterine infectionsneeds to be further study.

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

Science.gov (United States)

Chandra, Phool; Hughes, Mark

1984-01-01

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

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,…

Association of gender and specialty interest with video-gaming, three-dimensional spatial analysis, and entry-level laparoscopic skills in third-year veterinary students.

Science.gov (United States)

Bragg, Heather R; Towle Millard, Heather A; Millard, Ralph P; Constable, Peter D; Freeman, Lyn J

2016-06-15

OBJECTIVE To determine whether gender or interest in pursuing specialty certification in internal medicine or surgery was associated with video-gaming, 3-D spatial analysis, or entry-level laparoscopic skills in third-year veterinary students. DESIGN Cross-sectional study. SAMPLE A convenience sample of 68 (42 female and 26 male) third-year veterinary students. PROCEDURES Participants completed a survey asking about their interest in pursuing specialty certification in internal medicine or surgery. Subsequently, participants' entry-level laparoscopic skills were assessed with 3 procedures performed in box trainers, their video-gaming skills were tested with 3 video games, and their 3-D spatial analysis skills were evaluated with the Purdue University Visualization of Rotations Spatial Test. Scores were assigned for laparoscopic, video-gaming, and 3-D spatial analysis skills. RESULTS Significantly more female than male students were interested in pursuing specialty certification in internal medicine (23/42 vs 7/26), and significantly more male than female students were interested in pursuing specialty certification in surgery (19/26 vs 19/42). Males had significantly higher video-gaming skills scores than did females, but spatial analysis and laparoscopic skills scores did not differ between males and females. Students interested in pursuing specialty certification in surgery had higher video-gaming and spatial analysis skills scores than did students interested in pursuing specialty certification in internal medicine, but laparoscopic skills scores did not differ between these 2 groups. CONCLUSIONS AND CLINICAL RELEVANCE For this group of students, neither gender nor interest in specialty certification in internal medicine versus surgery was associated with entry-level laparoscopy skills.

Mapping Direct Observations From Objective Structured Clinical Examinations to the Milestones Across Specialties.

Science.gov (United States)

Baker-Genaw, Kimberly; Kokas, Maria S; Ahsan, Syed F; Darnley-Fisch, Deborah; Drake, Sean; Goyal, Nikhil; Inamdar, Kedar; Moutzouros, Vasilios; Prabhakar, Deepak; Rolland, Laurie; Sangha, Roopina; Shreve, Maria; Woodward, Ann

2016-07-01

Little is known about residents' performance on the milestones at the institutional level. Our institution formed a work group to explore this using an institutional-level curriculum and residents' evaluation of the milestones. We assessed whether beginner-level milestones for interpersonal and communication skills (ICS) related to observable behaviors in ICS-focused objective structured clinical examinations (OSCEs) for postgraduate year (PGY) 1 residents across specialties. The work group compared ICS subcompetencies across 12 programs to identify common beginner-level physician-patient communication milestones. The selected ICS milestone sets were compared for common language with the ICS-OSCE assessment tool-the Kalamazoo Essential Elements of Communication Checklist-Adapted (KEECC-A). To assess whether OSCE scores related to ICS milestone scores, all PGY-1 residents from programs that were part of Next Accreditation System Phase 1 were identified; their OSCE scores from July 2013 to June 2014 and ICS subcompetency scores from December 2014 were compared. The milestones for 10 specialties and the transitional year had at least 1 ICS subcompetency that related to physician-patient communication. The language of the ICS beginner-level milestones appears similar to behaviors outlined in the KEECC-A. All 60 residents with complete data received at least a beginner-level ICS subcompetency score and at least a satisfactory score on all 3 OSCEs. The ICS-OSCE scores for PGY-1 residents appear to relate to beginner-level milestones for physician-patient communication across multiple specialties.

Russian First Department of Roentgenology (on the occasion of 80th anniversary of Department of Roentgenology with a Course of Pediatric Roentgenology, Saint Petersburg Medical Academy for Postgraduate Training

International Nuclear Information System (INIS)

Trofimova, T.N.; Parizhskij, Z.M.

1999-01-01

Historical retrospective analysis is given for Oldest Russian (1898) - Department of Roentgenology of S.-Petersburg Medical Academy for Postgraduate Training permitting t assess the development of mentioned discipline in scientific, clinical, training, technical and organizational directions. For the period of existence of the Department the way was passed from biomedical radiography room to powerful Department based in many treatment-and-prophylactic establishments of the city carrying out large research work being a leading centre for postgraduate training on radiodiagnosis in the Northern-Western part of Russia [ru

The acceptance of dental operating microscope among advance education specialty programs in endodontics in the middle east

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Mansour Alrejaie

2012-01-01

Full Text Available Aim: To present the current situation of dental operating microscopy (DOM training in the available Advance Specialty Education Programs in Endodontics in Arab Middle-Eastern countries. Materials and Methods: A web-based survey was sent to the electronic mail address of Advance Specialty Education programs of 15 Arab and middle east countries. The questions were limited to those who have an advanced specialty education program in Endodontics at their University if they are using an operating microscope? Results: Out of 15 countries, only 4 countries have microscopic technology in their Advance Education Programs in Endodontics. Conclusion: Few Arab Middle-Eastern countries have DOM in their advance education programs in endodontics. The highest authority in advancing endodontic education in the Arab Middle-East should consider in the near future the importance of this technology as standard care in teaching advance endodontics. An advance workshops should be organized regularly to provide enough knowledge about this standard educational technology.

United States Air Force Summer Faculty Research Program 1989. Program Technical Report. Volume 3

Science.gov (United States)

1989-12-01

351-2807 R. H. Cofer Degree: PhD Professor Specialty: Electrical Eng. Florida Institute Assigned: Avionics Laboratory 150 W. University Blvd. Melbourne ...West University Blvd. Melbourne , FL 32901 407\\768-8000 Ernest Hallford Degree: PhD Assistant Prof. Specialty: Psychology Moorhead State Univ. Assigned...3. Henisch, Heinz K., Semiconductor Contacts: An Approach to Ideas and Models, Oxford, England, Clarendon Press, 1984. 118-15 1989 USAF-UES SUMMER

Problema Basarabiei reflectată în rapoartele ambasadorului francez la Petersburg Charles Auguste de Morny (1856-1857 / Bessarabian question reflected in the reports of the French ambassador in Petersburg Charles Auguste de Morny (1856-1857

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Eugen-Tudor Sclifos

2016-10-01

Full Text Available After the Crimean War the Bessarabian question had an important place in the foreign policy of the Great Powers. During the preliminaries of peace in 1855 it was decided that Russia should cede Southern Bessarabia to the Principality of Moldavia. Russia, of course, did not accept this point and at the Congress of Paris proposed a territorial exchange - the condition unacceptable to British diplomats. Thus it was created a commission to study the problem of border delimitation in Bessarabia. In August 1856, Charles Auguste de Morny, half-brother of Emperor Napoleon III, was appointed Ambassador to St. Petersburg. Count de Morny was significantly involved in the solution of the Bessarabian question. According to documents from the archives of foreign policy in Paris, the diplomat was obsessed with the idea that Southern Bessarabia must remain part of the Russian Empire and tried to convince the Emperor Napoleon III and Count Walewski that France should support the Russian point of view. De Morny had a rival, Count Persigny, the French Ambassador in London, who believed that this area should be part of the Principality of Moldavia. After long negotiations the Bessarabian question was resolved not in favor of Russia.

Effects of heated discharge on fish and invertebrates of White River at Petersburg, Indiana. Report of investigation No. 6

International Nuclear Information System (INIS)

Whitaker, J.O. Jr.; Schlueter, R.A.; Proffitt, M.A.

1973-12-01

This report is based upon data gathered from June, 1971 through October, 1972, as part of continuing studies initiated to determine the effects of heated water on aquatic resources of the White River at Petersburg, Indiana. The heated effluent is discharged into the river by an electric generating station. Emphasis was placed on the distribution and abundance of smaller fish and invertebrates. A primary concern was to determine if the heated water affected the food habits, external parasites, or reproduction of the fishes. Sampling was continued through the winter to determine effects of heated discharge during the colder parts of the year. Results showed that differences can be found between heated and unheated water. However, the differences are rather minor and it is not always clear that they relate to temperature. Some may relate to other habitat factors. Other than in the effluent canal itself, where populations of organisms are much depressed, no evidence of major harmful effects caused by heated water were found

6. Seminar of the IIE-ININ-IMP on technological specialties. Topic 4: dynamics

International Nuclear Information System (INIS)

1992-01-01

The document includes 7 papers presented at the 6. Seminar of the IIE-ININ-IMP (Mexico) on technological specialties in the field of dynamics. (Topic 4). One item was in INIS subject scope and a separate abstract was prepared for it

Oral speech teaching to students of mathematic specialties: a grammatical aspect

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Ibragimov I.I.

2016-08-01

Full Text Available the paper considers teaching features of English speech grammar aspects. The case studies include undergraduates of mathematical specialties. The content of students’ educational activity at the final stage of language teaching is pointed out. Besides the structure of grammar section, a special didactic training unit in which framework mastering grammar phenomena used in oral speech takes place is described.

Prediction of specialty coffee cup quality based on near infrared spectra of green coffee beans.

Science.gov (United States)

Tolessa, Kassaye; Rademaker, Michael; De Baets, Bernard; Boeckx, Pascal

2016-04-01

The growing global demand for specialty coffee increases the need for improved coffee quality assessment methods. Green bean coffee quality analysis is usually carried out by physical (e.g. black beans, immature beans) and cup quality (e.g. acidity, flavour) evaluation. However, these evaluation methods are subjective, costly, time consuming, require sample preparation and may end up in poor grading systems. This calls for the development of a rapid, low-cost, reliable and reproducible analytical method to evaluate coffee quality attributes and eventually chemical compounds of interest (e.g. chlorogenic acid) in coffee beans. The aim of this study was to develop a model able to predict coffee cup quality based on NIR spectra of green coffee beans. NIR spectra of 86 samples of green Arabica beans of varying quality were analysed. Partial least squares (PLS) regression method was used to develop a model correlating spectral data to cupping score data (cup quality). The selected PLS model had a good predictive power for total specialty cup quality and its individual quality attributes (overall cup preference, acidity, body and aftertaste) showing a high correlation coefficient with r-values of 90, 90,78, 72 and 72, respectively, between measured and predicted cupping scores for 20 out of 86 samples. The corresponding root mean square error of prediction (RMSEP) was 1.04, 0.22, 0.27, 0.24 and 0.27 for total specialty cup quality, overall cup preference, acidity, body and aftertaste, respectively. The results obtained suggest that NIR spectra of green coffee beans are a promising tool for fast and accurate prediction of coffee quality and for classifying green coffee beans into different specialty grades. However, the model should be further tested for coffee samples from different regions in Ethiopia and test if one generic or region-specific model should be developed. Copyright © 2015 Elsevier B.V. All rights reserved.

Les couleurs de Moscou et de Saint-Pétersbourg The colours of Moscow and Saint Petersburg

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Andréi Éfimov

2008-05-01

Full Text Available Moscou et Saint-Pétersbourg ont connu une évolution chromatique similaire mais les différences en matière de plan, d’urbanisme et d’influences culturelles, et leurs rôles alternés de capitale ont déterminé leurs particularités chromatiques propres. Le Moscou en bois du xiiie siècle s’est enrichi d’un ensemble de cathédrales blanches aux coupoles dorées entourées par la muraille en brique rouge du Kremlin. Le style baroque a introduit dans l’architecture de Moscou et de Saint-Pétersbourg les couleurs bleu foncé, orange et verte. À l’époque du classicisme, on utilisait la palette officielle de teintes pastel à dominante ocre. L’achromatisme devient ensuite un trait distinctif de l’éclectisme en Russie. Au début du XXe siècle, l’Art nouveau ranime les villes grâce aux couleurs verte, orange et violette. Dans les années 1920 et 1930, les constructivistes utilisent les tons gris mais tentent d’élaborer un code chromatique homogène. L’architecture soviétique, quant à elle, reprend l’esthétique du classicisme « ocre ». La construction de masse des années 1960 aux années 1980 méconnaît la couleur, mais à la charnière des XXe et XXIe siècles apparaissent des approches professionnelles qui visent à créer un milieu chromatique similaire pour les deux villes.Moscow and Saint Petersburg experienced similar evolutions in colour, but the differences in their plans, urbanity and cultural influences, and their alternating roles as capitals, determined the particularities of their palettes. The wooden Moscow of the thirteenth century was enriched by a group of white cathedrals with golden domes, surrounded by the red brick wall of the Kremlin. Baroque, as an architectural style, introduced Moscow and Saint Petersburg to the colours dark blue, orange, and green. The official palette of classicism was pastel, predominantly ochre, while the period of eclecticism in Russia was achromatic. At the

Mortality in HIV-Infected Alcohol and Drug Users in St. Petersburg, Russia.

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Nadia S Fairbairn

Full Text Available In Russia, up to half of premature deaths are attributed to hazardous drinking. The respective roles of alcohol and drug use in premature death among people with HIV in Russia have not been described. Criminalization and stigmatization of substance use in Russia may also contribute to mortality. We explored whether alcohol, drug use and risk environment factors are associated with short-term mortality in HIV-infected Russians who use substances. Secondary analyses were conducted using prospective data collected at baseline, 6 and 12-months from HIV-infected people who use substances recruited between 2007-2010 from addiction and HIV care settings in a single urban setting of St. Petersburg, Russia. We used Cox proportional hazards models to explore associations between 30-day alcohol hazardous drinking, injection drug use, polysubstance use and environmental risk exposures (i.e. past incarceration, police involvement, selling sex, and HIV stigma with mortality. Among 700 participants, 59% were male and the mean age was 30 years. There were 40 deaths after a median follow-up of 12 months (crude mortality rate 5.9 per 100 person-years. In adjusted analyses, 30-day NIAAA hazardous drinking was significantly associated with mortality compared to no drinking [adjusted Hazard Ratio (aHR 2.60, 95% Confidence Interval (CI: 1.24-5.44] but moderate drinking was not (aHR 0.95, 95% CI: 0.35-2.59. No other factors were significantly associated with mortality. The high rates of short-term mortality and the strong association with hazardous drinking suggest a need to integrate evidence-based alcohol interventions into treatment strategies for HIV-infected Russians.

Mortality in HIV-Infected Alcohol and Drug Users in St. Petersburg, Russia.

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Fairbairn, Nadia S; Walley, Alexander Y; Cheng, Debbie M; Quinn, Emily; Bridden, Carly; Chaisson, Christine; Blokhina, Elena; Lioznov, Dmitry; Krupitsky, Evgeny; Raj, Anita; Samet, Jeffrey H

2016-01-01

In Russia, up to half of premature deaths are attributed to hazardous drinking. The respective roles of alcohol and drug use in premature death among people with HIV in Russia have not been described. Criminalization and stigmatization of substance use in Russia may also contribute to mortality. We explored whether alcohol, drug use and risk environment factors are associated with short-term mortality in HIV-infected Russians who use substances. Secondary analyses were conducted using prospective data collected at baseline, 6 and 12-months from HIV-infected people who use substances recruited between 2007-2010 from addiction and HIV care settings in a single urban setting of St. Petersburg, Russia. We used Cox proportional hazards models to explore associations between 30-day alcohol hazardous drinking, injection drug use, polysubstance use and environmental risk exposures (i.e. past incarceration, police involvement, selling sex, and HIV stigma) with mortality. Among 700 participants, 59% were male and the mean age was 30 years. There were 40 deaths after a median follow-up of 12 months (crude mortality rate 5.9 per 100 person-years). In adjusted analyses, 30-day NIAAA hazardous drinking was significantly associated with mortality compared to no drinking [adjusted Hazard Ratio (aHR) 2.60, 95% Confidence Interval (CI): 1.24-5.44] but moderate drinking was not (aHR 0.95, 95% CI: 0.35-2.59). No other factors were significantly associated with mortality. The high rates of short-term mortality and the strong association with hazardous drinking suggest a need to integrate evidence-based alcohol interventions into treatment strategies for HIV-infected Russians.

Physician attitudes toward industry: a view across the specialties

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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

6. Seminar of the IIE-ININ-IMP on technological specialties. Topic 8: computation

International Nuclear Information System (INIS)

1992-01-01

The document includes 10 papers presented at the 6. Seminar of the IIE-ININ-IMP (Mexico) on technological specialties in the field of computation. (Topic 8). Three items were in INIS subject scope and a separate abstract was prepared for each of them

Epistemological Beliefs and Practices of Science Faculty with Education Specialties: Combining Teaching Scholarship and Interdisciplinarity

Science.gov (United States)

Addy, Tracie Marcella

2011-12-01

Across the United States institutions of higher education address educational reform by valuing scholarship that focuses on teaching and learning, especially in STEM fields. University science departments can encourage teaching scholarship by hiring science faculty with education specialties (SFES), individuals who have expertise in both science and science education. The goal of this study was to understand how the epistemological beliefs and teaching practices of SFES relate to national reform efforts in science teaching promoting student-centered instruction. The research questions guiding this investigation were: (1) What epistemological belief systems do science faculty with education specialties espouse concerning the teaching and learning of science?; and (2) What are the classroom practices of science faculty with education specialties? How are these practices congruent with the reform efforts described by the National Research Council (1996, 2001, 2003)? The theoretical framework guiding the study was interdisciplinarity, the integration of knowledge between two or more disciplines (science and science pedagogy). The research design employed mixed (qualitative and quantitative) approaches and focused on 25 volunteer SFES participants. The TBI, ATI, and RTOP were used to triangulate self-report and videotaped teaching vignettes, and develop profiles of SFES. Of the 25 SFES participants, 82 percent of their beliefs were transitional or student-centered beliefs. Seventy-two percent of the 25 SFES espoused more student-focused than teacher focused approaches. The classroom practices of 10 SFES were on average transitional in nature (at the boundary of student-focused and teacher-focused). The beliefs of SFES appeared to be influenced by the sizes of their courses, and were positive correlated with reform-based teaching practices. There was a relationship between the degree to which they implemented reform-based practice and their perceived level of

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

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

2018-01-01

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

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

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

2017-08-01

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

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

Science.gov (United States)

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

2015-08-01

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

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

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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.

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

8. Seminar of the IMP-IIE-ININ on technological specialties. Topic 10: Earth Sciences

International Nuclear Information System (INIS)

1996-01-01

The document contains two papers within INIS subject scope which were presented at the 8th Seminar of the IMP-IIE-ININ on technological specialties. Topic 10: Earth Sciences. A separate abstract was prepared for each paper

76 FR 2290 - TRICARE; Reimbursement for Travel for Specialty Care Under Exceptional Circumstances

Science.gov (United States)

2011-01-13

... or TRICARE Prime Remote. The Director, TRICARE Management Activity, shall issue procedures and... from members of the public is to make these submissions available for viewing on the Internet at http... live in certain more remote areas where there are insufficient numbers or types of specialty or...

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

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Vinícius Pedrazzi

2008-08-01

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

High prevalence of sexual dysfunction in a vulvovaginal specialty clinic

Science.gov (United States)

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

2014-01-01

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

Ethical issues in instructions to authors of journals in oral-craniomaxillofacial/facial plastic surgery and related specialties.

Science.gov (United States)

Pitak-Arnnop, Poramate; Bauer, Ute; Dhanuthai, Kittipong; Brückner, Martin; Herve, Christian; Meningaud, Jean-Paul; Hemprich, Alexander

2010-12-01

Ethical standards of biomedical publications are associated with editorial leadership, such as contents of instructions to authors and journal's mechanisms for research and publication ethics. To compare ethical issues in the guidelines for authors in oral-craniomaxillofacial/facial plastic surgery (OCM-FPS) journals with those in plastic surgery and otorhinolaryngology/head and neck surgery (ORL-HNS) journals, and to evaluate the relationship between journal's impact factor (IF) and ethical issues in the instructions to authors. This study used a cross-sectional study design. The predictor variables were journal's specialty and IF. The outcome variable was the presence of seven ethical issues in the online versions of journal's instructions to authors in October 2009. We included only journals with identifiable IF for 2008, published in English, French, German and Thai. Appropriate descriptive and univariate statistics were computed for all study variables. The level of statistical significance was set at Pjournals: seven OCM-FPS (14.6%), 14 plastic surgery (29.2%) and 27 ORL-HNS (56.2%) journals. Only four journals (8.3%) mentioned all ethical issues in their guidelines for authors. Neither journal's specialty nor IF was linked to completeness of the ethical requirements. The results of this study suggest that ethical issues in the instructions to authors of most IF-indexed journals in OCM-FPS, plastic surgery and ORL-HNS are incomplete, regardless of specialty and IF. There is room for substantial improvement to uphold scientific integrity of these surgical specialties. Copyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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

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Hamberg Katarina

2003-10-01

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

Motivators and barriers to HIV testing among street-based female sex workers in St. Petersburg, Russia.

Science.gov (United States)

King, Elizabeth J; Maman, Suzanne; Dudina, Victoria I; Moracco, Kathryn E; Bowling, J Michael

2017-07-01

Female sex workers are particularly susceptible to HIV-infection in Russia. However, a dearth of information exists on their utilisation of HIV services. A mixed-methods, cross-sectional study was conducted to examine motivators and barriers to HIV testing among street-based sex workers in St. Petersburg, Russia. The health belief model was the theoretical framework for the study. Twenty-nine sex workers participated in in-depth interviews, and 139 sex workers completed interviewer-administered surveys between February and September 2009. Barriers to getting an HIV test were fear of learning the results, worrying that other people would think they were sick, and the distance needed to travel to obtain services. Motivators for getting tested were protecting others from infection, wanting to know one's status and getting treatment if diagnosed. Logistic regression analysis demonstrated that knowing people living with HIV [aOR = 6.75, 95% CI (1.11, 41.10)] and length of time since start of injection drug use [aOR = 0.30, 95% CI (0.09, 0.97)] were significantly associated with recently getting tested. These results are important to consider when developing public health interventions to help female sex workers in Russia learn their HIV status and get linked to care and treatment services if needed.

How to Avoid Fragility of Financial Systems: Lessons from the Financial Crisis and St. Petersburg Paradox

Science.gov (United States)

Takayasu, Hideki

Firstly, I point out that the financial crisis occurred in 2008 has many analogous points with a physical phenomenon of brittle fracture in the sense that it is a highly irreversible phenomenon caused by concentration of stress to the weakest point. Then, I discuss distribution of gain-loss of continuous transactions of options which can be regarded as a source of stress among financial companies. The historical problem of Saint Petersburg paradox is reviewed and it is argued that the paradox is solved by decomposing the process into a combination of a fair gamble and an accompanied financial option. By generalizing this fair gamble it is shown that the gain-loss distribution in this problem is closely related to the distribution of gain-loss of business firms in the real world. Finally, I pose a serious question to the ordinary way of financing money to business firms with compound interest rates. Instead we introduce a new way of financing business firms without applying prefixed interest rates, in which financial stress is shared by all involved firms. This method is expected to reduce the risk of both financial firms and business firms, and is applicable even in the non-growing society.

Large quaternary landslides in the central appalachian valley and ridge province near Petersburg, West Virginia

Science.gov (United States)

Southworth, C. Scott

1988-01-01

Geological mapping and photointerpretation of side-looking airborne radar images and color-infrared aerial photographs reveal two large Quaternary landslides in the Valley and Ridge province of the central Appalachians near Petersburg, W. Va. The Elkhorn Mountain rock avalanche occurs on the thrust-faulted northwestern flank of the Elkhorn Mountain anticlinorium. A minimum of 7 ?? 106 m3 of quartzite colluvium was transported more than 3 km from a 91 m high escarpment of Silurian Tuscarora Quartzite. The extensively vegetated deposit may owe, in part, its transport and weathering to periglacial conditions during the Pleistocene. In contrast, the Gap Mountain rock block slide is a single allochthonous block that is 1.2 km long, 0.6 km wide, and at least 60 m thick. The 43 ?? 106 m3 block is composed of limestone of the Helderberg Group and the Oriskany Sanstone of Early Devonian age. Planar detachment probably occurred along a dissolution bedding plane near the Shriver Chert and the Oriskany Sandstone contact. Failure probably was initiated by downcutting of the South Branch Potomac River during the Pleistocene. Landslides of this magnitude suggest accelerated erosion during periglacial climates in the Pleistocene. The recognition of these large slope failures may provide evidence of paleoclimatic conditions and, thereby, increase our understanding of the geomorphologic development of the Valley and Ridge province. ?? 1988.

PHARMACOEPIDEMIOLOGY OF CARBAPENEMS APPLICATION AMONG THE PREMATURE NEWBORNS IN SAINT PETERSBURG. WORLD EXPERIENCE IN NEONATOLOGY

Directory of Open Access Journals (Sweden)

A.S. Kolbin

2008-01-01

Full Text Available Premature newborns are a high risk group in terms of the infection complications growth. therefore, it is highly urgent to choose the efficient and safe antibacterial medications for the given category of patients. The authors carried out a pharma coepidemiological study of the carbapenems application among 353 newborns with very low body weight at birth, as well as the literature analysis on the use of this medications group in compliance with the evidence based medicine. As a result, they showed that for the last 8 years the frequency of the carbapenems application in Saint-Petersburg among the newborns has grown from 10 to 52%. It is statistically accurate that imipenem/cilastatin was more often used to the amount of 25 mg/kg twice a day. In 71% of cases, carbapenems were applied in the form of the empiric therapy against the general bacterial infection in combination with vancomycin and/or metronidazole. Antibiotics proved to be safe. The literature analysis showed that there is no data, which would allow one to compare the efficiency of carbapenems with other antibiotics among the newborns based on the results of the meta analyses and randomized clinical studies. Nowadays, carbapenems demonstrated high efficiency and safety in the small clinical observations.Key words: carbapenems, imipenem, meropenem, newborns with very low body weight at birth.

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

Science.gov (United States)

Grey, Michael L.

2009-01-01

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

The impact of intensivists' base specialty of training on care process and outcomes of critically ill trauma patients.

Science.gov (United States)

Matsushima, Kazuhide; Goldwasser, Eleanor R; Schaefer, Eric W; Armen, Scott B; Indeck, Matthew C

2013-09-01

The care of the critically ill trauma patients is provided by intensivists with various base specialties of training. The purpose of this study was to investigate the impact of intensivists' base specialty of training on the disparity of care process and patient outcome. We performed a retrospective review of an institutional trauma registry at an academic level 1 trauma center. Two intensive care unit teams staffed by either board-certified surgery or anesthesiology intensivists were assigned to manage critically ill trauma patients. Both teams provided care, collaborating with a trauma surgeon in house. We compared patient characteristics, care processes, and outcomes between surgery and anesthesiology groups using Wilcoxon tests or chi-square tests, as appropriate. We identified a total of 620 patients. Patient baseline characteristics including age, sex, transfer status, injury type, injury severity score, and Glasgow coma scale were similar between groups. We found no significant difference in care processes and outcomes between groups. In a logistic regression model, intensivists' base specialty of training was not a significant factor for mortality (odds ratio, 1.46; 95% confidence interval; 0.79-2.80; P = 0.22) and major complication (odds ratio, 1.11; 95% confidence interval, 0.73-1.67; P = 0.63). Intensive care unit teams collaborating with trauma surgeons had minimal disparity of care processes and similar patient outcomes regardless of intensivists' base specialty of training. Copyright © 2013 Elsevier Inc. All rights reserved.

Collaboration to Unlock Access : Presentations at the LIBER Conference in ST Petersburg

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Frederick J. Friend

2004-09-01

Full Text Available The opportunities provided by open access to journal literature have generated much interest and discussion. LIBER's approach to this important topic at the St Petersburg Conference was through the theme of collaboration. Each group of stakeholders in scholarly communication, from author through to reader, has an interest in open access. If open access is to be achieved it has to be through collaboration between authors, funding agencies, publishers and librarians working together in the best interests of readers of academic literature. The benefits to individuals and to human society to be gained from open access are described in this quotation from the Budapest Open Access Initiative: "An old tradition and a new technology have converged to make possible an unprecedented public good. The old tradition is the willingness of scientists and scholars to publish the fruits of their research in scholarly journals without payment, for the sake of inquiry and knowledge. The new technology is the internet. The public good they make possible is the world-wide electronic distribution of the peer-reviewed journal literature and completely free and unrestricted access to it by all scientists, scholars, teachers, students, and other curious minds. Removing access barriers to this literature will accelerate research, enrich education, share the learning of the rich with the poor and the poor with the rich, make this literature as useful as it can be, and lay the foundation for uniting humanity in a common intellectual conversation and quest for knowledge." Since calling the meeting which developed the Budapest Open Access Initiative, the Open Society Institute has continued to support discussion and action to implement the two strategies leading to open access identified in Budapest, and the open access session at the LIBER Conference was supported by a grant from OSI.

Optimizing the pre-referral workup for gastroenterology and hepatology specialty care: consensus using the Delphi method.

Science.gov (United States)

Ho, Chanda K; Boscardin, Christy K; Gleason, Nathaniel; Collado, Don; Terdiman, Jonathan; Terrault, Norah A; Gonzales, Ralph

2016-02-01

Specialty care referrals have doubled in the last decade. Optimization of the pre-referral workup by a primary care doctor can lead to a more efficient first specialty visit with the patient. Guidance regarding pre-referral laboratory testing is a first step towards improving the specialty referral process. Our aim was to establish consensus regarding appropriate pre-referral workup for common gastrointestinal and liver conditions. The Delphi method was used to establish local consensus for recommending certain laboratory tests prior to specialty referral for 13 clinical conditions. Seven conditions from The University of Michigan outpatient referral guidelines were used as a baseline. An expert panel of three PCPs and nine gastroenterologists from three academic hospitals participated in three iterative rounds of electronic surveys. Each panellist ranked each test using a 5-point Likert scale (strongly disagree to strongly agree). Local panellists could recommend additional tests for the initial diagnoses, and also recommended additional diagnoses needing guidelines: iron deficiency anaemia, abdominal pain, irritable bowel syndrome, fatty liver disease, liver mass and cirrhosis. Consensus was defined as ≥70% of experts scoring ≥4 (agree or strongly agree). Applying Delphi methodology to extrapolate externally developed referral guidelines for local implementation resulted in considerable modifications. For some conditions, many tests from the external group were eliminated by the local group (abdominal bloating; iron deficiency anaemia; irritable bowel syndrome). In contrast, for chronic diarrhoea, abnormal liver enzymes and viral hepatitis, all/most original tests were retained with additional tests added. For liver mass, fatty liver disease and cirrhosis, there was high concordance among the panel with few tests added or eliminated. Consideration of externally developed referral guidelines using a consensus-building process leads to significant local

Oncology/haematology nurses: a study of job satisfaction, burnout, and intention to leave the specialty.

Science.gov (United States)

Barrett, Linda; Yates, Patsy

2002-01-01

The impact of the current nursing shortage on the health care system is receiving attention by both state and federal governments. This study, using a convenience sample of 243 oncology/haematology nurses working in 11 Queensland health care facilities, explored factors that influence the quality of nurses' working lives. Although nurses reported high levels of personal satisfaction and personal accomplishment, results indicated that nearly 40% of registered nurses (RNs) are dealing with workloads they perceive excessive, 48% are dissatisfied regarding pay, and professional support is an issue. Furthermore, emotional exhaustion is a very real concern: over 70% of the sample experienced moderate to high levels. Over 48% of the sample could not commit to remaining in the specialty for a further 12 months. Health care managers and governments should implement strategies that can increase nurses' job satisfaction and reduce burnout, thereby enhancing the retention of oncology/haematology nurses.

Петербургский текст русской литературы и Вильнюсский текст литовской литературы: еще раз об аналитическом потенциале концепции В. Н. Топорова | The Petersburg text of Russian literature and the Vilnius text of Lithuanian literature: once again on the analytical visa of Vladimir Toporov’s concept

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Inga Vidugiryte

2013-12-01

Full Text Available The Petersburg text of Russian literature and the Vilnius text of Lithuanian literature: once again on the analytical visa of Vladimir Toporov’s concept Inga Vidugiryte Summary The concept Petersburg text by Toporov is criticized for its mythological essence, for the confusion of the languages of the object and the analysis in its description, and for the very attempt to create a mental space in which one can escape politics and ideology. The point of such critique is that the concept of Petersburg text is a product of the Soviet era and its highly ideologized atmosphere, as well as of the wish of the intellectuals not to participate in it. Nevertheles, there is a range of texts of cities or regions made by analogy with the Petersburg text (e.g., Moscow, Permj, Siberian, Crimean texts in the recent Russian humanities. In this article, the author makes an attempt to show the actuality of the Toporov’s concept by comparing it with the modern geocritical theory that does not make a strict separation between cities and texts and treats them as transgressive and mobile. On the other hand, it is stated that the concept of Toporov gains its actuality in discussing the text of the city in its relation to the main historical event of the nation, viz. the founding of Petersburg. This thesis could be proved by applying the notion to Vilnius and its literature. The main event of the modern Lithuanian history concerning Vilnius is the fact that it was given over to Lithuania in 1939. It took another 40 years to create the Vilnius text of Lithuanian literature, in which heroes and their stories are inseparable from the city and its history as well as from its topography. This means that Vilnius and its semiotics have been assimilated by Lithuanian culture, and the city has acquired its text.

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

Science.gov (United States)

Kobryn, Nadia

2015-01-01

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

75 FR 52989 - Specialty Minerals, Inc., Franklin, VA; Notice of Negative Determination Regarding Application...

Science.gov (United States)

2010-08-30

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,057] Specialty Minerals, Inc., Franklin, VA; Notice of Negative Determination Regarding Application for Reconsideration By applications dated July 9, 2010 and July 16, 2010 (filed by a company official and a worker, respectively...

6. Seminar of the IIE-ININ-IMP on technological specialties. Topic 7: energy savings

International Nuclear Information System (INIS)

1992-01-01

The document includes 6 papers presented at the 6. Seminar of the IIE-ININ-IMP (Mexico) on technological specialties in the field of energy savings. (Topic 7). One item was in INIS subject scope and a separate abstract was prepared for it

Dentistry's oldest specialty: orthodontics and dentofacial orthopedics.

Science.gov (United States)

George, Raymond

2009-01-01

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

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.

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

Science.gov (United States)

Zevallos, Leslie; Pastor, Reyna; Moscoso, Betsy

2011-06-01

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

Variables associated with the performance of Centers for Dental Specialties in Brazil.

Science.gov (United States)

Cortellazzi, Karine Laura; Balbino, Edna Cesar; Guerra, Luciane Miranda; Vazquez, Fabiana de Lima; Bulgareli, Jaqueline Vilela; Ambrosano, Glaucia Maria Bovi; Pereira, Antonio Carlos; Mialhe, Fábio Luiz

2014-12-01

The aim of this study was to evaluate the performance of the Centers for Dental Specialties (CDS) in the country and associations with sociodemographic indicators of the municipalities, structural variables of services and primary health care organization in the years 2004-2009. The study used secondary data from procedures performed in the CDS to the specialties of periodontics, endodontics, surgery and primary care. Bivariate analysis by χ2 test was used to test the association between the dependent variable (performance of the CDS) with the independents. Then, Poisson regression analysis was performed. With regard to the overall achievement of targets, it was observed that the majority of CDS (69.25%) performance was considered poor/regular. The independent factors associated with poor/regular performance of CDS were: municipalities belonging to the Northeast, South and Southeast regions, with lower Human Development Index (HDI), lower population density, and reduced time to deployment. HDI and population density are important for the performance of the CDS in Brazil. Similarly, the peculiarities related to less populated areas as well as regional location and time of service implementation CDS should be taken into account in the planning of these services.

The demand for ambulatory mental health services from specialty providers.

Science.gov (United States)

Horgan, C M

1986-01-01

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

6. Seminar of the IIE-ININ-IMP on technological specialties. Topic 13: earth sciences

International Nuclear Information System (INIS)

1992-01-01

The document includes 12 papers presented at the 6. Seminar of the IIE-ININ-IMP (Mexico) on technological specialties in the field of earth sciences. (Topic 13). Four items were in INIS subject scope and a separate abstract was prepared for each of them

75 FR 6377 - Onyx Specialty Papers, Inc.; Notice of Availability of Draft Environmental Assessment

Science.gov (United States)

2010-02-09

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 2985-006] Onyx Specialty Papers, Inc.; Notice of Availability of Draft Environmental Assessment February 2, 2010. In accordance... lieu of paper. The Commission strongly encourages electronic filings. See 18 CFR 385.2001(a)(1)(iii...

Similarities and differences in curricula of a bachelor’s degree in oceanology at the universities in St Petersburg, Klaipeda, and Kaliningrad

Directory of Open Access Journals (Sweden)

Gritsenko Vladimir

2012-12-01

Full Text Available Conducting a multi-aspect comparative analysis of curricula of bachelor’s degree programmes in oceanology offered at universities in St Petersburg, Klaipeda and Kaliningrad, the authors trace similarities between the existing variants of oceanologist training in the context of competence modules, disciplines, the so-called academic practices, and the number of hours and credits stipulated in the existing curricula. A formal comparison of generalised quantitative indicators without analysing the content of curriculum components demonstrated certain similarities in all indicators in terms of workload, the number of disciplines (50, 56 and 45 and academic practices. The clustering of competence modules and disciplines at each university within generalised academic areas — physics and mathematics, philosophy, informatics and computers, geoecology, measurement disciplines, etc. — made a more detailed comparison possible. The results of research demonstrate considerable similarities in the curricula used at the given universities in terms of all variants of comparison. The strongest similarity is observed in the areas of basic and professional disciplines.

Five-year trends in epidemiology and prevention of mother-to-child HIV transmission, St. Petersburg, Russia: results from perinatal HIV surveillance

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Kissin Dmitry M

2011-10-01

Full Text Available Abstract Background The HIV epidemic in Russia has increasingly involved reproductive-aged women, which may increase perinatal HIV transmission. Methods Standard HIV case-reporting and enhanced perinatal HIV surveillance systems were used for prospective assessment of HIV-infected women giving birth in St. Petersburg, Russia, during 2004-2008. Trends in social, perinatal, and clinical factors influencing mother-to-child HIV transmission stratified by history of injection drug use, and rates of perinatal HIV transmission were assessed using two-sided χ2 or Cochran-Armitage tests. Results Among HIV-infected women who gave birth, the proportion of women who self-reported ever using injection drugs (IDUs decreased from 62% in 2004 to 41% in 2008 (P P P P for trend Conclusions Reduced proportion of IDUs and improved clinical services among HIV-infected women giving birth were accompanied by decreased perinatal HIV transmission, which can be further reduced by increasing outreach and HIV testing of women before and during pregnancy.

High HIV Prevalence, Suboptimal HIV Testing, and Low Knowledge of HIV-Positive Serostatus Among Injection Drug Users in St. Petersburg, Russia

Science.gov (United States)

Toussova, Olga V.; Verevochkin, Sergei V.; Barbour, Russell; Heimer, Robert; Kozlov, Andrei P.

2011-01-01

The purpose of this analysis was to estimate human immunodeficiency virus (HIV) prevalence and testing patterns among injection drug users (IDUs) in St. Petersburg, Russia. HIV prevalence among 387 IDUs in the sample was 50%. Correlates of HIV-positive serostatus included unemployment, recent unsafe injections, and history/current sexually transmitted infection. Seventy-six percent had been HIV tested, but only 22% of those who did not report HIV-positive serostatus had been tested in the past 12 months and received their test result. Correlates of this measure included recent doctor visit and having been in prison or jail among men. Among the 193 HIV-infected participants, 36% were aware of their HIV-positive serostatus. HIV prevalence is high and continuing to increase in this population. Adequate coverage of HIV testing has not been achieved, resulting in poor knowledge of positive serostatus. Efforts are needed to better understand motivating and deterring factors for HIV testing in this setting. PMID:18843531

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

6. Seminar of the IIE-ININ-IMP on technological specialties. Topic 3: thermal fluids

International Nuclear Information System (INIS)

1992-01-01

The document includes 10 papers presented at the 6. Seminar of the IIE-ININ-IMP (Mexico) on technological specialties in the field of thermal fluids. (Topic 3). From these, 4 papers were in INIS subject scope and a separate abstract was prepared for each of them

Evaluation of HIV testing recommendations in specialty guidelines for the management of HIV indicator conditions

DEFF Research Database (Denmark)

Lord, E; Stockdale, A J; Malek, R

2017-01-01

OBJECTIVES: European guidelines recommend HIV testing for individuals presenting with indicator conditions (ICs) including AIDS-defining conditions (ADCs). The extent to which non-HIV specialty guidelines recommend HIV testing in ICs and ADCs is unknown. Our aim was to pilot a methodology in the UK...... are piloting methods to engage with guideline development groups to ensure that patients diagnosed with ICs/ADCs are tested for HIV. We then plan to apply our methodology in other European settings as part of the Optimising Testing and Linkage to Care for HIV across Europe (OptTEST) project....... to review specialty guidelines and ascertain if HIV was discussed and testing recommended. METHODS: UK and European HIV testing guidelines were reviewed to produce a list of 25 ADCs and 49 ICs. UK guidelines for these conditions were identified from searches of the websites of specialist societies...

Lipid components and oxidative status of selected specialty oils

Directory of Open Access Journals (Sweden)

P. Madawala, S. R.

2012-06-01

Full Text Available Many vegetable oils are marketed as specialty oils because of their retained flavors, tastes and distinct characteristics. Specialty oil samples which were commercially produced and retailed were purchased from local superstores in Reading, UK, and Uppsala, Sweden and profiled for detailed lipid composition and oxidative status. These oil samples include: almond, hazelnut, walnut, macadamia nut, argan, avocado, grape seed, roasted sesame, rice bran, cold pressed, organic and cold pressed, warm pressed and refined rapeseed oils. The levels of PV were quite low (0.5-1.3mEq O₂/kg but AV and Rancimat values at 100 °C (except for rapeseed oils varied considerably at (0.5-15.5 and (4.2-37.0 h respectively. Macadamia nut oil was found to be the most stable oil followed by argan oil, while walnut oil was the least stable. Among the specialty oils, macadamia nut oil had the lowest (4% and walnut oil had the highest (71% level of total PUFA. The organic cold pressed rapeseed oil had considerably lower PUFA (27% compared with other rapeseed oils (28- 35%. In all the samples, α- and γ- tocopherols were the major tocopherols; nut oils had generally lower levels. Total sterols ranged from 889 to 15,106 μg/g oil. The major sterols were β-sitosterol (61-85% and campesterol (6-20%. Argan oil contained schottenol (35% and spinasterol (32%. Compared with literature values, no marked differences were observed among the differently processed, organically grown or cold pressed rapeseed oils and other specialty oils in this study.

Muchos aceites vegetales se venden como aceites especiales debido a su flavor, gusto y características distintas. Muestras de aceites especiales de almendra, avellana, nuez, nuez de macadamia, argán, aguacate, semillas de uva, de sésamo tostadas, salvado de arroz, y aceites orgánico de semillas de colza prensado en frío y, prensado caliente, y refinados que se producen y comercializan al por menor, se obtuvieron en

Evaluation of the influence exerted by different dental specialty backgrounds and measuring instrument reproducibility on esthetic aspects of maxillary implant-supported single crown.

Science.gov (United States)

Vaidya, Samriddhi; Ho, Yu Lau Elaine; Hao, Jie; Lang, Niklaus P; Mattheos, Nikos

2015-03-01

To evaluate the influence exerted by different dental specialty backgrounds as well as the validity and reproducibility of the Pink Esthetic Score/White Esthetic Score (PES/WES) and the modified Implant Crown Aesthetic Index (mod-ICAI) on the assessment of esthetic aspects of maxillary implants supported single-tooth prosthesis. A total of fourteen examiners (Two orthodontists, two prosthodontists, two oral surgeons, two periodontists, two dental technicians, two dental assistants, and two postgraduate students in Implant Dentistry evaluated 20 photographs of single-implant-supported crowns and five photographs of unrestored teeth of esthetic zone in a two part study. The examiners assessed the photographs with each index (Pink Esthetic Score/White Esthetic Score and modified Implant Crown Aesthetic Index), twice with a week's interval. Orders of photographs were rearranged in the second assessment. Kruskal-Wallis test results showed significant differences among all the six specialties (P ≤ 0.001). DAs and periodontists had significantly better ratings than other specialties with both indices. Prosthodontists had the lowest mean rank scores regardless of the index. Interobserver agreement was also lowest between the two prosthodontists (4-28%), rest of the groups had low-to-moderate agreement (20-80%) when limited allowance was accepted. With mod-ICAI, more interobserver agreement was noted within the specialty group than with PES/WES. The PES/WES and the modified ICAI can be reliable estimates of esthetic outcomes. The assessor degree of specialization affected the esthetic evaluation with both the PES/WES and the modified ICAI. DAs and periodontists were identified to provide more favorable ratings than other specialties while prosthodontists were most critical in this study. With modified ICAI, more interobserver agreement within specialty resulted. The interexaminer agreement may be increased if more tolerance of 1-2 points is considered. © 2014 John Wiley

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

NARCIS (Netherlands)

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

2011-01-01

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

[CLASSIFICATION OF ACUTE PANCREATITIS: CURRENT STATE OF THE ISSUE].

Science.gov (United States)

Bagnenko, S F; Gol'tsov, V P; Savello, V E; Vashetko, R V

2015-01-01

The article analyzed disadvantages of "Atlanta-92" classification of acute pancreatitis and its two modifications: APCWG-2012 and IAP-2011. The school of Saint-Petersburg pancreatologists suggested the classification AP of Russian Surgical Society (2014), which represented the concept of disease staging.

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

Science.gov (United States)

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

2015-08-05

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

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.

78 FR 79658 - Okanagan Specialty Fruits, Inc.; Availability of Plant Pest Risk Assessment and Environmental...

Science.gov (United States)

2013-12-31

..., DC, this 20th day of December 2013. Kevin Shea, Administrator, Animal and Plant Health Inspection... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service [Docket No. APHIS-2012-0025] Okanagan Specialty Fruits, Inc.; Availability of Plant Pest Risk Assessment and Environmental Assessment...

The relation between specialty choice of psychology students and their interests, personality, and cognitive abilities

NARCIS (Netherlands)

Wicherts, J.M.; Vorst, H.C.M.

2010-01-01

The aim of this longitudinal study was to investigate differences in interests, personality, and cognitive abilities between students majoring in the six specialties of psychology at the University of Amsterdam. Results show that students at Social Psychology and Work and Organizational Psychology

Specialty resident perceptions of the impact of a distributed education model on practice location intentions.

Science.gov (United States)

Myhre, Douglas L; Adamiak, Paul J; Pedersen, Jeanette S

2015-01-01

There is an increased focus internationally on the social mandate of postgraduate training programs. This study explores specialty residents' perceptions of the impact of the University of Calgary's (UC) distributed education rotations on their self-perceived likelihood of practice location, and if this effect is influenced by resident specialty or stage of program. Residents participating in the UC Distributed Royal College Initiative (DistRCI) between July 2010 and June 2013 completed an online survey following their rotation. Descriptive statistics and student's t-test were employed to analyze quantitative survey data, and a constant comparative approach was used to analyze free text qualitative responses. Residents indicated they were satisfied with the program (92%), and that the distributed rotations significantly increased their self-reported likelihood of practicing in smaller centers (p education program in contributing to future practice and career development, and its relevance in the social accountability of postgraduate programs.

Assessment of operative times of multiple surgical specialties in a public university hospital.

Science.gov (United States)

Costa, Altair da Silva

2017-01-01

To evaluate the indicators duration of anesthesia, operative time and time patients stay in the operating rooms of different surgical specialties at a public university hospital. It was done by a descriptive cross-sectional study based on the operating room database. The following stages were measured: duration of anesthesia, procedure time and patient length of stay in the room of the various specialties. We included surgeries carried out in sequence in the same room, between 7:00 a.m. and 5 p.m., either elective or emergency. We calculated the 80th percentile of the stages, where 80% of procedures were below this value. The study measured 8,337 operations of 12 surgical specialties performed within one year. The overall mean duration of anesthesia of all specialties was 178.12±110.46 minutes, and the 80th percentile was 252 minutes. The mean operative time was 130.45±97.23 minutes, and the 80th percentile was 195 minutes. The mean total time of the patient in the operating room was 197.30±113.71 minutes, and the 80th percentile was 285 minutes. Thus, the variation of the overall mean compared to the 80th percentile was 41% for anesthesia, 49% for surgeries and 44% for operating room time. In average, anesthesia took up 88% of the operating room period, and surgery, 61%. This study identified patterns in the duration of surgery stages. The mean values of the specialties can assist with operating room planning and reduce delays. Avaliar os indicadores de tempo da anestesia, da operação e da permanência do paciente em sala de diversas especialidades do centro cirúrgico de um hospital universitário. Foi realizado em estudo descritivo transversal a partir da base de dados do centro cirúrgico e mensuradas as seguintes etapas: duração de anestesia, tempo do procedimento e tempo de permanência do paciente em sala das diversas especialidades. Foram incluídas as operações realizadas em sequência na mesma sala, das 7h às 17h, eletivas ou de urg

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

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.

Contraception use and unplanned pregnancies among injection drug-using women in St Petersburg, Russia.

Science.gov (United States)

Abdala, Nadia; Kershaw, Trace; Krasnoselskikh, Tatiana V; Kozlov, Andrei P

2011-07-01

This cross-sectional study estimated the prevalence of contraceptive methods and investigated whether abortion rates influence contraceptive behaviour among injection drug-using (IDU) women in St Petersburg, Russia. A self-administered questionnaire of behaviour in the last 3 months was applied to a convenient sample of IDU women. Of 80 sexually active participants, 67% had had an abortion. No participant reported using hormonal contraceptives or intrauterine devices (IUDs). The only valid method of contraception used was condoms, which was reported by half of the participants. Consistent condom use was reported by 22% of participants and was no more likely among those who had an abortion. Condom use was significantly associated with having multiple or casual sex partners [prevalence ratio (PR) 1.75, 95% (confidence interval) CI 1.11-2.78, p = 0.01], having an IDU sex partner (PR 0.55, 95% CI 0.36-0.85, p = 0.029) and with a negative attitude toward condoms (PR 0.53, 95% CI 0.33-0.84, p = 0.01). Abortions were less likely among those who had multiple or casual sex partners (PR 0.69, 95% CI 0.49-0.97, p = 0.03). Despite the high prevalence of abortions among IDU women, none reported the use of hormonal contraception or IUDs. Having had an abortion was not associated with greater likelihood of using condoms. Participants mostly used condoms with casual or multiple sex partners, suggesting that condoms were used mainly to prevent HIV/sexually transmitted infection transmission and not to prevent pregnancy. Programmes to prevent unwanted pregnancies and reduce abortion-related health risks among this understudied vulnerable group are needed.

GENERAL PRINCIPLES OF EU (CRIMINAL LAW: LEGALITY, EQUALITY, NON-DISCRIMINATION, SPECIALTY AND NE BIS IN IDEM IN THE FIELD OF THE EUROPEAN ARREST WARRANT

Directory of Open Access Journals (Sweden)

NOREL NEAGU

2012-05-01

Full Text Available This article deals with the case law of the Court of Justice of the European Union in the field of the European arrest warrant, critically analysing the principles invoked in several decisions validating the European legislation in the field: legality, equality and non-discrimination, specialty, ne bis in idem. The author concludes that an area of freedom, security and justice could be built on these principles, but further harmonisation of legislation needs to be realised to avoid a ”journey to the unknown” for European citizens in respect to legislation of other member states of the EU.

76 FR 19467 - Mueller Steam Specialty Formerly Known As Core Industries Including Workers Whose Unemployment...

Science.gov (United States)

2011-04-07

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-73,851] Mueller Steam Specialty... to Apply for Worker Adjustment Assistance on October 7, 2010, applicable to workers of Mueller Steam... shows that workers separated from employment at the St. Pauls, North Carolina location of Mueller Steam...

Fostering Change from Within: Influencing Teaching Practices of Departmental Colleagues by Science Faculty with Education Specialties.

Science.gov (United States)

Bush, Seth D; Rudd, James A; Stevens, Michael T; Tanner, Kimberly D; Williams, Kathy S

2016-01-01

Globally, calls for the improvement of science education are frequent and fervent. In parallel, the phenomenon of having Science Faculty with Education Specialties (SFES) within science departments appears to have grown in recent decades. In the context of an interview study of a randomized, stratified sample of SFES from across the United States, we discovered that most SFES interviewed (82%) perceived having professional impacts in the realm of improving undergraduate science education, more so than in research in science education or K-12 science education. While SFES reported a rich variety of efforts towards improving undergraduate science education, the most prevalent reported impact by far was influencing the teaching practices of their departmental colleagues. Since college and university science faculty continue to be hired with little to no training in effective science teaching, the seeding of science departments with science education specialists holds promise for fostering change in science education from within biology, chemistry, geoscience, and physics departments.

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

Science.gov (United States)

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

2013-01-01

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

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

Directory of Open Access Journals (Sweden)

Christine M. Zachek

2012-09-01

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

77 FR 6774 - United States Standards for Grades of Eggplant

Science.gov (United States)

2012-02-09

... that mixing colors and/or types of eggplant in a specialty pack is a current marketing practice. The U... DEPARTMENT OF AGRICULTURE Agricultural Marketing Service [Doc. AMS-FV-11-0052] United States Standards for Grades of Eggplant AGENCY: Agricultural Marketing Service, USDA. ACTION: Notice. SUMMARY: The...

Purple Pelisse: A specialty fingerling potato with purple skin and flesh and medium specific gravity

Science.gov (United States)

Purple Pelisse is a specialty fingerling potato with purple skin and dark purple flesh. It has medium maturity and sets a large number of smooth, small, fingerling-shaped tubers. The tubers have medium specific gravity and high levels of antioxidants. This potato variety is mainly intended for the f...

75 FR 5152 - Ancor Specialties: A Division of Hoeganaes Corporation Ridgway, PA; Notice of Revised...

Science.gov (United States)

2010-02-01

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-71,251] Ancor Specialties: A..., resulted in a negative determination issued on October 15, 2009, was based on the finding that imports of... certification, and all workers in the group threatened with total or partial separation from employment on date...

Mapping change in scientific specialties: a scientometric case study of the development or artificial intelligence

NARCIS (Netherlands)

van den Besselaar, P.; Leydesdorff, L.

1996-01-01

Has an identifiable core of activities called AI been established, during the AI-boom in the eighties? Is AI already in a “paradigmatic” phase? There has been a lot of disagreement among commentators and specialists about the nature of Artificial Intelligence as a specialty. This makes AI an

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

Psychiatric symptoms, quality of life, and HIV status among people using opioids in Saint Petersburg, Russia.

Science.gov (United States)

Desrosiers, Alethea; Blokhina, Elena; Krupitsky, Evgeny; Zvartau, Edwin; Schottenfeld, Richard; Chawarski, Marek

2017-03-01

The Russian Federation is experiencing a very high rate of HIV infection among people who inject drugs (PWID). However, few studies have explored characteristics of people with co-occurring opioid use disorders and HIV, including psychiatric symptom presentations and how these symptoms might relate to quality of life. The current study therefore explored a.) differences in baseline psychiatric symptoms among HIV+ and HIV- individuals with opioid use disorder seeking naltrexone treatment at two treatment centers in Saint Petersburg, Russia and b.) associations between psychiatric symptom constellations and quality of life. Participants were 328 adults enrolling in a randomized clinical trial evaluating outpatient treatments combining naltrexone with different drug counseling models. Psychiatric symptoms and quality of life were assessed using the Brief Symptom Inventory and The World Health Organization Quality of Life-BREF, respectively. Approximately 60% of participants were HIV+. Those who were HIV+ scored significantly higher on BSI anxiety, depression, psychoticism, somatization, paranoid ideation, phobic anxiety, obsessive-compulsive, and GSI indexes (all pHIV-. A K-means cluster analysis identified three distinct psychiatric symptom profiles; the proportion of HIV+ was significantly greater and quality of life indicators were significantly lower in the cluster with the highest psychiatric symptom levels. Higher levels of psychiatric symptoms and lower quality of life indicators among HIV+ (compared to HIV-) individuals injecting drugs support the potential importance of combining interventions that target improving psychiatric symptoms with drug treatment, particularly for HIV+ patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Community reentry challenges after release from prison among people who inject drugs in St. Petersburg, Russia.

Science.gov (United States)

Cepeda, Javier A; Vetrova, Marina V; Lyubimova, Alexandra I; Levina, Olga S; Heimer, Robert; Niccolai, Linda M

2015-01-01

Little is known about the context of the post-release risk environment among formerly incarcerated people who inject drugs (PWID) in Russia. The purpose of this paper is to explore these challenges as they relate to reentry, relapse to injection opioid use, and overdose. The authors conducted 25 in-depth semi-structured interviews among PWID living in St Petersburg, Russia who had been incarcerated within the past two years. Participants were recruited from street outreach (n=20) and a drug treatment center (n=5). Emergent themes related to the post-release environment included financial instability, negative interactions with police, return to a drug using community, and reuniting with drug using peers. Many respondents relapsed to opioid use immediately after release. Those whose relapse occurred weeks or months after their release expressed more motivation to resist. Alcohol or stimulant use often preceded the opioid relapse episode. Among those who overdosed, alcohol use was often reported prior to overdosing on opioids. Future post-release interventions in Russia should effectively link PWID to social, medical, and harm reduction services. Particular attention should be focussed on helping former inmates find employment and overdose prevention training prior to leaving prison that should also cover the heightened risk of concomitant alcohol use. In addition to describing a syndemic involving the intersection of incarceration, injection drug use, poverty, and alcohol abuse, the findings can inform future interventions to address these interrelated public health challenges within the Russian setting.

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

Science.gov (United States)

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

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

Police sexual coercion and its association with risky sex work and substance use behaviors among female sex workers in St. Petersburg and Orenburg, Russia.

Science.gov (United States)

Odinokova, Veronika; Rusakova, Maia; Urada, Lianne A; Silverman, Jay G; Raj, Anita

2014-01-01

Extensive research documents that female sex workers (FSWs) in Russia are very vulnerable to abuses from police, including police sexual coercion. However, despite qualitative data suggesting abusive policing practices are more likely for FSWs contending with substance abuse issues and risky sex work contexts, there is a paucity of quantitative study evaluating these associations specifically in terms of police sexual coercion. Such research is needed to guide structural interventions to improve health and safety for FSWs in Russia and globally. The purpose of this study is to assess the prevalence of police sexual coercion among FSWs from two Russian cities, St. Petersburg and Orenburg, and to determine whether riskier sex work behaviors and contexts and substance use behaviors, including both IDU and risky alcohol use, are associated with increased risk for sexual coercion from police. FSWs in St. Petersburg and Orenburg were recruited via time-location and convenience sampling and completed structured surveys on demographics (age, education), sex work risks (e.g., violence during sex work) and substance use. Logistic regression analyses assessed associations of substance use and risky sex work with police sexual coercion, adjusting for demographics. Participants (N=896) were aged 15 and older (94% were 20+ years). Most (69%) reported past year binge alcohol use, and 48% reported IDU the day before. Half (56%) reported 4+ clients per day. Rape during sex work ever was reported by 64%. Police sexual coercion in the past 12 months was reported by 38%. In the multivariate model, both current IDU (AOR=2.09, CI=1.45-3.02) and past year binge alcohol use (AOR=1.46, CI=1.03-2.07) were associated with police sexual coercion, as was selling sex on the street (not in venues) (AOR=7.81, CI=4.53-13.48) and rape during sex work (AOR=2.04, CI=1.43-2.92). Current findings document the substantial role police sexual violence plays in the lives of FSWs in Russia. These findings

About training of Kazakh students of not language specialties basis of scientific speech

OpenAIRE

Ospanova D.

2016-01-01

The article discusses the process of written scientific speech training should include two components: teaching understanding and evaluating texts that make the scientific speech in all its substantive and problematic species and learning the rules of creating texts in the chosen specialty. The idea about functional languages develops in the theory vernaculars among which numerous languages of science take essentially important place; studying of these languages represents the theory and prac...

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 Relation between Specialty Choice of Psychology Students and Their Interests, Personality, and Cognitive Abilities

Science.gov (United States)

Wicherts, Jelte M.; Vorst, Harrie C. M.

2010-01-01

The aim of this longitudinal study was to investigate differences in interests, personality, and cognitive abilities between students majoring in the six specialties of psychology at the University of Amsterdam. Results show that students at Social Psychology and Work and Organizational Psychology were on average more extraverted than students of…

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.

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

75 FR 41693 - Export Inspection and Weighing Waiver for High Quality Specialty Grains Transported in Containers

Science.gov (United States)

2010-07-19

... Specialty Grains Transported in Containers AGENCY: Grain Inspection, Packers and Stockyards Administration... rule to potentially make permanent the current waiver for high quality grain exported in containers... exported in containers that was established by a final rule on December 13, 2005 (70 FR 73556). This...

6. Seminar of the IIE-ININ-IMP on technological specialties. Topic 15: commercialization and technology transfer

International Nuclear Information System (INIS)

1992-01-01

The document includes 9 papers presented at the 6. Seminar of the IIE-ININ-IMP (Mexico) on technological specialties in the field of commercialization and technology transfer. (Topic 15). One item was in INIS s ubject scope and a separate abstract was prepared for it

3rd International Conference on X-ray Technique

Science.gov (United States)

Potrakhov, N. N.; Gryaznov, A. Yu; Lisenkov, A. A.; Kostrin, D. K.

2017-02-01

In this preface a brief history, modern aspects and future tendencies in development of the X-ray technique as seen from the 3rd International Conference on X-ray Technique that was held on 24-25 November 2016 in Saint Petersburg, Russia are described On 24-25 November 2016 in Saint Petersburg on the basis of Saint Petersburg State Electrotechnical University “LETI” n. a. V. I. Ulyanov (Lenin) was held the 3rd International Conference on X-ray Technique. The tradition to hold a similar conference in our country was laid in Soviet times. The last of them, the All-Union Conference on the Prospects of X-ray Tubes and Equipment was organized and held more than a quarter century ago - on 21-23 November 1999, at the initiative and under the leadership of the chief engineer of the Leningrad association of electronic industry “Svetlana” Borovsky Alexander Ivanovich and the chief of special design bureau of X-ray devices of “Svetlana” Shchukin Gennady Anatolievich. The most active part in the organization and work of the conference played members of the department of X-ray and electron beam instruments of Leningrad Electrotechnical Institute “LETI” (the former name of Saint Petersburg State Electrotechnical University “LETI”), represented by head of the department professor Ivanov Stanislav Alekseevich.

PREFACE: XXI International Conference on Spectral Line Shapes (ICSLS 2012)

Science.gov (United States)

Devdariani, Alexander Z.

2012-12-01

The 21st International Conference on Spectral Line Shapes, ICSLS, was held in the historic main building of St Petersburg State University (St. Petersburg, Russia) on 3-9 June 2012. The event continued the tradition started in 1978 in Meudon Observatory in Paris. Representatives of line shape physics have since met every two years in different locations in Europe and North America. The most recent events were held in St John's, Newfoundland, Canada (2010), Valladolid, Spain (2008), and Auburn, AL (USA). Traditionally, the conferences consider experimental and theoretical issues of studying spectral line shapes, diagnostic utilization of spectral line profiles observed in absorption, emission or scattering of electromagnetic radiation by atoms, molecules, and clusters in different environments, including neutral environments, laboratory low and fusion plasmas, astrophysical conditions, and planetary atmospheres. The Conference was attended by over 100 professionals from Europe, Asia, America, Africa and New Zealand. The conference program was put together in such a way so as to exclude any parallel sessions. Five afternoon sessions featured 19 invited talks and 20 oral contributions, and two evening sessions offered 61 poster presentations, including post-deadline posters. This setup allowed for a relaxed and unhurried discussion of results and facilitated productive networking. The invited talks were selected by recommendation of members of the International Scientific Committee. The Organizers would like to thank all the members of the International Scientific Committee for their proposals on the agenda and their valuable advice. When considering candidates for oral contributions, the organizers took into account the suggestions and preferences of potential conference participants. When selecting the theses of poster presentations, the organizers focused on the topics in line with the theme of the conference and studies with well-formulated results. It must be

Fiscal 1999 research report. Basic research for promotion of joint implementation programs (Scrap and build for Central Heat-Power Station No. 2, St. Petersburg City, and others); 1999 nendo St. Petersburg shi netsuden heikyusho No.2 hoka Scrap and Build chosa hokokusho

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-03-01

Japan intends to resort to various means, including joint implementations with advanced countries, to fulfill its greenhouse gas reduction target in compliance with the United Nations Framework Convention on Climate Change. Exerting one of Japan's efforts, Mitsui and Co., Ltd., has signed a protocol with LENENEGRO on a survey of the Central Heat-Power Station, St. Petersburg City. The heat-power station started its operation in the 1910s and is now quite superannuated. Its efficiency and operating rate have extremely lowered, and its early modernization is earnestly wished for. The aim of the survey is to have the existing old facilities scrapped for the installation of gas combined cycle cogeneration facilities which are high in efficiency and low in greenhouse gas emissions. The new facilities will consist of three 67MW-class gas turbines, three exhaust heat recovery boilers, and one backpressure turbine, capable of 200MW power generation and 200Gcal/hour heat supply. A total of 140-million dollars will have to be invested and the construction work will require 36 months to complete. A reduction of 1,481,979.0 tons/year in CO2 emissions and an energy saving effect of 546,301 tons/year are expected. (NEDO)

Association between Pregnancy and Active Injection Drug Use and Sex Work among Women Injection Drug Users in Saint Petersburg, Russia.

Science.gov (United States)

Girchenko, P; Ompad, D C; Bikmukhametov, D; Gensburg, L

2015-06-01

Widespread use of unsafe sexual practices among women injecting drugs both practicing and not practicing sex work leads to high levels of unplanned pregnancies in this population. The goal of this study was to investigate the association between pregnancy and active drug use and sex work. Data were collected using a convenience sample of 500 women in Saint Petersburg, Russia, in 2013. All women had recent experience of drug use, of which 200 were pregnant at the time of the study. The study consisted of a structured interview followed by a rapid HIV test. Pregnancy was protective against both active drug use and sex work. For HIV-positive women, these associations were stronger than for HIV-negative women: drug use prevalence ratio (PR) was 0.59 vs 0.85; for sex work, the PRs were 0.36 vs 0.64. Higher levels of education were associated with a lower prevalence ratio for active drug use and sex work in all models. Having children was not associated with active drug use or sex work. Pregnancy might be an optimal time for conducting interventions aimed at cessation of drug use and sex work among women injecting drugs.

Institutional sponsorship, student debt, and specialty choice in physician assistant education.

Science.gov (United States)

Cawley, James F; Jones, P Eugene

2013-01-01

Physician assistant (PA) educational programs emerged in the mid 1960s in response to health workforce shortages and decreasing access to care and, specifically, the decline of generalist physicians. There is wide diversity in the institutional sponsorship of PA programs, and sponsorship has trended of late to private institutions. We analyzed trends in sponsorship of PA educational programs and found that, in the past 15 years, there were 25 publicly sponsored and 96 privately sponsored programs that gained accreditation, a 3.84:1 private-to-public ratio. Of the 96 privately sponsored programs, only seven (7.3%) were located within institutions reporting membership in the Association of Academic Health Centers, compared to eight of the 25 publicly sponsored programs (32%). In 1978, a large majority (estimated 43 of the 48 then-existing PA programs) received their start-up or continuing funding through the US Public Health Service, Section 747 Title VII program, whereas in 2012 there were far fewer (39 of 173). The finding of a preponderance of private institutions may correlate with the trend of PAs selecting specialty practice (65%) over primary care. Specialty choice of graduating PA students may or may not be related to the disproportionate debt burden associated with attending privately sponsored programs, where the public-to-private tuition difference is significant. Moreover, the waning number of programs participating in the Title VII grant process may also have contributed to the overall rise in tuition rates among PA educational programs due to the loss of supplemental funding.

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

Science.gov (United States)

Hatam, Nahid; Fardid, Mozhgan; Kavosi, Zahra

2013-12-01

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

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

Science.gov (United States)

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

2009-10-01

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

Specialty Store and Multi-Brand Store loyalty: An Indian consumer perspective

Directory of Open Access Journals (Sweden)

Sarabjot Singh

2013-12-01

Full Text Available In the competitive era of retailing, retailers need to understand the importance of store format preferences. The study aimed to understand consumer store loyalty; in-depth interview was conducted to examine consumer store loyalty antecedents for two retail formats: specialty stores and multi brand stores. The study conceptualizes store loyalty factors like program loyalty, trust and brand commitment. Trust and brand commitment act as mediating factors between store image and store loyalty formats, and also between brand image and store loyalty formats. The findings highlight how consumer store loyalty preference differ for these two formats.

Collaboration between specialties for respiratory allergies in the International Classification of Diseases (ICD)-11.

Science.gov (United States)

Tanno, Luciana Kase; Calderon, Moises; Linzer, Jeffrey F; Chalmers, Robert J G; Demoly, Pascal

2017-02-10

The International Classification of Diseases (ICD) has been grouping the allergic and hypersensitivity disorders involving the respiratory tract under topographic distribution, regardless of the underlying mechanisms, triggers or concepts currently in use for allergic and hypersensitivity conditions. In order to strengthen awareness and deliberate the creation of the new "Allergic or hypersensitivity disorders involving the respiratory tract" section of the ICD-11, we here propose make the building process public. The new frame has been constructed to cover the gaps previously identified and was based on consensus academic reports and ICD-11 principles. Constant and bilateral discussion was kept with relevant groups representing specialties and resulted in proposals submission into the ICD-11 online platform. The "Allergic or hypersensitivity disorders involving the respiratory tract" section covers 64 entities distributed across five main categories. All the 79 proposals submitted resulted from an intensive collaboration of the Allergy working group, relevant Expert working groups and the WHO ICD governance. The establishment of the ICD-11 "Allergic or hypersensitivity disorders involving the respiratory tract" section will allow the dissemination of the updated concepts to be used in clinical practice by many different specialties and health professionals.

6. Seminar of the IIE-ININ-IMP on technological specialties. Topic 14: systems and infomation services

International Nuclear Information System (INIS)

1992-01-01

The document includes 9 papers presented at the 6. Seminar of the IIE-ININ-IMP (Mexico) on technological specialties in the field of information systems and services. (Topic 14). Two items were in INIS subject scope and a separate abstract was prepared for each of them

Specialty Supplements and Prostate Cancer Risk in the VITamins And Lifestyle (VITAL) Cohort

Science.gov (United States)

Brasky, Theodore M.; Kristal, Alan R.; Navarro, Sandi L.; Lampe, Johanna W.; Patterson, Ruth E.; Peters, Ulrike; White, Emily

2011-01-01

Although there is evidence from studies of prostate cancer cell lines and rodent models that several supplements may have anti-inflammatory, anti-oxidant, or other anti-cancer properties, few epidemiologic studies have examined the association between non-vitamin, non-mineral, “specialty” supplement use and prostate cancer risk. Participants, 50–76 years, were 35,239 male members of the VITamins And Lifestyle (VITAL) cohort who were residents of western Washington State, and who completed an extensive baseline questionnaire in 2000–2002. Participants responded about their frequency (days/week) and duration (years) of specialty supplement uses. 1,602 incident invasive prostate cancers were obtained from the Surveillance, Epidemiology, and End Results registry. Multivariate-adjusted hazards ratios (HR) and 95% confidence intervals (95% CI) were estimated by Cox proportional hazards models. Any use of grapeseed supplements was associated with a 41% (HR 0.59, 95% CI: 0.40–0.86) reduced risk of total prostate cancer. There were no associations for use of chondroitin, co-enzyme Q10, fish oil, garlic, ginkgo biloba, ginseng, glucosamine, or saw palmetto. Grapeseed may be a potential chemopreventive agent, however as current evidence is limited, it should not yet be promoted for prevention of prostate cancer. PMID:21598177

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.

Feasibility study on the St. Petersburg City heat and electric cogeneration plant No.2, etc. scrap and build project

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-03-01

For the purpose of reducing greenhouse effect gas emissions in line with the Joint Implementation, a survey was made of the scrap and build project for the superannuated Central Heat Power Station in St. Petersburg City. The survey team visited the relevant sites twice during 1999. The team drafted an improvement plan afterwards and presented it to the Russian counterpart, LENENEGRO. Based on the discussions with LENENEGRO, it was determined that the proposed combined cycle cogeneration plant would contain three 67MW-class gas turbines, three heat recovery steam generators and one back pressure turbine to achieve the generation capacity of approximately 200MW and heat supply capacity of 200G cal/hr. The total investment required for this project is about 140 million dollars. The term of the construction work is estimated at 36 months. It is estimated that the implementation of the project will reduce 1,481,979 tons of CO2 per year, or a total of 40,013,434 tons in 27 years after the commencement of operation. In addition, the terminal power generation efficiency will be improved from the current 18.68% to 41%, which leads to an annual fuel saving of 546,301 tons of crude oil or its equivalent. (NEDO)

Gender differences in the relationship between alcohol use and depressive symptoms in St. Petersburg, Russia

Science.gov (United States)

Zhan, Weihai; Shaboltas, Alla V.; Skochilov, Roman V.; Kozlov, Andrei P.; Krasnoselskikh, Tatiana V.; Abdala, Nadia

2012-01-01

Background Gender differences in the relationship between alcohol use and depressive symptoms are inconsistent, and few studies have addressed this issue in Russia. Because this finding may have important implications for interventions to reduce alcohol misuse or alcohol related problems in Russia, we conducted a study to investigate whether the association between alcohol use and depressive symptoms differs by gender at high risk for HIV. Methods We used the Alcohol Use Disorders Identification Test (AUDIT) and the 10-item Center for Epidemiological Studies Depression Scale to measure alcohol use and depressive symptoms among 307 patients who attended a clinic for sexually transmitted infections in St. Petersburg, Russia. Logistic regression models were applied for the analysis. Results The comparison of data between men and women revealed a significant quadratic term of alcohol use and significant interactions between alcohol use and gender on depressive symptoms. Men with an AUDIT score in the first and fourth quartiles were more likely to report depressive symptoms in comparison to men in the second quartile. Their odds ratios (ORs) and 95% confidence intervals (CIs) were 7.54 (2.00–28.51) and 5.06 (1.31–19.63), respectively. Among women, a linear trend was observed such that those who misused alcohol were three times more likely to have depressive symptoms than those who did not misuse alcohol (OR = 3.03, 95% CI, 1.05–8.80). Conclusion The association between alcohol use and depressive symptoms differed by gender. Additional research is needed to investigate this relationship in Russia. Strategies to reduce alcohol-related problems in Russia may need to consider these differences. PMID:23240098

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

Science.gov (United States)

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

2010-10-01

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

6. Seminar of the IIE-ININ-IMP on technological specialties. Topic 11: standards and quality assurance

International Nuclear Information System (INIS)

1992-01-01

The document includes 8 papers presented at the 6. Seminar of the IIE-ININ-IMP (Mexico) on technological specialties in the field of standards and quality assurance. (Topic 11). From these, 2 papers were in INIS subject scope and a separate abstract was prepared for each of them

INTEGRATION OF BEVACIZUMAB IN METASTATIC COLORECTAL CANCER CHEMOTHERAPY REGIMENS IN 2 CLINICAL CENTERS IN MOSCOW AND SAINT PETERSBURG

Directory of Open Access Journals (Sweden)

N. V. Dobrova

2013-01-01

Full Text Available The aim of this study was to estimate efficacy of first line chemotherapy with bevacizumab in metastatic colorectal cancer patients and investigate the impact of different prognostic factors on treatment outcome.Methods.During 2004–2008 48 colorectal cancer patients were included (29 in Russian N.N. Blokhin Cancer Research Center, 19 in St. Petersburg, who had unresectable distant metastases. Primary tumor was resected in 93.8 % patients. 52.1 % had rectal cancer. 87.5 % had liver metastases, 43.8 % had more than 1 organ affected. 66.7 % received chemotherapy with bevacizumab 5 mg/kg biweekly, 33.3 % received bevacizumab 7,5 mg/kg every 3 weeks. 62.5 % patients had oxaliplatin-based regimens, 35.4 % – only fluorpyrimidines, 2.1 % – chemotherapy with irinotecan.Results.Median time of bevacizumab use was 7.8 months. 60.3 % had objective response, 87.4 % had stable diseases during more than 6 months. Median progression-free survival (PFS was 11.5 months. Median overall survival (OS was 24.1 months.Conclusions.Survival and efficacy results are comparable to international experience. Combination of fluorpyrimidines with bevacizumab had comparable efficacy to combined chemotherapy regimens with no impact on quality of life. Integration of bevacizumab in combined treatment regimens reduced the impact of negative prognostic factors on PFS and OS. 

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

Science.gov (United States)

Metz, Anneke M

2017-01-01

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

Specialty and Associate Specialist doctors: still the dependable backbone of genitourinary medicine.

Science.gov (United States)

Lee, J D; Carlin, E M; Robinson, A

2013-05-01

Workforce planning is an inexact science. Specialty and Associate Specialist (SAS) doctors are rarely included in workforce analyses. Past studies have shown that SAS doctors are significant contributors to the work in genitourinary (GU) medicine clinics. This survey confirms the large amount of clinical work undertaken by SAS doctors. It appears that 51% of SAS doctors in GU plan to retire in the next 15 years and it is uncertain what effect the 2008 SAS contract will have on SAS recruitment. This information should be taken into consideration in future GUM workforce planning.

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

Science.gov (United States)

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

2017-12-23

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

78 FR 44922 - Vegetable and Specialty Crop Marketing Orders; Notice of Request for Extension and Revision of a...

Science.gov (United States)

2013-07-25

... Approved Information Collection AGENCY: Agricultural Marketing Service, USDA. ACTION: Notice and request... assured of consideration. Additional Information or Comments: Contact Andrew Hatch, Supervisory Marketing....regulations.gov . SUPPLEMENTARY INFORMATION: Title: Vegetable and Specialty Crop Marketing Orders. OMB Number...