SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
A 15-minute questionnaire was administered to the pediatric housestaff in an academic training program to assess their breastfeeding attitudes, knowledge, and confidence to manage breastfeeding problems. Questionnaires were self-administered and anonymous. The participation rate was 53% (n = 29). Overall, the study participants indicated a supportive attitude toward breastfeeding (2.6 on a 6-point scale where 1 = most supportive and 6 = least supportive). Women agreed more strongly than men that pediatricians should strongly encourage mothers to breastfeed and disagreed more strongly than men that breastfeeding is instinctive. Although supportive of breastfeeding, the housestaff in this study were not knowledgeable regarding breastfeeding management, answering only 53% of the questions correctly. Their self-confidence in this area was appropriately low, with only 14% of the total sample describing themselves as "confident" or "very confident" to manage common breastfeeding problems. Pediatricians-in-training have extremely limited knowledge of breastfeeding management. To be truly supportive of breastfeeding, pediatricians should receive didactic and clinical training in breastfeeding management.
Acquiring the skill to be a psychiatrist requires learning in three fields: academic, clinical and research. Academic training includes various kinds of objectives which are analysed and to which the DSM IV provides only an imperfect response. Clinical training which shapes clinical practice, requires the organization of knowledge: the DSM IV, in so far as it analyses and classifies data is a useful tool, but the utility is limited since the DSM IV is inherently biased towards a psychiatric view of illness. The utility of the DSM IV is analysed for research training, particularly with the triple goal of preparing for the manipulation of knowledge, for practical care, and for the transmission of knowledge.
BACKGROUND: The state of academic paediatrics in the United Kingdom is a source of anxiety in view of anecdotal reports of loss of identity within medical schools and reductions in staffing levels. AIMS: To measure the current numbers and recent changes in clinical academic staff in all university departments of paediatrics in the UK. METHODS: A questionnaire was sent to all 24 university departments of paediatrics where undergraduates are taught, and to the postgraduate institute of paediatrics. RESULTS: Full responses were obtained from 24 medical institutions. In the past five years there has been an overall 7.2% decline in clinical academic staff, but among lecturers there has been a 26% reduction. Nine of 24 departments had undergone changes in name with at least some loss of paediatric identity. In 12 of 24 centres it was felt that the research assessment exercise had resulted in some, or severe, detriment. CONCLUSIONS: This study confirms the recent loss of academic training positions, leading to a serious concern about the future of academic paediatrics in some UK centres.
This paper describes the point of view of professionals working with traumatic brain injury (TBI) clients or people with schizophrenic disorders towards their collaboration with clients' families. Four hundred and thirty professionals from 3 different regions in the province of Quebec took part in the study. They were recruited from psychiatric and general hospitals and physical rehabilitation centres. The results of the study point up that conditions for collaboration with families are better for respondents working with TBI clients than for respondents in the psychiatric sector. Furthermore, the results showed that respondents working with TBI clients are significantly more satisfied with their working conditions and the services they deliver and perceive a higher degree of collaboration with families than mental health workers. Another finding of the study is that personnel intervening in an interdisciplinary team reported a higher degree of collaboration with families than respondents working in a multidisciplinary team setting or individually. In the same vein, respondents who received training regarding intervention with families during their practice or during their academic training reported a higher degree of collaboration with their clients' families.
The objective was to study the knowledge and attitude on risk factors in oral cancer held by dental hygienists working in private dental practices in the Autonomous Community of Murcia, Spain. An anonymous phone survey was made after obtaining consent from the interviewee. A simple randomized study was carried out and 240 dental hygienists were selected. The questionnaire was divided into three different parts: (1) professional data and years of practice; (2) knowledge of the risk factors in oral cancer and (3) education and training needs on oral cancer. The response rate was 58.3%. Regarding knowledge of the risk factors in oral cancer, 100% correctly identified tobacco and 90% alcohol, while only 50.7% identified sun exposure with labial cancer. Only 51.4% of the dental hygienists routinely gave advice to their patients on prevention of oral cancer. Furthermore, 57.1% did not consider themselves sufficiently well trained to discover suspected oral cancer lesions, and 84.3% recognized that their academic training on the early diagnosis and prevention of oral cancer was insufficient for their professional activity. To reduce morbidity and mortality of oral cancer it is necessary to implement training programs on oral cancer for dental hygienists, so they may acquire the necessary skills for its detection and prevention.
PURPOSE: Lately, pharmacovigilance (FV) and monitoring of adverse reactions to drugs are a frequent issue of analysis and discussion due the prospective alignment of Italian FV with the European Community (EC) guidelines. DESIGN: Most recent and significant available data have been reviewed. RESULTS: Analysis of the 1988-1994 period shows, even though with differences among the Italian regions, a low number of reports and a low index of interest and concern among Health officers. Three issues are discussed here: 1. The necessity and the modalities to provide specific training in FV to the medical community at large, before and after the academic studies; 2. The potential advantages and feasibility of establishing FV services at regional level, and 3. The necessity to maintain a national FV service that, in close collaboration with the regional offices, analyzes all the available information, determines the course of action and maintains a tight link with the European office. CONCLUSIONS: It is important to consider FV as an essential part of the academic training of medical and scientific operators, a field where universities and professional societies may play quite a significant role. The SSN (Italian Health Service) and the Health Ministry should, in turn, be responsible for organizing and directing the services provided to the territory, with acquisition and maintenance of specifically trained personnel.
Clinical psychology graduate programs need to pay attention to important issues involved in teaching psychological assessment, if graduate students are to be adequately prepared. Recent studies have suggested a gap between academic training in psychological assessment and internship expectations. Graduate students are not as well prepared as many internship settings would like. In addition to learning the fundamentals, students need help in dealing with issues of categorizing individuals, using tests in helpful ways, taking responsibility for decision-making, and developing a balance between critical evaluation of tests and appreciation of their usefulness. Teaching approaches for dealing with these issues are discussed. The importance of academic and clinical agencies working together is stressed. Goals for graduate training in assessment are suggested.
The competence of an occupational therapist in mental health is built on a generalist training acquired in a first university cycle. Several training techniques are described both in the basic studies and in the continuing professional, personal and academic training. The author also broaches the question of the sharing of the responsibility in the on going training.
Clinical Pathology (CP) in Nepal is still in primitive stage. All most all CP tests are done manually. In many health institutions, even a basic CP test facilities are not available leading to an empirical treatment. Even the so-called big medical centers are lacking many important CP test facilities forcing the patients (those who can afford) to proceed to foreign countries for investigation and treatment of their health problem. With regard to the training of man power in the field of CP, Tribhuvan University Institute of Medicine began an academic training course called Proficiency Certificate Level in Health Laboratory Technology (PCL Health Lab.) in 1972. Presently, undergraduate and post-graduate courses, namely, Bachelor in Medical Laboratory Technology (BMLT) and MD Pathology are also being run since 1987 and 1996, respectively. Presently, CP services in Nepal are being rendered at both public and private sectors. CP services in private sector are provided by small so-called CP laboratories usually attached to a medical shops to a well set laboratories run by qualified man power. All most all private CP laboratories in Nepal function at morning and/or evening as they are run by the people working at the hospitals or other medical institutions during day time. Beside, newly emerged nursing homes are also providing CP services. However, quality control system in CP service in Nepal, is not effective yet. Thus, establishment of a national institution functioning as both referral CP center and quality monitoring body on CP services, and introduction of mandatory CP license examination appears to be an urgent need of the days to provide a qualitative CP service to the needy people.
BACKGROUND: Neurologically impaired persons seem to benefit from driving-training programs, but there is no convincing evidence to support this notion. The authors therefore investigated the effect of simulator-based training on driving after stroke. METHODS: Eighty-three first-ever subacute stroke patients entered a 5-week 15-hour training program in which they were randomly allocated to either an experimental (simulator-based training) or control (driving-related cognitive tasks) group. Performance in off-road evaluations and an on-road test were used to assess the driving ability of subjects pre- and post-training. Outcome of an official predriving assessment administered 6 to 9 months poststroke was also considered. RESULTS: Both groups significantly improved in a visual and many neuropsychological evaluations and in the on-road test after training. There were no significant differences between both groups in improvements from pre- to post-training except in the "road sign recognition test" in which the experimental subjects improved more. Significant improvements in the three-class decision ("fit to drive," "temporarily unfit to drive," and "unfit to drive") were found in favor of the experimental group post-training. Academic qualification and overall disability together determined subjects that benefited most from the simulator-based driving training. Significantly more experimental subjects (73%) than control subjects (42%) passed the follow-up official predriving assessment and were legally allowed to resume driving. CONCLUSIONS: Simulator-based driving training improved driving ability, especially for well educated and less disabled stroke patients. However, the findings of the study may have been modified as a result of the large number of dropouts and the possibility of some neurologic recovery unrelated to training.
BACKGROUND: This study aimed to determine predictors for otolaryngology resident success using data available at the time candidates are interviewed (eg, medical school attended, letters of recommendation, test scores) and data that emerge during residency. STUDY DESIGN: We performed a retrospective cohort study of 36 residents who entered our program between 1983 and 1993. RESULTS: Seventy percent of Alpha Omega Alpha (AOA) members and 13% of nonmembers were in the highest tertile based on faculty ranking (p<0.01), and candidates with an exceptional trait were more likely than those without an exceptional trait to rank in the highest tertile (57% versus 10%, p<0.01). AOA membership was also related to current academic appointment (p=0.02). Significant correlations included United States Medical Licensing Examination (USMLE) I score, year 2 in-training score (0.48, p=0.03), and years 3 and 4 in-training score and faculty ranking (minus 0.39, minus 0.50, respectively, p 50% of the interviewers (p<0.05 for both). CONCLUSIONS: In our program designed to train academic otolaryngologists, postresident success was strongly predicted by having an exceptional trait and AOA membership. Success during residency was predicted by interviewer's impression of the candidate and a USMLE I score>570. Knowledge of these factors at the time of the resident interview could increase the likelihood of selecting the most appropriate candidates for academic otolaryngology. Resident success is a complex outcome, and other unmeasured and unexamined characteristics can provide additional insight into choosing successful residents.
OBJECTIVE: To evaluate the level of knowledge about the non-clinical areas which characterise the new model of primary care among doctors and nurses who work in primary care teams (PCT); and to identify the most deficient areas of knowledge and the variables associated with these lower levels of knowledge. DESIGN: An observation study of a crossover kind. SETTING: PCTs of Health Area 1 in Madrid. PARTICIPANTS: Doctors and nurses who were working in the 23 PCTs functioning when the study was carried out (321 people). MEASUREMENTS AND MAIN RESULTS: Knowledge was measured by a self-filled, anonymous questionnaire elaborated by a panel of experts. It contained 72 items with correct (C) or false (F) double reply, grouped in 12 basic areas of knowledge relating to the non-clinical aspects which characterise the new model of primary care (PC). A pilot test was done in a PCT in another Area. The data bases were performed on DBASEIII+ and the statistical analysis on SPSS v. 4.0. The required level of knowledge through the questionnaire as a whole was attained by 41.6% of the professionals. An association with the following was noted: Age (p < 0.0001), Profession (p < 0.005), Year that training ended (p < 0.01), Type of contract (p < 0.005), Nature of access to a permanent post (p < 0.0005), postgraduate academic training for doctors (p < 0.001) and Residency in Family and Community Medicine (p < 0.009). The most deficient areas of knowledge were: Evaluation of procedures and programmes (46%), Community Participation (51.6%), the filling-out and standardisation of records (55.2%), and the Evaluation of objectives and quality control mechanisms. CONCLUSIONS: Knowledge of non-clinical areas is low.
RATIONALE AND OBJECTIVES: The authors performed this study to examine the factors, particularly the modifiable factors, that influence the career choices of radiologists immediately after graduation from residency and later. MATERIALS AND METHODS: A survey was sent to 119 radiologists who had graduated from a large academic training program between 1981 and 2000. The graduates were asked to classify their first job and any subsequent jobs in academic radiology or private practice and to identify the reasons for their initial job choices and any job changes. A nested cohort study was performed to evaluate the effect of research experience on career choice. RESULTS: Seventy-nine (66%) graduates responded to the survey. Forty-three (54%) of the respondents had chosen academic positions as their first jobs. Those who had published during their residency were 26.4 times more likely to choose an academic position as a first job. Twenty-four graduates had since left their academic jobs for private practice. Although the discrepancy in financial rewards between academic radiology and private practice was the main reason for the job switch in 71% of these cases, 33% of the respondents cited difficulty with research as a reason. In addition, only 25% of current academic radiologists were satisfied with their research activities. CONCLUSION: An exodus from academic radiology to private practice is evident among graduates from this large academic residency program, with greater financial reward being the primary motivation. However, a positive research experience during residency could persuade more graduates to choose and to continue in an academic career.
Abuse of alcohol or other drugs is at the root of many child welfare problems, yet most workers receive little academic training to cope with these difficulties in their clients. Continuing education is a useful tool to facilitate the adoption of attitudes necessary for effective response to addicted persons. Workers may not approach continuing education with an eye to identifying specific opportunities for changing their practice, however, and impediments in the workplace make implementing change difficult. Continuing education is most effective if supervisors help in setting goals, removing obstacles, and facilitating workers' efforts to incorporate into practice what they learn in the training classroom.
The decrease in resident applicants for United States (U.S.) anesthesiology training programs in the mid-1990s has resulted in a national anesthesiologist shortage. This shortage has been associated with increased salaries for anesthesiologists in academic institutions. Salary increases have placed the financial condition of academic training departments in jeopardy, requiring increasing support from their institutions. In the year 2000, a nationwide survey of the financial status of the U.S. anesthesiology training programs was conducted. Follow-up surveys have been conducted each year thereafter. We present the results of the fifth such survey. One-hundred-twenty-eight departments were surveyed, with a response rate of 73%. The average department employs 45 faculty and 81% of those departments have an average of 3.3 open positions. Of the 91% of departments who employ Certified Registered Nurse Anesthetists (CRNAs) (an average of 25 CRNAs/department), 73% have an average of 4.2 open CRNA positions. The average department received 3,787,835 dollars (or 97,621 dollars/faculty) in institutional support, which is an increase over the 2003 amount of 85,607 dollars/faculty. In 36.6% of the departments a portion of these support dollars (1,888,111 dollars) was provided to support CRNA salaries. Therefore, the support to departments for faculty averaged 81,696 dollars/faculty, after the CRNA dollars were removed. Faculty academic time averaged 16% (where 20% is 1 day/wk) and departments billed an average of 11,954 anesthesia units/faculty/yr. These results demonstrate a continued shortage of anesthesiology faculty and continued institutional support to keep these training programs financially viable.
In response to the increasing trend toward community health care, a model of training that prepares students for community practice was incorporated into the occupational therapy curriculum at the University of Southern California. During academic training students are placed in a part-time community assignment where no occupational therapy services are offered. Training students for the role of community health specialist produces a dilemma for curriculum design. A balance must be achieved between providing traditional clinical content and providing the knowledge and expertise necessary for community practice. However, this training is considered necessary for maintaining the viability of the profession in a changing health system. Significantly, during the four-year period using this model, many graduates have sought employment in "nontraditional" community roles.
As the unified training body for osteopathic physicians specializing in dermatology, the American Osteopathic College of Dermatology (AOCD) sponsors 18 dermatology residency programs that integrate academic training (focusing on the core of basic medical sciences) with clinical instruction (emphasizing specialized diagnostic and laboratory techniques and the high-level performance of all dermatologic and surgical procedures) to engender the ability to provide superior, specialized dermatologic care. The board of directors of the American Academy of Dermatology (AAD) recommended passage of a bylaws amendment establishing a category of osteopathic fellow for those osteopathic physicians who are certified by the American Osteopathic Board of Dermatology; however, the AAD membership failed to adopt the amendment by the required two-thirds majority. Constitutional bylaws of both societies stress the importance of the goal of unification and representation of the specialty of dermatology. Continued rapprochement appears to be in the best interest of the AAD and AOCD and may well enhance our efforts to deal with the challenges that face dermatology and medical practice in the 21st century.