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PubMed1995

Gerontology for companions: a model curriculum.

Although paid companions spend many hours in direct contact with their older clients, the majority have little or no grounding in gerontological developmental theory. This article describes a project that provided academic training for paraprofessionals through a pilot curriculum. Goals were to provide companions who were already working with socially isolated clients with a sound theoretical and practical grounding in communication skills, the aging process, and issues of loss and grief. To accomplish these goals, partnership was developed between an academic institution, a case management agency, and a direct service provider. Preliminary analysis of the pretest and posttest data measuring the outcome of the modules found that, as companions learned about continued growth and development in their older clients, these workers achieved a greater sense of self-fulfillment and job satisfaction.

Adult↗
PubMed1989

Pacemaker therapy for academic medicine.

Both the clinical practice and the administrative environments of academic medicine have become progressively more complex. Although management methods for dealing with the administrative intricacies are commonly not part of academic training, guidelines may be derived from medical practice. The authors identify specific parallels and analogies between recent developments in the design of pacemakers and the requirements of organizations that implant them.

Academic Medical Centers↗
PubMed1998

A descriptive analysis of the Journal of Manipulative and Physiological Therapeutics, 1989-1996.

BACKGROUND: Two previous reports have summarized the content, institutional affiliations, academic training and funding sources for articles published in the Journal of Manipulative and Physiological Therapeutics (JMPT) from 1978-1986 and 1987-1988. OBJECTIVES: (a) to quantitatively assess the types of articles published in the JMPT from 1989-1996; (b) to identify the affiliations of contributors to the JMPT during this period; (c) to identify the academic backgrounds of contributors to the JMPT from 1989-1996; (d) to identify funding sources for scholarly works published in the JMPT during this period; (e) to identify the proportionate contributions of female authors; (f) to assess the proportion of articles contributed, i.e., foreign vs. domestic sources; and (g) to compare findings for the JMPT from 1989-1996 with similar data for 1978-1988. STUDY DESIGN: Survey of the contents of the JMPT from 1989-1996. METHODS: The contents of the 69 issues of the JMPT from 1989-1996 were reviewed by all authors. Characteristics extracted included category of the article, academic backgrounds of authors, institutional affiliations of authors, funding sources, gender of authors and nation(s) of origin of articles. RESULTS: The annual rate of published contributions to the Journal has more than doubled compared with its first 11 yr of publication, and the proportion of original data reports has grown slightly. Controlled and quasicontrolled clinical trials were 7 times more numerous (n = 28 articles) during the past 8 yr. Chiropractic colleges were the most frequently mentioned affiliation of authors, followed by private practice and nonchiropractic colleges. Collaborative articles submitted by authors at two or more chiropractic colleges grew from only 4 articles from 1978-1988 to 31 articles from 1989-1996. As in previous years, the National College of Chiropractic continued to be the most frequently mentioned academic affiliation of authors. The numbers of articles contributed by those holding scientific (e.g., PhD) and medical degrees have grown substantially. The number of articles mentioning financial support grew from 78 from 1978-1988 to 179 from 1989-1996, and 58 new funding sources were identified. The Foundation for Chiropractic Education and Research continues to be the most frequently mentioned source of funding. Of all articles published in the JMPT from 1989-1996, 21% were authored or coauthored by women. Of 1050 articles, 286 (27%) were authored or coauthored by individuals residing outside the United States of America. CONCLUSIONS: Substantial increases in scholarly activities within the chiropractic profession are suggested by the growth in scholarly products published in the discipline's most distinguished periodical. Increases in controlled outcome studies, collaboration among chiropractic institutions, contributions from nonchiropractors, contributions from nonchiropractic institutions and funding for research suggest a degree of professional maturation and growing interest in the content of the discipline.

Authorship↗
PubMed2001

Microsurgery in private practice: is it feasible economically?

Microsurgical free tissue transfer and replantations have long been the bailiwick of academic training centers and tertiary referral centers. However, the authors' experience with more than 350 consecutive free tissue transfers during a span of 15 years in a purely private setting illustrates the changing economics of the medical environment in that time frame. These data provide insight into the feasibility and practicality of maintaining a microsurgical practice outside an academic medical center.

Adolescent↗
PubMed2003

A national research agenda for the postsecondary education of deaf and hard of hearing students: a road map for the future.

This article describes converging nationwide changes in the postsecondary education of students with hearing loss during the past 30 years. Simultaneous trends in the economy, labor force, and business practices have magnified the need for literacy, postsecondary training, and career skills. These conditions stimulated institutional and professional activities that led to drafting a National Research Agenda report to guide development of federally funded research projects in postsecondary education. These studies will enhance better understanding of the complex interactions of diverse support services, learning-living environments, and student populations in a broad continuum of post-high school vocational and academic training programs. The conceptual framework of the Agenda is explained, as are its expected goals, criteria for research projects, benefits, and outcomes. This article interweaves the perspectives and roles of postsecondary and vocational rehabilitation professionals, federal officials, and researchers contributing to the preparation of the Agenda report. Relevant national research studies are cited and consumer involvement in research is emphasized.

Education of Persons with Hearing Disabilities↗
PubMed2006

A nutrition odyssey: knowledge discovery, translation, and outreach. 2006 Ryley-Jeffs Memorial Lecture.

BACKGROUND: The 21st-century model of health research is founded on a broad base of multidisciplinary research that is expeditiously and effectively translated into evidence-based practice, education, policy, and advocacy. The key objective is to improve the health of populations. DIETITIANS' ROLES: Dietitians, whether they are working in clinical or public health nutrition or food science, have a vital role to play in this paradigm of health research. As dietitians' roles have evolved beyond the traditional ones into subspecialties including epidemiology, nutrigenomics, functional foods, nutraceuticals, toxicology, natural health products, and multidisciplinary research, the need for advanced training in subspecialty fields has become essential. OPPORTUNITIES: A dietetics background is an excellent foundation upon which to develop a research career in one of these new areas of nutrition. Opportunities for personnel awards and research funding targeted at nutrition clinician-scientists and other nutrition subspecialists have grown tremendously in recent years. CONCLUSION: The information in this paper is intended to inspire dietitians seeking advanced academic training in one of the new exciting avenues for a career in nutrition. These avenues will permit dietitians to contribute to knowledge discovery, translation, and outreach to improve the nutritional status and health of populations in Canada and globally.

Canada↗
PubMed1998

[De-professionalization or 'para-professionalization'?. The professional development of the midwife and her place in the obstetrics of the 19th century].

The present article deals with the standing and the tasks of midwives in 19th century Württemberg. After outlining the legal framework of obstetrics, special emphasis was given to the education and activities of contemporary midwives, and to their numbers. At the beginning of the 18th century, obstetrics was almost exclusively in the hands of women. After 1800, a growing number of barber-surgeons and physicians began to practise obstetrics. At the same time, vocational training and qualification of women-obstetricians increased considerably. Schools for midwives and lying-in hospitals were founded. In these schools a limited number of midwives were trained by physicians. Finally a hierarchy of different groups of obstetricians developed: first physicians, then barber-surgeons, midwives and folk healers. Although midwives were more or less excluded from operative obstetrics and high-risk-pregnancies, care and supervision of uncomplicated pregnancies, and of women in childbed remained their responsibility. It could be shown that in 19th century Württemberg more than 90 percent of pregnancies ran a safe course, and neither physicians nor barber-surgeons took a special interest in the care of normal births. Thus there was no dramatic transfer of obstetric care from the hands of the midwives to those of academically trained men. The high social status of the university-bred physicians separated them from most of the patients, as did the doctors' high fees. A certain indolence, and a remarkable sense of shame on the part of the pregnant women prevented much demand for academic obstetricians.

Female↗
PubMed1988

Training in geriatric psychiatry: will the supply meet the demand?

The number of geriatric patients with major psychiatric disorders is expected to grow along with the rising proportion of people age 65 and older. Despite recognition of this growth and increases in the training of geropsychiatrists, the supply of specialists is unlikely to keep up with the demand. The authors argue for greater resource expenditure in fellowship programs and a focus on training academic leaders to serve as role models for general psychiatrists and other primary care givers.

Aged↗
PubMed2004

Children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment: impact on parental practices.

OBJECTIVE: To test the hypothesis that multimodal psychosocial intervention, which includes parent training, combined with methylphenidate significantly enhances the behavior of parents of children with attention-deficit/hyperactivity disorder (ADHD), compared with methylphenidate alone and compared with methylphenidate and nonspecific psychosocial treatment (attention control). METHOD: One hundred three children with ADHD (ages 7-9), free of conduct and learning disorders, who responded to short-term methylphenidate therapy were randomized for 2 years to receive either (1) methylphenidate treatment alone; (2) methylphenidate plus psychosocial treatment that included parent training and counseling, social skills training, academic assistance, and psychotherapy; or (3) methylphenidate plus attention control treatment. Parents rated their knowledge of parenting principles and negative and positive parenting behavior. Children rated their parents' behavior. RESULTS: Psychosocial treatment led to significantly better knowledge of parenting principles but did not enhance parenting practices, as rated by parents and children. Significant improvement in mothers' negative parenting occurred across all treatments and was maintained. CONCLUSIONS: In nonconduct-disordered, stimulant-treated children with ADHD, parent training does not improve self-rated parental behavior. The benefits of brief stimulant treatment for negative parental behavior are sustained with extended treatment.

Attention Deficit Disorder with Hyperactivity↗
PubMed1996

The Neurosurgical Clinic at the Ludwig-Maximilians University in Munich.

ThE NEUROSURGICAL CLINIC at the Ludwig-Maximilians University in Munich began as a small unit of the university's surgical clinic. Eduard Weber, who in 1952 became the first surgeon fully trained in the specialty of neurosurgery to join the surgical clinic's faculty, worked, until his death in 1962, to advance the new specialty. Neurosurgery became an independent department of the university in 1965, and the neurosurgical clinic moved to a new location at Beethovenplatz. Further expansion led the neurosurgical clinic to move again, in 1975, to the newly constructed Klinikum Grosshadern at the periphery of Munich. Frank Marguth, chairman of the department of neurosurgery from 1964 to 1991, had superb skill as an organizer and greatly enhanced the reputation of the department of neurosurgery. Today, the faculty of the department consists of 10 full-time staff members, 10 joint appointment staff members, and 16 residents and fellows. Annually, 2200 to 2300 procedures are performed in the neurosurgical clinic. The current philosophy in the department places heavy emphasis on subspecialization and academic training. Political and economic changes in Germany during recent years have affected the nation's public health system and pose major challenges to the department of neurosurgery.

Academic Medical Centers↗
PubMed2002

Managers, teachers, researchers: sharing experience in health care.

The author observes that academic training is an asset for any managerial position in the health sector. As with medicine and nursing, health care management should be more evidence-based. The author argues that top managers in health care generally lack adequate internal support to rigorously evaluate strategic interventions or consultant recommendations and to learn from industrywide best practices.

Academic Medical Centers↗
PubMed2004

Resident work hours: what they are really doing.

HYPOTHESIS: We attempted to better quantitate resident work within our system of care. DESIGN: Survey. SETTING: Academic training program. PARTICIPANTS: Surgical residents. INTERVENTIONS: A work-hour survey was developed defining 5 areas of activity: patient care related to educational objectives, required educational activities, patient care activities unrelated to educational objectives, off-duty educational activity, and off-duty hours. MAIN OUTCOME MEASURES: Total work hours and noneducational work hours were analyzed by resident level, rotation, and category. RESULTS: The survey response rate was 52%, covering 110 workweeks. Residents worked 80 hours or less for 57 weeks and more than 80 hours for 53 weeks. The mean number of hours worked was 77. Fewer than one quarter (21.9%) of work hours were unrelated to educational activities. The amount of time spent in noneducational activities was lowest at community hospitals (17%) and similar at the Veterans Affairs (23%) and academic (22%) medical centers. It did not vary by total hours worked, averaging 21% for rotations of more than 80 h/wk and 23% for rotations of 80 h/wk or less. CONCLUSIONS: Residents spend a large amount of time in noneducational activities. Eliminating these activities would bring our rotations into compliance with the 80-hour workweek. It would also generate a large amount of time for educational activities within our training program.

Adult↗
PubMed2000

An integrated residency in internal and preventive medicine.

The importance of preventive and population-based principles in clinical practice is widely acknowledged. The challenge of imparting these principles in either undergraduate or postgraduate medical education has, however, not been fully met. The necessary skills are provided comprehensively by preventive medicine residency programs, but at the expense of clinical training. Sequential residencies in primary care and preventive medicine, the currently available means of obtaining thorough preparation in both clinical and population-based principles, represent an inefficient, generally unappealing, and non-integrated approach. In response to these concerns, and in an effort to make preventive medicine training appeal to a wider audience, the authors developed and implemented a residency program fully integrating internal and preventive medicine. The program meets, and generally exceeds, the requirements of both specialty boards over a four-year period. The program provides extensive training in clinical, preventive, and public health skills, along with case management and cost-effective care, conferring the MPH degree and leading to dual board eligibility. The model is ideally wed to the demands of the modern health care environment in the United States, is extremely attractive to applicants, and may warrant replication both to train academic and administrative leaders and to raise the standards of preventive and public health practice in primary care.

Accreditation↗
PubMed1996

How successfully can academic faculty practices compete in developing managed care markets?

The author investigated the range of competitive options available for academic faculty practices and their associated academic medical centers located in health care markets with relatively limited development of managed care plans. Using personal and telephone interviews, he studied two such markets in 1994, one in Philadelphia, Pennsylvania, and one in Atlanta, Georgia. Representatives of faculty practices in these cities were asked to assess whether their practices would be attractive or unattractive for contracting with managed care providers; eight attributes of faculty practices (e.g., specialist physicians' availability within the group; prices of services offered by the group) were used as criteria. Similarly, representatives of local managed care plans were asked to use the same criteria to indicate what they would consider attractive or not in their local faculty practices when considering a physician services contract with such a practice. In both markets, the image of the academic medical center was generally considered to be a strong asset to the faculty practices. But all sectors also agreed that the nature of practices' utilization management and what was seen as their excessive use of resources in the academic environment were causes for concern. Also, the difference between the practice patterns of managed care physicians and academic faculty physicians was regarded as a cultural one in which traditional patterns of academic training are considered inimical to fostering the prudent management of patients. The findings strongly suggest that opportunities for faculty practices to negotiate with managed care plans and help shape their areas' future health care environments still exist in developing markets throughout the United States. But even those practices with such opportunities cannot succeed without significant internal restructuring to transform themselves to successfully deal with the new world of managed care.

Academic Medical Centers↗
PubMedDate not supplied

An assessment of the health communication job market across multiple types of organizations.

This study seeks to answer three questions: (1) What is the employment outlook for health communication practitioners? (2) What specialized knowledge and skills should a competent health communication practitioner possess? and (3) How much academic training or professional experience is necessary to become a competent health communication practitioner? To this end, 104 employers of health communication practitioners, representing different types of large, medium, and small companies and organizations from various regions of the United States, were interviewed by telephone. The interview protocol was based on nine core health communication responsibilities identified by a working group of health communication academicians and practitioners. The study suggests a positive employment outlook, where those seeking jobs in health communication before the year 2000 could enjoy varied job opportunities in the wake of an anticipated moderate expansion in the field. Those with 1 to 10 years of experience are most in demand. While an undergraduate degree provides an academic background to perform most responsibilities, for six of the nine core responsibilities an advanced degree was preferred by at least one-third of respondents.

Employment↗
PubMed1998

Johannes Scultetus (1595-1645). Urologic aspects in the 'Armamentarium chirurgicum'.

Johannes Schultheiss (Latinized to 'Scultetus') was one of the first academically trained physicians and surgeons in Germany in the 17th century. After his studies at the University of Padua under Adrian van Spieghel and Fabricius ab Aquapendente he became official physician of his home town of Ulm. His remarkable textbook on surgery, the 'Armamentarium chirurgicum' was first published 10 years after his death and passed through many editions and translations all over Europe. This work contains a complete catalogue of surgical instruments, illustrated demonstrations of a variety of operative procedures and 100 case reports. The success of Scultetus' publication was responsible for an improved standard of the education of the nonacademic barber surgeons, who were treating the majority of the population, and was a significant milestone for the development of surgery as an academic speciality. The life and work of Johannes Scultetus, with reference to urologic aspects, is outlined in this article.

Germany↗
PubMed2001

Distance learning in the digital environment.

The expansion of radiology departments and divisions often can not occur in adjacent geographic locations. This leads to a greater separation of staff and residents, as well as workers in similar divisions. This makes traditional teaching difficult in academic institutions. The economic drive forcing many departments to investigate more isolated outpatient imaging centers has further hindered the ability to continue effective academic training at many facilities. The ability to easily share a digital environment across physical distance can greatly enhance the teaching experience, as well as be a valuable tool for consultation and case discussion with referring clinicians. The transition to a filmless environment with picture archiving and communication systems (PACS) can be utilized for distance learning in addition to the clinical arena. It is possible to take advantage of the digital transformation to PACS and case-viewing browser programs to conduct improved interactions with referring clinicians as well as radiologic teaching with relatively minimal hardware and software demands. The integration of web-based teleradiology programs with business networking software can be used for effective distance learning in the digital environment, sufficiently closing the distance on our rapidly expanding departments. This same technology allows for greater interaction with referring clinicians for real-time consultation and enhanced case discussion to entrench a supportive referral base for the radiologic community.

Humans↗
PubMed1983

A survey of ergonomics in Yugoslavia.

The writer conducted a survey of ergonomics in Yugoslavia during the month of December 1982. This survey was made possible by the scientific exchange programme between the National Academy of Sciences of the USA and the Council of Academies of Yugoslavia. The writer met with engineers and scientists in academic, research and public health institutions to develop an overview of historical developments, the compostion of the ergonomics community, current research interests and methodologies, academic training programmes and future trends. The schedule of visits, which spanned four of the six Yugoslavian republics, is summarised in Table 1. The present study is a sequel to earlier surveys of ergonomics or human factors in Eastern Europe (Seminara, 1975; 1976; 1979a; 1979b; 1979/80; 1980; 1982; 1983).

Journal Article↗