scholarly journals Recent Trends in Neurosurgery Career Outcomes in Canada

2019 ◽  
Vol 46 (04) ◽  
pp. 436-442 ◽  
Author(s):  
Michael K. Tso ◽  
J. Max Findlay ◽  
Stephen P. Lownie ◽  
M. Chris Wallace ◽  
Brian D. Toyota ◽  
...  
Keyword(s):  
Full Employment ◽  
Statistical Significance ◽  
Fellowship Training ◽  
Full Time ◽  
Career Outcomes ◽  
Exact Test ◽  
The Usa ◽  
Surgical Career ◽  
Recent Trends ◽  
Full Time Employment

ABSTRACT:Background: As with other specialties, Royal College of Physicians and Surgeons of Canada (RCPSC) trainees in Neurosurgery have anecdotally had challenges securing full-time employment. This study presents the employment status, research pursuits, and fellowship choices of neurosurgery trainees in Canadian programs. Methods: RCPSC neurosurgery trainees (n = 143) who began their residency training between 1998 and 2008 were included in this study. Associations between year of residency completion, research pursuits, and fellowship choice with career outcomes were determined by Fisher’s exact test (p < 0.05, statistical significance). Results: In 2015, 60% and 26% of neurosurgery trainees had permanent positions in Canada and the USA, respectively. Underemployment, defined as locum and clinical associate positions, pursuit of multiple unrelated fellowships, unemployment, and career change to non-surgical career, was 12% in 2015. The proportion of neurosurgery trainees who had been underemployed at some point within 5 years since residency completion was 20%. Pursuit of in-folded research (MSc, PhD, or non-degree research greater than 1 year) was significantly associated with obtaining full employment (94% vs. 73%, p = 0.011). However, fellowship training was not significantly associated with obtaining full employment (78% vs. 75%, p = 1.000). Conclusions: Underemployment in neurosurgery has become a significant issue in Canada for various reasons. Pursuit of in-folded research, but not fellowship training, was associated with obtaining full employment.

scholarly journals Recent Canadian neurosurgery graduate employment outcomes

2015 ◽  
Vol 42 (S1) ◽  
pp. S18-S19
Author(s):  
MK Tso ◽  
JM Findlay ◽  
SP Lownie ◽  
MC Wallace ◽  
BD Toyota ◽  
...  
Keyword(s):  
Full Employment ◽  
Research Training ◽  
The United States ◽  
Employment Outcomes ◽  
Full Time ◽  
Career Changes ◽  
Exact Test ◽  
Neurosurgical Society ◽  
The Us ◽  
Time Position

Background: The American Board of Neurological Surgeons (ABNS) made persons beginning neurosurgical training in Canada after 1997 ineligible for ABNS board exams and certification in the United States (US). We set out to track employment outcomes for graduates who are “ABNS ineligible.” Methods: Graduates from Canadian neurosurgical programs who began training from 1998 to 2008 (ABNS ineligible) were followed regarding their employment status (n=143). Data was obtained from public-domain websites and direct connections though Canadian Neurosurgical Society (CNSS) members. Association between pursuit of research during residency (MSc, PhD, or ≥ 2 years of non-degree research) and full employment was determined by Fisher’s exact test. Results: 60% and 26% of graduates currently have full-time staff positions in Canada and the US, respectively. “Underemployment,” defined as failure to secure a full-time position in neurosurgery despite a desire to do so (including locums, additional fellowship positions, unemployment and career changes) is currently seen in 12% of graduates, with 20% having been underemployed at some point within 5 years of graduation. Pursuit of research during residency was significantly associated with obtaining full employment (94% vs. 73%, p=0.011). Conclusions: Underemployment is a significant issue in recent neurosurgical graduates from Canadian training programs. Research training during residency appears strongly associated with obtaining full employment.

Palliative care training: A national survey of U.S. hematology/oncology fellows.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 28-28
Author(s):  
Brendan F. Curley ◽  
Roby Antony Thomas ◽  
Sijin Wen ◽  
Jianjun Zhang ◽  
Jame Abraham ◽  
...  
Keyword(s):  
Palliative Care ◽  
Pearson Correlation ◽  
Statistical Significance ◽  
Fellowship Training ◽  
Categorical Variables ◽  
Exact Test ◽  
Dying Patients ◽  
Oncology Practice ◽  
Eol Care

28 Background: The American Society of Clinical Oncology (ASCO) has recommended integration of palliative care into oncology practice at the time of diagnosis of advanced cancer. The attitudes, knowledge, and skills of Hematology/Oncology fellows in palliative medicine to implement this recommendation have not been assessed. Methods: In 2013 we surveyed current US Hematology/Oncology fellows to assess their attitudes and the quality of teaching in palliative care received during fellowship and their perceived preparedness to care for patients at End of Life (EOL). Trainees at all US programs were surveyed via Research Electronic Data Capture. The survey was IRB approved, anonymous and voluntary. Results: 176 surveys were collected. Statistical analysis was performed with t-test for numeric and Fisher’s exact test for categorical variables. 98% of respondents felt that providing care for dying patients was important. 99% indicated that physicians have a responsibility to help patients at EOL. Fellows felt their overall training in fellowship was superior to their quality of training (p<0.0001) or teaching (p <0.0001) on EOL. Pearson correlation showed that those with training in palliative care felt more prepared caring for patients at EOL (p <0.0001). Fellows who had training in palliative care during fellowship (45.4% of those surveyed) felt they had better teaching on managing a patient at EOL than those who did not (p<0.0001). There was no statistical significance noted with self-identified roles of spirituality or religion in attitudes, knowledge, or skills. 64% reported having conducted over ten family meetings regarding EOL. Only 18.9% were supervised (p<0.0001) and only 13.1% were given feedback more than ten times (p<0.0001). 89.7% of fellows surveyed stated they have disagreed with treatment without palliative care on at least one occasion. 40% of respondents did not know how to respond to a request to stop chemotherapy. Conclusions: Hematology/Oncology fellows believe that EOL care is important. Education about EOL is not at the same level of their overall fellowship training despite the recognition of the benefit of palliative care in Oncology. Educational initiatives need to be introduced to improve training on EOL care.

Limitations of QOPI end-of-life (EOL) data use for purposes of accountability: Comparison of sample versus full cohort analysis.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 87-87
Author(s):  
Carole Kathleen Dalby ◽  
Paul J. Catalano ◽  
Caitlin C. Donohue ◽  
Julie M. Bryar ◽  
Andrew David Norden ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Cohort Analysis ◽  
Sampling Strategy ◽  
Full Time ◽  
Full Time Equivalent ◽  
Improvement Program ◽  
Full Cohort ◽  
Process Measures ◽  
Exact Test ◽  
Oncology Practice

87 Background: Quality Oncology Practice Initiative (QOPI) retrospectively collects process measures at the practice level. Sample size is determined by number of full-time equivalent physicians. Although intended as an improvement program, there is growing pressure to use QOPI for accountability. Methods: We investigated QOPI sampling strategy for EOL measures in a large three-site community oncology practice for all patients meeting QOPI sampling criteria. Analysis period was July 1 to December 31, 2012. We included all patients submitted for the QOPI EOL module and compared the QOPI sample to the full but non-QOPI cohort using Fisher’s exact test. To assess relative precision, we calculated rates and 95% confidence intervals (CI) for the sampled vs. full cohorts (inclusive of QOPI cohort). Results: 246 deaths were analyzed, with 34 (13.8%) from the QOPI sample. No statistically significant differences were found between sampled and full non-QOPI cohorts. However, sampling was associated with wide CIs compared to precision using the full cohort (Table); e.g. #38 yields a CI width of 24.2% QOPI vs. 4.9% full. Similarly, #47 shows CI width of 27.7% vs. 9.0%. Low statistical significance yet wide CIs indicate comparison data are representative but with variability in precision. Conclusions: Although no statistically significant differences were identified, comparing QOPI sampling strategy to full cohort yielded presence of marked differences in precision. We suggest caution in use of current QOPI EOL sampling strategy if used for purposes other than improvement. [Table: see text]

Time, Age, and Predictors of Psychosocial Outcome in Borderline Personality Disorder

2020 ◽  
Vol 34 (2) ◽  
pp. 145-160 ◽  
Author(s):  
Paul H. Soloff ◽  
Laurel Chiappetta
Keyword(s):  
Anxiety Disorder ◽  
Interpersonal Relationships ◽  
Psychosocial Functioning ◽  
Full Employment ◽  
Assessment Method ◽  
Psychosocial Outcome ◽  
Full Time ◽  
Total Recovery ◽  
Axis I ◽  
Full Time Employment

In longitudinal studies, BPD symptoms diminish over time, though psychosocial functioning lags far behind. The effects of time and advancing age on BPD are poorly understood. We sought prospective predictors of psychosocial outcome and recovery in 150 BPD subjects followed 2 to 31 years (mean 9.94 years) using a multidimensional assessment method and biannual follow-ups. Time-in-study had no significant effect on achieving diagnostic remission in BPD, good psychosocial outcomes, meaningful interpersonal relationships, full employment, or total recovery; however, younger age was associated with social and vocational achievement independent of BPD remission. Significant contributions to psychosocial outcome were found for age, employment status, MDD, SUD, Any Anxiety Disorder, and Alcohol abuse/dependence (ALC). Remission from BPD was neither necessary or sufficient for good interpersonal relationships or full-time employment. Full-time employment and social and vocational adjustment (SAS-sr) predicted good psychosocial outcome. Axis I comorbidity with Any Anxiety Disorder, MDD, or SUD predicted poor outcome.

scholarly journals High levels of household food insecurity on the Navajo Nation

2013 ◽  
Vol 17 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Marla Pardilla ◽  
Divya Prasad ◽  
Sonali Suratkar ◽  
Joel Gittelsohn
Keyword(s):  
Food Insecurity ◽  
Cross Sectional Study ◽  
Full Time ◽  
Navajo Nation ◽  
Cross Sectional ◽  
Food Stores ◽  
Food Knowledge ◽  
The Usa ◽  
Employment Rates ◽  
Full Time Employment

AbstractObjectiveTo assess levels of and identify factors associated with food insecurity on the Navajo Nation.DesignA cross-sectional study was conducted utilizing the ten-item Radimer/Cornell food insecurity instrument. Sociodemographic, psychosocial and anthropometric data were collected.SettingNavajo Nation, USA.SubjectsTwo hundred and seventy-six members of the Navajo Nation were randomly selected at food stores and other community locations.ResultsOf the sample, 76·7 % had some level of food insecurity. Less education (mean years of schooling: P = 0·0001; non-completion of higher education: P = 0·0003), lower full-time employment rates (P = 0·01), and lower material style of life (P = 0·0001), food knowledge (P = 0·001) and healthy eating self-efficacy (P < 0·0001) scores were all positively associated with food insecurity. Perceived expensiveness (P < 0·0001) and perceived inconvenience (P = 0·0001) of healthy choices were also positively associated with food insecurity.ConclusionsFood insecurity rates on the Navajo Nation are the highest reported to date in the USA and are likely attributable to the extremely high rates of poverty and unemployment. Reducing food insecurity on the Navajo Nation will require increasing the availability of affordable healthy foods, addressing poverty and unemployment, and providing nutrition programmes to increase demand.

Use of SAMe-TT₂R₂ Score to Predict the Quality of Anticoagulation Control in Patients with Atrial Fibrillation Receiving Warfarin in Thailand

2020 ◽  
Vol 103 (6) ◽  
pp. 548-552
Keyword(s):  
Atrial Fibrillation ◽  
Therapeutic Range ◽  
Statistical Significance ◽  
Discrimination Performance ◽  
Poor Quality ◽  
Chi Square ◽  
Exact Test ◽  
Time In Therapeutic Range ◽  
Anticoagulation Control

Objective: To predict the quality of anticoagulation control in patients with atrial fibrillation (AF) receiving warfarin in Thailand. Materials and Methods: The present study retrospectively recruited Thai AF patients receiving warfarin for three months or longer between June 2012 and December 2017 in Central Chest Institute of Thailand. The patients were classified into those with SAMe-TT₂R₂ of 2 or less, and 3 or more. The Chi-square test or Fisher’s exact test was used to compare the proportion of the patients with poor time in therapeutic range (TTR) between the two groups of SAMe-TT₂R₂ score. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics. Results: Ninety AF patients were enrolled. An average age was 69.89±10.04 years. Most patients were persistent AF. An average CHA₂DS₂-VASc, SAMe-TT₂R₂, and HAS-BLED score were 3.68±1.51, 3.26±0.88, and 1.98±0.85, respectively. The present study showed the increased proportion of AF patients with poor TTR with higher SAMe-TT₂R₂ score. The AF patients with SAMe-TT₂R₂ score of 3 or more had a larger proportion of patients with poor TTR than those with SAMe-TT₂R₂ score of 2 or less with statistical significance when TTR was below 70% (p=0.03) and 65% (p=0.04), respectively. The discrimination performance of SAMe-TT₂R₂ score was demonstrated with c-statistics of 0.60, 0.59, and 0.55 when TTR was below 70%, 65% and 60%, respectively. Conclusion: Thai AF patients receiving warfarin had a larger proportion of patients with poor TTR when the SAMe-TT₂R₂ score was higher. The score of 3 or more could predict poor quality of anticoagulation control in those patients. Keywords: Time in therapeutic range, Poor quality of anticoagulation control, Warfarin, SAMe-TT₂R₂, Labile INR

Coping experiences of graduate students on full-time employment and full-time academic programmes

2020 ◽  
Vol 39 (5-6) ◽  
pp. 605-618
Author(s):  
Samuel Amponsah ◽  
Alex Kumi-Yeboah ◽  
Stephen O. Adjapong ◽  
Chris Olusola Omorogie
Keyword(s):  
Graduate Students ◽  
Full Time ◽  
Full Time Employment

scholarly journals Antimicrobial resistance in Neisseria gonorrhoeae isolates and gonorrhoea treatment in the Republic of Belarus, Eastern Europe, 2009–2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aliaksandra Aniskevich ◽  
Iryna Shimanskaya ◽  
Iryna Boiko ◽  
Tatyana Golubovskaya ◽  
Daniel Golparian ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Eastern Europe ◽  
Treatment Guidelines ◽  
Statistical Significance ◽  
Antimicrobial Treatment ◽  
National Guidelines ◽  
First Line ◽  
Exact Test ◽  
The Republic

Abstract Background Limited antimicrobial resistance (AMR) data for Neisseria gonorrhoeae are available in Eastern Europe. We investigated AMR in N. gonorrhoeae isolates in the Republic of Belarus from 2009 to 2019, antimicrobial treatment recommended nationally, and treatment given to patients with gonorrhoea. Methods N. gonorrhoeae isolates (n = 522) cultured in three regions of Belarus in 2009–2019 were examined. Determination of minimum inhibitory concentrations (MICs) of eight antimicrobials was performed using Etest. Resistance breakpoints from the European Committee on Antimicrobial Susceptibility Testing were applied where available. A Nitrocefin test identified β-lactamase production. Gonorrhoea treatment for 1652 patients was also analysed. Statistical significance was determined by the Z-test, Fisher’s exact test, or Mann-Whitney U test with p-values of < 0.05 indicating significance. Results In total, 27.8% of the N. gonorrhoeae isolates were resistant to tetracycline, 24.7% to ciprofloxacin, 7.0% to benzylpenicillin, 2.7% to cefixime, and 0.8% to azithromycin. No isolates were resistant to ceftriaxone, spectinomycin, or gentamicin. However, 14 (2.7%) isolates had a ceftriaxone MIC of 0.125 mg/L, exactly at the resistance breakpoint (MIC > 0.125 mg/L). Only one (0.2%) isolate, from 2013, produced β-lactamase. From 2009 to 2019, the levels of resistance to ciprofloxacin and tetracycline were relatively high and stable. Resistance to cefixime was not identified before 2013 but peaked at 22.2% in 2017. Only sporadic isolates with resistance to azithromycin were found in 2009 (n = 1), 2012 (n = 1), and 2018–2019 (n = 2). Overall, 862 (52.2%) patients received first-line treatment according to national guidelines (ceftriaxone 1 g). However, 154 (9.3%) patients received a nationally recommended alternative treatment (cefixime 400 mg or ofloxacin 400 mg), and 636 (38.5%) were given non-recommended treatment. Conclusions The gonococcal resistance to ciprofloxacin and tetracycline was high, however, the resistance to azithromycin was low and no resistance to ceftriaxone was identified. Ceftriaxone 1 g can continuously be recommended as empiric first-line gonorrhoea therapy in Belarus. Fluoroquinolones should not be prescribed for treatment if susceptibility has not been confirmed by testing. Timely updating and high compliance with national evidence-based gonorrhoea treatment guidelines based on quality-assured AMR data are imperative. The need for continued, improved and enhanced surveillance of gonococcal AMR in Belarus is evident.

scholarly journals Gains in employment status following antidepressant medication or cognitive therapy for depression

2015 ◽  
Vol 206 (4) ◽  
pp. 332-338 ◽  
Author(s):  
Jay C. Fournier ◽  
Robert J. DeRubeis ◽  
Jay Amsterdam ◽  
Richard C. Shelton ◽  
Steven D. Hollon
Keyword(s):  
Cognitive Therapy ◽  
Employment Status ◽  
Antidepressant Medication ◽  
Relative Advantage ◽  
Full Time ◽  
Treatment Interaction ◽  
Effect Of Treatment ◽  
Using Data ◽  
A Site ◽  
Full Time Employment

BackgroundDepression can adversely affect employment status.AimsTo examine whether there is a relative advantage of cognitive therapy or antidepressant medication in improving employment status following treatment, using data from a previously reported trial.MethodRandom assignment to cognitive therapy (n = 48) or the selective serotonin reuptake inhibitor paroxetine (n = 93) for 4 months; treatment responders were followed for up to 24 months. Differential effects of treatment on employment status were examined.ResultsAt the end of 28 months, cognitive therapy led to higher rates of full-time employment (88.9%) than did antidepressant medication among treatment responders (70.8%), χ21 = 5.78, P = 0.02, odds ratio (OR) = 5.66, 95% CI 1.16–27.69. In the shorter-term, the main effect of treatment on employment status was not significant following acute treatment (χ21 = 1.74, P = 0.19, OR = 1.77, 95% CI 0.75–4.17); however, we observed a site×treatment interaction (χ21 = 6.87, P = 0.009) whereby cognitive therapy led to a higher rate of full-time employment at one site but not at the other.ConclusionsCognitive therapy may produce greater improvements in employment v. medication, particularly over the longer term.

Sign in / Sign up

Export Citation Format

Share Document