Project description:Since the acceptance of the Healthy DC - Go Local proposal in November 2007, members of the District of Columbia Area Health Sciences Libraries group supported the project by offering their time to select health care services, perform data entry, review records, and promote the database to their organizations. Although the amount of work required to sustain the database became more than the Go Local team was able to handle, the collaboration, dedication, and persistence of project managers, volunteers, and part-time staff members was what made the project a truly collaborative one and an ultimately successful resource for Washington, DC health care consumers.
Project description:Although physician-scientists generally contribute to the scientific enterprise by providing a breadth of knowledge complementary to that of other scientists, it is a challenge to recruit, train, and retain physicians in a research career pathway.To assess the outcomes of a novel program that combines graduate coursework and research training with subspecialty fellowship.A retrospective analysis was conducted of career outcomes for 123 physicians who graduated from the program during its first 20 years (1993-2013). Using curricula vitae, direct contact, and online confirmation, data were compiled on physicians' subsequent activities and careers as of 2013. Study outcomes included employment in academic and nonacademic research, academic clinical or private practice positions, and research grant funding.More than 80% of graduates were actively conducting research in academic, institutional, or industrial careers. The majority of graduates (71%) had academic appointments; a few (20%) were in private practice. Fifty percent had received career development awards, and 19% had received investigator-initiated National Institutes of Health (NIH) R01 or equivalent grants. Individuals who obtained a PhD during subspecialty training were significantly more likely to have major grant funding (NIH R series or equivalent) than those who obtained a Master of Science in Clinical Research. Trainees who obtained a PhD in a health services or health policy field were significantly more likely to have research appointments than those in basic science.Incorporation of graduate degree research, at the level of specialty or subspecialty clinical training, is a promising approach to training and retaining physician-scientists.
Project description:Phagocytosis is an essential step in the innate immune response to invasive fungal infections. This process is carried out by a proverbial "village" of professional phagocytic cells, which have evolved efficient machinery to recognize and ingest pathogens, namely macrophages, neutrophils and dendritic cells. These innate immune cells drive early cytokine production, fungicidal activity, antigen presentation and activation of the adaptive immune system. Despite the development of antifungal agents with potent activity, the biological activity of professional phagocytic innate immune cells has proven indispensable in protecting a host from invasive fungal infections. Additionally, an emerging body of evidence suggests non-professional phagocytes, such as airway epithelial cells, carry out phagocytosis and may play a critical role in the elimination of fungal pathogens. Here, we review recent advances of phagocytosis by both professional and non-professional phagocytes in response to fungal pathogens, with a focus on invasive aspergillosis as a model disease.
Project description:BackgroundPrevious studies suggest that neighborhood social capital is associated with children's mental health. The purpose of this study was to examine the association between neighborhood collective efficacy and children's psychosocial development.MethodsWe used data on children and their parents (n = 918) who were part of the Japanese study of Stratification, Health, Income, and Neighborhood (JSHINE) from 2010 to 2013 (wave 1 and wave 2). Households were recruited from the Tokyo metropolitan area through clustered random sampling. Changes in children's psychosocial development (assessed using a child behavioral checklist) between waves 1 and 2 were regressed on parents' perceptions of changes in neighborhood collective efficacy (social cohesion and informal social control).ResultsChange in perception of neighborhood social cohesion was inversely associated with change in child total problems (? = -0.22; 95% confidence interval [CI]: -0.37 to -0.001; effect size d = -0.03). Change in perceptions of neighborhood informal social control was inversely associated with change in children's externalizing problems (? = -0.16; 95% CI: -0.30 to -0.03; d = -0.02).ConclusionsThe results of these fixed-effects models suggest that strengthening neighborhood collective efficacy is related to improvements in child psychosocial development.
Project description:Quality of health care needs to be improved in rural China. The Chinese government, based on the 1999 Law on Physicians, started implementing the Rural Doctor Practice Regulation in 2004 to increase the percentage of certified physicians among village doctors. Special exam-targeted training for rural doctors therefore was launched as a national initiative. This study examined these rural doctors' perceptions of whether that training helps them pass the exam and whether it improves their skills.Three counties were selected from the 4 counties in Changzhou City in eastern China, and 844 village doctors were surveyed by a questionnaire in July 2012. Chi-square test and Fisher exact test were used to identify differences of attitudes about the exam and training between the rural doctors and certified (assistant) doctors. Longitudinal annual statistics (1980-2014) of village doctors were further analyzed.Eight hundred and forty-four village doctors were asked to participate, and 837 (99.17%) responded. Only 14.93% of the respondents had received physician (assistant) certification. Only 49.45% of the village doctors thought that the areas tested by the certification exam were closely related to the healthcare needs of rural populations. The majority (86.19%) felt that the training program was "very helpful" or "helpful" for preparing for the exam. More than half the village doctors (61.46%) attended the "weekly school". The village doctors considered the most effective method of learning was "continuous training (40.36%)" . The majority of the rural doctors (89.91%) said they would be willing to participate in the training and 96.87% stated that they could afford to pay up to 2000 yuan for it.The majority of village doctors in Changzhou City perceived that neither the certification exam nor the training for it are closely related to the actual healthcare needs of rural residents. Policies and programs should focus on providing exam-preparation training for selected rural doctors, reducing training expenditures, and utilizing web-based methods. The training focused on rural practice should be provided to all village doctors, even certified physicians. The government should also adjust the local licensing requirements to attract and recruit new village doctors.
Project description:Background: Research is needed to improve understanding of work-life integration issues in academic medicine and to guide the implementation of the Doris Duke Charitable Foundation's Fund to Retain Clinical Scientists (FRCS), a national initiative offering financial support to physician-scientists facing caregiving challenges. Materials and Methods: In 2018, as part of a prospective program evaluation, the authors conducted a qualitative study to examine FRCS program participants' initial impressions, solicit descriptions of their career and caregiving experiences, and inquire how such factors might influence their professional advancement. The authors invited all 33 awardees who had been granted FRCS funding in the first year of the program to participate in the study, of whom 28 agreed to complete an interview. Analysts evaluated de-identified transcripts and explicated the data using a thematic analysis approach. Results: While participants described aspects of a culture that harbor stigma against caregivers and impede satisfactory work-life integration, they also perceived an optimistic cultural shift taking place as a result of programs like the FRCS. Their comments indicated that the FRCS has the potential to influence culture if institutional leadership simultaneously fosters a community that validates individuals both as caregivers and as scientists. Conclusions: Insights garnered from this qualitative study suggest that there is a pressing need for institutional leaders to implement programs that can foster awareness and normalization of caregiving challenges. In addition to providing funding and other tangible resources, interventions should strive to reinforce a broader culture that affirms the presence of work-life integration challenges and openly embraces solutions.
Project description:Critical care scientists are a little known but increasingly prominent group of professionals, included in both the government-run Modernising Scientific Careers initiative and 2019 Guidelines for the Provision of Intensive Care Services. This article outlines the role of critical care scientists, their training programme and potential future directions for the role. A wider appreciation and acknowledgement of the critical care scientist's role within the multi-disciplinary team will allow critical care units to fully understand the potential benefits that may be brought to patient care and service delivery.
Project description:Facial image comparison practitioners compare images of unfamiliar faces and decide whether or not they show the same person. Given the importance of these decisions for national security and criminal investigations, practitioners attend training courses to improve their face identification ability. However, these courses have not been empirically validated so it is unknown if they improve accuracy. Here, we review the content of eleven professional training courses offered to staff at national security, police, intelligence, passport issuance, immigration and border control agencies around the world. All reviewed courses include basic training in facial anatomy and prescribe facial feature (or 'morphological') comparison. Next, we evaluate the effectiveness of four representative courses by comparing face identification accuracy before and after training in novices (n = 152) and practitioners (n = 236). We find very strong evidence that short (1-hour and half-day) professional training courses do not improve identification accuracy, despite 93% of trainees believing their performance had improved. We find some evidence of improvement in a 3-day training course designed to introduce trainees to the unique feature-by-feature comparison strategy used by facial examiners in forensic settings. However, observed improvements are small, inconsistent across tests, and training did not produce the qualitative changes associated with examiners' expertise. Future research should test the benefits of longer examination-focussed training courses and incorporate longitudinal approaches to track improvements caused by mentoring and deliberate practice. In the absence of evidence that training is effective, we advise agencies to explore alternative evidence-based strategies for improving the accuracy of face identification decisions.
Project description:Prematurity remains a major cause of morbidity and mortality. Research to prevent preterm birth and improve treatments for preterm infants involves both intramural and extramural research, not just at the National Institute of Child Health and Human Development, but across many institutes and centers at the National Institutes of Health.
Project description:ObjectivesConceptual clarity on physician volunteer engagement is lacking in the medical literature. The aim of this study was to present a conceptual framework to describe the elements which influence physician volunteer engagement and to explore volunteer engagement within a national educational programme.SettingThe context for this study was the Acute Critical Events Simulation (ACES) programme in Canada, which has successfully evolved into a national educational programme, driven by physician volunteers. From 2010 to 2014, the programme recruited 73 volunteer healthcare professionals who contributed to the creation of educational materials and/or served as instructors.MethodA conceptual framework was constructed based on an extensive literature review and expert consultation. Secondary qualitative analysis was undertaken on 15 semistructured interviews conducted from 2012 to 2013 with programme directors and healthcare professionals across Canada. An additional 15 interviews were conducted in 2015 with physician volunteers to achieve thematic saturation. Data were analysed iteratively and inductive coding techniques applied.ResultsFrom the physician volunteer data, 11 themes emerged. The most prominent themes included volunteer recruitment, retention, exchange, recognition, educator network and quasi-volunteerism. Captured within these interrelated themes were the framework elements, including the synergistic effects of emotional, cognitive and reciprocal engagement. Behavioural engagement was driven by these factors along with a cue to action, which led to contributions to the ACES programme.ConclusionThis investigation provides a preliminary framework and supportive evidence towards understanding the complex construct of physician volunteer engagement. The need for this research is particularly important in present day, where growing fiscal constraints create challenges for medical education to do more with less.