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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.
This study evaluated in a rigorous 18-month randomized controlled trial the efficacy of an enhanced vocational intervention for helping individuals with a recent first schizophrenia episode to return to and remain in competitive work or regular schooling.
Methods
Individual Placement and Support (IPS) was adapted to meet the goals of individuals whose goals might involve either employment or schooling. IPS was combined with a Workplace Fundamentals Module (WFM) for an enhanced, outpatient, vocational intervention. Random assignment to the enhanced integrated rehabilitation program (N = 46) was contrasted with equally intensive clinical treatment at UCLA, including social skills training groups, and conventional vocational rehabilitation by state agencies (N = 23). All patients were provided case management and psychiatric services by the same clinical team and received oral atypical antipsychotic medication.
Results
The IPS–WFM combination led to 83% of patients participating in competitive employment or school in the first 6 months of intensive treatment, compared with 41% in the comparison group (p < 0.005). During the subsequent year, IPS–WFM continued to yield higher rates of schooling/employment (92% v. 60%, p < 0.03). Cumulative number of weeks of schooling and/or employment was also substantially greater with the IPS–WFM intervention (45 v. 26 weeks, p < 0.004).
Conclusions
The results clearly support the efficacy of an enhanced intervention focused on recovery of participation in normative work and school settings in the initial phase of schizophrenia, suggesting potential for prevention of disability.
Limbic white matter pathways link emotion, cognition, and behavior and are potentially malleable to the influences of traumatic events throughout development. However, the impact of interactions between childhood and later life trauma on limbic white matter pathways has yet to be examined. Here, we examined whether childhood maltreatment moderated the effect of combat exposure on diffusion tensor imaging measures within a sample of military veterans (N = 28). We examined five limbic tracts of interest: two components of the cingulum (cingulum, cingulate gyrus, and cingulum hippocampus [CGH]), the uncinate fasciculus, the fornix/stria terminalis, and the anterior limb of the internal capsule. Using effect sizes, clinically meaningful moderator effects were found only within the CGH. Greater combat exposure was associated with decreased CGH fractional anisotropy (overall structural integrity) and increased CGH radial diffusivity (perpendicular water diffusivity) among individuals with more severe childhood maltreatment. Our findings provide preliminary evidence of the moderating effect of childhood maltreatment on the relationship between combat exposure and CGH structural integrity. These differences in CGH structural integrity could have maladaptive implications for emotion and memory, as well as provide a potential mechanism by which childhood maltreatment induces vulnerability to later life trauma exposure.
We present the results of two 2.3 μm near-infrared (NIR) radial velocity (RV) surveys to detect exoplanets around 36 nearby and young M dwarfs. We use the CSHELL spectrograph (R ~ 46,000) at the NASA InfraRed Telescope Facility (IRTF), combined with an isotopic methane absorption gas cell for common optical path relative wavelength calibration. We have developed a sophisticated RV forward modeling code that accounts for fringing and other instrumental artifacts present in the spectra. With a spectral grasp of only 5 nm, we are able to reach long-term radial velocity dispersions of ~20–30 m s−1 on our survey targets.
The reauthorization of the Pandemic and All-Hazards Preparedness Act in 2013 incorporated the dental profession and dental professionals into the federal legislation governing public health response to pandemics and all-hazard situations. Work is now necessary to expand the processes needed to incorporate and train oral health care professionals into pandemic and all-hazard response events.
Methods
A just-in-time (JIT) training exercise and immunization drill using an ex vivo porcine model system was conducted to demonstrate the rapidity to which dental professionals can respond to a pandemic influenza scenario. Medical history documentation, vaccination procedures, and patient throughput and error rates of 15 dental responders were evaluated by trained nursing staff and emergency response personnel.
Results
The average throughput (22.33/hr) and medical error rates (7 of 335; 2.08%) of the dental responders were similar to those found in analogous influenza mass vaccination clinics previously conducted using certified public health nurses.
Conclusions
The dental responder immunization drill validated the capacity and capability of dental professionals to function as a valuable immunization resource. The ex vivo porcine model system used for JIT training can serve as a simple and inexpensive training tool to update pandemic responders’ immunization techniques and procedures supporting inoculation protocols.
Observational data show an inverse association between the consumption of wholegrain foods, and inflammation and related diseases. Although the underlying mechanisms are unclear, wholegrains, and in particular the aleurone layer, contain a wide range of components with putative antioxidant and anti-inflammatory effects. We evaluated the effects of a diet high in wheat aleurone on plasma antioxidants status, markers of inflammation and endothelial function. In this parallel, participant-blinded intervention, seventy-nine healthy, older, overweight participants (45–65 years, BMI>25 kg/m2) incorporated either aleurone-rich cereal products (27 g aleurone/d), or control products balanced for fibre and macronutrients, into their habitual diets for 4 weeks. Fasting blood samples were taken at baseline and on day 29. Results showed that, compared to control, consumption of aleurone-rich products provided substantial amounts of micronutrients and phytochemicals which may function as antioxidants. Additionally, incorporating these products into a habitual diet resulted in significantly lower plasma concentrations of the inflammatory marker, C-reactive protein (P = 0·035), which is an independent risk factor for CVD. However, no changes were observed in other markers of inflammation, antioxidant status or endothelial function. These results provide a possible mechanism underlying the beneficial effects of longer-term wholegrain intake. However, it is unclear whether this effect is owing to a specific component, or a combination of components in wheat aleurone.
Edited by
Alex S. Evers, Washington University School of Medicine, St Louis,Mervyn Maze, University of California, San Francisco,Evan D. Kharasch, Washington University School of Medicine, St Louis
Recommendations limiting the intake of total fat, SFA, MUFA and PUFA have been established in several countries with the aim of reducing the risk of chronic diseases such as CVD. Studies have shown that intakes of total fat and SFA are above desired recommended intake levels across a wide range of age and sex groups. In addition, intakes of PUFA and MUFA are often reported to be less than the desired recommended intake levels. The aims of the present paper are to provide the first data on estimates of current intakes and main food sources of SFA, MUFA and PUFA in Irish children (aged 5–12 years), teenagers (aged 13–17 years) and adults (aged 18–64 years) and to analyse compliance with current dietary recommendations. Data for this analysis were based on the North/South Ireland Food Consumption Survey (n 1379, 18–64 years), the National Children’s Food Survey (n 594, 5–12 years) and the National Teen Food Survey (n 441, 13–17 years). Results showed that SFA intakes in Irish children, teenagers and adults are high, with only 6 % of children, 11 % of teenagers and 21 % of adults in compliance with the recommended daily intake. The main food groups that contributed to SFA intakes were whole milk; fresh meat; meat products; biscuits, cakes, buns and pastries; and sugars, confectionery and preserves.
The IAU Working Group (WG) on Numerical Standards for Fundamental Astronomy has been tasked with updating the IAU Current Best Estimates (CBEs), conforming with the IAU Resolutions, IERS Conventions and Système International d'Unités whenever possible. As part of its effort to achieve this, the WG is working in close cooperation with IAU Commissions 4 and 52, the IERS, and the BIPM Consultative Committee for Units.
Ingestion of foreign anthropogenic material, here called junk, has been documented in many avian taxa but has become especially problematic in some Old World Gyps vulture populations within the last 30 years. Here, we document the effects of ingested junk on a reintroduced population of the Critically Endangered California Condor Gymnogyps californianus in southern California, U.S.A. Of 13 breeding attempts to date (2001–2005), only one has resulted in successful fledging. Of nests where either the nest substrate was sifted (n = 10) or nestlings (n = 8) were examined, all but one held junk. Nine nestlings hatched in the wild between 2002 and 2005; of these six died at or near nests and two were removed from the wild for health reasons. Four dead nestlings and two removed from the wild held substantial quantities of junk. In two cases, junk ingestion was determined to be the cause of death. Five of six dead nestlings had elevated hepatic copper levels (150–531 ppm dry weight) although the significance of this, if any, remains undetermined. In comparison with historic condor nests (n = 69), junk was more prevalent and of greater size and quantity in reintroduced condor nests. To date, junk ingestion has been the primary cause of nest failure in the reintroduced condor population and threatens the reestablishment of a viable breeding population in southern California.
In order to detect directly faint planets around other stars it is important to develop techniques to cancel the central starlight. We report progress in terms of null depth on the visible nulling experiments at JPL, essential for NASAs future space missions as well as for an upcoming sounding rocket based experiment. A level of 1 Million to 1 nulling ratio (1e-6 rejection ratio) has been obtained for the first time for visible laser light, and a level of 100000 to 1 nulling ratio has been obtained for a relatively large (5%) bandpass at 650nm. Using a combination of a fiber array and deformable mirror a null of 1e-6 would correspond to a contrast of 1e-9 at a distance of 2-3$\lambda$ in the airy disk plane, only 10x away from TPFs goal. The configuration used was a fiber fed Mach Zender type interferometer, using 2 or 3 mirrors in each two arm, placed in an enclosed air container. For broadband light we used tilted dispersion glass plates in the nuller arms and an avalanche photon diode module to cover the large dynamic range. We describe a variety of conditions that have to be met and optimized to reach very deep nulls and sub-nanometer optical path difference stability, such as optical alignment, symmetry in the two arms, mechanical stability and vibration isolation.
Ground and space based coronagraphs have been proposed to suppress the light of the star so a planet nearby can be imaged. But even when starlight has been suppressed by $10^{10}$, the residual starlight is as bright as the planet, and must be subtracted to $2*10^{-11}$ for a 5 sigma detection of the planet. For a ground based AO coronagraph, the problem is even more severe. Typically suppression of starlight to $10^{-5}$ of the star is possible and the residual speckle pattern must not have any “bumps” that mimic a planet at $10^{-7}-10^{-8}$. This paper describes a speckle calibration approach that measures the electric field of the light after it exits the coronagraph, in order to estimate the speckle pattern in the image plane. This technique makes use of the coherence of star light or rather the incoherence of starlight to planet light, and has very significant advantages compared to other techniques.
For a space based coronagraph, an alternative approach is to rotate the telescope /coronagraph and subtract two images. The calibration interferometer described here has the advantage that the temporal stability of the system can be relaxed by several orders of magnitude. For a ground based AO coronagraph system this approach has none of the serious limitations of the techniques based on the radial expansion of the speckle pattern with wavelength and enables ground based AO coronagraphs to approach the photon limit rather than the atmospheric limit. The calibration interferometer is being built for a NASA sounding rocket experiment by BU, JPL, MIT, and GSFC (PICTURE) with a 50cm telescope and a nulling coronagraph to be launched in 2007. It is also part of a design study for an extreme AO coronagraph for the Gemini Telescope, and a conceptual study of an extreme AO coronagraph for the TMT.
A HST-wfpc2 survey of Galactic Wolf-Rayet stars was undertaken over a five year period, in an effort to discover new close visual companions, tight clusters, and/or association memberships. In total, 61 Galactic WR stars were observed, with nine objects being members of the subclasses WC8 and WC9, which are associated with dust production. For these nine, we present images of WR 11, WR 48a, WR 69, WR 70, WR 81, and WR 92. We refer to Wallace et al. (2002) for discussion of WR 98a, WR 104, and WR 112. Overall, we find for separations of approximately ≥ 150 mas, that the binary/association properties of the WC8/WC9 sample are statistically indistinguishable from the overall WR population. These statistics are limited, however, by the small numbers of each WR subclass observed.