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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.
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.
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).
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.
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.
We present preliminary results of our HST-WFPC2 pc-survey of Wolf-Rayet stars. Initiated in 1996, the goal was to discover new companions to, and cluster/association memberships of, known Galactic WR stars. From these results, Niemela et al. (1998) have already established a firm link between non-thermal radio emission and the location of binary wind-collision zones for WR 146 (confirming radio data of Dougherty et al. 1996) and WR 147 (confirming radio and IR data of Williams et al. 1997; see also Williams, these Proceedings), and confirmed the presence of a binary companion for WR 86 (listed by Jeffers et al. 1963). Here, for the first time, we present new information on WR38, WR38a, and WR 104.
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.
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.
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.
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.
In the three centuries or so since the modern international system began flo take on its present shape, its component members have come together in a wide variety of organizations, for a wide variety of purposes. Those who act on behalf of the nations have turned to international organizations to oversee peace settlements, to strengthen their collective defense capacity, to mediate conflicts between themselves, to discourage interference from the outside, to harmonize their trade relations, to supervise international waterways, to accelerate the production of food, to codify diplomatic practice, and to formalize legal proceedings. Some organizations are established primarily for the neutral purpose of making coexistence possible, others for the more affirmative purposes of positive cooperation. Some have been directed toward the modification of the system, others toward the preservation of its status quo.
It has often been observed that recent converts to any belief system tend to be among its most zealous adherents, and science (despite its emphasis on objectivity and detachment) has proved no exception. As the canons of scientific inquiry begin to take hold in each field of human knowledge, there have appeared those who seem, as it were, more royalist than the king. For these scholars the rules of scientific inference are not guidelines to be used with care but dogmas to be pursued unswervingly; to them science is not, as someone once expressed it, “attenuated common sense” but a totally different and rather severe regimen of thought.
In any field of scholarly inquiry it is recognized that we must describe before we can hope toexplain. That is, we cannot account for the incidence of a certain class of events or conditions until we have identified and described those particular phenomena. If we agree that the current state of theory in the field of international organization leaves much to be desired, this fact may be partly due to our violation of this principle. Whether we deal with all international organizations over a lengthy period of time or a smaller subset based on such inclusion criteria as function or time period and whether we treat such organizations as the dependent, intervening, or independent variable, it is essential that we first acquire the data by which such organizations can be described. The major purpose of this article is to report the results of a first systematic effort to generate this data, so that we may move on in a cumulative fashion toward the empirical testing of propositions, models, or theories in which international organization is a major variable.
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.