Reproductive Services and Conscience-Based Refusals in Obstetrics and Gynecology Training

2021 ◽  
pp. 002436392110405
Author(s):  
Kristin Kalinowski ◽  
Cara Buskmiller ◽  
Donald G. Ward
Keyword(s):  
Birth Control ◽  
Regional Differences ◽  
Univariate Analysis ◽  
Program Directors ◽  
Obstetrics And Gynecology ◽  
Reproductive Services ◽  
Refusal To Participate ◽  
The Impact ◽  
First Time ◽  
Question Survey

Purpose: Professional bodies such as the American College of Obstetrics and Gynecology recognize the impact of conscience-based decisions. The first time such decisions affect patients and providers is in residency. Our study sought to determine the attitudes of program directors towards various conscience-based refusals in potential applicants to obstetrics and gynecology programs. Method: An eight-question survey was sent to 279 directors of U.S. obstetrics and gynecology residencies in 2019. The survey proposed hypothetical conscientious refusals of common aspects of obstetric and gynecology practice. The survey asked respondents to categorize their reaction to these choices and choose from a list of factors which could modify their reaction. Univariate analysis and multivariate logistic regression were performed. Results: 97 program directors (35%) responded. A majority of PDs reported that the inability to prescribe or counsel on birth control, to provide methotrexate, to counsel on abortion, or to clearly enumerate refusals was impossible to work around, likely to lower an applicant’s rank, not compatible with training, or not good for patients; collectively, these responses were grouped as “negative reactions” (73–99%). Female program directors had more negative reactions to applicants who refused to prescribe birth control (aOR 15.8, 95% CI 1.7–99.5) and counsel on abortion (aOR 3.6, 95% CI 1.2–10.8). Directors from different locations and program types did not have significantly different responses. A few program directors identified that academic strength could mitigate otherwise negatively-viewed choices. Illustrative comments of directors’ attitudes are provided. Conclusions: Program directors agree that conscientious refusal to participate in certain activities is problematic for obstetrics and gynecology residency. There are very few subjective or regional differences on this stance, and few aspects of an application modify directors’ reactions.

scholarly journals P.177 The Effect of the COVID 19 Pandemic on theTraining of Surgical Residents in Canada. A Survey of Residents and Program Directors.

2021 ◽  
Vol 48 (s3) ◽  
pp. S70-S71
Author(s):  
H Girgis ◽  
V LeBlanc ◽  
A Chaput ◽  
F Alkherayf
Keyword(s):  
Health Care Systems ◽  
Program Directors ◽  
Secondary Effects ◽  
Program Administrators ◽  
Surgical Residents ◽  
Care Systems ◽  
Lost Time ◽  
The Impact ◽  
Insight Into ◽  
Question Survey

Background: The coronavirus 2019 pandemic has led to restructuring of health care systems and has subsequently had secondary effects on medical education. This study examines the impact on training of surgical residents in Canada. Methods: The study consisted of a 25-question survey for residents and a 22-question survey for program directors, which were distributed electronically through program administrators on July 3rd- July 11th, 2020. Questions sought to elicit residents’ current experiences and gain insight into methods by which to enhance future training. Results: 108 residents and 21 program directors, from various surgical specialties across Canada, completed the survey. Operative exposures were reported to be reduced by 25-100% and 39% of residents were redeployed. However, 89% of residents reported accessing academic half days virtually and 57% had additional online modules. Despite lost time, 100% of program directors confirmed that residents did not require training extensions. Concerns regarding training, personal health, employability and fellowships were raised. 55-70% of residents and program directors advocated for alternative educational courses, increasing elective time, utilizing simulation for assessment and flexibility in crediting different training experiences. Conclusions: Canadian surgical residents had a significant reduction in operative experiences during the pandemic. Moving forward, it will be important to find alternative educational experiences.

scholarly journals The Significance of Fast Radiative Transfer for Hyperspectral SWIR XCO2 Retrievals

Atmosphere ◽  
2020 ◽  
Vol 11 (11) ◽  
pp. 1219
Author(s):  
Peter Somkuti ◽  
Hartmut Bösch ◽  
Robert J. Parker
Keyword(s):  
Carbon Dioxide ◽  
Radiative Transfer ◽  
Bias Correction ◽  
Regional Differences ◽  
Regional Scale ◽  
Computational Effort ◽  
Retrieval Algorithm ◽  
Manageable Level ◽  
The Impact ◽  
First Time

Fast radiative transfer (RT) methods are commonplace in most algorithms which retrieve the column-averaged dry-mole fraction of carbon dioxide (XCO2) in the Earth’s atmosphere. These methods are required to keep the computational effort at a manageable level and to allow for operational processing of tens of thousands of measurements per day. Without utilizing any fast RT method, the involved computation times would be one to two orders of magnitude larger. In this study, we investigate three established methods within the same retrieval algorithm, and for the first time, analyze the impact of the fast RT method while keeping every other aspect of the algorithm the same. We perform XCO2 retrievals on measurements from the OCO-2 instrument and apply quality filters and parametric bias correction. We find that the central 50% of scene-by-scene differences in XCO2 between retrieval sets, after threshold filtering and bias correction, that use different fast RT methods, are less than 0.40 ppm for land scenes, and less than 0.11 ppm for ocean scenes. Significant regional differences larger than 0.3 ppm are observed and further studies with larger samples and regional-scale subsets need to be undertaken to fully understand the impact on applications that utilize space-based XCO2.

scholarly journals COVID-19’s Impact on the 2020-2021 Resident Match: A Survey of Otolaryngology Program Directors

2020 ◽  
pp. 000348942096704
Author(s):  
David A. Kasle ◽  
Sina J. Torabi ◽  
Said Izreig ◽  
Rahmatullah W. Rahmati ◽  
R. Peter Manes
Keyword(s):  
Program Directors ◽  
Large Majority ◽  
Free Text ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Residency Programs ◽  
Research Involvement ◽  
Historical Importance ◽  
The Impact ◽  
Question Survey

Objective: To determine the impact coronavirus disease of 2019 (COVID-19) will have on the 2020-2021 otolaryngology (OTO-HNS) resident application cycle. Methods: A cross-sectional survey targeting OTO-HNS program directors (PD) was created and disseminated via email to PDs on May 28th 2020. Descriptive analyses of the 19-question survey was performed, and free text responses for certain suitable questions were thematically categorized into groups determined to be relevant during analysis. Results: Twenty-nine of 123 solicited PDs (23.6%) completed the survey. Nineteen (65.5%) respondents indicated they would not host away rotations (AR) in 2020, and 9 (31.0%) reported that they would consider away rotators without home programs. Regarding the historical importance of AR, 21 (72.4%) PDs stated they were either “extremely” or “very” important in evaluating candidates. Sixteen (55.2%) PDs stated that virtual interviews would impact their ability to properly gauge candidates and 12 (41.4%) were unsure. Eight PDs (27.6%) stated their evaluation of candidates will likely change, with a shift toward an increased reliance on letters of recommendation, research involvement, and clerkship grades. The large majority of PDs—25 (86.2%)—were not worried that the COVID-19 pandemic would affect the abilities of new interns beginning in 2021. Conclusion: Virtual interviews and engagement activities will mostly supplant sub-Is and AR for the 2020-2021 OTO-HNS application cycle. Surveyed PDs largely believe these will be insufficient in providing a comprehensive assessment of candidates, and will similarly limit applicants’ ability to gauge residency programs. Criteria utilized to evaluate students is expected to change.

scholarly journals Comparing Single and Dual Console Systems in the Robotic Surgical Training of Graduating OB/GYN Residents in the United States

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Emad Mikhail ◽  
Jason L. Salemi ◽  
Stuart Hart ◽  
Anthony N. Imudia
Keyword(s):  
Surgical Training ◽  
Laparoscopic Hysterectomy ◽  
Program Directors ◽  
The United States ◽  
Obstetrics And Gynecology ◽  
Robotic Training ◽  
Case Volume ◽  
Robotic Assisted ◽  
Robotic Surgical Training ◽  
The Impact

Objective. To assess the impact of a single versus dual console robotic system on the perceptions of program directors (PD) and residents (RES) towards robotic surgical training among graduating obstetrics and gynecology residents.Design. An anonymous survey was developed usingQualtrics, a web-based survey development and administration system, and sent to obstetrics and gynecology program directors and graduating residents.Participants. 39 program directors and 32 graduating residents (PGY4).Results. According to residents perception, dual console is utilized in about 70% of the respondents’ programs. Dual console system programs were more likely to provide a robotics training certificate compared to single console programs (43.5% versus 0%,p=0.03). A greater proportion of residents graduating from a dual console program perform more than 20 robotic-assisted total laparoscopic hysterectomies, 30% versus 0% (p=0.15).Conclusions. Utilization of dual console system increased the likelihood of obtaining robotic training certification without significantly increasing the case volume of robotic-assisted total laparoscopic hysterectomy.

scholarly journals The Impact of COVID-19 pandemic on Obstetrics and Gynecology Residency Programs and perspectives on adaptive ways of training in Ethiopia

2020 ◽  
Author(s):  
Wondimu Gudu ◽  
Mekitie Wondafrash ◽  
Delayehu Bekele ◽  
Balkachew Nigatu ◽  
Malede Birrara ◽  
...  
Keyword(s):  
Data Analysis ◽  
Residency Training ◽  
Quantitative Data ◽  
Clinical Teaching ◽  
Program Directors ◽  
Obstetrics And Gynecology ◽  
Complete Suppression ◽  
Normal Delivery ◽  
Research Activities ◽  
The Impact

Abstract Background: The impact of Covid-19 on healthcare system and trainings has been tremendous and unpredictable. In addition to service re-organization, teaching institutions will have to devise adaptive mechanisms to cope up with the disruption in medical education and residency training. Objectives: to assess the effect of Covid-19 pandemic on obstetrics and gynecology residency program and explore residents’ & program directors’ perspectives on alternative academic approaches in Ethiopia.Methods: This is a cross sectional mixed method study which was conducted at 12 institutions engaged in obstetrics and gynecology residency training in Ethiopia from May to June 2020. Quantitative data were collected from 240 residents employing an online platform (Google Forms) and focus group discussion was conducted using the ZOOM video-conferencing platform with eleven chief residents and eight program directors. Quantitative data analysis was performed using Stata 15 statistical software while thematic synthesis approach was used for the qualitative data analysis assisted by ATLAS.ti 7 for windows. Ethical clearance was obtained from IRB of Saint Paul’s Hospital Millennium Medical College. Results: All levels of residents from all residency sites were represented. The level of residents’ engagement in various routine clinical services vary depending on the type of service during COVID-19 pandemic period. Residents’ involvement in routine ANC, high risk clinics are “slightly” reduced while in Gynecology OPDs, the reduction was “severe”. There was no effort made to address the psychological impact of the pandemic on residents. The level of reduction in didactic and clinical teaching (rounds, case presentations, seminars, management sessions ranged from “some” to “complete interruption” for most of the residents at different years of training. Although the reduction in obstetric practical exposure (normal delivery, cesarean delivery) was “slight”, there was “sever” reduction to “complete suppression” (>80%) in major gynecologic surgeries primarily affecting final year residents. Research activities are completely halted in most of the institutions. Generally, adaptive methods to sustain the residency training were implemented in very few of the institutions. Conclusions: There was significant disruption in all domains of the residency training following the report of the first case of COVID-19 in Ethiopia. The preparedness and response of the programs was very poor and there was limited effort in implementing adaptive teaching methods in almost all of the institutions.

Genetic variants involved in bromodomain-containing protein 4 (BRD4) regulating pathway to predict outcomes in patients with metastatic colorectal cancer: Results from FIRE3 and MAVERICC trials.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 232-232
Author(s):  
Jingyuan Wang ◽  
Yi Xiao ◽  
Fotios Loupakis ◽  
Sebastian Stintzing ◽  
Hiroyuki Arai ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Genetic Variants ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Discovery Cohort ◽  
Strong Trend ◽  
The Impact ◽  
First Time ◽  
Worse Prognosis

232 Background: BRD4 plays an important role in transcription, DNA repair and drug resistance. High expression and polymorphisms of BRD4 regulating pathways were reported to be related to worse prognosis in colorectal cancer. Therefore, we hypothesized that genetic variants in BRD4 regulating pathway may predict first-line treatment outcome in mCRC pts. Methods: The impact on outcome of 22 SNPs in 7 genes involved in BRD4 regulating pathway (BRD4, SIPA1, MYC, 53BP1, H2AX, BATF, CD47) was analyzed through the OncoArray, a customized array manufactured by Illumina, on genomic DNA from blood samples of pts enrolled in 2 randomized trials. MAVERICC FOLFIRI/bevacizumab (bev) arm served as discovery cohort (N = 107), FIRE3 FOLFIRI/bev arm as validation (N = 107) and FOLFIRI/cetuximab (cet) arm as control (N = 129). Results: In the discovery cohort, right(R)-sided pts with BRD4 rs4808272 any G allele (N = 46) showed significantly shorter PFS (9.5 vs 18 m) compared to carriers of A/A (N = 21) in both uni- and multi-variable analysis ( p < .01); R-sided pts carrying any T allele of BATF rs7161377 (N = 50) showed longer PFS (12.3 vs 6.8 m) compared to carriers of C/C (N = 14) in univariate analysis ( p < .05) and had a strong trend in multivariable analysis ( p = .06). These findings were all validated in R-sided pts in FIRE3 bev arm (BRD4 rs4808272, PFS 9.8 vs 18.7 m; BATF rs7161377, PFS 15.1 vs 4.2 m) in uni- (both p < .01) and multi-variable ( p = .08 and p < .05 respectively) analysis. No significant association was observed in the control arm. Interestingly, pts carrying CD47 rs3206652 any C allele (N = 13) only showed significant longer PFS (9.0 vs 3.0 m, univariable p < .01 and multivariable p = .07) in the R-sided pts of FIRE3 cet cohort, but no association was observed in the bev-based treatment. Conclusions: Our study demonstrates for the first time that BRD4 and BATF polymorphisms may predict outcomes of bev-based treatment in R-sided mCRC pts; Meanwhile CD47 polymorphism could predict outcomes of cet-based treatment in R-sided mCRC pts. This finding supports a possible role of BRD4 regulating pathway in contributing to resistance to anti-VEGF/EGFR treatment.

Relationship between big five personality model and abusive supervision

2019 ◽  
Vol 12 (2) ◽  
Author(s):  
Bibi Tahira ◽  
Naveed Saif ◽  
Muhammad Haroon ◽  
Sadaqat Ali
Keyword(s):  
Big Five ◽  
Abusive Supervision ◽  
State Universities ◽  
Big Five Personality ◽  
Big Five Model ◽  
The Impact ◽  
First Time ◽  
Supervisor Behavior ◽  
Moderating Role

The current study tries to understand the diverse nature of relationship between personality Big Five Model (PBFM) and student's perception of abusive supervision in higher education institutions of Khyber Pakhtoonkhwa Pakistan. Data was collected in dyads i.e. (supervisors were asked to rate their personality attributes while student were asked to rate the supervisor behavior) through adopted construct. For this purpose, data was collected from three government state universities and one Private Sector University. The focus was on MS/M.Phill and PhD student and their supervisors of the mentioned universities. After measuring normality and validity regression analysis was conducted to assess the impact of supervisor personality characteristics that leads to abusive supervision. Findings indicate interestingly that except agreeableness other four attributes of (PBFM) are play their role for abusive supervision. The results are novel in the nature as for the first time Neuroticism, openness to experience, extraversion and conscientiousness are held responsible for the abusive supervision. The study did not explore the demographic characteristics, and moderating role of organizational culture, justice and interpersonal deviances to understand the strength of relationship in more detail way. Keywords: Personality big five model, abusive supervision, HEIs

GAMBARAN PENGETAHUAN SISWA TENTANG PERILAKU SEKS BEBAS DI SMA/SMK KOTA LUBUKLINGGAU TAHUN 2016

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Rini Mayasari Rini Mayasari
Keyword(s):  
High School ◽  
Univariate Analysis ◽  
Good Knowledge ◽  
Sex Behavior ◽  
School Class ◽  
Sufficient Knowledge ◽  
High School Class ◽  
Study Population ◽  
The Impact ◽  
Disease Free

ABSTRACT   Free sex is a relationship that is done by men and women without matrimony. Various forms of sexual behavior, such as intimate dating, courtship, to have sexual contact. Factors associated with sex behavior among others, is the lack of knowledge about free sex, free sex impact, forms of promiscuity, perversion LGBT, and disease-free sex. This study design is the technique of sampling using quantitative indirectly using a questionnaire tools shaped questionnaires. Be knew overview of students' knowledge about sex in high school / vocational Lubuk Linggau Year 2016. The study population was high school class XII students in schools in the city Lubuklingga 2016. The sample in this study is the high school class XII students in 9 schools there in Lubuklinggau of 167 people. Results of univariate analysis showed respondent knowledge about free sex amounted to 48 people (28,74%), students with sufficient knowledge of 54 people (32,33%), and students with less knowledge of 65 people (38, 93%). Students with a good knowledge about the impact of free sex amounted to 57 (34,13%), students with sufficient knowledge of 69 people (41,31%), and students with less knowledge 41 (24,56%). Students with a good knowledge about the form of free sex amounted to 58 students (34,73%), students with sufficient knowledge totaled 49 peoples (29,34%), and students with less knowledge of 60 people (35,93%). Students with a good knowledge about LGBT amounted to 54 (32,34%), students with sufficient knowledge amounted to 68 peoples (40.71%), and students with less knowledge amounted 45 peoples (26,95%). Students with a good knowledge about the disease free sex amounted to 22 peoples (13,17%), students with sufficient knowledge of 39 peoples (23,35%), and students with less knowledge amounted to 106 peoples (63,48%).     ABSTRAK   Seks bebas merupakan hubungan yang dilakukan oleh laki-laki dan perempuan tanpa adanya ikatan perkawinan. Berbagai bentuk tingkah laku seksual, seperti berkencan intim, bercumbu, sampai melakukan kontak seksual. Faktor-faktor yang berhubungan dengan perilaku seks bebas antara lain adalah kurangnya pengetahuan tentang seks bebas, dampak seks bebas, bentuk-bentuk seks bebas, penyimpangan LGBT, dan penyakit seks bebas. Desain penelitian ini adalah teknik pengambilan sampel menggunakan teknik kuantitatif yaitu secara tidak langsung menggunakan alat bantu angket berbentuk kuisener. Di ketahuinya gambaran pengetahuan siswa tentang seks bebas di SMA/SMK Kota Lubuk Linggau Tahun 2016. Populasi penelitian ini adalah siswa kelas XII SMA di sekolah yang ada di Kota Lubuklingga tahun 2016. Sampel pada penelitian ini adalah siswa kelas XII SMA di 9 sekolah yang ada di Kota Lubuklinggau yang berjumlah 167 orang. Hasil analisis univariat menunjukan respondent pengetahuan tentang seks bebas berjumlah 48 orang (28,74%), siswa dengan pengetahuan cukup 54 orang (32,33%), dan siswa dengan pengetahuan kurang 65 orang (38,93%). Siswa dengan pengetahuan baik tentang dampak perilaku seks bebas berjumlah 57 orang (34,13%), siswa dengan pengetahuan cukup 69 orang (41,31%), dan siswa dengan pengetahuan kurang 41 orang (24, 56%). Siswa dengan pengetahuan baik tentang bentuk perilaku seks bebas  berjumlah 58 siswa (34,73%), siswa dengan pengetahuan cukup  berjumlah 49orang (29,34%), dan siswa dengan pengetahuan kurang berjumlah 60 orang  (35,93%). Siswa dengan  pengetahuan baik tentang LGBT berjumlah 54 orang (32,34%), siswa dengan pengetahuan cukup berjumlah 68 orang (40,71%), dan siswa dengan  pengetahuan kurang berjumlah 45orang (26,95%). Siswa dengan pengetahuan baik tentang penyakit seks bebas berjumlah 22 orang (13,17%), siswa dengan pengetahuan cukup 39 orang (23,35%), dan siswa dengan pengetahuan kurang berjumlah 106 orang (63,48%).  

The Influence of TRIPS Compliant Patent Laws on Indian Pharmaceutical Industry

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Rupesh Rastogi ◽  
Virendra Kumar
Keyword(s):  
Pharmaceutical Industry ◽  
Patent Protection ◽  
Uruguay Round ◽  
Pharmaceutical Products ◽  
Trips Agreement ◽  
Patent Law ◽  
Patent Laws ◽  
The Impact ◽  
First Time ◽  
Indian Pharmaceutical Industry

The first legislation in India relating to patents was the Act VI of 1856. The Indian Patents and Design Act, 1911 (Act II of 1911) replaced all the previous Acts. The Act brought patent administration under the management of Controller of Patents for the first time. After Independence, it was felt that the Indian Patents & Designs Act, 1911 was not fulfilling its objective. Various comities were constituted to recommend, framing a patent law which can fulfill the requirement of Indian Industry and people. The Indian Patent Act of 1970 was enacted to achieve the above objectives. The major provisions of the act, provided for process, not the product patents in food, medicines, chemicals with a term of 14 years and 5-7 for chemicals and drugs. The Act enabled Indian citizens to access cheapest medicines in the world and paved a way for exponential growth of Indian Pharmaceutical Industry. TRIPS agreement, which is one of the important results of the Uruguay Round, mandated strong patent protection, especially for pharmaceutical products, thereby allowing the patenting of NCEs, compounds and processes. India is thereby required to meet the minimum standards under the TRIPS Agreement in relation to patents and the pharmaceutical industry. India’s patent legislation must now include provisions for availability of patents for both pharmaceutical products and processes inventions. The present paper examines the impact of change in Indian Patent law on Pharmaceutical Industry.

The impact of traditional plants and their secondary metabolites in the discovery of COVID-19 treatment

2020 ◽  
Vol 26 ◽  
Author(s):  
Shabana Bibi ◽  
Ayesha Sarfraz ◽  
Ghazala Mustafa ◽  
Zeeshan Ahmed ◽  
Muhammad Aurang Zeb ◽  
...  
Keyword(s):  
Secondary Metabolites ◽  
Test System ◽  
Chemical Information ◽  
System Type ◽  
The Family ◽  
Comprehensive Search ◽  
Coronavirus Infection ◽  
The Impact ◽  
First Time ◽  
Plant Sources

Background: Coronavirus Disease-2019 belongs to the family of viruses which cause a serious pneumonia along with fever, breathing issues and infection of lungs for the first time in China and later spread worldwide. Objective: Several studies and clinical trials have been conducted to identify potential drugs and vaccines for Coronavirus Disease-2019. The present study listed natural secondary metabolites identified from plant sources with antiviral properties and could be safer and tolerable treatment for Coronavirus Disease-2019. Methods: A comprehensive search on the reported studies was conducted using different search engine such as Google scholar, SciFinder, Sciencedirect, Medline PubMed, and Scopus for the collection of research articles based on plantderived secondary metabolites, herbal extracts, and traditional medicine for coronavirus infections. Results: Status of COVID-19 worldwide and information of important molecular targets involved in COVID-19 is described and through literature search, is highlighted that numerous plant species and their extracts possess antiviral properties and studied with respect to Coronavirus treatments. Chemical information, plant source, test system type with mechanism of action for each secondary metabolite is also mentioned in this review paper. Conclusion: The present review has listed plants that have presented antiviral potential in the previous coronavirus pandemics and their secondary metabolites which could be significant for the development of novel and a safer drug which could prevent and cure coronavirus infection worldwide.

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