Training Opportunities for Overseas Psychiatrists

1975 ◽  
Vol 127 (2) ◽  
pp. 179-184 ◽  
Author(s):  
Peter Brook

SummaryThe literature relating to the training opportunities offered to overseas graduates in this country and the United States is reviewed. Although overseas trainees in psychiatry do not see themselves at a great disadvantage, the fact that the great majority are working in non-teaching hospitals means by implication that overall their training is not as good as that of home graduates.

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Saqib A Chaudhry ◽  
Iqra N Akhtar ◽  
Wei Huang ◽  
Ameer E Hassan ◽  
Mohammad Rauf A Chaudhry ◽  
...  

Background: Carotid revascularization procedure, carotid endarterectomy (CEA) and carotid stent placement (CAS), are some of the most common procedures performed in United States and expected to change due to wider adoption of CAS. We performed this study to determine the changes in utilization of CEA and CAS in United States using nationally representative data. Methods: We used the National Inpatient Sample (NIS) from 2005 to 2014 to assess the changes in utilization of CEA and CAS over last 10 years in patients with symptomatic and asymptomatic carotid artery stenosis. NIS is the largest all payer dataset that includes diagnoses, admissions and discharge, demographics, and outcomes data of patients admitted to short stay non-Federal hospitals in the United States. We analyzed patterns of changes in utilization in various subsets of patients with carotid artery stenosis. Results: A total of 1,186,182 patients underwent carotid revascularization procedures during study period; 1,032,148 (87.1%) and 154,035 (12.9%) were CEA and CAS, respectively. The overall carotid revascularization procedures decreased over last 10 years (11.1% in 2005 to 8.4%in 2014, trend test p <.0001). Carotid revascularization in symptomatic patients increased (7.64% in 2005 to 11.01% in 2014, trend test p <.0001) while it decreased in asymptomatic patients (92.36% in 2006 to 88.99% in 2014, trend test p <.0001). There was an overall decrease in CEA (11.6% in 2005 to 8.3% in 2014, trend test <.0001) while in CAS remained unchanged (8.1% in 2005 to 8.9% in 2014, p=NS). There was an increase in carotid revascularization in teaching hospitals (40.9% in 2005 to 67.1% in 2014, trend test p <.0001) while decrease in non-teaching hospitals (50.9% in 2006 to 27.1% in 2014, trend test p <.0001). There was a decrease in carotid revascularization procedures in patients aged ≥80 years (19.8% in 2005 to 18.7% in 2014, trend test p <.0001) and CEA (19.6% in 2006 to 18.8% in 2014, trend test P<.0001) and CAS (21.2% in 2006 to 18.6% in 2014, trend test p=<.0001). Conclusion: Although CAS is increasing in a disproportionate manner within patient subgroups in United States, overall carotid revascularization procedures have decreased for unclear reasons.


PEDIATRICS ◽  
1959 ◽  
Vol 23 (2) ◽  
pp. 369-370

A STUDY of the general practitioners' opinions about that portion of their practice devoted to pediatrics is the subject of a recent report. In view of the fact that the great majority of pediatric care in the United States is provided by general practitioners, this report is of interest to pediatricians as well as general practitioners. In this study, approximately 125 general practitioners living in the state of Washington were interviewed. All of them had graduated from medical school after 1950. The data obtained showed that the proportion of general practice devoted to pediatrics in 1957 was virtually identical to that reported in the survey made by the Academy of Pediatrics in 1948. In 1948, one-third of the general practitioners' patients were children; the figure obtained in 1957 was 34%.


Author(s):  
Jeffrey Van Blarcom ◽  
Andrew Chevalier ◽  
Benjamin Drum ◽  
Sarah Eyberg ◽  
Elizabeth Vukin ◽  
...  

PEDIATRICS ◽  
1978 ◽  
Vol 62 (6) ◽  
pp. 1098-1103
Author(s):  
Judith Bourne Rooks

It is estimated that each year approximately 20% of all 15- to 19-year-old American girls receive estrogens in the form of a pharmaceutical agent. The proportion of blacks in this age group who receive some form of estrogen therapy is estimated at 36%. The great majority of estrogen use is for the purposes of contraception and, to a lesser extent, suppression of lactation following childbirth. Less than 1% of the girls in this age group receive estrogen for treatment of medical conditions.


Author(s):  
Neill Y. Li ◽  
Justin E. Kleiner ◽  
Edward J. Testa ◽  
Nicholas J. Lemme ◽  
Avi D. Goodman ◽  
...  

Abstract Introduction Utilize a national pediatric database to assess whether hospital characteristics such as location, teaching status, ownership, or size impact the performance of pediatric digit replantation following traumatic digit amputation in the United States. Materials and Methods The Kid’s Inpatient Database (KID) was used to query pediatric traumatic digit amputations between 2000 and 2012. Ownership (private and public), teaching status (teaching and non-teaching), location (urban and rural), hospital type (general and children’s), and size (large and small-medium) characteristics were evaluated. Replantations were then divided into those that required subsequent revision replantation or amputation. Fisher’s exact tests and multivariable logistic regressions were performed with p <0.05 considered statistically significant. Results Overall, 1,015 pediatric patients were included for the digit replantation cohort. Hospitals that were privately owned, general, large, urban, or teaching had a significantly greater number of replantations than small-medium, rural, non-teaching, public, or children’s hospitals. Privately owned (odds ratio [OR]: 1.80; 95% confidence interval [CI]: 1.06–3.06; p = 0.03) and urban (OR: 2.29; 95% CI: 1.41–3.73; p = 0.005) hospitals were significantly more likely to perform replantation. Urban (OR: 4.02; 95% CI: 1.90–8.47; p = 0.0003) and teaching (OR: 2.11; 95% CI: 1.17–3.83; p = 0.014) hospitals were significantly more likely to perform a revision procedure following primary replantation. Conclusion Private and urban hospitals were significantly more likely to perform replantation, but urban and teaching hospitals carried a greater number of revision procedures following replantation. Despite risk of requiring revision, the treatment of pediatric digit amputations in private, urban, and teaching centers provide the greatest likelihood for an attempt at replantation in the pediatric population. The study shows Level of Evidence III.


2013 ◽  
Vol 141 (9) ◽  
pp. 3186-3202 ◽  
Author(s):  
Scott D. Rudlosky ◽  
Henry E. Fuelberg

Abstract Storm severity in the mid-Atlantic region of the United States is examined using lightning, radar, and model-derived information. Automated Warning Decision Support System (WDSS) procedures are developed to create grids of lightning and radar parameters, cluster individual storm features, and data mine the lightning and radar attributes of 1252 severe and nonsevere storms. The study first examines the influence of serial correlation and uses autocorrelation functions to document the persistence of lightning and radar parameters. Decorrelation times are found to vary by parameter, storm severity, and mathematical operator, but the great majority are between three and six lags, suggesting that consecutive 2-min storm samples (following a storm) are effectively independent after only 6–12 min. The study next describes the distribution of lightning jumps in severe and nonsevere storms, differences between various types of severe storms (e.g., severe wind only), and relationships between lightning and radar parameters. The 2σ lightning jump algorithm (with a 10 flashes min−1 activation threshold) yields 0.92 jumps h−1 for nonsevere storms and 1.44 jumps h−1 in severe storms. Applying a 10-mm maximum expected size of hail (MESH) threshold to the 2σ lightning jump algorithm reduces the frequency of lightning jumps in nonsevere storms to 0.61 jumps h−1. Although radar-derived parameters are comparable between storms that produce severe wind plus hail and those that produce tornadoes, tornadic storms exhibit much greater intracloud (IC) and cloud-to-ground (CG) flash rates. Correlations further illustrate that lightning data provide complementary storm-scale information to radar-derived measures of storm intensity.


1997 ◽  
Vol 50 (3) ◽  
pp. 400-410
Author(s):  
E. S. Calvert

This paper was first published in 1960 (Vol. 13, p. 127). It is followed by comments from John Kemp. The paper has been abridged, including the omission of section 5 which described a proposal for a new radar display.When the problem of collision in the air is discussed, it is usual to start by pointing out the enormous closing speed of two modern aircraft meeting head-on, and to conclude from this that avoidance on the ‘see and be seen’ principle has ceased to be possible. The fact is, however, that the great majority of mid-air collisions (about 85 percent) occur within five miles of an airport and the typical case is not the head-on one, but the case in which the two aircraft crab into one another from a direction which may be anywhere around the whole enclosing sphere. Since the field of view of the aircrew covers only about 20 percent of the enclosing sphere, the aircrew of colliding aircraft seldom see each other. It would seem, therefore, that the ‘see and be seen’ principle never did afford much protection, even when speeds were low. In other words, the fact that the number of mid-air collisions in Europe has hitherto been small is not primarily due to seeing and evading, although this sometimes happens, but to the fact that the airspace is very large compared to the volume of all the aircraft in it at any given time. However, as traffic densities go up, the risk rapidly increases, and in congested airspace, such as that around New York, the problem of avoiding collision has already become acute. In the period 1948–57, there were 159 mid-air collisions in the United States, and many of these made headlines in the world press. One can imagine the public outcry if two large transports were to collide over a housing estate; but unless something effective is done, something like this will presumably happen eventually. At very high altitudes the ‘see and be seen’ principle certainly fails, by day, because the speed will be high, and in addition, the range at which a pilot can see an object the size of an aircraft may be less than 1½ miles due to what is sometimes called ‘high-altitude myopia’.


1993 ◽  
Vol 28 (12) ◽  
pp. 1206
Author(s):  
D. M. Barlev ◽  
E. M. Lautin ◽  
E. S. Amis ◽  
M. E. Lerner

2006 ◽  
Vol 27 (7) ◽  
pp. 695-703 ◽  
Author(s):  
Tamar F. Barlam ◽  
Margarita DiVall

Objective.Improvements in antibiotic prescribing to reduce bacterial resistance and control hospital costs is a growing priority, but the way to accomplish this is poorly defined. Our goal was to determine whether certain antibiotic stewardship interventions were universally instituted and accepted at top US academic centers and to document what interventions, if any, are used at both teaching and community hospitals within a geographic area.Design.Two surveys were conducted. In survey 1, detailed phone interviews were performed with the directors of antibiotic stewardship programs at 22 academic medical centers that are considered among the best for overall medical care in the United States or as leaders in antibiotic stewardship programs. In survey 2, teaching and community hospitals throughout Massachusetts were surveyed to ascertain what antibiotic oversight program components were present.Results.In survey 1, each of the 22 participating hospitals had instituted interventions to improve antibiotic prescribing, but none of the interventions were universally accepted as essential or effective. In survey 2, of 97 surveys that were mailed to prospective participants, a total of 54 surveys from 19 teaching hospitals and 35 community hospitals were returned. Ninety-five percent of the teaching hospitals had a restricted formulary, compared with 49% of the community hospitals, and 89% of teaching hospitals had an antibiotic approval process, compared with 29% of community hospitals.Conclusion.There was great variability among the approaches to the oversight of antibiotic prescribing at major academic hospitals. Antibiotic management interventions were lacking in more than half of the Massachusetts community hospitals surveyed. More research is needed to define the best antibiotic stewardship interventions for different hospital settings.


2015 ◽  
Vol 2 (3) ◽  
Author(s):  
Philip M. Polgreen ◽  
Scott Santibanez ◽  
Lisa M. Koonin ◽  
Mark E. Rupp ◽  
Susan E. Beekmann ◽  
...  

Abstract Background.  The first case of Ebola diagnosed in the United States and subsequent cases among 2 healthcare workers caring for that patient highlighted the importance of hospital preparedness in caring for Ebola patients. Methods.  From October 21, 2014 to November 11, 2014, infectious disease physicians who are part of the Emerging Infections Network (EIN) were surveyed about current Ebola preparedness at their institutions. Results.  Of 1566 EIN physician members, 869 (55.5%) responded to this survey. Almost all institutions represented in this survey showed a substantial degree of preparation for the management of patients with suspected and confirmed Ebola virus disease. Despite concerns regarding shortages of personal protective equipment, approximately two thirds of all respondents reported that their facilities had sufficient and ready availability of hoods, full body coveralls, and fluid-resistant or impermeable aprons. The majority of respondents indicated preference for transfer of Ebola patients to specialized treatment centers rather than caring for them locally. In general, we found that larger hospitals and teaching hospitals reported higher levels of preparedness. Conclusions.  Prior to the Centers for Disease Control and Prevention's plan for a tiered approach that identified specific roles for frontline, assessment, and designated treatment facilities, our query of infectious disease physicians suggested that healthcare facilities across the United States were making preparations for screening, diagnosis, and treatment of Ebola patients. Nevertheless, respondents from some hospitals indicated that they were relatively unprepared.


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