HemeOncoPoeisis: A fellow’s perspective on training.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e23000-e23000
Author(s):  
Marwah Wafa Farooqui ◽  
Stephen Simeone ◽  
Yatri Desai ◽  
Krishnan Srinivasan ◽  
Masood Ghouse
Keyword(s):  
Supply And Demand ◽  
Community Setting ◽  
Academic Community ◽  
Academic Programs ◽  
Community Settings ◽  
Community Centers ◽  
Community Based ◽  
Future Directions ◽  
The Us ◽  
Future Demands

e23000 Background: The incidence of cancer is projected to increase 67% by 2030. Current projections suggest a 40% increase in demand for hematologists/oncologists (HO) yet only a 25% increase in trainees. This discrepancy between supply and demand represents an emerging challenge to public health. There are 3 types of training programs across the US: 1. Academic (69%), 2. Hybrid, which have both community and academic exposure (~15%), and 3. Community ( < 15%). The purpose of this study is to get feedback from fellows. Methods: Contact information was collected for 126 HO programs across the US and a short questionnaire was sent. Results: There were 36 respondents, 72% from academic programs, 20% from hybrid, and 8% were community based. 25%, 42%, and 33% were 1st, 2nd, and 3rd year fellows respectively. Only a quarter of the respondents had worked or pursued another fellowship prior to starting training and the majority were directly out of residency. Only 19% of the respondents indicated interest in practicing in the community setting, 30% wanted to practice in an academic-community hybrid, and 39% wanted to practice in an academic setting. Of note about 31% of academic fellows reported not attending any national meetings (ASH/ASCO/other) in the last 2 years, 71% of hybrid trainees reported attending more than two conferences, and 75% of the community trainees attended 1 or more national meetings. Most common concerns from trainees from all programs was workload, research support, and didactics. Most of the trainees (70%) felt prepared clinically, but only 40% felt prepared academically. See Table for additional results. Conclusions: Trainees in hybrid programs appear to be most satisfied with their training. Also, trainees in academic programs indicated they wanted more exposure to community settings for future jobs. A large HO workforce will be needed in the community setting yet there is a vacuum when it comes to community based HO training. Perhaps future directions in trainee education can be towards encouraging relationships between the academic and community centers to help trainees get a broad exposure in order to be prepared for the future demands the current projections predict. [Table: see text]

Abdominal Computed Tomography in the Evaluation of Acute and Perforated Appendicitis in the Community Setting

2007 ◽  
Vol 73 (10) ◽  
pp. 1002-1005 ◽  
Author(s):  
D.O. Vu Huynh ◽  
Fariborz Lalezarzadeh ◽  
Shokry Lawandy ◽  
David T. Wong ◽  
Victor C. Joe
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Predictive Value ◽  
Perforated Appendicitis ◽  
Community Setting ◽  
Diagnostic Value ◽  
Academic Community ◽  
Negative Appendectomy ◽  
Community Based ◽  
Abdominal Computed Tomography

Several studies report sensitivity and specificity of abdominal computed tomography scans (CT) for the evaluation of acute appendicitis as high as 98 per cent. Despite increased utilization of CT, the rate of negative appendectomy has remained constant at 10 to 20 per cent. The objective of this study was to assess the effectiveness of CT in the evaluation of acute and perforated appendicitis in an academic community-based setting. A retrospective review of 550 patient charts with International Classification of Diseases-9 (ICD-9) codes for acute and perforated appendicitis from January 2002 to October 2005 was performed. Sensitivity of CT was 87 per cent with a positive predictive value of 92 per cent. Specificity was 42 per cent with a negative predictive value of 29 per cent. Negative appendectomy rates were similar with or without CT (11% vs 13%, respectively). Our data suggests that CT used liberally in everyday practice in a community-based setting to evaluate acute appendicitis may not have as strong of a diagnostic value as those used in protocol-driven research studies. Further prospective studies are needed to formulate criteria to better delineate the role of CT in the evaluation of acute appendicitis.

scholarly journals Exploring attitudes of adolescents and caregivers towards community-based delivery of the HPV vaccine: a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shoba Ramanadhan ◽  
Constance Fontanet ◽  
Marina Teixeira ◽  
Sitara Mahtani ◽  
Ingrid Katz
Keyword(s):  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Population Level ◽  
Community Settings ◽  
Framework Analysis ◽  
Community Based ◽  
Multi Stage ◽  
The Us ◽  
Healthy People 2020 ◽  
Alternative Delivery

Abstract Background Human Papillomavirus (HPV) vaccination among adolescents is an important strategy to prevent cervical and other cancers in adulthood. However, uptake remains far below the Healthy People 2020 targets for the US. Given the barriers to population-level vaccination policies and challenges to incorporating additional action items during clinical visits, we sought to explore alternative delivery mechanisms, specifically delivery of the vaccine in community settings. Methods We conducted six focus groups (three with adolescents aged 11–14 who had not received the HPV vaccine and three with caregivers of adolescents meeting those criteria) from Black, Latino, and Brazilian communities in Massachusetts. We utilized a framework analysis approach that involved a multi-stage coding process employing both prefigured and emergent codes. Initial interpretations were refined through consultation with an advisory board. Results Adolescents and caregivers expressed a range of concerns about the HPV vaccine and also described interest in learning more about the vaccine, emphasizing the importance of a relationship with a trusted provider as a facilitator of vaccine acceptance. Regarding community-based delivery of the vaccine, reactions were mainly negative. However, adolescents and caregivers noted that receiving information in community settings that could seed a conversation with a trusted provider would be welcome. Interestingly, the notion of a trusted provider seemed to extend broadly to practitioners linked to the trusted main provider. Conclusions The study highlights an opportunity for increasing HPV vaccination among some racial and ethnic minority populations by leveraging trusted community organizations to provide information and seed conversations with a potentially broad group of trusted providers. A task-shifting approach, or reliance on staff with fewer formal credentials, may offer opportunities to support vaccination in resource-constrained settings.

scholarly journals Lung cancer screening in a community setting: Characteristics, motivations, and attitudes of individuals being screened

2019 ◽  
Vol 6 (1) ◽  
pp. 205510291881916 ◽  
Author(s):  
Margaret M Byrne ◽  
Sarah E Lillie ◽  
Jamie L Studts
Keyword(s):  
Lung Cancer ◽  
Primary Care ◽  
Cancer Screening ◽  
Care Provider ◽  
Community Setting ◽  
Lung Cancer Screening ◽  
Sufficient Information ◽  
Community Settings ◽  
Community Based ◽  
Factors Influencing

We describe the characteristics of individuals being screened in community settings including factors influencing screening decisions and the level of information sought prior to screening. Individuals from two community-based radiology clinics ( N = 27) were surveyed after screening. Screening efficacy and salience were the most important factors in screening decisions, whereas healthcare provider recommendations were rated not important. Half of participants reported no or little conversation about screening with their primary care provider, and 61.5 percent had not sought any information on screening. Individuals being screened in a community setting are unlikely to have sufficient information for an informed decision about screening.

МЕЖДИСЦИПЛИНАРНОСТЬ В ПОДГОТОВКЕ КОНФЛИКТОЛОГОВ: СОСТОЯНИЕ И ПЕРСПЕКТИВЫ

2020 ◽  
Vol 15 (1) ◽  
pp. 13
Author(s):  
А. И. Стребков ◽  
А. И. Мусаев
Keyword(s):  
Conflict Resolution ◽  
Comparative Analysis ◽  
Subject Matter ◽  
Academic Program ◽  
Academic Programs ◽  
Full Time ◽  
The Us ◽  
Promotional Materials ◽  
Russian Universities ◽  
Educational Methodology

The present article concerns with the modern state of things of the conflict resolution specialists’ training in the US universities. The analysis is based on the informational and promotional materials which were picked up from the 11 American universities’ websites. The aim of the analysis was the examination of the four sections, which are: the orientation of the academic program, the content of the program or the scope of the skills, the main methodology of the academic program and the educational technologies. Together with the analysis of the US universities’ academic programs the article provides the comparative analysis of these programs with the Russian academic programs. On the back of this comparative analysis the authors come to the comprehensive conclusion according to which the specialists’ training in the field of the conflict resolution and peacebuilding in the US does not have significant differences from Russian ones and is carried out within one international academic trend in regard to its main features which are: the orientation, content, educational methodology and technologies. The key distinction of the Russian training from the American one is that the Russian academic tradition does have the core subject matter around which the whole academic program is being developed and which is the conflict. This subject matter is being taken in its entirety and the conflict resolution is considered as the closing stage of the conflict studies specialists’ training whereas the academic programs of the US universities embrace the conflict resolution as the subject matter of the academic training and therefores leaves beyond the scope of the training both the theory of the conflict and the forms practice of its manifestation in a number of the programs. The letter is peculiar to both short-term academic programs and the full-time two-year academic programs as it is accepted in the educational space of the Russian Federation. Furthermore, the authors of the article make up the conclusion of the coinciding major educational methodology which guides the academic programs of the American and Russian universities and which is developed on the principles of the interdisciplinarity.

Alcohol Consumption and Risk of Uterine Fibroids

2020 ◽  
Vol 20 (4) ◽  
pp. 247-258 ◽  
Author(s):  
Hajra Takala ◽  
Qiwei Yang ◽  
Ahmed M. Abd El Razek ◽  
Mohamed Ali ◽  
Ayman Al-Hendy
Keyword(s):  
Alcohol Consumption ◽  
Animal Studies ◽  
Molecular Mechanisms ◽  
Legal Status ◽  
Current Knowledge ◽  
Uterine Fibroids ◽  
Future Directions ◽  
Working Adults ◽  
The Us ◽  
Alcohol Related Problems

Lifestyle factors, such as alcohol intake, have placed a substantial burden on public health. Alcohol consumption is increasing globally due to several factors including easy accessibility of this addictive substance besides its legal status and social acceptability. In the US, alcohol is the third leading preventable cause of death (after tobacco, poor diet and physical inactivity) with an estimated 88,000 people dying from alcohol-related causes annually, representing 1 in 10 deaths among working adults. Furthermore, the economic burden of excess drinking costs the US around $249 billion ($191.1 billion related to binge drinking). Although men likely drink more than women do, women are at much higher risk for alcohol-related problems. Alcohol use is also considered to be one of the most common non-communicable diseases, which affects reproductive health. This review article summarizes the current knowledge about alcohol-related pathogenesis of uterine fibroids (UFs) and highlights the molecular mechanisms that contribute to the development of UFs in response to alcohol consumption. Additionally, the effect of alcohol on the levels of various factors that are involved in UFs pathogenesis, such as steroid hormones, growth factors and cytokines, are summarized in this review. Animal studies of deleterious alcohol effect and future directions are discussed as well.

The Gnosis of Toni Morrison: Morrison’s Conversation with Herman Melville, with a Nod to Umberto Eco

2019 ◽  
Vol 13 (3) ◽  
pp. 357-376
Author(s):  
Justine Tally
Keyword(s):  
Toni Morrison ◽  
Herman Melville ◽  
Global Market ◽  
Academic Community ◽  
American Renaissance ◽  
Moby Dick ◽  
Nag Hammadi ◽  
The Us ◽  
The University ◽  
The Rose

Abstract Long before Toni Morrison was extensively recognized as a serious contender in the “Global Market of Intellectuals,” she was obviously reading and absorbing challenging critical work that was considered “provocative and controversial” by the keepers of the US academic community at the time. While no one disputes the influence of Elaine Pagels’ work on Gnosticism at the University of Princeton, particularly its importance for Jazz and Paradise, the second and third novels of the Morrison trilogy, Gnosticism in Beloved has not been so carefully considered. Yet this keen interest in Gnosticism coupled with the author’s systematic study of authors from the mid-19th-century American Renaissance inevitably led her to deal with the fascination of Renaissance authors with Egypt (where the Nag Hammadi manuscripts were rediscovered), its ancient civilization, and its mythology. The extensive analysis of a leading French literary critic of Herman Melville, Prof. Viola Sachs, becomes the inspiration for a startlingly different reading of Morrison’s seminal novel, one that positions this author in a direct dialogue with the premises of Melville’s masterpiece, Moby-Dick, also drawing on the importance of Gnosticism for Umberto Eco’s 1980 international best-seller, The Name of the Rose.

scholarly journals Identifying and Managing Malnutrition, Frailty and Sarcopenia in the Community: A Narrative Review

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2316
Author(s):  
Shelley Roberts ◽  
Peter Collins ◽  
Megan Rattray
Keyword(s):  
Healthcare Professionals ◽  
Monitoring And Evaluation ◽  
Community Dwelling ◽  
Community Context ◽  
Care Process ◽  
Community Settings ◽  
Community Based ◽  
Comprehensive Overview ◽  
Nutrition Care ◽  
Community Dwelling Older Adults

Malnutrition, frailty and sarcopenia are becoming increasingly prevalent among community-dwelling older adults; yet are often unidentified and untreated in community settings. There is an urgent need for community-based healthcare professionals (HCPs) from all disciplines, including medicine, nursing and allied health, to be aware of, and to be able to recognise and appropriately manage these conditions. This paper provides a comprehensive overview of malnutrition, frailty and sarcopenia in the community, including their definitions, prevalence, impacts and causes/risk factors; and guidance on how these conditions may be identified and managed by HCPs in the community. A detailed description of the care process, including screening and referral, assessment and diagnosis, intervention, and monitoring and evaluation, relevant to the community context, is also provided. Further research exploring the barriers/enablers to delivering high-quality nutrition care to older community-dwelling adults who are malnourished, frail or sarcopenic is recommended, to inform the development of specific guidance for HCPs in identifying and managing these conditions in the community.

Managerial Economics – Family Medicine Care

2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Ecler Jaqua ◽  
Terry Jaqua ◽  
Van Nguyen
Keyword(s):  
Family Medicine ◽  
Service Providers ◽  
Supply And Demand ◽  
Pricing Strategy ◽  
Demand And Supply ◽  
Business Opportunity ◽  
Is Research ◽  
The Us ◽  
Managerial Economics

Supply and demand are amongst the essential requirements before starting up a business. Understanding the quantity of a commodity wished to be sold by producers based on different prices and the item needed by consumers wish purchasing is essential in coming up with ideas. Based on the understanding of this and background research on costs in healthcare, specifically family medicine, it is found that healthcare is amongst the essential requirements, and thus the critical focus of the business idea in a physician’s practice focusing on family medicine care in the US. Starting up the business is based on healthcare demands in the market and further the pricing strategy utilized by most family medicine clinics. Through a connection to the business based on visits in hospitals and the quality offered by these service providers, it is noted that the demand is high and is the most expensive sector in the world, but care is ineffective (The Peterson Center on Healthcare, n.d.) thus leading to searching for effective alternatives by consumers. This creates a potential for offering the most effective services to cater to the demands, and as noted by the Peterson Center on Healthcare (n.d.), the US healthcare system is the most expensive, and costs are projected to grow dramatically in the coming years thus creating the most significant business opportunity to entrepreneurs. By adjusting the resources and trying to cater to the demand in various locations, the key idea is to cater to the need and profit from the sector. The concern of gaining information in the market is research on different healthcare websites and the prices offered and the quality of their services. This will aid in adjusting the prices effectively and thus retaining the demand and supply chain.

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