Pediatric Rheumatology Manpower and Training: Planning for the 1990s

PEDIATRICS ◽  
1989 ◽  
Vol 84 (3) ◽  
pp. 567-568
Author(s):  
THOMAS J. A. LEHMAN ◽  
DANIEL B. MAGILAVY ◽  
ROBERT WARREN
Keyword(s):  
Rheumatoid Arthritis ◽  
United States ◽  
Vascular Disease ◽  
Juvenile Rheumatoid Arthritis ◽  
Joint Pain ◽  
Pediatric Rheumatology ◽  
The United States ◽  
Collagen Vascular Disease ◽  
Faculty Positions ◽  
And Training

According to recent estimates, 350 000 children each year will experience an acute episode of joint pain, and nearly 200 000 will have juvenile rheumatoid arthritis or another collagen vascular disease. In 1976, there were only 30 pediatric rheumatologists, and fewer than 10 inpatient centers for the care of children with rheumatic diseases in the United States. By 1986, there were pediatric rheumatology faculty in 46 (37%) of the 126 academic pediatric departments in the United States. Recently, it was noted that several available pediatric rheumatology faculty positions remained unfilled for significant periods of time. Whether this indicated a need to train additional fellows or other problems was not clear.

scholarly journals Complementary and Integrative Health Knowledge and Practice in Primary Care Settings: A Survey of Primary Care Providers in the Northwestern United States

2021 ◽  
Vol 10 ◽  
pp. 216495612110233
Author(s):  
Malaika R Schwartz ◽  
Allison M Cole ◽  
Gina A Keppel ◽  
Ryan Gilles ◽  
John Holmes ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Health Knowledge ◽  
Care Delivery ◽  
Primary Care Providers ◽  
The United States ◽  
Research Network ◽  
Care Providers ◽  
Integrative Health ◽  
And Training

Background The demand for complementary and integrative health (CIH) is increasing by patients who want to receive more CIH referrals, in-clinic services, and overall care delivery. To promote CIH within the context of primary care, it is critical that providers have sufficient knowledge of CIH, access to CIH-trained providers for referral purposes, and are comfortable either providing services or co-managing patients who favor a CIH approach to their healthcare. Objective The main objective was to gather primary care providers’ perspectives across the northwestern region of the United States on their CIH familiarity and knowledge, clinic barriers and opportunities, and education and training needs. Methods We conducted an online, quantitative survey through an email invitation to all primary care providers (n = 483) at 11 primary care organizations from the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice and Research Network (WPRN). The survey questions covered talking about CIH with patients, co-managing care with CIH providers, familiarity with and training in CIH modalities, clinic barriers to CIH integration, and interest in learning more about CIH modalities. Results 218 primary care providers completed the survey (45% response rate). Familiarity with individual CIH methods ranged from 73% (chiropracty) to 8% (curanderismo). Most respondents discussed CIH with their patients (88%), and many thought that their patients could benefit from CIH (41%). The majority (89%) were willing to co-manage a patient with a CIH provider. Approximately one-third of respondents had some expertise in at least one CIH modality. Over 78% were interested in learning more about the safety and efficacy of at least one CIH modality. Conclusion Primary care providers in the Northwestern United States are generally familiar with CIH modalities, are interested in referring and co-managing care with CIH providers, and would like to have more learning opportunities to increase knowledge of CIH.

scholarly journals Drug prices in Latin American countries: the case of rheumatoid arthritis Biosimilars

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Gabriela Bittencourt Gonzalez Mosegui ◽  
Fernando Antõnanzas ◽  
Cid Manso de Mello Vianna ◽  
Paula Rojas
Keyword(s):  
Rheumatoid Arthritis ◽  
United States ◽  
Latin American ◽  
United States Of America ◽  
Purchasing Power Parity ◽  
The United States ◽  
Power Parity ◽  
Drug Prices ◽  
The Us ◽  
Latin American Countries

Abstract Background The objective of this paper is to analyze the prices of biological drugs in the treatment of Rheumatoid Arthritis (RA) in three Latin American countries (Brazil, Colombia and Mexico), as well as in Spain and the United States of America (US), from the point of market entry of biosimilars. Methods We analyzed products authorized for commercialization in the last 20 years, in Brazil, Colombia, and Mexico, comparing them to the United States of America (USA) and Spain. For this analysis, we sought the prices and registries of drugs marketed between 1999 and October 1, 2019, in the regulatory agencies’ databases. The pricing between countries was based on purchasing power parity (PPP). Results The US authorized the commercialization of 13 distinct biologicals and four biosimilars in the period. Spain and Brazil marketed 14 biopharmaceuticals for RA, ten original, four biosimilars. Colombia and Mexico have authorized three biosimilars in addition to the ten biological ones. For biological drug prices, the US is the most expensive country. Spain’s price behavior seems intermediate when compared to the three LA countries. Brazil has the highest LA prices, followed by Mexico and Colombia, which has the lowest prices. Spain has the lowest values in PPP, compared to LA countries, while the US has the highest prices. Conclusion The economic effort that LA countries make to access these medicines is much higher than the US and Spain. The use of the PPP ensured a better understanding of the actual access to these inputs in the countries analyzed.

scholarly journals Global variability in orthopedic surgery training

2019 ◽  
Author(s):  
Andrew D. Sobel ◽  
Davis Hartnett ◽  
David Hernandez ◽  
Adam E. M. Eltorai ◽  
Alan H. Daniels
Keyword(s):  
United States ◽  
Orthopedic Surgery ◽  
Orthopaedic Surgery ◽  
Educational Development ◽  
The United States ◽  
Surgery Training ◽  
Orthopaedic Care ◽  
The World ◽  
Orthopaedic Training ◽  
And Training

Medical and orthopaedic training varies throughout the world. The pathways to achieve competency in orthopaedic surgery in other countries differ greatly from those in the United States. This review summarizes international educational requirements and training pathways involved in the educational development of orthopaedic surgeons. Understanding the differences in training around the world offers comparative opportunities which may lead to the improvement in education, training, and competency of individuals providing orthopaedic care.

Access to pediatric rheumatology care in the United States

2003 ◽  
Vol 49 (6) ◽  
pp. 759-765 ◽  
Author(s):  
Michelle L. Mayer ◽  
Elizabeth D. Mellins ◽  
Christy I. Sandborg
Keyword(s):  
United States ◽  
Pediatric Rheumatology ◽  
The United States

scholarly journals Staffing at Ambulatory Endoscopy Centers in the United States: Practice, Trends, and Rationale

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Deepak Agrawal ◽  
Rajeev Jain
Keyword(s):  
United States ◽  
Patient Care ◽  
Response Rate ◽  
The United States ◽  
Survey Study ◽  
Moderate Sedation ◽  
Endoscopic Procedures ◽  
Staffing Patterns ◽  
And Training

Background. Endoscopy nurse (RN) has a pivotal role in administration and monitoring of moderate sedation during endoscopic procedures. When sedation for the procedure is administered and monitored by an anesthesia specialist, the role of an RN is less clear. The guidelines on this issue by nursing and gastroenterology societies are contradictory. Methods. Survey study of endoscopy lab managers and directors at outpatient endoscopy units in Texas. The questions related to staffing patterns for outpatient endoscopies and responsibilities of different personnel assisting with endoscopies. Results. Responses were received from 65 endoscopy units (response rate 38%). 63/65 (97%) performed at least a few cases with an anesthesia specialist. Of these, 49/63 (78%) involved only an endoscopy technician, without an additional RN in the room. At 12/49 (25%) units, the RN performed tasks of an endoscopy technician. At 14/63 (22%), an additional RN was present during endoscopic procedures and performed tasks not directly related to patient care. Conclusions. Many ambulatory endoscopy units do not have an RN present at all times when sedation is administered by an anesthesia specialist. An RN, when present, did not perform tasks commensurate with the education and training. This has implications about optimal utilization of nurses and cost of performing endoscopies.

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