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Selected AbstractsEmergency Medicine Residency Applicant Perceptions of Unethical Recruiting Practices and Illegal Questioning in the MatchACADEMIC EMERGENCY MEDICINE, Issue 6 2009R. Jason Thurman MD Abstract Objectives:, The authors hypothesized that unethical recruiting practices and illegal questioning occur during emergency medicine (EM) resident recruitment. The objectives were to estimate the prevalence of specific unethical recruiting practices and illegal questioning by EM programs based on the perceptions of residency applicants and to measure the effect of these perceptions on applicant appraisal of programs. Methods:, This was a cross-sectional survey of all applicants who matched to U.S. EM programs in 2005 and 2006. The survey questionnaire was developed by the study authors and was validated by pretesting on a small group representative of the study population. The survey addressed specific questions regarding program recruiting behaviors and interview questioning. The hyperlink to the secure anonymous online survey questionnaire was distributed to all EM program directors, asking them in turn to forward the hyperlink to their newly matched incoming residency class. All data were calculated with Score method with continuity correction and reported in proportions with 95% confidence intervals (CIs). Results:, The authors received 671 survey responses. Among respondents, 56 (8.3%, 95% CI = 6.4% to 10.7%) stated that they were specifically asked to disclose at least one program's position on their rank list by a program representative, and 44 (6.6%, 95% CI = 4.9% to 8.9%) reported that they matched at a program residing lower on their rank list than at least one other program that had informed the applicant they were ranked to match. Furthermore, 201 respondents (30.0%, 95% CI = 26.5% to 33.7%) believed that they were asked at least one illegal question during their interviews, the most common of which was inquiry into their marital status (189 respondents: 28.2%, 95% CI = 24.8% to 31.9%). Respondents were 11 times more likely to move a program to a lower position of preference on their rank order list (12.2%, 95% CI = 9.8% to 15.0%) rather than a higher position (1.1%, 95% CI = 0.5% to 2.3%) as a result of perceiving unethical recruiting behaviors or illegal questioning. Conclusions:, These results demonstrate that among survey respondents, some perceived unethical recruiting behaviors and illegal questioning in the 2005 and 2006 Match. Perceptions of such behaviors appeared to have a negative impact on applicant appraisal of EM residency programs. [source] The Watershed Deposition Tool: A Tool for Incorporating Atmospheric Deposition in Water-Quality Analyses,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 4 2009Donna B. Schwede Abstract:, A tool for providing the linkage between air and water-quality modeling needed for determining the Total Maximum Daily Load (TMDL) and for analyzing related nonpoint-source impacts on watersheds has been developed. Using gridded output of atmospheric deposition from the Community Multiscale Air Quality (CMAQ) model, the Watershed Deposition Tool (WDT) calculates average per unit area and total deposition to selected watersheds and subwatersheds. CMAQ estimates the wet and dry deposition for all of its gaseous and particulate chemical species, including ozone, sulfur species, nitrogen species, secondary organic aerosols, and hazardous air pollutants at grid scale sizes ranging from 4 to 36 km. An overview of the CMAQ model is provided. The somewhat specialized format of the CMAQ files is not easily imported into standard spatial analysis tools. The WDT provides a graphical user interface that allows users to visualize CMAQ gridded data and perform further analyses on selected watersheds or simply convert CMAQ gridded data to a shapefile for use in other programs. Shapefiles for the 8-digit (cataloging unit) hydrologic unit code polygons for the United States are provided with the WDT; however, other user-supplied closed polygons may be used. An example application of the WDT for assessing the contributions of different source categories to deposition estimates, the contributions of wet and dry deposition to total deposition, and the potential reductions in total nitrogen deposition to the Albemarle-Pamlico basin stemming from future air emissions reductions is used to illustrate the WDT capabilities. [source] The Making of a Global European EconomistKYKLOS INTERNATIONAL REVIEW OF SOCIAL SCIENCES, Issue 2 2008David Colander SUMMARY This paper provides results of a survey of European graduate programs that are designing their programs to be similar to top US programs and compares those results to an earlier study done by the author of US schools. The study (1) provides a profile of European graduate economics students; (2) considers the degree to which European training at these schools differs from U.S. training, (3) offers some insights into the differences that exist among some top European programs in economics, and (4) provides a glimpse of the views that the students have of economics and of the training they are receiving. It finds that these global European programs are similar in many ways to US programs and that the students are satisfied with the programs. However, because of the different job markets in the US and Europe, it is not clear that the training is appropriate for the majority of European students. The paper concludes with a discussion of some of the concerns that should be kept in mind by other programs as they consider adapting their programs to become a ,global' program. These concerns include the argument that the traditional European system did a number of things right; the European academic economics institutional structure is quite different from the U.S. institutional structure; and the U.S. system has its own set of problems. [source] Non-adherence to medications following pediatric liver transplantationPEDIATRIC TRANSPLANTATION, Issue 6 2004Eyal Shemesh Abstract:, Non-adherence to medications is a leading cause of organ loss and morbidity in children and adolescents who had a liver transplant. Yet there are very few published studies about ways to detect whether patients are taking their medications or not, and about treatment options to improve adherence. The Pediatric Liver/Liver Transplant Program at Mount Sinai developed clinical and research programs that evaluate adherence. We review initial results from these programs. Clinic patients participate in an adherence-monitoring program that involves standardized assessments by patients, parents, clinicians, and routine examinations of medication blood levels. A research program adds an electronic monitoring device (MEMS-caps©, AARDEX/APREX, Switzerland) and examines the use of azathioprine metabolites as predictors for non-adherence. Patients receive a thorough psychosocial evaluation to identify potential risk factors for non-adherence. Preliminary results indicate that an objective adherence detection method has to be incorporated into practice if non-adherence is to be reliably detected (clinicians' impressions and patients' reports are not sufficient). A risk factor for non-adhernce, post-traumatic stress disorder, emerges as a potential target for intervention. It is possible to integrate a formal mechanism to assess adherence into the work of a liver/liver transplant clinic. We hope that the presented program will inspire clinicians in the community and other programs to regard the assessment and improvement of adherence to medications as an important goal in the management of children who had a transplant. [source] Workers' compensation in Canada: a case for greater public accountabilityCANADIAN PUBLIC ADMINISTRATION/ADMINISTRATION PUBLIQUE DU CANADA, Issue 1 2000Therese Jennissen The changing nature of occupational risks has created a range of workplace injuries against which current workers' compensation programs do not adequately insure. The existence of workers' compensation alongside the other components of the social-safety net may have created significant numbers of individuals who are either not receiving compensation when they should be or are receiving compensation when they should not be. The implication is that other programs bear some of the costs that should be borne by workers' compensation and, conversely, that some of the costs borne by workers' compensation should be borne by other social programs. These "gaps and overlaps" indicate that workers' compensation should be better integrated with the rest of the programs that make up the Canadian social-safety net. The article concludes with a menu of reforms, including the establishment, through legislation, of a formal reporting relationship; changes to the composition and size of governance structures; the introduction of strategic planning; and the establishment of performance measurement processes. Sommaire: Selon les auteurs de cet article, les politiques concernant les accidents du travail au Canada devraient relever davantage des gouvernements élus. L'évolution des risques professionnels a Créé toute une gamme d'accidents du travail pour lesquels l'assurance des régimes actuels d'indemnisation est inadéquate. L'existence des régimes d'assurance contre les accidents du travail parallèlement aux autres éléments de sécurité sociale aurait pour effet de multiplier le nombre de personnes quisoit ne reçoivent pas de prestations lorsqu'elles devraient en recevoir, soit l'inverse. Par conséquent, d'autres programmes défraient certains des coûts qui incombent au régime des accidents du travail, tandis que ce dernier défraie des coûts imputables a d'autres programmes sociaux. Ces lacunes et chevauchements indiquent que le régime d'assurance contre les accidents du travail devrait être mieux intégré au reste des programmes qui constituent le filet de sécurité sociale au Canada. L'article propose une série de réformes, dont l'adoption légiférée d'une relation formelle de compte rendu, la modification de la composition et de la taille des structures de gouvernance, l'adoption de la planification stratégique, et l'établissement de processus de mesure du rendement. [source] Bioterrorism Training in U.S. Emergency Medicine Residencies: Has It Changed since 9/11?ACADEMIC EMERGENCY MEDICINE, Issue 3 2007MSPH, Philip Kevin Moye MD Objectives: To assess the change in prevalence of bioterrorism training among emergency medicine (EM) residencies from 1998 to 2005, to characterize current training, and to identify characteristics of programs that have implemented more intensive training methods. Methods: This was a national cross sectional survey of the 133 U.S. EM residencies participating in the 2005 National Resident Matching Program; comparison with a baseline survey from 1998 was performed. Types of training provided were assessed, and programs using experiential methods were identified. Results: Of 112 programs (84.2%) responding, 98% reported formal training in bioterrorism, increased from 53% (40/76) responding in 1998. In 2005, most programs with bioterrorism training (65%) used at least three methods of instruction, mostly lectures (95%) and disaster drills (80%). Fewer programs used experiential methods such as field exercises or bioterrorism-specific rotations (35% and 13%, respectively). Compared with other programs, residency programs with more complex, experiential methods were more likely to teach bioterrorism-related topics at least twice a year (83% vs. 59%; p = 0.018), to teach at least three topics (60% vs. 40%; p = 0.02), and to report funding for bioterrorism research and education (74% vs. 45%; p = 0.007). Experiential and nonexperiential programs were similar in program type (university or nonuniversity), length of program, number of residents, geographic location, and urban or rural setting. Conclusions: Training of EM residents in bioterrorism preparedness has increased markedly since 1998. However, training is often of low intensity, relying mainly on nonexperiential instruction such as lectures. Although current recommendations are that training in bioterrorism include experiential learning experiences, the authors found the rate of these experiences to be low. [source] | |||||||||||||