The vulnerability of quasi-professional experts:a study of the changing character of US airline pilots work

This article contributes to ‘sociology of professions’ theory through the study of changes that occurred in US airline pilots’ work. Findings reveal that airline pilots are quasi-professional experts who developed specialized skills based on talent and experience which allowed them to work autonomously and enjoy a correspondingly high sense of trust and prestige for which they were often well compensated. However, results of this study suggest high labour costs and weak professional communities leave quasi-professional experts vulnerable to managerial cost-cutting and work intensification agendas, particularly during periods of merger, downsizing and other forms of industry restructuring. Findings signal a deprofessionalization of some elite fields in which experts’ specialized skills become devalued and the industry-specific nature of their expertise reduces career options and job mobility. Although the present study identifies this trend in aviation, recent changes in a wide range of industries from healthcare to high-tech portend applicability in a variety of domains.</jats:p

Specialty distribution of physician assistants and nurse practitioners in North Carolina

Physician workforce projections often include scenarios that forecast physician shortages under different assumptions about the deployment of physician assistants (PAs) and nurse practitioners (NPs). These scenarios generally assume that PAs and NPs are an interchangeable resource and that their specialty distributions do not change over time. This study investigated changes in PA and NP specialty distribution in North Carolina between 1997 and 2013. The data show that over the study period, PAs and NPs practiced in a wide range of specialties, but each profession had a specifi c pattern. The proportion of PAs-but not NPs-reporting practice in primary care dropped signifi cantly. PAs were more likely than NPs to report practice in urgent care, emergency medicine, and surgical subspecialties. Physician workforce models need to account for the different and changing specialization trends of NPs and PAs

Future supply of pediatric surgeons

Objective: To describe the future supply and demand for pediatric surgeons using a physician supply model to determine what the future supply of pediatric surgeons will be over the next decade and a half and to compare that projected supply with potential indicators of demand and the growth of other subspecialties. Background: Anticipating the supply of physicians and surgeons in the future has met with varying levels of success. However, there remains a need to anticipate supply given the rapid growth of specialty and subspecialty fellowships. This analysis is intended to support decision making on the size of future fellowships in pediatric surgery. Methods: The model used in the study is an adaptation of the FutureDocs physician supply and need tool developed to anticipate future supply and need for all physician specialties. Data from national inventories of physicians by specialty, age, sex, activity, and location are combined with data from residency and fellowship programs and accrediting bodies in an agent-based or microsimulation projection model that considers movement into and among specialties. Exits from practice and the geographic distribution of physician and the patient population are also included in the model. Three scenarios for the annual entry into pediatric surgery fellowships (28, 34, and 56) are modeled and their effects on supply through 2030 are presented. Results: The FutureDocs model predicts a very rapid growth of the supply of surgeons who treat pediatric patients - including general pediatric surgeon and focused subspecialties. The supply of all pediatric surgeons will grow relatively rapidly through 2030 under current conditions. That growth is much faster than the rate of growth of the pediatric population. The volume of complex surgical cases will likely match this population growth rate meaning there will be many more surgeons trained for those procedures. The current entry rate into pediatric surgery fellowships (34 per year) will result in a slowing of growth after 2025, a rate of 56 will generate a continued growth through 2030 with a likely plateau after 2035. Conclusions: The rate of entry into pediatric surgery will continue to exceed population growth through 2030 under two likely scenarios. The very rapid anticipated growth in focused pediatric subspecialties will likely prove challenging to surgeons wishing to maintain their skills with complex cases as a larger and more diverse group of surgeons will also seek to care for many of the conditions and patients which the general pediatric surgeons and general surgeons now see. This means controlling the numbers of pediatric surgery fellowships in a way that recognizes problems with distribution, the volume of cases available to maintain proficiency, and the dynamics of retirement and shifts into other specialty practice

Zebrafish embryonic lipidomic analysis reveals that the yolk cell as metabolically active in processing lipid

The role of lipids in providing energy and structural cellular components during vertebrate development is poorly understood. To elucidate these roles further, we visualized lipid deposition and examined expression of key lipid-regulating genes during zebrafish embryogenesis. We also conducted a semiquantitative analysis of lipidomic composition using liquid chromatography (LC)-mass spectrometry. Finally, we analyzed processing of boron-dipyrromethene (BODIPY) lipid analogs injected into the yolk using thin layer chromatography. Our data reveal that the most abundant lipids in the embryo are cholesterol, phosphatidylcholine, and triglyceride. Moreover, we demonstrate that lipids are processed within the yolk prior to mobilization to the embryonic body. Our data identify a metabolically active yolk and body resulting in a dynamic lipid composition. This provides a foundation for studying lipid biology during normal or pharmacologically compromised embryogenesis

A Roadmap to Rural Residency Program Development

Rural communities face a pressing need for primary care, behavioral health, and obstetrical care services, yet rural hospitals around the country are closing, and the gap between mortality rates in rural and urban areas is widening. While there is some debate about whether the nation faces a shortage of physicians, there is general consensus that the workforce is maldistributed. Estimates suggested we face a shortfall of 14 164 practitioners in primary care health professional shortage areas. While efforts to address rural workforce shortages need to be targeted along multiple points in a physician’s career trajectory, exposure to rural and underserved settings during training has been shown to increase physicians’ sense of preparedness for rural practice and retention in rural communities. Despite this evidence, graduate medical education (GME) in rural areas remains very limited, and the US Government Accountability Office estimates that only 1% of residents across all specialties train in rural areas. This is due in part to the unique challenges that face rural health organizations in the United States, which often operate on thin financial margins with limited providers and staff. Rural hospitals and federally qualified health centers (FQHCs) often lack the capacity and resources to design, develop, start-up, and maintain rural residency training programs in their communities. The small size and remoteness of rural programs make them susceptible to unique challenges such as inadequate patient volumes, lack of sustained funding after start-up grants, frequent leadership turnover, limited educational resources, difficulty recruiting residents, and insufficient support for faculty development and protected teaching time

Three dimensional electron microscopy reveals changing axonal and myelin morphology along normal and partially injured optic nerves

Following injury to the central nervous system, axons and myelin distinct from the initial injury site undergo changes associated with compromised function. Quantifying such changes is important to understanding the pathophysiology of neurotrauma; however, most studies to date used 2 dimensional (D) electron microscopy to analyse single sections, thereby failing to capture changes along individual axons. We used serial block face scanning electron microscopy (SBF SEM) to undertake 3D reconstruction of axons and myelin, analysing optic nerves from normal uninjured female rats and following partial optic nerve transection. Measures of axon and myelin dimensions were generated by examining 2D images at 5 µm intervals along the 100 µm segments. In both normal and injured animals, changes in axonal diameter, myelin thickness, fiber diameter, G-ratio and percentage myelin decompaction were apparent along the lengths of axons to varying degrees. The range of values for axon diameter along individual reconstructed axons in 3D was similar to the range from 2D datasets, encompassing reported variation in axonal diameter attributed to retinal ganglion cell diversity. 3D electron microscopy analyses have provided the means to demonstrate substantial variability in ultrastructure along the length of individual axons and to improve understanding of the pathophysiology of neurotrauma

An introduction to video methods in organizational research

Video has become a methodological tool of choice for many researchers in social science, but video methods are relatively new to the field of organization studies. This article is an introduction to video methods. First, we situate video methods relative to other kinds of research, suggesting that video recordings and analyses can be used to replace or supplement other approaches, not only observational studies but also retrospective methods such as interviews and surveys. Second, we describe and discuss various features of video data in relation to ontological assumptions that researchers may bring to their research design. Video involves both opportunities and pitfalls for researchers, who ought to use video methods in ways that are consistent with their assumptions about the world and human activity. Third, we take a critical look at video methods by reporting progress that has been made while acknowledging gaps and work that remains to be done. Our critical considerations point repeatedly at articles in this special issue, which represent recent and important advances in video method

Axonal domains:role for paranodal junction in node of Ranvier assembly

SummaryA new study shows that communication between axons and glia at the paranodal junction can orchestrate the formation of the node of Ranvier

Bioprocessing strategies to enhance the challenging isolation of neuro-regenerative cells from olfactory mucosa

Olfactory ensheathing cells (OECs) are a promising potential cell therapy to aid regeneration. However, there are significant challenges in isolating and characterizing them. In the current study, we have explored methods to enhance the recovery of cells expressing OEC marker p75NTR from rat mucosa. With the addition of a 24-hour differential adhesion step, the expression of p75NTR was significantly increased to 73 ± 5% and 46 ± 18% on PDL and laminin matrices respectively. Additionally, the introduction of neurotrophic factor NT-3 and the decrease in serum concentration to 2% FBS resulted in enrichment of OECs, with p75NTR at nearly 100% (100 ± 0% and 98 ± 2% on PDL and laminin respectively), and candidate fibroblast marker Thy1.1 decreased to zero. Culturing OECs at physiologically relevant oxygen tension (2–8%) had a negative impact on p75NTR expression and overall cell survival. Regarding cell potency, co-culture of OECs with NG108-15 neurons resulted in more neuronal growth and potential migration at atmospheric oxygen. Moreover, OECs behaved similarly to a Schwann cell line positive control. In conclusion, this work identified key bioprocessing fundamentals that will underpin future development of OEC-based cell therapies for potential use in spinal cord injury repair. However, there is still much work to do to create optimized isolation methods

Mindfulness in Action: Discovering How U.S. Navy Seals Build Capacity for Mindfulness in High-Reliability Organizations (HROs)

This study of US Navy Sea Air and Land (SEAL) commandos contributes to research investigating mindfulness in High-Reliability Organizations (HROs) by identifying the individual and collective influences that allow SEALs to build capacity for mindful behaviors despite the complexity of their missions, the unpredictability of their operating environments, and the danger inherent in their work. Although the HRO literature identifies a number of hallmarks of reliability, less attention is paid to how mindfulness is operationally achieved in situ by individuals on the frontline working in HROs. This study addresses this gap using a multi-phase, multi-method investigation of US Navy SEALs, identifying new links between individual mindfulness attributes (comfort with uncertainty and chaos) and collective mindfulness influences (a positive orientation towards failure) that combine to co-create a phenomenon we call 'mindfulness in action'. Mindfulness in action occurs when HROs achieve an attentive yet flexible focus capable of incorporating multiple—sometimes competing—realities in order to assess alternative solutions and take action in dynamic situations. By providing a more nuanced conceptualization of the links between individual mindfulness attributes and collective mindfulness influences, this paper opens up new avenues of discovery for a wide range of reliability-seeking organizations.This study of US Navy Sea Air and Land (SEAL) commandos contributes to research investigating mindfulness in High-Reliability Organizations (HROs) by identifying the individual and collective influences that allow SEALs to build capacity for mindful behaviors despite the complexity of their missions, the unpredictability of their operating environments, and the danger inherent in their work. Although the HRO literature identifies a number of hallmarks of reliability, less attention is paid to how mindfulness is operationally achieved in situ by individuals on the frontline working in HROs. This study addresses this gap using a multi-phase, multi-method investigation of US Navy SEALs, identifying new links between individual mindfulness attributes (comfort with uncertainty and chaos) and collective mindfulness influences (a positive orientation towards failure) that combine to co-create a phenomenon we call 'mindfulness in action'. Mindfulness in action occurs when HROs achieve an attentive yet flexible focus capable of incorporating multiple—sometimes competing—realities in order to assess alternative solutions and take action in dynamic situations. By providing a more nuanced conceptualization of the links between individual mindfulness attributes and collective mindfulness influences, this paper opens up new avenues of discovery for a wide range of reliability-seeking organizations