A Study of Prospective Ophthalmology Residents’ Career Perceptions

Objectives: The purpose of this study was to identify differences in ophthalmology resident candidates and practicing ophthalmologists’ career perceptions. A secondary aim was to evaluate specific demographic factors (e.g., gender, ethnicity, career interests, etc.) among residency candidates regarding their career perceptions. Methods: A survey instrument (Critical factors in Career Perceptions) was sent by e-mail to prospective residents (n= 122). Group differences were calculated using a one sample t-test analysis. Results: Compared to practicing ophthalmologists (n = 56), residency candidates were more likely (p < 0.05) to expect greater professional job satisfaction from a number of career factors (e.g., time with patients, physician teamwork, etc.); family-personal factors (e.g., diversity of job skills, sole professional responsibility, etc.); and financial factors (i.e., income and security) than those in practice. Gender differences between candidates revealed that women were more interested in spending time with patients and in computer technology applications. Conclusions: These results suggest that medical school and residency program leaders to consider specific factors ophthalmologists encounter in their profession so that residency candidates have a more realistic view of their chosen profession. Several recommendations for resident recruitment and curriculum development are provided

Prevention and management of excessive gestational weight gain: a survey of overweight and obese pregnant women

Background - Excessive gestational weight gain is associated with adverse infant, childhood and maternal outcomes and research to develop interventions to address this issue is ongoing. The views of women on gestational weight gain and the resources they would consider helpful in addressing this are however largely unknown. This survey aimed to determine the views of newly pregnant women, living in areas of social disadvantage, on 1) their current body weight and potential gestational weight gain and 2) the resources or interventions they would consider helpful in preventing excessive gestational weight gain. Methods - A convenience sample of overweight and obese pregnant women living in Fife, UK, were invited to complete a short anonymised questionnaire at their 12 week booking visit. Results - 428 women, BMI&#62;25 kg/m2, completed the questionnaire. Fifty-four per cent of respondents were obese (231) and 62% were living in areas of mild to moderate deprivation. Over three-quarters of participants felt dissatisfied with their current weight (81%). The majority of women (60%) expressed some concern about potential weight gain. Thirty-nine percent were unconcerned about weight gain during their pregnancy, including 34 women (19%) who reported having retained weight gained in earlier pregnancies. Amongst those concerned about weight gain advice on physical activity (41%) and access to sports/leisure facilities were favoured resources (36%). Fewer women (12%) felt that group sessions on healthy eating or attending a clinic for individualised advice (14%) would be helpful. "Getting time off work" was the most frequently cited barrier (48%) to uptake of resources other than leaflets. Conclusions- These data suggest a lack of awareness amongst overweight and obese women regarding excessive gestational weight gain. Monitoring of gestational weight gain, and approaches for its management, should be formally integrated into routine antenatal care. Barriers to the uptake of resources to address weight gain are numerous and must be considered in the design of future interventions and services

Identification and correction of previously unreported spatial phenomena using raw Illumina BeadArray data

<p>Abstract</p> <p>Background</p> <p>A key stage for all microarray analyses is the extraction of feature-intensities from an image. If this step goes wrong, then subsequent preprocessing and processing stages will stand little chance of rectifying the matter. Illumina employ random construction of their BeadArrays, making feature-intensity extraction even more important for the Illumina platform than for other technologies. In this paper we show that using raw Illumina data it is possible to identify, control, and perhaps correct for a range of spatial-related phenomena that affect feature-intensity extraction.</p> <p>Results</p> <p>We note that feature intensities can be unnaturally high when in the proximity of a number of phenomena relating either to the images themselves or to the layout of the beads on an array. Additionally we note that beads neighbour beads of the same type more often than one might expect, which may cause concern in some models of hybridization. We highlight issues in the identification of a bead's location, and in particular how this both affects and is affected by its intensity. Finally we show that beads can be wrongly identified in the image on either a local or array-wide scale, with obvious implications for data quality.</p> <p>Conclusions</p> <p>The image processing issues identified will often pass unnoticed by an analysis of the standard data returned from an experiment. We detail some simple diagnostics that can be implemented to identify problems of this nature, and outline approaches to correcting for such problems. These approaches require access to the raw data from the arrays, not just the summarized data usually returned, making the acquisition of such raw data highly desirable.</p

CPT-11 and concomitant hyperfractionated accelerated radiotherapy induce efficient local control in rectal cancer patients: results from a phase II

Patients with rectal cancer are at high risk of disease recurrence despite neoadjuvant radiochemotherapy with 5-Fluorouracil (5FU), a regimen that is now widely applied. In order to develop a regimen with increased antitumour activity, we previously established the recommended dose of neoadjuvant CPT-11 (three times weekly 90 mg m−2) concomitant to hyperfractionated accelerated radiotherapy (HART) followed by surgery within 1 week. Thirty-three patients (20 men) with a locally advanced adenocarcinoma of the rectum were enrolled in this prospective phase II trial (1 cT2, 29 cT3, 3 cT4 and 21 cN+). Median age was 60 years (range 43–75 years). All patients received all three injections of CPT-11 and all but two patients completed radiotherapy as planned. Surgery with total mesorectal excision (TME) was performed within 1 week (range 2–15 days). The preoperative chemoradiotherapy was overall well tolerated, 24% of the patients experienced grade 3 diarrhoea that was easily manageable. At a median follow-up of 2 years no local recurrence occurred, however, nine patients developed distant metastases. The 2-year disease-free survival was 66% (95% confidence interval 0.48–0.83). Neoadjuvant CPT-11 and HART allow for excellent local control; however, distant relapse remains a concern in this patient population

Panarchy: opportunities and challenges for ecosystem management

Addressing unexpected events and uncertainty represents one of the grand challenges of the Anthropocene, yet ecosystem management is constrained by existing policy and laws that were not formulated to deal with today's accelerating rates of environmental change. In many cases, managing for simple regulatory standards has resulted in adverse outcomes, necessitating innovative approaches for dealing with complex social–ecological problems. We highlight a project in the US Great Plains where panarchy – a conceptual framework that emerged from resilience – was implemented at project onset to address the continued inability to halt large‐scale transition from grass‐to‐tree dominance in central North America. We review how panarchy was applied, the initial outcomes and evidence for policy reform, and the opportunities and challenges for which it could serve as a useful model to contrast with traditional ecosystem management approaches

The ethnoecology of Caiçara metapopulations (Atlantic Forest, Brazil): ecological concepts and questions

The Atlantic Forest is represented on the coast of Brazil by approximately 7,5% of remnants, much of these concentrated on the country's SE coast. Within these southeastern remnants, we still find the coastal Caiçaras who descend from Native Indians and Portuguese Colonizers. The maintenance of such populations, and their existence in spite of the deforestation that occurred on the Atlantic Forest coast, deserves especial attention and analysis. In this study, I address, in particular, the Caiçaras who live on the coast of São Paulo and Rio de Janeiro States, illustrating with examples of coastal inhabitants from other areas, such as Bahia State (NE coast) and of other forested areas (riverine caboclos of the Amazon). The major focus of this study, based on previous research, performed since 1986 in several populations or villages of the Atlantic Forest coast, is to understand the resilience of the Caiçaras, which is analyzed using ecological concepts, such as metapopulation, resilience and adaptive cycles. The Caiçara populations are located on islands (Búzios, Comprida, Grande, Ilhabela, Jaguanum, Gipóia) and on the coast (Bertioga, Puruba, Picinguaba, among others). Information gathered about the Caiçaras regarding the economic cycles of the local regions, along with ecological, historical and economic data available, are used to understand such resilience, and are complemented with comparative examples from the Brazilian Amazon and with variables such as the local restrictions imposed by environmental governmental agencies

The TERT variant rs2736100 is associated with colorectal cancer risk

BACKGROUND: Polymorphic variation at the 5p15.33 (TERT-CLPTM1L) locus is associated with the risk of many cancers but a relationship with colorectal cancer (CRC) risk has yet to be defined. METHODS: We used data from six genome-wide association studies (GWAS) of CRC, linkage disequilibrium mapping and imputation, to examine the relationship between 73 single-nucleotide polymorphisms at 5p15.33 and CRC risk in detail. RESULTS: rs2736100, which localises to intron 2 of TERT, provided the strongest evidence of an association with CRC (P=2.28 × 10⁻⁴). The association was also shown in an independent series of 10 047 CRC cases and 6918 controls (P=0.02). A meta-analysis of all seven studies (totalling 16 039 cases, 16 430 controls) provided increased evidence of association (P=2.49 × 10⁻⁵; per allele odds ratio=1.07). The association of rs2736100 on CRC risk was shown to be independent of 15 low-penetrance variants previously identified. CONCLUSION: The rs2736100 association demonstrates an influence of variation at 5p15.33 on CRC risk and further evidence that the 5p15.33 (TERT-CLPTM1L) locus has pleiotropic effects (reflecting generic or lineage-specific effects) on cancer risk