Astro2020 APC White Paper: The Early Career Perspective on the Coming Decade, Astrophysics Career Paths, and the Decadal Survey Process

In response to the need for the Astro2020 Decadal Survey to explicitly engage early career astronomers, the National Academies of Sciences, Engineering, and Medicine hosted the Early Career Astronomer and Astrophysicist Focus Session (ECFS) on October 8-9, 2018 under the auspices of Committee of Astronomy and Astrophysics. The meeting was attended by fifty six pre-tenure faculty, research scientists, postdoctoral scholars, and senior graduate students, as well as eight former decadal survey committee members, who acted as facilitators. The event was designed to educate early career astronomers about the decadal survey process, to solicit their feedback on the role that early career astronomers should play in Astro2020, and to provide a forum for the discussion of a wide range of topics regarding the astrophysics career path. This white paper presents highlights and themes that emerged during two days of discussion. In Section 1, we discuss concerns that emerged regarding the coming decade and the astrophysics career path, as well as specific recommendations from participants regarding how to address them. We have organized these concerns and suggestions into five broad themes. These include (sequentially): (1) adequately training astronomers in the statistical and computational techniques necessary in an era of "big data", (2) responses to the growth of collaborations and telescopes, (3) concerns about the adequacy of graduate and postdoctoral training, (4) the need for improvements in equity and inclusion in astronomy, and (5) smoothing and facilitating transitions between early career stages. Section 2 is focused on ideas regarding the decadal survey itself, including: incorporating early career voices, ensuring diverse input from a variety of stakeholders, and successfully and broadly disseminating the results of the survey

Validation of a Short Questionnaire in English and French for Use in Patients with Persistent Upper Gastrointestinal Symptoms Despite Proton Pump Inhibitor Therapy: The Pass (Proton Pump Inhibitor Acid Suppression Symptom) Test

BACKGROUND: The management of persistent symptoms during acid suppression therapy in patients with gastroesophageal reflux disease or dyspepsia might be improved if patient-physician communication regarding the presence and character of these persistent symptoms were facilitated

A one-year economic evaluation of six alternative strategies for the management of uninvestigated upper gastrointestinal symptoms in Canadian primary care

BACKGROUND: The cost-effectiveness of initial strategies in managing Canadian patients with uninvestigated upper gastrointestinal symptoms remains controversial

A one-year economic evaluation of six alternative strategies for the management of uninvestigated upper gastrointestinal symptoms in Canadian primary care

BACKGROUND: The cost-effectiveness of initial strategies in managing Canadian patients with uninvestigated upper gastrointestinal symptoms remains controversial OBJECTIVE: To assess the cost-effectiveness of six management approaches to uninvestigated upper gastrointestinal symptoms in the Canadian setting METHODS: The present study analyzed data from four randomized trials assessing homogeneous and complementary populations of Canadian patients with uninvestigated upper gastrointestinal symptoms with comparable outcomes Symptom-free months, quality-adjusted life-years (QALYs) and direct costs in Canadian dollars of two management approaches based on the Canadian Dyspepsia Working Group (CanDys) Clinical Management Tool, and four additional strategies (two empirical antisecretory agents, and two prompt endoscopy) were examined and compared Prevalence data, probabilities, utilities and costs were included in a Markov model, while sensitivity analysis used Monte Carlo simulations Incremental cost-effectiveness ratios and cost-effectiveness acceptability curves were determined RESULTS: Empirical omeprazole cost $226 per QALY ($49 per symptom-free month) per patient CanDys omeprazole and endoscopy approaches were more effective than empirical omeprazole, but more costly. Alternatives using H-2-receptor antagonists were less effective than those using a proton pump Inhibitor No significant differences were found for most incremental cost-effectiveness ratios As willingness to pay (WTP) thresholds rose from $226 to$24,000 per QALY, empirical antisecretory approaches were less likely to be the most cost-effective choice, with CanDys omepiazole progressively becoming a more likely option For WTP values ranging from $24,000 to$70,000 per QALY, the most clinically relevant range. CanDys omeprazole was the most cost-effective strategy (32% to 46% of the time), with prompt endoscopy-proton pump inhibitor favoured at higher WTP values CONCLUSIONS: Although no strategy was the indisputable cost-effective option. CanDys omeprazole may be the strategy of choice over a clinically relevant range of WTP assumptions in the initial management of Canadian patients with uninvestigated dyspepsi

The early career perspective on the coming decade, astrophysics career paths, and the decadal survey process

We discuss the concerns and ideas that emerged during discussion at the Early Career Focus Session at the National Academies regarding (1) the coming decade and the astrophysics career path, and (2) the decadal survey implementation and dissemination.Publisher PDFPeer reviewe