Views of new internal medicine faculty of their preparedness and competence in physician-patient communication

BACKGROUND: We sought to assess self-rated importance of the medical interview to clinical practice and competence in physician-patient communication among new internal medicine faculty at an academic medical center. METHODS: Since 2001, new internal medicine faculty at the Mayo Clinic College of Medicine (Rochester, Minnesota) have completed a survey on physician-patient communication. The survey asks the new faculty to rate their overall competence in medical interviewing, the importance of the medical interview to their practice, their confidence and adequacy of previous training in handling eight frequently encountered challenging communication scenarios, and whether they would benefit from additional communication training. RESULTS: Between 2001 and 2004, 75 general internists and internal medicine subspecialists were appointed to the faculty, and of these, 58 (77%) completed the survey. The faculty rated (on a 10-point scale) the importance of the medical interview higher than their competence in interviewing; this difference was significant (average ± SD, 9.4 ± 1.0 vs 7.7 ± 1.2, P < .001). Similar results were obtained by sex, age, specialty, years since residency or fellowship training, and perceived benefit of training. Experienced faculty rated their competence in medical interviewing and the importance of the medical interview higher than recent graduates (ie, less than one year since training). For each challenging communication scenario, the new faculty rated the adequacy of their previous training in handling the scenario relatively low. A majority (57%) said they would benefit from additional communication training. CONCLUSION: Although new internal medicine faculty rate high the importance of the medical interview, they rate their competence and adequacy of previous training in medical interviewing relatively low, and many indicate that they would benefit from additional communication training. These results should encourage academic medical centers to make curricula in physician-patient communication available to their faculty members because many of them not only care for patients, but also teach clinical skills, including communication skills, to trainees

Mentoring at the University of Pennsylvania: Results of a Faculty Survey

BACKGROUND: Research suggests mentoring is related to career satisfaction and success. Most studies have focused on junior faculty. OBJECTIVE: To explore multiple aspects of mentoring at an academic medical center in relation to faculty rank, track, and gender. DESIGN: Cross-sectional mail survey in mid-2003. PARTICIPANTS: Faculty members, 1,432, at the University of Pennsylvania School of Medicine MEASUREMENTS: Self-administered survey developed from existing instruments and stakeholders. RESULTS: Response rate was 73% (n = 1,046). Most (92%) assistant and half (48%) of associate professors had a mentor. Assistant professors in the tenure track were most likely to have a mentor (98%). At both ranks, the faculty was given more types of advice than types of opportunities. Satisfaction with mentoring was correlated with the number of types of mentoring received (r = .48 and .53, P < .0001), job satisfaction (r = .44 and .31, P < .0001), meeting frequency (r = .53 and .61, P < .0001), and expectation of leaving the University within 5 years (Spearman r = −.19 and −.18, P < .0001), at the assistant and associate rank, respectively. Significant predictors of higher overall job satisfaction were associate rank [Odds ratio (OR) = 2.04, CI = 1.29–3.21], the 10-point mentoring satisfaction rating (OR = 1.27, CI = 1.17–1.35), and number of mentors (OR = 1.60, CI = 1.20–2.07). CONCLUSIONS: Having a mentor, or preferably, multiple mentors is strongly related to satisfaction with mentoring and overall job satisfaction. Surprisingly, few differences were related to gender. Mentoring of clinician–educators, research track faculty, and senior faculty, and the use of multiple mentors require specific attention of academic leadership and further study

Biodiversity of Arbuscular Mycorrhizal Fungi in South America: A Review

Identification of species is crucial in understanding how diversity changes affect ecosystemic processes. Particularly, soil microbial are key factors of ecosystemic functioning .Among soil microbes, arbuscular mycorrhizal fungi (AMF, phylum Glomeromycota) are worldwide distributed and form symbiotic associations with almost 80% of the vascular plants of the earth, except for one species, Geosiphon pyriformis, which associates with the cyanobacteria Nostoc. AMF comprise around 300 morphologically defined or 350–1000 molecularly defined taxa. Since AMF associate with aboveground community, their occurrence and composition can influence ecosystemic processes either through affecting plant community composition and thus its processes rates, or soil microbial communities, which are directly involved in nutrient cycling. Soil microorganisms are considered a potentially suitable target for studying regional and local effects on diversity. The symbiosis with AMF not only increases nutrient uptake by the plant of mainly phosphorus (P) and nitrogen (N) in exchange for plant-assimilated carbon (C), but also improves the tolerance of plants to various biotic and abiotic stresses such as pathogens, salinity, and drought

Examination of the solubility of hydrogen in molten aluminium

26.00; Translated from Czech. (Hutn. Listy 1989 v. 44(4) p. 269-277)Available from British Library Document Supply Centre- DSC:9023.19(VR-Trans--4379)T / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Predictors and Outcomes of Burnout in Primary Care Physicians

Objective: To assess relationships between primary care work conditions, physician burnout, quality of care, and medical errors. Methods: Cross-sectional and longitudinal analyses of data from the MEMO (Minimizing Error, Maximizing Outcome) Study. Two surveys of 422 family physicians and general internists, administered 1 year apart, queried physician job satisfaction, stress and burnout, organizational culture, and intent to leave within 2 years. A chart audit of 1795 of their adult patients with diabetes and/or hypertension assessed care quality and medical errors. Key Results: Women physicians were almost twice as likely as men to report burnout (36% vs 19%, P < .001). Burned out clinicians reported less satisfaction ( P < .001), more job stress ( P < .001), more time pressure during visits ( P < .01), more chaotic work conditions ( P < .001), and less work control ( P < .001). Their workplaces were less likely to emphasize work-life balance ( P < .001) and they noted more intent to leave the practice (56% vs 21%, P < .001). There were no consistent relationships between burnout, care quality, and medical errors. Conclusions: Burnout is highly associated with adverse work conditions and a greater intention to leave the practice, but not with adverse patient outcomes. Care quality thus appears to be preserved at great personal cost to primary care physicians. Efforts focused on workplace redesign and physician self-care are warranted to sustain the primary care workforce

Methods of measuring hydrogen content in molten aluminium and its alloys

Translated from Czech. (Slevarenstvi 1988 v. 36(3) p. 99-101)Available from British Library Document Supply Centre- DSC:9022.0602(BISI-NF-Trans--447)T / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Thermochromic Fibers via Electrospinning

Cholesteryl ester liquid crystals exhibit thermochromic properties related to the existence of a twisted nematic phase. We formulate ternary mixtures of cholesteryl benzoate (CB), cholesteryl pelargonate (CP), and cholesteryl oleyl carbonate (COC) to achieve thermochromic behavior. We aim to achieve thermochromic fibers by incorporating the liquid crystal formulations into electrospun fibers. Two methods of incorporating the liquid crystal (LC) are compared: (1) blend electrospinning and (2) coaxial electrospinning using the same solvent system for the liquid crystal. For blend electrospinning, intermolecular interactions seem to be important in facilitating fiber formation since addition of LC can suppress bead formation. Coaxial electrospinning produces fibers with higher nominal fiber production rates (g/hr) and with higher nominal LC content in the fiber (wt. LC/wt. polymer assuming all of the solvent evaporates) but larger fiber size distributions as quantified by the coefficient of variation in fiber diameter than blend electrospinning with a single nozzle. Importantly, our proof-of-concept experiments demonstrate that coaxially electrospinning with LC and solvent in the core preserves the thermochromic properties of the LC so that thermochromic fibers are achieved