Formal Public Health Education and Career Outcomes of Medical School Graduates

Few data are available evaluating the associations of formal public health education with long-term career choice and professional outcomes among medical school graduates. The objective of this study was to determine if formal public health education via completion of a masters of public health (MPH) degree among US medical school graduates was associated with early and long-term career choice, professional satisfaction, or research productivity.We conducted a retrospective cohort study in 1108 physicians (17.1% completed a MPH degree) who had 10–20 years of follow-up post medical school graduation. Multivariable logistic regression analyses were conducted.Compared to their counterparts with no MPH, medical school graduates with a MPH were more likely to have completed a generalist primary care residency only [relative risk (RR) 1.79, 95% confidence interval (CI) 1.35–2.29], obtain employment in an academic institution (RR 1.81; 95% CI 1.33–2.37) or government agency (RR 3.26; 95% CI 1.89–5.38), and practice public health (RR 39.84; 95% CI 12.13–107.38) or primary care (RR 1.59; 95% CI 1.18–2.05). Furthermore, medical school graduates with a MPH were more likely to conduct public health research (RR 8.79; 95% CI: 5.20–13.82), receive NIH or other federal funding (RR 3.11, 95% CI 1.74–5.33), have four or more peer-reviewed publications (RR 2.07; 95% CI 1.56–2.60), and have five or more scientific presentations (RR 2.31, 95% CI 1.70–2.98).Formal public health education via a MPH was associated with career choice and professional outcomes among physicians

A 'snip' in time: what is the best age to circumcise?

<p>Abstract</p> <p>Background</p> <p>Circumcision is a common procedure, but regional and societal attitudes differ on whether there is a need for a male to be circumcised and, if so, at what age. This is an important issue for many parents, but also pediatricians, other doctors, policy makers, public health authorities, medical bodies, and males themselves.</p> <p>Discussion</p> <p>We show here that infancy is an optimal time for clinical circumcision because an infant's low mobility facilitates the use of local anesthesia, sutures are not required, healing is quick, cosmetic outcome is usually excellent, costs are minimal, and complications are uncommon. The benefits of infant circumcision include prevention of urinary tract infections (a cause of renal scarring), reduction in risk of inflammatory foreskin conditions such as balanoposthitis, foreskin injuries, phimosis and paraphimosis. When the boy later becomes sexually active he has substantial protection against risk of HIV and other viral sexually transmitted infections such as genital herpes and oncogenic human papillomavirus, as well as penile cancer. The risk of cervical cancer in his female partner(s) is also reduced. Circumcision in adolescence or adulthood may evoke a fear of pain, penile damage or reduced sexual pleasure, even though unfounded. Time off work or school will be needed, cost is much greater, as are risks of complications, healing is slower, and stitches or tissue glue must be used.</p> <p>Summary</p> <p>Infant circumcision is safe, simple, convenient and cost-effective. The available evidence strongly supports infancy as the optimal time for circumcision.</p

High-throughput fabrication of infinitely long 10 nm slit arrays for terahertz applications

In pursuit of higher field enhancement and applications in terahertz frequency regime, many techniques have been developed and reported for fabrication of high-aspect-ratio metallic nanostructures. While techniques utilizing spacer deposition has successfully overcome the size limit of conventional fabrication tools, they suffer from low throughput or vulnerability to mechanical and chemical treatment, limiting their further application to various fields. In this Letter we report a high-throughput scheme for fabricating metallic gap structures, free from all the aforementioned shortcomings. Vertically aligned gaps are first defined with photolithography and atomic layer deposition, and then made suitable for transmission measurements by etching out predefined sacrificial layers. Existence of the sacrificial layers alleviates many requirements associated with fabrication steps, thereby increasing the overall reliability of the whole process. Using this method we fabricate arrays of 10 nm wide metallic slits whose length is only limited by the substrate size, here 1 cm, and then characterize the sample with terahertz time domain spectroscopy. The sample show steady performance of up to 2500-fold field enhancement even after sonication under various solvents

Origin and evolution of a splay fault in the Nankai accretionary wedge

Subduction zones are often characterized by wedge-shaped sedimentary complexes—called accretionary prisms—that form when sediments are scraped off the subducting plate and added to the overriding plate. Large, landward-dipping thrust faults can cut through such a prism: these faults, known as 'megasplay faults'1, 2, originate near the top of the subducting plate and terminate at the shallow, landward edge of the prism1, 3, 4, 5, 6. Megasplay faults have been the subject of numerous geological and geophysical studies4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, but their initiation and evolution through time remains poorly constrained. Here we combine seismic reflection data from the Nankai accretionary wedge with geological data collected by the Integrated Ocean Drilling Program (IODP) and find that the splay fault cutting this wedge initiated approx1.95 Million years (Myr) ago in the lower part of the prism as an out-of-sequence thrust (OOST). After an initial phase of high activity, the movement along the fault slowed down, but uplift and reactivation of the fault resumed about 1.55 Myr ago. The alternating periods of high and low activity along the splay fault that we document hint at episodic changes in the mechanical stability of accretionary prisms