Perceptions of Specialties and Primary Care Careers: Findings from West Virginia Medical Student and Resident Focus Groups

The purpose of this study was to improve the understanding of how perceptions of practicing specific medical specialties contribute to career decisions. Participants included medical students and residents from training programs in West Virginia. Focus groups were conducted between September 2013 and February 2015. Thematic content analysis of focus group interviews was used to identify phrases indicating perceptions of person- versus technique-oriented personality medical specialties. “Self-focused” and “other-focused” themes emerged within person-oriented comments. Factors affecting “self”, including work/life balance and salary and practice environment, made certain specialties more appealing. Technique-oriented comments included working in a hospital setting, performing technical procedures, and solving immediate problems as opposed to long-term management. Technique-oriented comments from students emphasized learning about disease, and resident comments emphasized treatment as their primary focus. The majority of participants’ comments suggested that a strong patient-doctor relationship and continuity of care are rewarding components of primary care and more compatible with person-oriented personalities. Participants selecting person-oriented specialties viewed rural practice locations more favorably, especially the opportunity to become an integral part of a community. Participants selecting technique-oriented specialties preferred limited interactions with patients and stated that problem-solving and learning about disease states were the most appealing aspects of practicing medicine

Utilización de modelos de reflectancia como nexo entre muestras foliares y la cobertura forestal: aplicación a datos hiperespectrales

[ES] El presente trabajo demuestra la utilización de modelos de simulación de la cobertura forestal mediante su aplicación a datos hiperespectrales del sensor aerotransportado CASI. Los modelos SAIL y Kuusk permiten ser utilizados como nexo de unión entre los niveles de hoja y de cobertura: las relaciones a nivel de hoja obtenidas entre índices ópticos y bioindicadores de estrés, como contenido clorofílico o fluorescencia clorofílica, pueden ser transformadas a un nivel superior de cobertura mediante la utilización de dichos modelos. Finalmente se realiza una demostración de la utilización de modelos de cobertura a través de los resultados obtenidos en el proyecto Bioindicators of Forest Sustainability, desarrollado en 12 zonas de Acer saccharum M. localizadas en Ontario (Canadá) donde se obtuvieron medidas de campo de muestras foliares, así como datos hiperespectrales del sensor aerotransportado CASI en 1997, 1998 y 1999. Los indices ópticos desarrollados a nivel de hoja fueron aplicados, a través de modelos de cobertura, a los datos de reflectancia obtenidos por CASI de 2 m de resolución espacial y 72 bandas[EN] This paper demonstrates the use and applications of Canopy Reflectance Models (CR) with airborne hyperspectral CASI data. SAIL and Kuusk canopy reflectance models are the link between the leaf and canopy levels: leaf-level relationships obtained between optical indices and stress bioindicators, such as chlorophyll content and chlorophyll fluorescence can be scaled-up to the canopy level using canopy reflectance models. The application of canopy reflectance models is demonstrated with the results obtained in the Bioindicators of Forest Sustainability Project. The work was carried out in 12 study areas of Acer saccharum M. in the Algoma Region, Ontario (Canada), where field measurements and hyperspectral CASI imagery have been collected in 1997, 1998 and 1999 deployments. Single leaf reflectance and transmittance, chlorophyll and carotenoid content, and chlorophyll fluorescence of broad leaves were measured. The physiological indices and derivative analysis indices extracted from leaf spectral reflectance were tested at canopy level using CASI data of 72 channels and 2 m spatial resolution.Peer reviewe

Researching the lived experiences of cancer patients with malignant fungating wounds

Background: Researching the experiences of terminally ill patients with disfiguring wounds is likely to be a challenge anywhere, and this investigation came face-to-face with different attitudes on the part of both patients and nurses and doctors in England (the South-East) and Italy (Tuscany). Aim: To highlight the complexity of researching sensitive subjects and the difficulties encountered from the perspective of the researcher(s). Methods: Fourteen patients were interviewed. In England access was relatively straightforward, with nurses linked to the hospice doing most of the recruitment. Access was more difficult in Italy, with some doctors expressing opposition. Discussion: How ethical is it to treat dying patients as subjects for research? How does research of this kind vary from one culture to another? Conclusions: Interviewees can find it therapeutic to talk about their experiences to a sympathetic listener—although the listening does pose a considerable strain on the researcher

Six-color photometry of Iapetus, Titan, Rhea, Dione and Tethys

The extensive photometric observations of Titan, Iapetus, Rhea, Dione and Tethys have made it possible to separate the solar phase and orbital phase contributions to the observed light variations of these satellites. For Titan, the wavelength dependence of its solar phase coefficient has been obtained. This dependence should prove useful in constructing future model atmospheres. The other four satellites show a surprising array of different photometric behaviors. Despite these differences, all four satellites have similar spectral reflectivities. Clearly Iapetus, Rhea, Dione and Tethys are complex objects, varying substantially from one another in surface structure and/or composition

Vegetation stress detection through chlorophyll a+b estimation and fluorescence effects on hyperspectral imagery",

ABSTRACT between the light and the canopy under observation, physical methods must be developed (Zarco-Tejada, Physical principles applied to remote sensing data are key to suc- 2000). cessfully quantifying vegetation physiological condition from the study of the light interaction with the canopy under observation. We used The C aϩb content is a potential indicator of vegetatio

Better working memory for non-social targets in infant siblings of children with Autism Spectrum Disorder

We compared working memory (WM) for location of social vs. non-social targets in infant siblings of children with Autism Spectrum Disorders (sibs-ASD, n=25) and typically developing children (sibs-TD, n=30) at 6.5 and 9 months of age. There was a significant interaction of risk group and target-type on WM, in which the sibs-ASD had better WM for non-social targets as compared to controls. There was no group by stimulus interaction on two non-memory measures. The results suggest that the increased competency of sibs-ASD in WM (creating, updating, and using transient representations) for non-social stimuli distinguishes them from sibs-TD by 9 months of age. This early emerging strength is discussed as a developmental pathway that may have implications for social attention and learning in children at risk for ASD

Thiobenzothiazole-modified hydrocortisones display anti-inflammatory activity with reduced impact on islet β-cell function

© 2015, American Society for Biochemistry and Molecular Biology Inc. All rights reserved. Glucocorticoids signal through the glucocorticoid receptor (GR) and are administered clinically for a variety of situations, including inflammatory disorders, specific cancers, rheumatoid arthritis, and organ/tissue transplantation. However, glucocorticoid therapy is also associated with additional complications, including steroid-induced diabetes. We hypothesized that modification of the steroid backbone is one strategy to enhance the therapeutic potential of GR activation. Toward this goal, two commercially unavailable, thiobenzothiazole-containing derivatives of hydrocortisone (termed MS4 and MS6) were examined using 832/13 rat insulinoma cells as well as rodent and human islets. We found that MS4 had transrepression properties but lacked transactivation ability, whereas MS6 retained both transactivation and transrepression activities. In addition, MS4 and MS6 both displayed anti-inflammatory activity. Furthermore, MS4 displayed reduced impact on islet β-cell function in both rodent and human islets. Similar to dexamethasone, MS6 promoted adipocyte development in vitro, whereas MS4 did not. Moreover, neither MS4 nor MS6 activated the Pck1 (Pepck) gene in primary rat hepatocytes. We conclude that modification of the functional groups attached to the D-ring of the hydrocortisone steroid molecule produces compounds with altered structure-function GR agonist activity with decreased impact on insulin secretion and reduced adipogenic potential but with preservation of anti-inflammatory activity

Impaired Mitochondrial Fat Oxidation Induces FGF21 in Muscle

SummaryFatty acids are the primary fuel source for skeletal muscle during most of our daily activities, and impaired fatty acid oxidation (FAO) is associated with insulin resistance. We have developed a mouse model of impaired FAO by deleting carnitine palmitoyltransferase-1b specifically in skeletal muscle (Cpt1bm−/−). Cpt1bm−/− mice have increased glucose utilization and are resistant to diet-induced obesity. Here, we show that inhibition of mitochondrial FAO induces FGF21 expression specifically in skeletal muscle. The induction of FGF21 in Cpt1b-deficient muscle is dependent on AMPK and Akt1 signaling but independent of the stress signaling pathways. FGF21 appears to act in a paracrine manner to increase glucose uptake under low insulin conditions, but it does not contribute to the resistance to diet-induced obesity

A physical gene map of the bacteriophage P22 late region: Genetic analysis of cloned fragments of P22 DNA

A physical gene map of the late region of the P22 chromosome has been constructed by genetic analysis of restriction enzyme fragments of P22 DNA cloned in a plasmid vector. Cleavage sites for restriction endonucleases SalI, SstI, SmaI, Xhoi, and BglI were mapped on P22 DNA to provide physical reference points in addition to the EcoRI, HindIII, and BamHI cleavage sites previously mapped. Restriction enzymes KpnI, BglII, and Xbal were found to have no cleavage sites on P22 DNA. Fragments of P22 DNA produced by cleavage with EcoRI, BamHI, or EcoRI plus BamHI were cloned in Escherichia coli using the plasmid vector pBR322, and the resulting recombinant plasmids were introduced into Salmonella typhimurium. The genes present on a cloned fragment were identified by the ability of the hybrid plasmid to complement or recombine with P22 amber mutations in known genes when mutant phage were used to infect S. typhimurium strains carrying the recombinant plasmids. These experiments place all phage genes required for P22 head morphogenesis except gene 3 on the physical map between coordinates 0.000 and 0.318. The coding capacity of this interval is in close agreement with the molecular weights of the proteins assigned to it. The single gene for the P22 base plate protein is placed between coordinates 0.376 and 0.420 on the physical map. These results also show that distances on the recombination frequency map are significantly distorted relative to the physical gene map of the late region. The recombination frequency map is expanded in the region of the physical gene map where terminally redundant ends of the circularly permuted mature chromosomes fall.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/23263/1/0000197.pd

Perceptions of Specialties and Primary Care Careers: Findings from West Virginia Medical Student and Resident Focus Groups

The purpose of this study was to improve the understanding of how perceptions of practicing specific medical specialties contribute to career decisions. Participants included medical students and residents from training programs in West Virginia. Focus groups were conducted between September 2013 and February 2015. Thematic content analysis of focus group interviews was used to identify phrases indicating perceptions of person- versus technique-oriented personality medical specialties. “Self-focused” and “other-focused” themes emerged within person-oriented comments. Factors affecting “self”, including work/life balance and salary and practice environment, made certain specialties more appealing. Technique-oriented comments included working in a hospital setting, performing technical procedures, and solving immediate problems as opposed to long-term management. Technique-oriented comments from students emphasized learning about disease, and resident comments emphasized treatment as their primary focus. The majority of participants’ comments suggested that a strong patient-doctor relationship and continuity of care are rewarding components of primary care and more compatible with person-oriented personalities. Participants selecting person-oriented specialties viewed rural practice locations more favorably, especially the opportunity to become an integral part of a community. Participants selecting technique-oriented specialties preferred limited interactions with patients and stated that problem-solving and learning about disease states were the most appealing aspects of practicing medicine