A Survey of Kansas Physicians' Perceptions of Physician Assistant Education and Qualifications

BACKGROUND: Effective physician-physician assistant (PA) teams improve patient access and satisfaction, and increase productivity and revenue while reducing physician workload. This survey assessed perceptions of Kansas primary care physicians regarding educational requirements and qualifications of PAs, professional and legal regulations, and the most important skills and competencies for PAs to possess. Understanding these perceptions may lead to improved communication and refined expectations of physician-physician assistant teams, thereby increasing their utilization and effectiveness. METHODS: A 20-question survey was emailed to all 1,551 primary care physicians registered with the Kansas Board of Healing Arts in 2012. Descriptive data were reported as frequencies; comparisons between groups were analyzed using Chi-square. RESULTS: The response rate was 9.2% (n = 143). Physicians were highly accurate regarding the program’s generalist/primary care educational model and moderately accurate regarding the degree awarded, average pre-program grade point average, lock-step full-time curriculum, weeks of clinical rotations, recertification and continuing medical education hours, and Medicare PA fee schedule. Physicians had low accuracy regarding program and pharmacology credit hours, strict dismissal policy, pre-program healthcare experience, and co-signatory regulations. Physicians with PA supervisory experience had higher knowledge than those without (p = 0.001). Physicians most commonly selected history taking and performing physical exam as the most important skill (49%) and providing patient care that is patient-centered, efficient, and equitable as the most important competency (42%). CONCLUSIONS: Physicians often underestimated the average PA applicant qualifications, program rigor and intensity, professional regulatory standards, and co-signatory requirements. Correcting misperceptions and improving understanding of which PA skills and competencies are most valued by physicians may optimize PAs as part of the healthcare team

Paternal and Maternal History of Myocardial Infarction and Cardiovascular Diseases Incidence in a Dutch Cohort of Middle-Aged Persons

Background - A positive parental history of myocardial infarction (MI) is an independent risk factor for cardiovascular diseases (CVD). However, different definitions of parental history have been used. We evaluated the impact of parental gender and age of onset of MI on CVD incidence. Methods - Baseline data were collected between 1993 and 1997 in 10¿524 respondents aged 40–65 years. CVD events were obtained from the National Hospital Discharge Register and Statistics Netherlands. We used proportional hazard models to calculate hazard ratios (HR) and 95% confidence intervals (CI) for CVD incidence and adjusted for lifestyle and biological risk factors. Results - At baseline, 36% had a parental history of MI. During 10-year follow-up, 914 CVD events occurred. The age and gender adjusted HR was 1.3 (95% CI 1.1–1.5) for those with a paternal MI, 1.5 (1.2–1.8) for those with a maternal MI and 1.6 (1.2–2.2) for those with both parents with an MI. With decreasing parental age of MI, HR increased from 1.2 (1.0–1.6) for age =70 years to 1.5 (1.2–1.8) for ag

A Controlled Experiment of Surface Albedo Modification to Reduce Ice Melt

Abstract Loss of reflectivity in the Arctic and the wider cryosphere is known to increase global temperature rise through an ice‐albedo feedback loop, which has the potential to lead to loss of summertime ice cover in the Arctic Ocean, and to accelerate global warming. Despite the urgency of this situation, there are few options being developed to preserve and restore ice reflectivity. Localized surface albedo modification using reflective materials offers a potential pathway to restore Arctic ice. We conducted a controlled experiment to determine effects of surface albedo modification on ice melt and thermodynamic processes of a pond. We applied a coating of hollow glass microspheres (HGMs) to a test section, while leaving a control section unmodified. Laboratory measurements show that the loading of HGM materials used corresponds to a reflectivity of 30%. We measured ice and snow thickness, albedo, incoming and outgoing shortwave and longwave radiation, and ice, water, and ambient temperatures. A 1‐D thermodynamic model was developed to quantify the effect of albedo modification on the processes of heat transfer, energy absorption and ice melt. The albedo increased from 0.17 on a control section to 0.36 on a test section. During the 2‐week melt period, there was a 29% reduction in net radiative energy into the test section and a 33% reduction of ice melting rate measured by volume. This experiment using quantitative methods elucidates the mechanisms of ice preservation through surface albedo modification and demonstrates its effectiveness

YODA: An advanced display for personal computers

Executive Summary: From August 2010 to February 2011 personnel from Information and Innovation at the University of Southern Maine have conducted a study of IT skills needed, possessed and taught in Maine. The goals of this study were to provide fine-grained information to the Maine state Department of Labor to facilitate their workforce development activities. This study concerns the skills sought after by employers, possessed by unemployed and employed workers and taught in education and training establishments with a bricks and mortar presence in Maine. It relied on data created by third parties and by study personnel. Anecdotal evidence was gathered from meetings with local industry IT professionals as well. This study does not attempt to estimate demand or supply of a given skill, but it does assess which skills are in greatest and least demand, which skills are in greatest and least supply, and which skills are taught more and less often. The results of data analysis are presented in a new measure, skill rank disparity, which exposes skill and training gaps and gluts. This study provides certain insights into its results, observing individual cases of skills high in demand and low in supply, for example. Insights are also provided in terms of groups of skills that are often taught, often asked for, and whether these groups of skills are well-represente