Generational differences in factors influencing physicians to choose a work location.

INTRODUCTION: Canadian medical schools have increased enrolment and recruited more rural students in an effort to address general and rural physician shortages. The success of this approach depends on the recruitment of these newly trained physicians to under-serviced areas. Studies from North America suggest that the career expectations and practice patterns of younger, more recently graduated physicians differ from those of their older counterparts. This study explored the factors that influenced the work location choices of physicians of differing generations, who trained at universities in Saskatchewan, and Newfoundland and Labrador, two Canadian provinces with large rural populations and no community larger than 235 000 population. METHODS: Semi-structured, qualitative interviews were conducted with physicians who graduated from either the Memorial University of Newfoundland or the University of Saskatchewan. Generation definitions were based on the graduation year. Early-career physicians graduated between 1995 and 1999; mid-career physician graduated between 1985 and 1989; late-career physicians graduated between 1975 and 1979; and end-career physicians graduated between 1965 and 1969. Each physician was asked questions about the number and nature of work location changes over the course of their careers and the factors related to their decision to choose each location. Interview transcripts and notes were analyzed using a thematic analysis approach. Although the study focus was on generational differences, similarities and differences between universities, sexes and specialties (family physicians/GPs vs specialists) were also examined. Recruitment to the provinces was focused on as a whole, because the largest communities in the provinces are small compared with most urban communities. RESULTS: Forty-eight physicians were interviewed, five to nine physicians who graduated in each decade and from each university. The desire to be near family and friends was cited as the primary consideration when choosing a work location, regardless of generation. Likewise, residency training location, the ability to use their skills and knowledge fully, and the quality of recruitment efforts were important considerations in choosing a work location for all physicians. For some, remuneration was very influential in their work location decision; however, many physicians who chose to remain in their smaller 'home' provinces noted the lower cost of living in these provinces. Physicians who graduated in the 1980s and 1990s placed greater emphasis on work-life balance and spouse's employment opportunities than their older generation counterparts. In contrast, physicians who graduated in the 1960s and 1070s highlighted the medical need of the community, and the desire for adventure and to see new places as important. CONCLUSIONS: While many factors for choosing a work location appear to be stable over generations, a number of generational differences were found. Younger physicians placed greater emphasis on work-life balance and spouse's employment than older generation physicians. These differences may have important implications for small population regions which may not be able to support physician-spouse pairs or certain subspecialties. Although economic factors have largely been the focus of recruitment and retention initiatives in these provinces, the findings highlight the importance of addressing the needs and expectations of younger generation physicians in order to attract these physicians

HARDROC, Readout chip of the Digital Hadronic Calorimeter of ILC

HARDROC (HAdronic Rpc Detector ReadOut Chip) [1] is the very front end chip designed for the readout of the RPC or Micromegas foreseen for the Digital HAdronic CALorimeter (DHCAL) of the future International Linear Collider. The very fine granularity of the ILC hadronic calorimeters (1cm2 pads) implies a huge number of electronics channels (4 105 /m3) which is a new feature of “imaging” calorimetry. Moreover, for compactness, the chips must be embedded inside the detector making crucial the reduction of the power consumption to 10 μW per channel. This is achieved using power pulsing, made possible by the ILC bunch pattern (1 ms of data acquisition for 199 ms of dead time). HARDROC readout is a semi-digital readout with three thresholds which allows both good tracking and coarse energy measurement, and also integrates on chip data storage. The overall performance of HARDROC will be described with detailed measurements of all the characteristics. Hundreds of chips have indeed been produced and tested before being mounted on printed boards developed for the readout of large scale (1m2) RPC and Micromegas prototypes. These prototypes have been tested with cosmics and also in testbeam at CERN in 2008 and 2009 to evaluate the performance of different kinds of GRPCs and to validate the semi-digital electronics readout system in beam conditions

Heliophysics Event Knowledgebase for the Solar Dynamics Observatory and Beyond

The immense volume of data generated by the suite of instruments on SDO requires new tools for efficient identifying and accessing data that is most relevant to research investigations. We have developed the Heliophysics Events Knowledgebase (HEK) to fill this need. The HEK system combines automated data mining using feature-detection methods and high-performance visualization systems for data markup. In addition, web services and clients are provided for searching the resulting metadata, reviewing results, and efficiently accessing the data. We review these components and present examples of their use with SDO data.Comment: 17 pages, 4 figure

OMEGAPIX: 3D integrated circuit prototype dedicated to the ATLAS upgrade Super LHC pixel project

In late 2008, an international consortium for development of vertically integrated (3D) readout electronics was created to explore features available from this technology. In this paper, the OMEGAPIX circuit is presented. It is the first front-end ASIC prototype designed at LAL in 3D technology. It has been submitted on May 2009. At first, a short reminder of 3D technology is presented. Then the IC design is explained: analogue tier, digital tier and testability

Vismodegib resistant mutations are not selected in multifocal relapses of locally advanced basal cell carcinoma after vismodegib discontinuation.

Hedgehog pathway inhibitors (HPI) inactivating SMO 1, have become first line treatment for patients with locally advanced BCC (laBCC). HPI safety and efficacy have been shown in clinical trials2,3. Nevertheless, common adverse events lead to treatment discontinuation

MAROC: Multi-Anode ReadOut Chip for MaPMTs

International audienceFor the ATLAS luminometer, made of Roman pots, a complete readout ASIC has been designed in 0.35 SiGe technology. It is used to readout 64 channels multi anode photomultipliers and supplies 64 trigger outputs and a multiplexed charge. Since its delivery in November 2005, the MAROC chip has been tested at LAL. Despite a substrate coupling effect which affects the performance when all channels are used in high gain, the chip has shown nice global behavior and it has been used during beam tests at CERN in October 2006

Scalar conservation laws with nonconstant coefficients with application to particle size segregation in granular flow

Granular materials will segregate by particle size when subjected to shear, as occurs, for example, in avalanches. The evolution of a bidisperse mixture of particles can be modeled by a nonlinear first order partial differential equation, provided the shear (or velocity) is a known function of position. While avalanche-driven shear is approximately uniform in depth, boundary-driven shear typically creates a shear band with a nonlinear velocity profile. In this paper, we measure a velocity profile from experimental data and solve initial value problems that mimic the segregation observed in the experiment, thereby verifying the value of the continuum model. To simplify the analysis, we consider only one-dimensional configurations, in which a layer of small particles is placed above a layer of large particles within an annular shear cell and is sheared for arbitrarily long times. We fit the measured velocity profile to both an exponential function of depth and a piecewise linear function which separates the shear band from the rest of the material. Each solution of the initial value problem is non-standard, involving curved characteristics in the exponential case, and a material interface with a jump in characteristic speed in the piecewise linear case

An experimental investigation of a novel iron chelating protoporphyrin IX prodrug for the enhancement of photodynamic therapy (article)

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this recordThe dataset associated with this article is located in ORE at: http://hdl.handle.net/10871/32090Objectives: Non-melanoma skin cancers are the most frequently occurring type of cancer worldwide. They can be effectively treated using topical dermatological photodynamic therapy (PDT) employing protoporphyrin IX (PpIX) as the active photosensitising agent as long as the disease remains superficial. Novel iron chelating agents are being investigated to enhance the effectiveness and extend the applications of this treatment modality, as limiting free iron increases the accumulation of PpIX available for light activation and thus cell kill. Methods: Human lung fibroblasts (MRC-5) and epithelial squamous carcinoma (A431) cells were treated with PpIX precursors (aminolaevulinic acid (ALA) or methyl-aminolevulinate (MAL)) with or without the separate hydroxypyridinone iron chelating agent (CP94) or alternatively, the new combined iron chelator and PpIX producing agent, AP2-18. PpIX fluorescence was monitored hourly for 6 hours prior to irradiation. PDT effectiveness was then assessed the following day using the lactate dehydrogenase and neutral red assays. Results: Generally, iron chelation achieved via CP94 or AP2-18 administration significantly increased PpIX fluorescence. ALA was more effective as a PpIX-prodrug than MAL in A431 cells, corresponding with the lower PpIX accumulation observed with the latter congener in this cell type. Addition of either iron chelating agent consistently increased PpIX accumulation but did not always convey an extra beneficial effect on PpIX-PDT cell kill when using the already highly effective higher dose of ALA. However, these adjuvants were highly beneficial in the skin cancer cells when compared with MAL administration alone. AP2-18 was also at least as effective as CP94 + ALA/MAL coadministration throughout and significantly better than CP94 supplementation at increasing PpIX fluorescence in MRC5 cells as well as at lower doses where PpIX accumulation was observed to be more limited. Conclusions: PpIX fluorescence levels, as well as PDT cell kill effects on irradiation can be significantly increased by pyridinone iron chelation, either via the addition of CP94 to the administration of a PpIX precursor or alternatively via the newly synthesised combined PpIX prodrug and siderophore, AP2-18. The effect of the latter compound appears to be at least equivalent to, if not better than, the separate administration of its constituent parts, particularly when employing MAL to destroy skin cancer cells. AP2-18 therefore warrants further detailed analysis, as it may have 3 the potential to improve dermatological PDT outcomes in applications currently requiring enhancement.The authors wish to thank Professor Hider (King’s College London, UK) for synthesising CP94. The financial support of the Medical Research Council (MRC, UK) and Killing Cancer (UK) is very gratefully acknowledged