Do preceding questions influence the reporting of childbearing intentions in social surveys?

For demographers fertility intentions are a long standing source of both interest and scepticism. Scepticism has been expressed because fertility intentions regularly fail to precisely predict fertility and because they are liable to change across the life course. Here we demonstrate an additional consideration: simply changing the questions that precede fertility intentions questions can have a significant influence on responses. We illustrate this risk using a series of randomised experiments with different preceding questions; first, on mortality and risk in two convenience samples of UK undergraduate students. Secondly, we will present provisional results from a ground-breaking longitudinal experiment where the manipulated preceding questions are on close family and friends. As far as we are aware this later study is the first time that question ordering experiment looking at fertility intentions has been embedded in a representative survey, and the first longitudinal measurement of preceding-question effects using the same individuals

Perceptions de partialité dans la sélection des diplômés internationaux en médecine aux programmes de résidence au Canada

Background: In Canada, international medical graduates (IMG) consist of immigrant-IMG and previous Canadian citizens/permanent residents who attended medical school abroad (CSA). CSA are more likely to obtain a post-graduate residency position than immigrant-IMG and previous studies have suggested that the residency selection process favours CSA over immigrant-IMG. This study explored potential sources of bias in the residency program selection process. Methods: We conducted semi-structured interviews with senior administrators of clinical assessment and post-graduate programs across Canada. We asked about perceptions of the background and preparation of CSA and immigrant-IMG, methods applicants use to improve likelihood of obtaining residency positions, and practices that may favour/discourage applicants. Interviews were transcribed and a constant comparative method was employed to identify recurring themes.  Results: Of a potential 22 administrators, 12 (54.5%) completed interviews. Five key factors that may provide CSA with an advantage were: reputation of the applicant’s medical school, recency of graduation, ability to complete undergraduate clinical placement in Canada, familiarity with Canadian culture, and interview performance.  Conclusions: Although residency programs prioritize equitable selection, they may be constrained by policies designed to promote efficiencies and mitigate medico-legal risks that inadvertently advantage CSA. Identifying the factors behind these potential biases is needed to promote an equitable selection process.Contexte :Parmi les diplômés internationaux en médecine (DIM) au Canada, il y a des diplômés immigrants et des citoyens ou des résidents canadiens qui ont fait leurs études de médecine à l’étranger (CEE). Ces derniers ont plus de chances d’obtenir un poste de résidence postdoctorale que les DIM immigrants. Des études montrent que le processus de sélection des résidents favorise les CEE au détriment des DIM immigrants. La présente étude explore les sources potentielles de biais dans le processus d’attribution des postes de résidence. Méthodes : Nous avons mené des entrevues semi-structurées avec des gestionnaires principaux de programmes d’évaluation clinique et de programmes de formation postdoctorale de tout le Canada. Nous les avons interrogés sur leurs perceptions quant au parcours et au niveau de préparation des CEE et des DIM immigrants, quant aux méthodes utilisées par les candidats pour augmenter leurs chances d’obtenir un poste de résidence et quant aux pratiques qui peuvent encourager ou décourager les candidats. Les entretiens ont été transcrits et une méthode comparative constante a été employée pour identifier les thèmes récurrents. Résultats : Douze (54,5 %) des 22 gestionnaires sollicités ont participé aux entrevues. Les cinq facteurs clés susceptibles de procurer un avantage aux CEE sont : la réputation de la faculté de médecine où le candidat a obtenu son diplôme, la date récente d’obtention de ce dernier, la possibilité d’effectuer un stage clinique de premier cycle au Canada, la familiarité avec la culture canadienne et la performance à l’entrevue. Conclusions : Bien que la sélection équitable soit une priorité pour les programmes de résidence, ils doivent également respecter des politiques visant l’efficacité et l’atténuation des risques médico-légaux qui avantagent involontairement les CEE. Il faut déceler les facteurs qui sous-tendent ces biais potentiels pour renforcer le caractère équitable du processus de sélection

DEVELOPMENT AND EVALUATION OF DENTAL FILMS CONTAINING AN ANTIBACTERIAL AGENT FOR THE TREATMENT OF PERIODONTITIS

Objective: The present study aims at the development and evaluation of controlled release dental films containing metronidazole in a carrier which consists of a common non-biodegradable polymer and various co-polymers in different concentrations for targeted delivery of drug and thus prolonging the action.Methods: Solvent casting method is adopted. Nine formulations were prepared with ethyl cellulose as the main polymer and co-polymers like PVPK30, HPMC K4M, Eudragit RS 100 in 3 concentrations (10, 20, 30%w/w of ethyl cellulose). Ethyl cellulose and co-polymers were dissolved in the solvent system, containing ethanol, chloroform and dichloromethane. Drug was dissolved in this mixture and mixed homogeneously and films were casted. These films were evaluated for thickness & content uniformity, swelling index, percentage moisture loss, in vitro drug release studies.Results: The best film was selected as the one which is prepared with ethyl cellulose and eudragitRS100 (20%w/w of ethyl cellulose) ie F8 since it can release the drug above MIC in each day of treatment and having sufficient drug content and other required characteristics. This formulation undergoes zero order release kinetics and non-Fickian diffusion mechanism.Conclusion: Ethyl cellulose - eudragit RS100 (20%w/w of EC) combination is the best carrier among the others for the preparation of metronidazole dental film for prolonging the drug action up to 10 days. Â

Retention of provisionally licensed international medical graduates: a historical cohort study of general and family physicians in Newfoundland and Labrador

ABSTRACT Background: To alleviate the shortage of primary care physicians in rural communities, the Canadian province of Newfoundland and Labrador (NL) introduced provisional licensure for international medical graduates (IMGs), allowing them to practise in under-served communities while completing licensing requirements. Although provisional licensing has been seen as a needed recruitment strategy, little is known about its impact on physician retention. To assess the relationship between provincial retention time and type of initial practice licence, we compared the retention of: (1) IMGs who began practice with a provisional licence; (2) fully licensed Memorial University medical graduates (MMGs); and (3) fully licensed medical graduates from other Canadian medical schools (CMGs). Methods: Using administrative data from the NL College of Physicians and Surgeons, the 2004 Scott’s Medical Database, and the Memorial University postgraduate database, we identified family physicians/general practitioners (FPs/GPs) who began their practice in NL in the period 1997–2000 and determined where they were in 2004. We used Cox regression to examine differences in retention among these 3 groups of physicians. Results: There were 42 MMGs, 38 CMGs and 77 IMGs in our sample. The median time for IMGs to qualify for full licensure was 15 months. Twenty-one physicians (13.4%) stayed in NL after beginning their practice (35.7% MMGs, 5.3% CMGs, 5.2% IMGs; p < 0.000). The median retention time was 25 months (MMGs, 39 months; CMGs, 22 months; IMGs, 22 months; p < 0.000). After controlling for Certificant of the College of Family Physicians status, CMGs (hazard ratio [HR] = 2.15; 95% confidence interval [CI] 1.29–3.60) and IMGs (HR = 2.03; 95% CI 1.26–3.27) were more likely to leave NL than MMGs. Conclusions: Provisional licensing accounts for the largest proportion of new primary care physicians in NL but does not lead to long-term retention of IMGs. However, IMG retention is no worse than the retention of CMGs

Systematic scoping review of factors and measures of rurality: toward the development of a rurality index for health care research in Japan

Background: Rural-urban health care disparities are an important topic in health services research. Hence, developing valid and reliable tools to measure rurality is needed to support high quality research. However, Japan, has no index to measure rurality for health care research. In this study, we conducted a systematic scoping review to identify the important factors and methodological approaches to consider in a rurality index to inform the development of a rurality index for Japan. Methods: For our review, we searched six bibliographic databases (MEDLINE, PubMed, CINAHIL, ERIC, Web of Science and the Grey Literature Report) and official websites of national governments such as Government and Legislative Libraries Online Publications Portal (GALLOP), from 1 January 1989 to 31 December 2018. We extracted relevant variables used in the development of rurality indices, the formulas used to calculate indices, and any measures for reliability and validity of these indices. Results: We identified 17 rurality indices from 7 countries. These indices were primarily developed to assess access to health care or to determine eligibility for incentives for health care providers. Frequently used factors in these indices included population size/density and travel distance/time to emergency care or referral centre. Many indices did not report reliability or validity measures. Conclusions: While the concept of rurality and concerns about barriers to access to care for rural residents is shared by many countries, the operationalization of rurality is highly context-specific, with few universal measures or approaches to constructing a rurality index. The results will be helpful in the development of a rurality index in Japan and in other countries

More Than a Biological Condition: The Heteronormative Framing of Infertility

Infertility is often framed from the perspective of heterosexual couples, the dominant patient group using reproductive technologies. However, there are many types of patients availing of fertility treatments and those patients are often overlooked in policy, planning, service provision, and research. This commentary demonstrates the need for further research into LGBT subgroups, who frequently fall outside of infertility discourses, and are therefore especially disadvantaged by current policy and fertility service structures

ESL Student Perceptions of VLE Effectiveness at a University in South Korea

The purpose of this study is to determine students’ perception of the advantages, effects on language skills, suggestions for improvement, and limitations regarding the use of a VLE (Blackboard) and their differences according to gender, year, number of Blackboard courses taken, and computer literacy. The respondents of this study were 686 randomly selected university students enrolled in English classes at the University of Suwon in South Korea. An adapted survey questionnaire consisting of 33 items was administered to the students. The Mean was used to determine the students’ perceptions in the four areas followed by t-test and ANOVA to determine the differences in the students’ perceptions. The results showed that the students had a somewhat disagree rating in the areas of Advantages, Language, and Limitations and somewhat agree rating in the area of Suggestions. Significant differences were found in the students’ perceptions in the four areas when grouped according to gender and computer literacy; a significant difference was found in the area of Limitations when grouped according to year; and no significant differences were found according to number of Blackboard courses taken