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To estimate the prevalence and to explore the determinants of public speech anxiety (PSA) among family medicine trainees at the Joint Program of Family Medicine, Jeddah, Saudi Arabia, 2020. A cross-sectional study was conducted online for 131 residents who completed the original version (34 items) of the Personal Report of Public Speaking Anxiety (PRPSA) scale. The PRPSA score (range 34-170) was calculated as the sum of the item scores, and three PSA levels were defined including low (PRPSA score 131). Sociodemographic and academic data were collected and analyzed as factors of PSA. The mean PRPSA was 100.27 out of 170 (SD = 18.10). Of the participants, 55.0% had moderate and 6.9% had high PRPSA scores. Female participants had a higher percentage of moderate (61.5% vs 45.3%) and high (9.0% vs 3.8%) PRPSA scores compared with males, respectively (p=0.041). A previous negative experience with public speech was also associated with a higher percentage of moderate (73.7% vs 47.3%) and high (15.8% vs 3.2%) PRPSA scores compared to absence of such an experience (p The latency and high prevalence of PSA among family medicine residents highlight the relevance of incorporating curricula to enhance public speaking and communication skills among medical trainees.

The mission of the American Board of Ophthalmology (ABO) is to serve the public by improving the quality of ophthalmic practice through a continuing certification process that fosters excellence and encourages continual learning. Since 2001, achieving this mission has been enhanced by including public directors in the ABO governance. We review the evolution of including nonprofessional members on the governing boards of professional regulatory and self-regulatory organizations generally, provide history about the incorporation of non-professional public directors into the governance structure of the American Board of Medical Specialties and the ABO, and offer insights about the perceived impact of public directors on the ABO.

Nesse artigo, analisamos duas formas simbólicas brasileiras (comerciais de televisão) tendo como enquadre teórico uma metodologia crítica baseada em alguns elementos teóricos dos Estudos Culturais. O ponto de partida é o conceito de minoria e maioria, e seu caráter nômico e anômico. Assumimos que as formas simbólicas podem ser entendidas como portadoras de ideologia, e para entender a ideologia subjacente a elas nós temos que desconstruir a unidade da mensagem e expor sua "naturalidade". Nesse processo, aspectos relacionados às relações de dominação de gênero e raça foram desveladas, indicando que a discriminação em direção às minorias ainda é parte da nossa realidade mediada. In this article we analyze two Brazilian symbolic forms (television commercials) having as theoretical framework a critical methodology based on some theoretical elements of Cultural Studies. The starting point is the concept of minority versus majority, and its nomic and anomic character. We assume that symbolic forms can be understood as carriers of ideology, and in order to understand its underpinned ideology we have to deconstruct the messages unity and expose its "naturality". In this process issues regarding gender and racial relations of domination were unveiled, indicating that discrimination towards minorities still takes part of our mediated reality.

The treatment of pediatric mandibular fractures is rare, controversial, and complicated by mixed dentition.To determine if open mandibular fracture repair with intraoral and extraoral rigid plate placement, after free hand occlusal and bone reduction, without intermaxillary fixation (IMF), is appropriate and to discuss postoperative advantages, namely, maximal early return of function and minimal oral hygiene issues.A group of 29 pediatric patients with a mandibular fracture were examined. Twenty pediatric patients (13 males and 7 females) with a mean age of 9 years (age range, 1-17 years) were treated using IMF. All patients were treated by the same surgeon (G.S.).Surgical time for plating was reduced by 1 hour, the average time to place patients in IMF. The patients who underwent open reduction internal fixation without IMF ate a soft mechanical diet by postoperative day 3 compared with postoperative day 16 for those who underwent IMF. Complication rates related to fixation technique were comparable at 20% for those who did not undergo IMF and 33% for those who did.We believe that free hand reduction is a valuable technique to reduce operative time for pediatric mandibular fractures. It maximizes return to function while minimizing the oral hygiene issues and hardware removal of intermaxillary function.

As the number of older Americans increased in the twentieth century, training programs added geriatrics to their teaching and clinical experiences. The advent of added qualifications in geriatrics through board examination and the accreditation of geriatric residency (fellowship) programs brought further recognition of the geriatric imperative. Yet curricular requirements for experience with old age mental illness remain minimal. Reduced support for graduate medical education dictates that general—rather than geriatric—psychiatrists will continue to provide the majority of specialty mental health services to older adults. The authors review the emergence of geriatrics in general residency training and present recommendations for further evolution.

This study follows up one in which was derived a two-item screening questionnaire for pathological gambling. In the previous study, the two-item screening questionnaire had sensitivity of .99 and specificity of .91. In this study, testing 295 men (116 pathological gamblers and 179 controls) and 128 women (30 pathological gamblers and 98 controls), sensitivity was 1.00 and specificity .85. In the previous study, the predictive value of a positive result was .92 and of a negative result .99. In this sample, the predictive value of a positive result was .78 and of a negative result 1.00. These results indicate the two questions represent a useful screening device for a DSM-IV diagnosis of pathological gambling.

Hoy en día, en el que el mundo continuamente sufre transformaciones, el hombre se ha preocupado por conocer y hacer de su entorno ambiental un lugar vivible, pero al mismo tiempo, él mismo se ha encargado de mantenerlo y llevarlo a situaciones que generan un verdadero caos. Ese caos, conocido como impacto ambiental es necesario medirlo, para lo cual se ha empleado la metodologia de la Evaluación del Impacto Ambiental EIA, sin contar hasta hoy con un modelo sistematico para hacerlo cuantitativamente a nivel de una cuenca hidrografica, generando así un problema en terminos de la evaluación para la gestión ambiental. La aplicación del modelo desarrollado en este trabajo denominado IVAFIC, Responde al problema presentado, evaluando a través de un modelo matematico y con la ayuda de herramientas computacionales de programación estructurada y de sistemas de información geografica, el impacto ambiental en una cuenca de forma cuantitativa definido como factor de impacto F1 y factor de impacto corregido FIC.

Antecedentes: Los brotes por gastroenteritis aguda constituyen un problema de salud pública. Se conoce al norovirus como la causa más común (50%). En Chile, la vigilancia de estos eventos, se establece mediante la notificación inmediata. Objetivo: Investigar y caracterizar el brote de gastroenteritis aguda ocurrido en la Región de Antofagasta, durante los meses de marzo y abril de 2010. Método: Se efectuó un estudio observacional descriptivo para realizar la investigación de brote. Se incluyó a residentes de la región que cumplían con la definición de caso. Se solicitó muestras de deposición, encuesta epidemiológica y muestras ambientales. Resultados: Se estimó que el brote comenzó el 8 de marzo de 2010 y duró hasta el 28 de abril del mismo año; se notificaron 31. 036 casos (tasa 54 por 1.000 habitantes). El grupo de 25 y 44 años de edad fue el más afectado y la diarrea fue el síntoma predominante (97% de los casos). Se determinó la presencia de norovirus genogrupo II en muestras clínicas y ambientales. Conclusiones: El brote se originó por el consumo crudo de hortalizas que provenían del sector La Chimba, las que fueron regadas y contaminadas con agua servida tratada que contenía baja concentración de cloro libre residual y posteriormente se propagó por transmisión persona-persona, en un ambiente sanitario deficiente. Outbreaks of acute gastroenteritis are a public health problem. Norovirus is known as the most common cause (50%). In Chile, immediate notification allows surveillance of these events. We describe an acute gastroenteritis outbreak that occurred in Antofagasta region, between March and April 2010. An observational study was conducted to perform the outbreak investigation. Local residents who met case definition were included. Stool samples, epidemiological surveys and environmental samples were requested. The outbreak began approximately on March 8, 2010 and lasted until April 28 with 31,036 reported cases (rate 54 per 1000 inhabitants). The most affected age group was between 25 and 44 years, and diarrhea was the main symptom (97% of cases). We determined the presence of norovirus genogroup II in clinical and environmental samples. This outbreak was caused by consumption of raw vegetables from La Chimba, which were watered and contaminated with treated sewage containing low concentration of free residual chlorine. Subsequently, the outbreak spread from person to person in a poor sanitary environment.

Gyrokinetic equations of motion, Poisson equation, and energy and momentum conservation laws are derived based on the reduced-phase-space Lagrangian and inverse Kruskal iteration introduced by Pfirsch and Correa-Restrepo [J. Plasma Phys. 70, 719 (2004)]. This formalism, together with the choice of the adiabatic invariant J=⟨p⃗ ⋅∂x⃗ /∂ϕ⟩ as one of the averaging coordinates in phase space, provides an alternative to the standard gyrokinetics. Within second order in gyrokinetic parameter, the new equations do not show explicit ponderomotivelike or polarizationlike terms. Pullback of particle information with an iterated gyrophase and field dependent gyroradius function from the gyrocenter position defined by gyroaveraged coordinates allows direct numerical integration of the gyrokinetic equations in particle simulation of the field and particles with full distribution function. As an example, gyrokinetic systems with polarization drift either present or absent in the equations of motion are considered.

Profile surveys, completed Rotter I-E scales, and questionnaires on past relapse behavior were collected from 108 New Jersey compulsive gamblers who attended Gamblers Anonymous, and an attempt was made, based on the findings, to predict incidence of compulsive gamblers' relapse. Relationships between I-E scores and extent of relapse-free periods, and I-E scores and relapse, with the variables of religious background, age, marital status, education, type of work, and childhood physical abuse were investigated. In every instance the relationship found was statistically nonsignificant.

En Chile, se realiza la vigilancia de gastroenteritis causadas por rotavirus en niños bajo 5 años a través de centros centinelas ambulatorios y hospitalarios. Objetivo: Conocer la epidemiología de las diarreas por rotavirus y evaluar la carga de morbi-mortalidad. Método: La vigilancia ambulatoria se desarrolla en 14 centros de 8 regiones y la vigilancia hospitalaria se lleva a cabo en 8 hospitales pediátricos de las regiones Vª, VIIIªy RM. Resultados: En 2007, 9,3% de las consultas por diarrea fue estudiada (339), detectándose rotavirus en 15% de ellas. Se hospitalizaron por diarrea, 2.074 casos, 9% del total de las hospitalizaciones en este grupo etario. De estas, 13,6% fueron por rotavirus. Conclusiones: Dada la situación epidemiológica actual, es importante mantener la vigilancia, ampliar la pesquisa de los casos, aplicar el protocolo de vigilancia establecido y determinar el serotipo/genotipo circulante en el país. A sentinel-based outpatient and inpatient surveillance for rotavirus infection has been implemented in Chile. Aim: Update the impact of rotavirus infections in Chile. Methods: Ambulatory surveillance is performed in 14 centers from 8 Regions and hospital-based surveillance in 8 hospitals from three Regions (V, VIII and Metropolitan). Results: In 2007, 339 stool samples that represented 9.3% of all outpatient cases were studied of which 15% were rotavirus positive. A total of 2.074 children younger than 5 years of age were hospitalized representing 9% of all hospitalizations for this age group. Rotavirus was detected in 13.6% of these cases. Conclusions: In the current epidemiological situation, rotavirus surveillance needs to be sustained with increased efforts to detect cases in order to avoid underreporting. Serotype/genotype surveillance of rotavirus strains needs to be included in the near future.

En una finca localizada en el municipio de Montería, departamento de Córdoba, se evaluó el comportamiento animal en cuatro ecotipos de especies del género Brachiaria : B. brizantha CIAT 26110, B. brizantha CIAT 16322, B. brizantha cv Marandú y B. decumbens . Se utilizó semilla sexual para sembrar una hectárea de cada material, dividiéndose en dos potreros para ser manejados en sistema de pastoreo alterno de 24 días de descanso y 24 días de ocupación. En cada accesión se estimo el rendimiento de materia seca y la relación hoja/tallo a la entrada de los animales. En muestras de cada ecotipo fueron analizadas el contenido de proteína bruta, fibra en detergente neutro (FDN), fibra en detergente ácido (FDA) y la digestibilidad In Situ por 48 horas. En la época de lluvias, a los 24 días de rebrote, la producción de materia seca fue de 3534 kg/ha, 3192 kg/ha, 2684 kg/ha y 1916 kg/ha, respectivamente para B. brizantha CIAT 26110, B. decumbens , B. brizantha CIAT 16322 y B. brizantha cv Marandú, en este mismo orden, durante la época seca, a los 24 días de rebrote, los rendimientos fueron 1184 kg/ha, 950 kg/ha, 710 kg/ha y 1400kg/ha. La calidad nutritiva de los diferentes ecotipos estuvo dentro del rango de esta especies, según revisión hecha por Lascano y Euclides (1998). La ganancia de peso por animal, en una primera evaluación de 168 días (octubre a marzo), con 2 animales de carga por hectárea, fue de 1.255 kg/animal/día, 1.07 kg/animal/día, 071 kg/animal/día y 1.0 kg/animal/día, respectivamente para CIAT 16322, CIAT 26110, cv Marandú y B. decumbens . En una segunda evaluación con duración de 120 días (julio a noviembre) la ganancia de peso por animal fue de 0.51 kg/animal/día, 0.610 kg/animal/día, 0.57 kg/animal/día y 0.700 kg/animal/día, para los ecotipos CIAT 16322, CIAT 26110, cv Marandú y B. decumbens , respectivamente con una carga de 3, 5, 2 y 3 animales por hectárea.

Study design: Multicentered follow-up with centralized data collection based on retrospective study. Objectives: To assess the outcome in a population of patients with spinal cord injury (SCI). The assessed outcomes are mortality, state of health, occupation, mobility, autonomy, social and partner relationships, quality of life (QoL), with the identification of any relation between results and demographic–clinical data. Setting: Two rehabilitation centers (Udine and Trevi) and a Spinal Injuries Unit (Torino). Methods: A total of 251 patients with SCI discharged after first hospitalization from rehabilitation facilities between 1989 and 1994 were enrolled. A questionnaire was administered by telephone. Results: During the time between discharge and follow-up, 25 out of the 251 patients had died, yielding a mortality rate of 9.96%. A total of 80 patients did not give their consent. The 146 patients' mean interval from discharge from the rehabilitation facility was 6 years. At least 25% has been hospitalized again. The descriptive analysis also shows that 29.5% of patients were working, 48.6% were able to drive, 63.7% would leave their home alone, 61% would leave home every day, 63% reported of a change in their relationships, 48.6% were happy with their love lives. Significant correlations have emerged between certain items and age: those who had a job, who could drive, were more autonomous and had a higher QoL are generally younger. Level of injury appear to be only associated with the degree of autonomy, which seems to be inferior for tetraplegic subjects. The injury's completeness and etiology do not exhibit any correlation. QoL is associated with a number of items: a higher QoL is linked to the possibility to work, especially if it is a paid job, to the ability to drive, to a good degree of autonomy, to a lack of change in the social and partner relationships, and to a satisfactory love life. Conclusion: At 6 years after discharge from rehabilitations, the effects of trauma on work and social and partner relationships, domains correlated with autonomy and QoL, are evident. Further investigation by means of a prospective study over the years are therefore necessary.

To examine the University of Kentucky College of Medicine's community-based faculty's (CBF) perspective on computing skills that students should acquire for future medical practice, and if the CBF currently use these skills in their daily practice.A survey was mailed to 281 of the institution's CBF in the spring of 1997. The survey listed eight basic computing skills derived from our computing curricular objectives for students and asked respondents (a) if they use the skill, and (b) if students should learn the skill.200 respondents returned a completed survey. 14 CBF (7.2%) indicated that they have all eight computer skills while 91 CBF (46.4%) indicated that students should learn all eight computer skills. 25 CBF (13%) indicated that they have none of the computer skills, while none of the CBF indicated students need none of the skills. A significant difference between primary care CBF and other specialist CBF was found with respect to self-report of computer use, but not regarding their opinions about students' need to learn computer skills.The majority of our CBF report using at least one computer skill in their practices. Regardless of specialty, CBF report that students should possess more computer skills than they themselves have. Medical educators should incorporate computing applications into the curriculum to provide appropriate computer training for future physicians.

Computers are increasingly being used in clinical practice settings. Aware of the need to educate students regarding computer applications in medicine, the University of Kentucky College of Medicine is in the midst of developing a computer curriculum. To that end, many courses and clerkships have devised software packages for transmittal of course information and for evaluation of student performance. This paper outlines requisite computer skills that applicants applying to medical school should possess, broadly reviews how those computer skills will be used in medical school, and suggests means for attaining computer competency prior to making application to medical school.

A 2-item questionnaire was derived from 10 DSM-IV criteria for pathological gambling. Subjects were 362 men, 191 classified as pathological gamblers and 171 as nonproblem-gambling controls. The two items were significant in sensitivity and negative predictive value and significant in specificity and positive predictive value.

Violence should be viewed from biological, psychological, ethnological, and anthropological perspectives. Consideration of theories on biopsychosocial vulnerabilities and cultural and environmental factors have implications for diagnostic, therapeutic, and rehabilitative approaches.

Postulating that a program integrating language skills with other aspects of cultural knowledge could assist in developing medical students' ability to work in cross-cultural situations and that partnership with targeted communities was key to developing an effective program, a medical school and two organizations with strong community ties joined forces to develop a Spanish Language and Hispanic Cultural Competence Project. Medical student participants in the program improved their language skills and knowledge of cultural issues, and a partnership with community organizations provided context and resources to supplement more traditional modes of medical education.

Between the 26th of April and the 8th of july 1987 a seroepidemiological survey was conducted in the district of Chlef located in an endemic cholera area of Algeria. The purpose of this work was to evaluate the seroprevalence of vibriocidal antibodies and to study some epidemiological characteristics of cholera. This survey concerns the representative samples of patients and asymptomatic carriers such as they were declared during the epidemic periods of 1982 and 1986 and a sample of contacts of these latter. A bacteriology of stools practised on all the subjects did not reveal a carrying of vibrios. The seroprevalence was 37.6% and it concerned all ages. It was linked meaningfully to the age category and not to the sex. This seroprevalence was not significantly different between the cases, the carriers and the contacts. Thus this study reveals that Algeria has a seroprevalence rate less important than others countries.

Bioethics is the discipline of ethics dealing with moral problems arising in the practice of medicine and the pursuit of biomedical research. Physicians may confront ethical dilemmas regularly in their individual relationships with patients and in institutional and societal decisions on health care policy. Ethical problem solving requires the application of certain ethical rules and principles to specific situations. Although ethical theories differ, certain ethical rules and principles appear consistently. These include nonmaleficence, beneficence, respect for individual autonomy, confidentiality, and justice. This article discusses some of the ethical issues that arise in clinical practice, including informed consent, do-not-resuscitate orders, noninitiation and termination of medical therapy, genetic intervention, allocation of scarce health resources, and infection with the human immunodeficiency virus (HIV). Some of these problems require ethical analysis at the bedside; others require physician involvement on a broader level. Perspectives on the different ethical issues are presented; however, absolute answers to these ethical dilemmas are not provided. Interpretation of the ethical principles and the application of these principles to each clinical situation demands the thoughtful attention of the practitioner.

Society faces moral and practical choices of treatment for mental illness: warehousing, neglect, or appropriate treatment. Mental and physical health care must be available to all Americans. There must be a balance between cost containment and patient needs.

A 3-mo. follow-up was made of 64 male veterans who were discharged from a 21-day Alcohol Detoxification Treatment Program at the Veterans Affairs Medical Center at Lyons, NJ. Scores on the Rotter I-E and Alcohol Responsibility Scales were significantly correlated with tendencies toward a more external direction among the 13% who relapsed, significant on the I-E scale and nonsignificant on the Alcohol Responsibility Scale. When tests were compared as possible predictor variables of alcoholic relapse, the difference in favor of the I-E scale was statistically nonsignificant.