Assessing the Current State of USA-Based Disaster Medicine Fellowships.

Objectives: This study aimed to understand the current landscape of USA-based disaster medicine (DM) programs through the lens of alumni and program directors (PDs). The data obtained from this study will provide valuable information to future learners as they ponder careers in disaster medicine and allow PDs to refine curricular offerings.

Methods: Two separate surveys were sent to USA-based DM program directors and alumni.

Combating the Opioid Crisis and Its National Security Threat Through CReDO: A Multidisciplinary Solution With Disaster Medicine Implications.

For the first time in history, the United States surpassed 100 000 overdose-related deaths in a 12-month period, driven by synthetic opioids such as fentanyl. Also, for the first time, potential chemical weapons are readily available on the streets and the dark web. Opioids represent a rare trifecta, used for licit pain management, as an illicit drug of abuse, and with potential use as a weapon of terror.

The role of distal third radius dual energy X-ray absorptiometry (DXA) and central DXA in evaluating for osteopenia and osteoporosis in men receiving androgen deprivation therapy for prostate cancer.

The authors assessed the use of distal third radius dual energy X-ray absorptiometry (DXA) concomitantly with central (hip and lumbar spine) DXA to identify men with osteopenia or osteoporosis receiving androgen deprivation therapy (ADT) for prostate cancer. Initial classification with central DXA demonstrated 60 (17%) normal, 187 (55%) osteopenic, and 96 (28%) osteoporotic patients. Sixteen of 60 (27%) normal patients were reclassified as osteopenic (14) or osteoporotic (2), and 20 of 187 (11%) osteopenic patients were reclassified as osteoporotic with the combination of central DXA plus distal third radius DXA.

Factors associated with open practices: results from the Canadian National Family Physician Survey.

Objective: Closed and conditionally closed practices appear to be increasing in many parts of Canada as reflected in the fact that more and more patients report difficulties finding family physicians who accept new patients. But the extent of, nature of, and factors related to open, closed, and conditionally closed practices are still largely unknown.

Design: This study used data from the 2001 National Family Physician Workforce Survey for secondary analysis.

When a physician marries a physician: effect of physician-physician marriages on professional activities.

Objective: To determine whether more Canadian family physicians are marrying other physicians and to examine the influence of physician-physician marriages on FPs' professional activities.

Design: Secondary analysis of a population survey (mailed questionnaire) using regression analysis.

Setting: Canadian family medicine.

What is important to continuity in home care?. Perspectives of key stakeholders.

In Canada, home care is growing rapidly. Each province takes a somewhat different approach to its delivery. Ontario uses a competitive bidding model to award contracts to community agencies that bid for service delivery rights.

Examining the role of health services research in public policymaking.

Conceptual, methodological, and practical issues await those who seek to understand how to make better use of health services research in developing public policy. Some policies and some policymaking processes may lend themselves particularly well to being informed by research. Different conclusions about the extent to which policymaking is informed by research may arise from different views about what constitutes health services research (is it citable research or any professional social inquiry that can aid in problem solving?) or different views about what constitutes research use (is it explicit uses of research only, or does it also include tacit knowledge or the positions of stakeholders when they are informed by research and are influential in the policymaking process?).

Health care system reform. Ontario family physicians' reactions.

Objective: To determine the effect on a cohort of family physicians of health care system reforms in Ontario and the relationship of reforms to their career satisfaction.

Design: Follow-up survey in 1999 of a cohort initially studied in 1993, posing many of the original questions along with some new ones. Four focus groups of other Ontario family physicians.

Professional activity. How is family physicians' work time changing?

Objective: To examine hours worked professionally, work preferences, and changes in both of these and their correlates.

Design: Repeated surveys done in 1993 and 1999.

Setting: Ontario family practices.

Physicians certified in family medicine. What are they doing 8 to 10 years later?

Objective: To determine field of medicine and location of a cohort of physicians certified in family medicine between 1989 and 1991 and residing in Ontario in 1993 and to gather information on the scope of practice of family physicians in the cohort in 1999.

Design: Responses to a mailed questionnaire sent in 1999 were compared with responses to a 1993 survey of this group.

Setting And Participants: All family physicians in Ontario in 1993 who received certification in 1989, 1990, or 1991 after completing a family medicine residency.

Health services utilization after induced abortions in Ontario: a comparison between community clinics and hospitals.

The purpose of this study was to compare postabortion health services utilization of hospital abortion patients with community clinic abortion patients using administrative databases. The study was a retrospective cohort study. The study group consisted of patients with induced abortions (n = 41,039) performed in hospitals or community clinics recorded in the 1995 Ontario Health Insurance Plan claims (OHIP) database.

Changes in general health and musculoskeletal outcomes in the workforce of a hospital undergoing rapid change: a longitudinal study.

This article aimed to examine changes in general health and time with back pain and neck pain and to identify predictors of any such changes. Hospital workers were studied longitudinally with surveys in 1995, 1996, and 1997 (N = 712). Back and neck pain were reported only at the 2nd and 3rd surveys.

Predictors of job stress and satisfaction among hospital workers during re-engineering: differences by extent of supervisory responsibilities.

After two years of rapid organizational change within a large teaching hospital, 83 percent of workers remained employed there. Among these "survivors," job satisfaction decreased and job stress increased regardless of whether they were employed in a supervisory position. This article examines the predictors of job satisfaction and job stress for managers, for people who indicated that they supervised others but were not managers, and for workers.

Patient satisfaction as an indicator of quality care in independent health facilities: developing and assessing a tool to enhance public accountability.

The objective of this research was to examine the performance of a brief patient survey about quality of care received in community-based diagnostic and therapeutic facilities. The survey was administered to patients in 44 facilities that were also scheduled for a formal external assessment. The response rate was 53%.

Determinants of job stress and job satisfaction among supervisory and non-supervisory employees in a large Canadian teaching hospital.

This article explores the extent to which hospital workers at a large teaching hospital at different managerial/supervisory levels (designated and non-designated supervisors, and non-supervisory staff), experienced job stress and job satisfaction prior to the re-engineering of hospital services. For all groups, increased levels of job demands were associated with higher levels of stress. Lower levels of decision latitude were associated with increased job stress for designated supervisors.

Going the distance: the influence of practice location on the Ontario Maternal Serum Screening Program.

Background: The Ontario Maternal Serum Screening (MSS) Program was introduced by the Ontario Ministry of Health as a province-wide pilot project in 1993. The objective of this study was to determine the influence of practice location on Ontario health care providers' use of and opinions regarding MSS, access to follow-up services and recommendations about the program.

Methods: A questionnaire was mailed to a random sample of 2000 family physicians, all 565 obstetricians and all 62 registered midwives in Ontario between November 1994 and March 1995.

Stability and sulfur-reduction activity in non-aqueous phase liquids of the hydrogenase from the hyperthermophile Pyrococcus furiosus.

Hydrogenase from the hyperthermophilic archaeon, Pyrococcus furiosus, catalyzes the reversible activation of H(2) gas and the reduction of elemental sulfur (S degrees ) at 90 degrees C and above. The pure enzyme, modified with polyethylene glycol (PEG), was soluble (> 5 mg/mL) in toluene and benzene with t(1/2) values of more than 6 h at 25 degrees C. At 100 degrees C the PEG-modified enzyme was less stable in aqueous solution (t(1/2) approximately 10 min) than the native (unmodified) enzyme (t(1/2) approximately 1 h), but they exhibited comparable H(2) evolution, H(2) oxidation, and S degrees reduction activities at 80 degrees C.

Poly(ethylene glycol)-modified ligninase enhances pentachlorophenol biodegradation in water-solvent mixtures.

Polychlorinated hydrocarbons are prevalent environmental contaminants whose rates of biodegradation are limited by their minimal solubilities in aqueous solutions where the biological reactions take place. In this study, ligninase (LiP) from Phanerochaete chrysosporium was modified by poly(ethylene glycol) to enhance its activity and stability for the biodegradation of pentachlorophenol (PCP) in the presence of acetonitrile (MeCN), a water-miscible solvent. The modified enzyme retained 100% of its activity in aqueous solutions and showed enhanced tolerance against the organic solvent.

The impact of re-engineering and other cost reduction strategies on the staff of a large teaching hospital: a longitudinal study.

Objectives: To examine changes over time in the hospital staff's perceptions of how rapid organizational change, caused by fiscal constraints imposed by governments, affects them, their work environment, and the quality of care and services that they provide.

Methods: A random sample of hospital employees (n = 900) of a large Ontario teaching hospital participated in a longitudinal study which involved surveys at 3 measurement periods over a 2-year period. The questionnaire used in this study included scales reflecting work environment, emotional distress, personal resources, spillover from work to home and vice versa, and perceptions regarding patient care and the hospital as an employer.

Fielding standardized patients in primary care settings: lessons from a study using unannounced standardized patients to assess preventive care practices.

Objectives: To document detection and suspicion rates of unannounced standardized patients visiting community-based practices.

Design: Primary care physicians were recruited to participate in a study using standardized patients. Four standardized patient scenarios were used.

What factors influence primary care physicians' charges for their services? An exploratory study using standardized patients.

Objective: To determine the extent of variation in physicians' charges for health care encounters with unannounced standardized patients and factors associated with the variation.

Design: Cross-sectional study.

Setting: Family practices open to new patients within 1 hour's drive of Hamilton, Ont.

Provision of preventive care to unannounced standardized patients.

Objective: To examine the relation between physician, training and practice characteristics and the provision of preventive care as described in the guidelines of the Canadian Task Force on the Periodic Health Examination.

Design: Cross-sectional study.

Setting: Family practices open to new patients within 1 hour's drive of Hamilton, Ont.

Closed and restricted practices.

Objective: To determine the proportion of recently certificated Ontario family physicians who have closed their practices to new patients or restricted their services.

Design: Cross-sectional survey mailed between September 1993 and January 1994.

Setting: Ontario family practices.