Time well spent: the association between time and effort allocation and intent to leave among clinical faculty.

Purpose: To explore the relationship between clinical faculty members' time/effort in four mission areas, their assessment of the distribution of that time/effort, and their intent to leave the institution and academic medicine.

Method: Faculty from 14 U.S.

HCV among The Miriam Hospital and Rhode Island Hospital Adult ED Patients.

The Emergency Department (ED) appears to be an ideal place to conduct hepatitis C virus (HCV) screening. We aimed to estimate the prevalence of prior HCV test positivity among adult (18-64 year-old) patients at The Miriam Hospital and Rhode Island Hospital EDs, as well as the undiagnosed HCV antibody seroprevalence among patients with any self-reported injection or non-injection drug use who agreed to undergo rapid HCV antibody testing. The prevalence of prior HCV test positivity among 8,500 adult ED patients was approximately 4.

Engagement, workplace satisfaction, and retention of surgical specialists in academic medicine in the United States.

Background: Academic medical centers strive for clinical excellence with operational efficiency and financial solvency, which requires institutions to retain productive and skillful surgical specialists. Faculty workplace perceptions, overall satisfaction, and intent to leave are relationships that have not been examined previously among US surgeons in academic medicine. We hypothesize that critical factors related to workplace satisfaction and engagement could be identified as important for enhancing institutional retention of academic surgeons.

How to choose core outcome measurement sets for clinical trials: OMERACT 11 approves filter 2.0.

Objective: The Outcome Measures in Rheumatology (OMERACT) initiative works to develop core sets of outcome measures for trials and observational studies in rheumatology. At the OMERACT 11 meeting, substantial time was devoted to discussing a conceptual framework and a proposal for a more explicit working process to develop what we now propose to term core outcome measurement sets, collectively termed "OMERACT Filter 2.0.

Is self-perceived HIV risk congruent with reported HIV risk among traditionally lower HIV risk and prevalence adult emergency department patients? Implications for HIV testing.

Because reliance on patients' self-perceived risk for HIV might mislead emergency department (ED) clinicians on the need for HIV testing, we aimed to measure congruency between self-perceived and reported HIV risk in a traditional lower prevalence, lower-risk cohort. A random sample of 18- to 64-year-old patients at a large academic urban ED who were by self-report not men-who-have-sex-with-men (MSM) or injection-drug users (IDUs) were surveyed regarding their self-perceived and reported HIV risk. Sixty-two percent of participants were white non-Hispanic, 13.

Venous thromboembolism in children: preliminary results of a survey of POSNA members.

Background: The term venous thromboembolism (VTE) includes deep venous thrombosis of the extremity and pulmonary embolism, a potentially fatal clinical entity. Although the prevalence of VTE may be lower in children compared with adults, recent reports suggest a possible rise in this diagnosis among pediatric patients, especially in association with certain risk factors. We assessed the clinical experience and practice of members of the Pediatric Orthopaedic Society of North America (POSNA) related to VTE among their pediatric patients.

Setting priorities for stroke care and research.

Recent publications describing the sobering global increase in stroke mortality and global life years lost due to stroke despite improvements in developed countries have drawn focus on the severe impact of stroke in the developing world. At the same time, three recent interventional trials that failed to demonstrate an important role for catheter-based therapies in acute stroke have called into question this expensive use of technology. Coupling all of this new data leads to the natural conclusion that a focus on stroke prevention for the developing world, and for the poor in developed countries, should be where we set our priorities for the foreseeable future.

Transcriptome profiling identifies HMGA2 as a biomarker of melanoma progression and prognosis.

The genetic alterations contributing to melanoma pathogenesis are incompletely defined, and few independent prognostic features have been identified beyond the clinicopathological characteristics of the primary tumor. We used transcriptome profiling of 46 primary melanomas, 12 melanoma metastases, and 16 normal skin (N) samples to find genes associated with melanoma development and progression. Results were confirmed using immunohistochemistry and real-time PCR and replicated in an independent set of 330 melanomas using AQUA analysis of tissue microarray (TMA).

Data management and data integration in the HUPO plasma proteome project.

The Human Plasma Proteome Project (HPPP) is an international collaboration coordinated by the Human Proteome Organisation (HUPO). Its Pilot Phase generated the 2005 Proteomics special issue "Exploring the Human Plasma Proteome" (Omenn et al. Proteomics 5:3226-3245, 2005) and a book with the same title (Omenn GS (ed) (2006) Exploring the human plasma proteome.

Darwin and Lincoln: their legacy of human dignity.

The legacy of Charles Darwin and Abraham Lincoln is to champion the dignity inherent in every human being. The moment of the bicentennial of their births provides an opportunity to celebrate and reflect on ways they have shaped our understanding and commitment to human rights. The naturalist and the constitutional lawyer, so different in circumstance and discipline, were morally allied in the mission to eradicate slavery.

Evolution in health and medicine Sackler colloquium: Evolution and public health.

Evolution and its elements of natural selection, population migration, genetic drift, and founder effects have shaped the world in which we practice public health. Human cultures and technologies have modified life on this planet and have coevolved with myriad other species, including microorganisms; plant and animal sources of food; invertebrate vectors of disease; and intermediate hosts among birds, mammals, and nonhuman primates. Molecular mechanisms of differential resistance or susceptibility to infectious agents or diets have evolved and are being discovered with modern methods.

Epidemiology of cryptosporidiosis in North American travelers to Mexico.

We studied 1,179 North American travelers who visited Mexico from 2005 to 2007. Travelers' diarrhea (TD) was reported by 521 (44%) participants. Among subjects with TD, 218 cases were examined for cryptosporidiosis by polymerase chain reaction (PCR) and enzyme-linked immunoassays (ELISA).

FGFR2 is a breast cancer susceptibility gene in Jewish and Arab Israeli populations.

Genetic variation in FGFR2 is a newly described risk factor for breast cancer. We estimated the relative risk and contribution of FGFR2 polymorphisms to breast cancer risk in diverse ethnic groups within Jewish and other Middle Eastern populations. We genotyped four FGFR2 single nucleotide polymorphisms (SNP) and tested for association of these SNPs and haplotypes with breast cancer risk in a population-based case-control study of 1,529 women with breast cancer and 1,528 controls.

The case for treating tobacco dependence as a chronic disease.

Smoking remains the leading cause of preventable death in the United States, yet it is still regarded by many as merely a bad habit. Most smokers want to quit but find it difficult. Behavioral counseling and pharmacotherapies are available, safe, and effective in the treatment of tobacco dependence.

Clinical and analytical considerations in the study of health status in device trials for heart failure.

Background: Measures of health status (including symptoms, functional status, or quality of life) assess patients' experiences of their disease, and may therefore be used to quantify the benefits and risks of treatment. The aim of this article is to provide recommendations to regulatory agencies and research sponsors regarding the use of health status measures in medical device trials.

Methods And Results: A workshop jointly planned by the Heart Failure Society of America and the US Food and Drug Administration was convened in October 2003 in Washington, DC.

Are questions on both achieving and maintaining an erection needed to define erectile dysfunction?

Our aim was to ascertain if the assessment of erectile dysfunction (ED) should include questions on difficulty in both achieving and maintaining erection. A population-based study of 3143 men in Tampere region in Finland was conducted by mailed questionnaire. The 1983 men who responded questions on erectile function were included in the analysis.

Cryptosporidiosis in children.

Cryptosporidiosis is an important enteric parasitic infection that is associated with significant morbidity and mortality, especially among individuals who are immunosuppressed and infants and children in the developing world. The seroprevalence of this pathogen is high worldwide, suggesting that exposure occurs commonly. The routes of Cryptosporidium spp.

Antibody response of healthy adults to recombinant thrombospondin-related adhesive protein of cryptosporidium 1 after experimental exposure to cryptosporidium oocysts.

Thrombospondin-related adhesive protein of Cryptosporidium 1 (TRAP-C1) belongs to a group of proteins that are also found in Toxoplasma gondii, Eimeria tenella, and Plasmodium species. TRAP-related proteins are needed for gliding motility, host-cell attachment, and invasion. The objective of this study was to characterize the antibody response to recombinant TRAP-C1 (rTRAP-C1) in healthy volunteers exposed to C.

Anatomic and functional assessment and risk factors of recurrent prolapse after vaginal sacrospinous fixation.

Background: To identify risk factors in recurrence and to evaluate anatomic and functional results of vaginal sacrospinous ligament fixation and pelvic floor reconstruction for genital prolapse.

Methods: One hundred and thirty-eight women underwent surgery for uterovaginal or vault prolapse. Follow-up data were available for 122 cases; 83% were examined and others were interviewed by telephone.

Enterotoxigenic Escherichia coli as cause of diarrhea among Mexican adults and US travelers in Mexico.

Background: Enterotoxigenic Escherichia coli (ETEC) is the most common pathogen identified in travelers to Mexico with diarrhea. There have been few recent studies looking at the etiology of diarrhea in travelers compared with the local resident population.

Methods: We compared enteric pathogens isolated in two populations experiencing acute diarrhea acquired in Guadalajara, Mexico and also compared clinical illness caused by the principal pathogen, ETEC.

Process measures for the assessment and improvement of quality of care for schizophrenia.

The development of process measures for the assessment and improvement of care for schizophrenia is at an early stage. As part of a national inventory of mental health quality measures, we identified 42 process measures developed to assess the quality of schizophrenia care. A greater proportion of measures assessed pharmacotherapy than assessed psychosocial interventions or other clinical processes, such as assessment, continuity, or coordination.

Natural history of enteroaggregative and enterotoxigenic Escherichia coli infection among US travelers to Guadalajara, Mexico.

The natural history of enteroaggregative Escherichia coli (EAEC) and enterotoxigenic E. coli (ETEC) infection was studied among 40 US travelers who provided weekly stool samples for 4 weeks after arrival in Mexico. At enrollment, 5 subjects were colonized by EAEC and 3 by ETEC.

Self-disparagement as feature and forerunner of depression: findings from the Stirling County Study.

Sleep disturbance has attracted considerable attention as an early indicator of depression. However, three epidemiologic investigations have shown psychological symptoms, such as self-disparagement, to be stronger predictors. This report examines the depressive symptoms commonly assessed in modern epidemiologic surveys and estimates the generalizability of this information using data from the Stirling County Study, a long-term epidemiologic investigation of psychiatric disorders.