Career flexibility for PAs: What makes switching specialties successful?

Switching specialties is common among physician associates/assistants (PAs) and important in combating burnout. Despite this, little is known about the PA experience with switching specialties. This study sought to identify factors associated with successfully switching specialties using semistructured interviews with PAs and hiring managers.

Assessing and benchmarking equity, diversity, and inclusion in healthcare professions.

Healthcare professions are among the fastest growing careers in the United States, but the issues of equity, diversity, and inclusion remain a challenge. The percentage of underrepresented minority groups is disproportionately small despite many efforts to increase workforce diversity over the past several decades. As the demographics in our nation are rapidly changing, increasing racial, ethnic, and cognitive diversity is crucial to achieving a workforce with the capacity to provide accessible and equitable healthcare.

PA job satisfaction and career plans.

Objective: To understand the relationships between burnout, job satisfaction, and career plans among physician assistants in the United States.

Methods: The authors surveyed PAs in 2016. The survey included the Maslach Burnout Inventory and items on job satisfaction and career plans.

Burnout and satisfaction with work-life integration among PAs relative to other workers.

Objective: To evaluate burnout and satisfaction with work-life integration among physician assistants (PAs) compared with other US workers.

Methods: We surveyed PAs and a probability-based sample of US workers. The survey included the Maslach Burnout Inventory and an item on satisfaction with work-life integration.

Overview of phase II surgery for obstructive sleep apnea syndrome.

Maxillomandibular advancement is an extremely effective surgical procedure for the treatment of obstructive sleep apnea syndrome. When properly executed, it is associated with minimal morbidity and is well accepted by patients. It is a treatment option that achieves long-term care.

Overview of phase I surgery for obstructive sleep apnea syndrome.

It is well established that obstructive sleep apnea syndrome is associated with increased morbidity and mortality. Surgical therapy has been demonstrated to be a viable treatment option for cure. Thorough presurgical evaluation with the identification of the type of airway abnormality is mandatory to allow for the utilization of a surgical protocol that results in improved clinical outcomes.

Septal function during left ventricular unloading.

Background: Left ventricular (LV) unloading with mechanical support devices alters biventricular geometry and impairs right ventricular (RV) contractility, but its effect on septal systolic function remains unknown.

Methods And Results: To evaluate the effects of LV volume and pressure unloading on septal geometry and function, LV preload was abruptly reduced by clamping left atrial pressure between 0 and -2 mm Hg in seven open-chest, anesthetized dogs by use of a pressure-control servomechanism to withdraw blood from the left atrium. With left atrial pressure clamping, maximal LV pressure decreased 30 +/- 12% (mean +/- SD) (P < .

Pediatric resident training in a school environment. A prescription for learning.

Objective: To describe our experience with developing, implementing, and evaluating the educational effect of a school health experience for pediatric residents.

Design: Descriptive.

Setting: University-based pediatric residency program and five public elementary and middle schools in surrounding communities.

Induction of nitric oxide synthase in the human cardiac allograft is associated with contractile dysfunction of the left ventricle.

Background: The mechanisms underlying cardiac contractile dysfunction after transplantation remain poorly defined. Previous work has revealed that inducible nitric oxide synthase (iNOS) is expressed in the rat heterotopic cardiac allograft during rejection; resultant overproduction of nitric oxide (NO) might cause cardiac contractile dysfunction via the negative inotropic and cytotoxic actions of NO. In this investigation, we tested the hypothesis that induction of iNOS may occur and be associated with cardiac allograft contractile dysfunction in humans.

Prognostic importance of intimal thickness as measured by intracoronary ultrasound after cardiac transplantation.

Background: Although intracoronary ultrasound (ICUS) has been validated for the early detection of transplant coronary artery disease (TxCAD), the prognostic importance of findings detected by this new imaging technique is unknown.

Methods And Results: This study examined the relation of clinical outcome in 145 heart transplant recipients (mean age, 45.1 +/- 11.

An updated standard for clinical electroretinography.

The value of the electroretinogram (ERG) in clinical practice depends in part on its consistency and the ability to compare results with other laboratories and the literature. These issues were addressed by the publication of the International Standard for Clinical Electroretinography in 1989. This Standard provided technical information and defined a core of basic test procedures and test responses (Figure) to ensure that ERGs performed worldwide would be equivalent for clinical and research purposes.

Improved detection of enhancing and nonenhancing lesions of multiple sclerosis with magnetization transfer.

Purpose: To determine whether magnetization transfer imaging can improve visibility of contrast enhancement of multiple sclerosis plaques.

Methods: Fifty-nine enhancing and 63 nonenhancing lesions in 10 patients with multiple sclerosis were evaluated to calculate contrast-to-noise ratios on conventional T1-weighted and T1-weighted magnetization transfer images. The signal intensity of the lesion and the background (white matter) were measured on precontrast T1-weighted and T1-weighted magnetization transfer images (800/20/1 [repetition time/echo time/excitations]) and on postcontrast T1-weighted and T1-weighted magnetization transfer images.

Investigation of the phenylethanolamine N-methyltransferase gene as a candidate gene for hypertension.

Genetic mapping studies have located a gene, Bp1, that accounts for approximately 30% of the genetic variation in the stroke-prone spontaneously hypertensive rat (SHRSP) to a region on chromosome 10 containing the angiotensin-converting enzyme gene. In humans, the gene encoding phenylethanolamine N-methyltransferase (PNMT) was localized near the angiotensin-converting enzyme gene on human chromosome 17. Since most of human chromosome 17 is known to be homologous to rat chromosome 10 and PNMT is known to play a role in blood pressure homeostasis, we reasoned (1) that the rat gene encoding PNMT (Pnmt) may reside on chromosome 10 within the confidence interval containing Bp1 and (2) that Pnmt is a good candidate gene for Bp1.

Prognostic factors in erythrodermic mycosis fungoides and the Sézary syndrome.

Background And Design: There are no large studies evaluating patients with erythrodermic mycosis fungoides and Sézary syndrome to determine the important prognostic factors that may influence survival. This is important since new treatment modalities have been proposed as superior to existing primary therapies. We performed a retrospective cohort study of 106 patients with erythrodermic mycosis fungoides and Sézary syndrome, followed up in the Stanford (Calif) Mycosis Fungoides Clinic, to define the important prognostic factors in this group.

Sumatriptan prophylaxis for postelectroconvulsive therapy headaches.

Very little has been written about headaches following electroconvulsive therapy (ECT) but the incidence has been estimated at 26%. Patients with a history of migraine occasionally have similar headaches precipitated by ECT. In addition, some patients may have headaches that persist for months after a series of ECT treatments, while some patients who have a preexisting headache problem report improvement with ECT.

The influence of volumetric tumor doubling time, DNA ploidy, and histologic grade on the survival of patients with intracranial astrocytomas.

Purpose: To improve the prediction of individual survival in patients with intracranial astrocytomas through the analysis of volumetric tumor doubling time (VDt) and DNA ploidy.

Methods: A pilot study was retrospectively conducted on a group of 25 patients with intracranial astrocytomas in whom recurrent and/or progressive disease was observed on serial contrast-enhanced CT or MR examinations. VDt was computed using two or more data points from a semilogarithmic plot of tumor volume versus time.

Longitudinal volumetric computed tomographic analysis of regional brain changes in normal aging and Alzheimer's disease.

Objective: This study used a semiautomated image analysis technique to quantify the rate and regional pattern of cerebrospinal fluid (CSF) volume changes in the computed tomographic brain examinations of healthy adults and patients with Alzheimer's disease (AD).

Design: Longitudinal, within-subject design, with statistical correction for longitudinal method error (eg, head repositioning effects).

Setting: Palo Alto (Calif) Department of Veterans Affairs Medical Center.

Standard for clinical electro-oculography. International Society for Clinical Electrophysiology of Vision.

The electro-oculogram is a widely used electrophysiological test, but recording techniques vary among different laboratories. This standard, approved by the International Society for Clinical Electrophysiology of Vision (ISCEV), describes simple technical procedures that will allow reproducible and comparable electro-oculograms to be recorded under a few defined conditions. The document is intended to improve the comparability of electro-oculographic data obtained throughout the world by guiding both clinicians and manufacturers, and the ISCEV recommends that future published reports indicate whether the recording technique meets the international standard.

Endocanalicular laser-assisted dacryocystorhinostomy. An anatomic study.

In human cadaver specimens, a laser fiberoptic was advanced through the canalicular systems to create fistulas between the nasolacrimal sac and nose. A 400- to 600-microns, blunt-tipped quartz fiberoptic was then advanced through the upper and/or lower canaliculus to the medial aspect of the nasolacrimal sac. After 10 to 15 laser pulses (10 W for 0.

A double-blind comparison of adhesive bandages with the use of uniform suction blister wounds.

Background And Design: The assessment of cutaneous wound healing in humans has been hampered by the inability to evaluate multiple wounds with identical origins, treatment histories, and sizes. There have been no double-blind wound healing studies in humans that compared one wound dressing with another. The purpose of this study was to determine if identical suction blister wounds could serve as a model to evaluate and compare wound healing and overall cosmetic appearance of wounds treated with commercially available adhesive bandages.

Widespread cerebral gray matter volume deficits in schizophrenia.

Magnetic resonance imaging was used to investigate whether the structural brain differences commonly observed in patients with schizophrenia as compared with normal control subjects are specific to gray or white matter, and furthermore whether such abnormalities are localizable to circumscribed cortical regions. Accordingly, 22 patients meeting DSM-III-R criteria for schizophrenia and 20 healthy community volunteers, all 23 to 45 years old, received magnetic resonance imaging scans. Seven axial magnetic resonance imaging sections of 5-mm thickness were segmented into cerebrospinal fluid, gray matter, and white matter compartments and used for volumetric quantification.

Is puberty a risk factor for eating disorders?

Objective: To examine the association between stage of sexual maturation and eating disorder symptoms in a community-based sample of adolescent girls.

Participants: All sixth- and seventh-grade girls (N = 971) enrolled in four northern California middle schools.

Main Variables Examined: Pubertal development measured using self-reported Tanner stage and body mass index (kg/m2).

No linkage between D2 dopamine receptor gene region and schizophrenia.

The dopamine hypothesis is one of the major etiological hypotheses of schizophrenia. The well-established role of genetic factors in schizophrenia together with reports of increased D2 dopamine receptor densities in untreated schizophrenic patients support the D2 dopamine receptor gene as a strong candidate gene for schizophrenia. The recent cloning of the D2 dopamine receptor gene made it possible to test the involvement of the D2 dopamine receptor locus (DRD2) in a large Swedish and a smaller Californian schizophrenia pedigree.

Weight-bearing exercise, overexercise, and lumbar bone density over age 50 years.

This cross-sectional study of 78 healthy subjects older than age 50 years was designed to examine the association between weight-bearing exercise and lumbar bone mineral content as assessed by quantitative computed tomography. In women, a strong correlation existed between bone density and the amount of exercise for up to 300 min/wk. However, 5 of 28 women exercising 300 min/wk or more had surprisingly low bone density, not explained by other factors.