Medical physics graduate education in Mexico and its relation to the advances in radiation oncology

AimTo evaluate the state of graduate education in medical physics and progress in radiation oncology (RO) equipment in Mexico since 2000, when conferring degrees from two master’s-degree programs in Medical Physics began.BackgroundMedical physics is a Health Profession and there are international recommendations for education, training, and certification. Both programs follow these education guidelines. The most common clinical occupation of graduates is in RO services. Techniques in Mexican RO include traditional and high-precision procedures.MethodsAcademic and occupational information about the programs and their graduates were obtained from official websites. Graduates were invited to respond to a survey that requested information about their present job. We obtained data on RO equipment and human resources from public databases and estimated staffing requirements of medical physicists (MPs).ResultsMedical physics programs have graduated a total of 225 MPs. Half of them work in a clinical environment and, of these, about 90 work in RO services. MPs with M.Sc. degrees constitute 36% of the current MP workforce in RO, estimated to be 250 individuals. Survey responses pointed out the main merits and limitations of the programs. The number of MPs in RO has increased fivefold and the number of linacs sixfold in 15 years. The present number of MPs is insufficient, according to published guidelines.ConclusionAll MPs in RO services with advanced modalities must be trained following international recommendations for graduate education and post-graduation clinical training. Education and health institutions must find incentives to create more graduate programs and clinical residencies.     

An Assessment of Nutrition Education in Endocrinology Fellowship Programs in the United States

ObjectiveCounseling patients about nutrition significantly improves chronic disease outcomes. Endocrinologists are uniquely positioned to educate patients regarding nutrition. The purpose of this study was to define the current state of nutrition education in endocrinology fellowship programs in the United States and assess the needs for future nutrition training.MethodsEndocrinology program directors were surveyed via an online questionnaire between February and April 2021.ResultsThirty-eight program directors responded (25% response rate) to the survey. Twenty-two (58%) programs offered nutrition education. Existing nutrition education offerings were 1 to 5 total hours (13, 34%), primarily didactic (20, 53%), and often led by registered dietitian nutritionists (15, 39%). Only 3 (8%) programs rated their current nutrition education as extremely effective; 95% of respondents believed that further nutrition education was needed. According to respondents, the ideal nutrition education for endocrine trainees should be 1 to 5 total hours (19, 50%) over multiple sessions (25, 66%), be interactive (24, 63%), and be led by registered dietitian nutritionists (26, 68%). The most important topics for independent practice included diet-related behavior modification (21, 55%), components of a healthful diet (19, 50%), and energy expenditure/intake (18, 47%).ConclusionAlthough the majority of the program directors believe that further nutrition education is needed, almost half of the surveyed programs do not offer such training. Programs that offer nutrition education primarily rely on a didactic format. There is an unmet need for interactive, multidisciplinary nutrition education in these programs.     

An Update on the Louisiana and Texas Rigs-to-Reefs Programs in the Gulf of Mexico

Abstract

The Louisiana and Texas Rigs-to-Reefs programs enjoy widespread public, industry, and government support and have become models for similar programs around the world. Louisiana’s Rigs-to-Reefs program is the largest in the world, and since its inception in 1986 about 363 oil and gas platforms have been donated, or on average about 12 structures per year. Texas’s Rigs-to-Reefs program started in 1990, and since this time about 154 structures have been donated, or about six structures per year. A summary update of the Louisiana and Texas reef programs is provided, along with recent changes in legislative activity. Donation trends and statistics are reviewed. The Rigs-to-Reefs programs are unlikely to see donation activity above historic levels, and both programs should start planning for a future where the income generated from future projects diminishes.     

Evaluating the Impact of a Humane Education Summer-Camp Program on School-Aged Children's Relationships with Companion Animals

ABSTRACT

This study evaluated the impact of children's participation in a five-day humane education summer-camp program on the quality of their relationships with and treatment of companion animals. We measured changes from pre- to post-program in 77 children (50 girls, 27 boys) aged 6–12 years. The program promoted positive interactions between children and animals in natural settings, with a focus on either companion animals or farm/forest animals. The Companion Animal Bonding Scale, the Pet Friendship Scale, the Comfort from Companion Animal Scale, the Children's Treatment of Animal Questionnaire, and a drawing task were administered to children prior to the beginning of the camp on day one and again at the end of day five. Overall, the results showed that after five days of humane education in summer camp, children reported sharing significantly closer bonds and friendships with their companion animals. These results were more pronounced for girls versus boys, among younger (aged 6 to 8 years) versus older (aged 9 to 12 years) children, and among children receiving the companion-animal versus farm/forest-animal curriculum. Older boys reported significantly lower scores on the humane treatment of their companion animals, compared with younger boys, and both older and younger girls. Comparisons by type of curriculum also suggested that the humane education curriculum that focused on farm/forest animals resonated more with the girls versus the boys. The implications for camp- and classroom- based humane education programs are discussed.     

An Assessment of Diversity,Inclusion, and Health Equity Training in Endocrinology Fellowship Programs in the United States

ContextThe Accreditation Council for Graduate Medical Education has instituted common program requirements related to diversity, equity, and inclusion (DEI) for postgraduate trainees in the United States; however, the extent to which DEI training is being incorporated across endocrinology fellowship programs is unknown.ObjectivesTo describe the sociodemographic representation and DEI training experiences within endocrinology fellowship programs.Design, setting, and participantsNational cross-sectional survey study of fellows and fellowship program leaders in the United States whose fellowships were members of the Association of Program Directors in Endocrinology and Metabolism.Main outcome measures(1) Demographics of fellows and program leaders and (2) programs’ experience, confidence, and interest in formal DEI training.ResultsA total of 108 and 106 fellow and faculty responded to the survey, respectively. The majority of fellows and faculty are female. Less than 3% of fellows and 3.7% of faculty identify as Black. More than 90% of fellows/faculty are heterosexual and no respondents identified as transgender/nonbinary; however, 5% and 2% of all respondents preferred not to disclose their sexual orientation and gender identity, respectively. While 85% of faculty received institutional diversity and inclusion training, 67.6% of fellows did. Fellows are more likely to have received training in health equity than program leaders. Both fellows and program leaders express a high interest in health equity curriculum.ConclusionsWithin the diversity of endocrinology training programs, Black physicians are underrepresented in medicine, which persists in endocrinology fellowships. Fellowship programs express enthusiasm for national diversity and health equity curricula, with the majority of programs reporting institutional DEI training.     

Dynamics of the public concern and risk communication program implementation

Abstract

The public concern about electromagnetic field (EMF) exposure varies due to different reasons. A part of them are connected with the better and higher quality of information that people receive from science, media, Internet, social networks, industry, but others are based on good communication programs performed by the responsible institutions, administration and persons. Especially, in Bulgaria, public concern follows interesting changes, some of them in correlation with the European processes of concern, but others following the economic and political processes in the country. Here, we analyze the dynamics of the public concern over the last 10 years. Our explanation of the decrease of the people’s complaints against EMF exposure from base stations for mobile communication is as a result of our risk communication program that is in implementation for >10 years.     

Genetic counselor training: a review and considerations for the future.

The first training program for genetic counselors began in 1969. Since then a number of other programs have been developed and more than 650 individuals have graduated from these programs. This article reviews the development and current status of training opportunities for genetic counselors. Twelve programs that currently grant a master's-level degree in genetic counseling are reviewed. Other areas, such as certification and licensure, that reflect genetic counseling training or such issues of professional growth as continuing education and career advances are addressed.     

Recuperación funcional al alta y a tres meses tras una intervención multicomponente de ejercicio físico en ancianos hospitalizados en una unidad de agudos de geriatría

IntroductionHospitalization in the elderly, even in short stays, is associated with functional impairment. Once the acute illness is reversed, the evolution of this hospital-generated impairment can be variable, and a year after hospitalization more than half of the elderly patients remain impaired. This impairment is associated with a higher risk of institutionalization, of mortality at discharge and of 30-day mortality. Previous studies have shown how interdisciplinary physical exercise programs can improve functionality at discharge and decrease mortality rate, hospital stay and institutionalization.Study design and objectivesIn the Acute Geriatric Unit of the Gregorio Marañon University hospital a randomized controlled trial was carried out to assess the effectiveness of an exercise and health education program to prevent functional decline during hospitalization and at three months after discharge in elderly subjects aged 74 years or older. Patients were excluded if at least one of the following exclusion criteria was met: baseline Barthel Index (15-days prior hospitalization) below 20, severe cognitive impairment or inability to walk. The intervention consisted on a physical exercise program (that included squats, balance, gait stimulation, elastic bands, and inspiratory muscle training) and health education program. The control group received usual care.     

Program MULDER -- a tool for extracting torsion angles from NMR data

MULDER (Mostly UniversaL Dihedral angle ExtractoR) is a program for extraction of torsion angle information from NMR data. Currently, it can analyze two types of input data: The torsion angle data, where several ³J-coupling constants and/or interatomic distances are combined in order to reduce the torsion angle ambiguity arising from solving the isolated Karplus (or distance) equation, and the sugar pucker data, where the dynamics of five-membered sugar rings is evaluated by postprocessing the results calculated from ³J_(HH) coupling constants by program PSEUROT. Program MULDER can be used either as an alternative to r-MD programs in situations where only specific structural features are studied, or as a preparatory tool in connection with full r-MD structure calculation for extraction of unambiguous torsion angle restraints.     

The rise of creative youth development

ABSTRACT

Creative youth development (CYD) is a dynamic area of community arts education that successfully bridges youth development and arts education. CYD is an intentional, holistic practice that combines hands-on artmaking and skill building in the arts with development of life skills to support young people in successfully participating in adolescence and navigating into adulthood. Young people in CYD programs exhibit high levels of artistic skill and accomplishment along with increased self-esteem and sense of belonging. CYD participants are immersed in a broad array of rigorous artistic endeavors, including creating documentary films, researching and reporting on community issues through radio broadcasts, writing and staging new theatrical works, and engaging in thoughtful critique of one another's visual art work. The impact for youth of program participation extends beyond pride in artistic accomplishment. Throughout the United States, teen participants in CYD programs assert that the programs saved their lives, putting them on positive trajectories and away from gangs, drug use, crime, and ennui. This article provides a definition for the term creative youth development, describes core characteristics of CYD programs, and briefly describes four CYD programs. It provides background on the origins and history of creative youth development, including current advances in the field and signs the field is coalescing. The article describes creative youth development in the larger contexts of arts education and of education reform. Lastly, the article discusses policy, funding, and research needs and opportunities and provides questions for consideration.     

A Resource Guide to Travel Film Repositories

Travel films, broadly defined, exist in most moving image collections. Theatrical shorts and features, television series, tourism promotion films, professional and amateur lecture films, expeditionary films and footage, unedited amateur footage are all held by regional and government archives, museums, historical societies, universities, libraries, commercial footage houses, and film distributors. The following is intended to be an annotated guide to a representative set of repositories in North America containing significant amounts of travel film material.     

A Multi-country Study of the Household Willingness-to-Pay for Dengue Vaccines: Household Surveys in Vietnam,Thailand, and Colombia

BackgroundThe rise in dengue fever cases and the absence of dengue vaccines will likely cause governments to consider various types of effective means for controlling the disease. Given strong public interests in potential dengue vaccines, it is essential to understand the private economic benefits of dengue vaccines for accelerated introduction of vaccines into the public sector program and private markets of high-risk countries.Conclusions/SignificanceKnowing that dengue vaccines are not yet available, our study provides critical information to both public and private sectors. The study results can be used to ensure broad coverage with an affordable price and incorporated into cost benefit analyses, which can inform prioritization of alternative health interventions at the national level.     

Maximizing and evaluating the impact of test-trace-isolate programs: A modeling study

BackgroundTest-trace-isolate programs are an essential part of coronavirus disease 2019 (COVID-19) control that offer a more targeted approach than many other nonpharmaceutical interventions. Effective use of such programs requires methods to estimate their current and anticipated impact.Methods and findingsWe present a mathematical modeling framework to evaluate the expected reductions in the reproductive number, R, from test-trace-isolate programs. This framework is implemented in a publicly available R package and an online application. We evaluated the effects of completeness in case detection and contact tracing and speed of isolation and quarantine using parameters consistent with COVID-19 transmission (R₀: 2.5, generation time: 6.5 days). We show that R is most sensitive to changes in the proportion of cases detected in almost all scenarios, and other metrics have a reduced impact when case detection levels are low (<30%). Although test-trace-isolate programs can contribute substantially to reducing R, exceptional performance across all metrics is needed to bring R below one through test-trace-isolate alone, highlighting the need for comprehensive control strategies. Results from this model also indicate that metrics used to evaluate performance of test-trace-isolate, such as the proportion of identified infections among traced contacts, may be misleading. While estimates of the impact of test-trace-isolate are sensitive to assumptions about COVID-19 natural history and adherence to isolation and quarantine, our qualitative findings are robust across numerous sensitivity analyses.ConclusionsEffective test-trace-isolate programs first need to be strong in the “test” component, as case detection underlies all other program activities. Even moderately effective test-trace-isolate programs are an important tool for controlling the COVID-19 pandemic and can alleviate the need for more restrictive social distancing measures.     

Conservation education program for threatened Asian horseshoe crabs: A step towards reducing community apathy to environmental conservation

Long-term and locally-based public education programs are essential in supporting conservation initiatives for horseshoe crab protection, particularly in Asia, where their populations have been largely exploited for food and biomedical applications. However, the implementation of such conservation initiatives can be difficult due to a community’s ingrained apathy towards the environment. In addition, the effectiveness of similar education programs to engage the community in conservation work has rarely been assessed. We described the implementation strategies of a conservation education program in Hong Kong, with the objective to improve the community’s awareness, engagement and environmental attitudes towards the conservation of Asian horseshoe crabs. This study evaluated the program’s outreach, outcomes and impacts between 2009 and 2016. By raising laboratory-cultured juvenile horseshoe crabs at local secondary schools, this long-term conservation education program succeeded in enhancing students’ knowledge on the biology and ecology of horseshoe crabs, as well as promoting positive attitudes and behaviors towards relevant conservation issues. Lessons and recommendations derived from this program can serve as guidance for similar campaigns in other places.     

The Development of After-School Program Educators Through University-Community Partnerships

Participation in after-school programs (ASPs) can positively affect the development of young people. However, whether ASPs are beneficial depends on program quality. Although many factors influence the quality of a program, the competencies of adult staff who lead ASPs are a critical determinant. Unfortunately, ASP staff members often do not receive the education and training needed to provide high quality programming. This article discusses how training provided through university-community (U-C) partnerships can help to fill this educational void. After summarizing existing research on staff development for educators, the role that U-C partnerships can play in providing a realistic and viable means to developing the competencies of ASP educators is described and examples of two model programs are provided. Challenges and future directions for the development of the after-school workforce are discussed.     

Evaluating the impact of the nationwide public–private mix (PPM) program for tuberculosis under National Health Insurance in South Korea: A difference in differences analysis

BackgroundPublic–private mix (PPM) programs on tuberculosis (TB) have a critical role in engaging and integrating the private sector into the national TB control efforts in order to meet the End TB Strategy targets. South Korea’s PPM program can provide important insights on the long-term impact and policy gaps in the development and expansion of PPM as a nationwide program.Methods and findingsHealthcare is privatized in South Korea, and a majority (80.3% in 2009) of TB patients sought care in the private sector. Since 2009, South Korea has rapidly expanded its PPM program coverage under the National Health Insurance (NHI) scheme as a formal national program with dedicated PPM nurses managing TB patients in both the private and public sectors. Using the difference in differences (DID) analytic framework, we compared relative changes in TB treatment outcomes—treatment success (TS) and loss to follow-up (LTFU)—in the private and public sector between the 2009 and 2014 TB patient cohorts. Propensity score matching (PSM) using the kernel method was done to adjust for imbalances in the covariates between the 2 population cohorts. The 2009 cohort included 6,195 (63.0% male, 37.0% female; mean age: 42.1) and 27,396 (56.1% male, 43.9% female; mean age: 45.7) TB patients in the public and private sectors, respectively. The 2014 cohort included 2,803 (63.2% male, 36.8% female; mean age: 50.1) and 29,988 (56.5% male, 43.5% female; mean age: 54.7) patients. In both the private and public sectors, the proportion of patients with transfer history decreased (public: 23.8% to 21.7% and private: 20.8% to 17.6%), and bacteriological confirmed disease increased (public: 48.9% to 62.3% and private: 48.8% to 58.1%) in 2014 compared to 2009. After expanding nationwide PPM, absolute TS rates improved by 9.10% (87.5% to 93.4%) and by 13.6% (from 70.3% to 83.9%) in the public and private sectors. Relative to the public, the private saw 4.1% (95% confidence interval [CI] 2.9% to 5.3%, p-value < 0.001) and −8.7% (95% CI −9.7% to −7.7%, p-value <0.001) higher rates of improvement in TS and reduction in LTFU. Treatment outcomes did not improve in patients who experienced at least 1 transfer during their TB treatment. Study limitations include non-longitudinal nature of our original dataset, inability to assess the regional disparities, and verify PPM program’s impact on TB mortality.ConclusionsWe found that the nationwide scale-up of the PPM program was associated with improvements in TB treatment outcomes in the private sector in South Korea. Centralized financial governance and regulatory mechanisms were integral in facilitating the integration of highly diverse South Korean private sector into the national TB control program and scaling up of the PPM intervention nationwide. However, TB care gaps continued to exist for patients who transferred at least once during their treatment. These programmatic gaps may be improved through reducing administrative hurdles and making programmatic amendments that can help facilitate management TB patients between institutions and healthcare sectors, as well as across administrative regions.

Sarah Yu and co-workers study population-level provision of tuberculosis care and outcomes in South Korea.     

Cash transfers for HIV prevention: A systematic review

BackgroundGiven the success of cash programs in improving health outcomes and addressing upstream drivers of HIV risk such as poverty and education, there has been an increasing interest in their potential to improve HIV prevention and care outcomes. Recent reviews have documented the impacts of structural interventions on HIV prevention, but evidence about the effects of cash transfer programs on HIV prevention has not been systematically reviewed for several years.Methods and findingsWe did a systematic review of published and unpublished literature to update and summarize the evidence around cash programs for HIV prevention from January 2000 to December 17, 2020. We included studies with either a cash transfer intervention, savings program, or program to reduce school costs. Included studies measured the program’s impact on HIV infection, other sexually transmitted infections (STIs), or sexual behaviors. We screened 1,565 studies and examined 78 in full-text review to identify a total of 45 peer-reviewed publications and reports from 27 different interventions or populations. We did not do a meta-analysis given the range of outcomes and types of cash transfer interventions assessed. Most studies were conducted in sub-Saharan Africa (N = 23; South Africa, Tanzania, Malawi, Lesotho, Kenya, Uganda, Zimbabwe, Zambia, and eSwatini) followed by Mexico (N = 2), the United States (N = 1), and Mongolia (N = 1)). Of the 27 studies, 20 (72%) were randomized trials, 5 (20%) were observational studies, 1 (4%) was a case–control study, and 1 (4%) was quasi-experimental. Most studies did not identify a strong association between the program and sexual behaviors, except sexual debut (10/18 finding an association; 56%). Eight of the 27 studies included HIV biomarkers, but only 3 found a large reduction in HIV incidence or prevalence, and the rest found no statistically significant association. Of the studies that identified a statistically significant association with other STIs (N = 4/8), 2 involved incentives for staying free of the STI, and the other 2 were cash transfer programs for adolescent girls that had conditionalities related to secondary schooling. Study limitations include the small number of studies in key populations and examining interventions to reduce school costs and matched saving programs.ConclusionsThe evidence base for large-scale impacts of cash transfers reducing HIV risk is limited; however, government social protection cash transfer programs and programs that incentivize school attendance among adolescent girls and young women show the greatest promise for HIV prevention.

Marie Stoner and co-workers assess the evidence on potential benefits of cash transfer interventions for HIV prevention.     

政府补偿与监管机制改革对公立医疗卫生机构科教与学科建设的影响分析

目的 分析政府补偿与监管机制改革对公立医疗卫生机构教学、科研以及学科建设的影响。方法 通过对上海市闵行区的机构调查,收集并分析2008—2012年3所公立综合性医院和12家社区卫生服务中心的医学教育、科研项目、论文发表及重点学科建设状况的相关数据。结果 闵行区公立综合性医院和社区卫生服务中心的医学教育和科研能力有所提升,重点学科建设也有所加强;但仍然存在教学能力薄弱,科研水平层次偏低,缺乏高质量的重点学科等问题。结论 政府补偿与监管机制改革在一定程度上强化了公立医疗机构的医学教育、科研能力和学科建设,但未来需进一步加大对科教和学科建设的鼓励和支持力度。     

Autosonntag (Switzerland, 1930) -- A Film Safari in the Swiss Alps

Two couples discover the attractions of the mountain world. With the cine camera they bring along, they record domestic animals and farmers, vegetation and impressive views. The result is a five-and-a-half minute amateur travel film documenting their excursion. In Autosonntag ( A Sunday Drive , Switzerland, 1930), the amateur film intersects with the genre of the travel film to form a kind of "safari to the Swiss interior" Between spontaneous observation, playful staging, and photographic posing, a specific tourist gaze emerges. Through the filming process, the mountain people are turned into trophies to be brought home from the "film safari"