The practice of neurology, 2000-2010: report of the AAN Member Research Subcommittee.

OBJECTIVE: To present an analysis of American Academy of Neurology (AAN) membership demographics and practice trends over the past decade. METHODS: Data from the 2009 AAN Census and 2010 Practice Profile Form (PPF) surveys were compared to results from 2004 and 2000 surveys. The Census was sent to all AAN members, and the PPF was sent to a random sample of US practicing neurologists. RESULTS: Since 2000, AAN membership increased by 31%, and the number of US neurologist-members increased by 14%. Mean age of US neurologists increased from 48.6 to 53.3 years, and 23.9% of neurologists are women. There was a 15% increase in the proportion of neurologists relative to the US population, from 3.41 neurologists per 100,000 population in 2000 to 3.92 neurologists in 2009. In 2009, 24.1% of US neurologists were in solo practice, 27.8% were in a neurology group, and 35.6% were in multispecialty/university settings, with little change in practice arrangements over time. The top 5 practice interest areas were unchanged since 2004 as were the number of hours devoted to patient care (42.3) or total work hours per week (57.1). Little change was observed in performed procedures, except increased use of botulinum toxin and nerve blocks and a decline in lumbar punctures. Neurologists rely more on physician assistants to see follow-up and new patients independently (p < 0.001). CONCLUSION: Despite advances in neurologic diagnosis and therapy, there has been little change in practice characteristics of US neurologists.

The sunken nuclear submarine Komsomolets and its effects on the environment.

This paper discusses the possible release mechanisms for radionuclides on board the sunken nuclear submarine Komsomolets. With an aim to determine whether or not the sunken submarine presents any significant hazards to man, a worst-case approach is taken in estimating the environmental effects of the released radionuclides. It is found that neither the submarine hull nor the reactor vessel will be destroyed by corrosion for at least 1000 years. While the total radionuclide inventory presently is estimated to be approx. 8 PBq, only approx. 1 TBq is released annually into the surrounding environment. The distribution of the released radionuclides in the ocean has been modeled, and it was found that not even in the most heavily affected waters will the present contamination levels change significantly due to the Komsomolets. In short, this study, which does not pretend to completely answer all environmental questions related to the sunken submarine, clearly indicates that the Komsomolets represents no significant hazard to man, today or in the future.