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Prior research suggests COVID-19 has amplified stress on Academic Clinician Frontline-Workers (ACFW). The aim of this paper is: (1) to better understand the experiences of ACFW during the COVID-19 pandemic including their mental-emotional wellbeing, academic productivity, clinical experiences, and (2) to examine any gender differences. A cross-sectional survey was administered to University of Minnesota/M Health Fairview systems' faculty February-June 2021. Of the 291 respondents, 156 were clinicians, with 91 (58 %) identifying as Frontline-Workers (ACFW). Faculty wellbeing was assessed using validated measures in addition to measures of productivity and sociodemographics. For example, ACFW reported a higher Work-Family Conflict (WFC) scores compared to non-ACFW (26.5 vs. 24.1, p = 0.057) but did not report higher Family-Work Conflict (FWC) scores (17.7 vs. 16.3, p = 0.302). Gender sub-analyses, revealed that women ACFW compared to men ACFW reported higher WFC scores (27.7 vs. 24.1, p = 0.021) and FWC (19.3 vs. 14.3, p = 0.004). Academically, ACFW reported submitting fewer grants and anticipated delays in promotion and tenure due to the COVID-19 (p = 0.035). Results suggest COVID-19 has exacerbated ACFW stress and gender inequities. Reports of anticipated delay in promotion for ACFW may pose a challenge for the long-term academic success of ACFW, especially women ACFW. In addition, women may experience higher FWC and WFC as compared to men. Schools of academic medicine should consider re-evaluating promotion/tenure processes and creating resources to support women ACFW as well as ACFW caregivers.
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In line with the rapid progress in technical innovation, the wave of informationization is now reaching every aspect of Japanese society. With the explosive spread of the Internet, local governments are implementing administrative policies to facilitate the construction of information network systems which will help promote the spread of information at the local level. The Ministry of Posts and Telecommunications, the Ministry of International Trade and Industry, and other organizations of the Japanese government are also implemending a variety of measures to assist these moves on the part of local governments. A look at administrative services for local residents reveals a great need for the proliferation of information within the areas of welfare and medical care; in particular, counselling concerning nursing care and medical services in remote areas are needed. In order to realize new measures promoting informationization, however, the cooperation and understanding of local governors or mayors are essential. Because these people are very busy, short video and computer graphic presentations should be prepared in order to make the greatest impact in the least amount of time.
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Computadores , Servicios de Información , Gobierno Local , JapónRESUMEN
OBJECTIVES: To determine how standard residency training and educational background affect otolaryngology resident auditory-perceptual judgments compared with inexperienced listeners. A secondary aim was to assess the impact of a brief training session on the reliability of judgments among otolaryngology residents. STUDY DESIGN: Mixed cross-sectional and cohort study. METHODS: Twenty adult dysphonic and four normal speaker samples were selected from a database. Fifteen listeners at various stages of residency in otolaryngology judged all samples for breathiness and roughness using visual analog scales. Fifteen inexperienced listeners judged the same samples. Subsequently, 12 otolaryngology residents underwent a brief training session. During training, listeners were provided definitions of rating dimensions and accuracy feedback while rating 20 novel (training) stimuli. The feedback included averaged responses from experienced clinicians who had previously evaluated the same speech samples. The residents then completed posttraining evaluations. RESULTS: As a group, otolaryngology resident listeners had significantly better interrater agreement for judgments of roughness compared with inexperienced listeners (P<0.05) and trended toward better interrater agreement for judgments of breathiness (P=0.058). Posttraining, no significant improvement in interrater agreement for judgments of roughness was observed; however, a significant improvement was found in interrater agreement of judgments of breathiness (P<0.05). CONCLUSIONS: Compared with inexperienced (untrained) listeners, otolaryngology resident listeners had better interrater agreement overall for judgments of dysphonia. A short training module was associated with improved reliability in resident evaluation of breathiness. Results have implications for improving and standardizing resident evaluation of dysphonia.
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Percepción Auditiva , Competencia Clínica , Disfonía/diagnóstico , Educación de Postgrado en Medicina , Internado y Residencia , Juicio , Otolaringología/educación , Medición de la Producción del Habla , Calidad de la Voz , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Competencia Clínica/normas , Estudios Transversales , Disfonía/fisiopatología , Disfonía/psicología , Educación de Postgrado en Medicina/normas , Retroalimentación Psicológica , Femenino , Humanos , Internado y Residencia/normas , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Otolaringología/normas , Reproducibilidad de los Resultados , Medición de la Producción del Habla/normas , Washingtón , Adulto JovenRESUMEN
The mechanisms by which neural stem cells give rise to neurons, astrocytes, or oligodendrocytes are beginning to be elucidated. However, it is not known how the specification of one cell lineage results in the suppression of alternative fates. We find that in addition to inducing neurogenesis, the bHLH transcription factor neurogenin (Ngn1) inhibits the differentiation of neural stem cells into astrocytes. While Ngn1 promotes neurogenesis by functioning as a transcriptional activator, Ngn1 inhibits astrocyte differentiation by sequestering the CBP-Smad1 transcription complex away from astrocyte differentiation genes, and by inhibiting the activation of STAT transcription factors that are necessary for gliogenesis. Thus, two distinct mechanisms are involved in the activation and suppression of gene expression during cell-fate specification by neurogenin.