Administrative Titles Research Articles

Policy whiplash: How California Title IX coordinators navigated local, state, and federal policy changes during the Trump administration

AbstractFederal Title IX policy requires institutions of higher education (IHEs) to prevent and respond to sexual misconduct. Based on 23 in‐depth interviews, this study explores California Title IX coordinator experiences at a critical policy juncture—the recension of the Obama‐era guidance and the implementation of the Trump administration Title IX rules and regulations—to understand how they responded to, implemented, or resisted federal mandates. Most California Title IX officers reported that the recension of Obama guidelines had limited impact on their daily operations because they lived in a state with more progressive social policy. Participants singled out California case law, state statues, the California Education Code and university system mandates as protective legislation to ensure survivors’ rights. By contrast, the new Title IX regulations that became law in August 2020 were perceived as more consequential. The tight implementation time frame, combined with the complicated and unfunded policy directives, imposed heavy burdens on their administrative offices. Title IX officers foresaw implementation consequences to campus safety, survivors’ willingness to report, and to the credibility of the Title IX office. Taken together, their experiences lend support to progressive state legislative action, restorative justice approaches and for a survivor bill of rights as important counterpoints to federal Title IX policy.

Electronic Health Record Usage Patterns Across Surgical Subspecialties.

This study aimed to utilize metrics from physician action logs to analyze surgeon clinical, volume, electronic health record (EHR) efficiency, EHR proficiency, and workload outside scheduled time as impacted by physician characteristics such as years of experience, gender, subspecialty, academic title, and administrative title. We selected 30 metrics from Epic Signal, an analytic tool in Epic that extracts metrics related to clinician documentation. Metrics measuring appointments, messages, and scheduled hours per day were used as a correlate for volume. EHR efficiency, and proficiency were measured by scores built into Epic Signal. Metrics measuring time spent in the EHR outside working hours were used as a correlate for documentation burden. We analyzed these metrics among surgeons at our institution across 4 months and correlated them with physician characteristics. Analysis of 133 surgeons showed that, when stratified by gender, female surgeons had significantly higher EHR metrics for time per day, time per appointment, and documentation burden, and significantly lower EHR metrics for efficiency when compared to male surgeons. When stratified by experience, surgeons with 0 to 5 years of experience had significantly lower EHR metrics for volume, time per day, efficiency, and proficiency when compared to surgeons with 6 to 10 and more than 10 years of experience. On multivariate analysis, having over 10 years of experience was an independent predictor of more appointments per day, greater proficiency, and spending less time per completed message. Female gender was an independent predictor of spending more time in notes per appointment and time spent in the EHR outside working hours. The burden associated with volume, proficiency, efficiency, and workload outside scheduled time related to EHR use varies by gender and years of experience in our cohort of surgeons. Evaluation of physician action logs could help identify those at higher risk of burnout due to burdensome medical documentation.

The Old Turkic Title Buyruq Reconsidered

First attested among the administrative titles used in the Türk Qaghanate, the Old Turkic title Buyruq was used by various Eurasian steppe peoples and polities from the 6th to the 13th centuries. In this paper, examples of the title Buyruq seen in historical sources are identified and examined, while different views put forth by modern scholars up to the present day are also brought together. Apparently, instead of indicating a fixed ministerial office or a commandership, this title, generally understood as meaning ‘having received an order’, indicates a position for dignitaries that was bestowed by rulers upon officials who were holding numerous administrative titles and were also tasked with certain duties by their rulers.

Impact of professor‐directors on Chinese firms' environmental performance

AbstractThis study investigates the impact of academic professor‐directors on Chinese firms' environmental performance. We find that the presence of board directors who are also professors has a positive impact on firms' environmental protection performance, and the result is robust after controlling for the potential endogeneity of professor‐directors. This is consistent with the notion that professor board directors are perceived to take more social responsibility and are more likely to advocate for sustainability. However, this positive impact is mitigated significantly by the presence of professor board directors with administrative titles. Moreover, the above results are mainly driven by non‐state‐owned enterprises, firms with less powerful CEOs, firms with better analyst coverage, and firms with less financial distress. Our study highlights the importance of academic directors for firms' environmental performance.

The Majority of Orthopaedic Surgery Residency Faculty in the United States are Allopathic Males

Introduction There is a paucity of information regarding the demographic characteristics of faculty at Accreditation Council for Graduate Medical Education (ACGME) orthopaedic surgery residency programs. The purpose of this study was to determine the demographics and education training of all current orthopaedic surgery residency program faculty members. We hypothesized that there would be a sex discrepancy among orthopaedic surgery faculty, and that there would be fewer DO (Doctor of Osteopathic Medicine) than MD (Medical Doctor) orthopaedic surgeons in academic medicine. Methods The Fellowship and Residency Electronic Interactive Database was used to identify all orthopaedic surgery residency programs in the United States. The following information was collected from each program website: faculty sex, degree, academic role, administrative title, and subspecialty. Faculty roles, titles, and subspecialties were compared across type of institution, degree earned, and sex using Chi squared and Analysis of Variance (ANOVA). Results Of the 4,325 faculty members identified, 3,893 were male (90%) and 4,033 were MDs (93%). The most common subspecialty was sports medicine (789, 18%). While traditional ACGME programs still had more MD faculty (3,728, 97.5%) (p<0.001), the majority of faculty at traditional American Osteopathic Association (AOA) programs were also MDs (305, 61%). There were more male DOs than male MDs (95.6% vs. 89.3%, p<0.001). More DOs practiced general orthopaedics (14.8% vs. 4.1%), whereas more MDs practiced upper extremity and orthopaedic oncology (p<0.001). More male faculty practiced adult reconstruction (616, 15.8%), trauma (489, 12.6%), spine (471, 12.1%), and sports medicine (719, 18.5%), whereas more female faculty practiced pediatrics (135, 31.3%), upper extremity (100, 23.1%), and oncology (33, 7.6%). More male faculty held titles as chair of orthopaedic surgery (145, 3.7%) and fellowship director (111, 2.9%) than females (5, 1.2% and 5, 1.2%). Males were also listed as assistant professor (1057, 27.2% vs 188, 43.5%), associate professor (636, 16.3% vs 86, 19.9%), and professor (618, 15.9% vs 41, 9.5%) more commonly than females. Conclusion The current faculty of orthopaedic surgery residency programs is heavily male dominated, holding higher academic roles and administrative titles than women. There is also a high prevalence of MDs with higher academic roles and administrative titles than DOs.

Evolution of the Chief Medical Officer Role in Teaching Hospitals and Health Systems.

Clinical physician leaders have become an increasingly important asset to hospitals and hospital systems in a changing healthcare environment. Specifically, the role of the chief medical officer (CMO) has expanded and evolved amid the shift to value-based payment models and sharpened focus on patient safety, quality, community engagement, and equity in healthcare, as well as a global pandemic. In light of these changes, this study examined the transformation of CMOs and similar roles and evaluated the current needs, challenges, and responsibilities of clinical leaders today. The primary data source used in this analysis was a survey fielded to 391 clinical leaders in 290 Association of American Medical Colleges-member hospitals and health systems in 2020. In addition, this study compared responses to the 2020 survey with findings from two prior iterations of the survey from 2005 and 2016. The surveys collected information regarding demographics, compensation, administrative titles, qualifications for the position, and the scope of the role, among other questions. All surveys consisted of multiple-choice, free response, and rating questions. The analysis was conducted using frequency counts and percentage distributions. Thirty percent of eligible clinical leaders responded to the 2020 survey. Twenty-six percent of the clinical leader respondents identified as female. Ninety-one percent of the CMOs were members of the senior management team in their hospital or health system. CMOs reported that they were responsible for five hospitals, on average, with 67% indicating they were responsible for more than 500 physicians. This analysis provides hospital and health systems with insight into the expanding scope and complexity of CMOs as they take on greater leadership responsibilities within their institutions amidst a shifting healthcare landscape. In reflecting on our results, hospital leaders can understand the current needs, barriers, and responsibilities of today's clinical leaders.

Symbolizing Reverence and Imperial Identity: The Elephant on the epi ton barbaron Seal

Abstract: Recent scholarship on Byzantine seals has broadened our understanding of both the practical and symbolic functions of these objects, as it primarily concerns their material, iconographic, and epigraphic content. This article focuses on one of only two known Byzantine seals featuring an image of an elephant. This eleventh-century seal belonged to an individual bearing the title “ἐπὶ τῶν βαρβάρων” ( epi ton barbaron ). Receiving little scholarly attention, this object is generally discussed in the context of other seals of the Byzantine period. I offer a new reading of this object and its image, arguing that the elephant on this seal served two primary functions: it represented its owner’s claim to imperial identity, and it also symbolized its owner’s reverence for the emperor. Through close iconographic and social art historical analysis, I examine the elephant’s use during the Roman and Byzantine periods in three distinct categories: as a motif, as material, and as a living animal. I draw upon primary texts, seals, and ivory objects of the Byzantine period to emphasize the elephant’s imperial associations. I also analyze this seal’s image in conjunction with the administrative titles present in this object’s inscription— epi ton barbaron , in particular. This article expands the ways in which both the iconographic and epigraphic content of Byzantine seals can be used to interpret the symbolic identities their owner’s often project.

Advancing integrated care through cotraining of residents and psychology postdoctoral fellows.

While integrated behavioral health (IBH) is growing as a primary care practice paradigm, there are gaps in developing the workforce needed. In particular, there are few examples of cotraining curricula in IBH for family medicine residents with postdoctoral psychology fellows. Furthermore, even fewer programs incorporate a colearning primary care practice environment featuring a targeted approach to care for patients with chronic illness using panel management and integrated care. In this article, the authors describe a cotraining experience in an urban federally qualified health center supported by a 5-year Health Resources and Services Administration Title VII grant, within a social justice mission-driven academic department to prepare both family medicine (FM) residents and primary care psychology (PCP) postdoctoral fellows for IBH practice. The article will discuss the specific components of the shared/parallel curriculum, integration of social justice and population health principles and practices, and a structured approach for resident/fellow partnership. The authors share the clinical and educational impacts of this integrated cotraining curriculum model as described by the FM residents and PCP fellows. The article describes workforce results measuring the diversity of the trainees and their postprogram jobs serving vulnerable populations. The interdisciplinary cotraining between FM residents and PCP fellows presents an innovative approach to developing workforce capacity for integrated practice in medically underserved settings. This article describes the creation and implementation of a cotraining curriculum and provides recommendations for other programs and residencies preparing their residents and future PCP psychologists to practice and teach skills in integrated care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Survey of Salary and Job Satisfaction of Transplant Nephrologists in the United States.

There are no standardized benchmarks to measure productivity and compensation of transplant nephrologists in the United States, and consequently, criteria set for general nephrologists are often used. A web-based survey was sent to 809 nephrologists who were members of the American Society of Transplantation to gather data on measures of productivity, compensation, and job satisfaction. Factors associated with higher total compensation and job satisfaction were examined. Of 365 respondents, 260 were actively practicing in the United States and provided data on compensation. Clinical productivity was assessed variably, and although 194 (76%) had their work relative value units (wRVUs) reported to them, only 107 (44%) had an established RVU target; 234 (90%) had fixed base compensation, and 172 (66%) received a bonus on the basis of clinical workload (68%), academic productivity (31%), service (32%), and/or teaching responsibility (31%). Only 127 respondents (49%) filled out time studies, and 92 (35%) received some compensation for nonbillable transplant activity. Mean total compensation (base salary and bonus) was $274,460±$91,509. The unadjusted mean total compensation was higher with older age and was higher for men; Hispanic and White respondents; adult care transplant nephrologists; residents of the western United States; US medical school graduates; nonuniversity hospital employees; and those with an administrative title, higher academic rank, and a higher number of years in practice. Two hundred and nine respondents (80%) thought their compensation was unfair, and 180 (70%) lacked a clear understanding of how they were compensated. One hundred forty-five respondents (55%) reported being satisfied or highly satisfied with their job. Job satisfaction was greater among those with higher amounts of compensation and US medical school graduates. We report significant heterogeneity in the assessment of productivity and compensation for transplant nephrologists and the association of compensation with job satisfaction.

P-030: CRIZANLIZUMAB REDUCES ENDOTHELIAL ADHESION OF RED BLOOD CELLS FROM SCD PATIENTS IN STANDARDIZED MICROFLUIDIC PLATFORM: IN VITRO TECHNOLOGY ASSESSMENT

Purpose: Crizanlizumab (ADAKVEO®, Novartis, Switzerland) a monoclonal P-selectin blocking antibody designed to disrupt the blood cells and endothelium interactions in sickle cell disease (SCD) patients, which leads to reduction of vaso-occlusive crises, the major manifestation of the disease. We report the novel microfluidic platform (endothelium-on-a-chip), to test the effects of Crizanlizumab on the adhesion of red blood cells (RBCs) to perfusion-cultured, acutely and chronically activated human endothelial cells (ECs). Materials and methods: Whole blood samples collected from SCD subjects (n=21), 20 HbSS and 1 HbSC in EDTA and sodium citrate. RBCs were isolated via centrifugation from whole blood and resuspended in basal cell culture medium (EBM; Lonza, Morristown, NJ, USA) at a hematocrit of 20% with 10 mM of HEPES. Human umbilical vein endothelial cells (HUVECs; Lonza, Morristown, NJ, USA) were cultured within the microfluidic platform channels at 15 dyne/cm2 for at least 48 hours prior to experiments. To mimic chronic pre-activation in SCD HUVECs were pretreated for 4 hours with heme (40 µM), TNFα (20 ng/ml) or 50% plasma of SCD patients in basal media, +/- 100 µg/ml Crizanlizumab followed by injection of blood samples through the microfluidic channels. For acute EC activation, blood samples were supplemented with 40 µM heme +/- 100 µg/ml Crizanlizumab and injected through the microfluidic channels for 15 minutes. Thereafter, non-adherent RBCs were rinsed via washing solution with or without Crizanlizumab and the remaining RBCs were quantified based on previous published methods. Paired t-test was used to calculate statistical significance. Results: The inhibitory effects of Crizanlizumab on blood cell adhesion to ECs was linked to the type and duration of EC activation (Fig. 1). Crizanlizumab slightly reduced RBC adhesion to 4-hours heme activated ECs (1170±413vs1671±522 p>0.05). Reduction of RBC adhesion due to Crizanlizumab treatment was significant in 15-minutes heme activated ECs (135±40 vs 1513±617, p≤0.05). The effect of Crizanlizumab on decreasing RBC adhesion was significant when ECs were pre-activated by TNF-α (4404±1393 vs 2016±609, p≤0.05) or subjects’ autologous plasma for 4 hours followed by a 15-minute heme activation (5876±2579 vs 2397±1381p≤0.05). Conclusion: In accordance with the label of Crizanlizumab to reduce VOC, application of microfluidic platform associated with Crizanlizumab use displayed a reduced RBC adhesion to acutely heme-activated EC. Effects were preserved in presence or absence of chronic TNFα or autologous plasma pre-activation. Endothelium-on-a-chip microfluidic platform has been shown as reliable in monitoring patient response to anti-adhesive therapies in SCD.Effects of Crizanlizumab on RBC adhesion levels to HUVECs activated for (A) 4-hours with heme (B) 15-minutes with heme (C) 4-hours with TNF-? and 15-minutes with heme, (D) 4-hours with plasma and 15-minutes with heme. Error bars represent the standard err J. ZAK declares a conflict of interest: Research support/Scientific studies: I am the Administrative Officer on several federal grants that support the development of the BioChip Labs assay platform: NIH phase I & II grant NSF phase I grant State of Ohio TVSF grant Stock shareholder: I am the founder of BioChip Labs Inc. and own a majority stake in the company Other: I hold the administrative title of CEO at BioChip Labs Inc. U. GURKAN declares a conflict of interest: Consultancy, Expert: Hemex Health Inc, BioChip Labs Inc Patent or product inventor: Hemex Health Inc, BioChip Labs Inc, Xatek Inc, DxNow Inc Research support/Scientific studies: Hemex Health Inc, BioChip Labs Inc, Stock shareholder: Hemex Health Inc, BioChip Labs Inc, Xatek Inc, DxNow Inc

Carle Illinois College of Medicine.

Carle Illinois College of Medicine.

La Grande Fête d’Abydos et le « Tribunal de Justification »

Summary This study aims to understand the title of jmy-rꜣ ḏꜣḏꜣ.t n(y.t) mꜣꜥ-ḫrw, worn by the High Priest of Osiris Wennefer (Ramesses II). The author shows it can not be interpreted as an administrative title but rather as a ceremonial function related to certain episodes of the great feast of Osiris at Abydos.

Characteristics of Faculty at Risk of Leaving Their Medical Schools: An Analysis of the StandPoint™ Faculty Engagement Survey.

PurposeThis study seeks to identify the characteristics and attitudes of faculty in US medical colleges who are at risk of leaving their institution.MethodsThis research leverages data from the AAMC StandPoint Faculty Engagement Survey administered to 37,779 faculty representing 36 institutions participating during 2013–2016. Univariate and multivariable robust logistic regression models were used to assess predictors of the intent to leave based on the question: “Do you plan to leave this medical school in the next 1–2 years?”.ResultsThirty percent (n=5559/18,475) of faculty responded that they were considering leaving their institution. Thirty-one percent of female faculty vs 29% of male faculty expressed an intent to leave. At-risk faculty were likely to be at junior faculty rank and at their institutions for 6–15 years vs other time periods (OR=1.16; p≤0.001). Having an administrative title (OR=0.72; p≤0.001) and receiving formal mentorship (OR=0.65; p≤0.001) were protective. Finally, faculty answering “disagree” or “strongly disagree” to any one of these StandPoint Survey questions were at > 6 fold risk of expressing an intent to leave: 1) I am satisfied with my opportunities for professional development, 2) I feel appreciated by my supervisor, 3) My day-to-day activities give me a sense of accomplishment.ConclusionFaculty expressing an intent to leave their institution have an identifiable profile. Top concerns of at-risk faculty relate to supervisory relationships and growth opportunities rather than compensation or governance. Institutional leaders should consider these factors in the development of a proactive strategy to retain talented faculty.

The Vice Chair of Education in Emergency Medicine: A Workforce Study to Establish the Role, Clarify Responsibilities, and Plan for Success.

Despite increasing prevalence in emergency medicine (EM), the vice chair of education (VCE) role remains ambiguous with regard to associated responsibilities and expectations. This study aimed to identify training experiences of current VCEs, clarify responsibilities, review career paths, and gather data to inform a unified job description. A 40-item, anonymous survey was electronically sent to EM VCEs. VCEs were identified through EM chairs, residency program directors, and residency coordinators through solicitation e-mails distributed through respective listservs. Quantitative data are reported as percentages with 95% confidence intervals and continuous variables as medians with interquartiles (IQRs). Open- and axial-coding methods were used to organize qualitative data into thematic categories. Forty-seven of 59 VCEs completed the survey (79.6% response rate); 74.4% were male and 89.3% were white. Average time in the role was 3.56years (median= 3.0years, IQR= 4.0years), with 74.5% serving as inaugural VCE. Many respondents held at least one additional administrative title. Most had no defined job description (68.9%) and reported no defined metrics of success (88.6%). Almost 78% received a reduction in clinical duties, with an average reduction of 27.7% protected time effort (median= 27.2%, IQR= 22.5%). Responsibilities thematically link to faculty affairs and promotion of the departmental educational mission and scholarship. Given the variability in expectations observed, the authors suggest the adoption of a unified VCE job description with detailed responsibilities and performance metrics to ensure success in the role. Efforts to improve the diversity of VCEs are encouraged to better match the diversity of learners.

Levels of Maternal Care in the United States: An Assessment of Publicly Available State Guidelines.

Background: Recent increases in maternal mortality and severe maternal morbidity highlight the need to improve systems for safe maternity care. We sought to identify whether publicly available state perinatal guidelines incorporate levels of maternal care (LoMC) criteria. Materials and Methods: We searched websites for 50 U.S. states and Washington, D.C. for LoMC guidelines. The Health Resources and Services Administration's Title V Program directors confirmed/updated search results through January 2018. Data abstracted included: (1) definitions of levels; (2) provider types; (3) facility capabilities and services; and (4) programmatic responsibilities as promoted in the 2015 Society for Maternal/Fetal Medicine and American College of Obstetricians and Gynecologists consensus document on LoMC. Results: LoMC guidelines were identified for 17 states; 12 defined four levels and five defined three levels of care. In Level I, 14/17 states specified obstetric provider availability for every birth and five specified an available surgeon to perform emergency cesareans. Fourteen states specified the availability of blood bank and laboratory services at all times. In the highest level (III or IV), 16/17 state guidelines specified a maternal/fetal medicine specialist; all but two specified anesthesia providers or services. Ten states referenced availability of an onsite intensive care unit in their highest level. All 17 state guidelines specified maternal transport and referral systems. Conclusions: Only one-third of states have publicly available perinatal guidelines incorporating LoMC criteria. Definitions, criteria, and nomenclature varied. Lack of LoMC guidelines with standardized criteria limits monitoring and evaluation of regionalized systems of maternal care.

Proposed changes to Title IX regs likely to impact higher ed attorneys

The Department of Education recently released its long‐awaited proposal for new Title IX regulations. As widely anticipated, the proposed regulations effectively reverse many elements of the Obama administration's Title IX guidance for responding to sexual misconduct and impose new mandates for live hearings and cross‐examination that will require an overhaul of institutional processes.

Gain insight into potential impact of proposed changes to Title IX regs

The U.S. Department of Education recently released its long‐awaited proposal for new Title IX regulations governing institutional response to reports of sexual harassment and sexual assault. As widely anticipated, the proposed regulations effectively reverse many elements of the Obama administration's Title IX guidance and impose new mandates for live hearings and cross‐­examination that will require an overhaul of institutional processes for resolving complaints against students. The proposed regulations, which were published in the Federal Register on Nov. 29, 2018, are open for public comment for a period of 60 days before being finalized.

Consider how proposed changes to Title IX regs might impact college athletics

The U.S. Department of Education recently released its long‐awaited proposal for new Title IX regulations governing institutional response to reports of sexual harassment and sexual assault. As widely anticipated, the proposed regulations effectively reverse many elements of the Obama administration's Title IX guidance and impose new mandates for live hearings and cross‐examination that will require an overhaul of institutional processes for resolving complaints against students, including student‐athletes. The proposed regulations do not affect current Title IX guidance governing gender equity with respect to the number of sports teams and institutional support for teams. The proposed regulations, which were published in the Federal Register on Nov. 29, 2018, are open for public comment for a period of 60 days before being finalized.

Addendum Report: Additional Cultural Resources Investigations of the Vista Ridge Regional Water Supply Project in Burleson, Lee, Bastrop, Caldwell, Guadalupe, Comal and Bexar Counties, Texas

Addendum Report: Additional Cultural Resources Investigations of the Vista Ridge Regional Water Supply Project in Burleson, Lee, Bastrop, Caldwell, Guadalupe, Comal and Bexar Counties, Texas

Some Rock Inscriptions from Gebel el-Silsila

The subject of this article is a selected group of textual graffiti intended as a preview to a comprehensive hieroglyphic and hieratic corpus of Middle Kingdom rock inscriptions at Gebel el-Silsila currently being prepared for publication. All texts included were incised into the sandstone bedrock and stretched along the so-called Middle Kingdom road as well as along today’s main touristic pathway along the New Kingdom cenotaphs, also on the west bank of Gebel el-Silsila. The inscriptions were documented by the current scientific team during the course of several survey seasons (2012–15) and demonstrate various administrative and official titles providing an insight into activity during the Middle Kingdom, which otherwise is difficult to demonstrate archaeologically, i.e. within the physical remains of the ancient quarries. Titles included herein, such as [Formula: see text] – inspector, [Formula: see text] – general/mission leader, [Formula: see text] – seal-bearer of the God and [Formula: see text] – Royal seal-bearer, indicate an official politico-economic interest in the site, while simultaneously demonstrating religious activity and involvement. The current selection of texts is merely intended as a very brief introduction to the variety of titles and individuals once active at Gebel el-Silsila.