Course Of Career Research Articles

Variations in surgical practice and short-term outcomes for degenerative lumbar scoliosis and spondylolisthesis: do surgeon training and experience matter?

For diverse procedures, sizable geographic variation exists in rates and outcomes of surgery, including for degenerative lumbar spine conditions. Little is known about how surgeon training and experience are associated with surgeon-level variations in spine surgery practice and short-term outcomes. This retrospective observational analysis characterized variations in surgical operations for degenerative lumbar scoliosis or spondylolisthesis, two common age-related conditions. The study setting was two large spine surgery centers in one region during 2017-19. Using data (International Classification of Diseases-10th edition and current procedural terminology codes) extracted from electronic health record systems, we characterized surgeon-level variations in practice (use of instrumented fusion - a more extensive procedure that involves device-related risks) and short-term postoperative outcomes (major in-hospital complications and readmissions). Next, we tested for associations between surgeon training (specialty and spine fellowship) and experience (career stage and operative volume) and use of instrumented fusion as well as outcomes. Eighty-nine surgeons performed 2481 eligible operations. For the study diagnoses, spine surgeons exhibited substantial variation in operative volume, use of instrumented fusion, and postoperative outcomes. Among surgeons above the median operative volume, use of instrumented fusion ranged from 0% to >90% for scoliosis and 9% to 100% for spondylolisthesis, while rates of major in-hospital complications ranged from 0% to 25% for scoliosis and from 0% to 14% for spondylolisthesis. For scoliosis, orthopedic surgeons were more likely than neurosurgeons to perform instrumented fusion for scoliosis [49% vs. 33%, odds ratio (OR) = 2.3, 95% confidence interval (95% CI) 1.3-4.2, P-value = .006] as were fellowship-trained surgeons (49% vs. 25%, OR = 3.0, 95% CI 1.6-5.8; P = .001). Fellowship-trained surgeons had lower readmission rates. Surgeons with higher operative volumes used instrumented fusion more often (OR = 1.1, 95% CI 1.0-1.2, P < .05 for both diagnoses) and had lower rates of major in-hospital complications (OR = 0.91, 95% CI 0.85-0.97; P = .006). Surgical practice can vary greatly for degenerative spine conditions, even within the same region and among colleagues at the same institution. Surgical specialty and subspecialty, in addition to recent operative volume, can be linked to variations in spine surgeons' practice patterns and outcomes. These findings reinforce the notion that residency and fellowship training may contribute to variation and present important opportunities to optimize surgical practice over the course of surgeons' careers. Future efforts to reduce unexplained variation in surgical practice could test interventions focused on graduate medical education. Graphical Abstract.

Differences in buprenorphine prescribing readiness among primary care professionals with and without X-waiver training in the US

BackgroundMedications for opioid use disorder (OUD) are effective at preventing overdose and infectious disease but are vastly under-prescribed in the US. For decades, prescribers faced additional training and regulation to prescribe buprenorphine which stigmatized the medication and lessened support for a harm reduction approach to treating opioid use disorder. The Drug Enforcement Administration removed the X-waiver requirement for prescribing buprenorphine in late 2022, which removed stigma and lessened important barriers to prescribing but also left training at the discretion of individual organizations. Our study aimed to assess differences in knowledge, confidence, and stigma regarding buprenorphine between those who went through the X-waiver training and those who did not, among practicing primary care providers (PCPs).MethodsWe assessed buprenorphine prescribing readiness among primary care aligned outpatient providers in Ohio, USA. Using survey data, we conducted bivariate and regression analyses predicting primary prescribing outcomes. Primary outcomes measured knowledge of and confidence in buprenorphine, as well as perceived adequacy of one’s training. Secondary outcomes were attitudes toward patients with OUD, including bias toward OUD patients, stress when working with them, and empathy toward them. Participants (n = 403) included physicians, nurse practitioners, and physician assistants practicing in primary care aligned disciplines.ResultsSurvey data showed that PCPs who received X-waiver training were more likely to understand and have confidence in the mechanism of buprenorphine, and consider their training on treating OUD to be adequate. PCPs with an X-waiver showed more empathy, less negative bias, and experienced less stress when working with patients with OUD.ConclusionRemoving restrictive policies for prescribing buprenorphine is an important step to expanding access and reducing the stigma associated with opioid use disorder treatment. Yet, our findings suggest that the training received alongside regulation may be important for improving prescribing confidence and reducing stigma. Strategies to increase buprenorphine prescribing are unlikely to be effective without also expanding access to prescribing support for primary care providers across the career course.

문화예술대학 신입생의 대학적응 및 진로탐색을 위한 교양 교과목 개발

The purpose of this study is to develop a liberal arts course for freshmen in College of Culture and Arts which facilitates their adaptation to college and promotes career awareness. The study was based on literature reviews and analysis of the existing career course for freshmen at other universities in Korea. In addition, learning objects was determined by subject analysis of current career-related programs and IPA Matrix analysis of survey response data from the first-year students. After we developed a 15-week lesson plan through the process of specification of performance goals, content structure, and evaluation tool design, we implemented it for new students in the spring semester of 2023. The result shows the effectiveness of the career course for freshmen evidenced by students’ positive adaptation to college, major satisfaction, self leadership, learning outcomes. Hence, we discussed the implications of improvement strategies for the new student career course from the teaching and learning perspective.

Career course, coach, and cohort framework: A design thinking approach to enhance career self-efficacy

Prior studies show students' career self-efficacy (CSE) significantly impacts their employability. This study utilized a design thinking approach to identify various stakeholders and perceived self-efficacy enablers and barriers among MBA students in India. Six student groups participated in the design thinking workshop and collected responses from 125 students. The most important stakeholders, barriers, and enablers of career self-efficacy in different MBA student segments were identified. The 3C (Career Course, Coach, and Cohort) framework of intervention strategies was proposed under the context of the Social Cognitive Career Theory (SCCT). It was conceptualized that these intervention strategies would mediate the association between the learning experience and self-efficacy expectations. This paper has practical implications for management instructors and administrators who can implement the intervention techniques suggested in the study to enhance the CSE of MBA students in their colleges.

Retention of highly qualified wildland firefighters in the Western United States

Federal agencies responsible for wildland fire management face increasing needs for personnel as fire seasons lengthen and fire size continues to grow, yet federal agencies have struggled to recruit and retain firefighting personnel. While many have speculated that long seasons, challenging working conditions, and low wages contribute to recruitment and retention challenges, there has been no empirical investigation of these claims. We assemble a unique dataset on the federally funded Interagency Hotshot Crews in the Western United States, which are comprised of highly qualified firefighters, from 2012 to 2018 to analyze the factors that affect firefighter retention. Using a Cox proportional hazard model, we find that a higher workload, a proxy for higher earnings, and cumulative experience over the course of an employee's career both have a significant positive impact on retention. The wage of alternative occupations had no significant effect on retention. Retention decreases over the study period.

Becoming Trustworthy in Treating Patients With Borderline Personality Disorder.

No one doubts the importance of trust in psychotherapy, but few therapists think about the complexities of trusting relationships, and the trustworthiness that would justify trusting remains far from view. Fortunately, inasmuch as trusting and trustworthiness are inherently ethical concepts, contemporary philosophers have given trust the consideration it warrants. Integrating science and philosophy, the author reviews the broad scope and multifaceted nature of trust and trustworthiness, the social-cognitive development of trust, and the development of distrust in the context of borderline personality disorder. Without questioning therapists' character, the author makes the case for shifting the emphasis from the patient's distrust to the therapist's challenge to become trustworthy in the course of each treatment relationship and, more broadly, over the course of a professional career.

인제대학교 진로교육과정 개편 현황과 전망

The purpose of this study is to improve the performance of career and employment support in university and to suggest the right direction of career education in university through the reorganization of career curriculum focused on career course. The results of the analysis on the operation status of major university career course and the recognition and demand of students for the reorganization of career curriculum are as follows: First, the operation status of major university career course was classified into three types. Second, students' positive perception and relatively high demand for the operation of career and employment course as essential courses were confirmed. Third, in terms of students' recognition and demand for learning support for career course, the top category was formed by the learning methods of the lecture-focused course, the experience-focused course, and the interaction-focused course. The results of this study were used as basic data for the reorganization of career curriculum at Inje University and the development of career and employment courses.

Experiential Learning Practices and Career Courses: Predictors of First Destination Outcomes

This study examined connections between experiential learning practices, mandatory career courses, and positive first destination outcomes of graduates from a large public institution prior to and during the COVID-19 pandemic. The rising cost of education and competition among universities has led to consumer demands for information pertaining to their return on investment. Universities have been encouraged to provide first-destination outcomes for graduates as a way to show the value of their degree programs. To strengthen these outcomes, many programs encourage or mandate experiential learning known as high-impact practices (HIPs) and career courses to prepare emerging adult learners for the transition to employment or further education. However, little is known as to the impact these practices have on the first-destination outcomes of these graduating students. This study identified specific experiential practices which proved beneficial to securing employment or acceptance to continued education, with an important caveat that career courses added only limited benefit for some respondents. These findings will better inform the allocation of university teaching resources and are a basis for further study of career practices in higher education.

The initial development and validation of the Social Adaptability Skills Questionnaire: SASQ.

Changing clubs over the course of an athletic career may not always be easy, and this has raised questions about how these changes affect career development. However, few studies have focused on the process of adapting to a new club and the factors that lead to success or failure. To address this gap in the literature, we aimed to develop and provide the initial validation of a questionnaire designed to assess athletes' social adaptability skills (SAS). To do so, we conducted four studies, from the initial development stage to the final validation stage. In the first phase, we generated questionnaire items with clear content and face validity. The second phase explored the factor structure and reliability of the Social Adaptability Skills Questionnaire (SASQ). This was carried out with 543 young athletes in talent development through exploratory factor analysis (EFA), which was validated with confirmatory factor analysis (CFA). The EFA yielded a 17-item, four-factor structure with good internal reliability (⍺ = 0.876). The CFA revealed that the model fit indices were acceptable (RMSEA = 0.06, CFI = 0.809, TLI = 0.844, and GFI = 0.926). In addition, Latent Class Analysis (LCA) was applied to determine the predictive validity of SASQ resulting into identification of three classes (low achievers, average achievers, and high achievers) with four discriminating dimensions (coach, teammates, family, and club). The SASQ appears to be a promising psychometric instrument of potential usefulness for education and program reviews in applied settings and a measurement tool in talent development research.

Can a fighter develop glass jaw? Statistical evidence from mixed martial arts

This paper deals with a phenomenon in combat sports called the glass jaw or glass chin. It is the ability of a fighter to withstand punches to the jaw area without falling unconscious and thus receiving a knockout. The main objective of this paper is to investigate the possibility of developing a glass jaw over the course of a fighter's career, and whether certain fighters are more predisposed to experiencing knockouts. Utilizing data from the largest Mixed Martial Arts organization, the Ultimate Fighting Championship, spanning from 2010 to 2021, statistical models reveal that certain fighters may be more susceptible to knockouts compared to others. Conversely, it could not be shown that the probability of a future knockout loss, that is developing a glass jaw, increased with the number of knockouts received. However, there remains space for a more detailed investigation of this phenomenon. The historically debated resistance training of punches to the head area cannot be recommended. Conversely, it is advisable to observe the fighters' reactions to punches to the head in order to pick out those with a greater predisposition for a knockout. They should then be especially cautious when practicing combat sports.

Career decision-making readiness among students’ in the system of higher education: career course intervention

Career decision-making is a complicated process in which students must understand themselves. In this paper, the influence of the implemented “Career development” course on the Toraighyrov University undergraduate students’ readiness for career decision-making was analyzed. The Career Decision-making Difficulties Questionnaire (CDMDQ) and it was used to test the hypothesis that by implementing “Career Development” course the level of students’ career decision-making readiness would increase. The participants were 104 students at Toraighyrov University, divided equally into the control and experimental groups (52 students each). The experimental group, unlike the control group, took the “Career Development” course for 15 weeks. Students were randomly chosen from humanities (psychology, education, journalism, and social work) and Science, Technology, Engineering, and Mathematics (electrical engineering, computer science, and metallurgical engineering) fields. The average age of participants was 21 years. The results show that there is significant difference in pre-course and post-course testing in each of the career decision-making difficulties cluster: (1) Lack of Readiness; (2) Lack of Information and (3) Inconsistent information in experimental in comparison to control group.

New Impressions XX Seven Types of Ambiguity

WILLIAM EMPSON’S SEVEN TYPES OF AMBIGUITY is one of those books that most professionals in literary studies have heard of, but fairly few, as it turns out, have actually read.1 Those who have done so tend to be of the generation educated in the period when ‘New Criticism’ was dominant (roughly speaking, from the 1950s to the mid-1970s), a movement with which Empson is often associated – to some extent correctly and to some extent incorrectly.2 I am a member of that group and have asserted at various times and to various persons in the course of my academic career that Seven Types is ‘the best book ever written about poetry’. However, it occurred to me recently that I had not sat down and read the book, cover to cover, in decades, perhaps since I first read it. I had used it in teaching particular lyric poems and particular passages in Shakespeare’s plays, and had defended a controversial section of it in print, but had not actually read the book itself, as such, in all that time.3 What follows is a ‘report from the field’ that can serve as an account of what rereading, or simply reading, Seven Types of Ambiguity now is like. It should also make clear why I continue to maintain my high regard for the book and would argue for its special relevance to literary studies now, when historicism and formalism are no longer seen as at odds, when Theory has moved from ‘high’ to ‘low’, and when ‘close reading’ is being considered and (often) defended – but without set protocols.4

A Clinical Psychologist Who Studies Alcohol

In this article, I describe why I believe the study of alcohol use and its consequences is a rich and rewarding area of scholarly activity that touches on multiple disciplines in the life sciences, the behavioral sciences, and the humanities. I then detail the circuitous path I took to become an alcohol researcher and the various challenges I encountered when starting up my research program at the University of Missouri. A major theme of my journey has been my good fortune encountering generous, brilliant scholars who took an interest in me and my career and who helped guide and assist me over the course of my career. I also highlight selected, other professional activities I've been involved in, focusing on editorial work, quality assurance, and governance of professional societies. While the focus is on my training and work as a psychologist, the overarching theme is the interpersonal context that nurtures careers.

Health Services Aimed at Improving Wellness: What All Physician Leaders Should Know

Recently, I have taken notice of health services that continue to cross over to areas that were traditionally called beauty, cosmetic, and wellness services. These services are increasingly being offered by healthcare providers around the country. Admittedly, I knew very little about this area despite being a physician leader in several roles over the course of my career. I quickly came to learn that there are important implications for ensuring the delivery of high-quality services in the health, wellness, and beauty space that have relevance for physician leaders more broadly.

“Profesyonel Hayata Geçiş” Dersinin Öğrencilerin Kariyer Kararı Verme Yetkinlikleri Üzerindeki Etkisi

This study aims to reveal the effectiveness of the ESTU401 Transition to Professional Life (1+1; 2 ECTS) course, designed to help university senior students gain the competencies needed for career development and to develop their existing competencies, on the students’ career decision-making self-efficacy (CDMSE) levels. An experimental model with pretest-posttest control group was used, with an effort to evaluate the effect of the students taking the 8th semester ESTU401 course on their career decision-making self-efficacy and the differentiation status based on the factors affecting these levels. All the analyses were done by using R. The results show that the career decision-making self-efficacy of the students who took the ESTU401 course increased in all of the factors. In addition, the CDMSE levels of the students were found to differ in the Level of Satisfaction with the Department. These results make an important contribution to the literature by revealing the effects of a career course given online during the Covid-19 pandemic on students’ CDMSE.

Perceptions and knowledge of personal finance in doctor of pharmacy versus undergraduate students: More wisdom or just more debt?

Background and Purpose: Evolution of personal finance beliefs over the course of a college career are unknown. The purpose of this study is to compare perceptions and knowledge of personal finance in undergraduate and pharmacy students at baseline and after completing a personal finance course.Educational Activity and Setting: A personal finance elective course was implemented for second- and third-year doctor of pharmacy (PharmD) students and for undergraduate freshman students. On the first and last day of class, students completed an anonymous survey evaluating demographics, opinions and knowledge regarding personal finance, and current financial status. Baseline data between undergraduate and pharmacy students was compared and the impact of the personal finance course was assessed.Findings: The median score on the baseline knowledge assessment was 58% for freshman (n = 19) and 50% for pharmacy students (n = 28) (P = .571). Five percent of freshman and 86% of pharmacy students reported having debt at baseline (P < .001) compared to 84% and 68%, respectively, having savings (p = .110). After completing the personal finance course, knowledge assessment scores were 54% and 73% for freshman and pharmacy students, respectively (P < .001).Summary: Despite additional years of education and life experience, PharmD students had similar knowledge and perceptions of personal finance while reporting more debt than freshmen. Pharmacy students, however, exhibited improvement in knowledge after taking a personal finance course, while freshman students did not. Personal finance-focused education may help empower graduating pharmacists for financial decision-making upon entering the workforce.

Interview: Timothy Clinton

Interview: Timothy Clinton

Interview: Bhaskar Somani

Interview: Bhaskar Somani

Change in athletic identity after retirement from elite sport: In search of potential predictors using multi-level analysis

Introduction&#x0D; Elite athletes spend a great amount of time training and competing. Accordingly, their live is focused on and shaped by sport. As a result, many athletes develop a strong athletic identity, which may be defined as the extent to which athletes identify with their role as athletes (Brewer, 1993). While risk and opportunities associated with a strong athletic identity are clear, little is known about how athletic identity develops over the course of a sport career. Some studies suggest that athletic identity remains stable over time (e.g., Hadiyan &amp; Cosh, 2019), while other studies attribute some plasticity to it (e.g., Brewer et al., 2010). The purpose of this study was to examine how the athletic identity develops beyond a career in elite sport. In addition, we searched for potential predictors of athletic identity during and after career.&#x0D; Methods&#x0D; A longitudinal survey of 290 athletes (32.8% women; 67.2% men) was conducted during (t1) and after their careers (t2; 12 years later). The German version of the Athletic Identity Measurement Scale (AIMS D; Schmid &amp; Seiler, 2003) was used to measure athletic identity. Besides, data were collected on demographic (gender, age) and sports-related variables (sporting success, career satisfaction, time of retirement, voluntariness of retirement, involvement in sport after retirement). Data were analyzed using multi-level regression models.&#x0D; Results&#x0D; The analysis revealed that athletic identity decreased over time. However, there was considerable heterogeneity across athletes. In particular, the status as an athlete (i.e., professional vs. dual career), exclusivity of the role as an athlete, and time to retirement predicted athletic identity at t1. To explain the development of athletic identity, interaction terms between time and the different predictors were also modeled. Three significant effects were found: In particular, a slower decline in athletic identity was found for athletes who were (a) working in the field of sport after their athletic retirement, (b) involved in (recreational) competitive sport, and (c) satisfied with their sport career.&#x0D; Discussion/Conclusion&#x0D; As expected, on average, the role as an athlete is reduced in an individual’s identity (and is probably replaced by other roles). However, sport may still be shaping athletes’ identity, notably their athletic career has been satisfying and if their occupation revolves around sports. Future research is needed to better understand how former athletes reshape their identity and what sources of meaning they tap into after athletic retirement to promote quality of life.&#x0D; References&#x0D; Brewer, B. W. (1993). Self-identity and specific vulnerability to depressed mood. Journal of Personality, 61(3), 343–364. https://doi.org/10.1111/j.1467-6494.1993.tb00284.x&#x0D; Brewer, B. W., Cornelius, A. E., Stephan, Y., &amp; van Raalte, J. (2010). Self-protective changes in athletic identity following anterior cruciate ligament reconstruction. Psychology of Sport and Exercise, 11(1), 1–5. https://doi.org/10.1016/j.psychsport.2009.09.005&#x0D; Hadiyan, H., &amp; Cosh, S. (2019). Level of physical and motor fitness post retirement and maintenance of athletic identity within active retired athletes. Journal of Loss and Trauma, 24(1), 84–95. https://doi.org/10.1080/15325024.2018.1540206&#x0D; Schmid, J., &amp; Seiler, R. (2003). Identität im Hochleistungssport: Überprüfung einer deutschsprachigen Adaptation der Athletic Identity Measurement Scale (AIMS-D) [Identity in high-performance sport: Psychometric investigations with a German Language adaptation of the Athletic Identity Measurement Scale (AIMS-D)]. Diagnostica, 49(4), 176–183. https://doi.org/10.1026//0012-1924.49.4.176

Four reasons why we should screen for dissociation in competitive sports

Four reasons why we should screen for dissociation in competitive sports