Center Affiliation Research Articles

Prevalence and correlates of central venous catheter use among haemodialysis patients in the Irish health system - a national study

BackgroundCentral venous catheters (CVC) are associated with substantial morbidity and mortality among patients undergoing haemodialysis (HD), yet they are frequently used as the primary vascular access for many patients on HD. The goal of this study was to determine the prevalence and variation in CVC use across centres in the Irish health system.MethodsData from the National Kidney Disease Clinical Patient Management System (KDCPMS) was used to determine CVC use and patterns across centres. Data on demographic characteristics, primary cause of end-stage kidney disease (ESKD), comorbid conditions, laboratory values and centre affiliation were extracted for adult HD patients (n = 1, 196) who were on dialysis for at least three months up to end of December 2016. Correlates of CVC use were explored using multivariable logistic regression.ResultsOverall prevalence of CVC use was 54% and varied significantly across clinical sites from 43% to 73%, P < 0.001. In multivariate analysis, the likelihood of CVC use was lower with increasing dialysis vintage, OR 0.40 (0.26–0.60) for 4 years vs 1 year vintage, rising serum albumin, OR 0.73 (0.59–0.90) per 5 g/L), and with cystic disease as a cause of ESKD, OR 0.38 (95% CI 0.21–0.6). In contrast, catheter use was greater for women than men, OR 1.77 (1.34–2.34) and for 2 out of 10 regional dialysis centres, OR 1.98 (1.02–3.84) and OR 2.86 (1.67–4.90) respectively compared to referent group).ConclusionsCatheters are the predominant type of vascular access in patients undergoing HD in the Irish health system. Substantial centre variation exists which is not explained by patient-level characteristics.

Academic Surgical Oncologists' Productivity Correlates with Gender, Grant Funding, and Institutional NCI Comprehensive Cancer Center Affiliation.

A scholar'sh-index is defined as the number of h papers published, each of which has been cited at least h times. We hypothesized that the h-index strongly correlates with the academic rank of surgical oncologists. We utilized the National Cancer Institute (NCI) website to identify NCI-designated Comprehensive Cancer Centers (CCC) and Doximity to identify the 50 highest-ranked general surgery residency programs with surgical oncology divisions. Demographic data of respective academic surgical oncologists were collected from departmental websites and Grantome. Bibliometric data were obtained from Web of Science. We identified 544 surgical oncologists from 64 programs. Increased h-index was associated with academic rank (p < 0.001), male gender (p < 0.001), number of National Institutes of Health (NIH) grants (p < 0.001), and affiliation with an NCI CCC (p = 0.018) but not number of additional degrees (p = 0.661) or Doximity ranking (p = 0.102). H-index was a stronger predictor of academic rank (r = 0.648) than total publications (r = 0.585) or citations (r = 0.450). This is the first report to assess the h-index within academic surgical oncology. H-index is a bibliometric predictor of academic rank that correlates with NIH grant funding and NCI CCC affiliation. We also highlight a previously unexpected and unappreciated gender disparity in the academic productivity of US surgical oncologists. When academic rank was accounted for, female surgical oncologists had lower h-indices compared with their male colleagues. Evaluation of the etiologies of this gender disparity is needed to address barriers to academic productivity faced by female surgical oncologists as they progress through their careers.

Molecular testing practices and perceptions among dermatopathologists.

We evaluated how dermatopathologists are employing molecular testing in the setting of neoplastic skin diseases, and assessed their opinions of the broader role and utility of molecular technologies in clinical practice. A 15-question online survey was sent to Fellows of the American Society of Dermatopathology in April 2017. One hundred and thirty-six dermatopathologists completed the survey (response rate = 16%). A majority (94%) of respondents reported experience with one or more molecular testing strategies. Sixty-two percent of dermatopathologists order 12 or more molecular tests per year, while 5% of respondents order 2 or fewer assays per year. More frequent utilization of molecular testing is associated with relevant instruction during residency training (P = .009), primary board certification in pathology (P = .008), academic medical center affiliation (P = <.0001), higher volume clinical practice (P = .0004), presence of on-site clinical molecular pathology/cytogenetics laboratory (P = .007), and greater physician confidence incorporating test results into histopathological assessments (P = <.0001). Wider adoption of molecular testing in dermatopathology may be limited by factors such as physician training, test costs/insurance coverage, logistical issues and lack of evidence-based clinical practice guidelines. Dermatopathologists have concerns regarding clinical validity/utility and inappropriate/overuse of some molecular tests. The importance of longitudinal education in molecular technologies and their applications for trainee and practicing physicians is highlighted.

Pharmacy Residency School-wide Match Rates and Modifiable Predictors in ACPE-accredited Colleges and Schools of Pharmacy

Objective. To analyze the modifiable predictors of institution-wide residency match rates. Methods. This was a retrospective analysis of colleges and schools of pharmacy data and school-wide PGY-1 pharmacy residency match rates for 2013 through 2015. Independent variables included NAPLEX passing rates, history of ACPE probation, NIH funding, academic health center affiliation, dual-degree availability, program length, admit-to-applicant ratio, class size, tuition, student-driven research, clinically focused academic tracks, residency affiliation, U.S. News & World Report rankings, and minority enrollment. Results. In a repeated measures model, predictors of match results were NAPLEX pass rate, class size, academic health center affiliation, admit-to-applicant ratio, U.S. News & World Report rankings, and minority enrollment. Conclusion. Indicators of student achievement, college/school reputation, affiliations, and class demographics were significant predictors of institution-wide residency match rates. Further research is needed to understand how changes in these factors may influence overall match rates.

Gender disparities in gastroenterology fellowship director positions in the United States

Despite a paucity of women occupying leadership positions in academic medicine, studies have shown a higher ratio of female representation in the program director position compared withdivision chief in multiple specialties. This study aims to determine whether this trend exists in 3-year gastroenterology fellowships in the United States and to evaluate for any factors that may affect these differences. In 2015, data were collected for the 163 U.S. gastroenterology fellowship programs including program director, associate program director, division chief, gender distribution, program size, academic center affiliation, and geographic region. A higher percentage of men than women held the role of program director (82% vs 18%), associate program director (72% vs 28%), and division chief (93% vs 7%). Women in program leadership held lower academic rank than their male counterparts (P< .0001). The program director was more likely to be female if the division chief also was female (P= .03). Programs with a higher number of trainees tended to be led by a female program director (P= .06). A gender disparity exists in all gastroenterology leadership roles, although the magnitude is smaller for program director and associate program director than the role of division chief. Further studies are needed to investigate the impact of this disparity on promotion and academic productivity.

Academic impact and rankings of neuroendovascular fellowship programs across the United States.

OBJECTIVE Publication has become a major criterion of success in the competitive academic environment of neurosurgery. This is the first study that has used departmental h index-and e index-based matrices to assess the academic output of neuroendovascular, neurointerventional, and interventional radiology fellowship programs across the continental US. METHODS Fellowship program listings were identified from academic and organization websites. Details for 37 programs were available. Bibliometric data for these programs were gathered from the Thomson Reuters Web of Science database. Citations for each publication from the fellowship's parent department were screened, and the h and e indices were calculated from non-open-surgical, central nervous system vascular publications. Variables including "high-productivity" centers, fellowship-comprehensive stroke center affiliation, fellowship accreditation status, neuroendovascular h index, e index ( h index supplement), h10 index (publications during the last 10 years), and departmental faculty-based h indices were created and analyzed. RESULTS A positive correlation was seen between the neuroendovascular fellowship h index and corresponding h10 index (R = 0.885; p < 0.0001). The mean, median, and highest faculty-based h indices exhibited positive correlations with the neuroendovascular fellowship h index (R = 0.662, p < 0.0001; R = 0.617, p < 0.0001; and R = 0.649, p < 0.0001, respectively). There was no significant difference (p = 0.824) in the median values for the fellowship h index based on comprehensive stroke center affiliation (30 of 37 programs had such affiliations) or accreditation (18 of 37 programs had accreditation) (p = 0.223). Based on the quartile analysis of the fellowship h index, 10 of 37 departments had an neuroendovascular h index of ≥ 54 ("high-productivity" centers); these centers had significantly more faculty (p = 0.013) and a significantly higher mean faculty h index (p = 0.0001). CONCLUSIONS The departmental h index and analysis of its publication topics can be used to calculate the h index of an associated subspecialty. The analysis was focused on the neuroendovascular specialty, and this methodology can be extended to other neurosurgical subspecialties. Individual faculty research interest is directly reflected in the research productivity of a department. High-productivity centers had significantly more faculty with significantly higher individual h indices. The current systems for neuroendovascular fellowship program accreditation do not have a meaningful impact on academic productivity.

Capsule Commentary on Gao, et al., Characteristics Associated with Patient-Centered Medical Home Capability in Health Centers: A Cross-Sectional Analysis.

T his study by Gao et al. examined characteristics of federally qualified health centers (FQHCs) to determine factors that were predictive of patient-centered medical home (PCMH) capability. The authors abstracted FQHC data from several sources and identified variables likely to be associated with PCMH capability. They then identified correlations between these HC characteristics and PCMH capability. Their results showed that the presence of an electronic health record (EHR), the number of types of financial performance incentives, and the number of types of hospital–health center affiliations were predictive of PCMH capability. The authors rated PCMH capability using the Safety Net Medical Home Scale (SNMHS) which was created by this research team using data from the 2009 Commonwealth Fund National Survey of Federally Qualified Health Centers. The data source for the three predictive characteristics identified in the study was the same survey used to create their capability assessment tool, the SNMHS. As the Commonwealth Fund Survey specifically assessed the presence and use of EHRs, it is not surprising that having an EHR in place was found to be predictive of greater PCMH capability based on the SNMHS. In addition, as the authors point out, identifying the EHR as a factor in predicting PCMH capability is less important given that, by 2014, 97 % of FQHCs had adopted an EHR. More interesting, however, are the findings that PCMH capability was associated with provider financial incentives and network affiliations. These data support the ongoing incorporation of PCMH and National Committee for Quality Assurance (NCQA) standards in both FQHC designation requirements and provider incentives. What remains unclear is how to properly align financial incentives to support increased PCMH capability. It is important to note that these authors evaluated PCMH capability, as assessed by their survey instrument, and did not include any patient-level outcomes. Assessment of PCMH achievement via outcomes rather than structural or process elements remains an essential yet elusive goal. Outcomes data related to FQHC PCMH implementation, including ongoing demonstration projects, will likely contribute substantially to the growing base of evidence related to the PCMH.

Inpatient Mortality Among Solid Organ Transplant Recipients Hospitalized for Sepsis and Severe Sepsis.

Solid organ transplant (SOT) recipients are at elevated risk of sepsis. The impact of SOT on outcomes following sepsis is unclear. We performed a retrospective cohort study using data from University HealthSystem Consortium, a consortium of academic medical center affiliates. We examined the association between SOT and mortality among patients hospitalized with severe sepsis or explicitly coded sepsis in 2012-2014. We used International Classification of Diseases, Ninth Revision (ICD-9) codes to identify severe sepsis, explicitly coded sepsis, and SOT (kidney, liver, heart, lung, pancreas, or intestine transplants). We fit random-intercept logistic regression models to account for clustering by hospital. There were 903 816 severe sepsis hospitalizations (39 618 [4.4%] with SOT) and 410 623 sepsis hospitalizations (14 526 [3.9%] with SOT) in 250 hospitals. SOT recipients were younger and more likely to be insured by Medicare than those without SOT. Among hospitalizations for severe sepsis and sepsis, in-hospital mortality was lower among those with vs those without SOT (5.5% vs 9.4% for severe sepsis; 8.7% vs 12.7% for sepsis). After adjustment, the odds ratio for mortality comparing SOT patients vs non-SOT was 0.83 (95% confidence interval [CI], .79-.87) for severe sepsis and 0.78 (95% CI, .73-.84) for sepsis. Compared to non-SOT patients, kidney, liver, and co-transplant (kidney-pancreas/kidney-liver) recipients demonstrated lower mortality. No association was present for heart transplant, and lung transplant was associated with higher mortality. Among patients hospitalized for severe sepsis or sepsis, those with SOT had lower inpatient mortality than those without SOT. Identifying the specific strategies employed for populations with improved mortality could inform best practices for sepsis among SOT and non-SOT populations.

Awareness of racial/ethnic disparities in surgical outcomes and care: factors affecting acknowledgment and action

BackgroundStudies have demonstrated racial/ethnic disparities in surgical outcomes and care. Surgeon awareness and its association with institutional action remain unclear. The study sought to assess surgeons' awareness of racial/ethnic disparities, ascertain whether demographic and practice factors influence acknowledgement of disparities, and determine whether surgeons are seeking to mitigate disparities. MethodsAnonymous online survey was administered to a random sample of American College of Surgeons (ACS) general surgeons (July 2013 to March 2014). Responses were weighted for nonresponse and risk-adjusted using logistic regression. Results172 surgeons completed the survey. Levels of acknowledged disparities were low. Less than one half reported institutional efforts to address disparities, and less than one fourth had taken efforts to investigate disparities in their personal practice. Several respondent factors including Academic Medical Center affiliation, awareness of the ACS statement on optimal access, and year of medical school graduation significantly associated with expressed acknowledgment of disparities. ConclusionsSuch associations speak to the need for continued efforts to promote enhanced provider awareness and participation. As the field of surgical disparities moves from understanding to action, we must acknowledge the contributing role that providers play.

Networks of Collaboration among Scientists in a Center for Diabetes Translation Research.

BackgroundTransdisciplinary collaboration is essential in addressing the translation gap between scientific discovery and delivery of evidence-based interventions to prevent and treat diabetes. We examined patterns of collaboration among scientists at the Washington University Center for Diabetes Translation Research.MethodsMembers (n = 56) of the Washington University Center for Diabetes Translation Research were surveyed about collaboration overall and on publications, presentations, and grants; 87.5% responded (n = 49). We used traditional and network descriptive statistics and visualization to examine the networks and exponential random graph modeling to identify predictors of collaboration.ResultsThe 56 network members represented nine disciplines. On average, network members had been affiliated with the center for 3.86 years (s.d. = 1.41). The director was by far the most central in all networks. The overall and publication networks were the densest, while the overall and grant networks were the most centralized. The grant network was the most transdisciplinary. The presentation network was the least dense, least centralized, and least transdisciplinary. For every year of center affiliation, network members were 10% more likely to collaborate (OR: 1.10; 95% CI: 1.00–1.21) and 13% more likely to write a paper together (OR: 1.13; 95% CI: 1.02–1.25). Network members in the same discipline were over twice as likely to collaborate in the overall network (OR: 2.10; 95% CI: 1.40–3.15); however, discipline was not associated with collaboration in the other networks. Rank was not associated with collaboration in any network.ConclusionsAs transdisciplinary centers become more common, it is important to identify structural features, such as a central leader and ongoing collaboration over time, associated with scholarly productivity and, ultimately, with advancing science and practice.

Associations between workplace affiliation and phlebotomy practices regarding patient identification and test request handling practices in primary healthcare centres: a multilevel model approach.

BackgroundClinical practice guidelines aim to enhance patient safety by reducing inappropriate variations in practice. Despite considerable efforts to enhance the use of clinical practice guidelines, adherence is often suboptimal. We investigated to what extent workplace affiliation explains variation of self-reported adherence to venous blood specimen collection regarding patient identification and test request handling practices, taking into consideration other primary healthcare centre and individual phlebotomist characteristics.MethodsData were collected through a questionnaire survey of 164 phlebotomy staff from 25 primary healthcare centres in northern Sweden. To prevent the impact of a large-scale education intervention in 2008, only baseline data, collected over a 3-month period in 2006–2007, were used and subjected to descriptive statistics and multilevel logistic analyses.ResultsIn two patient identification outcomes, stable high median odds ratios (MOR) were found in both the empty model, and in the adjusted full model including both individual and workplace factors. Our findings suggest that variances among phlebotomy staff can be largely explained by primary healthcare centre affiliation also when individual and workplace demographic characteristics were taken in consideration. Analyses showed phlebotomy staff at medium and large primary healthcare centres to be more likely to adhere to guidelines than staff at small centres. Furthermore, staff employed shorter time at worksite to be more likely to adhere than staff employed longer. Finally, staff performing phlebotomy every week or less were more likely to adhere than staff performing phlebotomy on a daily basis.ConclusionWorkplace affiliation largely explains variances in self-reported adherence to venous blood specimen collection guidelines for patient identification and test request handling practices among phlebotomy staff. Characteristics of the workplace, as well as of the individual phlebotomist, need to be identified in order to design strategies to improve clinical practice in this and other areas.

Oral health practices of state and non-state-funded licensed childcare centers in Wisconsin, USA.

Objectives:To determine whether there is a difference between state-funded childcare centers and non-state-funded centers in Wisconsin, USA, with regard to their oral health practices.Materials and Methods:This is a cross-sectional study using an internet-based survey. The participants were licensed childcare centers in Wisconsin, USA. Of the 1265 eligible childcare centers invited (centers providing day time care to children aged 2–5), 322 chose to participate. The main outcome measures were the practice of tooth brushing as a routine classroom activity, any educational practice related to oral health, any screening and referral practice related to oral health issues, and any practice related to dental emergencies. Mediating variables were profit status, center location, center affiliation, years of operation, licensed capacity, and child to staff ratio.Results:Of the 322 participating centers, 28 centers were classified as state-funded and 294 as non-state-funded. Logistic regression analysis revealed non-state-funded centers were three times [odds ratio (OR): 3.01; 95% confidence interval (CI): 1.23, 7.41] more likely to have some kind of oral health practice and five times (OR: 5.18; 95% CI: 2.17, 12.50) more likely to provide oral health education. However, state-funded centers were five times (OR: 5.09; 95% CI: 1.99–13.06) more likely to have tooth brushing as a routine classroom activity.Conclusion:There is a difference between the oral health practices of licensed childcare centers in Wisconsin. An increase in oral health practices of state-funded centers is warranted and could make a significant difference in the oral health of young children.

Impact of Academic Affiliation and Training on Knowledge of Hereditary Colorectal Cancer

Background: Knowledge about hereditary colorectal cancer (CRC) can aid cancer screening and prevention in high-risk patients. Genetic testing, once conducted primarily at academic centers, is now routinely performed in a variety of clinics. Nonacademic physicians may not be aware of hereditary CRC standards of care. Methods: From August to November 2012, a survey was administered to predominantly primary care physicians evaluating academic center affiliation, past training in genetics and knowledge regarding hereditary CRC. Results: One hundred forty physicians completed the survey. Knowledge of hereditary CRC was neither associated with academic affiliation nor with training during medical school or residency, but with continuing medical education (CME) training. Those with CME training were more likely to know that screening could be enhanced for patients with a hereditary cancer risk (OR = 4.49, 95% CI = 1.40-14.38) and that an individual with hereditary CRC would have different screening recommendations (OR = 7.49, 95% CI = 1.37-40.81). Residency training and CME training were associated with more frequent hereditary risk assessment. Conclusion: Genetics training may be associated with physicians' knowledge and assessment of hereditary CRC. Training at the CME level in particular may be integral to the delivery of genetic services in clinical practice.

Academic scientists’ affiliation with university research centers: Selection dynamics

University research centers have been institutionalized as a part of the science policy repertoire committed to strategic use of science and technology. Based on a representative sample of academic scientists and engineers in American research universities, this study investigates the selection dynamics, attempting to unfold the determinants of department-affiliated faculty members to be center affiliates. The findings suggest that university research centers select their affiliates on the basis of individual scientific and technical human capital. Scientists from prestigious departments are more likely to be center affiliates, so are prolific scientists, former postdoctoral scholars and the elder cohorts. In the meantime, university research centers are able to overcome the incentive incongruity with academic departments, as is evidenced by a higher likelihood among junior scientists to secure center connections. Dedicated to diversity and equity, university research centers provide a level playing field for women, minority and foreign-born scientists. The study concludes with a discussion of the scientific and technical human capital theory and policy implications in the science enterprise.

Participation in university-based research centers: Is it helping or hurting researchers?

In general, affiliation with a university research center is considered to be an activity that can improve the research activities of scientists and academics. Yet there have only been a few studies examining whether research centers are positive institutional structures for individual researchers. Our research examines how affiliation with a research center in the United States can impact research productivity, collaboration, and careers of faculty members in the multidisciplinary field of learning sciences. This study utilizes data from a curriculum vitae (CV) analysis of 402 faculty members who are currently employed at research universities. The results indicate that, on average, the research productivity of faculty members affiliated with a research center is higher than non-center affiliated faculty members. The effects, however, disappear when controlling for factors such as years since Ph.D., gender, post-doctoral status, quality of publications, and quantity of other research outputs. Senior tenured faculty members appear to benefit greatly from affiliation with a research center, while center affiliation does not positively correlate with the productivity of junior faculty members.

Quality of life, impaired vision and social role in people with diabetes: a multicenter observational study

Diabetic retinopathy may induce visual impairment. We evaluated vision-related quality of life in patients with visual acuity <5/10 in the better eye induced by retinopathy using the 25-item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25). The NEI VFQ-25 was self-administered to 196 patients in 3 Italian centres (A, B and C; n = 64, 61 and 71, respectively) dedicated to DR screening and treatment. Patients in the 3 centres did not differ by age, gender, occupation and diabetes duration. Multivariate analysis demonstrated that reduced visual acuity was associated with decreased scores for General Vision, Near Activities, Distance Activities, Visual-Specific Social Functioning, Mental Health, Role Difficulties and Dependency, Driving, Colour Vision and Peripheral Vision (p < 0.01, all). Treatment by photocoagulation was associated with reduced scores in General Health (-8.3; p = 0.002), General Vision (-7.2; p = 0.001), Visual-Specific Role Difficulties (-8.8; p = 0.015) and Driving (-13.7; p = 0.003). Centre affiliation was associated with different scores for General Health, Ocular pain, Distance Activities, Visual-Specific Social Functioning and Role Difficulties and Peripheral Vision. Women had higher scores for General Vision (p = 0.015), Near Activities (p = 0.005), Distance Activities (p = 0.006), Visual-Specific Social Functioning (p = 0.03), Visual-Specific Mental Health (p = 0.035) and Colour Vision (p = 0.012). Diabetic retinopathy and vision loss modify the way people perceive their own ability to function autonomously. More data should be collected to confirm this interpretation and to guide the development of more appropriate settings to improve approach and support to patients.

Factors Associated with False-Positive Results from Fingerstick OraQuick ADVANCE Rapid HIV 1/2 Antibody Test

Identify factors associated with false-positive rapid HIV antibody tests. This retrospective cohort study with nested case-controls involved patients tested for HIV by Boston Medical Center (BMC) affiliates. Cases had a reactive fingerstick OraQuick ADVANCE rapid HIV 1/2 antibody test and a negative Western blot. Controls had nonreactive rapid tests. We compared the prevalence of HIV risk factors between cases and the total nonreactive population and the prevalence of other clinical factors between cases and controls. Of the 15 094 tests, 14 937 (98.9%) were negative and 11 (0.07%) were false positives (specificity of 99.9%). Cases were more likely to have had an HIV-infected sex partner and to be tested at certain sites compared to true negatives. More cases than controls had O-negative blood type. O-negative blood type and sex with an HIV-infected person may increase false-positive HIV fingerstick results. More targeted studies should examine these risk factors.

HIV Health Center Affiliation Networks of Black Men Who Have Sex With Men

In the United States, black men who have sex with men (BMSM) are at highest risk for HIV infection and are at high risk for limited health service utilization. We describe HIV health center (HHC) affiliation network patterns and their potential determinants among urban BMSM. The Men's Assessment of Social and Risk Network instrument was used to elicit HHC utilization, as reported by study respondents recruited through respondent-driven sampling. In 2010, 204 BMSM were systematically recruited from diverse venues in Chicago, IL. A 2-mode data set was constructed that included study participants and 9 diverse HHCs. Associations between individual-level characteristics and HHC utilization were analyzed using Multiple Regression Quadratic Assignment Procedure. Visualization analyses included computation of HHC centrality and faction membership. High utilization of HHCs (45.9%-70.3%) was evident among BMSM, 44.4% who were HIV infected. Multiple Regression Quadratic Assignment Procedure revealed that age, social network size, and HIV status were associated with HHC affiliation patterns (coeff., 0.13-0.27; all P < 0.05). With the exception of one HHC, HHCs offering HIV prevention services to HIV-infected participants occupied peripheral positions within the network of health centers. High-risk HIV-uninfected participants affiliated most with an HHC that offers only treatment services. Subcategories of BMSM in this sample affiliated with HHCs that may not provide appropriate HIV prevention services. Using 2-mode data, public health authorities may be better able to match prevention services to BMSM need; in particular, HIV prevention services for high-risk HIV-uninfected men and HIV "prevention for positives" services for HIV-infected men.

Features of the sexual life during pregnancy

Background. The aim of our study was to evaluate Vilnius and Vilnius Region women’s knowledge about sexual intercourse during pregnancy. Materials and methods. The study included 94 women who were in the Center Affiliate of VUH Santariskiu Clinics after delivery. The women were interviewed using a questionnaire. They were divided in three groups by levels of education. Results. The study showed that 83% of pregnant women had sexual intercourse during pregnancy. 55.1% had coitus several times a month. The first trimester was the most frequent period of sexual intercourse (52.6%). 22.6% of pregnant women were at high risk of miscarriage and 61.9% of them have had sexual intercourse. The frequency of miscarriage in the sexually active group was 17.9% and in the non-active group it was 50% (p &lt; 0.05). All women who reported frequent sexual intercourse were not at threat for miscarriage compared to incidence of miscarriage of those 13 (22%) women who reported infrequent intercourse (p = 0.019). 79.8% of pregnant women were concerned about the adverse effects of sexual intercourse on pregnancy outcomes. 20.2% of the women thought that intercourse during pregnancy was safe. 63.8% of pregnant women were not asked by doctors during pregnancy about their sexual life. Conclusions. The majority (79.8%) of pregnant women were concerned about the adverse effects of sexual intercourse on pregnancy outcomes but even 83% of pregnant women had sexual intercourse during pregnancy. There were no statistical differences between women with different education level. Pregnant women were rarely asked by doctors about their sexual life.

Academic Faculty Affiliated with University Research Centers: Selection Dynamics

University research centers constitute a new part of the science policy repertoire committed to strategic use of science and technology and prove influential to individual career development. The existing literature casts much light on the challenges arising from managing centers and the potential benefits participants may receive, with little attention paid to the selection dynamics through which individuals gain affiliation with centers. The selection process not only shapes the extent to which centers fulfill their missions, but also structures the distribution of potential career benefits. Based on a representative sample of academic scientists and engineers in research extensive universities, this article investigates the dynamics of individual affiliation with centers. The findings suggest that university research centers represent a combination of cumulative advantage and equal treatment, reinforcing advantages on prolific scientists and those in prestigious departments and providing equal treatment for scientists with different demographic backgrounds. Instead of being career distractions, center affiliation proves more appealing to junior scientists than tenured peers. The study concludes with a discussion of the policy implications in the science enterprise.