Doctoral Research Articles

Comparison of Outcomes for Patients Treated by Allopathic vs Osteopathic Surgeons

There are 2 degree programs for licensed physicians in the US: allopathic medical doctorate (MD) and osteopathic doctorate (DO). However, evidence is limited as to whether outcomes differ between patients treated by MD vs DO surgeons. To evaluate differences in surgical outcomes and practice patterns by surgeon medical school training (MD vs DO). This retrospective cohort study used 100% Medicare claims data from inpatient hospitals providing surgical services from January 1, 2016, to December 31, 2019 among Medicare fee-for-service beneficiaries aged 65 to 99 years who underwent 1 of the 14 most common surgical procedures. Data analysis was performed from January 17, 2023, to August 13, 2024. Medical school degree (MD vs DO). The primary outcome was 30-day mortality, and the secondary outcomes were readmissions and length of stay. To assess differences between surgeons by medical school training, a multivariable linear probability model was used, which was adjusted for hospital fixed effects and patient, procedure, and surgeon characteristics. Of the 2 360 108 total surgical procedures analyzed, 2 154 562 (91.3%) were performed by MD surgeons, and 205 546 (8.7%) were performed by DO surgeons. Of 43 651 total surgeons, most surgeons were MDs (39 339 [90.1%]), the median (SD) age was 49.0 (9.8) years, and 6649 surgeons (15.2%) were female. The mean (SD) age of patients undergoing surgical procedures was 74.9 (6.7) years, 1 353 818 of 2 360 108 patients (57.4%) were female, and 2 110 611 patients (89.4%) self-reported as White. DO surgeons were significantly more likely to operate on older patients (DO patient mean [SD] age: 75.3 [7.1] years; MD patient mean [SD] age: 74.8 [6.6]), female patients (DO: 60.2% of patients; MD: 57.1% of patients), and Medicaid dual-eligible patients (DO: 10.3% of patients; MD: 8.6% of patients). DOs performed a lower proportion of elective operations (DO: 74.2% vs MD: 80.2%) and were more likely to work in public hospitals (DO: 10.3%; MD: 9.5%) and nonteaching hospitals (DO: 57.9%; MD: 68.1%). There was no evidence that 30-day mortality differed between MD and DO surgeons (adjusted mortality rate, DO: 1.61%; MD: 1.58%; absolute risk difference [aRD], -0.04 percentage points; 95% CI, -0.11 to 0.04; P = .37). On secondary analyses, no difference was found in 30-day readmissions or length of stay between MD and DO surgeons. In this retrospective cohort study using Medicare data, there was no evidence that patient outcomes differed between MD and DO surgeons for common operations after adjusting for patient factors and practice settings.

A unified educational space for internists and general practitioners (family doctors) as a way to improve the quality of training

The article examines the implementation of the principle of educational space unity, ensuring the quality of education throughout the Russia. We also describe the interdependence of practical health care needs for primary care specialists capable of providing high-quality primary care and the functions of an integrated system of a unified educational space for internists and general practitioners (family doctors) (GPs) focused on the social order.Aim. To analyze the conceptual foundations of the system of a unified educational space for internists and GPs (family doctors) as ways to improve the quality of training of specialists.Material and methods. The following were used in this study: analysis of educational trends in the modern world and medical education in particular; structural and functional analysis in the study of legislation regulating the training of internists and GPs (family doctors); a system approach that defines the components of a unified educational space for in ternists and GPs (family doctors); a method for predicting changes in the de velopment of a unified educational space for internists and GPs (family doctors).Results. Having considered the potential capabilities of a unified educational space for internists and GPs (family doctors), the following were revealed: regulatory, social, educational, managerial factors influencing the training of internists and GPs (family doctors) were identified; strategies for the development of a unified educational space for internists and GPs (family doctors) were determined at the level of goals, content, processes, and results; the relationship between the training of internists and GPs (family doctors) and the needs of practical healthcare was established; the internal components and functions of a unified educational space for internists and GPs (family doctors) have been identified and substantiated, and the framework factors have been defined. A theoretical model of a unified educational space for internists and GPs (family doctors) has been created, including external factors, target, motivational, design, content, managerial and evaluative components, as well as planned results, manifested in the functions.Conclusion. To summarize, we can state the following: for effective and high-quality management training of internists and GPs (family doc tors), a unified educational space is of paramount importance, this will make it possible to preserve the best traditions of the country's therapeutic school and its future development.

A unified educational space for internists and general practitioners (family doctors) as a way to improve the quality of training

The article examines the implementation of the principle of educational space unity, ensuring the quality of education throughout the Russia. We also describe the interdependence of practical health care needs for primary care specialists capable of providing high-quality primary care and the functions of an integrated system of a unified educational space for internists and general practitioners (family doctors) (GPs) focused on the social order.Aim. To analyze the conceptual foundations of the system of a unified educational space for internists and GPs (family doctors) as ways to improve the quality of training of specialists.Material and methods. The following were used in this study: analysis of educational trends in the modern world and medical education in particular; structural and functional analysis in the study of legislation regulating the training of internists and GPs (family doctors); a system approach that defines the components of a unified educational space for in ternists and GPs (family doctors); a method for predicting changes in the de velopment of a unified educational space for internists and GPs (family doctors).Results. Having considered the potential capabilities of a unified educational space for internists and GPs (family doctors), the following were revealed: regulatory, social, educational, managerial factors influencing the training of internists and GPs (family doctors) were identified; strategies for the development of a unified educational space for internists and GPs (family doctors) were determined at the level of goals, content, processes, and results; the relationship between the training of internists and GPs (family doctors) and the needs of practical healthcare was established; the internal components and functions of a unified educational space for internists and GPs (family doctors) have been identified and substantiated, and the framework factors have been defined. A theoretical model of a unified educational space for internists and GPs (family doctors) has been created, including external factors, target, motivational, design, content, managerial and evaluative components, as well as planned results, manifested in the functions.Conclusion. To summarize, we can state the following: for effective and high-quality management training of internists and GPs (family doc tors), a unified educational space is of paramount importance, this will make it possible to preserve the best traditions of the country's therapeutic school and its future development.

Diversity Differences Among Cardiovascular Fellowships Across Five Geographic Regions in the United States.

Introduction Diversity and inclusion in cardiovascular fellowships are necessary for addressing the healthcare needs of diverse patient populations. However, regional disparities in the diversity of these programs persist, diminishing efforts to create a representative workforce. We observe the regional differences in the diversity of cardiovascular fellowship programs, focusing on gender, doctorate designation, and graduation within the United States (US) or other. We hypothesized that males, medical doctors (MD), and US graduates would be in majority across all regions. Methods Data for cardiovascular fellowships from the Fellowship and Residency Electronic Database Access (FREIDA) system for the matriculation year 2022-2023 was obtained to assess the representation of male vs female gender, MD vs osteopathic doctor (DO) designation, and US vs non-US graduate. We then compared these backgrounds to five defined regions (Midwest, Northeast, Southeast, Southwest, and West)in the United States to define representation for backgrounds across geographic areas. Statistical significance was determined by p<0.05 with the use of SAS Studio 3.8, version 9.4 (Cary, NC: SAS Institute, Inc.), and Wilson score for confidence intervals. Results We found significant disparities across all background factors for all regions. This includes that females, DOs, and non-US graduates were underrepresented among Midwest, Northeast, Southeast, Southwest, and West regions, and the p-value was <0.001 for all variations. Specificallyfor Midwest, the female frequency was 155 (23.81%; CI: 21, 27; p<0.001), DO frequency was101 (15.51%; CI: 13, 19; p<0.001), and non-US graduate frequency was 206 (31.84%; CI: 28, 36; p<0.001). For Northeast, the female frequency was 231 (29.62; CI: 27, 33; p<0.001), DO frequency was 72 (9.22; CI: 7, 11; p<0.001), and non-US graduate frequency was 239 (30.68; CI 28, 34; p<0.001). For Southeast, the female frequency was 178 (25.99; CI: 23, 29; p<0.001), DO frequency was 67 (9.78; CI: 8, 12; p<0.001), and non-US graduate frequency 279 (41.46; CI: 38, 45; p<0.001). For Southwest, the female frequency was 74 (26.71; CI: 22, 32; p<0.001), DO frequency was 21 (7.58; CI 5, 11; p<0.001), and non-US graduate frequency was 110 (39.71; CI: 34,46; p<0.001). For West, the female frequency was 107 (31.75; CI 27, 37; p<0.001), DO frequency was 15 (4.45; CI: 3, 7; p<0.001), and non-US graduate frequency was 54 (16.07; CI: 13, 20; p<0.001). Conclusion We emphasize the regional disparities for females, DOs, and non-US graduates within cardiovascular fellowships in the past matriculation year. Understanding that we have not reached diversity goals allows for further reflection and implementation of targeted interventions and initiatives aimed at promoting equal opportunities for applicants. This is true for all regions of the United States. By addressing these disparities, fellowship programs can more effectively mirror the diverse patient populations they serve and foster a healthcare environment that is inclusive and accommodating. This, in turn, contributes to the overall enhancement of healthcare outcomes.

Safety of clinical engineer-assisted percutaneous coronary intervention

Percutaneous coronary intervention (PCI) requires multiple staff members, including interventional cardiologists, with the physical burden of heavy protective measures to minimize radiation exposure. Here, we aimed to investigate the safety of task sharing with clinical engineers (CEs) working as 1st assistant during ad hoc PCI. We retrospectively included 286 patients who underwent ad hoc PCI following diagnostic catheterization for coronary artery disease between April 2019 and March 2021. Procedural complications including coronary perforation or rupture, myocardial infarction, cerebral embolism, cardiovascular death, decreased kidney function, and radiation parameters were compared between the two clinical settings [CE group, CEs as the 1st assistant from the beginning of diagnostic coronary angiography to the end of PCI vs. doctor (DR) group, others]. There was no increase in the ratio of procedural complications in the CE group (1.7%) versus the DR group (1.2%). Fluorescence time and radiation exposure dose were significantly reduced in the CE group {25 min [interquartile range (IQR), 19–35 min] vs. 28 min (IQR, 20–39 min), P = 0.036; 908 mGy (IQR, 654–1326 mGy) vs. 1062 mGy (IQR, 732–1594 mGy), P = 0.049}. The median amount of contrast medium was significantly reduced in the CE group [100 mL (IQR, 80–119 mL) vs. 110 mL (IQR 90–140 mL), P < 0.001]. After propensity matching, fluorescence time, radiation exposure dose, and contrast medium amount were similar between groups. Task sharing with CEs as the 1st assistant during ad hoc PCI could contribute to clinical safety in patients with coronary artery disease.

COVID-19 Infectious Disease Prevention and Mitigation Practices by Chiropractic Physicians and Licensed Massage Therapists in Mississippi: A Needs Assessment to Inform Health Education and Promotion

ObjectiveThe purpose of this study was to assess self-reported infection prevention processes and their effect on businesses of chiropractic doctors (DCs) and licensed massage therapists (LMTs) in Mississippi during the COVID-19 pandemic. MethodsWe developed a survey that was electronically delivered to all licensed DCs and LMTs in Mississippi between August and September 2020. Assessments were made using Qualtrics software, with data management and subsequent analysis including Pearson's χ2 test. ResultsResponses were based on 32 of 323 DCs and 69 of 934 LMTs that were still seeing patients through the pandemic (n = 101, response rate 8%). The DC and LMT practitioners (94%) used treatment table and/or surface sanitizing (91.8%) and hand washing and/or sanitizing (89.8%) between all patients. Female practitioners reported practicing handwashing for at least 20 seconds, whereas male practitioners reported practicing handwashing for at least 15 seconds (P < .001). DCs were more likely to report using gloves for personal protective equipment, and LMTs were more likely to report using face masks (P < .001). Other COVID-19 procedures included limiting practice to acute care (82.5%), checking all patient temperatures (62.9%), sign-in and wait in the car (53.2% LMT vs 6.5% DC, P < .001), and prohibiting all nonpatient visitors (87.7% LMTs vs 9.4% DCs, P < .001). DCs (96.9%) and LMTs (89.9%) reported making referrals for COVID-19 testing or treatment when indicated. LMTs (82.3%) reported seeing fewer patients (P = .03), and older practitioners reported the most economic impact (P = .003) by the pandemic. Patient concerns and LMTs needing more time to perform infection control (P = .04) were reasons cited by practitioners for the reduced number of visits seen. ConclusionMost respondents had moderate to high compliance with guidelines on recommended infection prevention processes during fall 2020 of the COVID-19 pandemic. This assessment of compliance may be used to help guide future health education and promotion research of disease prevention and mitigation as well as physical and economic burdens faced by DCs and LMTs in Mississippi during a pandemic.

Collective achievement and resistance: Understanding the motivations of doctoral women of color.

Collective achievement and resistance: Understanding the motivations of doctoral women of color.

Announcement of doctoral theses

Announcement of doctoral theses

Памяти Александра Сергеевича Илюшина

Provides information about the deceased Alexander Sergeevich Ilyushin - Doctor of Physical and Mathematical Sciences, professor, Head of the Chair of Solid State Physics, Faculty of Physics, Lomonosov Moscow State University, Honored Professor of Lomonosov MSU, a full member of the Russian Academy of Natural Sciences, a well-known specialist in the field of structural solid state physics: basic biographical data, training at the Physics Faculty of Lomonosov MSU, postgraduate studies and work at the Solid State Physics Chair of Moscow State University, defense of candidate and doctoral dissertations, authorship of hundreds of scientific works, dozens of monographs and textbooks, pedagogical activity, leadership of the Solid State Physics Chair of MSU, membership in the academic councils of the Physics Faculty, participation and organization of Russian and international conferences, editorial scientific journals, creation and management of the Museum of History of the Physics Faculty of MSU, membership in the Russian Academy of Natural Sciences, management of its Division, creation and management of the Union of Philatelists of Russia, participation and organization of Russian and international philatelic exhibitions and conferences.

An Overview of Writing Rubrics in Doctoral Dissertations in Turkey

Writing rubrics have been used in doctoral dissertations in Turkey to assess student writing for nearly twenty years. This study aims to determine which features are assessed in the rubrics used in doctoral dissertations. Twenty-five rubrics were selected to determine the analysis of validity and reliability, rubric dimensions, features of criterion descriptions, and performance levels. The results showed that researchers did not attach much importance to the validity of rubrics, and some studies provided insufficient information about reliability. Rubrics typically have three and five performance levels. As a result of the content analysis based on the descriptions, nine categories (genre-oriented content, organization, style, presentation, mechanics, vocabulary, sentences, textuality, process) and 104 features were identified. The frequency of these features was 567. According to the emerging categorization in the present study, we observed that the rubrics used in doctoral dissertations were similar to the criteria in the 6 +1 Trait Writing Model. However, the descriptions were found to be more straightforward and concise. The features in the rubrics were similar to one another yet differed depending on the purpose, type, and length of descriptions. Some of the rubrics had descriptions that were ill-suited to the nature of the rubric. The results were discussed, presenting recommendations.

A Narrative Inquiry about the Experience of ‘Self-Care’ of Elementary School Teachers Conducting Doctoral Courses in Art Education

A Narrative Inquiry about the Experience of ‘Self-Care’ of Elementary School Teachers Conducting Doctoral Courses in Art Education

Announcement of doctoral theses

Announcement of doctoral theses

David Tracy on fragments, fragmentation, and frag-events: On picking up a conversation

This contribution offers a review of David Tracy’s recent collection of essays entitled Fragments: The Existential Situation of Our Time (2020). This volume is quite an event since Tracy’s last monograph was published in 1994. This review gives an account of the continuity and discontinuity in Tracy’s oeuvre with reference to themes such as conversation, fragments, the Infinite, and an analogical imagination. It also mentions some other jewels found in Fragments by picking up on a conversation with Tracy that started with the author’s doctoral thesis on Tracy, completed in 1992.

Cracks in Doctoral STEM Mentoring Relationships: Students’ Perceptions

Cracks in Doctoral STEM Mentoring Relationships: Students’ Perceptions

Escultura cinética en Quito: Precursores y cinetistas.

&lt;p&gt;Ciertamente existen expresiones artísticas de orden cinético en la ciudad de Quito, Ecuador; sin embargo, tales manifestaciones han sido poco estudiadas en su integralidad, razón por la cual el autor de este artículo ha considerado oportuno, más aún en su condición de ciudadano y escultor quiteño, levantar información bibliográfica y de campo que aporte a la documentación, sistematización, visibilización y futuro debate del tema en cuestión; en ello, la presente investigación recoge parte de los resutados obtenidos de la tesis doctoral sobre “Escultura cinética en acero estructural, el movimiento como agente mediador entre obra de arte y espectador”, actualmente en proceso, que aporta sobre dicho tema la debida contextualización en el panorama global y, en concreto, sobre el arte cinético ecuatoriano. La información ofrecida, en lo posible, se presenta libre de especulaciones o juicios de valor, los que quedarán a cargo, hipotéticamente, de futuros emprendimientos de orden teórico y crítico realizados por terceros.&lt;/p&gt;

Multidimensional meanings of studying abroad : international mobility experiences of Taiwanese joint dual doctoral program students in Belgium

Promoting dual doctoral degree programs is a critical strategy adopted to not only internationalize Taiwan's higher education system but also improve the low enrollment rates in doctoral programs in the country. However, limited research attention has been paid to the experiences of Taiwanese students enrolled in dual degree programs. Therefore, the present study adopted a qualitative approach to explore the experiences of Taiwanese students enrolled in a Taiwanese-Belgian joint dual doctoral program. A total of seven Taiwanese students and Belgian scholars participated in this study. The findings indicated that all student informants intended to study abroad before deciding to participate in the joint dual doctoral program; however, due to time and money restrictions, they participated in the joint dual doctoral programs established by their home universities in Taiwan. This study highlighted that students were motivated to participate in international, cooperative doctoral programs because obtaining dual learning experiences at both domestic and overseas universities differentiated them from purely domestic doctoral students. In this manner, the experience of studying abroad enhances their unique value in the academic market. While studying abroad, intercultural communication, in addition to differences in doctoral training schemes and supervision styles, were vital challenges that affected student informants' learning experiences and adaptation to life. During this process, the students constructed their adaptation and negotiation strategies to address those challenges. These strategies made them (re)define and (re)confirm their academic positions and identities. However, the limited period for studying abroad reduced students' motivation to participate and engage in local activities and establish social networks with local residents and friends in the host society. Moreover, the public and academic colleagues' limited understanding of the joint dual doctoral program may not only negatively affect students' academic mobility in terms of obtaining positions in the academic market but also influence prospective students' willingness to participate in such programs. Moreover, this study provides constructive suggestions for the development of joint dual doctoral programs on the basis of students' own practical experiences. Finally, the study's limitations and suggestions for future research are discussed.

Announcement of doctoral theses

Announcement of doctoral theses

Announcement of doctoral theses

Announcement of doctoral theses

Announcement of doctoral theses

Announcement of doctoral theses

MORPHOLOGICAL MARKING IRREGULARITY OF BAHASA INDONESIA AND THE ACQUISITION OF ENGLISH WORDS

All languages share the same lexical categories. Unlike English, however, Bahasa Indonesia carries fewer consistent patterns of morphological markers for word categories. A verb, for instance, is marked with the prefix {me-} as in me- nginjak (to step on); however, other verbs do not carry this marker as in makan (eat), tidur (sleep), and tergantung (depend). As for English, the suffix {-ing} or {-ed/-en}, for instance, indicates that the root is a verb regardless of the verb transitivity. This research investigated if the irregularity in the morphological marking of Bahasa Indonesia verbs created problems in acquiring English words. A test of the "word category assignment" (Test 1) was provided to two groups of respondents: undergraduate students of English and doctoral students of Bahasa Indonesia. And, "word-in-context translation into English" (Test 2) was given to a group of undergraduates of English group. The first was to know if the respondents managed to assign the Bahasa Indonesia words with correct lexical categories, and the second was to know if the words were assigned with correct word categories when translated in English. This was to know if the Bahasa Indonesia and English words received the same word-category assignment. The results show that errors in the assignment of the grammatical categories of the Bahasa Indonesia words were found pervasive among the two groups. And the lexico-grammar behavior seems to give impact on the categorization of the Bahasa Indonesia words when provided in English as also detected in the translation. It is strongly indicative that confusion in the word category assignment of Bahasa Indonesia gives impact on the acquisition of English words.