Total Number Of Men Research Articles

Gender Composition in Biomedical Research Grant Submissions and Grant Review Panels Before Versus During the COVID-19 Pandemic.

Purpose: This study examined the gender composition of career development award applicants and grant review panels during the pandemic compared with that beforehand. Methods: Data were collected from 14 Health Research Alliance (HRA) organizations, which fund biomedical research and training. HRA members provided the gender of grant applicants and grant reviewers during the pandemic (April 1, 2020, to February 28, 2021) and prepandemic (April 1, 2019, to February 29, 2020). The signed-rank test compared medians and the chi square test compared the overall gender distribution. Results: The total number of applicants was similar during the pandemic (N = 3,724) and prepandemic (N = 3,882) periods, as was the percentage of women applicants (45.2% pandemic vs. 44.9% prepandemic, p = 0.78). The total number of men and women grant reviewers declined during the pandemic (N = 856) compared with that pre-pandemic (N = 1,689); this decrease was driven by a change for the largest funder. Also driven by changes for this one funder, the percentage of total grant reviewers who were women increased significantly during the pandemic (45.9%) compared with that during prepandemic (38.8%; p = 0.001), but the median percentage of women grant reviewers across organizations remained similar during the pandemic (43.6%) and prepandemic periods (38.2%; p = 0.53). Conclusions: In a sample of research organizations, the gender composition of grant applicants and grant review panels remained similar, except for the review panel composition for one large funder. Given evidence from other studies that have revealed gender differences in other career and life experiences of scientists during the pandemic, ongoing evaluation of women's representation in grant submission and review mechanisms is essential.

Effect of Prescription Drug Monitoring Programs on Testosterone Prescriptions

ABSTRACT Introduction Symptoms of testosterone deficiency are increasingly prevalent in the aging male population. Oftentimes, this is managed medically with exogenous testosterone supplementation. Pharmacologic testosterone is classified as a schedule III controlled substance by the Food and Drug Administration. In recent years, many states have implemented prescription drug monitoring programs (PDMP) to help track the prescribing and dispensing of controlled substances in an effort to curb the opioid epidemic. Many states also require a provider query of an online system prior to prescribing controlled medications, which has led to a reduction in opioid prescriptions. Objectives We sought to determine if the implementation of a state mandated query of PDMP prior to prescribing testosterone impacted provider prescribing behavior. Methods State PDMP requirements were determined by examining state regulatory websites. Only states who had recently implemented PDMP query mandates (since 2016) for testosterone were included. Using an insurance claims database, we evaluated all men aged 40-70 in each state who were enrolled for at least 1 year and did not move to another state during follow up. From this, a sub-cohort of men who enrolled within 3 and 6 months before and after the start date of their respective state's mandate in attempt to identify any immediate effect. Men were also stratified by race/ethnicity (White, Black, Hispanic, Asian) to observe any demographic trend. In a similar fashion, the total number of men who ever or never filled prescriptions for testosterone were identified. Rates before and after mandate implementation were compared using the generalized estimating equations test. Results 11 states (AK, CA, FL, HI, MI, NM, NV, PA, SC, WI, WY) were identified has having recent PDMP mandates for testosterone. A total of 2,297,290 men who met enrollment criteria were identified. Rates of testosterone prescriptions varied around the country (from 5.02 to 32.80 per 1000 person years). Moreover, there were no consistent changes in the rates of testosterone prescriptions after mandate implementation, regardless of the timeframe evaluated. Testosterone prescriptions increased in a majority of the states after implementation of a PDMP mandate (6 of 11 states, p<0.05) or showed no change (3 states). South Carolina and Wisconsin showed a decrease in the number of prescriptions after mandate implementation (p<0.05). While differences in the rates of testosterone prescriptions existed between races, the association with PDMP mandates were similar to the statewide analyses. Conclusion The implementation of state mandated PDMP query prior to prescribing testosterone does not appear to have a reliable effect on testosterone prescription patterns. Men with symptomatic hypogonadism do not appear to be negatively affected by new regulatory controls largely meant to curb opioid prescriptions. Disclosure No

Gender differences in solo entrepreneurship in modern countries

Aim of the study is to evaluate the indicators describing the level of solo entrepreneurship among women and men who are beginning entrepreneurs in different countries. Empirical data provided in the Global Entrepreneurship Monitoring Project for fifty-nine countries were used as initial information in calculations. Economic and mathematical modeling was based on development of density functions normal distribution. In the study, three indicators describing solo entrepreneurship in 59 countries were evaluated: share of solo entrepreneurs-women in the total number of women who participate in the creation of their own businesses in different countries; share of solo entrepreneurs-men in total number of men who participate in creation of their own businesses in different countries; ratio of the above-mentioned shares of solo entrepreneurs of women and men. Average values and ranges of changes in considered indicators were determined, which are typical for most countries. In addition, national economies that are characterized by high and low values of each of the three indicators were identified. The study showed that there is a gender gap in the values of indicators in most countries. It is proved that share of women involved in solo entrepreneurship in most countries is higher than that of men.

Disability adjusted life years lost due to acute, chronic disability and premature death in arterial hypertension

ResumenObjetivo:Determinar la vida saludable perdida por hipertensión arterial sin diabetes mellitus.Método:La vida saludable perdida se determinó a partir de la discapacidad crónica (enfermedad renal crónica, cardiopatía y evento vascular cerebral), la discapacidad aguda (crisis hipertensiva y emergencia hipertensiva) y la muerte prematura. Se identificaron la edad del diagnóstico, la edad de la complicación, la prevalencia de la complicación, la duración del evento agudo, el número de eventos agudos, el tiempo vivido con hipertensión, la edad de la muerte y la esperanza de vida. En todos los casos se aplicó una tasa de descuento del 3%. La estimación se realizó por 100,000.Resultados:Cuando se utilizó como referencia el total de mujeres, la vida saludable perdida en ellas es de 198,498.28. Empleando como referencia el total de hombres, el valor para ellos es de 204,232.13. Si el referente es el total de la población, para las mujeres la vida saludable perdida es de 102,028.11 y para los hombres es de 99,256.98.Conclusiones:La vida sWaludable perdida por hipertensión arterial sin diabetes es diferente en hombres y mujeres; no obstante, tiene muchas aristas que deben abordarse.

A Retrospective Study on 1587 Exotic Pets Presented to The Small Animal Veterinary Hospital, University of Tehran

In recent decades, exotic pets are increasingly invited to homes with a wide range of variation in species and requirements that are more specialized. During a one-year period, 2408 exotic animals admitted to the Small Animal Veterinary Hospital, University of Tehran were assessed. Rabbits, hamsters, squirrels, turtles/tortoises, guinea pigs, lizards, hedgehogs, reindeer, monkeys, and snakes were referred, respectively. Owner referral cause and their gender in addition to the disease diagnosis were analyzed. While no statistical significance (P>0.05) was observed in the total number of men and women presenting these animals, gender-based preferences were spotted for owning specific types of animal species in this study (P<0.05). Furthermore, analysis showed that snakes and rabbits were more commonly (P<0.05) presented for checkup; while chelonians, lizards, hedgehogs, and monkeys were more presented with health problems (P<0.05). Other animals’ results did not show statistically significant difference for admission reasons (P>0.05). The health record assessment included 1587 animals with complete health files. The most common diseases diagnosed in most of these animals were metabolic bone disease/musculoskeletal problems and dental problems. In addition, eye problems in chelonians and urinary problems in hedgehogs were the most common diagnosis of those species. In conclusion, since the most common health problems of most participating animals were associated with mismanagement and inappropriate diet, it is highly recommended that owners be thoroughly educated by veterinarians to reduce the possibility of such conditions in exotic captive animals.

Development of Algorithm of Surgical Treatment Choice in Patients with Cataract and Asteroid Hyalosis

The method of phacovitrectomy can be used for surgical treatment of patients with cataract and asteroid hyalosis. However, there is still a topical question in the choice of surgical treatment taking into account the completeness of the posterior hyaloid membrane (PHM) detachment.Patients and methods: the study involved 24 patients (24 eyes) with cataract and asteroid hyalosis. The average age of patients was 72.9 years, out of the total number of men — 11, women — 13. Pre-and postoperative diagnosis of all patients included standard methods of investigation, as well as optical coherence tomography performed on the Cirrus HD-OCT 400, Carl Zeiss, Germany. Pre-and postoperative subjective satisfaction was assessed using a validated visual Function Qusetionnaire 14 ophthalmological questionnaire. Patients were divided into 3 groups. In the first group of patients, cataract phacoemulsification with posterior chamber lens implantation and total three-port vitrectomy through a flat part of the ciliary body were performed. In the second patients’ group, cataract phacoemulsification with posterior chamber lens implantation and subtotal vitrectomy through posterior capsulorexis were performed. In the third group of patients, cataract phacoemulsification with posterior chamber lens implantation was performed. All operations were performed with the help of ophthalmic systems Infinity Vision System (Alcon, USA) and Constellation Vision System (Alcon, USA).Results: in the first day after the operation, all patients noted improvement in visual acuity and quality of life, but more significant improvement was noted in patients of the first and second groups.Conclusion: analysis of the results of surgical treatment, questionnaire survey, preoperative diagnosis allowed to develop an algorithm for choosing the method of surgical treatment in patients with cataract and asteroid hyalosis, taking into account the state of PHM.

Morbimortalidade por doenças oncohematológicas no Brasil entre 2002 e 2016

Objetivo: Analisar a tendência temporal de morbimortalidade por doenças oncohematológicas no Brasil, entre 2002 e 2016. Métodos: Estudo descritivo de série temporal. Os dados foram extraídos dos sistemas nacionais de informação de Mortalidade e Internações Hospitalares, no período de 2002 a 2016, analisados no Excel e software STATA. Resultados: De modo geral, observou-se uma tendência crescente nas taxas de mortalidade e morbidade hospitalar por doenças oncohematológicas no Brasil entre 2002 e 2016. Para os óbitos, houve incremento anual de 0.04 óbitos/ano por Leucemias, de 0.03/ano por Linfomas e de 0.04/ano por Mieloma, estatisticamente significante (P=0.000). O número total de homens falecidos por essas doenças foi superior ao de mulheres e as taxas de óbitos foram, para ambos os sexos, crescentes com a idade. As maiores taxas de hospitalização foram encontradas nos idosos, com maior proporção de atendimentos em caráter de urgência e diagnóstico principal de leucemias. As regiões Sul e Sudeste concentram quase 70% das mortes e das internações, porém houve um incremento importante nessas taxas no Nordeste. Conclusão: Os dados mostram o perfil das mortes e hospitalizações causadas por doenças oncohematológicas, sua distribuição regional e reafirmam a sua importância para a avaliação dos serviços de saúde em oncologia.

Thoracoscopic lobectomy with mediastinal lymph node dissection as a standard surgery for T1-2N0M0 non-small cell lung cancer (>300 surgeries experience)

BackgroundA lot of clinics worldwide in recent years recommend the use of minimally invasive surgical procedures in the early stages of lung cancer claiming that this technique helps reduce the number of postoperative complications, shortens the period of social rehabilitation of patients, without significantly affecting the long-term results of treatment. In this study we evaluate immediate and long-term results of surgical treatment of patients with early stages of non-small cell lung cancer (NSCLC) after video-assisted thoracoscopic lobectomy (VATS) with mediastinal lymph node dissection.Materials and methodsSince 2008 317 patients with T1-2N0M0 NSCLC over 20 (median age was 65.3 ± 2.5) years underwent VATS with mediastinal lymphadenectomy. Total number of men was 186 (58.7%), women – 131 (41.3%). Histologically verified adenocarcinoma was in 278 (87, 7%), Squamous cell carcinoma in 39 (12.3%). A group of patients who underwent thoracotomy lobectomy (n = 189) was taken to compare immediate and long-term results. Median age in this group was 66.5 ± 1.7. Total number of men was 115, women – 74. Histologically verified adenocarcinoma was in 154 (82.4%), Squamous cell carcinoma in 35 (17.6%).ResultsConversion to thoracotomy during VATS was in 14.3% of surgeries. There was no postoperative mortality in VATS group, whereas in open surgeries this happened in 2.6%. The 3 and 5-year overall survival (OS) rate was 94.0% and 94.0% in the VATS group respectively, 83.0% and 78.0% in the thoracotomy group for clinical stage T1N0M0 NSCLC (p = 0.04554).ConclusionConsidering the results of our research and the literature review we made sure that VATS lobectomy with mediastinal lymph node dissection is an alternative procedure to open approaches: it is much safer, reduce the frequency of post-operative complications and the rehabilitation period. We believe that complete VATS lobectomy with mediastinal lymph node dissection must be taken as a standard in surgical treatment of patients with early stages of non-small cell lung cancer.

Gender Stereotypes in Science Education Resources: A Visual Content Analysis.

More men are studying and working in science fields than women. This could be an effect of the prevalence of gender stereotypes (e.g., science is for men, not for women). Aside from the media and people’s social lives, such stereotypes can also occur in education. Ways in which stereotypes are visible in education include the use of gender-biased visuals, language, teaching methods, and teachers’ attitudes. The goal of this study was to determine whether science education resources for primary school contained gender-biased visuals. Specifically, the total number of men and women depicted, and the profession and activity of each person in the visuals were noted. The analysis showed that there were more men than women depicted with a science profession and that more women than men were depicted as teachers. This study shows that there is a stereotypical representation of men and women in online science education resources, highlighting the changes needed to create a balanced representation of men and women. Even if the stereotypical representation of men and women in science is a true reflection of the gender distribution in science, we should aim for a more balanced representation. Such a balance is an essential first step towards showing children that both men and women can do science, which will contribute to more gender-balanced science and technology fields.

A Longitudinal Study Of The Utilization Of Resistance Training Facilities By Men And Women.

Resistance training is important for muscular strength and endurance, bone health, and metabolism. Despite its importance, women are participating in resistance training at lower rates than men. PURPOSE: To longitudinally determine the utilization rates of resistance training facilities within a recreation center on a university campus. METHODS: Five specific areas dedicated to resistance training were examined. Employees record hourly use by sex for each area. Usage rates were monitored for 5 distinct hours per day (morning, noon, peak, evening and peak female utilization) over a 21-month period. RESULTS: Table 1 contains the total number of men and women and the percentage of women using resistance training areas during the selected hours. Men primarily used the free weight room with women demonstrating usage rates of 5.4% or less. The core training area remains the most utilized area by women, (58.5% usage rate) during morning hours. CONCLUSIONS: The data collected from the longitudinal study show that women are not participating in resistance training in numbers close to their male counterparts. Despite the importance of resistance training for women for their health and well being, very few tend to participate in resistance training activities. A follow-up survey to examine the barriers that prevent women from participating in resistance training activities is next. Responses from the survey will serve to formulate interventions to promote women’s participation in resistance training activities.Table: No title available.

Association of Men's Awareness of Danger Sign of Obstetric Complication and Male Involvement’s in Birth Preparedness Practices at South Ethiopia

The Ethiopian Demographic and Health Survey (EDHS) indicate that maternal mortality in Ethiopia is one of the highest in the world. This death toll can be prevented partially through increasing awareness on danger sign of obstetric complications and birth preparedness practices for mother, husbands and other family members. Community based cross sectional study was done. Adult males with a wife or partner who had been through childbirth in the preceding 36 months were included in the study. Data was collected by pretested structured questionnaires and multi stage cluster sampling was used to reach 845 samples which were calculated by using StatCalc program of Epi Info 7. Collected data was cleaned and entered in to Epi Info 7 and exported to SPSS (IBM-20) for further analysis. Hierarchical logistic regression model and adjusted odds ratio with 95% confident interval were used to show association between men awareness and birth preparedness practices. The total numbers of men interviewed were 836 that makes response rate of 98.9%. Severe abdominal pain (87%) was the most recognized danger sign during pregnancy and 17.9% men involve in saving money. Forty two point two percent of men had awareness of danger sign and 9.4 %( 95% CI: (7.42, 11.4) of men involved in birth preparedness practice. Strong association between men awareness of danger sign of obstetric complications and involvements in birth preparedness practices persisted after adjusting for probable confounders. Thus respondents who had awareness of danger signs were two times (AOR: 1.91, 95% CI: 1.06, 3.41) more likely to involve in preparedness practice than respondents who had no awareness of danger signs of obstetric complication. The prevalence of men awareness of danger sign & involvement in birth preparedness practice was very low.

Sex- and gender-specific research priorities for the emergency management of heart failure and acute arrhythmia: proceedings from the 2014 Academic Emergency Medicine Consensus Conference Cardiovascular Research Workgroup.

The emergency department (ED) is the point of first contact for patients with acute heart failure and arrhythmias, with 1 million annual ED visits in the United States. Although the total numbers of men and women living with heart failure are similar, female patients are underrepresented in clinical studies, with current knowledge predominantly based on data from male patients. This has led to an underappreciation of the sex-specific differences in clinical characteristics and pathophysiology-based management of heart failure. Similar disparities have been found in management of acute arrhythmias, especially atrial arrhythmias that lead to an increased risk of stroke in women. Additionally, peripartum and postpartum cardiomyopathy represent a diagnostic and treatment dilemma. This article is the result of a breakout session in the cardiovascular and resuscitation work group of the 2014 Academic Emergency Medicine consensus conference "Gender-Specific Research in Emergency Medicine: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." A nominal group technique was used to identify and prioritize themes and research questions using electronic mail, monthly conference calls, in-person meetings, and Web-based surveys between June 2013 and May 2014. Consensus was achieved through three rounds of nomination followed by the meeting on May 13, 2014, and resulted in seven priority themes that are essential to the common complex clinical syndrome of heart failure for both men and women and include the areas of pathophysiology; presentation and symptomatology; and diagnostic strategies using biomarkers, treatment, and mortality, with special consideration to arrhythmia management and pregnancy.

Incidence and prevalence rates of diabetes mellitus in Taiwan: Analysis of the 2000–2009 Nationwide Health Insurance database

Formerly, Taiwan's diabetic population has been estimated by surveys conducted at irregular intervals and using different sampling methods. To obtain nationwide data on the incidence and prevalence of diabetes mellitus (DM) in Taiwan, we performed an analysis of the 2000-2009 claim data from the National Health Insurance (NHI) database. One-third of the claims in the NHI database from 2000 to 2009 were randomly sampled. DM was defined by three or more outpatient visits with diagnostic codes (ICD-9-CM: 250 or A code: A181) within 1 year or by one inpatient discharge diagnosis of DM. Confirmation of type 1 diabetes mellitus was based on the issue of a catastrophic illness certificate with the same diagnostic codes. Age and/or gender distribution for DM were determined. In accordance with the global trend for DM, with a near constant standardized incidence rate, there was a more than 70% increase in the total diabetic population, or a 35% increase in the standardized prevalence rate, in Taiwan from 2000 to 2009. The incidence of diabetes was higher in men, especially in the 20-59-year-old age group, and the total number of men with diabetes exceeded the number of women with diabetes in 2005. However, the prevalence and incidence rates in women over the age of 60 years were higher than those in men. Type 1 DM was present in less than 1% of the diabetic population in Taiwan. The incidence of diabetes, including type 1, remained stable over this 10-year period in Taiwan. However, the incidence rate in men aged 20-59 years was higher than that in age-matched women. With our nationwide database, subgroup analysis of DM incidence can be performed to refine our health policies for the prevention, screening, and treatment of diabetes mellitus.

Food for thought. What you eat depends on your sex and eating companions

In a naturalistic study, we investigated the influence of gender, group size and gender composition of groups of eaters on food selected for lunch and dinner (converted to total calories per meal) of 469 individuals (198 groups) in three large university cafeterias. In dyads, women observed eating with a male companion chose foods of significantly lower caloric value than those observed eating with another woman. Overall, group size was not a significant predictor of calories, but women's calories were negatively predicted by numbers of men in the group, while the numbers of women in the group had a marginally significant positive impact on calorie estimates. Men's calorie totals were not affected by total numbers of men or women. This study supports previous investigations, but is unique in making naturalistic observations.

Clinical aspects of hyperparathyroidism in Japanese multiple endocrine neoplasia type 1

We describe here the clinical aspects of hyperparathyroidism (HP) in Japanese multiple endocrine neoplasia type 1 (MEN 1). The total number of MEN 1 patients was 37, and they originated from ten unrelated Japanese families. Nine of the ten families were proven to have heterozygous germline mutations of the MEN 1 gene. The incidence of HP, pituitary tumors, and pancreatic tumors in 37 MEN 1 patients was 91.9%, 32.4%, and 45.9%, respectively. The age-related penetrances of HP were 50%, 79%, 84%, by 20, 30, and 40 years of age, respectively. Of these MEN 1 patients, we used 28 individuals, diagnosed with HP at our hospitals, to study the clinical aspects of MEN 1-associated HP. The mean age was 40 years, and the mean was much lower in the sporadic (non-MEN 1) HP patients. The mean levels of calcium, phosphate, and intact PTH were 10.8 mg/dL, 2.3 mg/dL, and 178.0 pg/mL, respectively, and these were not different from those of sporadic HP patients. The levels of intact PTH were positively correlated with age, suggesting that HP may be progressive with time in MEN 1. The percentage of symptomatic HP was 36% in MEN 1, whereas it was 55% in sporadic HP patients. Although histopathological findings revealed that all four parathyroid glands were involved in hyperplasia, imaging studies showed an enlargement of only the single parathyroid gland in most patients. The combination of total parathyroidectomy and autoplantation succeeding in improving HP in MEN 1.

Dr. Moberg and Colleagues Reply

Back to table of contents Previous article Next article Letter to the EditorFull AccessDr. Moberg and Colleagues ReplyPAUL J. MOBERG, PH.D., RICHARD L. DOTY, PH.D., BRUCE I. TURETSKY, M.D., STEVEN E. ARNOLD, M.D., RICHARD N. MAHR, PSY.D., RUBEN C. GUR, PH.D., WARREN BILKER, PH.D., and RAQUEL E. GUR, M.D., PH.D., PAUL J. MOBERGSearch for more papers by this author, PH.D., RICHARD L. DOTYSearch for more papers by this author, PH.D., BRUCE I. TURETSKYSearch for more papers by this author, M.D., STEVEN E. ARNOLDSearch for more papers by this author, M.D., RICHARD N. MAHRSearch for more papers by this author, PSY.D., RUBEN C. GURSearch for more papers by this author, PH.D., WARREN BILKERSearch for more papers by this author, PH.D., and RAQUEL E. GURSearch for more papers by this author, M.D., PH.D., Philadelphia, Pa.Published Online:1 Oct 1998https://doi.org/10.1176/ajp.155.10.1463aAboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: We appreciate the opportunity to respond to the comments of Good and colleagues. To clarify the gender composition of our study group, there were 12 male and eight female younger patients, 13 male and seven female younger comparison subjects, five male and 13 female older patients, and six male and 14 female older comparison subjects. While there was a difference in gender distribution by age, there was no difference in the total numbers of men and women studied. The lack of a main effect of gender on performance on the University of Pennsylvania Smell Identification Test cannot, therefore, be explained by an unequal distribution of male and female subjects. Concerning the interaction between gender and diagnosis, we reanalyzed our data as suggested by Good and colleagues. Our findings do not support their contention that “sex differences in olfactory function in schizophrenia are age related.” While we observed main effects of diagnosis (F=83.04, df=1, 70, p<0.0001), age (F=55.78, df=1, 79, p<0.0001), and a diagnosis-by-age interaction (F=43.43, df=1, 70, p<0.0001), there was no evidence for a main gender effect (F=1.23, df=1, 70, p=0.27), a gender-by-diagnosis interaction (F=1.79, df=1, 70, p=0.19), or an age-by-gender-by-diagnosis interaction (F=0.01, df=1, 70, p=0.93). Moreover, there is little evidence in the literature to support such a statement. Contrary to their own assertion that “female patients become impaired only postmenopausally,” Kopala et al. (1) reported significant olfactory deficits in premenopausal schizophrenic women. Of the nine published studies that have included both male and female patients, only one (2)observed a significant gender-by-diagnosis interaction. The four others reporting sex differences employed less stringent statistical models and/or questionable contrasts (e.g. schizophrenic men versus a pooled group of schizophrenic women, healthy men, and healthy women).We also disagree that it is more appropriate to use a regression model based on the patients’ own age and gender to examine the effect of illness duration. Such a model implicitly assumes that the onset of schizophrenia occurs with equal frequency over the life span and that the illness itself does not interact with the aging process. Schizophrenia has its onset in late adolescence and young adulthood, and as a result, age and duration of illness are highly correlated. Moreover, since illness begins earlier in men, the effects of illness duration and gender are also confounded. Regressing out the normal effects of aging and gender, as we did, avoids such confounds. Last, Good and colleagues are correct in noting that a curvilinear relationship between illness duration and olfactory deficit cannot be ruled out. However, duration of illness and performance on the University of Pennsylvania Smell Identification Test performance were highly correlated in both our young and elderly groups, and the rate of decline was identical across the two groups. The best approach to this problem is obviously a longitudinal study that examines within-subject decline over time. Within the stated limitations, however, we believe that the observed relationship between duration of illness and odor identification is valid.

Certification in internal medicine: 1989–1992

To determine whether changes in the demographic/educational mix of those entering internal medicine from 1986 to 1989 were associated with differences among them at the time of certification. Included in the study were all candidates for the 1989 to 1992 American Board of Internal Medicine certifying examinations in internal medicine. Demographic information and medical school, residency training, and examination experience were available for each candidate. Data defining quality, size, and number of subspecialties were available for internal medicine training programs. From 1990 to 1992, the total number of men and women candidates increased as did the numbers of foreign-citizen non-U.S. medical school graduates and osteopathic medical school graduates; the number of U.S. medical school graduates remained nearly constant and the number of U.S.-citizen graduates of non-U.S. medical schools declined. The pass rates for all groups of first-time examination takers decreased, while the ratings of program directors remained relatively constant. Program quality, size, and number of subspecialty programs had modest positive relationships with examination performance. Changes in the characteristics of those entering internal medicine from 1986 to 1989 were associated with declines in performance at the time of certification. These declines occurred in all content areas of the test and were apparent regardless of program quality. These data identify some of the challenges internal medicine faces in the years ahead.

Rivals for Ministry? Ordinations of Secular and Regular Clergy in Southern England c. 1300–1500

At the beginning of the fourteenth century ecclesiastical recruitment AA was flourishing in England. Hundreds of men turned up to be ordained at the four Ember seasons each year at which major ordinations were permitted to be held. The majority of these men were secular clergy; only a small proportion were members of religious orders. Of the scores of people in the diocese of Winchester who came at the stipulated time to be ordained to the major orders at this date only about one fifth were members of religious orders and of those, only a handful were mendicants. However, by the end of the century, after the ravages of the Black Death, although the total numbers of men being ordained had declined dramatically a greater percentage of these were regular rather than secular clergy. A similar pattern can be seen all over Southern England. It was a trend which persisted throughout much of the fifteenth century. This paper will investigate the changing patterns of secular and regular ordinations to the priesthood in southern England in the period between 1300 and 1500. In the late fourteenth and fifteenth centuries extensive anti-mendicant feeling was expressed both in late medieval literature and in rivalry between the secular clergy and the friars over the pastoral role of the latter. Was this, in fact, a reflection of a reality which meant that, compared to the position in the early fourteenth century, far more ordained friars were on the streets and in the parishes?

Gallstones, gallbladder cancer, and other gastrointestinal malignancies. An epidemiologic study in Rochester, Minnesota.

All 2583 residents of Rochester, Minnesota, who had gallstones initially diagnosed during the years 1950 to 1970 were followed for the development of gastrointestinal malignancies. Although 69 members of the cohort subsequently developed 72 gastrointestinal malignancies, this number of cases did not exceed the 76 cases expected (relative risk, 1.0). The risk for gallbladder cancer was increased threefold, but the increase was significant only in men (p = 0.05; 95% confidence interval, 1.0 to 30.0). The absolute incidence and the total number of men and women who developed gallbladder cancer was low (n = 5). The actual incidence of other gastrointestinal malignancies in our cohort with gallstones did not exceed the expected incidence in the general population of Rochester, Minnesota. Specifically, the risk for colon cancer was not increased, even after cholecystectomy. These data support an association between cholelithiasis and gallbladder cancer. We found, however, no association between cholelithiasis or cholecystectomy and any other gastrointestinal malignancy.

A Method for Solving Crew Scheduling Problems

The method discussed provides an allocation of jobs to men in a transportation system. Each man is assigned a prespecified shift, associated with a base station, and returned to his base station at the end of his shift. The total number of men required is minimized, subject to a minimum time between jobs, a suitable lunch break, and the performance of all the jobs, employing the decomposition principle of linear programming.