US Academic Research Articles

The Early Years of the MIT PhD Program in Industrial Economics

The immediate postwar period witnessed not only a considerable expansion of economics graduate education in the United States but also its reformulation. Graduate education at MIT became more technical, with shorter theses on narrowly defined problems. This occurred as economics was going through important changes, informed by its mathematization, by the stabilization of a neoclassical way of doing economics, by the advancement of econometrics and the “Keynesian revolution,” and by the Americanization of economics. The MIT PhD program in economics was created only in 1941 but very quickly became a major producer of PhDs. The new training offered by MIT to economists not only followed larger changes in US academe but also contributed to them, and this makes it an important case study of the transformation of American economics more generally. My aim here is to scrutinize the formative years of this graduate program, mostly the 1940s and 1950s.

The Status of Women in US Academic Pharmacy

To describe the status of women in pharmacy education with particular focus on a 10-year update of a previous study. Information was obtained from national databases, published reports, scholarly articles, and association websites. Comparisons were made between men and women regarding degree completion, rank, tenure status, leadership positions, research awards, salaries, and career advancement. There have been modest gains in the number of women serving as department chairs and deans. Salary disparities were found between men and women at several ranks within pharmacy practice. Men were more apt to be tenured or in tenure-track positions and received 89.4% of the national achievement awards tracked since 1981. The problem cannot be simply attributed to the pipeline of those entering academia. Barriers to advancement differ between men and women. We recommend that individuals, institutions, and associations implement strategies to decrease barriers and reduce bias against women.

Influence of Access, Anticoagulant, and Bleeding Definition on Outcomes of Primary Percutaneous Coronary Intervention: Early Experience of an US Academic Center.

Background We aimed to carry out comparison of different bleeding avoidance strategies in doing primary percutaneous coronary intervention (PPCI) using either radial or femoral as access of choice and either bivalirudin or unfractionated heparin as anticoagulant of choice. In this analysis, we analyzed the influence of major bleeding definition on bleeding outcomes as well. Methods We did a retrospective analysis of 139 patients with ST-segment elevation myocardial infarction (STEMI) who had PPCI in our academic center from January 2010 till October 2013. The primary outcome at 30 days was a composite of death from any cause or stent thrombosis or non-coronary artery bypass grafting (CABG) related major bleeding (CathPCI Registry definition) and secondary outcomes were individual components of primary outcome and the hospital length of stay. Results There was no significant difference among different access/anticoagulant combinations with regards to primary outcome (22% in radial/bivalirudin vs. 5% in radial/heparin vs. 17% in femoral/bivalirudin vs. 28% in femoral/heparin group; p = 0.2) as well as its individual components except the hospital length of stay (2.56 vs. 3 vs. 3.97 vs. 4.4 days each; p < 0.0001). The overall rate of major bleeding was 11.5%. When we use HORIZON-AMI bleeding definition, it went up to 25 % due to one particular component (p < 0.004). Conclusions This single center observational study doing PPCI did not show any superiority of one bleeding avoidance strategy over others with regard to primary outcome and its individual components except the hospital length of stay. It also shows the importance of bleeding definition on bleeding outcomes.

Content and timing of feedback and reflection: a multi-center qualitative study of experienced bedside teachers.

BackgroundCompetency-based medical education increasingly recognizes the importance of observation, feedback, and reflection for trainee development. Although bedside rounds provide opportunities for authentic workplace-based implementation of feedback and team-based reflection strategies, this relationship has not been well described. The authors sought to understand the content and timing of feedback and team-based reflection provided by bedside teachers in the context of patient-centered bedside rounds.MethodsThe authors conducted a thematic analysis qualitative study using transcripts from audio-recorded, semi-structured telephone interviews with internal medicine attending physicians (n= 34) identified as respected bedside teachers from 10 academic US institutions (2010–2011).ResultsHalf of the respondents (50%) were associate/full professors, with an average of 14 years of academic experience. In the context of bedside encounters, bedside teachers reported providing feedback on history-taking, physical-examination, and case-presentation skills, patient-centered communication, clinical decision-making, leadership, teaching skills, and professionalism. Positive feedback about physical-exam skills or clinical decision-making occurred during encounters, positive or constructive team-based feedback occurred immediately following encounters, and individualized constructive feedback occurred in one-on-one settings following rounding sessions. Compared to less frequent, emotionally-charged events, bedside teachers initiated team-based reflection on commonplace “teachable moments” related to patient characteristics or emotions, trainee actions and emotions, and attending physician role modeling.ConclusionsBedside teachers use bedside rounds as a workplace-based method to provide assessment, feedback, and reflection, which are aligned with the goals of competency-based medical education. Embedded in patient-centered activities, clinical teachers should be encouraged to incorporate these content- and timing-related feedback and reflection strategies into their bedside teaching.

Collaboration between a US Academic Institution and International Ministry of Health to develop a culturally appropriate palliative care navigation curriculum

Implementation lessons: (1) The development and testing of a culturally appropriate palliative care navigation curriculum for countries facing high cancer and non-communicable diseases burden requires collaboration with the local Ministry of Health. (2) Lay volunteers from non-governmental and faith-based organizations are potential candidates to provide patient navigation services.

The peer-review process in English-language advertising journals: a survey of US academics

This study examined the views of advertising academics regarding the peer-review process in English-language advertising journals. Three issues were examined. First, how do advertising academics assess the peer-review process in advertising journals on the following dimensions: fairness, anonymity (truly double-blind), timeliness, and effectiveness in improving the quality of research? Second, how do they perceive the ethicality of review process behaviors? Third, what steps do they suggest for improving the quality or integrity of the peer-review process? Data was collected through a survey of US-based advertising academics. The findings reveal that advertising academics believe that, for the most part, advertising journals are succeeding at fairness, protecting anonymity, improving the research of submitters, and avoiding ethical infractions in the review process. However, advertising academics would like to see improvements in timeliness as well as in incentives and guidelines provided to participants in the peer-review process.

Transitive reduction of citation networks

In many complex networks, the vertices are ordered in time, and edges represent causal connections. We propose methods of analysing such directed acyclic graphs taking into account the constraints of causality and highlighting the causal structure. We illustrate our approach using citation networks formed from academic papers, patents and US Supreme Court verdicts. We show how transitive reduction (TR) reveals fundamental differences in the citation practices of different areas, how it highlights particularly interesting work, and how it can correct for the effect that the age of a document has on its citation count. Finally, we transitively reduce null models of citation networks with similar degree distributions and show the difference in degree distributions after TR to illustrate the lack of causal structure in such models.

The System Cannot Withstand Close Scrutiny: 1966, the Hopkins Conference, and the Anomalous Rise of Theory

It is often said that the 1960s was an era of phenomenology in literary criticism. Interrogating this only partly justified statement leads us to a revised genealogy of theory in US academe. The famed 1966 conference at Johns Hopkins University saw the nearly simultaneous emergence of structuralism and poststructuralism on American shores. In charting the happenstance of critical fortune at this pivotal and liminal moment, this essay suggests a new understanding of the institutional and intellectual bases of theory. It also addresses the anomalous status of the 1960s as a decade tumultuous in the outer world but fairly placid in academe, and it mediates the role that discussions of theory play in the attempt to categorize the 1960s as a “very short twentieth century” that can be outflanked by past and future.

Governance Practices and Performance in US Academic Medical Centers

Recognition of the complex nature of modern health care delivery has led to interest in investigating the ways in which various factors, including governance structures and practices, influence health care quality. In this study, the chief executive officers (CEOs) of US academic medical centers were surveyed to elicit their perceptions of board structures, activities, and attitudes reflecting 6 widely identified governance best practices; the relationship between use of these practices and organizational performance, based on the University HealthSystem Consortium's Quality & Accountability rankings, was assessed. High-performing hospitals showed greater use of all 6 practices, but the strongest evidence supported a focus on board member education and development, the rigorous use of performance measures to guide quality improvement, and systematic board self-assessment processes. All hospitals, even those with the highest quality ratings, had major gaps in their use of best practices for CEO and board assessments. These findings can serve as the basis for developing sound board improvement plans.

Burden of Readmission Following Liver Transplantation: Results From US Academic Medical Centers.

Burden of Readmission Following Liver Transplantation: Results From US Academic Medical Centers.

Between Ethnic and English Names: Name Choice for Transnational Chinese Students in a US Academic Community

This article explores how transnational Chinese students negotiate identity options through name choice while studying in the US. Name choice can discursively index membership in various communities. Drawing on theories of heteroglossia (Bakhtin, 1981) and community of practices (Lave and Wenger, 1991), this study examines how name choice becomes a site of identity negotiation for transnational Chinese students who received their English names from ESL classes in China. Using a qualitative approach, the analysis illustrates divergent patterns in name choice among a group of transnational Chinese students within one academic community, and demonstrates how membership in the community intersects with notions of cosmopolitanism to affect their name choice. The findings shed light on the pedagogical practice of assigning English names in ESL classrooms. They also call for future research to study the complex links between Chinese students’ histories of engagement in such practices and their identity negotiation processes when overseas.

Academic family medicine physicians' confidence and comfort with opioid analgesic prescribing for patients with chronic nonmalignant pain.

To examine academic family medicine physicians' current practices, experiences, beliefs, level of concern about negative outcomes, and confidence and comfort when prescribing opioid analgesics for chronic nonmalignant pain management. Electronic cross-sectional survey. This study was part of the Council of Academic Family Medicine (CAFM) Educational Research Alliance omnibus survey of active academic US family physicians. Respondents completed survey items addressing their 1) sociodemographic and practice characteristics, 2) current opioid prescribing practices, 3) experiences and beliefs toward prescribing opioid analgesics for chronic nonmalignant pain management, 4) level of concern about negative opioid-related outcomes, and 5) confidence and comfort when prescribing opioid analgesics. The majority of the sample (n=491) were male (57.8 percent) with 84.1 percent identifying themselves as non-Hispanic white. Nearly all respondents (91.0 percent) reported currently prescribing opioids to patients with chronic nonmalignant pain. Most respondents reported being confident (88.4 percent) and comfortable (76.2 percent) in their prescribing for patients with chronic nonmalignant pain. Family physicians who were comfortable in their opioid prescribing skills were more likely to report satisfaction in prescribing opioids to patients with chronic pain (ρ=0.494, p<0.001), while those who were confident in their opioid prescribing skills were more likely to identify pain management as high priority (ρ=-0.287, p<0.001). Most academic family physicians currently prescribed opioid analgesics to patients with chronic nonmalignant pain. There was a strong inverse relationship between confidence regarding opioid prescription and concern about negative consequences. Similarly, comfort level was tied to increased satisfaction with the overall process of opioid prescription.

An Academic Medical Center's Expansion to the European Union: A Case Study of UPMC's Joint Projects in Italy and Ireland

This case study examines the expansion of the University of Pittsburgh Medical Center (UPMC) to Italy and Ireland in the European Union. The authors use international business theory to help understand why US Academic Medical Centers (AMCs) are beginning to go abroad and, through semistructured interviews with UPMC officials, they examine the market entry issues UPMC faced when expanding to Italy and Ireland. The authors also explain why UPMC’s first successful foreign ventures took place in the European Union. They conclude with comments on several of the strategic issues that AMCs should address if they wish to successfully expand overseas.

SAT0028 Pregnancy Outcomes in Systemic Lupus Erythematosus: Experiences from A Single US Academic Medical Center – Hopkins Lupus Pregnancy Cohort

BackgroundPrevious research shows that high disease activity is associated with an increased prevalence of fetal loss in systemic lupus erythematosus (SLE) pregnancies1.ObjectivesTo analyze the association of SLE disease severity with...

Staphylococcus aureus bacteremia at 5 US academic medical centers, 2008-2011: significant geographic variation in community-onset infections.

The incidence of community-onset (CO) methicillin-resistant Staphylococcus aureus (MRSA) bacteremia rose from the late 1990s through the 2000s. However, hospital-onset (HO) MRSA rates have recently declined in the United States and Europe. Data were abstracted from infection prevention databases between 1 January 2008 and 31 December 2011 at 5 US academic medical centers to determine the number of single-patient blood cultures positive for MRSA and methicillin-susceptible S. aureus (MSSA) per calendar year, stratified into CO and HO infections. Across the 5 centers, 4171 episodes of bacteremia were identified. Center A (Los Angeles, California) experienced a significant decline in CO-MRSA bacteremia rates (from a peak in 2009 of 0.42 to 0.18 per 1000 patient-days in 2011 [P = .005]), whereas CO-MSSA rates remained stable. Centers B (San Francisco, California), D (Chicago, Illinois), and E (Raleigh-Durham, North Carolina) experienced a stable incidence of CO-MRSA and CO-MSSA bacteremia. In contrast, at center C (New York, New York), the incidence of CO-MRSA increased >3-fold (from 0.11 to 0.34 cases per 1000 patient-days [P < .001]). At most of the sites, HO-MRSA decreased and HO-MSSA rates were stable. USA300 accounted for 52% (104/202) of genotyped MRSA isolates overall, but this varied by center, ranging from 35% to 80%. CO-MRSA rates and the contribution of USA300 MRSA varied dramatically across diverse geographical areas in the United States. Enhanced infection control efforts are unlikely to account for such variation in CO infection rates. Bioecological and clinical explanations for geographical differences in CO-MRSA bacteremia rates merit further study.

Effect of Vitamin D3on Asthma Treatment Failures in Adults With Symptomatic Asthma and Lower Vitamin D Levels

In asthma and other diseases, vitamin D insufficiency is associated with adverse outcomes. It is not known if supplementing inhaled corticosteroids with oral vitamin D3 improves outcomes in patients with asthma and vitamin D insufficiency. To evaluate if vitamin D supplementation would improve the clinical efficacy of inhaled corticosteroids in patients with symptomatic asthma and lower vitamin D levels. The VIDA (Vitamin D Add-on Therapy Enhances Corticosteroid Responsiveness in Asthma) randomized, double-blind, parallel, placebo-controlled trial studying adult patients with symptomatic asthma and a serum 25-hydroxyvitamin D level of less than 30 ng/mL was conducted across 9 academic US medical centers in the National Heart, Lung, and Blood Institute's AsthmaNet network, with enrollment starting in April 2011 and follow-up complete by January 2014. After a run-in period that included treatment with an inhaled corticosteroid, 408 patients were randomized. Oral vitamin D3 (100,000 IU once, then 4000 IU/d for 28 weeks; n = 201) or placebo (n = 207) was added to inhaled ciclesonide (320 µg/d). If asthma control was achieved after 12 weeks, ciclesonide was tapered to 160 µg/d for 8 weeks, then to 80 µg/d for 8 weeks if asthma control was maintained. The primary outcome was time to first asthma treatment failure (a composite outcome of decline in lung function and increases in use of β-agonists, systemic corticosteroids, and health care). Treatment with vitamin D3 did not alter the rate of first treatment failure during 28 weeks (28% [95% CI, 21%-34%] with vitamin D3 vs 29% [95% CI, 23%-35%] with placebo; adjusted hazard ratio, 0.9 [95% CI, 0.6-1.3]). Of 14 prespecified secondary outcomes, 9 were analyzed, including asthma exacerbation; of those 9, the only statistically significant outcome was a small difference in the overall dose of ciclesonide required to maintain asthma control (111.3 µg/d [95% CI, 102.2-120.4 µg/d] in the vitamin D3 group vs 126.2 µg/d [95% CI, 117.2-135.3 µg/d] in the placebo group; difference of 14.9 µg/d [95% CI, 2.1-27.7 µg/d]). Vitamin D3 did not reduce the rate of first treatment failure or exacerbation in adults with persistent asthma and vitamin D insufficiency. These findings do not support a strategy of therapeutic vitamin D3 supplementation in patients with symptomatic asthma. clinicaltrials.gov Identifier: NCT01248065.

Survey of After-Hours Coverage of Emergency Department Imaging Studies by US Academic Radiology Departments

The aim of this study was to document how academic radiology departments cover emergency department radiologic services after hours. Program directors of neuroradiology fellowship programs were invited to participate in a web-based survey addressing how their radiology departments covered after-hours emergency department studies. A total of 67 separate institutional responses were obtained from 96 institutions, for a 70% response rate. Seventy-three percent of programs (49 of 67) reported providing exclusively preliminary interpretations on emergency department reports for some overnight hours. Only 27% of respondents (18 of 67) said that they provided 24-hour real-time staff coverage. Among those who provided around-the-clock staff coverage, 72% (13 of 18) did so with dedicated emergency department sections. Only 2 respondents offered 24-hour subspecialty staff coverage. Emergency departments and hospital administrators were noted as the most frequent drivers of these changes. Academic radiology departments vary widely in how they cover after-hours emergency department examinations. A number have recently expanded their hours of coverage under institutional pressures.

Current controversies and challenges in robotic-assisted, laparoscopic, and open partial nephrectomies

Recent studies demonstrate that partial versus radical nephrectomy confers a survival advantage while lowering the risk of severe chronic kidney disease. Open partial nephrectomy remains the gold standard, but the use of minimally invasive approaches is expanding. Using a MEDLINE literature search, we reviewed all relevant literature between 2000 and 2014. Fifty-one articles were left for review after filtering for inclusion of trends, learning curve, perioperative outcomes, warm ischemia time, and costs. Partial nephrectomy use has increased over the past decade accounting for 24.7 % of all surgeries performed for the treatment of organ-confined renal masses in 2008. The introduction of robotic technology has continued to alter the landscape accounting for 47 % of all partial nephrectomies at academic US centers in 2011, though a center bias and publication bias likely exist. A slower adoption rate has been seen at non-academic centers and those in low-income areas. The learning curve for robotic-assisted laparoscopic nephrectomy has been shorter than for laparoscopic partial nephrectomy, explaining, in part, why the rate of partial nephrectomy remained relatively stagnant before the robotic-assisted laparoscopic nephrectomy, despite an increase in the detection of small renal masses. Operative and warm ischemia time remain shortest for open partial nephrectomy, though it is associated with the highest blood loss and longest hospital stay. Finally, open partial nephrectomy remains the least costly modality. Each approach to partial nephrectomy has its advantages and disadvantages, and continued effort must be applied to comparative effectiveness research for nephron-sparing treatments for renal cell carcinoma.

미국 대학도서관의 RDA 적용에 관한 비교 연구

미국 대학도서관의 RDA 적용에 관한 비교 연구

Spinning the web of open science

Digital and information technologies have drastically changed the way how people work, interact professionally and socially and spend their leisure time. Scientific research is not exempt from these changes: the free and rapid flow of information, ideas and documents will both require and foster new habits of collaboration among researchers, stimulate economic activities and even improve public dialogue on science (http://royalsociety.org/policy/projects/science-public-enterprise/report/). “A growing body of evidence suggests that public visibility and constructive conversation on social media networks can be beneficial for scientists, impacting research in a number of key ways,” wrote computational biologist Holly Bik and marine biologist Miriam Goldstein [1]. The digital revolution could herald a new era of “open science” where scientists freely and easily share published work, experimental data, ideas and opinions and mutually benefit from the open and collaborative realm that is emerging in the digital age. Yet, not all is brave in the new digital world and scientists seem to be rather reluctant to engage in what the web 2.0 has to offer in terms of exchanging ideas. Most scientists use social media for two main reasons: networking with other researchers and for public visibility (Fig 1). “Scientists need to be engaged in new media platforms because everyone else is already talking about their thoughts and feelings, having discussions about things they care about, and generally—as the name implies—being social,” commented marine biologist and blogger Christie Wilcox [2]. Beyond making research more visible to funders or policymakers, social media may also help to build dialogue and constructive conversation with the general public, in particularly about sensitive topics, such as stem cell research or genetically modified food. “[W]e have to make a concentrated effort to get involved in the public discussion about science. We have to be approachable and available to talk …