11 Temmuz 2012 Çarşamba

Medical school was a time in my life where the details are sketchy because it was a blur of studying, isolation, anxiety, frustration…sprinkled with intermittent moments of fascination and joy. I can completely relate to his thoughts about pediatrics, “Little people, little dollah”, and being torn between life-style specialties and being a “real” doctor. I shared his dislike for the standardized patients and the weirdness that entire situation evokes in all of us.

My favorite aspect about this book is its honesty and authenticity. As I devoured the book chapter by chapter, I felt like I UNDERSTOOD Tony. I was able to peek into a life very similar, but very different from my own. His book was truthful, the language was clear, the humor and candidness kept me interested and I really felt like I traveled this journey with Tony. As I read the pages, I thought of my OWN similar experiences….and my reaction to them. And as I flipped the page….reading his words were like reading my own mind. It was quite amazing!

There were only two questions that stayed with me through-out the book: Why didn’t his family help him acquire better living conditions? And was he really a virgin until medical school? (implied, but not stated)

I will say that I feel like the first part of the book would appeal more to young men, with all the talk about girls, women, and overall “manning up.” Since women do not (typically) go through this, it’s all very foreign in an annoying kind of way (as a woman). I was much more interested in…all the rest. Thankfully there’s plenty of ‘all the rest’ and the book was thoroughly enjoyable.

I would LOVE to read a “part II” plastic surgery residency memoir. It really was *that* good!

Rancho Cordova - LRC Manager, Corinthian Colleges

To contact us Click HERE
Job Posting Link

The Manager of Learning Resources and Services Center (LRC) manages the daily operation of the LRC and collaborates with the Associate Director of Academic Affairs on activities relating to programs, services, and events associated with enhancing student satisfaction, success, retention, and program completion for the campus.

Note: The term “campus” encompasses both physical campuses and Heald’s online campus

Oakland - K-8 Librarian - Head-Royce School

To contact us Click HERE
http://www.headroyce.org/page.cfm?p=3264

K-8 Librarian -2012-13

Responsibilities

The K-8 Librarian works closely with the Library Director to develop curriculum and instructional programs for the libraries, to develop a K-12 information literacy curriculum, and to promote the American Library Association national literacy standards for the school.

More specifically, the K-8 Librarian:

•Designs an accessible, efficient, and inviting facility for student learning.

•Develops and maintains a library collection that supports the school’s curriculum and fosters a love of reading.

•Plans and evaluates the school library program.

•Works collaboratively with teachers to provide information and resources to support K-8 curriculum.

•Collaborates with other teachers to teach information literacy, support ethical use of resources, and provide growth in reading comprehension.

•Shares in the leadership for the curricular, instructional, and professional development of the school.

•Manages the library support staff and parent volunteers at the K-8 level.

•Participates in and seeks professional growth and learning opportunities.

The K-8 Librarian is expected to fully participate in the life of the community including attendance at appropriate faculty and committee meetings. The school seeks applicants who have a strong academic background, experience in multicultural education, an understanding of children, and a genuine fondness for working in a dynamic school community.

Qualifications

We are seeking candidates with classroom teaching and library experience, an MLIS degree, a California teaching credential or a California Library Media Specialist credential and experience with computerized information systems, and library catalogue software.

Salary/Benefits

Head-Royce is committed to attracting and retaining outstanding employees through a competitive compensation package. The school provides a strong professional development program including funding for conferences, advanced education and other unique professional opportunities.

Application Process

Applicants should submit a cover letter and resume to the Assistant Head of School, Crystal Land, via jobs@headroyce.org. Please put “K-8 Librarian” in the subject line of your email. No phone inquiries please. Head-Royce is an equal opportunity employer.

City of Palm Springs - Director of Library Services

To contact us Click HERE
http://bit.ly/I8HJL9

Assume full management responsibility for all library services and activities including contract management with outside agencies; recommend and administer policies and procedures.
Manage the development and implementation of departmental goals, objectives, policies and priorities for each assigned service area.
Establish, within City policy, appropriate service and staffing levels; monitor and evaluate the efficiency and effectiveness of service delivery methods and procedures; allocate resources accordingly.
Plan, direct and coordinate, through subordinate level staff, the library's work plan; assign projects and programmatic areas of responsibility; review and evaluate work methods and procedures; meet with key staff to identify and resolve problems.
Assess and monitor workload, administrative and support systems, and internal reporting relationships; identify opportunities for improvement; direct and implement changes.
Promote and coordinate specific activities within the library; prepare program event and facility marketing material including news releases, flyers, schedules of events, pamphlets and brochures.
Coordinate the services of the library with the programs of other libraries; cooperate with such agencies to provide extended library services.
Evaluate the needs of the community; plan, develop and direct library programs and services to address such needs.
Identify alternative means of supporting and financing library services and programs.
Select, train, motivate and evaluate assigned personnel; provide or coordinate staff training; work with employees to correct deficiencies; implement discipline and termination procedures.
Oversee and participate in the development and administration of the department, historical society and PEG access television budget; approve the forecast of funds needed for staffing, equipment, materials and supplies; approve expenditures and implement budgetary adjustments as appropriate and necessary.
Explain, justify and defend department programs, policies and activities; negotiate and resolve sensitive and controversial issues.
Represent the library to other departments, elected officials and outside agencies; coordinate assigned activities with those of other departments and outside agencies and organizations.
Provide staff assistance to the City Manager; participate on a variety of boards, commissions and committees; prepare and present staff reports and other necessary correspondence.
Provide staff support to assigned boards and commissions.
Attend and participate in professional group meetings; stay abreast of new trends and innovations in the field of library services.
Respond to and resolve difficult and sensitive citizen inquiries and complaints.
Perform related duties and responsibilities as required.

Oakland - Library Assistant - Head-Royce School

To contact us Click HERE
This is a 25 hour per week position in both the lower school (K-5) and main (6-12) libraries. As a member of the Head-Royce Library team the candidate will work with learners k-adult in a community of 950 members.Priorities will be set to maximize contributions to the overall goals of the libraries determined annually. However, duties may be modified depending on particular experience/expertise.Founded in 1887, Head-Royce is an independent, non-denominational, coeducational college-preparatory, K-12 school, which offers a challenging educational program to educate the whole child. The mission of theSchool is to inspire in our students a life-long love of learning and pursuit of academic excellence, to promote understanding of and respect for the diversity that makes our society strong, and to encourage active and responsible citizenship. More informationabout the School can be obtained on our website: www.headroyce.org.Qualifications:

Experience working with children and/or adolescents and an ability to work effectively with employees and parents.
Ability to work independently and as an effective member of a team.
Cataloging and general library experience.
Comfortable with computers, technology, Web/Library 2.0 tools, and willing to learn continually.
Ability to multi-task
Ideal candidates will have an understanding of and a genuine fondness for working with students of all ages.

Responsibilities: the School Library Assistant will know, or be willing to learn, how to do the following:

Catalog and process materials in a variety of formats
Search for and add age-appropriate, authoritative web sites to online catalogs
Prepare online resources
Maintain circulation system
Track overdue materials – generate notices, follow through with students, parents,and business office when necessary
Maintain print collection as necessary : clean, repair, and shelve with assistance of parent volunteer
Maintain periodicals and subscriptions.
Basic Maintainenance of A/V/tech (laptops, camera, shuffles, etc.)
Order and maintain office/cataloging/processing/book repair supplies
Prepare displays as needed
Oversee annual inventory
Assist in the general supervision of the library and help maintain welcoming, quiet atmosphere, general order, neatness, and learning environment
Open and/or close the library when needed
Miscellaneous, as arises
Assist students, faculty, and staff:
- Assist with research and ready reference
- Assist with exploration of tools and technology for library of the future

Salary/Benefits
Beginning salary is $15 per hour plus benefits.Application Process
Interested parties should send a cover letter, resume, and references to: Mary Goglio, Library Director, Head-Royce School, 4315 Lincoln Avenue, Oakland, CA 94602 or mgoglio@headroyce.org.Head-Royce is an equal opportunity employer.

8 Temmuz 2012 Pazar

Medical Quack Employs “Watch Dog” Service for My Auxiliary Hard Drives (Humor)

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Ok now that I have your attention, here’s the Watch Dog:) Actually over the 4th of July my little assistant is very sensitive to the noise and found a new place to hang out to escape. His place of choice was right on top of my hard drives and he had to crawl up a few shelves to get there. Anyway this was a little too cute to pass up. BD

wienerdog_harddrives

As far as avoiding hardware theft, I don’t think I can get any better than this:) BD

Online Encyclopedia Writes Itself–Machine Learning From News Sources

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No you can’t go there yet as this is being built for intelligence agencies by Raytheon. the government gets it first. It picks up everything from a news item and finds the relationships between the data and information. It still doesn’t get everything right but getting closer. This sounds a bit like what we are doing in healthcare with non structured data, doesn’t it? BD

They look a bit like communally written Wikipedia pages

. But these articles—concise profiles of people and organizations, complete with lists of connected organizations, people, and events—were in fact written by computers, in a new bid by the Pentagon to build machines that can follow global news events and provide intelligence analysts with useful summaries in close to real time.

The prototype system is part of a nonpublic site built for intelligence agencies by Raytheon BBN in Cambridge, Massachusetts, and scheduled for delivery to the government later this year. It gathers information from 40 news websites written in English, Chinese, and Arabic, and eventually it will cover hundreds of news sites in all major languages. Ultimately the system will be linked with an existing TV broadcast monitoring network.

Automatically summarizing text is notoriously tricky given the difficulty of detecting humor, sarcasm, obviously incorrect information, idioms, and variant spellings and syntax, not to mention the problems involved in interpreting and translating information sources in different languages.

http://www.technologyreview.com/news/428333/an-online-encyclopedia-that-writes-itself/2/

Saringer Life Sciences Seeking $10 Billion Dollar Investment For Their Current Business Plan Which Includes 2 Advanced Medical Devices To Treat Pain and Deep Vein Thrombosis Prevention

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My first comment here is that’s a lot of money. The company is located in Canada and works with doctors and surgeons to develop devices in the area of DVT prevention and vascular solutions as well as wound healing and pain management. Check these 2 products out as I have not seen anything like them out there. The Venowave seems to work by improving circulation and attaches to the back of your leg and the IceOtherm gives feelings of sensation to relieve pain. Again, this is still a lot of money. BD

From the website:

“The Venowave VW5 is a medical device that has been statistically proven to prevent a DVT from occurring, in at risk patients. Traditionally, compression stockings and anti-coagulants (blood thinners) have been the gold standard in DVT prevention until today. The Venowave VW5 can be used alone or in conjunction with blood thinners and/or compression stockings.

The Venowave VW5 is applied to the back of the calf and mimics the body's venous system preventing blood from remaining still and clotting. The Venowave VW5 is unique because it is lightweight (250g, less then ½ pound), discreet and allows patients to remain completely mobile. There are no wires, tubes or sleeves. The Venowave VW5 can be used in hospital or during homecare after discharge from the hospital”.

“The IceOtherm is a class II medical device designed to engage the body’s natural healing abilities using both hot and cold stimuli. The interlaced hot and cold stimuli, induces a paradoxical burning sensation known as the Thermal Grill Illusion. The Thermal Grill Illusion has been known to scientists for over a century, and was developed and first studied extensively by Thunberg in 1896. In scientific research applications, the thermal grill is used to create harmless sensations of pain.”

Saringer Life Science Technologies Inc. (SLST Inc.) is seeking a major investment in order to expand their medical technology company. Business experts claim that this is one of the biggest and most lucrative propositions in Saringer’s history and that the company shows an enormous potential for return.

The Venowave VW5 and the ICE-O-therm. After years of clinical studies and product testing, both products use the latest state of the art technology (IP protected) and are ready to be commercialized. The products have a broad range of approved indications including pain treatment, preventing blood clotting or Deep Vein Thrombosis (DVT), and a broad range of vascular conditions including the most severe; Post Thrombotic Syndrome (PTS). Most recently scientists are studying the Venowave and its ability to heal chronic diabetic foot sores after an impressive case study was conducted with a 100% success rate. Many of these conditions are largely unmet clinical needs and alternative treatments are scarce.

“We’re definitely on the verge of reaching one of our biggest milestones yet,” exclaims Saringer. Although the majority of investor dollars will go towards expansion and revenue generating initiatives, some will also go towards Saringer’s most recent focus: how the Venowave VW5- a sequential compression pump that attaches to the back of the calf in order to increase circulation - can heal diabetic foot ulcers. “It’s time to take things to the next level and find a cure for chronic diabetic foot ulcers.”

http://www.sfgate.com/business/prweb/article/Toronto-Medical-Company-Seeks-10-Billion-Dollar-3683292.php

Patients File Lawsuit Against Human Biostar–Stem Cell Procedures With False Claims to Cure Diseases–Patients Received No Benefits And A Charge of Elder Abuse Included

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This does make the Celltex case in Texas come back to light again as a few weeks ago it was all over the news. These were all non substantiated stem cell treatments to where fat cells were taken, shipped to Korea and then returned. Perhaps the FDA has another upcoming inspection? As this article points out though lawyers know a good lawsuit when they see one. Any MD who is participating in non substantiated stem cell procedures today is walking on thin ice. We do hear so many claims about stem cells and sometimes folks can’t tell the difference especially when any of their other treatments have not worked prior.

The treatments all took place in China or Tijuana and at the Mexico location, 5 of the patients developed infections after their injections, not good. RNL Bio is the parent company of Human Biostar. Back to the Texas case, who was Celltex doing business with, RNL Bio. BD

In what could be a landmark case, six patients in California are suing one of the world’s largest stem-cell companies for allegedly misleading them about the effectiveness of its stem-cell treatments.

The six patients all live in Los Angeles or Orange County and share the last name Lee. Some of them are related, according to their lawyer, the unrelated Sang I Lee. They are suing Human Biostar based in Sugar Land, Texas; Jin Han Hong, the company’s chief operating officer; and Jeong Chan Ra, a Korean citizen and chairman of the board of Seoul-based RNL Bio, the parent company of Human Biostar.

The six patients claim they were sold the procedures by Hong when he was president RNL Life Science, another subsidiary of RNL Bio, based in Los Angeles. The procedure consists of taking fat from a patient, removing stem cells from the sample, processing and expanding them in RNL’s Seoul laboratory, and then sending them to one of RNL’s clinics to inject them into patients to treat a variety of diseases.

The case could bring closer scrutiny to stem-cell treatments throughout the United States. Until now, clinics advertising or selling unproven and unapproved stem cell treatments to patients had to worry only about the FDA, which monitors the clinical use of stem cells to ensure safety and efficacy — but moves slowly and bureaucratically.

FDA Approves Genetic Test To Help Patients and Doctors Determine If Erbitux Would Be an Effective Treatment For Colorectal Cancer

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Erbitux has been approved since 2004 to treat colorectal cancer for late stage cancer after chemotherapy treatments had ended. The drug sends a signal to stop the growth of tumors in short. When a KRAS gene mutation is found, the tumors continue to grow so with finding this mutation it gives additional information on whether or not the patient should be on the medication or whether the treatment would not do any good.

The FDA also approved the use of the drug in combination with Folfiri chemotherapy drugs as a first line treatment for patients with metastic tumors with CRC . BD

The U.S. Food and Drug Administration today approved the first genetic test that can help some colorectal cancer (CRC) patients and their doctors determine if the drug Erbitux (cetuximab) would be an effective treatment based on the absence of a gene mutation.

The therascreen KRAS RGQ PCR Kit can provide information about the KRAS gene mutation in patients whose CRC has spread to other parts of their body (metastasized).

Studies have found that Eribitux is not effective in those who have the mutation.

CRC is the third leading cause of cancer death in the United States. According to the American Cancer Society, there were more than 141,000 new CRC cases in 2011, and nearly 50,000 deaths resulted from CRC.

Among patients with tumors that did not have one of the seven KRAS mutations, median survival was 23.5 months for those who received Erbitux plus FOLFIRI compared with 19.5 months for those who received FOLFIRI. Among patients whose tumors had a KRAS mutation, median survival was similar between those who received Erbitux compared with those who did not.

7 Temmuz 2012 Cumartesi

City of Sierra Madre - Electronic Resources Analyst

To contact us Click HERE
http://cityofsierramadre.simplicant.com/job/detail/8491

GENERAL PURPOSE

Under general direction, the Electronic Resources Analyst is responsible for managing and maintaining the complex functions of both the City’s and the Library’s electronic resources, including the City website, and online document management. This position will also contribute to the development, implementation and evaluation of technology plans, policies and procedures.

ESSENTIAL FUNCTIONS
The following duties are normal for this position. These are not to be construed as exclusive or all-inclusive. Other duties may be required and assigned.

Monitor city-wide web services, social media, and other applications for performance and satisfaction, recommend procedures for dissemination of city information;
Identify, evaluate and implement current and emerging technologies and applications for delivery of library services;
Collect and report statistics and assess impact of technology-based services;
Participate in the design and development of the City’s website;
Maintain the City’s website and digital archives;
Develops best practices for citywide implementation of the Tyler Content Management system; Interacts and collaborates with City employees, IT consultants, and stakeholders to analyze current document management workflow, and make recommendations for workflow efficiencies and the delivery of City Council meeting packets using the Tyler Content Management system;
Ensure federal and state law compliance of applications and user interface designs;
Monitors metadata quality and the results of search queries and makes recommendations to improve search results;
Coordinates the retrospective conversion of City Council meeting packets, resolutions and ordinances from paper to digital;
Manages and assists patrons at the public service desk, answering reference questions and performing reader’s advisory activities and services; performs daily circulation functions of public service desk, assisting patrons with computer related questions, checking out books, issuing library cards, and acting as an information source regarding library and City events;
Participates in evaluating and measuring library services, contributing ideas and measures to maintain, enhance or improve library services;
Seeks information from users and potential users regarding their information and library needs; creates, and implements technology training for staff and the public for enhanced utilization of resources;
Supervise library staff involved in web design and document management; provide direction, evaluate performance, and assign job duties;
Performs other related duties as assigned.

City of Calabasas (Los Angeles area) - Librarian

To contact us Click HERE
http://www.cityofcalabasas.com/jobs/librarian.html

Essential Job Duties:
The following tasks are essential for this position. Incumbents in this classification may not perform all of these tasks, or may perform similar related tasks not listed here.

Answer reference questions and reader's advisory questions; assists or instructs in the use of the library resources.
Evaluate and select library materials; recommend and purchase materials for collection development; remove obsolete, non-relevant and worn books from library collection.
Interpret and communicate library policies and programs to staff, patrons and community groups.
Assist in the development and implementation of programs and services.
Participate in the administration of a variety of library programs including volunteer and summer youth; develop and coordinate assigned library programs.
Recommend additions to collection and services appropriate to the needs of the community.
Work with automated systems; perform searches of databases.
Conduct school class visits and other community outreach programs.
Assist with budget recommendations for collection development.
Perform other related duties as assigned.

Sacramento - California State Library

To contact us Click HERE
http://jobs.spb.ca.gov/wvpos/more_info.cfm?recno=483400

Under the supervision of the Principal Librarian, the incumbent in this position is primarily responsible for providing law reference assistance to patrons, both on a public service desk and remotely. This person is also the lead coordinator in providing text and operative dates of criminal statutes to other state agencies. This person is also a member of the public service librarian team that provides reference assistance to all patrons of the State Library.Please see full Job Bulletin at the link above. Please include position number 175-620-2951-115 when submitting an application. All applications must be submitted by mail with original signature. State Application (STD. 678) can be found at www.jobs.ca.gov. Thank you.

Attendings who don't want to teach

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Q: Now that I'm *officially* well into my intern year, I realize that some of our EM attendings are not interested in teaching (or otherwise interacting) with interns. As an intern, I'm offended. Is this acceptable behavior, and how should I handle it?

A: You're right, the attendings should be willing to work with ALL of their OWN residents (interns included). Its one thing to shun rotating residents/intern/students, but *your own* should be taken care of.

There are two different ways to look at this to help explain why SOME (i.e. not me, LOL) attendings avoid students/interns. The first way is to try and see their point of view.

Imagine you’re an attending:

When you go to work, you feel exposed (legally) because the residents are a liability. They don’t always know what to look for, what to tell you about, and how to treat the problem. Even if you, yourself, get up and go see/talk to the patient, you may miss something in your short interaction. And there are LOTS of patients. Actually, you feel overwhelmed at times because you’re responsible for the actions of others, although you don’t know what they’re doing/hearing/seeing. You have to ‘trust’ them…and that’s hard to do. And, you are just one person, and to have 2-4 people ‘presenting’ cases to you for 8-12 hours is just too hard. You can’t think, you don’t know who’s sick…and you can’t physically see everyone and do everything yourself.

And it’s even *worse* when an intern is working. BECAUSE they *really* don’t know what to look for, ask about, check or test for. And when they present to you, the story is often unclear, and you’re left sorta confused. The differential is too broad when the intern presents, and you either have to go see the patient yourself, or ask lots of detailed questions to the intern to get a better story. If the intern didn’t ask the important questions, you either have to send them back to get a better history and physical, OR you order tons of tests/studies to compensate.

Example:

10 month old baby is brought in my mom with a fever to 102.9 x 1 week. Intern presents it as a viral syndrome. Great, discharge, right? BUT they didn’t notice the dehydration and lethargy. They didn’t comment on the petechial rash. So, as an attending you can either:

1) get up and see the patient yourself as if he’s your own (this isn’t very practical if you have more than a couple of residents/interns to supervise or else the flow of the department will be very slow)

2) have the intern order more tests and studies to support the ultimate dispo (which isn’t really teaching, and isn’t really proper EM)

3) you can have a senior resident see the patient, and ‘advise’ the intern. That way, the likelihood of missing meningitis is lower if the senior resident signed off on the intern’s work.

Of the 3 – it’s easier to have the senior resident involved. Also, it’s logical because it allows the senior resident to see more, do more, supervise a bit, and begin managing an entire department. And as attending, you’re there just as back-up for the senior resident. It’s easier to teach the intern if the obvious nuances of the case have been discussed with the senior (at least from July – December). And it frees the attending up to work with the senior and students as well.

The attendings look forward to working with certain residents, just as much as residents like particular attendings. Typically attendings like residents who are confident, do appropriate work-ups, then come to them with their own thoughts about what’s going on, and what to do about it. Then the attending can talk to the resident as an educational ‘coach’ and (almost) colleague about the case. This is fun for attending.

Being stressed out about missing something because an unreliable resident (whether it’s because they’re ‘new’ or just ‘suck’) is telling you half-truths and cannot think for themselves…is miserable.

***

The second way to try and understand what’s going on is to realize that this has nothing to do with you, and everything to do with their own issues:

Imagine you’re an attending…and you’re a bit bitter about your job (for whatever reason). Really, you don’t want to work shifts, you’d rather get credit for shifts worked, while NOT doing any shifts. BUT, you’re not quite *important* enough for the department to allow you to engage in other scholarly activities…and since they NEED attendings to work shifts, you get more than your “fair share” (for your rank and experience), in your opinion. But you can’t quit, because you need your benefits and paycheck too bad. So you make due.

There are two types of doctors (those who actually are comfortable with themselves, their knowledge, and love to share and can readily admit when they are unsure of something....and there are those who pretend to know *everything* and don't want to answer questions because they feel threatened by the resident who's actively reading, and who, on any given day, may be better-read on a particular topic than the attending).

So let's say I'm the second type of attending -

I don't want to 'expose' myself as interns don't know much about 'the way things work' and instead of just 'going with it' they'll ask:

"why? why? why do we use this drug instead of that drug? why can't we just do the procedure this way like Rivers said? Tintinali's new edition said that we shouldn't use this study, that the new ultrasound technique is better..."

Whereas a senior would be more apt to 'just go with it' as per current local ED culture. And if the senior asks questions, it's more appropriate for the attending to follow-up their question with a 'reading assignment' to be presented the next shift. So the residents ‘learn’ to not ask questions.

So, in short: either this is their way of hiding the fact that they don’t know something….OR they’re acting out because they don’t want to be in the position they’re in….

Either way nothing to do with you.

My advice is: YOU SAY NOTHING! Go with the flow...and do not let the Eye of Sauron fall upon you. Stay below the radar right now. Learn, learn, learn. Shine on the inservice in February.

Next year...maybe say something if you're still so inclined (maybe). It's not worth the risk right now. If you're black-listed, you will have a horrible residency experience. Lots of former residents can attest to this fact.

Medical Memoir - In Stitches One Girl's Opinion

To contact us Click HERE

Medical school memories came *flooding* back as I read Anthony Youn’s memoir, In Stitches.

I would LOVE to read a “part II” plastic surgery residency memoir. It really was *that* good!