Job satisfaction of Swiss general practitioners with and without proficiency certificate in homeopathy

Introduction: Job satisfaction and therefore wellbeing of physicians is an important issue in high quality and safety of health care provision. The role of additional qualification in complementary medicine (CM) for job satisfaction of general practitioners (GPs), however, has not been explored. This study compared job satisfaction of conventional and homeopathic Swiss GPs. Methods: Participants of the Swiss Family Doctors Conference 2013 and members of the Swiss Association of Homeopathic Physicians participated in the survey. They indicated the extent of job satisfaction on 17 questions covering patient care, work-related burden, income-prestige, personal rewards, and professional relations. Results: Data of n = 125 GPs with homeopathic proficiency certificate and data of n = 143 GPs without any proficiency certificate in CM were analyzed. Overall job satisfaction was high and did not differ between the groups. However, due to lower number of patients per day, homeopathic GPs reported higher satisfaction in relations with patients and with workload, and lower satisfaction with income and in relations with peers compared to conventional GPs. Controlling for further confounding variables (e.g. working hours per week, practice setting), homeopathic GPs reported less satisfaction with their income than their conventional colleagues. Conclusions: Longer consultation time and lower number of patients homeopathic GPs see per day, may allowthem to unfold a deeper and more satisfying relationship with their patients and to lessen the workload. However, this comes along with financial discontent compared to conventional GPs. Certification in homeopathy and increased consultation time, respectively, may represent a way to enhance GPs’ job satisfaction.

Variation in treatment strategies of Swiss general practitioners for subclinical hypothyroidism in older adults.

QUESTIONS UNDER STUDY As the best management of subclinical hypothyroidism is controversial, we aimed to assess variations in treatment strategies depending on different Swiss regions, physician and patient characteristics. METHODS We performed a case-based survey among general practitioners (GPs) in different Swiss regions, which consisted of eight hypothetical cases presenting a female patient with subclinical hypothyroidism and nonspecific complaints differing by age, vitality status and thyroid-stimulating hormone (TSH) concentration. RESULTS A total of 262 GPs participated in the survey. There was considerable variation in the levothyroxine starting dose chosen by GPs, ranging from 25 µg to 100 µg. Across the Swiss regions, GPs in the Bern region were significantly more inclined to treat, with a higher probability of initiating treatment (60%, p = 0.01) and higher mean starting doses (45 µg, p <0.01) compared with the French-speaking region (44%, 36 µg); the Zurich region had intermediate values (52%, 39 µg). We found no association between treatment rate and other physician characteristics. GPs were more reluctant to initiate treatment in 85-year-old than in 70-year-old women (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.63-0.94), and more likely to treat women with a TSH of 15 mU/l than those with a TSH of 6mU/l (OR 8.71, 95% CI 6.21-12.20). CONCLUSIONS There are strong variations in treatment strategies for elderly patients with subclinical hypothyroidism across different Swiss regions, including use of higher starting doses than the recommended 25 µg in the Swiss guidelines, which recommend a starting dose of 25 µg. These variations likely reflect the current uncertainty about the benefits of treatment, which arise from the current lack of evidence from adequately powered clinical trials.

What Is behind God’s Name? Martin Buber’s and Franz Rosenzweig’s Reflections on the Name of God

What meaning does God’s name convey? This was a question Martin Buber and Franz Rosenzweig had to answer when working on their translation of the Bible. They noticed that, as certain crucial biblical verses suggest, there is indeed a meaning behind God’s name in the Bible. Thus, an important moment in their joint translation was their account of the self-revelation of God in Exod. III, together with the question of how best to translate the tetragrammaton YHWH— the name of God. This article will explore their decisions, based both on their dialogue concerning the translation of the Bible, and on their papers, especially Rosenzweig’s well-known article ‘Der Ewige’ (‘The Eternal’) and Buber’s response to it. Less well known is the fact that there exist two unpublished typescripts by Martin Buber reflecting on the name of God, which will also be taken into consideration. Contrary to the received view that the choice of the personal pronoun to transliterate the name of God in the Bible translation was mainly Rosenzweig’s, I will show that it was actually a joint decision in which both thinkers’ philosophies,1 and a question that had haunted Buber since his youth, played an important part. The choice of the personal pronoun is an answer to this question, addressing the omnipresent God, the eternal Thou, in a kind of cultic acclamation.

AN ANALYSIS OF THE GENERAL WELL-BEING OF BLACKS AND WHITES

The importance of race as a factor in mental health status has been a topic of controversy. This study reviews the history of research in this area and examines racial variances in the relationship between selected socio-demographic variables and general well-being. The study also examines the appropriateness of an additive versus an interactive statistical model for this investigation.^ The sample consists of 6,913 persons who completed the General Well-Being Schedules as administered in the detailed component of the first National Health and Nutrition Examination Survey (NHANES I) conducted by the National Center for Health Statistics between April, 1971 and October, 1975. The sampling design is a multistage, probability sample of clusters of persons in area based segments. Of the 6,913 persons, 873 are Black.^ Unlike other recent community based mental health studies, this study revealed significant differences between the general well-being of Blacks and Whites. Blacks continued to exhibit significantly lower levels of well-being even after adjustments were made for income, education, marital status, sex, age and place of residence. Statistical interaction was found between race and sex with Black females reporting lower levels of well-being than either Black or White males or their White female counterparts.^ The study includes a detailed review of the NHANES I sample design. It is shown that selected aspects of the design make it difficult to render appropriate national comparisons of Black-White differences. As a result conclusions pertaining to these differences based on NHANES I may be of questionable validity. ^

Application of the general linear model to assess the effect of missing data on bone marrow mononuclear cell therapy with infusion timing and follow-up MRI

With most clinical trials, missing data presents a statistical problem in evaluating a treatment's efficacy. There are many methods commonly used to assess missing data; however, these methods leave room for bias to enter the study. This thesis was a secondary analysis on data taken from TIME, a phase 2 randomized clinical trial conducted to evaluate the safety and effect of the administration timing of bone marrow mononuclear cells (BMMNC) for subjects with acute myocardial infarction (AMI).^ We evaluated the effect of missing data by comparing the variance inflation factor (VIF) of the effect of therapy between all subjects and only subjects with complete data. Through the general linear model, an unbiased solution was made for the VIF of the treatment's efficacy using the weighted least squares method to incorporate missing data. Two groups were identified from the TIME data: 1) all subjects and 2) subjects with complete data (baseline and follow-up measurements). After the general solution was found for the VIF, it was migrated Excel 2010 to evaluate data from TIME. The resulting numerical value from the two groups was compared to assess the effect of missing data.^ The VIF values from the TIME study were considerably less in the group with missing data. By design, we varied the correlation factor in order to evaluate the VIFs of both groups. As the correlation factor increased, the VIF values increased at a faster rate in the group with only complete data. Furthermore, while varying the correlation factor, the number of subjects with missing data was also varied to see how missing data affects the VIF. When subjects with only baseline data was increased, we saw a significant rate increase in VIF values in the group with only complete data while the group with missing data saw a steady and consistent increase in the VIF. The same was seen when we varied the group with follow-up only data. This essentially showed that the VIFs steadily increased when missing data is not ignored. When missing data is ignored as with our comparison group, the VIF values sharply increase as correlation increases.^

Towards the Compilation of a Consistent Asian International I-O Table--The Report of the General Survey on National I-O Tables--

This paper reports on the survey of the characteristic features of national input-output tables compiled by the member countries of the Asian International Input-Output Table project. In making any inter-regional tables, the presentation format of each constituent table has to be carefully studied in order to design a common adjustment rule. The survey was conducted in the period of 2003-04, with invaluable cooperation from each collaborating institution of the project. Some analytical findings are drawn from the survey results, such as the similarity between each national table and the Japanese table, the responsiveness to the 1993 SNA, and the major areas of conflict regarding the presentation format.

Parameterization of applied general equilibrium models with flexible trade specifications based on the Armington, Krugman, and Melitz models

This paper explains how the Armington-Krugman-Melitz supermodel developed by Dixon and Rimmer can be parameterized, and demonstrates that only two kinds of additional information are required in order to extend a standard trade model to include Melitz-type monopolistic competition and heterogeneous firms. Further, it is shown how specifying too much additional information leads to violations of the model constraints, necessitating adjustment and reconciliation of the data. Once a Melitz-type model is parameterized, a Krugman-type model can also be parameterized using the calibrated values in the Melitz-type model without any additional data. Sample code for the General Algebraic Modeling System (GAMS) has also been prepared to promote the innovative supermodel in the AGE community.