Client perceptions of dietetic students and registered dietitians at a university-based nutrition clinic

Client perceptions of students enrolled in a nutrition counseling practicum were compared with client perceptions of those students' clinical instructors, who were registered dietitians. One hundred forty-two clients who had either a student (no. = 81) or a dietitian (no. = 61) as primary counselor completed a postcard evaluation or a telephone interview. Students were rated significantly more positively (p less than .01) than their instructors for the item "I would recommend the clinic to others" and (p less than .05) for the items "The counselor helped me with my problem" and "I learned at the clinic what I did not know before." Seventy-two of the 89 clients interviewed by telephone replied to the question "Did students enhance or detract from services provided?" Sixty-one percent replied that students enhanced, but 25% replied that students detracted in some way, primarily because of concerns about having an additional observer during counseling sessions. In general, clients receiving nutrition counseling evaluated student dietitians very positively.     

Up & comers succeed by motivating others

Few clues in the early lives of Modern Healthcare's 1990 Up & Comers indicate that they were destined to become young leaders of the healthcare industry. A diverse group, they started out in strikingly different directions. Gary Shorb trained as an engineer and aspired to be an admiral in the Navy. Deborah Johnson studied law but had dreams of becoming a professional musician. Larry Hough started out as a certified public accountant. Somewhere along the line, they were attracted to the healthcare profession. Despite their differences, they have much in common. A psychological survey conducted for the magazine by Michael Leibman of Caliper Human Strategies indicates they are strong motivators who set the tone for their organizations by soliciting the views of their staffs and structuring the agenda. As a group, they are bright, shrewd and goal-oriented. They also fully understand their role. As David Jimenez, president of Hialeah (Fla.) Hospital, said, "Every day you've got to go out there and demonstrate that you're capable of holding down the job, that you deserve to be the leader." These 12 executives, all 40 or younger, were chosen from more than 50 candidates suggested by Modern Healthcare's editorial staff and readers. They represent many facets of the industry and come from every part of the country. As the healthcare industry continues to evolve, they are well positioned to play a leadership role in meeting the challenges of providing high-quality and cost-efficient patient care.     

CEOs, chairmen split over CEO background

A new survey shows that board chairmen and chief executive officers have different opinions about what type of background future hospital leaders should have. Most chairmen say CEOs should have specialized educational training, but CEOs and heads of graduate programs say leaders should have generalist backgrounds.     

Ossification and pseudoepiphysis formation in the “nonepiphyseal” end of bones of the hands and feet

Metacarpals, metatarsals, and phalanges were studied to assess the developmental morphology of secondary ossification in the nonepiphyseal ends of these bones as well as the formation of the pseudoepiphysis as an epiphyseal ossification variant. Both direct ossification extension from the metaphysis into the epiphysis and pseudoepiphysis formation preceded, and continued to be more mature than, formation and expansion of the classic epiphyseal (secondary) ossification center at the opposite end of each specific bone. Direct metaphyseal to epiphyseal ossification usually started centrally and expanded hemispherically, replacing both physeal and epiphyseal cartilage simultaneously. In contrast, when remnants of physis were retained, while juxtaposed epiphyseal cartilage was replaced, a pseudoepiphysis formed. There were three basic patterns of pseudoepiphysis formation. First, a central osseous bridge extended from the metaphysis across the physis into the epiphysis and subsequently expanded to create a mushroom-like osseous structure. In the second pattern a peripheral osseous bridge formed, creating either an osseous ring or an eccentric bridge between the metaphysis and the epiphysis. In the third pattern, multiple bridging occurred. In each situation the associated remnant physis lacked typical cell columns and was incapable of significantly contributing to the postnatal longitudinal growth of the involved bone. Pseudoepiphyses were well formed by 4–5 years and coalesced with the rest of the bone months of years before skeletal maturation was attained at the opposite epiphyseal end, which ossified in the typical pattern (i.e., formation of a secondary center de novo completely within the cartilaginous epiphysis). This process may also affect the development and appearance of ossification within the longitudinal epiphyseal bracket (delta phalanx).