Current Residents Research Articles

“Throw Dat Hat!”: Educational Experiences, Attainment, and Aspirations of Adolescent Female Trafficking Survivors in a Residential Facility

This study addresses the gap in research on the educational experiences of adolescent human trafficking survivors, with a focus on their past, present, and future educational experiences and goals. Its objective is to inform the best practices for educational programming within female adolescent residential care centers in the United States. Drawing on a subset of data from a broader mixed-methods case study conducted at the Allasso House residential facility, this research involved 11 current residents. The data sources included case files detailing their past educational experiences, assessments of their current educational achievements, and interviews exploring their future aspirations. The findings reveal key themes related to the residents past risk factors, current educational successes and barriers, and tensions in setting future goals. Most of the residents expressed a desire to attain high school equivalency, identifying financial stability as a primary motivation. They also aspired to form healthy families, while placing significant value on material success. Unlike studies that define success primarily through survival, sobriety, and the avoidance of re-trafficking, this research highlights the broader aspirations of these adolescents, emphasizing the critical role of education in general wellbeing, risk mitigation, and future success. This study underscores the importance of prioritizing educational attainment and long-term aspirations in future research and in the design of residential programs for adolescent survivors of trafficking.

Opportunities to Improve Communication With Residency Applicants: Cross-Sectional Study of Obstetrics and Gynecology Residency Program Websites.

As part of the residency application process in the United States, many medical specialties now offer applicants the opportunity to send program signals that indicate high interest to a limited number of residency programs. To determine which residency programs to apply to, and which programs to send signals to, applicants need accurate information to determine which programs align with their future training goals. Most applicants use a program's website to review program characteristics and criteria, so describing the current state of residency program websites can inform programs of best practices. This study aims to characterize information available on obstetrics and gynecology residency program websites and to determine whether there are differences in information available between different types of residency programs. This was a cross-sectional observational study of all US obstetrics and gynecology residency program website content. The authorship group identified factors that would be useful for residency applicants around program demographics and learner trajectories; application criteria including standardized testing metrics, residency statistics, and benefits; and diversity, equity, and inclusion mission statements and values. Two authors examined all available websites from November 2011 through March 2022. Data analysis consisted of descriptive statistics and one-way ANOVA, with P<.05 considered significant. Among 290 programs, 283 (97.6%) had websites; 238 (82.1%) listed medical schools of current residents; 158 (54.5%) described residency alumni trajectories; 107 (36.9%) included guidance related to the preferred United States Medical Licensing Examination Step 1 scores; 53 (18.3%) included guidance related to the Comprehensive Osteopathic Medical Licensing Examination Level 1 scores; 185 (63.8%) included international applicant guidance; 132 (45.5%) included a program-specific mission statement; 84 (29%) included a diversity, equity, and inclusion statement; and 167 (57.6%) included program-specific media or links to program social media on their websites. University-based programs were more likely to include a variety of information compared to community-based university-affiliated and community-based programs, including medical schools of current residents (113/123, 91.9%, university-based; 85/111, 76.6%, community-based university-affiliated; 40/56, 71.4%, community-based; P<.001); alumni trajectories (90/123, 73.2%, university-based; 51/111, 45.9%, community-based university-affiliated; 17/56, 30.4%, community-based; P<.001); the United States Medical Licensing Examination Step 1 score guidance (58/123, 47.2%, university-based; 36/111, 32.4%, community-based university-affiliated; 13/56, 23.2%, community-based; P=.004); and diversity, equity, and inclusion statements (57/123, 46.3%, university-based; 19/111, 17.1%, community-based university-affiliated; 8/56, 14.3%, community-based; P<.001). There are opportunities to improve the quantity and quality of data on residency websites. From this work, we propose best practices for what information should be included on residency websites that will enable applicants to make informed decisions.

Community Preferences for Agrarian Reform in Kampung Reforma Agraria: A Case Study of Mekarsari Village, Banten

Abstract: An agrarian reform program encompassing asset and access arrangement was implemented to address the inequality in land ownership. Furthermore, asset management and access management models are integrated in the same location to increase the effectiveness of the agrarian reform program. As a pilot project, the first Kampung Reforma Agraria (KRA) was implemented in Mekarsari Village, Panimbang District, Pandeglang Regency, by distributing land to 225 subjects. However, after five years of implementing agrarian reform, some subjects still have not occupied KRA locations. This condition indicates that some subjects are reluctant to live in the designated location. Therefore, this research aims to analyze the profile and characteristics of TORA subjects’ residences who have yet to occupy the land granted in the KRA and the influence of these two factors on their spatial preferences regarding agrarian reform policies. By interviewing 23 TORA subjects who had yet to occupy the Tanah Objek Reforma Agraria (TORA) location and transfer their land rights, the results show that 52.5% wanted to move to KRA. In contrast, 47.5% did not want to occupy their land in KRA. Based on the analysis of the physical characteristics of the TORA subjects’ residences, the relationship between the physical distance from the subject’s current residence to KRA and the subject’s preference to move to KRA was not very significant. The factors most influencing the subject’s preferences are the residence’s non-physical characteristics, the land’s current legal status, and the socio-economic profile. Based on these findings, policymakers responsible for setting the criteria for land recipients should enhance the supervision system for subject selection from the outset. Furthermore, when designing access provision programs, it is essential to account for the diverse preferences and needs of each subject group. Keywords: Agrarian Reform; Access Arrangement; Asset Arrangement; Kampung Reforma Agraria; Spatial Preferences.

Pediatric pain physician workforce: an assessment of supply and demand

IntroductionMany youth with pain lack access to pediatric pain expertise. There is a critical shortage of pediatric pain physicians, due partly to a paucity of training programs in Pediatric Pain Medicine. Pain fellowships are Anesthesiology-based and there is no pathway to fellowship training or Pain Medicine board certification for pediatricians. This workforce assessment sought to examine the current state of Pediatric Pain Medicine in the United States and future interest in pursuing Pain Medicine among pediatricians.MethodsA multidisciplinary working group of Pain Medicine clinicians designed three surveys to examine pediatric comprehensive pain programs in the US, practice patterns of pediatricians and their motivations and opinions regarding Pain Medicine board certification, and current residents’ exposure to and interest in Pediatric Pain Medicine.ResultsWait times for initial evaluations are two months or longer for two-thirds of responding centers, and barriers to increase staff size and resources were reported, including an inadequate number of trained or available physicians. Pediatricians expressed interest in earning board certification in Pain Medicine, given the opportunity. Additionally, there is interest among pediatric residents in pursuing Pediatric Pain Medicine, and qualitative data highlight information residents perceived needing in order to pursue a career in the field.DiscussionResults demonstrate the need for increased training opportunities in pediatric pain medicine. A formal pathway to Pain Medicine for Pediatricians should be developed to increase the potential workforce and to address the lack of trained pediatric pain specialists, thereby improving access to care for youth with pain.

Benefits of Practicing Teaching as a Resident: A Single Institute Experience of a Formal Teaching Curriculum for Pathology Residents

Abstract Introduction/Objective The practice of near-peer teaching, both in lecture style and small group formats, has been shown to have benefits for the educator in improving communication skills, gaining knowledge in a subject, and providing a tangible experience that may aid in applying for employment. The purpose of this study is to present the current curriculum and teaching opportunities at the Medical University of South Carolina (MUSC) and their impacts on developing pathology residents’ teaching skills and perceptions of their growth as educators. Methods/Case Report Data regarding curriculum format and learner surveys for various teaching programs at MUSC was gathered from residency program leadership and the MUSC College of Medicine. An anonymous survey was distributed to current MUSC pathology residents to assess their participation, current comfort level, and comfort level prior to the start of residency in regard to various teaching modalities. Results (if a Case Study enter NA) The resident curriculum offers teaching modalities such as small group co-leader for medical students, didactic presentations, and on-the-job teaching. On a Likert scale of 1 to 5, with 5 being very comfortable, residents reported an average comfort level with teaching before starting residency as 2.11 and a current comfort level with teaching as 2.67. Residents were split on their perception of what affect residency has had on their comfort in teaching. Medical student evaluations of their small group teaching sessions co-led by pathology residents averaged 77.6% approval per course. Conclusion Through providing an overview of required and voluntary teaching opportunities offered at one institute and residents’ perceptions on their experiences while teaching there, we hope to both provide curriculum examples for other institutions and to advocate for placing greater importance on providing opportunities for residents. Such opportunities to practice teaching help them develop skills to benefit them as pathologists and in their future employability.

Implementation and reception of a semi-structured resident interview to improve equity

Abstract Introduction/Objective To improve equity and inclusion in the residency candidacy interview process, we collaborated with our human resources and graduate medical education colleges to develop standardized interview questions based on best practices reported in corporate and medical literature. These standardized questions were piloted by resident interviewers during the 2023-2024 Pathology residency application cycle in a semi-structured interview format. Methods/Case Report With consultants from the graduate medical education and human resources, we identified favored qualities of expectational candidates (e.g., passion for pathology, interest in program, collaboration, reliability, and compassion) and developed a list of standardized questions with a corresponding answer scoring guide to guide objective assessment of answers for each quality. Residents and fellows (“interviewers”) who volunteer to interview Pathology residency candidates (“candidates”) received training on interviewing best practices, identifying and mitigating bias, and the new semi-structured interview format at the beginning of the interview season. Interviewers were encouraged to use a semi-structured interview format where at least one standardized question is included in addition to their usual ad hoc interview questions and discussions. After the interview season concluded, we surveyed all interviewers (n=39) and candidates (n=90) who participated in this process, for feedback on the semi-structured interview process. Results (if a Case Study enter NA) 31/90 (34%) applicants provided feedback about their interview with 15/29 (52%) applicants agreeing that the semi-structured interview format enhanced their experience. 20/31 (65%) applicants agreed that their impression of Stanford would be positively affected if all interviews were conducted in a semi- structured format. 24/31 (77%) think faculty members should use standardized questions while 17/31 (55%) think residents should use standardized questions in either a semi-structured or structured formats. 17/31 (55%) feel that structured interviews contribute to improving equity. 12/39 (31%) of current residents provided feedback about their interviews. All 12 (100%) respondents used standardized questions in a semi-structured interview format. 10/12 (83%) interviewers think the new format improves our resident interview process. Conclusion Overall, responses from both resident interviewers and applicants support the implementation of semi- structured interviews and the continuation and expansion of this initiative.

Perspectives on program duration and research: A survey of graduates of a 3-year medical physics residency program.

The goal of this manuscript is to evaluate strengths and weaknesses of a 3-year medical physics residency program with the first year dedicated to research and the remaining 2 years dedicated to clinical training. An anonymous survey was distributed to graduates of a 3-year medical physics residency program with a dedicated year of research. Questions focused on several categories: (1) in retrospect, factors graduates considered at the time of application, (2) aspects of respondents' career and life after graduating from residency, (3) respondents' opinions on the residency duration, and (4) research productivity during residency. Of 22 graduates who were contacted, 17 filled out the survey. In retrospect, the most impactful consideration at the time of application was quality of clinical training. Extra time for research was reported as the factor with the most positive career impact and financial considerations as the most negative impact of completing a 3-year residency. Preference for a 3-year residency at the time of application and in retrospect was expressed by 47% and 88% of respondents, respectively. 71% of respondents would recommend applying to a 3-year program to current residency candidates, and 29% respondents said their recommendation on entering a 3-year program would depend on the candidate's interests. 76% of respondents preferred dedicated time for research during residency. The optimal duration of medical physics residency depends on the goals and career objectives of the incoming residents. Two years may be an optimal duration for clinical training. For candidates interested in a career with a substantial research component, a 3-year program may be a good option, and graduates express favorable opinions after completing such a program. A 4-year residency duration is not viewed favorably by the graduates.

AAPM BTSC Report 377.B: Physicist brachytherapy training in 2022 - A survey of therapeutic medical physics residents.

A survey of medical physics residency program directors was conducted in Spring 2021 to examine the current state of brachytherapy (BT) training during residency. In this related work, a subsequent survey of therapeutic medical physics residents in 2022 was conducted to assess the confidence and experience of the trainees. Concerns for access to high-quality and diverse training in BT have escalated in importance due to recent declines in BT utilization. A survey consisting of 26 questions was designed by a working unit of the Brachytherapy Subcommittee of the American Association of Physicists in Medicine (AAPM) and approved for distribution by the Executive Committee of the AAPM. The survey was distributed to current trainees and recent graduates of the Commission on Accreditation of Medical Physics Education Programs accredited therapeutic medical physics residency programs by the AAPM. The participant response was anonymously recorded in an online platform and subsequently analyzed using spreadsheet software. The survey was distributed to 796 current medical physics residents or recent graduates over the course of 6weeks in February and March of 2022. The survey received 736 views and a total of 182 responses were collected, with 165 respondents completing the survey in full. Among those responses, 110 had completed their residency training, with program start dates ranging from calendar years 2015 to 2021. Individual responses from the survey takers (including partial survey submissions) were evaluated and analyzed to compile results. Medical physics residents reported the highest levels of confidence and caseload for gynecological BT procedures when compared with other surveyed treatment techniques. This indicates opportunities to improve training and increase access to clinical caseload are needed in order to improve competency and confidence. Time constraints (clinical and rotation-based) were indicated as impediments to BT proficiency. Medical physics residents reported enthusiasm for additional training opportunities in BT, and it is evident that additional structure and programs are required to ensure adequate access to BT training during residency.

Quality improvement of breast and cervical cancer screening satisfaction rate at a resident-led clinic.

308 Background: In the US, 77.3% of women aged 21-65 years have had a Pap smear within the past three years and around 75.9% of women aged 50-74 years reported having a mammogram within the past two years as recommended according to the U.S. Preventive Services Task Force (USPSTF). In UTRGV Resident-led Clinic located in Hidalgo County, the quality metrics data demonstrated screening satisfactory rate for cervical and breast cancer to be 18% in August 2023. This Quality Improvement project is aimed at enhancing the screening satisfactory rate of breast and cervical cancer by 20% at UTRGV Knapp IM Clinic by December 2023. Methods: First, we focused on the education of the residents through noon conference and 1:1 education. This included comprehensive instruction on latest USPSTF guidelines and proper documentation on the electronic health record system, Athena. Second, we introduced a patient screening questionnaire, available in both English and Spanish. These efforts were evaluated through a pre-and-post-intervention survey designed to assess changes in residents' confidence, aligning with quality metrics data. We obtained and filtered the quality metrics raw data to include all the current residents in PGY1-3 and summed the number of patients who had records of breast and cervical cancer screening and divided the sum of all patients that required the record. The satisfaction rate was rounded to the 2nd decimal place. Results: The raw data from 8/2023 showed screening satisfactory rate for cervical and breast cancer to be 18%. With the initiation of intervention, the data from 9/2023 showed rate of 35%, finally reaching 39% on 12/2023, fulfilling our aim of 20% increase in the screening satisfactory rate. Survey data shows that there was an improvement of confidence observed in both breast and cervical cancer screening. Respectively, 27.5% and 30.9% increase in the residents who responded confident in breast cancer and cervical cancer screening were observed. 84.4% of residents responded that they are less forgetfulness in screening patients after the intervention. There was 22.9% increase in residents who know how to record the cancer screening result in Athena. 87.5% of the residents responded that they experienced improvement in implementing and documenting the breast and cervical cancer screening. Conclusions: Despite several limitations in acquiring and analyzing the data, this QI project positively impacted both subjective and objective data for the improvement of the breast and cervical cancer screening, fulfilling our aim of 20% increase in screening satisfactory rate by December 2023. Breast and cervical screening satisfactory Rate. Month/year Number of patients requiring breast and cervical cancer screening Number of patients with satisfaction in breast and cervical cancer screening Satisfactory rate (%) 08/2023 42 229 18 9/2023 999 2844 35 10/2023 454 1458 31 11/2023 649 1771 37 12/2023 113 287 39

Exploring Impact and Variability of Research Productivity Among Academic Orthopaedic Leaders.

Assessing scholarly contributions in academic orthopaedic surgery remains challenging, despite the importance of publication productivity in evaluating academic leaders. The Hirsch (h)-index and its derivative, the m-index, offer objective measures to compare and evaluate publication productivity. The primary aims of this study were to compare h- and m-indices of department chairs and residency program directors of orthopaedic training programs in the United States and assess the association between h-index and program rank. A publicly available Doximity report was used to identify and rank orthopaedic surgery residency programs in the United States. Internet-based searches of institution-specific websites were performed to confirm current department chairs and residency program directors as of January 2024. H-index data were collected from a publicly available database known as Scopus. The m-index was calculated as the quotient of h-index and years in practice. Gender and years in practice were obtained through available biographies on institution-specific websites. Department chairs had significantly higher h- and m-indices at both the career and 5-year time intervals compared with program directors. Upon subgroup analysis, department chairs and program directors at top-10 ranked programs had significantly higher h- and m-indices compared with the entire population of department chairs and program directors. Linear regression analyses demonstrated a direct linear association between department chair/program director h- and m-indices and program rank. Publication productivity was higher for department chairs than residency program directors. Orthopaedic leaders at top-10 institutions had higher publication productivity compared with those at institutions outside of the top 10, per Doximity rankings. Finally, there is substantial variation in publication productivity of orthopaedic surgeons in leadership roles at academic institutions in the United States. This study highlights the publication productivity of orthopaedic surgery department chairs and residency program directors and describes the linear association between publication productivity of academic orthopaedic leaders and program rank. This information can be utilized by those interested in learning more about the publication productivity among academic orthopaedic surgeons across different institutions and can assist those who are involved in the hiring and promotion process at these academic institutions.

Defining Future Cities: A comparative review of future cities’ definitions and characteristics across multiple fields

The rapid interest in future cities within academia is driven by the rising complexity of urban development and challenges such as rapid urbanization, population growth, and inequality. Researchers across various fields have different understandings of future cities and their characteristics, causing confusion and divergence between implementation goals and theories. This research addresses this gap by providing a unified, multidisciplinary definition of future cities, critically analyzing their intellectual and practical characteristics across fields including philosophy, computer science, engineering, environmental science, management, economics, social science, health sciences, architecture and planning.This research employed a mixed-method approach of a hybrid systematic-narrative literature review to identify key characteristics, followed by a multidisciplinary focus group of experts to synthesize the definition and key characteristics. It concluded that despite the rising interest in academia about future cities in recent years, there are differences in how various fields perceive future cities, particularly in areas like infrastructure, resource management, innovation, adaptability, technology, sustainability, and human needs. Despite these differences, future cities share common goals of meeting the well-being and justice needs of both current and future residents. They rely on technology, sustainability practices, community involvement, responsible citizenship, and efficient governance and leadership to ensure sustainable and effective long-term outcomes.

Determinants and predictors of Occupational Burnout syndrome among Residents Physicians

Background: The burnout syndrome has 3 dimensions; first is emotional exhaustion, second one is depersonalization, and third is low personal accomplishment. Work related burnout is increased nowadays and it becomes a serious problem affecting people who working in human services, particularly healthcare workers. This study aimed to: Determine the frequency of burnout syndrome and related factors among Salahaddin resident physicians. Subject and Method: A cross-sectional study , done from 11th of November 2021 to 15th of March 2022. A convenient sample of 100 resident and permanent doctors, working in Salahdin Public hospitals. Inclusion criteria were current residents doctor who had at least one year in a residency program. Data collected using interview questionnaire form based on the Maslach Burnout Inventory. Results: The 100 resident doctor information analyzed and found that 56(56%) , 44(44%) were male and female respectively. High frequency of the resident aged 26-30 years 68(68%), 75(75%) of them living in Salahdin, junior residents represent 52(52%) and 48(48%) were permanent resident. The high scores of occupational exhaustion was reported among 41(41%). The high scores of depersonalization / loss of empathy was reported among 42(42%). The low scores of personal accomplishment assessment scores was reported among 64(64%). Females 21(47.7%) had more occupational exhaustion than male doctors 20(35.7%). high score of depersonalization / loss of empathy reported among 22(39.3%) of the male and 20(45.5%) of the females. Conclusion: burnout frequency was high among Iraqi residents with high scores of occupational exhaustion, and depersonalization/ loss of empathy, and high percentage of low scores of personal accomplishment assessment.

You Can't Be What You Can't See: The Progression of Women in Otolaryngology-Head and Neck Surgery.

Objective: To examine trends in the gender composition of residents and faculty in Otolaryngology-Head and Neck Surgery residency programs in the United States and to investigate the correlation between women's representation in leadership positions and the proportion of women faculty and residents. Methods: A literature review was first performed to analyze trends in the gender composition of residents and faculty in Otolaryngology-Head and Neck Surgery (OHNS) residency programs. Current residency programs were then identified using the Electronic Residency Application Service 2023 Participating Specialties and Programs website. The following data was collected from each program website: gender of associated medical school dean, gender of department chair, gender of residency program director, and total number and gender of fellowship directors, faculty, and residents. Wilcoxon rank sum test and Fischer's exact test were used to analyze relationships between the number of women in leadership positions and the proportion of women faculty and residents. Results: An increase in the number of women chairs, residency program directors, residents, and faculty over the past decade is documented across published literature. One hundred twenty-three current academic residency programs were identified. Women accounted for 42%, 30%, 27%, and 8% of current residents, residency program directors, faculty, and department chairs, respectively. Department chair gender was significantly correlated with number of women faculty (P = .01). Any women in a leadership position were correlated with a statistically significant increase in median percent of women faculty (P = .006). Conclusion: Further understanding of how the mentorship of women promotes gender equity is necessary to promote gender diversity in OHNS.

Shaping stable support: Leveraging digital feedback interventions to elicit socio-Political acceptance of renewable energy

In democratic countries, the success of energy policies hinges on citizens' support and their acceptance of policy outcomes. In this study, we develop a digital feedback intervention to prompt citizens with information that visualizes the geographical distribution of wind turbines and to evaluate the effects on socio-political acceptance. In an online experiment, we exposed 430 German citizens to a personalized digital feedback intervention and elicited their acceptance of renewable wind energy. The results are threefold: First, citizens' acceptance of renewable wind energy that results from digital feedback is lower than initially claimed. Second, citizens who meaningfully engage with the digital feedback intervention are more likely to revise their acceptance of wind energy. Third, and surprisingly, citizens’ ecological attitude and place attachment to their current residence had no significant effect on the extent to which they revised their acceptance of renewable wind energy. Our results demonstrate that digital feedback interventions can act as a “sensor” for socio-political acceptance. This contributes to informing citizens about energy policy outcomes and provides valuable insights for policymakers promoting a participatory democracy paradigm.

Analysis of urban households’ perception and factors that influence participation in urban agriculture in Kumasi, Ghana

The agricultural sector in Ghana heavily relies on rural farmers, but burgeoning population growth and rapid urbanisation, driven by the pursuit of higher incomes, pose challenges to food security. The increasing demand for agricultural products has outpaced production, resulting in a heightened dependence on imports. To address these challenges, urban agriculture emerges as a potential solution. This study examines the dynamics of urban farming participation by surveying 363 urban farming households in Ghana. The study uses descriptive statistics, perception index analysis, and regression analysis to find that urban agriculture participation is 59.8 %, depending on factors like household size and length of time in the current residence. Urban households generally perceive urban agriculture positively, associating it with increased income and improved food accessibility. The majority of participants focus on food production (89.86 %), with a notable portion also incorporating livestock farming (45.78 %). Primary purposes include household consumption (97.74 %) and commercial use (38.95 %). Binary logistic regression identifies set of contributors to participation, such as household size, income, available land, time availability, and positive perceptions of backyard gardening. The study recommends governmental intervention, emphasising policy formulation and regulation by the Ministry of Food and Agriculture, alongside zoning regulations that integrate urban agriculture into infrastructure planning for sustainable development.

Qualitative Comparative Analysis of exercise interventions for fall prevention in residential aged care facilities

BackgroundExercise interventions are highly effective at preventing falls in older people living in the community. In residential aged care facilities (RACFs), however, the evidence for effectiveness is highly variable, warranting exploration of drivers of successful trials. This study aims to identify the conditions of randomised controlled trials (RCTs) that are associated with reducing falls in RACFs and test whether it can explain the variability.MethodsRCTs testing exercise interventions in RACFs compared to usual care, reporting rate or risk of falls from the 2018 Cochrane Collaboration review and a search update to December 2022 were included. Two authors independently extracted and coded trial conditions and outcomes according to a theory developed from prior Intervention Component Analysis. Trial outcomes were coded as successful or unsuccessful based on point estimates for the rate or risk ratio for falls, or p value. Qualitative Comparative Analysis (QCA), utilising Boolean minimisation theory, was conducted to determine the key conditions driving trial success. A subgroup meta-analysis and the GRADE approach was applied to the final theory.ResultsEighteen trials undertaken in 11 countries with 2,287 residents were included. Participants were predominately ambulant females aged 70 to 80 with cognitive impairment. Most interventions were fully supervised or supervised at the start of the intervention. QCA identified two configurations as drivers of successful exercise falls prevention programs: (i) group exercise that is moderate or low intensity, or (ii) for independent ambulatory residents, exercise for more than 1 h per week. The combination of configuration (i) and (ii) had consistency and total coverage scores of 1, indicating all trials were explained. This combination was associated with a reduction in falls (rate ratio 0.45, 95%CI 0.34 to 0.59; risk ratio 0.66, 95%CI 0.53 to 0.82; low certainty evidence).ConclusionTo successfully reduce falls in RACFs, exercise programs should provide continuous supervised moderate-intensity group exercise. For programs that mostly include independent ambulatory residents, exercise for at least 80 min per week should be provided. As many current residents are frail, tailored exercise is likely necessary and an individualised dose may be required. Future trials should test exercise interventions for less mobile residents.

Population Movement and Poliovirus Spread across Pakistan and Afghanistan in 2023.

Population movement dynamics are a critical part of understanding communicable disease transmission patterns and determining where, when, and with whom to deliver appropriate prevention interventions. This study aimed to identify the origin of the Afghan population and their patterns of movement within Karachi, to assess the polio vaccination status of children under the age of five, and to investigate the travel history and guest arrival patterns of individuals from Afghanistan and other regions known to be affected by wild poliovirus type 1 (WPV1) within the past six months. A cross-sectional survey was conducted in selected 12 union councils of Karachi, Pakistan. The data were collected through interviews with Afghan household members and from the frontline workers (FLWs) responsible for the polio vaccination of the children of the same households. Cohen's kappa was used to check the agreement between information provided by the household participant and FLWs. A total of 409 Afghan household members were interviewed. Travel of any household member outside the city within the last six months was reported by 105 (25.7%) participants, 140 (34.2%) hosted guests within the last six months, and 92 (22.5%) participants reported that guest children were vaccinated in their households. A total of 230 (56.2%) participants observed polio teams at relatives' households within Karachi, and 127 (31.1%) observed polio teams at relatives' households outside Karachi in different districts of Pakistan and Afghanistan. Fair to moderate agreement was observed between information provided by the household members and FLWs on the variable's duration of living at current residence (Kappa = 0.370), travel history (Kappa = 0.429), guest arrival (Kappa = 0.395), and household children vaccinated for OPV (Kappa = 0.419). Substantial population mobility was observed between Afghanistan and Pakistan as well as significant movement of the Afghan population within Karachi in the last six months. These findings warrant attention and targeted implementation of interventions to enhance and sustain both routine and supplementary immunization activities within this demographic group.

Development of a residents’ needs assessment-based novel pathology residency boot camp designed on the graduated release of responsibility model

Boot camps in medical education have emerged as effective tools for addressing knowledge gaps and facilitating the integration of incoming residents into clinical training. We developed a pathology boot camp designed on a needs assessment survey, the graduated release of responsibility model, and active involvement of senior residents as educators. A comprehensive survey was administered to current first-year residents to assess educational needs to identify significant knowledge gaps and difficult areas. Based on these findings, a four-week, three-phase curriculum was developed, comprising introductory didactics, hands-on training, and mentorship under senior residents. Pre- and post-tests, as well as resident surveys, were used to evaluate the efficacy of the boot camp curriculum. Senior residents unanimously expressed the need for a boot camp, expressing challenges in histology, workflow, autopsy, and laboratory operations. Pre- and post-boot camp assessment tests showed a 15% knowledge improvement. Most pathology programs across the country have implemented structured pathology boot camps. The strengths of our boot camp included the emphasis on the previous year's residents' feedback, and the challenges that they encountered, serving as a comparison group; a graduated release of responsibility model; and the involvement of senior residents as designated mentors for the duration of the boot camp. The pathology boot camp presented here serves as a promising model for addressing foundational knowledge deficits among incoming residents. By tailoring the curriculum to meet specific educational needs and leveraging senior residents as educators, institutions can better prepare residents for the challenges of clinical training.

Top DEI Topics to Incorporate Into Dermatology Residency Training: An Electronic Delphi Consensus Study.

Current dermatology residency education may be deficient in curricular topics and training related to diversity, equity, and inclusion (DEI). Integrating more DEI topics within residency curricula may improve clinical care delivered to diverse populations and improve cultural humility among trainees. The objective of this electronic Delphi (e-Delphi) study was to reach a consensus on the most important DEI topics for inclusion in dermatology residency program curricula nationwide. Sixty-one DEI-related topics were proposed by an expert panel consisting of dermatologists from the Association of Professors of Dermatology DEI subcommittee and the American Academy of Dermatology Diversity Task Force. Two rounds of anonymous electronic surveys based on a 5-point Likert scale were administered using a modified e-Delphi design. Voluntary participants including residents and academic dermatologists were self-selected after an email was sent to the Association of Professors of Dermatology listserve.

Exploring the gender gap in neurosurgery: A cross-sectional analysis of preresidency publications among neurosurgery residents.

While the number of female physicians has increased since the 1970s, there continues to be a lack of female surgeons compared to their male counterparts, with the gender gap more prominent in surgical subspecialties such as neurosurgery. While surgical subspecialities have accelerated initiatives to close the gap, potential disparities in research opportunities may position women at a disadvantage, particularly in neurosurgery, where academic publications are an indicator of residency match success. In this paper, we sought to investigate whether gender disparities exist in preresidency neurosurgery publications among current neurosurgery residents. The present study selected residency programs from the top 25 neurology and neurosurgery hospitals in US News & World Report's 2022 Ranking. A database of neurosurgery residents and their publications was created using PubMed, neurosurgery residency program websites, and supplementary search. Articles published between the time of birth and December 31st of the year of graduation (medical degree) were used to determine publications before residency. Our research indicates that 25.7% (n = 135/526) of US neurosurgery residents at top 25 hospitals are women and 74.3% (n = 391/526) are men. Men (n = 391) had a median of 7 (interquartile range [IQR], 3-14.5; range, 0-129) publications before residency, and women (n = 135) had a median of 7 (IQR, 4-11.0; range, 0-74) publications before residency. There were no significant differences in the median number of publications between genders (p = 0.65). In conclusion, our research indicates there is no gender disparity in preresidency publications among neurosurgery residents. To improve women's representation in the field, further study is needed to better understand gender inequality among neurosurgeons, particularly in the earlier stages of medical training.