Current Residents Research Articles

Medical training affected during COVID-19 pandemic and measures to overcome it

Background: The COVID-19 pandemic has affected the medical training due to lockdowns and ever changing SOP’s that has resulted in cancelling elective cases and restructuring of healthcare system. In all of this, the profound effect on resident’s wellness and effects on their clinical skills have not been characterized. Methods: It is a cross-sectional survey based study done in Liaquat National Hospital. An online questionnaire comprising of 21 questions were sent using online platform and the study includes all current residents working in affiliated hospitals in Pakistan. Respondents were asked about healthcare restructuring, educational experiences and impact on their wellness. Results: A total of 120 residents participated in the study, having response rate of 46.7 percent. Gender, postgraduate year, and city were well represented within the sample. Roughly all of the residents (82.1 percent) informed the restructuring of their residency program and most of them (75 percent) were assigned in the management of Covid-19 patients. Most of the residents has likely negative (4 percent) or somewhat negative (35.7 percent) impact on their training and wellness. Overall, 85.7 percent were discontented that they will not be able meet minimum case numbers due to reduce numbers of elective procedures. Most of the residents accepted that virtual lectures from professors outside the hospital were of the greatest value. Forty-six percent of the respondents felt isolated due to social-distancing during lockdown. Conclusions: The COVID-19 pandemic had a great amount of impact on plastic surgery resident’s education and wellness. Although reductions in elective cases may be temporary, this may represent a loss of critical clinical experience. Some effects were positive like conducting virtual meetings which have somewhat balanced the learning experience of residents.

Capacity and demand forecasting in Urban Air Mobility - A simulation of air transportation in Hamburg

This paper presents an innovative approach to urban air transportation planning through the development of a "digital twin" representation encompassing airspace and infrastructure elements, including route structures, existing airports, and future vertiports. The primary objective is to formulate a model that mirrors the dynamics of contemporary and prospective urban air mobility (UAM), driven by the focus on sustainability and electrification in the transportation sector. Given the multifaceted advancements in both personal aerial vehicles (PAVs) and unmanned aerial vehicles (UAVs), along with the emergence of cutting-edge electric aircraft, a multitude of scenarios become feasible. The air transport system we focus on, is the urban area of Hamburg, Germany, and its two inner-city airports and a prototype vertiport. Anticipating a growth in demand for air transport services for the nearly 1.9 million current residents of Hamburg over the next two decades, we assume various feasible scenarios, which in turn would result in an increasing energy demand. Our SIMMOD simulation model utilizes flight schedules for each airport in Hamburg, to which flights are incrementally added until practical capacity is reached at 80% above baseline levels. Our findings reveal that, as demand increases at Hamburg Airport and average operational delay approaches the level-of-service (LoS) threshold of 4 minutes per flight, the necessity for expanded air traffic and ground infrastructure becomes evident. Electric grids should be dimensioned according to these demands. Our results suggest that the capacity of the Hamburg airspace is currently limited by the main airport, and that the Airbus production facility in Hamburg-Finkenwerder can substantially augment its capacity by constructing a parallel taxiway alongside its runway. Moreover, vertiport capacity primarily is limited by factors such as UAV parking and charging positions, drone speeds, turnaround times, available airspace, degree of autonomy and the length of service routes.

Impact of Peer Feedback on the Quality of Academic Sessions in an Emergency Medicine Training Program: A Quality Improvement Project.

Introduction Feedback is at the heart of medical education; different teaching encounters call for different types of feedback. Due to multiple reasons presenters are not able to receive adequate feedback, which provides them with little to no areas to improve upon and hence affects the quality of the academic sessions(1). Feedback serves as a powerful tool in the realm of education, playing a vital role in shaping students' learning experiences and fostering their academic growth. Recognizing the importance of feedback and implementing effective feedback mechanisms can lead to enhanced learning outcomes, improved performance and increased motivation among learners(3). It can be incorporated to enhance teaching and learning techniques since it has an immediate impact on the process of acquiring knowledge and has a direct impact on both teaching and learning(4). Feedback has been shown to help speakers gain confidence, self-awareness, and enthusiasm(5). Methods: We designed a project to improve the quality of our academic day by integrating feedback forms into all our academic activities. In November 2022 we sent out a survey to all residents to evaluate the quality of the sessions in the academic day.Based on the responses received we incorporated feedback forms into each session to allow the audience to evaluate the speakers. All presenters presenting between February to July 2023 were provided with a QR code to be presented at the end of their presentation, to allow instant feedback by peers. At the end of the 6 month cycle we sent out 2 sets of surveys to both the speakers and audience to assess the impact of peer feedback on the quality of sessions presented during academic day. The surveys asked the audience and speakers to rate their experience of feedback forms and how it has impacted their performance. Each question was scored on a likert scale 1 to 5 with 1 being strongly disagree to 5 being strongly agree. Results: 30 out of 33 current residents responded to the surveys. Based on the responses received, there has been a positive outcome on all domains for both audience and speakers Fig 1,2). The audience felt it helped increase their weekly quiz scores(3.3/5), allowed them to better understand the topics(3.7/5) and improved the quality of presentations delivered (3.9/5). The speakers felt it helped them in delivering better lectures (4/5), Improved their ability to present to an audience (4.1/5), made them aware of their weakness and allowed them to work on them (4.3/5). Both the audience (4.3/5) and audience (4.4/5) would like to see the feedback forms to continue. Conclusion: In the era of formative assessment peer feedback will go a long way in improving the quality of educational activities. Our project has similar outcomes to multiple similar studies done elsewhere which have demonstrated an improvement in their educational experience (2). We hope our findings can aspire other programs in the region to incorporate similar feedback forms into their sessions. To evaluate effectiveness of peer feedback as a method of improving the quality of lectures conducted during academic day

The Mediating Effect of Appearance of Appearance in the Relationship between the 20s and Cosmetics Purchase Behavior

This study was attempted to find out demographic characteristics of women in their 20s in China, identify lifestyle, appearance interest, and cosmetics purchase behavior, and reveal the mediating effect of appearance interest in the effect of lifestyle on cosmetics purchase behavior. To this end, this study selected a woman in her 20s in China as the subject of the survey and conducted a survey. A total of 491 copies of the survey were used as final analysis data, excluding 15 incomplete or insincere responses among the questionnaires collected from August 1 to August 31, 2023. The data analysis used frequency analysis, factor analysis, reliability verification, technical statistics analysis, correlation analysis, regression analysis, and Sobel test using the SPSSWIN 21.0 program, and the following analysis results were raised. First, the most common characteristics of the survey subjects were the current residence in large cities (Beijing, Tianjin), the final academic background was a four-year university (re-school), unmarried, employed, monthly income was less than 500,000 won, and the average monthly cosmetics purchase cost was less than 200,000 to 300,000 won. Second, the correlation with each sub-factor of lifestyle, appearance interest, and cosmetics purchasing behavior all showed a positive (+) correlation, indicating that the higher the lifestyle, the more active the appearance interest and the higher the cosmetics purchasing behavior. Third, in terms of the impact of lifestyle on appearance interest, the higher the trend-seeking type and personality-seeking type, the higher the appearance interest. Fourth, the higher the trend-seeking type, a sub-factor of lifestyle, the higher the self-directed type of cosmetics purchase behavior, and the higher the trend-seeking type of lifestyle, the higher the brand preference for cosmetics purchase behavior. Fifth, as a result of verifying the mediating effect of appearance interest in the relationship between lifestyle and cosmetics purchase behavior, the mediating effect of appearance interest in the relationship between fashion-seeking type and self-directed type of cosmetics purchase behavior was significant, and the mediating effect of appearance interest in the relationship between fashion-seeking type and cosmetics purchase behavior was significant. The results of step-by-step verification of the mediating effect of appearance interest in the relationship between lifestyle and cosmetics purchase behavior are as follows. In Stage 1 and Stage 2, the significant trend-seeking type no longer significantly affects the self-directed type of cosmetics purchase behavior in Stage 3, indicating that appearance interest completely mediates the relationship between fashion-seeking type and self-directed type of cosmetics purchase behavior, and appearance interest partially mediates the relationship between fashion-seeking type and brand preference type of cosmetics purchase behavior. The results of this study are expected to be used as basic data necessary to identify the characteristics of the lifestyle of women in their 20s in Huabei, China, and to develop and specify cosmetics industry services and marketing strategies based on lifestyle using the results of this study are expected to be used.

Українські воєнні мігранти – мотивації, очікування, прагнення та інші напрями соціологічного осмислення

The author considers the problem of Ukrainian war migrants in the context of the sociological study of this phenomenon. Almost from the first weeks of crossing the western border, Ukrainian war migrants became the object of surveys, which encountered several methodological problems: insufficient sensitivity of quantitative research, socially desirable responses about returning, the impossibility of long-term planning under stress and uncertainty, etc. In addition, quantitative surveys of migrants are not representative, given the unavailability of data on the general population of such people in the countries of temporary stay. Despite the large array of accumulated empirical data, knowledge about the motivations for migration and plans for return remains somewhat fragmented. The paper examines available empirical data on this topic, conducts a theoretical analysis of modern migration studies, and takes steps to form a sociological framework for further study of the situation of Ukrainian war migrants. Among other things, it is suggested to consider positive and negative motivations and comparisons between Ukraine and the country of current residence. It is also recommended to apply an importance filter and to use the terminology of “delayed return”. The necessity of studying the aspirations of migrants is proved, which will help to shed light on the aspect of agency, which remains in a shadow. The relevance of studying family dynamics of migration is also argued. The article also discusses the need to understand that returning to Ukraine after the war can be another migration into the unknown, not a return to the familiar. As for the object of the research, the importance of studying the motivations of those who returned after a more or less long experience in other countries and those who changed from one host country to another is emphasized. Implementing these frames to the research arsenal will expand the possibilities of sociological understanding of this phenomenon.

INTERSECTIONAL AND BIOSOCIAL PATHWAYS TO COGNITIVE FUNCTION AMONG OLDER HISPANICS AND LATINOS

Abstract Hispanics/Latinos are the fastest-growing segment of older adults in the United States (U.S.). They are at high risk for cognitive impairment (CI) and Alzheimer’s disease and related dementias (ADRD). While increased research attention has been given to the socioeconomic and cultural factors that influence the prevention, diagnosis, and care provided to Hispanics/Latinos with CI and ADRD, there are still theoretical and methodological gaps in clarifying the mechanisms and pathways that produce ADRD inequities, including life course and multilevel mechanisms. Given the diverse origins of Hispanics/Latinos in the U.S. – in ethnic origin, birthplace, and current residence – it is crucial to understand how these social conditions get “under the skin” that influence cognitive function in older adulthood. Namely, it is important to unpack how different intersectional positions show different relationships with deprivation that influence cognitive and healthy aging. Thus, this study had two main objectives: (1) to examine the mediating role of physiological (dys)regulation between education and cognition, and (2) to understand for which Hispanic/Latino subgroups the interrelated relationships are stronger/weaker for. Correspondingly, we employed multigroup structural equation modeling to address our study objectives. We used data from the Health and Retirement Study (HRS) to discern and assess the effects between education, physiological factors, and cognitive function at baseline and follow-up by Hispanic/Latino subgroups (e.g., foreign-born Mexicans, U.S.-born Mexicans, island-born Puerto Ricans, foreign-born Cubans, etc.). The results from this study underscore the role of structural interventions and community engagement in reducing and eliminating cognitive health disparities among Hispanics/Latinos.

Concerning Trends in Vascular Surgery Trainee Operative Experience in Venous Disease

Comprehensive vascular care includes both arterial and venous disease management. However, operative training in venous disease is often significantly overshadowed by arterial procedures, despite the public health burden of acute and chronic venousdisease.The purpose of this study is to evaluate the case-mix and volume of venous procedures performed by graduating integrated vascular surgery residents and fellows in the United States. Accreditation Council for Graduate Medical Education national operative log reports were compiled for graduating integrated VSR (vascular surgery residency) and traditional vascular surgery fellowship (VSF) trainees from academic years 2013 to 2022. Only cases categorized as "surgeon fellow", "surgeon chief", or "surgeon junior" were included. Linear regression analysis was utilized to evaluate trends in case-mix and volume. Over the 10-year study period, total vascular cases increased for both VSR (mean 870.5±9.3 cases, annual change +9.5 cases/year, R2=0.77, P<0.001) and VSF (mean 682.1±6.9 cases, annual change +6.7 cases/year, R2=0.85, P<0.001) trainees. Concurrently, the proportion of venous cases in the VSR group decreased from 12.5% to 7.3% (annual change -3.7 cases/year, R2=0.72, P<0.001). VSR trainees experienced an annual decrease in 4 of the top 5 venous case types performed, including venous angioplasty/stenting (-1.6 cases/year, P=0.002), vena cava filter placement (-0.9 cases/year, P=0.002), endoluminal ablation (-0.2 cases/year, P=0.47), diagnostic venography (-1.7 cases/year, P<0.001), and varicose vein treatment (-1.0 cases/year, P<0.001). Venous cases proportions also decreased in the VSF group from 8.4% to 6.2% (annual change -2.2 cases/year, R2=0.54, P=0.002). VSF trainees experienced an annual decrease in 4 of the top 5 venous case types, including venous angioplasty/stenting (-1.5 cases/year, P=0.003), diagnostic venography (-1.2 cases/year, P<0.001), vena cava filter placement (-0.2 cases/year, P=0.44), endoluminal ablation (-0.6 cases/year, P<0.001), and varicose vein treatment (-0.1 cases/year, P=0.04). Both VSR and VSF trainee groups graduated with fewer than 5 cases for each of the following venous procedures-percutaneous mechanical thrombectomy, venous thrombolysis, open venous reconstruction, sclerotherapy, venous embolectomy, portal-systemic shunting, venous ulceration treatment, and arteriovenous malformation treatment. Current vascular residents and fellows have limited exposure to venous procedures, in part due to a proportional decline in venous cases. More robust venous operative experience is needed during surgical training. Further studies are needed to understand whether this discrepancy in venous and arterial training impacts career progression and patient outcomes.

The mediating effect of perceived stress on the relationship between big five personality traits and suboptimal health status in Chinese population: a nationwide survey in the framework of predictive, preventive, and personalized medicine.

The effects of psychological factors on suboptimal health status (SHS) have been widely described; however, mechanisms behind the complex relationships among the Big Five personality traits and SHS are unclear. Identifying people with specific traits who are susceptible to SHS will help improve life quality and reduce the chronic disease burden under the framework of predictive, preventive, and personalized medicine (PPPM/3PM). This study investigated the relationships among personality traits and SHS. It also explored whether perceived stress plays a mediating role in SHS development. A nationwide cross-sectional survey based on multistage random sampling was conducted in 148 cities in China between June 20 and August 31, 2022. Personality traits, perceived stress, and SHS were evaluated using the Big Five Inventory-10 (BFI-10), the 4-item Perceived Stress Scale (PSS-4), and the Short-Form Suboptimal Health Status Questionnaire (SHSQ-SF), respectively. Pearson's correlation analysis was employed to examine the associations between personality traits, perceived stress, and SHS. Structural equation modeling (SEM) was used to discern the mediating role of perceived stress in the relationships among personality traits and SHS. A total of 22,897 participants were enrolled in this study, among whom the prevalence of SHS was 52.9%. SHS was negatively correlated with three trait dimensions (i.e., extraversion, agreeableness, and conscientiousness) but positively correlated with neuroticism. Meanwhile, stress was negatively correlated with extraversion, agreeableness, conscientiousness, and openness, whereas it was positively correlated with neuroticism. The SEM results showed that, when adjusting for covariates (i.e., gender, age, BMI, educational level, current residence, marital status, and occupational status), higher agreeableness (β = - 0.049, P < 0.001) and conscientiousness (β = - 0.103, P < 0.001) led to lower SHS prevalence, higher neuroticism (β = 0.130, P < 0.001), and openness (β = 0.026, P < 0.001) caused SHS to be more prevalent. Perceived stress played a partial mediating role in the relationships among personality traits and SHS, respectively, contributing 41.3%, 35.9%, and 32.5% to the total effects of agreeableness, conscientiousness, and neuroticism on SHS. Additionally, the mediating impact of stress was significant even though extraversion had no direct effect on SHS. This study revealed a high prevalence of SHS in Chinese residents. Personality traits significantly influenced SHS rates, which perceived stress tended to mediate. From a PPPM perspective, early screening and targeted intervention for people with neuroticism (as well as stress alleviation) might contribute to health enhancement and chronic disease prevention. The online version contains supplementary material available at 10.1007/s13167-023-00349-x.

Factors affecting residency selection for underrepresented minorities pursuing orthopaedic surgery

BackgroundThe United States is increasingly diverse and there are many benefits to an equally diverse physician workforce. Despite this, the percentage of under-represented minorities in orthopaedic surgery has remained stagnant. The purpose of this study was to describe the characteristics underrepresented minorities pursuing orthopaedic surgery value most when evaluating residency programs. MethodsThe contact information of current underrepresented minority orthopaedic surgery residents were obtained through professional society databases, residency program coordinators and residency program websites. Individuals were sent a survey through which they evaluated the importance of a variety of program characteristics. ResultsThe most influential program characteristics were resident happiness and camaraderie, program reputation, geographic location, and relationships between residents and attendings. The least influential characteristics were sub-internship scholarship opportunities for minorities, program affiliation with diversity organizations, word of mouth from others, number of fellows, and centralized training sites. ConclusionsThere is a need to diversify the field of orthopaedic surgery, which begins by selecting more diverse trainees. This study demonstrates that underrepresented applicants are most influenced by many of the same characteristics as their well-represented peers. However, diversity-related factors still play an important role in the decision-making process. Many residents highlighted the impact microaggressions and mistreatment played in their residency experience, emphasizing the need for residency programs to focus not only on recruitment, but also on the successes and retention of their residents. Only once this is done will the field of orthopaedic surgery find sustained improvement in its diversification efforts.

What Can You Learn About Psychiatry Programs from Their Website? A Content Evaluation for Potential Applicants.

This project aimed to assess the information contained on general psychiatry program websites and identify common themes that may be useful and informative for residency applicants. A survey study design was used to evaluate all US general psychiatry program websites as listed in the FREIDA database. The evaluation form included 44 binary (yes or no) items. Two reviewers rated each item on all program websites between September 2021 and January 2022. Item discrepancies were settled by a third reviewer. Fisher's exact tests evaluated differences between geographic regions and program types. Multidimensional scaling and Rasch modeling were conducted to examine clustering and the probability of items reported on program websites. A total of 285 websites were identified; 13 were excluded. Internal consistency was high among reviewers, Cronbach's Alpha = 0.927; κ = 0.863. Websites varied considerably in quality. Significant inconsistent reporting was observed by region for current residents' photos and alumni careers (fellowship/jobs); p<0.001. Program types varied regarding information about program faculty, which included significant differences for faculty photo, faculty research interest, and faculty research publications; p<0.001. While inter-rater reliability was high, considerable variation among websites was observed. Residency programs could be improved by consistently reporting resident and faculty information. Results show that applicants may encounter issues finding pertinent information, as programs' FREIDA link did not direct the user to the residency program website two-thirds of the time.

A life-course approach to assessing residential mobility dynamics in selected immigrant communities in Kumasi, Ghana

This paper responds to the emerging concerns of residential dissonance character by examining the position and influence of the “life-course” framework of households on residential mobility decisions and the conjunct attainment of subjective well-being in their current and anticipated residential locations. Using data from a cross-sectional survey design and adopting a multi-stage sampling procedure, a comparative study of 397 households from immigrant communities within the Kumasi metropolis is conceptualized. Results from the study revealed contrasting variabilities in the push and pull factors influencing households' relocation experiences and decisions to move. Also, the likelihood of households relocating over the life course was significantly anchored on the employment stage. Thus, decision-making proxies for households' relocation intentions, preparedness, and realizing actual moves were noticeably rapid decisions during active employment life. The study further found that the associated perception of attaining subjective well-being attached to a household's anticipated residential locations was significantly higher than that of their current residence. On the premise of these empirical contributions, the paper outlines how findings could ultimately inform the development of sustainable urban growth management and shape housing mobility planning policies for rapidly growing regions within the global south.

Thoughts, perceptions and concerns of coastal residents regarding the discharge of tritium-containing treated water from the Fukushima Daiichi Nuclear Power Plant into the Pacific Ocean

BackgroundAs a part of the decontamination process after the Fukushima Daiichi Nuclear Power Plant accident of 2011, 1.32 million tonnes of tritium-containing water will be discharged from the power plant into the Pacific Ocean. Although radiobiological impacts of the treated water discharge on the public and the environment were reported to be minimal, Tomioka and Okuma locals expressed unease regarding the long-term recovery of their towns, which are economically dependent on the agricultural, fishery, and tourism sectors. This study presents thoughts, perceptions and concerns of Tomioka and Okuma locals regarding the discharge of FDNPP-treated water containing tritium into the Pacific Ocean to facilitate a more inclusive decision-making process that respects local stakeholder interests.MethodsConducted from November to December 2022, surveys were mailed to current residents and evacuees aged 20 years or older registered with the town councils.ResultsOut of 1268 included responses, 71.5% were from those > 65 years. 65.6% were unemployed, 76.2% routinely visited hospitals, and 85.5% did not live with children. 61% did not want to return to Okuma/Tomioka. Anxiety about radiation-related health effects (38.7%), consuming food produced in Okuma/Tomioka (48.0%) and genetic effects (45.3%) were low. >50% reported poor physical and mental health. 40% were acceptive, 31.4% were unsure, and 29.7% objected to the discharge plans. Multinomial regression analysis revealed that, compared to acceptive responders, those who objected were more likely to be female, unemployed, and have anxiety about radiation-related genetic effects and poor mental health. Unsure responders were similarly more likely to be female, anxious about radiation-related genetic effects and have poor mental health.ConclusionThe poor mental health of the locals, connected to high levels of risk perception and anxiety about the loss of economic opportunities related to the discharge plans, must be addressed. The 30-year discharge process could handicap local industries and hamper post-disaster socioeconomic recovery due to the circulation of false rumours among consumers. These results highlight the need to actively involve residents in the towns’ recovery process to address local concerns. The focus should be on the judicious combination of transparent science with the human aspect of recovery and narratives highlighting dialogues between local stakeholders and experts to enable the locals and the general public to make informed decisions about their protection and future.

Life course rural/urban place of residence, depression and cognitive impairment among older adults: Findings from the Longitudinal Aging Study in India

AbstractBackgroundGiven the unique socioeconomic structures and rural/urban differentials in mental health outcomes in the country, this study aimed to explore the associations of childhood, adulthood and late‐life place of residence with mental health outcomes of depression and cognitive impairment among older adults in India. The study also examined the relationship between older individuals’ life‐course rural/urban place of residence and late‐life mental and cognitive health.MethodUtilizing data from the Longitudinal Aging Study in India (n = 28,041 older adults age 60 years and above), I employed multivariable logistic and linear regression models to examine the association between urban/rural residential status, life‐course residence, depression and cognitive impairment among older adults.ResultChildhood and adulthood place of residence was not associated with depression in older men and women. Current rural place of residence was positively associated with depression in older women [OR: 1.37, CI: 1.05‐ 1.80] but not men. Childhood [OR: 1.88, CI: 1.16‐ 3.04], adulthood [OR: 2.00, CI: 1.26‐ 3.16] and current rural residence [OR: 1.93, CI: 1.27‐ 2.91] was positively associated with cognitive impairment in men. Only current rural residence [OR: 1.71, CI: 1.29‐ 2.27] was associated with cognitive impairment in women. There was no significant association between life‐course place of residence and depression except in case of lifetime rural residence Respondents with urban‐urban‐urban place of residence were less likely to be depressed [Coef.: ‐0.14, CI: ‐0.21‐ ‐0.07] compared to those with rural‐rural‐rural place of residence. There were significant associations between life‐course residence and cognitive impairment except among rural‐urban‐rural and urban‐rural‐rural migrants, showing a urban advantage in cognitive function among older adults.ConclusionThis study showed significant associations between life‐course residence and depression among permanent rural/urban residents. The study also showed significant associations between life‐course residence and cognitive impairment except among rural‐urban‐rural and urban‐rural‐rural migrants. Considering the rural disadvantage, the government should continue to support policies that can promote education among people residing in rural areas. The findings also urge social scientists and gerontologists, in particular, to consider the importance of lifetime historical context while evaluating mental and cognitive health of older persons.

Hearing impairment and risk of dementia in The HUNT Study (HUNT4 70+): a Norwegian cohort study

Hearing impairment is strongly associated with future dementia. No studies have reported objectively measured hearing impairment in a cohort with a long period of follow-up (>20 years), and few have reported follow-up over 10 years. Hence, there is a need for high quality studies with sufficient follow-up time and data to account for reverse causality and confounding. We aimed to address this knowledge gap. This cohort study used individual participant data from The Trøndelag Health Study (HUNT) in Norway. All current residents aged at least 20 years in the former Norwegian Nord-Trøndelag County were invited to participate in four decennial surveys: HUNT1 (1984-1986), HUNT2 (1995-1997), HUNT3 (2006-2008), and HUNT4 (2017-2019) with individuals aged at least 70 years included in a substudy, known as HUNT4 70+. Here, we report the findings of this substudy. HUNT4 70+ comprised 7135 participants who were assessed for dementia using the Diagnostic and Statistical Manual of Mental Disorders 5 criteria and who had audiometry between 1996 and 1998. The primary objective was to investigate, with gold standard audiometric testing and dementia diagnostic assessment, whether hearing impairment was an independent risk factor for all-cause dementia. The secondary objective was to investigate if a risk also applied to Alzheimer dementia and non-Alzheimer dementia. We analysed the association using Poisson regression and adjusted for confounders. This study is registered with ClinicalTrials.gov (NCT04284384). At baseline, 1058 (15%) individuals had acquired hearing impairment with a hearing threshold of at least 25 decibel (dB) and, at follow-up, 1089 (15%) had dementia. In the total group, people with hearing impairment had a relative risk (RR) 1.04 (95% confidence interval (CI) 1.00-1.09) per 10dB increase in hearing thresholds. For individuals younger than 85 years at follow-up the RR was 1.12 (95% CI 1.05-1.21). Associations between hearing impairment and Alzheimer dementia and non-Alzheimer dementia were similar. There was no association for individuals aged at least 85 years. We found a moderate association between objectively measured hearing impairment and dementia in the younger age group (<85 years). The findings of no association in the older age group (≥85 years) might be due to the competing risk of death. The present study adds to the literature showing that acquired hearing impairment is a risk for dementias over a period which is too long for reverse causation, and with thorough consideration of confounders. Further research is needed to investigate associations between the different aetiologies of hearing loss and dementia subtypes, and risk differences for sexes. The Norwegian National Centre for Ageing and Health with a grant from Health South-East.

Effective Factors for Implementing Building Information Modeling Using Fuzzy Method to Manage Buildings on Mars

Ever since mankind has known the world around him and space, he has been trying to find a suitable alternative for his current residence, the Earth. In this research, two main criteria for buildings on Mars and their information management were extracted by checking the library of studies on Mars. These two main criteria are the components of the building and the internal components of the building. The criteria for building components include the health of walls, the health of roofs, meteor protection, the health of facilities, and the health of windows (air exchange), and the internal components of the building, including air temperature, air pressure, ambient oxygen, ambient carbon dioxide, humidity, and the amount of light. These criteria, which were extracted from the library materials, were screened using the fuzzy Delphi method, which is one of the most accurate criteria screening methods and is completed by experts. After the opinions of experts, the criteria of health of walls, health of roofs, health of facilities, rejection, air exchange, ambient temperature, and oxygen content were extracted as final criteria. The results of the experts’ paired questionnaire were analyzed using the fuzzy AHP method, and the health criteria of the walls, the health of the ceilings, and air exchange have the first priority; the criteria of the ambient temperature and oxygen level are the second priority; and the criteria of the facilities are the last priority. These were placed as a suggestion, and it can be stated to the researchers that these priorities should be implemented in the blockchain platform so that the building information management system (BIM) works well in buildings on Mars and against any intrusion or damage. Being resistant, but it seems that the experts considered the components of the building separately from its protective components and put components such as the health of the window as a guarantee of the architecture of Martian buildings and did not include them as part of the main criteria of the research. Also, this research can be used as background for other research in this field.

National ABSITE Preparation Practices: A Survey of General Surgery Residency Program Directors

The American Board of Surgery In-Training Examination (ABSITE) was designed as a low-stakes, medical knowledge examination for US general surgery residency programs. However, in practice, this exam has been utilized for higher stakes purposes, such as resident promotion or remediation, and fellowship selection. Several studies have demonstrated the efficacy of ABSITE preparation resources, but best practices for ABSITE preparation and national preparatory habits are currently unknown. The aim of this work was to determine current residency programs' strategies for ABSITE preparation. We distributed an electronic survey to program directors or program coordinators of US general surgery programs asking them to anonymously report program ABSITE educational practices and ABSITE scores. We analyzed the proportion of responses using descriptive statistics and compared the effect of various strategies using the Mann-Whitney testing for nonparametric data. An average ABSITE percentile score was calculated for each residency based on program self-reported scores. Association of Program Directors (APDS) Listserv PARTICIPANTS: General surgery residency programs participating at the time of distribution (278). Response rate was 24% (66/278); 41 programs (62.1%) identified as university-affiliated, and 25 (37.9%) were community-based. Median intern class size was 8 (range: 3-14), including preliminary interns. Average ABSITE percentile score was 52.8% (range 36.9%-67.6%). There were no significant differences in ABSITE scores based on affiliation or program size. Educational resources utilized for ABSITE preparation included SCORE (89.3%), Q-banks (50%), and surgical textbooks (25.8%). The majority (56.1%) of programs reported using a year-long curriculum for ABSITE preparation, and 66.6% used a time-limited curriculum completed in the months immediately prior to ABSITE. Most programs reported that ABSITE scores were a low priority (63.6%) or not a priority (13.6%). The existence of a year-long curriculum for ABSITE was positively correlated with score as compared to programs without a year-long curricula (53.9% vs 48.5%, p <0.01). Programs using a time-limited curriculum demonstrated lower scores as compared to programs without time-limited curricula (51.3% v 56.1%, p < 0.01). General surgery programs use a variety of strategies to prepare residents for the ABSITE. Despite reporting that they utilize ABSITE scores for a variety of high stakes purposes including evaluation for promotion and as a predictor of the preparedness for the ABS QE, many programs reported that they consider ABSITE scores as a low priority. A year-long focused curriculum was the only strategy correlated with increased scores, which may reflect the value of encouraging consistent studying and spaced repetition. Additional work is needed to guide programs in optimal utilization of ABSITE scores for remediation and resident evaluation, as well as understanding how ABSITE preparatory strategies correlate with clinical performance.

General surgery applicant perspectives: Two years of virtual interview experiences and supplemental application impressions

BackgroundWe sought to evaluate the unique benefits and challenges the virtual recruitment and interviewing platform had on general surgery residency applicants. MethodsApplicants who interviewed for a categorical position at our institution during the 2021 and 2022 Match season were contacted to participate in the anonymous online survey focused on applicant behavior related to the virtual interview format. Data were analyzed using chi-square and paired t-tests. ResultsA response rate of 56.7 ​% (n ​= ​135) was achieved. Applicants accepted a median of 17 (IQR 13–20) interviews in 2021 and 15 (IQR 11–19) interviews in 2022. More than half (54 ​%) of applicants indicated they applied to more programs, and 53 ​% accepted more interviews, because of the virtual format. The greatest advantages of the virtual interviews as cited by applicants were saving money (96.3 ​%), saving time (49.6 ​%), and avoiding travel risks (43.7 ​%). The top limitations of virtual interviews were less exposure to current residents and faculty (61.5 ​%), to the city or location of the program (58.5 ​%), and difficultly comparing programs (57.8 ​%). The 2022 Match cycle included use of the supplemental application; however, 85 ​% of applicants did not feel that the supplemental improved their overall application. Some applicants (20 ​%) who “signaled” programs did not receive an interview offer from any of the programs they signaled. ConclusionThe transition to virtual interviews saved applicants time and money but limited their exposure. Future efforts to maintain virtual interviews will need to be balanced against the intangible benefit of human interaction and observing a program's culture.

Sociodemographics Impact Competitiveness in the Neurosurgical Match: Survey Results

BackgroundThe Neurosurgical Match involves selecting future neurosurgeons who will comprise the future national workforce, based on a competitive ranking process against other applicants. We aimed to identify which sociodemographic and academic factors influence competitiveness and rank position in The Match. MethodsA Council of State Neurosurgical Societies survey was distributed to current United States neurosurgical residents. The primary outcome measure was self-reported rank position of matched program. Variables queried included sociodemographic and academic metrics. Fisher’s exact, logistic regression, and t-tests were performed. ResultsFrom the 72 responses, there was a median United States Medical Licensing Exam (USMLE) Step 1 score of 248, 34.7% were Alpha Omega Alpha inductees, 77.8% completed one-to-three sub-internship rotations, median number of publications was 5, and 13.9% of respondents had PhDs. Sociodemographic analysis demonstrated that 69.4% were male and 30.6% were female. Applicants with a home-neurosurgery program or of female gender had statistically significantly higher odds of matching into a top three program on their rank list (OR 9 and OR 6, respectively). Females exhibited similar mean, but less variance, compared to male respondents for USMLE Step 1 scores and number of publications. Of those with a top three program match, respondents were more likely to agree that the home program supported his/her pursuance of neurosurgery. ConclusionsTwo sociodemographic factors were independently associated with high match rank: presence of home-neurosurgery program and female gender (OR 9 and 6, respectively). Female respondents reported consistently strong academic metrics (similar mean to males, but less variance compared to males).

Long-Term Effects of the Kumamoto Earthquake on Young Children’s Mental Health

Natural disasters cause numerous short- and long-term psychosocial effects on young children because of their increased vulnerability. This study aimed to examine the mental health of young children at 15 months after the Kumamoto earthquake. We conducted a self-administered questionnaire survey on the parents of 363 children aged 4–6 years across Kumamoto Prefecture. The questionnaire items included current residence, housing damage and evacuation experience during the disaster, as well as the Strengths and Difficulties Questionnaire (SDQ). The results showed that children who could stay in their home during the disaster had lower percentages of scores in the clinical range for conduct problems (odds ratio [OR] = 0.33, 95% confidence interval [CI]: 0.13–0.85) and hyperactivity/inattention (OR = 0.42, 95%CI: 0.19–0.93) on the SDQ. Furthermore, children who experienced living apart from their parents during the disaster had a higher percentage of scores in the clinical range for conduct problems (OR = 2.39, 95%CI: 1.05–5.42). At 15 months post-disaster, the mental health of the sample was worse than the normative data of Japan, indicating that the mental health of young children who experienced living at home and apart from their parents during the disaster was still affected.

Factors Influencing Specialty and Training Center Choices Among Saudi Medical Residents.

This cross-sectional study aims to identify and quantify the factors influencing Saudi medical residents in selecting their desired specialty and primary training center, while examining the associations between these factors. The study received approval from an institutional ethical committee at King Abdulaziz University. An electronic questionnaire was designed and validated via content, face validity, and the Content Validity Index. The sample size was calculated based on a 95% CI and a 5% margin of error. The study targeted all current residents in the current Saudi Specialty Certificate Programs. Descriptive statistics summarized demographic characteristics, training-related information, and factors influencing the selection of a specialty and training center. Fisher's exact test and Chi-square tests were employed for data analysis. A total of 387 respondents completed the survey, with a 32.3% response rate. The majority of respondents were male (n = 232, 59.9%), and the majority were also married (n = 67.2%), with internal medicine (n = 92, 23.8%) and family medicine (n = 74, 19.1%) being the most prevalent specialties. Notably, 89.4% (n = 346) reported matching into their first-choice specialty, and 67.2% (n = 260) into their first-choice training center. Furthermore, 90.2% (n = 349) had prior training (elective/internship) in their chosen specialty, and 63% (n = 244) had previous training (elective/internship) at their primary training center. Prior exposure to both specialty and center significantly resulted in them being the resident's top choice (p < 0.01). Multiple factors influencing the choice of either the specialty or the center were found to have statistically significant associations with the gender, specialty, residency level, sector of the training center, and timing of the specialty decision (p < 0.05). This study reveals the substantial influence of early experiences on Saudi medical residents' specialty and training center choices. It also uncovers gender disparities and variations in the influence of specialty-related factors. Future research with larger and more diverse samples is recommended to gain a deeper understanding of the multifactorial decision-making processes, enabling the development of strategies to better meet the evolving needs and preferences of healthcare professionals in Saudi Arabia.