Longitudinal Look Research Articles

Longitudinal look at individual resident preferences to prevent burnout: Which matter the most?

ABSTRACT A longitudinal look at individual resident preferences to prevent burnout: Which matter the most? Background and Objectives Burnout among residents-in-training is being reported more frequently. Previous studies have shown that lower measures of emotional intelligence, mindfulness, emotional regulation, and gratitude earlier in residency were associated with higher burnout scores later. Many studies have reported interventions intended to lessen burnout but not chosen by the residents with variable results on subsequent burnout measures. This paper reports an individually paired longitudinal analysis of strategies ranked by the resident as important with a subsequent burnout measure. Methods From 2017 through 2021, 32 residents completed a survey ranking their preference of ten approaches to preventing burnout at the beginning of the academic year. Then they later completed a burnout survey at the end of each year. Results With a usable response rate of 94% and calculating Spearman’s Correlation, residents completing their first year of training after medical school (PG-1) who gave a higher rank to a workplace supporting their personal values (p=.016), self-care (p=.031), and administrative support (p=.046) showed less burnout at the end of the year. PG-3s (those completing their third year of training after medical school) who gave a higher rank to spending time with family and friends (p=.002) showed less burnout. For all three years, the most powerful correlation was with adopting a healthy philosophical outlook (p=.014, .008, <.001). Conclusions In this group of residents, the correlations of preferred strategies for lessening burnout differed by training level. Rather than faculty choosing an intervention, we propose these ten strategies as a potential menu, allowing the individual resident to focus on their preferences working with a mentor. Group discussion of methods used by individual residents to adopt a healthy philosophical outlook would also be helpful.

QOL-12. LESSONS LEARNED FROM LONGITUDINAL CARE IN POSTERIOR FOSSA SYNDROME

Abstract BACKGROUND Posterior fossa syndrome (PFS) is a constellation of neurobehavioral symptoms occurring in 8–24% of children following surgical resection of posterior fossa tumors. Symptoms may include a combination of mutism or reduced verbal output, emotional lability, hypotonia, dysphagia, ataxia and weakness. Direct surgical injury to the dentato-thalamo-cortical pathway has been the proposed pathological mechanism. The trajectory of recovery and the functional outcomes of PFS are not well described. Khan et al. published a prospective study on children after medulloblastoma resection where they divided PFS into type 1 (complete mutism) and type 2 (diminished speech). They showed that PFS type 1 patients had a worse prognosis and a delayed recovery with 44.4% of children being non-ambulatory at one year. Ricci et al. recently published a more detailed severity grading algorithm which over time will hopefully help with data collection and analysis leading to improved prognostication regarding functional recovery. METHODS We present a unique longitudinal look (range 12 months to 19 years) at 5 pediatric patients with posterior fossa tumors who developed PFS following their tumor resections. RESULTS Tumor diagnoses included ependymoma and medulloblastoma. Rehabilitation interventions consisted of acute inpatient rehabilitation where they received intensive physical, occupational, speech and feeding therapy. Most patients benefited from early utilization of trunk and lower extremity bracing as well as a variety of assistive devices and durable medical equipment. Patients continued their rehabilitation for months to years in an outpatient and school setting. All patients demonstrated significant neurological and functional gains however, none of them had a complete resolution of symptoms. We discuss the anatomy, the time to symptom onset, the trajectory of our patients’ recoveries and the rationale behind the applied rehabilitation strategies. CONCLUSIONS This work gives insights on long term sequalae of PFS and demonstrates current rehabilitation approach for children with this complex condition.

1098-P: A Longitudinal Look at SGLT-2i/GLP-1RA Prescription Records in Evaluation of a Primary Care Quality Improvement Education Initiative

1098-P: A Longitudinal Look at SGLT-2i/GLP-1RA Prescription Records in Evaluation of a Primary Care Quality Improvement Education Initiative

Changing cannabis legislation in Canada and a longitudinal look at “regular” cannabis use in patients with eating disorders

Regular cannabis use (CU), defined as “weekly or more often”, is associated with a number of negative mental health outcomes. In the last decade, Canada legalized first medical and then recreational CU. Despite higher prevalence in mental health populations, little research has documented changes in frequency of CU with progressive legalization of cannabis. This study examined rates of CU in a sample of 843 treatment-seeking patients with eating disorders (ED) in an outpatient setting between 2004 and 2020. Across ED diagnoses, segmented regression indicated a significant break-point in regular CU in 2014, commensurate with the relaxation of medical cannabis laws. Regular CU increased from 4.9 % to 23.7 % from 2014 to 2020; well above the stable 6 % found in the general population. No significant break-point was observed in either alcohol or illicit substance use over the same time period. Significant increases in regular CU were found in patients with anorexia nervosa and binge eating disorder, while regular use remained stable in patients with bulimia nervosa. Comorbid psychiatric diagnoses did not increase odds of regular CU. Findings suggest certain patient groups with mental illness may be at risk of engaging in high frequency use in the context of legislation implying medical benefits of cannabis.

Abstract 6299: Psychometric evaluation of the FACIT-SP 12 in a primary brain tumor patient population

Abstract Spirituality is a social determinant of health associated with psychosocial adjustment to serious illnesses including cancer but is not often assessed in clinical care. Here we perform psychometric evaluation of a tool developed to report spiritual well-being in chronic illness in a cohort of 248 patients with primary brain tumors (PBT) enrolled in a natural history study (NCT02851706, PI: T. Armstrong). Participants completed the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 (FACIT-SP 12) as part of yearly clinical outcome assessments. Total score, Meaning/Peace and Faith scores were calculated. Internal consistency (Cronbach’s alpha) and construct validity (principal components analysis with varimax rotation) evaluated psychometric properties of the FACIT-SP 12; one-way ANOVAs, one-sample t-test and Wilcoxon signed rank tests evaluated group differences (sig. p<0.05) on patient report of spirituality/beliefs including belief in god(s)/higher power, being religious, and prayer and in comparison to scores of previously reported studies. Participants were majority male (57%), white (79%) with high grade tumor (59%) and a median age of 48 (range: 20-82). Seven different religions were reported (majority Christianity [55%]) but also spiritual non-religious (9%), no beliefs (13%), and 6% preferring not to answer. The principal components analysis confirmed the original 2 factor solution (Meaning/Peace and Faith) and explained 66.8% of the variance (KMO =0.87, 43% of residuals < 0.05), with one item not loading cleanly on either factor (“I know that whatever happens with my illness, things will be okay”). Cronbach’s alphas were 0.90, 0.90, and 0.89, for the total, Meaning/Peace, and Faith scales, respectively. For all three spiritual/belief questions, patients who responded “yes” had higher total and faith scores than those who responded “no"; but not in the Meaning/Peace score when reporting religion (p=0.108). This cohort reported lower total scores (mean=32.5), Meaning/Peace scores (mean=23.4, median=24.0) and Faith scores (mean=9.2, median=10.0) compared to the initial validation in other solid tumors and HIV/AIDs (means=38.5, 25.2, 13.6, respectively) and to a smaller, less diverse PBT sample (medians: Meaning/Peace=25.8, Faith=14.0). The FACIT-SP 12 demonstrated internal consistency and construct validity, with lower scores in comparison to populations in prior studies. More diverse belief systems than previously reported may contribute to differences among studies. Future analysis should explore the increased percentage of “prefer not to answer” respondents compared to earlier reports, associations with clinical and self-reported outcomes including symptoms and quality of life, evaluation of illness-related factors that contribute to poor spiritual well-being, and a longitudinal look at spiritual well-being. Citation Format: Elizabeth Vera, Byram Ozer, Alvina Acquaye-Mallory, Valentina Pillai, Anna Choi, Ewa Grajkowska, Tricia Kunst, Hope Miller, Kimberly Reinhart, Terri S. Armstrong, Macy Stockdill. Psychometric evaluation of the FACIT-SP 12 in a primary brain tumor patient population [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6299.

A Longitudinal Look at Student Attitude, Perceived Competence, and Fitness Test Performance of Elementary Students

The purpose of this study was to assess relationships between students’ attitudes toward physical education (PE), their perceived competence toward PE, and their fitness test performance, as well as how these relationships change over time. Measurements were conducted with validated instruments across five time points during two school years with fourth and fifth grade students across ten schools (n = 636, 48% = female). This study was developed to address a need for examining how attitudes and perceived competence change over time. Descriptive statistics and latent growth models were run with the variables of interest to investigate four research questions. We found that greater fitness scores are associated with greater competence scores at all time points and that fitness testing may have an impactful, yet brief impact on overall attitudes toward PE. Results showed that fitness test scores predicted higher levels of perceived competence but not higher positive attitudes. Greater attitude levels were predictive of higher competence. Results suggested that previous fitness test experiences shaped future attitudes over time as opposed to “in the moment” attitude scores, a finding not identified in previous research. This study used multiple data points to study PE attitudes and competence, two pillars of behavioral intention. Attitudes can shift and how previous PE content, like fitness testing, can predict future attitudes in PE. The actual relationship between competence and attitude over time is also identified. The results also point to attitude as more of a developed attribute as compared to one that changes only from one event.

Starting Now: Implementing the Healthy Work Environment Standards Is More Important Than Ever

Starting Now: Implementing the Healthy Work Environment Standards Is More Important Than Ever

Differentiated Profiles of Elected Officials in Montreal: A Specific Party Identity Around Mobility, Urban Planning, and Environment?

In Quebec, in 2004, a new municipal political party was created in Montreal: the Projet Montréal party. Several aspects distinguish this party from other municipal political parties. Among these—the supposedly particular composition of the party's team and its activists, which brings together academics, environmental activists and experts in urban planning and transportation—attracts attention. The objective of this paper is to verify the specificity of the profiles of elected officials of the Projet Montréal political party by comparing them with those of other elected officials affiliated with municipal political parties between 2009 and 2017. Based on an extensive documentary survey of the 103 elected officials of the City of Montréal during the last three municipal elections, we will present how the profiles of elected officials differed depending on whether or not they belonged to Projet Montréal. More specifically, we will show that the profiles of Projet Montréal officials are more pronounced in the area of “mobility, urban planning, and environment” understood as one broad entity, whereas those of the other parties are stronger in the fields of administration and commerce. That said, the characteristics of the Projet Montréal team did shift over the course of the elections, insofar as officials with an education in the respective mentioned fields have made way for participants with more of an activist and volunteer profile. This research thus offers a first different and longitudinal look at the evolution of a municipal political party, the project it carries and the way in which the elected officials who compose it contribute to the identity of the party. By doing so, this study also shed light on municipal democracy and the conditions of entry into political office in that context.

Reflecting the Changing Landscapes of Edo-Tokyo's East Bank Waterways

It is often difficult today to appreciate the important role that waterways played in the development of Edo-Tokyo. For most of the city's history, however, they have been fundamental to its economic prosperity and its cultural landscape. In this chapter, I focus on the city's main river, the Sumida, and the waterways that drain into it from its east bank, away from the centre of the city. During the Edo period, the east bank presented space for urban expansion. Its many waterways provided extra capacity for the offloading of goods and provisions and the establishment of marketplaces. Indeed, the ubiquity of water and waterways meant that the east bank became the principal site of industrialisation and the problems that accompanied it. Here I take a longitudinal look at the Sumida and the east bank's waterways. I start with a brief introduction to water and land in the city's early years. The bulk of this chapter explores the development of waterways and activities along their banks in the XIX and early XX centuries, bridging the change from shogunal to imperial rule. This long temporal span throws a number of changes into relief. The first is the nature of the documentary material, whose nature and idiom changes radically through this period. Second is the process of urbanisation and later of industrialisation that occurred as the east bank became ever more densely populated. The third relates to the waterways themselves, vital to the provisioning of the city, arena of recreation but also source of pollution.

Perceived Discrimination in School: a Longitudinal Look at the Impact on Expectations and Health.

The purpose of the study was to look at levels of perceived discrimination in school among students of different races and to assess whether there are significant short- or long-term effects as they develop. This study analyzed data from the National Longitudinal Study of Adolescent Health, which is a multi-stage nationally representative study of individuals who were in 7th-12th grade during the 1994-1995 school year. Responses on teacher discrimination items showed that Black students reported the highest levels of perceived teacher discrimination. Educational expectations were lowest for Hispanic students. At wave three, participants who identified their race/ethnicity as Hispanic or other reported the worst overall health, whereas at wave four, White participants had significantly better overall health than the other three groups. Teacher discrimination was found to be a significant predictor for educational expectations, income expectations, and overall health eight and 15years later. When stratified by race, higher teacher discrimination predicted lower educational expectations and poorer overall health eight years later for Black, Hispanic, and White students.

A Longitudinal Look at Family Communication about Sexual Issues

Parent–child communication about sex and relationships can protect adolescents from risky sexual behaviors, but few studies investigate how family talk may change over the course of development from adolescence to emerging adulthood. This current study uses thematic analysis to explore continuity and change in perceived talk with parents about sex and relationships, following a United States sample of 15 adolescent participants over three time points: early adolescence (age 13–14), middle adolescence (age 15–16), and emerging adulthood (age 20–21). Analyses addressed participants’ experiences of talk with parents about sex and relationships (comfort, engagement) and the content of talk: dating and relationships, pregnancy and parenting, protection, STIs, and sexual behavior. Findings show that family communication about sex and relationships extends from early adolescence to emerging adulthood, but changes in content to reflect shifts in adolescent and emerging adult development. Further, while positive engagement and comfort with talk about sex remain relatively high over time, participants’ discomfort and negative engagement appear to increase, highlighting challenges for ongoing family communication. These findings suggest a meaningful, ongoing role for parents in family communication about sex and relationships as their children develop, and suggest some opportunities and challenges that parents may face through this process.

Does empathy really decline during residency training? A longitudinal look at changes in measured empathy in a community program

Introduction Some studies, most cross sectional and urban, have shown a decline in empathy during residency training prompting medical educators to consider changes in curriculum or training environment. Our aim was to determine if there was a decline using a longitudinal, paired annual empathy measure across three years of a family medicine residency in a rural community hospital. Methods We administered a validated measure from 2015 through 2020 and of the 116 opportunities for survey completion, 112 from 48 residents were available for scoring. We also asked our residents to rank 10 factors that affected their empathy scores. The Baptist Health Madisonville IRB approved the protocol as exempt and the authors have no conflicts of interest.. Results With a response rate of 97%, we found no statistically significant decrease in our resident scores across the three years. Scores after our PG-1 year were significantly lower than two previous comparable studies. The longitudinal, paired study design revealed very wide ranges among individual residents even when group means indicated a statistical difference. Residents also differed widely on their rankings of factors that could affect the score, with only outlook on life showing a narrow range and high ranking. Conclusions The very wide range of individual paired scores as well as the broad range of factors the residents thought affected their scores indicate that empathy is a very individual concept. Some of our residents actually increased scores leading to resilience and others declined toward cynicism. Those seeking to make changes to curriculum or training environment to facilitate empathy during residency should consider this diversity of individual resident training experience.

The ongoing mystery of renal cell cancer

Au et al. take an in-depth longitudinal look at tumor cells and T cells in patients with renal cancer undergoing anti-PD1 blockade.

Assessment, Usability, and Sociocultural Impacts of DataONE

DataONE, funded from 2009-2019 by the U.S. National Science Foundation, is an early example of a large-scale project that built both a cyberinfrastructure and culture of data discovery, sharing, and reuse. DataONE used a Working Group model, where a diverse group of participants collaborated on targeted research and development activities to achieve broader project goals. This article summarizes the work carried out by two of DataONE’s working groups: Usability & Assessment (2009-2019) and Sociocultural Issues (2009-2014). The activities of these working groups provide a unique longitudinal look at how scientists, librarians, and other key stakeholders engaged in convergence research to identify and analyze practices around research data management through the development of boundary objects, an iterative assessment program, and reflection. Members of the working groups disseminated their findings widely in papers, presentations, and datasets, reaching international audiences through publications in 25 different journals and presentations to over 5,000 people at interdisciplinary venues. The working groups helped inform the DataONE cyberinfrastructure and influenced the evolving data management landscape. By studying working groups over time, the paper also presents lessons learned about the working group model for global large-scale projects that bring together participants from multiple disciplines and communities in convergence research.

Self-Organization and Maintenance of Simulated Nocturnal Convective Systems from PECAN

AbstractThe Plains Elevated Convection at Night (PECAN) field project was designed to explain the evolution and structures of nocturnal mesoscale convective systems (MCSs) and relate them to specific mechanisms and environmental ingredients. The present work examines four of the strongest and best-organized PECAN cases, each numerically simulated at two different levels of complexity. The suite of simulations enables a longitudinal look at how nocturnal MCSs resemble (or differ from) more commonly studied diurnal MCSs. All of the simulations produce at least some surface outflow (“cold pools”), with stronger outflows occurring in environments with more CAPE and weaker near-ground stability. As these surface outflows emerge, the lifting of near-ground air occurs, causing each simulated nocturnal MCS to ultimately become “surface-based.” The end result in each simulation is a quasi-linear convective system (QLCS) that is most intense toward the downshear flank of its cold pool, with the classical appearance of many afternoon squall lines. This pathway of evolution occurs both in fully heterogeneous real-world-like simulations and horizontally homogeneous idealized simulations. One of the studied cases also exhibits a back-building “rearward off-boundary development” stage, and this more complex behavior is also well simulated in both model configurations. As a group, the simulations imply that a wide range of nocturnal MCS behaviors may be self-organized (i.e., not reliant on larger-scale features external to the convection).

Do CE mandates impact the number of CE providers and licensing board complaints? A longitudinal look

ABSTRACT With few exceptions, the effectiveness of continuing education (CE) mandates has been measured by self-report assessments of the professional psychologists who fulfill them. The present investigation provided a longitudinal look at the number of approved CE providers and the incidence of licensing board complaints across a succession of two-year cycles prior to, and following, the 2012 implementation of CE mandates in the State of Illinois. Findings showed a substantial increase in the number of CE providers across that time, though no significant change in the incidence of licensing board complaints, suggesting that the increased availability of CE did not translate into lower complaint rates. Possible reasons for these findings are noted, and recommendations for future work are detailed in support of an evidence-based approach to CE that better articulates and aligns its objectives with its outcomes in an era of renewed accountability in the health professions.

Para além dos retratos comuns sobre a condição de refúgio e de migração: narrativas de mulheres palestinas sobre seu protagonismo no Brasil

This article deals with processes of overcoming refuge and migration situations. We start from the observation that both situations are characterized, in general, by vulnerability, having seen the exposure of the people involved to situations of survival limits. However, by demonstrating a lesser known side of this context, we intend to give visibility and voice to examples of overcoming and female Arab-Palestinian protagonist of these situations, through the reports of experiences of two women of Palestinian origin, who took refuge in Brazil and currently assist refugees. / the ones that arrive here. As methodology we use bibliographic research and structured interviews, whose narratives we will interpret based on the statements. The reports corroborate the need for a longitudinal look at the implications of migration and refuge processes in which the resilience and overcoming capacity of women who have experienced such processes is manifested and despite their state of vulnerability, point out that the main supporters the actions are people and civil entities, given the current disregard of the public power towards these projects.

Exploring the impact of continuing education mandates: A longitudinal look.

Exploring the impact of continuing education mandates: A longitudinal look.

With a little help from my friends? A longitudinal look at the role of peers versus friends on adolescent alcohol use

IntroductionAlcohol is the most commonly used substance by South African adolescents. Social norms play a key role in alcohol use, although distinctions are not always made between descriptive and injunctive norms and peer proximity. Additionally, little research identifies factors attenuating social norms, peer proximity, and alcohol use, such as one's ability to resist peer influence. MethodsThe current study investigates the relationship between adolescent alcohol use in 9th Grade and descriptive peer and injunctive friend norms in 8th grade, the moderating role of resistance to peer influence, and sex differences. Data were from South African students (N = 3592; Mage = 14) participating in the HealthWise South Africa implementation quality trial. ResultsPath model results indicated injunctive friend norms, but not peer norms, influenced alcohol use. Resistance to peer influence did not moderate relationships and group comparisons found no sex differences. ConclusionFindings suggest social proximity shapes influences of alcohol use. Despite a differing cultural context, findings were consistent with those from the United States, indicating social proximity is relevant cross-culturally.

Developing civic competence through action civics: A longitudinal look at the data

This paper describes student outcomes from participating in a week-long out-of-school action civics program designed to increase students’ civic and political competence and engagement. Using analysis from four years of survey data, this paper presents findings related to changes in students’ civic competence as a result of participating in the program, including findings related to both first time and repeat campers. Data revealed that participants experienced gains in half of the civic competence construct variables, with first-time campers experiencing significant gains in five of the civic competence construct variables. Data analysis suggests that iEngage, an action civics summer experience, was effective in increasing elements of students’ civic competence, including their ability to get people to care about a problem, organize and run a meeting, write an opinion letter or contact a media outlet to express their views, and contact an elected official or community leader to address an issue.