Majority Of Residents Research Articles

Adaptation and Management Practices of Communities Vulnerable to Gully Erosion in Anambra and Imo States, Nigeria

This study is aimed at evaluating the adaptation and management practices of communities vulnerable to gully erosion in Anambra and Imo States, respectively. The study employed qualitative research methods involving a cross sectional research design using questionnaire survey and interviews. The information for the causes of gully erosion among sampled communities showed the following distribution: 13.1% respondents believed that it has been caused by deforestation; 25.2% of the respondents indicated infrastructural development causes; 20.5% of the sampled respondents indicated poor farming systems; 31.8% of the respondents were of the opinion that the misuse of land contributes more to the causes of gully erosion in the study area; while the remaining 9.4% of the respondents indicated mining as one of the causes of gully erosion in the study area. The distribution revealed that majority of sampled respondents indicated land misuses as a prominent factor leading to gully erosion formation in the study area. The study therefore noted that gullies have impact on depletion of the soil through constant action of erosion and these have several implications for food production which is the primary economic activity engaged on by the majority of residents in the study area. Thus, adaptive capacities of residents in affected gully erosion areas in Anambra and Imo States have not been effective. This will definitely lead to increased socio-economic effects which have several implications on their potential for growth and development in the study area.

SAFETY, SOCIAL RELATIONS AND SATISFACTION IN POSTDISASTER RESETTLED COMMUNITIES: A CASE OF KEDAH, MALAYSIA

This research aims to study the changes in physical and social patterns among tsunami victims in Kedah, Malaysia by examining the relationship between their perceptions of safety and satisfaction. Data were obtained through a questionnaire survey on 109 respondents who live in Taman Permatang Katong, a new housing area built by the federal government. Results indicated the positive relationship between perception of safety and satisfaction. Meanwhile, social relations played a mediating role on the relationship between perception of safety and satisfaction. This finding implies that those who perceived the new resettlement area to be safer reported higher levels of social relations and, consequently, higher levels of satisfaction. Overall, the majority of residents in Taman Permatang Katong are satisfied with their new houses after the tsunami and feel safe in their area of residency. In conclusion, the resettlement programme should be well planned and should consider both social and physical aspects to improve the well-being of residents.

Resilience and Mental Health Among Male Older Adults in Extreme Poverty in Long-term Care Facilities in Rural China

BackgroundThe number of older adults in the United States is growing rapidly. The percentage of individuals from ethnic minority groups that make up this population is also rapidly increasing, with Latinx older adults comprising the fastest growing subgroup. However, Latinx older adults historically underutilize mental health services, in large part due to the lack of culturally sensitive and informed care provided by mental health professionals (de Guzman et al., 2015). However, to date, comprehensive, evidence-based best practices for mental healthcare for Latinx older adults do not exist. Method: A literature review was conducted of research on the developmental, social, cognitive, biological, and affective bases of behavior among Latinx older adults.ResultsTaking an integrated, evidence-based psychological approach with cultural considerations, we found that the literature could broadly be organized into six best practice guidelines. We propose assessing for and incorporating the following topics into mental health treatment of Latinx older adults: immigration status, acculturation, attitudes towards mental health, physical and cognitive health disparities, discrimination, and unique preferences for care structure in later life.DiscussionThese guidelines are intended to represent basic principles to incorporate into practice and do not represent an exhaustive list of factors to consider for a heterogenous group of older adults. Instead, the six, empirically-based guidelines proposed in this study can serve as a starting point for increasing mental health providers’ awareness of the unique experiences of Latinx older adults, with the aim of improving the experience of this historically underserved population in mental healthcare treatment.

Host Community’s Perception on the Socio-Cultural Effects of Carnival Calabar Festival and Tourism Development in Calabar City, Nigeria

This study examines residents’ perception of Carnival Calabar festival and tourism development in Calabar City, Nigeria. It intends to understand whether tourism development of the festival is commonly perceived as positive or negative in the city. A survey research technique was utilized for this study; thus, a total of 200 usable questionnaires were administered to the respondents in Calabar municipality. The findings revealed that, majority of residents have positive attitude about tourism. Findings revealed that pride in heritage, unification of the host community and employment opportunities associated to the event are the primary factors that influence tourism development of the festival. However, regardless of the general positive attitude accorded to tourism development of the festival, there are varying opinions by the residents on tourism influence in Calabar City. These opinions are largely influenced by the perceived benefits from tourism related activities. The results of this study contribute to the data for the management and sustainable development of festivals for tourism in Africa.

Taking the Pulse of POCUS: The State of Point-of-Care Ultrasound at a Pediatric Tertiary Care Hospital.

We aim to quantify and categorize point-of-care ultrasound (POCUS) usage by pediatric practitioners and trainees at our tertiary care center, and assess the degree of interest from pediatric residents, fellows, and program leaders for integrating POCUS into their training. Data was collected via online survey, evaluating the current use of POCUS in clinical decision making, desire for further formal training, and opinions on the importance of POCUS to future clinical practice. In total, 14 program directors/assistant program directors (PD/APDs) representing 10 of 15 training programs, 30 of 95 fellows representing 9 of 15 fellowships, and 32 of 82 residents responded. From PD/APDs, only 2 of the programs reported active use POCUS for clinical decision making, but 13 of the fellows and 9 residents reported doing so. In regard to desire for a formal POCUS program, 30.8% of PD/APDs, 43.8% of fellows without current curricula, and 87.5% of residents were interested in participating in such a program. When considering specialty, some non-acute care-based PD/APDs and fellows at our institution felt that POCUS was important to future practice. Pediatric subspecialty PD/APDs and their fellows had divergent outlooks on the importance of POCUS in future practice. Finally, an overwhelming majority of residents at our institution expressed a desire to learn, and half believing it will be important to future practice. Based on the degree of interest, medicolegal considerations, and trajectory of patient care, pediatric residency and fellowship programs should strongly consider integrating POCUS education into their curricula.

Municipal Programs and Sustainable Development in Russian Northern Cities: Case Studies of Murmansk and Magadan

Cities play an important role in promoting sustainable development. In the Arctic, most particularly in Russia, cities concentrate the majority of residents and economic activity. Sustainable development initiatives are often deployed through programs that operate at different spatial and jurisdictional scales. While national and regional policies and programs have received some attention, the understanding of urban development policies and programs at the municipal level in the Arctic is still limited. This paper presents a case study of municipal sustainable development programming in Arctic cities and examines municipal programs in two larger Russian northern cities: Murmansk and Magadan. While both are regional capitals and the most populous urban settlements in their regions, the cities have district historical, economic and geographical contexts. Through the content analysis of municipal programs active in 2018, we aim to understand, systematize and compare the visions and programmatic actions of the two municipalities on sustainable development. Ten sustainable development programming categories were identified for using a UN SDG-inspired approach modeled after the City of Whitehorse, Canada. While the programs in Magadan and Murmansk are quite different, we observed striking commonalities that characterize the national, regional and local models of urban sustainable development policy making in the Russian Arctic.

Coyote Management Plans and Wildlife Watch: implications for community coaching approach to public outreach in southern California

The majority of residents in southern California live in urban areas. Therefore, working with cities to promote tolerance and coexistence with urban wildlife is crucial to the conservation and management of native species. Human conflicts with coyotes (Canis latrans) illustrate the importance of incorporating the social sciences, particularly knowledge of human behavior, communication, and education, in a coyote management strategy. Here, we review 199 cities across southern California to determine which localities have a coyote management website or a coyote management plan. We also included cities that have collaborated with the California Department of Fish and Wildlife in developing a “Wildlife Watch” program model. Wildlife Watch (based on the Neighborhood Watch national crime prevention program) uses conservation-oriented principles to empower local communities, agencies, and residents to remove wildlife attractants and to exclude or deter coyotes from neighborhoods. We examine how cities with coyote management websites and programs differ from cities without, based on U.S. census demographics. Using data from coyote conflict and sighting tools (Coyote Cacher, iNaturalist, and CDFW’s Wildlife Incident Reporting System) we compare coyote reports across cities with different management plans and websites. Finally, based on demographics from the US Census, we examine ways Wildlife Watch, or related programs, can be expanded and improved. An adaptive community-based program, like Wildlife Watch, offers a valuable toolkit to managers for navigating the diverse array of human perceptions, values, and attitudes regarding urban species and human-wildlife conflicts.

Assessing implementation of low-carbon technologies in Thekelan Hamlet, Indonesia using participatory rural appraisal method

Thekelan hamlet is located at the foot of Mount Merbabu makes the electricity that reaches this village experience a reasonably high loss percentage. By utilizing the sunlight, the community can make a power plant with solar cell technology. In addition, the majority of residents in Thekelan Hamlet still use wood-fired stoves for cooking. This condition is, of course, not environmentally friendly because the combustion releases high carbon into the atmosphere. Therefore, the prospect of renewable energy has not yet been fully exploited. This situation is due to the low level of knowledge, education, and capital owned by residents. The Participatory Rural Appraisal (PRA) approach were used to develop low-carbon society in Thekelan Hamlet. This approach comprises three stage including workshop, action, and reflection stage. Result shows that the community in Thekelan District were able to implement low-carbon society. However, the capital price of low-carbon technology such as solar cells and dew catcher is still high with respect to the output that they can generate. Therefore, the community is agree to contribute and join to the development of this program in the future since they realize that low-carbon society can induce economic development of the hamlet.

A Vicious Cycle of Bias: Residents' Perceptions of Leadership in Health Care.

Despite growing interest in shared leadership models, autocratic physician leadership remains the norm in health care. Stereotype and bias limit leadership by members of other professions. Furthermore, traditional views of effective clinical leadership emphasize agentic behaviors associated with male gender. To shift the prototypical concept of a leader from a male physician to a more inclusive prototype, a better understanding of prototype formation is needed. This study examines leader prototypes and their development among resident physicians through the lens of leadership categorization theory. One researcher conducted semistructured interviews with anesthesia and internal medicine residents at a single institution, asking participants to describe their ideal team leader and comment on the video-recorded performance of either a male or female nurse practitioner (NP) leading a simulated resuscitation. Interview questions explored participants' perceptions of NPs as team leaders and how these perceptions developed. The researchers conducted deductive analysis to examine leadership prototypes and prototype formation, and inductive analysis to derive additional themes. The majority of residents described a male physician as the ideal resuscitation team leader. Exposure to male physician leaders, and lack of exposure to NP leaders, contributed to this prototype formation. Residents described a vicious cycle in which bias against female and NP leaders diminished acceptance of their leadership by team members, resulting in decreased confidence and performance, further aggravating bias. These results provide suggestions for interventions that can help shift the leadership prototype in health care and promote shared leadership models. These include increasing exposure to different professionals of either gender in leadership roles and increased representation in educational materials, education about effective leadership strategies to create awareness of the benefits of shared leadership, and reflection during team training to increase awareness of bias and the backlash effect faced by individuals whose behaviors counter established stereotypes.

Training junior doctors to lead rapid responses.

Transitions during medical training are a significant source of stress, and junior doctors (residents) primarily learn new skills through on-the-job training. As residents transition from postgraduate year (PGY) 1 to 2, they take on new responsibilities, including the management of clinically unstable patients in rapid response (RR) scenarios. In 2018, the internal medicine training programme at Brigham and Women's Hospital implemented a 'Transitions Retreat' to prepare PGY-1s for Year 2. In an informal survey, residents endorsed feeling underprepared to lead RRs. We designed a simulation-based curriculum to teach these skills. Participants completed a questionnaire pre-simulation and post-simulation exploring their perceived preparedness. Volunteer residents assessed performance on the simulation using skills checklists and led structured debriefing sessions. We audiotaped, transcribed and thematically analysed these sessions. Forty-eight of 58 (82%) PGY-1s participated. Pre-intervention, 12.5% felt 'well-prepared' or 'very well-prepared' to lead RRs, compared with 33% post-intervention. Through qualitative analysis, we identified four key themes in our post-simulation debriefing conversations: (1) the chaos of RRs, (2) emotional reactions during RRs, (3) challenges and goals of task management and (4) value of interdisciplinary collaboration. Though the majority of residents indicated that the curriculum enabled their preparedness to lead RRs and allowed them to process complex emotions in a safe space, we do not know how well this experience translates to the clinical setting. Therefore, we aim to collect follow-up data 6 months into the PGY-2 to explore residents' reflections on real-life experiences as well as whether the simulation impacted their preparedness to lead real-life RRs.

Exploring the Effects of Carpooling on Travelers’ Behavior during the COVID-19 Pandemic: A Case Study of Metropolitan City

Transportation accounts for more than a quarter of the greenhouse gas emissions that are causing climate change. Carpooling is a subset of the sharing economy, in which individuals share their vehicle with commuters to save travel expenses. In recent decades, carpooling has been promoted as a feasible alternative to car ownership with the potential to alleviate traffic congestion, parking demand, and environmental problems. Unstable economic conditions, cultural norms, and lack of infrastructure make cultural exchange activities and mobility habits different in developing nations to those in developed countries. The rapid evolution of sharing mobility has reshaped travelers’ behavior and created a dire need to determine the travel patterns of commuters living in megacities in developing countries. To obtain data, a web-based stated choice (SC) experiment was used in this study. It used mode-related variables, socioeconomic demographic variables, and a coronavirus disease 2019 (COVID-19) precautionary measure variable. Logit models, namely the mixed logit regression model (ML) and the multinomial logit regression model (MNL), were applied to analyze the available data. According to modeling and survey data, economic variables associated with modes of transport, such as trip time and trip cost, were determined to be significant. Additionally, the results revealed that commuters were more conscious of COVID-19 preventive measures, which was determined to be highly significant. The findings showed that the majority of residents in the COVID-19 pandemic continue to rely on automobiles and motorcycles. It is noteworthy that individuals with more than two members in their family and a travel distance of less than seven miles were more likely to prefer a carpooling service. This study’s findings will provide a basis for researchers to aid existing operators in the field of transportation, as well as offer guidelines for governments in developing countries to enhance the utility of transportation networks.

Care home residents’ quality of life and its association with CQC ratings and workforce issues: the MiCareHQ mixed-methods study

BackgroundCare home staff have a critical bearing on quality. The staff employed, the training they receive and how well they identify and manage residents’ needs are likely to influence outcomes. The Care Act 2014 (Great Britain.The Care Act 2014. London: The Stationery Office; 2014) requires services to improve ‘well-being’, but many residents cannot self-report and are at risk of exclusion from giving their views. The Adult Social Care Outcomes Toolkit enables social care-related quality of life to be measured using a mixed-methods approach. There is currently no equivalent way of measuring aspects of residents’ health-related quality of life. We developed new tools for measuring pain, anxiety and depression using a mixed-methods approach. We also explored the relationship between care home quality, residents’ outcomes, and the skill mix and employment conditions of the workforce who support them.ObjectivesThe objectives were to develop and test measures of pain, anxiety and depression for residents unable to self-report; to assess the extent to which regulator quality ratings reflect residents’ care-related quality of life; and to assess the relationship between aspects of the staffing of care homes and the quality of care homes.DesignThis was a mixed-methods study.SettingThe setting was care homes for older adults in England.ParticipantsCare home residents participated.ResultsThree measures of pain, anxiety and low mood were developed and tested, using a mixed-methods approach, with 182 care home residents in 20 care homes (nursing and residential). Psychometric testing found that the measures had good construct validity. The mixed-methods approach was both feasible and necessary with this population, as the majority of residents could not self-report. Using a combined data set (n = 475 residents in 54 homes) from this study and the Measuring Outcomes in Care Homes study (Towers AM, Palmer S, Smith N, Collins G, Allan S. A cross-sectional study exploring the relationship between regulator quality ratings and care home residents’ quality of life in England.Health Qual Life Outcomes2019;17:22) we found a significant positive association between residents’ social care-related quality of life and regulator (i.e. Care Quality Commission) quality ratings. Multivariate regression revealed that homes rated ‘good/outstanding’ are associated with a 12% improvement in mean current social care-related quality of life among residents who have higher levels of dependency. Secondary data analysis of a large, national sample of care homes over time assessed the impact of staffing and employment conditions on Care Quality Commission quality ratings. Higher wages and a higher prevalence of training in both dementia and dignity-/person-centred care were positively associated with care quality, whereas high staff turnover and job vacancy rates had a significant negative association. A 10% increase in the average care worker wage increased the likelihood of a ‘good/outstanding’ rating by 7%.LimitationsNo care homes rated as inadequate were recruited to the study.ConclusionsThe most dependent residents gain the most from homes rated ‘good/outstanding’. However, measuring the needs and outcomes of these residents is challenging, as many cannot self-report. A mixed-methods approach can reduce methodological exclusion and an over-reliance on proxies. Improving working conditions and reducing staff turnover may be associated with better outcomes for residents.Future workFurther work is required to explore the relationship between pain, anxiety and low mood and other indicators of care homes quality and to examine the relationship between wages, training and social care outcomes.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full inHealth Services and Delivery Research; Vol. 9, No. 19. See the NIHR Journals Library website for further project information.

THE IMPACT OF COVID-19 PANDEMIC ON THE CHOICE OF SUB-SPECIALTY TRAINING IN US MEDICAL RESIDENCY PROGRAMS

TOPIC: Education, Research, and Quality Improvement TYPE: Original Investigations PURPOSE: The Covid-19 pandemic led to critical shortage of personal protective equipment worldwide & challenged the motto of safety in healthcare occupations. Pulmonary & critical care medicine (PCCM) is one of the specialties that was heavily involved in care of Covid-19 infected patients. It is not yet determined how an active pandemic can shape the minds of Internal Medicine (IM) residents who wished to pursue fellowship training. While some may deem PCCM to be too high a risk and avoid it altogether, others may process it as a calling. The purpose of this survey study was to determine these effects. METHODS: We surveyed the IM residents enrolled in ACGME accredited residency programs in the United States. The survey invitation link was distributed to the preferred contact email listed on the American Medical Association: Residency & Fellowship Database (FREIDA™) using a mass emailing service. Programs were requested to distribute the survey to IM residents to complete voluntarily. Study data were collected & managed using REDCap electronic data capture tools hosted at Case Western Reserve University. A reminder email was sent at 2-week period to the programs that didn't open the initial enrollment email. Data analysis was completed using REDCap & Microsoft Excel. RESULTS: Of the 258 responses, 12 were excluded due to incomplete data or not meeting criteria. A total of 245 responses were used for analysis of which 48.4% self-identified as male & 51.6% as female. Subgroups based on year of training were: PGY1(66, 26.9%), PGY2(94, 38.4%), PGY3(75, 30.6%) & PGY4(10, 4.1%). Majority of residents were in age group 26-35 (226, 92.2%) with geographical distribution into Northeast (55, 22.4%), Midwest (82, 33.5%), South (61, 24.9%) & West (47, 19.2%). Of the respondents, 179/245(73.1%) were residents aspiring for fellowship positions, 30/245(12.2 %) were undecided & 36/245(14.69%) were not interested in pursuing fellowship. The pandemic events of year 2020 altered the decision to pursue fellowship with an average influence factor of 59.08 (SD 23.4) on a linear scale of 0-100. This change affected 10.6% (26/245) of the respondents, swaying 46.1% of these residents against the field of PCCM & 23% for it. CONCLUSIONS: The COVID-19 pandemic affected only a small proportion of residents into altering their decisions to pursue fellowship of their original choice. However, when applicable it mostly deterred residents from applying to a high risk fellowship such as PCCM. This survey study is limited by the relatively small number of respondents, general limitations of voluntary surveys & lack of responses from some geographic locations. CLINICAL IMPLICATIONS: Covid-19 pandemic may have influenced the decision to pursue fellowship training with a potentially deleterious effect on PCCM. This could be due to ongoing concerns for personal safety. Additional studies are needed to determine underlying factors. DISCLOSURES: No relevant relationships by Samantha DiBenedetto, source=Web Response No relevant relationships by Enambir Josan, source=Web Response No relevant relationships by Ziad Shaman, source=Web Response No relevant relationships by vikrant singh, source=Web Response

BENTONITE APPLICATIONS IN SIMPLE PURIFICATION OF BULK COOKING OIL AS ALTERNATIVE SOLUTIONS FOR HOUSEHOLD COST EFFICIENCY

Utilization of Crude Palm Oil (Crude Palm Oil) in food cooking activities is a strong activity in Indonesian society, more than 80% of household activities use this type of oil to process food ingredients. The affordable price with a variety of packaging makes this type of cooking oil has many fans. A survey that has been conducted on residents of the Kalideres area with a total of 20 respondents stated that in addition to using new palm cooking oil in cooking activities, the majority of residents are also accustomed to using this oil used in cooking activities that require the deep-fried method. The quality of cooking oil is largely determined by the level of purity of the solution, the clearer the color of the solution, the better the quality, the darker the color of the solution indicates the presence of more impurities, the higher the saturated fatty acid emulsion, indicating poor cooking oil quality. This is what was raised in this community service (CS) activity, namely socializing alternatives to the use of purified bulk cooking oil. The purification material uses bentonite clay minerals which are heated and dissolved in a certain amount and duration of time which is able to maximize the adsorption power of impurities according to the natural structure of bentonite. CS activities carried out online include counseling and training activities for housewives in the economically densely populated Kalideres area. Through the socialization program for the purification of bulk cooking oil using bentonite clay minerals, it is hoped that residents will have an alternative to reduce the cost of processing food raw materials in a more effective and healthy way. This program is also expected to function as a medium to socialize the application of earth science in helping activities of daily living.

Impact of COVID-19 on Postgraduate research in Obstetrics and Gynaecology: Challenges, Solutions and Opportunities

Objectives: COVID-19 pandemic has affected medical services and facilities throughout the world. This has resulted in unavoidable decline in postgraduate training and learning in different medical specialties. There has been reduction in all aspects of training and learning of Obstetrics and Gynaecology (OBG) residents in general and research training in particular. At the time of the study, although limited institutions have started to put some efforts to resume and endure resident research in OBG but still there are no uniform adaptive measures which can be implemented in all of the institutions. The present study was conducted with the aim to assess challenges faced by OBG residents in doing research during COVID-19 pandemic in a government medical college of India. We also assessed the helpfulness and support provided by the Thesis Mentorship Programme (TMP) of the department during pandemic. Material and Methods: A self developed semi structured, pre-validated questionnaire was mailed to the residents of the OBG training program of our medical college. It was completed anonymously by them after accepting an informed consent. Results: 21 postgraduates from the second and third year OBG residency participated in this cross-sectional study. We found that COVID-19 pandemic was associated with a significant research training impairment. There was “some” to “complete interruption” in the various research activities of the residents. The research aspect most severely affected was data collection. Also majority of residents were satisfied with the support offered by the TMP of the department in sustaining resident research during pandemic. Conclusion: COVID-19 has significant and critical implications for the resident research training in OBG.The TMP and similar experiences also helps residents in continuing research during untoward circumstances. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.77-84

Co-Learning Curriculum in Quality Improvement for Surgical Residents– Five-Year Experience from the University of Toronto

We describe our five-year experience with a novel co-learning curriculum in quality improvement (CCQI)1 for the largest reported cohort of surgical residents. The program introduces trainees to principles of quality improvement (QI)2 and empowers them to complete collaborative projects with mentorship from faculty experts. Each iteration consists of three interactive seminars. Residents are required to complete and present a QI project in the third seminar. To assess the impact of the program, graduates of the 2020-2021 iteration were surveyed using validated tools to examine changes in confidence and knowledge of QI principles. Department of Surgery, University of Toronto, Toronto, ON, Canada. Participation ranged from 57 to 63 residents yearly, from diverse surgical disciplines including General Surgery, Plastic Surgery, Obstetrics and Gynecology, amongst others. Multiple small groups consisted of 4-6 residents from each speciality, mentored by a faculty lead from the same specialty. Approximately 300 first-year surgical residents have participated in the CCQI since 2015, with over 60 completed QI projects. A total of 41(66%) and 51(82%) residents completed the survey in its pre- and post-course administration in 2020-2021, respectively. There was a significant increase in confidence scores with respect to describing a QI issue, building a team, and testing the change, amongst other aspects. There was also a statistically significant increase in mean knowledge scores for both scenarios of the Quality Improvement Knowledge Application Tool. 69% and 73% of residents reported "some improvement" in their knowledge, and confidence in applying QI principles to patient care, respectively. A majority of residents (73%) found the QI curriculum somewhat valuable, with 23% reporting it to be very valuable to their residency and future surgical career. We describe successful long-term implementation of a novel co-learning curriculum in quality improvement. Residents derive value from this curriculum with a meaningful increase in confidence and knowledge of QI as an integral part of surgical practice.

Relationship Between Family Environment and Discipline Study in the Equivalency Education Program

This research is motivated by the low learning discipline of children in the equality program at PKBM Karang Putih II, Padang City, allegedly due to the influence of a poor family environment. The purpose of this study was to examine the relationship between family environment and learning discipline in the equality program at PKBM Karang Putih II, Padang City. This type of research is quantitative correlational. In this study, the population is all residents studying the equivalence program package A, B, and C in 2021, totaling 87 people. The sampling technique is cluster random sampling. Samples were taken as much as 30% from each study group, namely as many as 26 samples. The data collection technique used is a questionnaire, the data collection tool uses a questionnaire containing a list of statements. The data analysis technique uses percentages. The results showed that (1) the description of the family environment had been carried out well, (2) the description of learning discipline in the equality program at PKBM Karang Putih had been carried out quite well, (3) the relationship between the family environment and learning discipline was categorized as strong (significant). It can be seen from the majority of residents who learn to give frequent statements. Based on the results of the data obtained, it can be concluded that the relationship between the family environment and learning discipline in the equality program at PKBM Karang Putih II has been carried out well.

The Impact of COVID-19 on the Orthopaedic Surgery Residency Experience.

INTRODUCTIONThe rapid spread of the COVID-19 virus led to dramatic changes in graduate medical education and surgical practice. The purpose of this study was to evaluate the effects of the COVID-19 pandemic on Orthopaedic Surgery residency education in the United States.METHODSA survey sent to all residents of the 201 ACGME-accredited Orthopaedic Surgery programs in the United States.RESULTSA total of 309 Orthopaedic surgery residents responded to our survey. A subset of 283 (91.6%) residents surveyed reported decreased Orthopaedic-related clinical duty hours due to the COVID-19 pandemic, and 300/309 (97.1%) reported a decrease in surgical case volume. 298 (96.4%) residents reported that their program had scheduled activities or made changes to supplement their education, most common being virtual and video conferences 296/309 (95.5%), required practice questions 132/309 (42.7%), required reading or pre-recorded lectures 122/309 (39.5%), in-person small group meetings or lectures 24/309 (7.77%), and surgical simulation activities 17/309 (5.50%). Almost half (152/309 (48.9%)) of respondents reported their overall resident education was somewhat or much worse due to the impact of COVID-19. Over a quarter (81 (26.2%)) of residents reported their well-being was negatively impacted by residency-related changes due to COVID-19.CONCLUSIONSBased on these results, the COVID-19 pandemic has brought about significant changes to the training experience of Orthopaedic surgery residents in the United States. Although the majority of residents in this sample had favorable opinions of the educational changes their programs have instituted in light of the pandemic, clinical duty hours and case volume were reported to have substantially decreased, with a large portion of residents viewing their overall resident education as worsened and reporting negative impacts on their overall well-being.

How Much Education and Training Do Residents Across Specialties Receive in Neuropsychology?

IntroductionNeuropsychologists play an important role on multidisciplinary teams with physicians from multiple specialties. The extent of residency training on the use of neuropsychological services is unclear. Medical residents across multiple specialties throughout the United States were surveyed to assess resident education, training, and understanding of neuropsychological services, along with their intent to consult neuropsychologists in the future.MethodsA survey was sent to residents in accredited psychiatry, neurology, family medicine, and internal medicine programs. After data were collected, chi-square group level analyses with post-hoc pairwise comparisons were used to analyze the data.ResultsA total of 434 residents took the survey. The proportion of residents exposed to neuropsychology during residency varied significantly according to specialty (χ2 (3, N = 419) = 51.4, p < 0.001), with more psychiatry and neurology residents reporting exposure than residents in family medicine or internal medicine. Similarly, the proportion of psychiatry and neurology residents who ‘agree’ or ‘strongly agree’ that they understand the nature of neuropsychological services differed significantly from family medicine and internal medicine residents (χ2 (3, N = 415) = 40.4, p < 0.001). The majority of residents across all specialties (85.7%) reported they are likely to consult/order neuropsychological services in future practice.ConclusionsThe majority of residents in all specialties reported exposure to neuropsychological services in some manner, but forms of exposure varied. Results indicated a need for increased education and training in neuropsychological services, especially within family medicine and internal medicine programs.

There Is No Place Like Assisted Living: Can the Setting Evolve While Staying True to Itself?

There Is No Place Like Assisted Living: Can the Setting Evolve While Staying True to Itself?