Individual Residents Research Articles

Personality: A potentially untapped resource in the selection of postgraduate pharmacy residents.

This study assessed whether personality testing of postgraduate year 1 (PGY1) pharmacy residency applicants was feasible and predicted important selection outcomes, including interview offers. Applicants to the PGY1 pharmacy residency program at a large academic medical center were invited to complete a 50-item online personality test based on the 5-factor model (ie, the "Big Five"). Scores were sealed until after matching, at which point they were compared to screening, interview, and ranking and match outcomes. Endpoints of interest included the feasibility of the test (eg, time required for completion, completion rate) and whether personality predicted the odds of an interview offer. The personality test was taken by 137 PGY1 applicants (69.5%) and required a median of 6.8 minutes to complete. Openness to experience was associated with decreased odds of an interview offer (adjusted odds ratio [OR], 0.86; 95% confidence interval [CI], 0.75-0.98), whereas conscientiousness and extraversion were associated with increased odds of an interview offer (conscientiousness: adjusted OR, 1.26; 95% CI, 1.02-1.55; extraversion: OR, 1.16; 95% CI, 1.03-1.31). When combined with traditional screening criteria (eg, awards, leadership positions), openness to experience and extraversion remained predictors of an interview offer (in the directions specified above), whereas conscientiousness did not. In an exploratory analysis of interviewees, agreeableness was a negative predictor of interview score. Personality did not predict screening scores or final ranking. Personality testing, based on the traits desired at individual residency programs, could be a valuable addition to the methods used for selecting PGY1 pharmacy residents.

Transparency in the Ophthalmology Residency Match: Background, Study, and Implications

BackgroundMedical students are applying to dramatically more ophthalmology residency programs than in the past, causing an increased administrative burden for programs and financial harm to students. This study considers the background of this situation and looks at how a lack of transparency surrounding potential residency match filters contributes. Furthermore, this study raises several potential solutions to this lack of transparency that may increase the functionality of the ophthalmology residency match.ObjectiveThe purpose of this study was to determine the availability and consistency of potential ophthalmology residency match filters through training program websites and the American Medical Association’s (AMA) Residency & Fellowship Database (FREIDA).MethodsThis study was a cross-sectional observational study of ophthalmology residency program websites and AMA's FREIDA database entries. For 119 ophthalmology residency programs, five potential filters were evaluated for both availability and consistency on individual residency websites and FREIDA. These filters were: (1) whether a program required a minimum United States Medical Licensing Examination (USMLE) Step 1 score; (2) minimum number of letters of recommendation required; 3) whether a minimum USMLE Step 2 score was required; (4) if the program accepts the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) sequence in lieu of the USMLE; and (5) ability of the residency to sponsor a visa (J-1, H-1B, or F-1). Each program's website and FREIDA entry were independently evaluated by two authors to increase validity, with a third author brought in to break the tie in case of a disagreement.ResultsOnly two ophthalmology residency programs had information about all five filters both available and consistent on their website and FREIDA. Inter-reviewer reliability was 92.5%.ConclusionsInformation about potential filters used in the ophthalmology residency match is neither publicly available nor consistent. This lack of transparency may contribute to the phenomenon of medical students applying to dramatically more ophthalmology residency programs. A standardized database of these filters is needed to increase transparency to applicants, which may reduce the expenses of medical students and the workload of program directors.

The Residential Population Generator (RPGen): Parameterization of Residential, Demographic, and Physiological Data to Model Intraindividual Exposure, Dose, and Risk

Exposure to chemicals is influenced by associations between the individual’s location and activities as well as demographic and physiological characteristics. Currently, many exposure models simulate individuals by drawing distributions from population-level data or use exposure factors for single individuals. The Residential Population Generator (RPGen) binds US surveys of individuals and households and combines the population with physiological characteristics to create a synthetic population. In general, the model must be supported by internal consistency; i.e., values that could have come from a single individual. In addition, intraindividual variation must be representative of the variation present in the modeled population. This is performed by linking individuals and similar households across income, location, family type, and house type. Physiological data are generated by linking census data to National Health and Nutrition Examination Survey data with a model of interindividual variation of parameters used in toxicokinetic modeling. The final modeled population data parameters include characteristics of the individual’s community (region, state, urban or rural), residence (size of property, size of home, number of rooms), demographics (age, ethnicity, income, gender), and physiology (body weight, skin surface area, breathing rate, cardiac output, blood volume, and volumes for body compartments and organs). RPGen output is used to support user-developed chemical exposure models that estimate intraindividual exposure in a desired population. By creating profiles and characteristics that determine exposure, synthetic populations produced by RPGen increases the ability of modelers to identify subgroups potentially vulnerable to chemical exposures. To demonstrate application, RPGen is used to estimate exposure to Toluene in an exposure modeling case example.

Agent-Based Modeling of the Formation and Prevention of Residential Diffusion on Urban Edges

This paper presents an exploratory urban dynamics agent-based model (ABM) that simulates the relationship between the introduction of a hub facility open to residents, the interaction promotion around it, and transport policies on the sustainability of urban development through the autonomous actions of individual residents. By contrasting the model results with theoretical and empirical insights from actual cities, the validity of modeling the formation of residential diffusion on urban edges based on individual gain-maximizing daily travel and residential relocation is explained. The major contribution of the model is that it offers a new perspective on the bottom-up control of residential diffusion on urban edges, with benefits for productive human interactions at the microscale. Specifically, the model experimentally suggests the existence of a trade-off between increasing human interactions, through the introduction of an open hub attracting diverse activities and promotion of interaction around it, as well as the progression of residential diffusion. The model also suggests that the direction of urbanization is the result of collective action, and sustainable urbanization may be achieved through concerted efforts.

Evaluation of Lung Functional Status among People Living in Different Type of Housing in Chennai City

Background: Different housing has its influence on the health of the residents. The high rise apartment is a type of living adapted by people in urban areas of India. It becomes inevitable and poses much convenience and economy without occupying much land area. It is known that the floor of residence is related to the pulmonary function of the individuals.
 Objective: The aim of the present study was to comparatively evaluate the lung functional status among the people living in high rise apartments and individual houses in Chennai city.
 Materials and Methods: The study included 20 healthy individuals, 10 residents from Individual houses and 10 residents from high rise apartments from the 10th to 15th floor. The lung function was measured using RMS Helios 702 spirometer. They were assessed for a lung function test using RMS Helios 702 spirometer. The parameters such as FVC, FEV1, FEV1/FVC, PEFR, FEF25-75 were assessed, and the statistical test used was independent t test.
 Results: The mean of FVC, FEV1, FEV1/FVC ratio, FEF 25-75, PEFR were maximum in high rise apartment residents compared to individual house residents. Statistically significant change was observed in the FEF25-75 value among the two groups.
 Conclusion: The study concluded an innovative finding that subjects living in high rise apartments showed innovation in finding better lung functions and this may be attributed to the pollution free zone in high floors.

Using Individual Residents' Learning Trajectories to Better Understand the Impact of Gaps in Practice.

To optimize learning, health professional training programs need to achieve the right balance between depth of practice (gaining more experience with particular skills) and breadth of practice (spreading experience across an array of activities). Better understanding how training for a particular skill set is impacted by periods of focus on a different skill set would allow improved curriculum and assessment design, thereby enhancing the efficiency of training and effectiveness of care. To this end, learning curves were used to compare performance in surgery after prolonged periods of practice to performance after gaps in surgical training. Daily operative assessments from the Dalhousie obstetrics and gynecology program were analyzed retrospectively and learning curves were generated. In addition to examining the variability in learning trajectories, the impact of gaps was systematically assessed by comparing resident scores after 2 successive months in which they were not assessed operatively to those collected after 2 successive months in which they were assessed at least once. Four thousand four hundred sixteen scores for 33 residents over a 10-year period were analyzed. Trajectories and peak performances were identified. Residents performed better during their third sequential month of being assessed (mean = 4.40, 95% CI = 4.33-4.46) relative to during months following a period of being away from the operating room for at least 2 months (mean = 4.21, 95% CI = 4.13-4.29; P < .01; d = 0.7). However, maximum performance achieved was more strongly related to the number of times residents experienced a gap in training (r = 0.50) than to the number of times residents experienced 3 consecutive months of training (r = 0.25). Distinct patterns of development exist for individual residents. Time away from surgical practice and assessment negatively impacted short-term performance, but may improve long-term learning trajectories. This speaks to the value of spaced education and is important for the design of longitudinal skills-based training programs.

Effects of Milk or Soy Milk Combined with Mild Resistance Exercise on the Muscle Mass and Muscle Strength in Very Old Nursing Home Residents with Sarcopenia.

Background and aims: Sarcopenia is recognized as a major public health issue, because it is prevalent in the elderly, especially those who live in long-term care facilities. The purpose of this study was to investigate the beneficial effects of milk or soy milk combined with resistance exercise on the muscle mass and muscle strength of individual elderly nursing home residents with sarcopenia. Methods: This study was a randomized controlled trial (clincaltrials.gov as NCT05035121) that recruited very old (>75 years) subjects with sarcopenia in a nursing home (Su-Ao and Yuanshan Branches, Taipei Veterans General Hospital) from June to December 2017. Thirty-five elderly (84.9 ± 6.1 years old) subjects were recruited and divided into three groups: control (n = 12), milk supplemented (n = 12), and soy milk supplemented (n = 11). All participants joined a mild resistance exercise training program three times a week (30 min/time). Moreover, elderly subjects in the milk and soy milk groups drank 200 mL of milk or soy milk for breakfast and as a snack after exercise. Results: After 12 weeks, compared to the baseline, calf circumferences had significantly increased in the control and soy milk groups (p = 0.0362 and p = 0.0197, respectively). Hand grip strength had significantly improved in the milk and soy milk groups (p = 0.0407 and p = 0.0096, respectively). In addition, there was no difference among the three groups. Conclusions: Mild resistance exercise combined with milk or soy milk improved the calf circumference and hand grip strength in very old nursing home residents with sarcopenia.

Treponema peruense sp. nov., a commensal spirochaete isolated from human faeces.

A Gram-stain-negative, obligatory anaerobic spirochaete (RCC2812T) was isolated from a faecal sample obtained from an individual residing in a remote Amazonian community in Peru. The bacterium showed highest 16S rRNA gene sequence similarity to the pig intestinal spirochete Treponema succinifaciens (89.48 %). Average nucleotide identity values between strain RCC2812T and all available Treponema genomes from validated type strains were all <73 %, thus clearly lower than the species delineation threshold. The DNA G+C content of RCC2812T was 41.24 mol%. Phenotypic characterization using the API-ZYM and API 20A systems confirmed the divergent position of this bacterium within the genus Treponema . Strain RCC2812T could be differentiated from the phylogenetically most closely related T. succinifaciens by the presence of alkaline phosphatase and α -glucosidase activities. Unlike T. succinifaciens , strain RCC2812T grew equally well with or without serum. Strain RCC2812T is the first commensal Treponema isolated from the human faecal microbiota of remote populations, and based on the collected data represents a novel Treponema species for which the name Treponema peruense sp. nov. is proposed. The type strain is RCC2812T (=LMG 31794T=CIP 111910T).

Impact of geographic access to primary care providers on pediatric behavioral health screening

Behavioral Health (BH) screening is critical for early diagnosis and treatment of pediatric mental disorders. The objective of this study was to assess the impact of geographic access to primary care providers (PCP) on pediatric BH screening in children with different race/ethnicity. A retrospective cohort study was conducted using the 2013–2016 administrative claims data from a large pediatric Medicaid Managed Care Plan that have been linked to 2010 US Census data and the 2017 National Provider Identifier (NPI) Registry. Geographic access was defined as the actual travel distance to nearest PCP and the PCP density within 10-mile travel radius from each individual's residence. Stratified multivariate logistic regression was conducted to examine the association between the geographic access to PCP and the likelihood of receiving screening for behavioral disorders within each racial/ethnic group. BH screening rate was 12.6% among 402,655 children and adolescents who met the inclusion criteria. Multivariable analysis stratified by individual race/ethnicity revealed that Hispanic and Black children were more vulnerable to the geographic access barriers than their non-Hispanic White counterparts. The increase in travel distance to the nearest PCP was negatively associated with screening uptake only among Hispanics (10–20 miles vs. 0–10 miles: OR = 0.78, 95% CI [0.71–0.86]; 20–30 miles vs. 0–10 miles: OR = 0.35, 95% CI [0.23–0.54]). In a subgroup that had access to at least one PCP within 10 miles of travel distance, the variation in PCP density had a greater impact on the screening uptake among Hispanics and Blacks than that in non-Hispanic Whites.

The Closer the Better? Modeling Spatial Spillover Effects of Ecological Externalities in Coastal Mangroves

As an important part of ecological externalities, the spatial spillover effect has attracted the attention of researchers in the field of environmental economics. However, the traditional view that the spillover mechanism of ecological externalities generally decreases in line with increases in distance remains to be thoroughly proven. Effective ecological management requires an understanding of the relationship between the natural environment and human communities. In this study, the concept of geographical accessibility and a two-step mobile search model are introduced in order to connect ecosystems and humans by a spatial distance. This model can fully demonstrate the external spatial spillover effect of ecology. Based on research from the Beihai Wetland Reserve, Guangxi, China, this study found that the change in the ecological externality spillover mechanism is not only affected by spatial distance but is also affected by the pro-environmental attributes of individual residents around the region. Under the same conditions, residents with a high degree of interaction with ecological protection zones can display a stronger spatial spillover effect. The conclusion of this study provides a more accurate understanding of the changes in the spillover effect of ecological externalities, which in turn can help managers to formulate more adequate ecological protection policies that are based on the specific conditions of different residents. This is crucial for the successful management of protected ecological areas that are highly linked to human communities.

Factors predictive of an academic otolaryngologist's scholarly impact.

ObjectivesDescribe the h index as a bibliometric that can be utilized to objectively evaluate scholarly impact. Identify which otolaryngology subspecialties are the most scholarly. Describe if NIH funding to one’s choice of medical school, residency, or fellowship has any impact on one’s scholarly output. Determine other factors predictive of an academic otolaryngologist’s productivity.Study designAnalysis of bibliometric data of academic otolaryngologists.MethodsActive grants from the National Institutes of Health (NIH) to otolaryngology departments were ascertained via the NIH Research Portfolio Online Reporting Tools Expenditures and Reports database. Faculty listings from these departments were gleaned from departmental websites. H index was calculated using the Scopus database.ResultsForty-seven otolaryngology programs were actively receiving NIH funding. There were 838 faculty members from those departments who had a mean h index of 9.61. Otology (h index 12.50) and head and neck (h index 11.96) were significantly (P < 0.0001) more scholarly than the rest of subspecialists. H index was significantly correlative (P < 0.0001) with degree of NIH funding at a given institution. H index was not significantly higher for those that attended medical school (P < 0.18), residency (P < 0.16), and fellowship (P < 0.16) at institutions with NIH funding to otolaryngology departments.ConclusionsH index is a bibliometric that can be used to assess scholarly impact. Otology and head and neck are the most scholarly subspecialists within otolaryngology. NIH funding to an individual’s medical school, residency, or fellowship of origin is not correlative with one’s scholarly impact, but current institutional affiliation and choice of subspecialty are.

Aspects of ICT connectivity among older adults living in rural subsidized housing: reassessing the digital divide

PurposeThis article examines aspects of information communication technology (ICT) connectivity among the understudied population of low-income older adults living in rural and peri-urban subsidized housing. We aim to investigate if variations exist in access and connectivity when economic and housing conditions are constant and use data from northern New England.Design/methodology/approachThe multidisciplinary, mixed-methods approach involved administering structured surveys using iPads with senior residents (n = 91) from five housing sites, qualitative observations by field researchers and an ecological assessment of ICT resources at housing, community and state levels.FindingsAll subsidized housing sites were broadband accessible and nearby libraries. Fewer sites had Wi-Fi freely available to residents, and individual residents disparately accessed the Internet. Age and education demonstrably influenced ICT use of social media and email. Technology in the form of iPads used for surveys posed functional challenges for some older adults, but these technology-mediated interactions were also perceived as important sites of sociability.Originality/valueOlder adults disparately access and use ICT relative to socioeconomic status even as housing conditions remain constant, and access and use influences frequency of social connections with friends and family. The findings reveal factors that contribute to the existing digital divide facing older adults and broader lack of digital equity.

An Examination of General Surgery Residency Programs with a Rural Track

There is a steady decline in the general surgery workforce in rural areas of the United States. In response, some surgery residency programs have developed rural tracks to encourage rural practice and adequately prepare trainees for this setting. To compare the practice type and location of graduates from general surgery residency programs with and without a dedicated rural track between 2011-2020. General surgery residency programs with and without a rural track were identified using the American Medical Association Residency and Fellowship Electronic Interactive Database and the Rural Surgery Program list from the American College of Surgeons. Graduates of these programs who entered general surgery practice between 2011-2020 were subsequently identified from individual residency program websites and tracked to their current practice setting using a Google search of first and last name and residency affiliation. Practice location was identified by zip code or county name and coded by Rural-Urban Continuum Codes (RUCC, Economic Research Service, USDA). We identified 2,582 general surgery residency graduates from 2011 to 2020 across 66 residency programs. Of these graduates from programs without a rural track, 23.6% entered general surgery practice without additional fellowship training, compared to 34.0% from residency programs with a rural track (p = 0.019). Community or University-based program designation was not associated with decision to enter general surgery practice over fellowship training (p = 0.420). Proportion of graduates entering rural practice as defined by RUCC groups 7-9 was not associated with having a rural program track or with community or university-based program status. Residency programs with a rural track produce a higher proportion of graduates entering general surgery compared to fellowship, though they are no more likely than programs without a rural track to produce graduates who ultimately practice in rural areas.

Contracting with citizens: How residents in Hamburg and New York negotiated development agreements

Residents are often excluded from contractual negotiations, which limits their influence over development projects. In this article, I explored four cases in Hamburg and New York in which residents succeeded in negotiating agreements on developments in their neighborhoods. The aim of this study was to understand how residents can harness agreements to bend development processes toward their goals. In each case, various types of agreements were used. The agreements differed in terms of neighborhood benefits, planning, monitoring, flexibility and enforceability aspects. The benefits of each project to the respective neighborhood were first assessed by an organization that represents residents or involves individual residents. Next, each project was monitored through oversight committees or by providing reports to representatives of the neighborhood. The agreements in three of the four cases were relatively rigid. Lastly, the contracts were designed by the parties involved to include penalties or mitigation processes if parties failed to perform their obligations. This research project contributes to the body of literature on contractual governance and participatory democracy by showing how agreements are designed when residents are involved in negotiation processes. This study shows that contracts can be used as accountability mechanisms and enhance residents’ influence over development projects in their neighborhoods.

Amenities, disamenities, and decision-making in the residential forest: An application of the means-end chain theory to roadside trees

The residential forest provides many amenities to communities, including aesthetics, air quality improvement, and higher property values. However, the residential forest may also contribute human-perceived problems or disamenities including allergens, leaf debris, infrastructure damage, and maintenance costs. Vegetation management by utility companies along power lines is one process that shapes the residential forest. Property owners’ decisions to consent or object to utility vegetation management may be influenced by perceived tree amenities and disamenities. To explore this decision-making process, we conducted 32 one-on-one semi-structured qualitative interviews with resident-homeowners who consented or objected to a utility company tree removal on their property between 2014 and 2017. The study area included several towns in eastern Connecticut, USA, representing urban, suburban, and exurban residential areas. We applied the means-end chain theory as a theoretical framework, and used laddering interviews to explore the tree amenities, disamenities, and values associated with trees. Attractiveness, shade, and privacy were the most frequently identified amenities of trees; risk to power lines, trees being dead or diseased, and risk to people were the most frequently identified disamenities. Amenities and disamenities were connected to such values as happiness and enjoyment, closeness to nature, comfort, pride in one’s home, aesthetics, life, avoiding harm to others, and time or money for other priorities. Participants who objected to utility tree removals primarily identified tree amenities as reasons to retain the trees, whereas participants who allowed tree removals primarily identified disamenities as reasons for their decision. The most common reason for objecting to removal was uncertainty about the need for removal. Participants had diverse perceptions of how tree amenities and disamenities affected their potential consent to utility vegetation management, illustrating that the priorities and concerns of individual residents are important considerations for forest managers and arborists engaged in vegetation management on private property.

A novel method for identifying care home residents in England: a validation study.

IntroductionThe ability to identify residents of care homes in routinely collected health care data is key to informing healthcare planning decisions and delivery initiatives targeting the older and frail population. Health-care planning and delivery implications at national level concerning this population subgroup have considerably and suddenly grown in urgency following the onset of the COVID-19 pandemic, which has especially hit care homes. The range of applicability of this information has widened with the increased availability in England of retrospectively collected administrative databases, holding rich patient-level details on health and prognostic status who have made or are in contact with the National Health Service. In practice lack of a national registry of care homes residents in England complicates assessing an individual’s care home residency status, which has been typically identified via manual address matching from pseudonymised patient-level healthcare databases linked with publicly availably care home address information.ObjectivesTo examine a novel methodology based on linking unique care home address identifiers with primary care patient registration data, enabling routine identification of care home residents in health-care data.MethodsThis study benchmarks the proposed strategy against the manual address matching standard approach through a diagnostic assessment of a stratified random sample of care home post codes in England.ResultsDerived estimates of diagnostic performance, albeit showing a non-insignificant false negative rate (21.98%), highlight a remarkable true negative rate (99.69%) and positive predictive value (99.35%) as well as a satisfactory negative predictive value (88.25%).ConclusionsThe validation exercise lends confidence to the reliability of the novel address matching method as a viable and general alternative to manual address matching.

Behavioural determinants of an individual's intention to adapt to climate change: Both internal and external perspectives

Climate change has had a significant negative impact on socio-economic factors and the earth's ecology. To cope with climate change, many countries have employed various policies and measures to reduce damage due to climate change. For individual residents, adaptation behaviour is vital for reducing individual welfare losses. This research analysed how psychological determinants and other external factors influence residents' intention to adapt to climate change. We proposed an extended protection motivation theory (PMT) model, developed a reliable scale and conducted a nationwide field survey. We interviewed 1402 residents in 29 provinces, and 874 valid questionnaires were collected, providing data that were used in a structural equation model. The results show that our model can serve as a reliable framework for analysing the determinants of residents' intention to adapt to climate change. Policy is the most important factor for stimulating the formation of residents' adaptation intention. Risk appraisals and adaptation appraisals have positive and significant impacts on the intention of residents to adopt climate change adaptation behaviour. Information and climate perception do not directly influence residents' behavioural intentions but indirectly affect their intentions through the process of risk appraisal and adaptation appraisal. Corresponding policy suggestions are made that may be helpful for the formulation of adaptation policies.

A descriptive analysis of emergency medicine resident productivity over the course of training.

The primary objective of emergency medicine (EM) residency training is to develop knowledgeable, procedurally competent, and highly efficient physicians. We aimed to determine current overall productivity statistics and if there is an average rate of productivity change for individual residents as they progress through their training. This was a retrospective review of EM resident productivity performed at two American Council of Graduate Medical Education-accredited, community-academic residency programs from July 2012 to June 2018. Productivity was defined by relative value units (RVU)/h, RVU/patient, and patients/h. Mixed-effects models for repeated-measures data were used to assess change in outcome over postgraduate year (PGY) levels. The models included the interaction between progressive PGY levels to assess whether there was a pattern of change between each training year. A total of 102 unique EM residents were included in the analysis. All three productivity measures increased linearly between PGY levels. However, while each graduating class had linear improvement throughout training, the rates of change were not consistent from one class to the next. Furthermore, a consistent rate of change between PGY for individual residents could not be established. Productivity can increase, decrease, stay the same, or any combination as residents advance through their training. Overall productivity of EM residents increases as they advance through their training. However, there is no consistent pattern of increase from one graduating class to the next and no reliable pattern of change for individual residents. Having increased granularity and understanding of productivity as it relates to individual residents will allow for more enhanced advisement of residents about their current productivity and their anticipated course through residency.

Integrating Leadership Competencies in Clinical Didactic Curricula: The Mock Tumor Board

Developing leadership competencies has been identified as an essential part of graduate medical education 1 Turner S Seel M Trotter T et al. Defining a Leader Role curriculum for radiation oncology: A global Delphi consensus study. Radiotherapy and oncology: journal of the European Society for Therapeutic Radiology and Oncology. 2017; 123: 331-336 Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar that has oft been neglected with minimal dedicated didactic programs. A few ad hoc programs have been created at individual residency programs, 2 Song EY Chuang J Frakes JM et al. Developing a Dedicated Leadership Curriculum for Radiation Oncology Residents. J Cancer Educ. 2021; Crossref Scopus (1) Google Scholar ,3 Berriochoa C Amarnath S Berry D et al. Physician Leadership Development: A Pilot Program for Radiation Oncology Residents. International journal of radiation oncology, biology, physics. 2018; 102: 254-256 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar but the current limits on extra didactic time in many curricula preclude robust implementation of dedicated leadership didactics. As attending radiation oncologists, we are expected to advocate for our patients at multi-disciplinary tumor boards in which we are almost certainly in the minority. Trainees receive little to no training or opportunities to practice these skills prior to independent practice.

The Rule of Choice: Frames and Overflows in the History of New York City Roadway Planning

Two episodes of roadway planning in New York City—the 1937 Henry Hudson Parkway construction and the 2018 congestion pricing legislation—show the dangers and productive possibilities that result when planners “frame” problems as to be resolved by the choices of either experts or individual urban residents. Framing planning as a matter of choices is a reductive dualism that ignores the intellectual, material, and networked relationships that “overflow” such narrow conceptions. Planners and advocates seeking to intervene in choice frames, from Jane Jacobs to congestion pricing advocates, have repurposed metaphors, technology, and scale to link individuals with community, mobility with environmentalism, and planning with politics.