Residency Requirements Research Articles

Residency Requirements for Medical Aid in Dying.

In 1997, when Oregon became the first U.S. jurisdiction authorizing medical aid in dying (MAID), its law included a requirement that patients be legal residents of the state. Other U.S. jurisdictions legalizing MAID followed Oregon in adopting residency requirements. Recent litigation challenges the legality, as well as the justification, for such requirements. Facing such challenges, Oregon and Vermont eliminated their MAID residency requirements. More states could follow this move, for, in certain circumstances, the U.S. Constitution's privileges and immunities clause protects citizens' right to travel to secure medical care. Policy considerations could also motivate states to reexamine whether such requirements are justified in light of existing evidence of how MAID laws have been applied.

Overview of recent cases before the European Court of Human Rights and the European Committee of Social Rights (June 2023 – December 2023)

This case law report discusses two cases before the European Court of Human Rights and two cases before the European Committee of Social Rights. The first case (Pająk and others v. Poland) concerns the introduction of a lower and different retirement age on the basis of sex for judges of the Polish Constitutional Court. In the case X and others v. Ireland, the ECtHR had to examine the extent to which the residence requirement for child benefits violated Article 14 ECHR, read in conjunction with Article 8 ECHR and Article 1 of the Additional Protocol to the ECHR. Child benefits were paid only to claimants who were fully resident in Ireland, and the applicants, who were awaiting a decision on their residency status, did not fulfil this requirement under Irish law. The collective complaint no. 167/2018 (Sindacato autonomo Pensionati Or.S.A. v. Italy) concerned an alleged violation of Article 12 (3) ESC due to the total or partial suspension of the automatic indexation of a large share of pensions in 2011. The measure was extended in 2015 and revised in 2018, taking into account the position of particularly vulnerable persons. In the last case (collective complaint no. 185/2019, European Roma Rights Centre (ERRC) v. Belgium), the applicants argued that their right to social assistance had been violated, as they had not received social assistance benefits following a police investigation. The ECSR did not go along with the applicants’ claim.

Mundane Urban Governance and AI Oversight: The Case of Vienna's Intelligent Pedestrian Traffic Lights

ABSTRACT This article examines the implications of integrating Artificial Intelligence (AI) into urban infrastructures, using Vienna's Intelligent Pedestrian Traffic Light (IPTL) as a focal point. As cities globally embrace AI, Urban AI (UAI) emerges, reshaping urban life. The central inquiry is: How does AI in urban governance alter urban spaces, and what new political dynamics arise? The IPTL, a UAI exemplar, uses advanced surveillance and algorithms to enhance pedestrian signaling, aiming to reduce jaywalking and optimize traffic. Through mixed-methods, combining theoretical and empirical approaches, the study delves into expert narratives, public perceptions, and the technology's design. It uncovers the transformative effects of such technologies on urban spaces and human–vehicle interactions. Findings highlight that while the IPTL promises urban governance advancements, it may overlook diverse urban needs, as seen in the neglect of the visually impaired. The research accentuates the imperative for a more encompassing, inclusive lens in AI-centric urban endeavors, underscoring the significance of recognizing and addressing the myriad rhythms and requirements of all urban residents. The article culminates in a call for a reconstructivist perspective on UAI, championing the democratization of urban realms and foregrounding pedestrian-centric visions in upcoming mobility ventures.

Breaking down organ donation borders: Revisiting “opt out” residency requirements in the UK

All four UK nations have, in recent years, introduced “opt out” organ donation systems. Whilst these systems are largely similar, they operate independently. A key feature of each policy is a residency requirement, stipulating that opt out may only apply where the deceased had been ordinarily resident in that nation for at least 12 months. A resident of Scotland who dies in England, for example, would not fall under opt out. Public awareness is the underlying reasoning for such stipulations. A residency requirement was appropriate when Wales was the only UK nation with an opt out system, but, I suggest, the continued imposition of intra-UK borders on organ donation is unjustified now that all four nations operate the same policy. Further, it has the potential to limit organ donation. There is a need for all four systems to be amended to allow for UK-wide applicability, such that providing the deceased was ordinarily resident in the UK, they can fall under opt out in any of the four nations. I argue that such an amendment is ethically justified – continuing to satisfy the public awareness criterion – and practically straightforward. In doing so, I emphasise that my proposed amendment should extend only to the four UK nations, stopping short of the Crown Dependencies even though they also operate opt out systems for organ donation.

Variation in pediatric orthopaedic case volume and type during residency: An updated report after Accreditation Council of Graduate Medical Education case volume minimums

BackgroundIn 2013, the Accreditation Council of Graduate Medical Education (ACGME) instituted a case minimum requirement for orthopaedic residents. It is unknown how pediatric orthopaedic case volume and variability have been affected by this change. MethodsThe ACGME orthopaedic surgery case log data from 2007 to 2020 were used to evaluate the number and type of pediatric orthopaedic procedures logged by graduating residents. The mean and median number of cases logged were compared for the years before (2007-2013) and after (2014-2020) the case minimum implementation using a Student t-test. ResultsIn the period after case minimum implementation, there were significant decreases in both overall cases (2080.6-1639.2; P < .001) and pediatric cases (328.7-264.7; P < .001) logged by residents. However, pediatric case volumes in certain areas significantly increased. Pediatric humerus/elbow procedures went up by 19.7% (29.4-35.2; P < .001), driven by an increase in fracture and dislocation treatments (21.5-28.17, 31.0%; P < .001). Similarly, pediatric forearm/wrist procedures went up by 31.7% (33.7-44.5; P < .001), driven by an increase in manipulation (19.0-31.9, 67.8%; P < .001). All other anatomic areas besides the shoulder experienced significant decreases in case volume, including spine procedures, which experienced the greatest decrease: 52.1% (28.4-13.5; P < .001). ConclusionsParadoxically, since the implementation of case minimums in 2013, residents have logged fewer overall cases and pediatric orthopaedic cases. One may hypothesize that, when residents are required to submit a certain minimum number of cases, there is little incentive to submit additional cases. Key Concepts1)The ACGME instituted a case minimum requirement for Orthopaedic surgery residents starting in 2013.2)Since 2013, residents have logged fewer pediatric orthopaedic cases.3)Since 2013, residents have logged fewer overall orthopaedic cases. Level of EvidenceIII, Cross-Sectional Study

Decentralized Data and Artificial Intelligence Orchestration for Transparent and Efficient Small and Medium-Sized Enterprises Trade Financing

The complexities arising from disparate data sources, conflicting contracts, residency requirements, and the demand for multiple AI models in trade finance supply chains have hindered small and medium-sized enterprises (SMEs) with limited resources from harnessing the benefits of artificial intelligence (AI) capabilities, which could otherwise enhance their business efficiency and predictability. This paper introduces a decentralized AI orchestration framework that prioritizes transparency and explainability, offering valuable insights to funders, such as banks, and aiding them in overcoming the challenges associated with assessing SMEs’ financial credibility. By utilizing an orchestration technique involving symbolic reasoners, language models, and data-driven predictive tools, the framework empowers funders to make more informed decisions regarding cash flow prediction, finance rate optimization, and ecosystem risk assessment, ultimately facilitating improved access to pre-shipment trade finance for SMEs and enhancing overall supply chain operations.

Have Arguments For and Against Medical Aid in Dying Stood the Test of Time?

Have Arguments For and Against Medical Aid in Dying Stood the Test of Time?

Information System for Integrated Administrative Services at the District Office of Seberang Ulu Satu Palembang City

Seberang Ulu Satu District of Palembang City is a government institution whose duties include serving community needs in terms of administrative data, in this case specifically regarding licensing and non-licensing services, public complaints and hearse lending services. Based on the observations results, it is found that the mechanism for submitting and managing administrative documents at the Seberang Ulu Satu District office still had some obstacles, such as difficulties for residents to get information about service administration requirements, the requirement for residents to come directly to the office and queues for residents to submit letters applications for both licensing and non-licensing, complaints and borrowing hearses. To overcome this, the authors will design an integrated administrative service information system for Seberang Ulu Satu District, Palembang City using the waterfall software development method, as well as the UML (Unified Modeling Language) design system model which includes use case diagrams, activity diagrams, sequence diagrams, and class diagrams. The end result is building an integrated administrative service information system at the Seberang Ulu Satu District office, Palembang City, which can help and facilitate the process of Integrated Administrative Services for Seberang Ulu Satu District, Palembang City.

Parliamentary activity of Kyril Trylovskyi in the context of social and political processes in the Ukrainian lands, beginning 20 th century

The article reveals the human rights activities of lawyer Кугуїо Trilovskyi during his first parliamentary term in the Austrian parliament (1907-1911). The advantages and disadvantages of the election law, as well as the consequences of its adoption for the Ukrainian population of the region, are analyzed. It was noted that the reform had a number of significant shortcomings, namely: voting rights did not extend to women and military personnel, the age for elections was set at 24 years, for deputies - 30 years, the residency requirement - one year. The distribution of deputy seats by nationality was also quite uneven. At the same time, the law introduced democratic innovations, in particular, providing for voting on the basis of general direct and secret suffrage.&#x0D; K. Trylovskyi’s views on the inclusion of Ukrainian lands in Austria-Hungary, which the researcher considered a more positive phenomenon than their stay in Poland, were revealed. The lawyer believed that the legal status of the Ukrainian population within Austria is more promising.&#x0D; The vectors of Кугуїо Trylovsky’s parliamentary activity are characterized. In particular, the priority of the Ukrainian issue was emphasized in the speeches of the human rights defender. It is noted that the lawyer devoted his first speech in the walls of the Austrian Parliament (July 22, 1907) to highlighting issues related to numerous abuses of the position of the Polish nobility in Galicia.&#x0D; It is indicated that in his speeches the parliamentarian raised other, no less important issues for the Ukrainian population: state compensation for damages caused by the flood; the right to own and use weapons by shepherds to protect domestic animals; mandatory use in courts when writing protocols and indictments in the Ukrainian language; establishment of a clear list of items that cannot be taken away in case of tax collection; the right and opportunity of Ukrainian military personnel to celebrate Ukrainian holidays, etc.

International Medical Graduates and the Shortage of US Pathologists: Challenges and Opportunities.

Physician shortages are affecting many communities across the United States and all medical specialties, including pathology. International medical graduates (IMGs) make up a significant proportion of US physicians and graduate medical education (GME) trainees, including pathologists. However, noncitizen IMGs continue to face great challenges in entering the US health care workforce. To show recent and historical data on noncitizen IMGs in pathology GME training and current limitations on them remaining in the US health care workforce. Compared with applicants who do not need a visa, applicants who need a visa to train in the United States have a greatly reduced chance of matching to a residency program. After completion of residency and fellowship, noncitizen IMGs with J-1 visas face the 2-year home country residence requirement unless they obtain a waiver. H-1B visas facilitate the transition to independent practice but have limited availability. Job announcements for pathologists often do not indicate whether J-1 and H-1B visa holders are considered, which makes the job search process difficult for noncitizen IMGs. Academic and nonacademic institutions with departments of pathology should increase awareness of the pathologist shortage in the United States and the rules and regulations that limit hiring of non-US IMGs. Such institutions should also actively educate policymakers to promote durable solutions to these issues. One potential solution to these shortages may be to make it easier for noncitizen IMGs to access GME and join and remain in the US physician workforce.

Enhancing the Community Environment in Populous Residential Districts: Neighborhood Amenities and Residents’ Daily Needs

Due to urban population growth, dense communities have emerged as a common approach to improve land utilization and minimize resource consumption to foster sustainable development in cities. In densely populated neighborhoods, the accessibility, availability, and appropriateness of amenities play a crucial role in the sustainable development of cities and residents’ quality of life. This study integrates the distribution of amenities within densely populated cities and utilizes residential assessments to analyze the effectiveness of these amenities in meeting the daily needs of residents. This analysis is based on a survey conducted in the three most populated cities in China. The study utilizes two sets of data: amenity distribution information and a questionnaire regarding the state of amenities and residents’ daily needs. The survey began in 2019 and was completed in 2021. A total of 1060 valid questionnaires were collected, with Shanghai accounting for 42%, and Beijing and Chongqing accounting for 30% and 28%, respectively. The findings demonstrate a higher density of amenities in populous areas, indicating a response to the overall requirements of residents. In these areas, the transportation network is extended more widely. Moreover, neighborhoods equipped with outdoor green spaces, ample parking, security services, and accessible public institutions received positive evaluations from residents, as they actively fulfilled their living needs. In neighborhood planning, prioritizing the coverage and quantity of these amenities can enhance the functionality and effectiveness of dense residential areas. This approach promotes sustainable development goals by improving the efficiency of urban resource allocation and establishing a convenient neighborhood environment.

Comparisons of Procedures Performed in Training vs in Early Practice by Orthopaedic Trauma Surgeons.

The Orthopaedic Trauma Association (OTA) has maintained an accreditation process of orthopaedic trauma fellowships with various requirements including an annually reviewed list of qualifying trauma cases in the form of American Medical Association Current Procedural Terminology (CPT) codes. The correlation between these established and monitored CPTs and the actual practices of orthopaedic trauma surgeons has not been studied. American Board of Orthopaedic Surgery part II case logs (trauma subspecialty) (2012 to 2018) were compared with OTA fellowship case logs (2015 to 2019). Case logs from 447 surgeons and 166 trauma fellowship programs were compared. Four CPT code categories were defined: complex trauma (OTA required CPT codes, excluding Accreditation Council for Graduate Medical Education [ACGME] orthopaedic residency requirements), general trauma (ACGME residency required trauma codes), general orthopaedics (nontrauma ACGME residency requirements), and others (codes not included in residency or trauma fellowship requirements). OTA fellows performed a higher median percentage of complex trauma compared with American Board of Orthopaedic Surgery candidates (34% vs. 21%, P < 0.001): Both cohorts performed a similar percentage of general trauma (23%). OTA fellows performed more general orthopaedics (40% vs. 1%, P < 0.001). Several OTA required codes were performed infrequently (0 to 3 during board collection) by most surgeons, and several procedures are being performed that are not included in current CPT code requirements. Early-career traumatologists are performing orthopaedic trauma procedures they were trained on during residency and fellowship, with varying complexity. Trauma fellows perform a higher percentage of complex trauma compared with early-career trauma surgeons. Continued surveillance is necessary such that educational improvements can be made to maximize the quality of trauma fellowship education. Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

Residents' Report of COVID-19 Associated Training Disruptions, Stressors, and Opportunities During the Pandemic-The Singapore Experience.

The COVID-19 pandemic has disrupted residency training. Several studies have been performed to investigate the impact of the pandemic on residency training in Accreditation Council for Graduate Medical Education-International (ACGME-I)-accredited institutions. However, these were either limited to certain specialties or failed to consider possible opportunities from the pandemic. To determine the stressors on residents as well as the opportunities that arose from the COVID-19 pandemic across multiple specialities in Singapore. A cross-sectional survey among SingHealth residents was conducted between July and September 2020. The survey assessed the balance between service and training during hospital postings, the pandemic's influence on examination and teaching, the psychological impact of the pandemic, the level of burnout, and the effect on morale of residents during the pandemic. The response rate was 27.1% (253 of 934). Out of the 253 residents, 136 (53.8%) felt stressed during the pandemic. Concerns about family's health and safety pertaining to potential COVID-19 infection, progression in training, and completion of examinations were the top 3 stressors. One-hundred and three residents (40.7%) had their training disrupted either by being placed in an interim posting not part of their residency requirements or being deployed to care for patients with COVID-19. Although administrative support and information for virtual teaching were sufficient, only 108 (42.7%) agreed it had the same value as face-to-face sessions. Despite the challenges, 179 (70.8%) thought that experiencing this crisis provided more meaning in their career. The COVID-19 pandemic has brought about challenges and learning opportunities for residents.

Public Service Innovation Towards Smart Villages: Between Expectation and Realisation in Melikan Village

The idea of a smart village encompasses various aspects of rural life in the modern digital era, with a key focus on information technology infrastructure. The aim of this study is to explore the hopes and requirements of rural residents and assess the level of preparedness of village authorities to leverage technological advancements towards creating smart villages. The research method used is the qualitative research method. The research was conducted in Melikan Village, Klaten Regency, Central Java. The research used several main data sources: village officials and the Melikan Village community. The data collection techniques used were interviews, observation, and FGD. The results show that information and communication technology is vital for the Melikan Village community, but the village government is not yet sufficiently prepared to fulfil the community's expectations. The village government is encouraged to collaborate and be creative with parties that can develop digital services. Community empowerment can technically be done by using application software or websites to open up opportunities for information channelling and support overall rural development. However, the successful implementation of smart villages is highly dependent on the motivation of village leaders, active community participation, and potential village resources. The implication of this research is that the Melikan Village government needs to immediately overcome the obstacles that hinder the adoption of innovations in government services towards smart villages.

Migration Law and Issues in Sports

The international migration of athletes has become an essential feature of sports competition. These days foreign travel is often the name of the game. The purposes and duration of such migration range from participation in single events to long-term, even permanent relocation involving professional transfers. Each purpose or duration may generate a different body of law and regulations. Varying national visa, residence and other requirements for territorial entry of noncitizens are of course essential. Regional, especially European Union law may also be foundational as it was, for example, in defeating a practice within the EU of transfer payments between clubs in different member states that impeded freedom of movement. Also applicable is international law, notably that of the several institutions within the Olympic Movement insofar as it is one of the very few NGOs vested with international legal personality. Supporting that legal authority or extending beyond it are bilateral treaties of friendship and cooperation. More broadly, international human rights law applies, particularly in reinforcing the rights of athletes to be free of political discrimination against their participation in international competition.

Medical Aid in Dying: Gaining Attention in America

Medical Aid in Dying: Gaining Attention in America

Reconceptualizing the emergency medicine resident scholarly requirement: Proposed framework and rubric.

The completion of a scholarly project is a common program requirement by the Accreditation Council for Graduate Medical Education (ACGME) for all residency training programs. However, the implementation can vary significantly between programs. Lack of generalizable standards for scholarly projects required of all trainees within ACGME-accredited residencies has led to a large range of quality and effort put forth to complete these projects. Our goal is to introduce a framework and propose a corresponding rubric for application to resident scholarship to quantify and qualify the components of scholarship to better measure resident scholarly output across the graduate medical education (GME) continuum. Eight experienced educators and members of the Society for Academic Emergency Medicine Education Committee were selected to explore the current scholarly project guidelines and propose a definition that can be universally applied to diverse training programs. Following a review of the current literature, the authors engaged in iterative, divergent, and convergent discussions via meetings and asynchronous dialogue to develop a framework and associated rubric. The group proposes that emergency medicine (EM) resident scholarship should (1) involve a structured process, (2) generate outcomes, (3) be disseminated, and (4) be peer reviewed. These components of resident scholarly activity are achieved whether this is a single project encompassing all four domains, or multiple smaller projects that sum to the whole. To assist residency programs in assessing a given individual resident's achievement of the standards set forth, a rubric is proposed. Based on current literature and consensus, we propose a framework and rubric for tracking of resident scholarly project achievement in an effort to elevate and advance EM scholarship. Future work should explore the optimal application of this framework and define minimal scholarship goals for EM resident scholarship.

Whose Life Is It Anyway? Medical Aid in Dying and Its Legal, Medical, and Ethical Conundrums

Whose Life Is It Anyway? Medical Aid in Dying and Its Legal, Medical, and Ethical Conundrums

Optimal configuration for multi-purpose mine water quality-classified utilization

ABSTRACT Comprehensive utilization of mine water is of immense significance to avoid water wastage and protect the environment. To maximize the benefit of mine water utilization by calculating the available water in the goaf of Wucun Mine and analyzing the characteristics of water quality, combined with the water requirements of residents, power plants, irrigation, aquaculture, and ecology around the mining area and their water quality requirements, a mathematical model for optimal allocation of water quality-classified utilization in a 718-m3/h mine was constructed and solved using differential evolution algorithm and genetic algorithm, respectively. While the results of seven iterations of genetic algorithm varied between 215.24 and 232.36 China Yuan/h, those of differential evolution algorithm were all 232.36 China Yuan/h. When compared with genetic algorithm, differential evolution algorithm has the advantages of better convergence and stable and reliable calculation results. In the irrigation period, differential evolution algorithm indicated supply of 6.00, 334.95, 353.89, 19.76, and 3.40 m3/h treated mine water for residential usage, power plant, irrigation, aquaculture, and ecology, respectively, whereas in the non-irrigation period, differential evolution algorithm suggested supply of 6.00, 688.84, 0, 19.76, and 3.40 m3/h treated mine water, respectively. The annual income from quality-classified utilization of the mine water was the highest. Thus, the present study provides a model that can be used for reference for rational utilization of mine water resources.

Negotiating precarity: Recent immigrants’ perceptions of waiting for public healthcare in Ontario, Canada

Canada is widely known for its universal publicly funded health care system. While its health care system is an important part of Canadian identity, recent immigrants living in some provinces and territories are not covered by the publicly funded healthcare system until they have met a minimum residency requirement. This article seeks to understand the multiple manifestations of financial and emotional precarity that recent immigrants face as they navigate a lack of access to health care during their first three months of arrival in Ontario. This paper draws on qualitative semi-structured interview data from 46 recent immigrants who came from 12 different countries and had been living in Ontario, Canada. We found that the wait period to obtain health care often added to the prohibitive costs associated with immigration and settlement. During the wait period, recent immigrants faced financial burdens and their inability to access publicly funded hospitals and medical services when needed which resulted in feelings of vulnerability, anxiety, and emotional hardship. Given the financial and emotional precarities faced by recent immigrants during the wait period, we argue that the Canadian ‘universal’ healthcare system excludes and creates barriers to timely and equitable access to healthcare services for recent immigrants. We recommend to permanently eliminate the wait period policy to ensure the health and wellbeing of recent immigrants.