Resident Involvement Research Articles

Impact of Cleft and Craniofacial Surgery Experience in Oral and Maxillofacial Surgery Residency Training Programs

The impact of cleft and craniomaxillofacial surgeons (CCMFSs) on oral and maxillofacial surgery (OMS) resident training is not well known. The purpose of this study was to measure the association between resident exposure to OMS faculty with CCMFS training, clinical experience, and scholarly activity. An anonymous survey of OMS residency directors in the United States, distributed electronically by the American Association of Oral and Maxillofacial Surgeons, was used to conduct a cross-sectional study. Survey consisted of 3 following sections: 1) CCMFS faculty and program-related information, 2) CCMFS curriculum in residency programs, and 3) academic productivity related to CCMFS. Primary predictor variable was CCMFS exposure: presence or absence of an OMS faculty with CCMFS fellowship or equivalent. Primary outcome variables were: 1) number of CCMFS cases with OMS resident involvement, 2) number of OMS residents who pursued CCMF surgery fellowship, and 3) CCMFS-related academic productivity of faculty and residents by abstract or publication. Covariates include clinical experience of OMS residents in CCMFS cases and CCMFS-related academic productivity. Descriptive statistics and continuous/ordinal variables were summarized. Fisher exact and Wilcoxon Rank Sum tests were completed. 2-sided P values of <.05 were considered statistically significant. There were 81 completed surveys (91% response rate; excluded military programs). Almost half of OMS training programs have at least one attending surgeon who completed a CCMF surgery fellowship (n=36/81, 44.4%). OMS departments with a CCMFS-trained faculty performed more operations on patients with congenital craniofacial differences (P value <.001) and were more likely to publish at least one manuscript related to CCMF surgery in the last 5years (P value=.029). Nearly half of OMS training programs have at least one attending surgeon who completed a CCMF surgery fellowship or equivalent. CCMF surgery faculty may increase opportunities for OMS resident involvement in caring for patients with congenital craniofacial differences. There is academic productivity in programs with CCMF surgeons. This should improve as the cohort of CCMF trained oral and maxillofacial surgeons increases.

Неформальное гражданское участие населения в развитии малых и средних городов Европейского Севера России (на примере некоммерческих организаций и городских интернет-сообществ)

This article explores the informal public participation in the development of small and medium-sized cities in the European North of Russia. It focuses on two main aspects: the impact of nonprofit organizations (NGOs) and the activity of residents on social networks, particularly in discussions and solutions to local socio-economic issues. The study reveals that NGO activities create significant opportunities for addressing local concerns raised by residents to municipal authorities. An analysis of the official pages of local governments on the VKontakte social network shows that, compared to larger cities, residents of these smaller cities are more engaged in dialogue with local authorities, demonstrate higher loyalty to published content, and actively share information of interest. The research also finds that while residents of small and medium-sized cities actively discuss urban problems in informal online communities and participate in various kinds of socially beneficial events, their participation is generally prompted by external organizers. The level of self-organization to address broader citywide problems remains relatively low. However, when dealing with personal household matters, citizens actively communicate through urban online communities. The study also highlights a high level of trust among residents, as evidenced by their strong response to calls for help in the comments. The scientific novelty of this research lies in its first-time analysis of public participation and the assessment of resident involvement in the management and development processes of small and medium-sized cities, through mechanisms such as NGOs and urban Internet communities.

Obgyn resident research program practices and outcomes after implementation in an academically affiliated residency program

ProblemUnlike other aspects of Obstetrics and Gynecology (OBGYN) residency training, the research education curriculum and requirements are not standardized. It is unclear what constitutes core curricula in educational research programs, which components are most useful and efficacious, and how to use these findings to adapt existing programs.ApproachA multi-phase approach to (1) garner cross-sectional data from United States OBGYN Residency Program Directors and review previously published literature, (2) use Phase I and input from clinical, research and education faculty to develop a comprehensive program, and (3) evaluate the program for resident research productivity, knowledge and satisfaction.OutcomesPhase I: Sixty-one (31%) Program Directors completed the survey. Most reported ≤ 4 research didactics per year and no dedicated research rotation. Programs with post graduate year (PGY) level specific didactics, a research rotation, or allocated time for the Research Director role noted higher odds of resident research resulting in peer-reviewed publication. Phase II: A Resident Research Program was adapted to include a clinical and research faculty co-directorship and seven additional didactics (all of which were PGY-specific). A departmentally funded resident research grant and a repository to monitor completion of milestones and program requirements have been developed. Surveys were used to track residents’ research competence and satisfaction with the research program. While resident involvement in research activities and satisfaction with opportunities for scholarly activity have improved, resident self-evaluations and mentor evaluations have not. In addition, we have not seen an increase in publications or presentations.ConclusionImplementation of components of a research program associated with increased productivity did not result in increased productivity in our program, however, resident satisfaction with scholarly activity did improve.

Unveiling the Lasting Impact: A 15-Year Follow-Up of Short-Term Surgical Mission Experiences

IntroductionResident interest in global surgery has increased over recent years. Incorporating short-term surgical missions (STSMs) into training improves Accreditation Council for Graduate Medical Education (ACGME) competencies and aids in understanding of global health infrastructure. We aim to investigate the impact of STSM participation during residency on the desire for participation after residency, and barriers in doing so. MethodsEighteen general surgery residents who participated in STSM with the International Surgical Health Initiative from 2009 to 2017 were surveyed. An 18-question survey encompassing demographics, mission-specific data, ACGME competencies, current perspectives, barriers, and areas for improvement was distributed. ResultsThe group averaged 5.4 y out of residency and 89% (n = 16) completed the survey. Mean age was 38.5 y with a female predominance (62.5%). During residency, 10 (62.5%) participated in ≥ two STSMs and six (37.5%) participated in one STSM. On average, each resident performed 24 cases per mission. All reported that after their resident STSM experience, they were more inclined to participate as an attending. Twenty-five percent (n = 4) participated in STSMs after residency. Vacation, scheduling, and family factors were ranked the highest barriers. All ACGME competencies were felt to be significantly improved by STSMs. ConclusionsThis is the first long-term follow-up study of general surgery residents who participated in STSMs confirming that resident involvement increases desire for continued participation. Although 100% of residents wanted to participate as attendings, only 25% were successful in doing so. While operative experience is salient in surgical residency, there are other valuable experiences to be gained. Further work should focus on enhancing experiences and mitigation of barriers to continued participation in global humanitarian initiatives.

Impact of resident training on cardiac electrophysiological procedures

BackgroundModern management of cardiac arrhythmias often requires interventions in which young physicians must acquire a high level of expertise. However, concerns have been raised about the increase in side effects during procedures performed with resident involvement. AimThis study aims to identify the effects of resident training on cardiac electrophysiological procedures within a university centre. MethodsIn a single-centre study, cardiac arrhythmia procedures were reviewed retrospectively, and resident involvement was scrutinized. Univariate and multivariable models were built for the following outcomes: fluoroscopy time; operative time; length of hospitalization after procedure; and adverse events. ResultsWe reviewed 991 procedures, 574 without and 417 with resident involvement (650 cardiac pacemakers or defibrillators, 120 generator replacements, 188 electrophysiological studies and 153 radiofrequency ablations). Resident involvement was associated with an increase in fluoroscopy time: +1.7±0.4minutes (P<0.01) for pacemaker implantation; and +2.5±0.9minutes (P=0.01) for electrophysiological studies. Operative time was longer for electrophysiological studies (+10.8±4.9minutes; P=0.03) and pacing implantation (+8.4±2.2minutes; P<0.01). There was no significant association between resident training and adverse events (7.67 vs. 9.83%; P=0.28). ConclusionsCardiac electrophysiological procedures performed with resident involvement have a good safety profile. However, resident training modestly, but significantly, prolongs fluoroscopy time and operative time.

Local versus outsider developers: Impact on development duration and its’ implications for community acceptance of solar PV plants in South Korea

This study focused on community acceptance of small to medium solar PV plant projects in South Korea, which has rarely been the subject of research despite reports of disputes. It set out to determine whether there is a difference in community acceptance based on a project being developed by local residents or by outsiders. We used the duration of development for each plant as a proxy variable for the level of acceptance. We interpreted longer development duration as corresponding to a lower level of community acceptance when other characteristics of solar PV plants were controlled for. Analyses using a censored regression model indicated that the development duration was shorter (with statistical significance) when plants were developed by local residents rather than by outsiders. Further investigation revealed local resident involvement had more effect on reducing the development duration for plants exploiting forested land, the type for which community acceptance was known to be low. The effect was not evident when the plants were developed using existing buildings.

Effect of General Surgery Resident Participation in Thoracic Surgery on Oncologic Outcomes: An Observational Cohort Study.

Background: Despite increasing sub-specialization, general surgeons continue to perform oncologic thoracic surgeries. Our objective was to determine whether general surgery resident participation in thoracic surgery affects surgical quality or oncologic outcomes. We hypothesized that patient outcomes with and without resident participation would be similar. Methods: We retrospectively reviewed the electronic health records of patients with stage 0-IV lung cancer undergoing oncologic pulmonary resection at BLINDED FOR REVIEW during an 11-year period (2012-2022). Patients younger than 18years or older than 85years were excluded, as were those who had incomplete follow-up data or were unregistered in our institutional cancer registry. Patients were divided into groups based on whether residents or staff surgeons completed >50% of the critical portions of the operation. We compared 30-day morbidity outcomes, overall survival (OS), and disease-free survival (DFS). Results: Three hundred thirteen patients met inclusion criteria. Demographic and clinical characteristics were similar between groups, as were types of surgical resection and median operative times. A statistical difference was found in the distribution of surgical approach. The odds of morbidity were 65% higher in the Staff group (OR=1.65; 95% CI, 1.007-2.71). Resident participation was not significantly associated with OS or DFS (P =.32 and P =.54, respectively). Discussion: General surgery resident involvement in lung cancer operations is not associated with longer operative times but is associated with a higher likelihood of a thoracotomy. General surgery resident involvement was associated with decreased postoperative morbidity and did not significantly affect OS or DFS.

Evidence Against a Traumatic Brain Injury "July Effect": An Analysis of 3 160 452 Patients From the National Inpatient Sample.

The "July Effect" hypothesizes increased morbidity and mortality after the addition of inexperienced physicians at the beginning of an academic year. However, the impact of newer members on neurosurgical teams managing patients with traumatic brain injury (TBI) has yet to be examined. This study conducted a nationwide analysis to evaluate the existence of the "July Effect" in the setting of patients with TBI. The Healthcare Cost and Utilization Project Central Distributor's National Inpatient Sample data set was queried for patients with TBI using International Classification of Diseases (ICD)-9 and ICD-10 codes. Discharges were included for diagnoses of traumatic epidural, subdural, or subarachnoid hemorrhages. Only patients treated at teaching hospitals were included to ensure resident involvement in care. Patients were grouped into July admission and non-July admission cohorts. A subgroup of patients with neurotrauma undergoing any form of cranial surgery was created. Perioperative variables were recorded. Rates of different complications were assayed. Groups were compared using χ2 tests (qualitative variables) and t-tests or Mann-Whitney U-tests (quantitative variables). Logistic regression was used for binary variables. Gamma log-linked regression was used for continuous variables. The National Inpatient Sample database yielded a weighted average of 3 160 452 patients, of which 312 863 (9.9%) underwent surgical management. Patients admitted to the hospital in July had a 5% decreased likelihood of death (P = .027), and a 5.83% decreased likelihood of developing a complication (P < .001) compared with other months of the year. July admittance to a hospital showed no significant impact on mean length of stay (P = .392) or routine discharge (P = .147). Among patients with TBI who received surgical intervention, July admittance did not significantly affect the likelihood of death (P = .053), developing a complication (P = .477), routine discharge (P = .986), or mean length of stay (P = .385). The findings suggested that there is no "July Effect" on patients with TBI treated at teaching hospitals in the United States.

Vascular Surgery Procedures Performed By Residents. A Narrative Review On The Impact In 30-Day Outcomes.

Worldwide, there is an increase in scrutiny after surgical treatment of a vast array of pathologies. Doing so, a large body of evidence clearly supports centralisation, such as teaching hospitals, where a larger caseload enables optimal outcomes. These institutions have a strong presence of surgical residents seeking training in both technical and non-technical skills. Inevitably, as part of training, they will be involved in the surgical treatment of those patients, even as the primary operator. We sought to investigate the impact of trainee performed procedures in outcomes of common vascular procedures of different technical complexity. A non-systematic MEDLINE and Scopus databases review on the outcomes of resident performed common vascular procedures was performed. Specific evidence in many procedures (venous disease, aortic aneurysms, peripheral artery disease) is lacking. After carotid endarterectomy (CEA), resident performed procedures seem to have similar cranial nerve palsy and stroke when compared to expert surgeons. Generally, resident-performed primary radiocephalic and elbow arteriovenous fistula (AVF) presents similar primary and secondary patency. As with CEA, AVF procedures performed by residents took longer. On aortic aneurysms, although no specific comparison has been performed, resident involvement (irrespective of surgeon or assistant) in these procedures does not seem associated with increased adverse events. In most vascular surgery procedures, little is known about resident performance and their impact on outcomes. Notwithstanding, resident-performed CEA and primary AVF seem free of major compromise to patients. Further research is warranted to clarify this topic.

Risk of Bleeding Versus Venous Thromboembolism After Surgery for Breast Cancer: A National Surgical Quality Improvement Program Analysis

IntroductionPatients who undergo surgery for breast cancer are at risk for venous thromboembolism (VTE) and bleeding, which can lead to significant consequences on outcomes. This study examined factors related to VTE and bleeding risk in breast cancer surgery, with and without reconstruction. We also investigated the relationship between operative time and resident involvement on bleeding and VTE risk. MethodsUsing the ACS-NSQIP database, patients who underwent mastectomy, implant, pedicled, or free flap reconstruction from 2005 to 2021 were identified. Resident involvement was available from 2007 to 2010. We fitted two logistic regressions to model the log odds of bleeding occurrence and VTE as linear functions of procedure type, controlling for age, body mass index, and comorbidities. ResultsImplant reconstruction had significantly reduced 30-d incidence of bleeding, compared to those who underwent transverse rectus abdominus muscle flap (P < 0.001). Free flap was associated with a significant increase in bleeding but not VTE risk (P < 0.001; P = 0.132). Increase in operative time significantly increased the risk of bleeding and VTE (P < 0.001). For surgeries with resident involvement coded, there was no significantly increased risk of bleeding or VTE (P = 0.600; P = 0.766). ConclusionsImplant reconstruction remains the procedure with the lowest risk of both bleeding and VTE. Free flap reconstruction did not show a significantly increased risk of VTE, potentially expanding reconstruction options for patients previously excluded from autologous reconstruction. Surgeons should be mindful of operative time, with re-evaluation of risk factors with each additional hour of surgery, irrespective of reconstruction type. Resident involvement in surgeries should continue to be encouraged by faculty.

Unlocking Peer Review: Elevating Scholarly Writing and Research Competence in Urology Residency.

It is incumbent upon training programs to set the foundation for evidence-based practices and to create opportunities for trainees to develop into academic leaders. As dedicated resident research time and funding have declined in recent years, residency programs and the field at large will need to create new ways to incorporate scholarly activity into residency curricula. Literature across specialties demonstrates barriers to resident involvement including lack of time, cost, and absent scholarly mentorship. Peer review stands as a ready-made solution that can be formalized into a collaborative relationship with journals. A formal relationship between professional societies, academic journals, and residencies can facilitate the use of peer review as a teaching tool for residency programs.

Research on Regional Culture Integration and Community Cultural Development Mechanisms

As time progresses, the importance placed on community cultural construction and regional cultural integration has significantly increased. Community cultural construction is not only the core of community development but also a key factor in community cohesion and residents' identity recognition. However, in the actual process of advancing community culture, we still face many challenges and issues. Firstly, there is insufficient participation from residents, many cultural activities and projects lack adequate resident involvement, making it difficult to achieve the expected effects of community mobilization and cultural heritage. Secondly, residents' sense of identification with their community is weak, which to some extent affects the stability and development of the community. Moreover, current community cultural content construction often lacks innovation; many cultural activities and content are repetitive and lack appeal, insufficient to meet residents' diverse and growing cultural needs. To delve deeper into these issues and find solutions, this paper has chosen Humen in Dongguan as the research subject. Due to its rich historical and cultural resources and unique geographical location, Humen serves as an ideal case study for community cultural construction and regional cultural integration. By conducting an in-depth analysis of the current cultural development status in the Humen community, the participation level of its residents, and the implementation effects of cultural projects, this study aims to explore effective mechanisms for community cultural construction and historical cultural integration. Through this research, we hope to provide practical strategies and recommendations for community cultural construction and regional cultural integration, thereby helping cultural workers and community managers more effectively inspire residents' enthusiasm for culture, enhance community cohesion, and promote comprehensive and harmonious community development. Ultimately, this paper will provide valuable references and insights for community cultural construction and regional cultural integration practices in China and globally.

Person-centred medicine in the care home setting: development of a complex intervention.

Person-centred medicine is recommended in the care of older patients. Yet, involvement of care home residents and relatives in medication processes remains limited in routine care. Therefore, we aimed to develop a complex intervention focusing on resident and relative involvement and interprofessional communication to support person-centred medicine in the care home setting. The development took place from October 2021 to March 2022 in the Municipality of Aarhus, Denmark. The study followed the Medical Research Council guidance on complex intervention development using a combination of theoretical, evidence-based, and partnership approaches. The patient involvement tool, the PREparation of Patients for Active Involvement in medication Review (PREPAIR), was included in a preliminary intervention model. Study activities included developing programme theory, engaging stakeholders, and exploring key uncertainties through interviews, co-producing workshops, and testing with end-users to develop the intervention and an implementation strategy. The Consolidated Framework for Implementation Research and the Interprofessional Shared Decision Making Model were used. Data were analysed using a rapid analysis approach. Before the workshops, six residents and four relatives were interviewed. Based on their feedback, PREPAIR was modified to the PREPAIR care home to fit the care home population. In total, ten persons participated in the co-producing workshops, including health care professionals and municipal managerial and quality improvement staff. The developed intervention prototype was tested for three residents and subsequently refined to the final intervention, including two fixed components (PREPAIR care home and an interprofessional medication communication template) delivered in a flexible three-stage workflow. Additionally, a multi-component implementation strategy was formed. In line with the developed programme theory, the intervention supported health care professionals´ awareness about resident and relative involvement. It provided a structure for involvement, empowered the residents to speak, and brought new insights through dialogue, thereby supporting involvement in medication-related decisions. The final intervention was perceived to be relevant, acceptable, and feasible in the care home setting. Our results indicate that the final intervention may be a viable approach to facilitate person-centred medicine through resident and relative involvement. This will be further explored in a planned feasibility study.

Resident level is associated with operative time in laparoscopic cholecystectomy

BackgroundWhile previous literature has shown that resident involvement increases operative time, the influence of resident involvement on operative time is generally not considered in current methods of case time predictions or operating room planning. Furthermore, evidence of prolonged case times based on the level of the assisting resident is yet scarce. We hypothesized that operative time would increase with the post-graduate year of assisting residents as they gain more autonomy in the operating room. Study designThis was an observational cohort study in which we retrospectively analyzed 802 laparoscopic cholecystectomy cases performed in a single academic institution between May 2014 and December 2020. Only cases in which a Post Graduate Year 1 to 5 (PGY) resident was assisting were included. ResultsPGY1–4 residents had statistically significant positive time coefficient results in all linear regression models, except PGY2s in urgent cases. PGY-2 residents had the longest overall average case time of 98 min. Emergent cases were more likely to have prolonged case times. ConclusionsThe increased average case time associated with PGY-2 residents is likely due to a new level of increased autonomy in the operating room (OR) during this year of training. The linear regression results indicated PGY1–4 residents were more likely to have longer laparoscopic cholecystectomy operative times than the PGY5 residents, except PGY2s in urgent cases. This may reflect the accumulation of surgical skills at the PGY5 level. Resident involvement should be considered in the prediction of operative time in an academic setting.

Understanding Health-Related Motivations for Urban Food Self-Production in the Light of Semantic Fields Analysis.

One of the contemporary challenges facing urban areas is the necessity to identify novel approaches to resident involvement in solution creation, with a particular focus on ensuring the best possible nutrition. By investigating the process of co-participation of city dwellers in a unique education project, this paper aims to gain a deeper understanding of the health-related motivations that underpin the decision of early adopters of the implemented technological innovations to join the social experiment. The qualitative study employed purposive sampling and in-depth interviews conducted in two waves, the first between October and November 2022 and the second between September 2023 and January 2024. The study comprised 42 participants drawn from two communities of residents in Łódź and Warsaw, Poland. Transcriptions of the interviews were carried out using semantic field analysis, employing a quantitative approach that counts the frequency of keyword occurrences. Three categories of semantic fields were identified: associations, oppositions, and actions toward the subject, including positive, neutral, and negative temperatures. The findings demonstrate that the health concerns of residents are a pivotal factor in their decision to participate in urban food self-production initiatives, given their limited access to nutritious and healthy vegetables. This is related to several factors, including restrictions related to urbanization and the displacement of local suppliers, lifestyle, and the fast pace of urban life. The dissemination of innovative solutions for growing food in urban environments could, therefore, facilitate awareness-raising and motivation to alter the dietary habits of inhabitants.

Enhancing Radiology Training Amidst Resource Limitations: Leveraging Resident Involvement: A Response to Establishing and Leading a 3D Postprocessing Radiology Lab.

Enhancing Radiology Training Amidst Resource Limitations: Leveraging Resident Involvement: A Response to Establishing and Leading a 3D Postprocessing Radiology Lab.

Adequate Reporting Among Ventral Hernia Repair Operative Reports: A Cross-Sectional Study of Prevalence of Details and Association With Clinical Outcomes.

We aimed to evaluate the prevalence of highly detailed ventral hernia repair (VHR) operative reports and associations between operative report detail and postoperative outcomes in a medico-legal dataset. VHR are one of the most common surgical procedures performed in the United States. Previous work has shown that VHR operative reports are poorly detailed, however, the relationship between operative report detail and patient outcomes is unknown. This is a retrospective cross-sectional observational study. Operative reports describing VHR were obtained from a medical-legal database. Medical records were screened and data was extracted including clinical outcomes, such as surgical site infection (SSI), hernia recurrence, and reoperation and the presence of key details in each report. Highly detailed operative reports were defined as having 70% of recommended details. The primary outcome was the prevalence of highly detailed VHR operative reports. A total of 1011 VHR operative reports dictated by 693 surgeons across 517 facilities in 50 states were included. Median duration of follow-up was 4.6 years after initial surgery. Only 35.7% of operative reports were highly detailed. More recent operative reports, cases with resident involvement, and contaminated procedures were more likely to be highly detailed (all P < 0.05). Compared to poorly detailed operative reports, cases with highly detailed reports had fewer SSIs (13.2% vs 7.5%, P = 0.006), hernia recurrence (65.8% vs 55.4%, P = 0.002), and reoperation (78.9% vs 62.6%, P = 0.001). In this medico-legal dataset, most VHR operative reports are poorly detailed while highly detailed operative reports were associated with lower rates of complications. Future studies should examine a nationally representative dataset to validate our findings.

Does resident involvement in tonsillectomy affect outcomes?

ObjectiveTonsillectomy is essentially a solo surgery with a well-described complication profile. It may serve as a good benchmark to evaluate the resident-as-surgeon. This study examined complications such as post-tonsillectomy bleeding in children undergoing tonsillectomy by attending surgeons (AS) or pediatric otolaryngologist-supervised residents. MethodsCharts were reviewed of all children aged 12 and under who had tonsillectomy +/− adenoidectomy at a children's hospital between Jan 2019 and Dec 2020. Patient age, gender, BMI, indication for surgery, surgical technique, presence of a resident surgeon, primary bleeding, secondary bleeding, treatment of bleeding, other Emergency Room (ER) visits, and clinic phone calls were recorded. Binary logistic regression was performed. Results2051 total children (1092 (53.2 %) males and 956 (46.6 %) females) with a mean age of 6.1 years (95 % CI 6.0–6.2) were included. 1910 (93.0 %) underwent surgery for tonsillar obstruction. 1557 (75.9 %) underwent monopolar cautery tonsillectomy. 661 (32.2 %) had a resident surgeon. 274 (13.4 %) had a related ER visit within 15 days. 18 (0.9 %) had a primary bleed and 155 (7.6 %) had a secondary bleed. Binary logistic regression showed that significant predictors of postoperative ER visits were patient age (OR = 1.101, 95 % CI = 1.050–1.154, p < .001) and resident involvement (OR = 0.585, 95 % CI = 0.429-,797, p < .001). Only age was associated with overall postoperative bleeding incidence (OR = 1.131, 95 % CI = 1.068–1.197, p < .001), as well as secondary bleeding (OR = 1.128, 95 % CI = 1.063–1.197, p < .001). There were no significant predictors of primary bleeding. ConclusionResident involvement in pediatric tonsillectomy is associated with decreased postoperative ER utilization and does not appear to increase common postoperative complications including bleeding and dehydration.

The peer effects of resident stock market participation: Evidence from 2019 CHFS.

Limited resident's participation in the stock market has become a key constraint to the capital market development. Utilizing the 2019 China Household Financial Survey (CHFS) data, our paper designs probit models to examine the peer effects of residents' stock market participation and explore the intermediary mechanisms with a multiple intermediary model. We find that: (1) Resident involvement in stock market decision-making exhibits significant peer effects. (2) Heterogeneity analysis reveals that males and rural residents display more pronounced peer effects than females and urban residents. Additionally, middle-aged residents demonstrate more potent peer effects than their younger and older counterparts, with the intensity of peer effects correlating with education levels. (3)We observe that the peer effects of market participation operate by altering economic expectations and enhancing residents' financial literacy. (4) Further investigation establishes that individuals engaging in stock market investments manifest peer effects when deciding whether to diversify their stock portfolio. This study holds reference value for analyzing the impact of social interaction on financial behaviors and regulating individuals' financial conduct.

Family Involvement among Oregon Adult Foster Home Residents, 2018–2023

ObjectivesTo track the changes that occurred in family involvement among Oregon Adult Foster Home (AFH) residents following the COVID-19 pandemic and to examine the associations between home and resident characteristics and family involvement. DesignRetrospective analysis of repeated cross-sectional data. Setting and ParticipantsA total of 2027 responses from AFH providers that replied to a mailed questionnaire from a sample of eligible licensed Oregon AFH selected to participate annually between 2018 and 2023 (6 waves). MethodsAFH providers filled out a questionnaire containing questions about family involvement (residents who received 6 types of support from family members or friends, such as help with personal care or social visit) and resident characteristics (activities of daily living needs, payer mix, age, gender, dementia status). Additional contextual data (size, rural/urban) were obtained from state agencies. Associations among family involvement and home and resident characteristics were examined using multivariable linear regression models. ResultsBivariate analyses showed statistically significant declines in social visits and outings and help getting to medical appointments during the first 2 years (2021 and 2022) of the COVID-19 pandemic, but little change in help with personal care or taking medications or phone calls. By 2023, social visits had recovered to pre-pandemic levels but remained significantly lower for help getting to medical appointments and going on outings. Multiple regression models that included controls showed that rural AFH and those with higher Medicaid use reported significantly lower family involvement in social visits, outings, and help getting to medical appointments. Conclusions and ImplicationsThe continued decline in assistance for medical appointments and outings portends potential challenges in resident socioemotional well-being and accessing health care services in this setting. Understanding the long-term impacts of the pandemic on quality of life and quality of care for residents living in community-based care settings may require a multifaceted approach to measuring family involvement.