US Seniors Research Articles

Geospatial analysis of dermatologist distribution and access among US seniors

Geospatial analysis of dermatologist distribution and access among US seniors

Macroeconomic news, senior officials' speeches, and emerging currency markets: An intraday analysis of price jump reaction

We examine intraday emerging currency jumps in response to domestic and foreign macroeconomic news announcements, as well as US senior officials' speeches. We use the robust-to-jump volatility estimator to estimate currency jumps. We provide evidence that both emerging currency jumps and cojumps exhibit significant and pronounced responses to US monetary policy and real activity news releases. Moreover, we find that domestic monetary policy and economic real activity data, and senior Federal Reserve officials' speeches, trigger significant jumps in emerging currencies, leading to large currency fluctuations that would disrupt market stability, undermining economic resilience and potentially diminishing ESG ratings.

Summary of influences that led to introduction of frontal airbags on US passenger vehicles

Objective The history of airbags for occupant protection in frontal crashes is reviewed from the perspective of a former Senior Executive at NHTSA from the early 1970’s to the late 1980’s. This paper summarizes the factors that led to regulatory delays as well as those that led to voluntary adoption of airbags by several manufacturers. Methods The regulatory history and interactions with airbag suppliers and vehicle manufactures is recounted citing key steps in the evolution of frontal airbags. Results When the Advanced Notice of Proposed Rulemaking for Standard 208, “Occupant Protection” was issued on July 2, 1969 the Safety Agency anticipated that the industry response would provide automatic frontal crash protection from airbags that deployed to protect all front seat occupants from injury in severe frontal crashes. It was not until, September 1, 1998 that airbags were required in all cars and light trucks. The interim 29 years involved a series of stops and starts during which most of the original airbag suppliers lost interest and abandoned the airbag market. The issues associated with airbags and their place in Standard 208 were directly influenced by interventions from the President, the Congress, the Supreme Court, Secretaries of Transportation, NHTSA Administrators, the Presidents of US Auto Companies and Senior Executives of Insurance Companies. Conclusion In 1966, there was support from the US auto industry for a single source of safety regulations that apply to new vehicles sold in the US. This is evidenced by the unanimous passage by the House of Representatives and Senate of the Law that created the Federal auto safety regulatory framework. The Law also required seatbelts in new cars and prohibited States from making separate safety rules. However, the large safety benefits offered by seatbelts were negated because they were rarely used. Consequently, finding ways of providing high levels of protection without requiring action by occupants became a goal of the new Safety Agency. The airbag offered the possibility of achieving that goal. From the initial airbag notice of proposed rulemaking on July 2, 1969, Safety Agency required 2 years to resolve objections before a final Standard 208 could be issued (on July 8,1971). The subsequent industry opposition to the Standard 208 employed Presidential influence and Court suits to cause a 5½ year delay until the Coleman Decision on December 6, 1976. Changes in regulatory approach of the Ford, Carter, and Reagan Administrations and associated Court suits caused another 7½ year delay until the Dole Decision on July 17, 1984. It required another 7 ½, until December 18, 1991, for market forces to reduce industry opposition to airbags and permit Congress to pass a law that mandated them. Another 6½ years of lead time was required before all cars and light trucks were required to meet the airbag standard. During the mid and late 1980’s vehicle safety ratings, seatbelt use laws, and Vince and Larry PSA’s had all acted to increase safety awareness and safety belt use. Consequently, added public demand for vehicle safety features slowly developed. Changes in economic incentives encouraged a number of vehicle lines to install driver airbags as standard equipment and the feature was being widely advertised by Chrysler. This combination of events made it possible for Congress to pass and President Bush 41 to sign legislation requiring airbags in cars and light trucks by September 1, 1998 – more than 29 years after the initial rulemaking notice in 1969.

US seniors' intention to vaccinate against RSV in fall and winter 2023-2024.

In the fall and winter of 2023-2024, the United States may experience a "tripledemic" of COVID-19, influenza, and respiratory syncytial virus (RSV) that may lead to 100 000 deaths. Seniors will be disproportionally affected. The newly released RSV vaccines for those age 60 years and over may reduce the number of deaths for the expected 6000 to 10 000 seniors expected to die from RSV alone. Using a large national survey, we queried Americans over age 60 about their RSV vaccination status and their intention to vaccinate this fall and winter. We found that 9% of seniors had already been vaccinated. Of the remaining unvaccinated, 42% indicated their intent to vaccinate. We found that those with higher levels of concerns for the disease, higher levels of self-assessed risk, believing that vaccines were safe and important, higher levels of trust in health institutions, and men were more likely to seek out vaccinations. Vaccine-hesitant respondents listed a lack of necessity, concerns about side effects and safety, and a lack of information as primary reasons. The large number of unvaccinated seniors will likely lead to an excessive number of hospitalizations and deaths as well as augmented social costs. Evidence-based mitigation measures tailored to seniors' concerns should be implemented immediately.

Russia specialists panel of the Trump administration national security council

The article presents the state of the Russia Group (Russia specialist’s panel) of the National Security Council (NSC) Staff in the Donald Trump Administration term. The point at issue is officer’s group in charge of US-Russian relations. The article chronological framework - from January 2017 to January 2021. The essay’s focus on the personalities who held the Senior Director for European and Russian Affairs incumbency in the NSC office. Fiona Hill, Timothy Morrison, Andrew Peek, Tom Williams and Ryan Tully held it position the period under review. The article consciously thinks the NSC Russia Ring main functionality and its role in the Donald Trump Administration foreign policy priorities. The special attention had given to the NSC Russian Directorate personnel changes under the Donald Trump Cabinet. Their main reasons are considered. The research paper also analyzes the US National Security Advisors and Senior Directors for European and Russian Affairs relationship system under the Donald Trump presidency. The article considered the National Security Advisor John Bolton influential role on the NSC Russia Group political mood and professional activities.

Setting the Agenda on the United Kingdom's Policy towards the European Community: Miriam Camps at Chatham House

Historical analysis of the UK government's policy towards European integration is mostly confined to the ‘official’ sphere, that is government, civil service and professional diplomacy. Non-governmental actors within the wider field of para-diplomacy such as policy entrepreneurs or elite foreign policy think tanks have not yet been systematically incorporated in this history. This article explores when and under what circumstances such diplomatic actors can influence government foreign policy formulation. The case explored here is that of Miriam Camps (1916–94), a scholar, former US diplomat and senior researcher at Chatham House. Camps utilised her Chatham House contacts, including key Foreign Office officials as well as her wider transnational network, to influence the Foreign Office's stance on the so-called ‘empty chair’ crisis of the European Economic Community in 1965/6. The article argues that during the crisis Camps acted as a policy entrepreneur with the aim of advancing her own ideas and changing the UK government's position towards the European Economic Community. Besides demonstrating the influence of unofficial diplomats on policy formulation, the article also contributes to the growing literature on the varied roles of women in international relations and diplomacy.

Retirement risk factors, exercise management and muscle mass in US senior horses.

Information on the management and health of US senior horses (≥15 years of age) is currently limited. Provide information on (1) primary use of US senior horses, (2) reasons and risk factors for horse retirement, (3) exercise management, (4) prevalence of low muscle mass and (5) risk factors for, and owner-perceived consequences of, low muscle mass. Online survey. Survey responses from 2717 owners of U.S.-resident senior horses (≥15 years of age) were analysed descriptively and inferentially, using ordered and binomial logistic regression, ANOVA and the Kruskal-Wallis test. The most frequently reported primary uses were pleasure riding/driving (38.5%) and full retirement (39.8%). Most horses (61.5%) were retired between 15 and 24 years of age, with health problems being the main reason. Age, female sex, Thoroughbred breed and various medical conditions were identified as risk factors for retirement. In working horses (i.e., those not retired or semi-retired), exercise intensity was negatively associated with age. The owner-reported prevalence of low muscle mass in all horses was 17.2% (95%CI = 15.7-18.7). In those affected by low muscle mass, the ability to work and welfare-related aspects were commonly perceived to be impaired. Increasing age, sex (gelding), pituitary pars intermedia dysfunction, osteoarthritis, laminitis and primary use (retired and semi-retired vs. use for competition) were identified as risk factors for owner-reported low muscle mass. Potential response, recall and sampling bias. Causal relationships cannot be established. Although structured exercise into old age may provide health benefits (as seen in elderly people), a large proportion of horses were fully retired in the current study. Senior horses were mainly retired for health problems and characterising these problems may aid in extending their work/active life. Low muscle mass was perceived to affect horses' welfare and ability to work, and identification of prevention and treatment strategies is therefore warranted.

123 US senior horses: Prevalence of medical conditions and routine preventative veterinary care

Although senior horses (aged ≥ 15 years) account for up to one-third of the equine population, information regarding their health and management is currently limited in the US To address this gap, we conducted a US-wide survey with senior horse owners. The present project is a subsection of this study with the objectives to 1) determine the prevalence of medical conditions in senior horses, 2) assess the frequency of routine preventative veterinary care (RPVC) for senior horses, and 3) identify risk factors for lack of RPVC. The anonymous survey was distributed through a press-release and social media channels and was online from Oct. 15th to Nov. 21st, 2020. Of 2927 started surveys, 2717 were eligible for analysis. Disease-prevalence estimates were calculated from response frequencies. For each RPVC frequency category (0, 1–2, ≥ 3 times/year) responses were counted and expressed as percentages. Risk factors for lack of RPVC were determined by binomial logistic regression, with P ≤ 0.05 indicating statistical significance. The top 5 veterinary-diagnosed medical conditions reported to affect horses at the time of the survey were: osteoarthritis 29.8%, dental disorders 14.8%, lameness 13.9%, pituitary pars intermedia dysfunction 11.8%, and ocular disorders 6.0% (n = 2433 total responses to question). The 5 most reported non-veterinary diagnosed (i.e., self-diagnosed, farrier-diagnosed, etc..)medical conditions were: osteoarthritis 10.8%, lameness 4.5%, dental disorders 3.3%, abscess 2.3%, and gastric ulcers 1.9% (n = 2247). Overall, 36.0% of owners stated that their horse did not have any veterinary-diagnosed medical conditions (n = 2433), while 28.6% reported that their horse had no veterinary or non-veterinary diagnosed condition (n = 2236). Most horses had received RPVC 1–2 times during the year before the survey (75.5%), while 14.3% had received RPVC more frequently, and 10.2% never during that year (n = 2402). The risk of no RPVC during the year before the survey was significantly higher for pleasure, semi-retired, and retired horses when compared with competition horses (P < 0.05) and was also higher in retired horses compared with pleasure horses (P < 0.05). In conclusion, about 2-thirds of senior horses were reportedly affected by at least one veterinary-diagnosed medical condition, with osteoarthritis being the condition most frequently reported. Diagnosis for medical conditions was predominantly made by veterinarians and rarely by other individuals. While most horses had received at least one RPVC visit during the year before the survey, retired senior horses were at a particularly high risk of not having received any RPVC that year.

122 US senior horses: When are they considered “old” and how does that affect their management?

Depending on the age definition applied (e.g., chronologic, demographic, physiologic), a horse may be considered old at 15 years, 20 years, or even at an older age. The management of a horse is likely adjusted once it is considered old, however, details concerning these changes are currently sparse. Similarly, it is unclear at what age owners typically consider their horses to be old and why. To learn more about these and other topics related to older horses, a US-wide survey was conducted with owners of horses aged ≥ 15 years. The objectives of the present subsection of this survey were to 1) determine at what age horses were considered old by their owners, 2) identify the reasons for this decision, and 3) assess management changes made because the horse was considered old. The anonymous survey was distributed through social media and a press release and was online from Oct. 15th to Nov. 21st, 2020. 2717 of 2927 started surveys were eligible for analysis. Responses were received from all US states with southeastern states being most represented (38%; n = 2607). Data were analyzed descriptively with frequency counts expressed as percentages. Percentages amounted to maximally 100% for single-choice questions (s-c q.) but could exceed 100% for multiple-choice questions (m-c q.). All responses were discrete variables. At the time of the survey, about half (47.4%)of the participants considered their horse to be old (n = 2528 total responses to question; s-c q.). Most indicated to have first considered their horse old at an age of 20 (22.8%) or 25 years (14.1%) (n = 1181; s-c q.). Other ages were overall less commonly reported and hence grouped: < 15 years (1.0%), 15–19 years (24.0%), 21–24 years (22.4%), 26–30 years (13.9%), and > 30 years (1.9%). The top 3 reasons for considering their horses old were: 1) horse showed reduced ability to work/exercise (43.6%), 2) horse showed first signs of age-related disease/disorder (43.5%), 3) horse's hair turned gray/increase in gray hair (29.3%) (n = 1153; m-c q.). Ninety-one percent (90.6%) made changes to their horse's management once it was considered old (n = 1187; m-c q.). The top 3 changes were: 1) changed diet and/or supplements (65.9%), 2) exercised horse less intensely (31.3%), and 3) stopped riding/driving exercise (29.6%) (n = 1187; m-c q.). In conclusion, horses were often considered old at distinct ages (20 and 25 years), with changes in fitness level, health status, and physical characteristics (i.e., gray hair) reported as the main reasons. For almost all horses, management was adjusted once they were considered old, and changes mainly pertained to exercise regimen and diet.

Evaluating PubMed-Indexed Publications of Applicants Successfully Matching into the Top 50 Urology Residency Programs in the 2021-2023 Cycles.

Background and objective Urology residency match occurs through the American Urological Association (AUA), and hence information about the success of applicants in finding a match is not readily available. The average number of publications a successful urology applicant has when applying for residency is unknown. In light of this, we conducted this study to examine the number of PubMed-indexed research projects involving US senior medical students who successfully matched into the top 50 urology residency programs in the 2021, 2022, and 2023 match cycles. We also assessed these applicants based on their medical schools and gender. Methods Doximity Residency Navigator was used to generate the top 50 residency programs as sorted by reputation. Newly matched residents were found using program Twitter accounts and residency program websites. PubMed was queried for peer-reviewed publications of incoming interns. Results The average number of publications across all incoming interns in the three years was 3.65. The average number of urology-specific publications was 1.86 and that of first-author urology publications was 1.11. The median number of total publications for matched applicants was 2, and applicants with a total of five publications were in the 75th percentile for research productivity. Conclusion A successful applicant had two PubMed-indexed urology paperson average and also had a urology-specific first-author paper in the cycles we surveyed. There has been an increase in publications per applicant when comparing the results to previous application cycles, which can be attributed to post-pandemic changes.

MP66-11 PREFERENCE SIGNALING IN THE UROLOGY MATCH: IMPACT AND USAGE TRENDS

You have accessJournal of UrologyCME1 Apr 2023MP66-11 PREFERENCE SIGNALING IN THE UROLOGY MATCH: IMPACT AND USAGE TRENDS Ralph Grauer, Daniel Ranti, Kirsten Greene, Michael Gorin, Mani Menon, and Saša Zorc Ralph GrauerRalph Grauer More articles by this author , Daniel RantiDaniel Ranti More articles by this author , Kirsten GreeneKirsten Greene More articles by this author , Michael GorinMichael Gorin More articles by this author , Mani MenonMani Menon More articles by this author , and Saša ZorcSaša Zorc More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003329.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Analyzing behavior from the implementation of signals during the American Urological Association (AUA) urology match will help clarify applicant/program signal usage and trends. METHODS: Using verified data from the match as well as survey data reported by applicants and programs, a logistic regression was performed on applicant factors associated with obtaining a residency interview: age, gender, degree (MD or DO), distribution of signals, US senior status, minority status, Latino status, IMG status, presence of a home urology program, AUA geographic section, and USMLE Step 1 score. We described signal distribution strategies stratified by program competitiveness and program behavior upon receipt of signals with respect to interviewing/ranking applicants. RESULTS: A total of 2,659 signals were sent by 553 candidates submitting rank lists for 364 positions at 142 programs. Programs received a median of 352 applications and were signaled to a median of 16 times each (IQR: 8–26). In a logistic regression predicting interview status, we found that geographic proximity (OR 3.25, 95% CI, 2.05–5.15; p=0.001), and signal status (OR 6.04, 95% CI, 3.50–10.40; p<0.001) were predictive of receiving an interview. Using multiple imputation to broadening the dataset, male gender (OR: 0.64, 95% CI, 0.45–0.92; p=0.039) and IMG status (OR: 0.35, 95% CI, 0.15–0.81; p=0.036) were negatively predictors, while MD degree (OR 2.36, 95% CI, 1.27–4.36; p=0.023), and US senior status (OR 1.91, 95% CI, 1.13–3.23; p=0.039), were positive predictors. CONCLUSIONS: We analyzed trends of the newly added signals. We reportedstrategies for signal dispersal, factors associated with obtaining interviews, and how signals informed program interviewing/ranking decisions. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e936 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ralph Grauer More articles by this author Daniel Ranti More articles by this author Kirsten Greene More articles by this author Michael Gorin More articles by this author Mani Menon More articles by this author Saša Zorc More articles by this author Expand All Advertisement PDF downloadLoading ...

Characterization of Applicant Preference Signals, Invitations for Interviews, and Inclusion on Match Lists for Residency Positions in Urology

Preference signals were to be implemented in over 15 specialties during the 2022-2023 residency match. Analyzing results from the implementation of signals during the American Urological Association (AUA) urology match may inform future behavior. To characterize applicant and program signal usage and results in the Society of Academic Urology and AUA databases with respect to interview invites and rank list creation. This cohort study involved all applicants and residencies in the 2021-2022 AUA match with data analysis conducted in April through July 2022. Five signals indicating interest. Using verified match and survey data reported by applicants and programs, a logistic regression was performed on applicant factors associated with obtaining an interview-the main outcome (using inclusion on rank list as a proxy): age, gender, degree (MD or DO), dispersal of signal, US senior status, racial minority group status, Latino ethnicity, international medical graduate status, presence of a home program, AUA geographic section, and US Medical Licensing Examination Step 1 score. Applicant signal dispersal strategies were stratified by applicant and program competitiveness, as well as program behavior upon receipt of signal with respect to extending interviews and rank list ordering of applicants. A total of 2659 signals were sent by 553 candidates (mean [SD] age, 27.4 [2.9] years; 179 female [32.4%], 243 racial minority candidates [61.2%]) submitting rank lists for 364 positions at 143 programs. Programs received a median (IQR) of 352 (295-411) applications and were signaled to a median of 16 (8-26) times each. In a logistic regression estimating interview status, geographic proximity (OR, 3.25; 95% CI, 2.05-5.15; P = .001) and signal status (OR, 6.04; 95% CI, 3.50-10.40; P < .001) were associated with receiving an interview. Using multiple imputation by chained equations to impute missing data and broadening the data set, male gender (OR, 0.64; 95% CI, 0.45-0.92; P = .04) and international medical graduate status (OR, 0.35; 95% CI, 0.15-0.81; P = .04) were negative variables, while MD degree (OR, 2.36; 95% CI, 1.27-4.36; P = .02) and US senior status (OR, 1.91; 95% CI, 1.13-3.23; P = .04) were positive variables. This study of the usage and trends of the newly added preference signals reported the most common strategies for signal dispersal; in an analysis of factors involved in obtaining an interview, geographic similarity between applicant and program and preference signal usage were associated with successful applications.

The Costliness of US Residency Applications: Moving Toward Preference Signaling and Caps.

The Costliness of US Residency Applications: Moving Toward Preference Signaling and Caps.

The Virtual Interview Experience: Advantages, Disadvantages, and Trends in Applicant Behavior.

A survey was distributed to 302 applicants to a single plastic surgery residency program during the 2020 application cycle. Demographics, social media presence and utilization, and experience with the virtual application and interview process were analyzed. A 2018 survey from our institution was compared with a subset of questions for longitudinal analysis. Seventy-six respondents (25.2%) completed the survey. Most applicants (88.2%) spent less than $1000 during the interview and application cycle. Over half (56.6%) did not receive letters of recommendation from outside their home program. A significant minority (27.6%) of applicants attended more than one interview in a single day. Compared to 2018, applicants in 2021 were significantly more likely to access alternative digital resources (forums/discussion boards, social media, and podcasts) when learning about programs. Average number of interviews remains in the range of pre-COVID studies, but the percentage of interviews attended increased. Applicants spent substantially less money on interviews and relied on alternative digital sources to learn about residency programs. This study objectively quantifies the advantages of virtual interviews. Disadvantages include inability to assess "fit" and lack of nonverbal communication.

Evaluation of the Virtual Interviews for Resident Recruitment Due to COVID-19 Travel Restrictions: A Nationwide Survey of US Senior Medical Students

Due to COVID-19, residency programs could not conduct in-person interviews during the 2020-2021 match and were forced to implement a virtual format. We conducted a nationwide survey of US senior medical students to evaluate their perception of the virtual interview process and to solicit their recommendations for future virtual interview best practices. This study was administered to US fourth-year medical students currently participating in the residency match using Survey Monkey during March 2021. Students were contacted through their respective student affairs deans. Surveys solicited demographic information, 26 4-point Likert-scale questions, and four free-response questions. A total of 357 surveys were completed. Most respondents stated that they could confidently represent themselves to the program (71.7%) using a virtual platform. However, only 11.6% stated that they could confidently assess a program's facility using a virtual platform. Although most respondents (58.26%) found that virtual meet and greets helped them better assess their fit for the program, less than half (46%) confidently believed they could assess their fit into the program after the conclusion of the virtual interview. Regarding potential disparities introduced by virtual interviews, 40.6% believed that the virtual interviews introduce greater inequalities into the match process. Two-thirds of respondents (239, 66.95%), believed that there should be a limit on the number of interview offers an applicant can accept, with the maximum number of interviews per specialty capped at 25.7 (10-150). Finally, just over two-thirds (69.47%), claimed they could confidently prepare their rank-order list at the conclusion of the interview. Most respondents found virtual interviews financially beneficial, however difficulty in assessing fit was a challenge. Best practice recommendations from the respondents include shorter interviews, more engaging resident-led social hours without faculty present, and preinterview packages to include video representations of the program facilities.

The Unmatched Integrated Plastic Surgery Applicant: A Focus on Improving the Application.

The Unmatched Integrated Plastic Surgery Applicant: A Focus on Improving the Application.

Laissez-Faire, Social Networks, and Race in a Pandemic

We study the effects of race, network centrality, and policies that tolerate some level of virus spread (laissez-faire) on COVID-19 deaths in nursing homes in the United States. Our analysis uses unique data on nursing home networks and calibration-based estimates of states' preferences for health relative to short-term economic gains. Our findings suggest that laissez-faire policies increase deaths. Nursing homes with a larger share of Black residents experience more deaths, but they are less vulnerable to laissez-faire policies, especially when not central in social networks. Our findings highlight significant interactions between COVID-19 policies, race, and network structure among US seniors.

Association between tendon ruptures and use of fluoroquinolone, and other oral antibiotics: a 10-year retrospective study of 1 million US senior Medicare beneficiaries

Association between tendon ruptures and use of fluoroquinolone, and other oral antibiotics: a 10-year retrospective study of 1 million US senior Medicare beneficiaries

Financial hardship from purchasing prescription drugs among older adults in the United States before, during, and after the Medicare Part D "Donut Hole": Findings from 1998, 2001, 2015, and 2021.

BACKGROUND: Cost-related nonadherence compromises successful and effective management of chronic disease. The Medicare Modernization Act of 2003 (MMA) and Patient Protection and Affordable Care Act of 2010 (ACA) aimed to increase the affordability of outpatient prescription drugs for older adults (older than age 64 years). The Medicare Part D prescription drug insurance coverage gap ("donut hole") created by the MMA was fully closed in 2020 by the ACA. OBJECTIVES: To (1) describe prescription drug coverage and financial hardship from purchasing prescription drugs among older American adults for 2021, (2) compare these results with findings from data collected before the MMA and during the progressive elimination of the Medicare Part D coverage gap, and (3) compute the likelihood for financial hardship from purchasing prescription drugs using variables for year, prescription drug insurance coverage, health-related information, and demographics. METHODS: Data were obtained from 4 nationally distributed, crosssectional surveys of older adults to track coverage for and financial hardship from purchasing prescription drugs. Surveys in 1998 and 2001 were mailed to national random samples of US seniors. Of 2,434 deliverable surveys, 700 (29%) provided useable data. Data were collected in 2015 and 2021 via online surveys sent to samples of US adults. Of 27,694 usable responses, 4,445 were from older adults. Descriptive statistics and logistic regression analyses described relationships among financial hardship and demographics, diagnoses, and daily prescription drug use. RESULTS: Five percent of older adults lacked prescription drug coverage in 2021, continuing a downward trend from 32% in 1998, 29% in 2001, and 9% in 2015. Contrastingly, 20% of older adults reported financial hardship from prescription drug purchases in 2021, bending an upward trend from 19% in 1998, 31% in 2001, and 36% in 2015. Financial hardship from purchasing prescription drugs was more likely to be reported by older adults lacking prescription drug insurance, taking multiple medications daily, and having a low annual household income across all survey years. The latter 2 of these 3 factors were still predictive of financial hardship from purchasing prescription drugs among older adults with prescription drug insurance. CONCLUSIONS: Financial hardship from purchasing prescription drugs is still experienced by many older adults after the full implementation of the MMA and ACA. Lacking prescription drug coverage, taking more than 5 prescription drugs daily, and a low annual household income may increase the likelihood of experiencing this financial hardship. Pharmacists can be a resource for older adults making choices about their prescription drug coverages and purchases. DISCLOSURES: Funding was provided by the American Association of Colleges of Pharmacy New Investigator Program, the University of Minnesota Grant-in-Aid of Research Program, the Peters Endowment for Pharmacy Practice Innovation, the Chapman University Research Program, and the University Minnesota Research Program.

Integrated cardiothoracic surgery match: Trends among applicants compared with other surgical subspecialties

ObjectiveThe objective of this study was to evaluate trends, qualifications, race/ethnicity, and gender of applicants to integrated cardiothoracic (CT I-6) residency programs and compare them with other competitive surgical subspecialties. MethodsData were collected from the National Residency Matching Program, Electronic Residency Application Service, and Association of American Medical Colleges for thoracic surgery, orthopedic surgery, neurological surgery, otolaryngology (ENT), plastic surgery, and vascular surgery for 2010 t0 2020. Applicant gender, race/ethnicity, Alpha Omega Alpha (AOA) membership, United States Medical Licensing Examination scores, research productivity, and graduation from a top-40 medical school were analyzed. ResultsFrom 2010 to 2020, CT I-6 experienced growth in postgraduate year 1 positions (280.0%), total applicants (62.2%), and US senior applicants (59.2%). No growth in CT I-6 positions (38) or programs (29) occurred from 2016 to 2020. CT I-6 had the lowest match rates among total applicants (31.7%) and US seniors (41.0%) in 2020. CT I-6 had fewer female applicants compared with ENT (P < .001) and plastic surgery (P < .001), but more than orthopedic surgery (P < .001). Although most CT I-6 US applicants self-identified as White (75.0%), there were more Asian applicants compared with applicants for orthopedic surgery (P < .001), ENT (P < .001), plastic surgery (P < .001), and neurological surgery (P < .01). Matched applicants averaged the highest Step 2-Clinical Knowledge scores (255.1), AOA membership (48.5%), and graduation rates from top-40 medical schools (54.5%). ConclusionsDespite tremendous growth in positions, CT I-6 has consistently been the most difficult surgical subspecialty to match. CT I-6 has recently attracted an increasingly diverse applicant pool. For the 2019 to 2020 National Residency Matching Program Match Cycle, successful applicants had the highest Step 2-Clinical Knowledge scores, AOA membership rates, and graduation rates from a top-40 medical school among all surgical subspecialties examined.