scholarly journals 2533. HIV Training Pathways in Residency: A National Survey of Curricula and Outcomes

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S880-S881
Author(s):  
Jehan Budak ◽  
David Sears ◽  
Brian Wood ◽  
Shireesha Dhanireddy ◽  
Shireesha Dhanireddy ◽  
...  
Keyword(s):  
United States ◽  
National Survey ◽  
Geographic Area ◽  
The United States ◽  
Snowball Sampling ◽  
The West ◽  
Cross Sectional ◽  
Workforce Shortage ◽  
Northeast United States ◽  
The Impact

Abstract Background Despite dramatic advances in the care of people with HIV (PWH), the shortage of HIV providers is worsening. An approach to this workforce shortage has been integration of robust HIV training into residency. We created a national survey to describe curricula and outcomes of formal HIV training pathways and how this may impact the HIV workforce shortage. Methods We designed a cross-sectional study of Internal Medicine (IM) and Family Medicine (FM) Residency HIV pathways in the United States. We identified programs via literature review, internet search, and snowball sampling. A draft survey was piloted with two pathway directors, and in January 2019, the final survey was sent via email to all pathway directors. This survey included 33-items, predominantly quantitative, and focused on program organization, curricular content, graduate outcomes, and challenges. We used descriptive statistics to summarize numeric responses. Results Twenty-five residency programs with dedicated HIV pathways were identified; 11 IM and 15 FM. The majority of the programs are in the West and Northeast United States. Twenty-four (96%) of programs have completed the survey. Since the first program was established in 2006, 228 residents have graduated from HIV pathways in the United States (151 IM, 77 FM). Programs have varying goals, application procedures, clinical requirements, didactic structures, graduation requirements, and assessments of competency. Of graduates, 108 (47%) have American Academy of HIV Medicine (AAHIVM) certification. Ninety-two (42%) of graduates are reported as currently providing primary care to ≥ 20 PWH (the majority in the West and Northeast United States). The most commonly cited reported barrier to graduates finding jobs caring for PWH are lack of job opportunities in their geographic area. Conclusion HIV pathways in IM and FM programs are heterogenous in their structure and curricula. Less than 50% of pathway graduates remain in the HIV provider workforce, and the majority of those work in the West and Northeast United States. The impact of these programs might be enhanced by interventions to increase graduate retention in this workforce and to launch pathways in the areas of greatest need, such as the Southern United States. Disclosures All authors: No reported disclosures.

scholarly journals Racial, Economic and Health Inequality and COVID-19 Infection in the United States

2020 ◽  
Author(s):  
Vida Abedi ◽  
Oluwaseyi Olulana ◽  
Venkatesh Avula ◽  
Durgesh Chaudhary ◽  
Ayesha Khan ◽  
...  
Keyword(s):  
United States ◽  
New York ◽  
Health Care Access ◽  
Urban Areas ◽  
Death Rate ◽  
The United States ◽  
Preliminary Evidence ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
The Impact

AbstractBackgroundThere is preliminary evidence of racial and social-economic disparities in the population infected by and dying from COVID-19. The goal of this study is to report the associations of COVID-19 with respect to race, health and economic inequality in the United States.MethodsWe performed a cross-sectional study of the associations between infection and mortality rate of COVID-19 and demographic, socioeconomic and mobility variables from 369 counties (total population: 102,178,117 [median: 73,447, IQR: 30,761-256,098]) from the seven most affected states (Michigan, New York, New Jersey, Pennsylvania, California, Louisiana, Massachusetts).FindingsThe risk factors for infection and mortality are different. Our analysis shows that counties with more diverse demographics, higher population, education, income levels, and lower disability rates were at a higher risk of COVID-19 infection. However, counties with higher disability and poverty rates had a higher death rate. African Americans were more vulnerable to COVID-19 than other ethnic groups (1,981 African American infected cases versus 658 Whites per million). Data on mobility changes corroborate the impact of social distancing.InterpretationThe observed inequality might be due to the workforce of essential services, poverty, and access to care. Counties in more urban areas are probably better equipped at providing care. The lower rate of infection, but a higher death rate in counties with higher poverty and disability could be due to lower levels of mobility, but a higher rate of comorbidities and health care access.

scholarly journals The Economic Policy Uncertainty in China, the United States, and Europe: The Empirical Impact on Chinese Stock Markets

2019 ◽  
Vol 6 (5) ◽  
pp. 131
Author(s):  
Wannakomol Supachart
Keyword(s):  
United States ◽  
Economic Policy ◽  
Stock Markets ◽  
The United States ◽  
Policy Uncertainty ◽  
Cross Sectional ◽  
Economic Policy Uncertainty ◽  
Chinese Markets ◽  
Chinese Stock Markets ◽  
The Impact

The objective of this paper is to analyze the impact of economic policy uncertainty (EPU) in China, the United States, and Europe, which are influent to the Chinese stock markets. We employed Vector Autoregression (VAR) model with relative variables including the EPU indices and three Chinese stock markers indices to display the impulse responses of the markets to the EPUs. Our results indicate that the Chinese stock markets negatively respond to their domestic economic policy uncertainty in the first, second, and third month after the EPU shocks. Moreover, we also found the negative responses of the Chinese markets to the EPU from the United States that require five months to rebalance the markets. However, the Chinese markets seem positively respond to the shocks of the economic policy uncertainty in Europe and also took five months to archive market rebalancing. The significant correlation of the economic policy uncertainty between China and the United States resulted in cross-sectional correlation estimates among the EPU indices. Furthermore, there is the reasonable interesting result to claim that the economic policy uncertainty in China is statistically influenced by their own trade and fiscal policy uncertainty that may be considered to be related with China-US trade war in our conclusion.

scholarly journals Gender-Inclusive Fellowship Naming and Equity, Diversity, and Inclusion in Radiology: An Analysis of Radiology Department Websites in Canada and the United States

2022 ◽  
pp. 084653712110661
Author(s):  
Tyler D. Yan ◽  
Lauren E. Mak ◽  
Evelyn F. Carroll ◽  
Faisal Khosa ◽  
Charlotte J. Yong-Hing
Keyword(s):  
United States ◽  
Breast Imaging ◽  
The United States ◽  
Radiology Department ◽  
Imaging Data ◽  
Body Imaging ◽  
Cross Sectional ◽  
Diversity And Inclusion ◽  
The Us ◽  
The Impact

Purpose: Transgender and gender non-binary (TGNB) individuals face numerous inequalities in healthcare and there is substantial work to be done in fostering TGNB culturally competent care in radiology. A radiology department’s online presence and use of gender-inclusive language are essential in promoting an environment of equity, diversity, and inclusion (EDI). The naming of radiology fellowships and continuing medical education (CME) courses with terminology such as “Women’s Imaging” indicates a lack of inclusivity to TGNB patients and providers, which could result in suboptimal patient care. Methods: We conducted a cross-sectional analysis of all institutions in Canada and the United States (US) offering training in Breast Imaging, Women’s Imaging, or Breast and Body Imaging. Data was collected from each institution’s radiology department website pertaining to fellowship names, EDI involvement, and CME courses. Results: 8 Canadian and 71 US radiology fellowships were identified. 75% of Canadian and 90% of US fellowships had gender-inclusive names. One (12.5%) Canadian and 29 (41%) US institutions had EDI Committees mentioned on their websites. Among institutions publicly displaying CME courses about breast/body or women’s imaging, gender-inclusive names were used in only 1 (25%) of the Canadian CME courses, compared to 81% of the US institutions. Conclusions: Most institutions in Canada and the US have gender-inclusive names for their radiology fellowships pertaining to breast and body imaging. However, there is much opportunity to and arguably the responsibility for institutions in both countries to increase the impact and visibility of their EDI efforts through creation of department-specific committees and CME courses.

Research Note: Smoking in Prisons—A National Survey of Correctional Administrators in the United States

1993 ◽  
Vol 39 (2) ◽  
pp. 225-239 ◽  
Author(s):  
Michael S. Vaughn ◽  
Rolando V. del Carmen
Keyword(s):  
United States ◽  
Case Studies ◽  
National Survey ◽  
Tobacco Smoke ◽  
The United States ◽  
Research Note ◽  
Correctional Institutions ◽  
Pros And Cons ◽  
The Impact

This article presents a national survey that assesses the policies of correctional institutions regarding staff and inmate exposure to secondary tobacco smoke. Correctional administrators from the 50 states were queried about smoking problems in prisons, focusing on disputes among inmates, among staff, and between staff and inmates. The respondents identified nonsmoking areas in their facilities and listed the various administrative responses used to alleviate the problem. The article compares the opinions of administrators on the impact of a policy that restricts or bans smoking with case studies of institutions that have already banned smoking, and concludes that more research is needed to determine the relative pros and cons of restricting or banning smoking in prisons.

What the Axis of Evil Metaphor Did to Iran

2007 ◽  
Vol 61 (3) ◽  
pp. 421-440 ◽  
Author(s):  
Daniel Heradstveit ◽  
Matthew G. Bonham
Keyword(s):  
United States ◽  
North Korea ◽  
Political Discourse ◽  
The United States ◽  
The West ◽  
State Of The Union ◽  
Self Image ◽  
Main Target ◽  
The Impact ◽  
Depth Interviews

This article focuses on the Axis of Evil metaphor that was used by President George W. Bush in his State of the Union Address in 2002 to represent Iran, Iraq, and North Korea. After describing "axis" as a metonym for fascism and Nazism, and "evil" as a metonym for Satanic forces that implies an alliance of Iran, Iraq, and North Korea that is collectively responsible for evil deeds, the authors analyze the impact of this metaphor on Iranian self-image and politics. The data for this analysis are drawn from in-depth interviews conducted with 18 members of the Iranian oppositional elite. The interview results suggest that the Axis of Evil metaphor had an impact on political discourse in Iran and strengthened the rhetorical position of conservatives vis-à-vis reformers by reviving militant revolutionary language with the Great Satan (the United States) as the main target of the theocratic and conservative forces. The article concludes with some observations about the implications of using cultural and historical experiences for explaining differences between the ways in which Americans (and other people in the West) and Iranians have understood the metaphor.

scholarly journals Relationship between Dietary Habits, Food Attitudes and Food Security Status among Adults Living within the United States Three Months Post-Mandated Quarantine: A Cross-Sectional Study

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3468
Author(s):  
Aljazi Bin Zarah ◽  
Juliana Enriquez-Marulanda ◽  
Jeanette Mary Andrade
Keyword(s):  
United States ◽  
Food Security ◽  
Dietary Habits ◽  
The United States ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Food Security Status ◽  
Food Attitudes ◽  
The Impact

COVID-19 has disrupted the lives of many and may have influenced dietary habits through factors such as food security status and attitudes. The purpose of this study was to identify dietary habits and their associations with food insecurity and attitudes among adults living in the United States within three months post-mandated quarantine. An online cross-sectional study was conducted from April to June 2020. Participants (n = 3133) responded to a 71-item questionnaire regarding demographics (n = 7), health information (n = 5), lifestyle habits (n = 8), dietary habits (n = 37), food attitudes (n = 8), and food security status (n = 6). Frequency counts and percentages were tabulated, and multivariate linear regression was conducted to examine associations using STATA v14 at a statistical significance level of p < 0.05. Results showed that most participants indicated no change in dietary habits (43.6–87.4%), yet participants reported increased consumption of sweets (43.8%) and salty snacks (37.4%). A significant positive association for food attitude scores (1.59, 95% CI 1.48 to 1.70; p < 0.001) and food security scores (1.19, 95% CI 0.93 to 1.45; p < 0.001) on total dietary habit scores was found. Future extensive population studies are recommended to help public health authorities frame actions to alleviate the impact that mandated quarantine has on dietary habits.

scholarly journals Interns’ perspectives on impacts of the COVID-19 pandemic on the medical school to residency transition

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ariel S. Winn ◽  
Matthew D. Weaver ◽  
Katherine A. O’Donnell ◽  
Jason P. Sullivan ◽  
Rebecca Robbins ◽  
...  
Keyword(s):  
United States ◽  
Medical School ◽  
Social Connectedness ◽  
Well Being ◽  
The United States ◽  
Medical Conditions ◽  
Cross Sectional ◽  
Medical School Training ◽  
School Training ◽  
The Impact

Abstract Background The COVID-19 pandemic resulted in disruptions to medical school training and the transition to residency for new post-graduate year 1 resident-physicians (PGY1s). Therefore, the aim of this study was to understand the perspectives of United States PGY1s regarding the impact of the pandemic on these experiences. Our secondary aims were to understand how desire to practice medicine was impacted by the pandemic and whether PGY1s felt that they were able to meaningfully contribute to the COVID-19 response as students. Method We conducted a national, cross-sectional study of PGY1s who had recently graduated from medical school in 2020. A survey was distributed to PGY1s from across specialties, in programs distributed throughout the United States. It included questions about medical school training during the pandemic, impact on graduation timing and transition to internship, concerns about caring for patients with COVID-19, desire to practice medicine, and ability to meaningfully contribute to the pandemic. Findings are presented using descriptive statistics and univariate logistic regression models. Results 1980 PGY1s consented to participate, 1463 completed the survey (74%), and 713 met criteria for this analysis. 77% of PGY1s reported that the pandemic adversely affected their connection with their medical school communities, and 58% reported that the pandemic impeded their preparation for intern year. 4% of PGY1s reported graduating medical school and practicing as an intern earlier than their expected graduation date. While the majority of PGY1s did not have a change in desire to practice medicine, PGY1s with concerns regarding personal health or medical conditions (OR 4.92 [95% CI 3.20–7.55] p < 0.0001), the health or medical conditions of others in the home (OR 4.41 [2.87–6.77], p < 0.0001]), and PGY1s with children (OR 2.37 [1.23–4.58], p < 0.0001) were more likely to report a decreased desire. Conclusions The COVID pandemic disrupted the social connectedness and educational experiences of a majority of PGY1 residents in a sample of trainees in United States training programs. Those with health concerns and children had particularly challenging experiences. As the current and subsequent classes of PGY1s affected by COVID-19 proceed in their training, ongoing attention should be focused on their training needs, competencies, and well-being.

scholarly journals Sleep Quality Among Informal Caregivers During the COVID-19 Pandemic: A Cross-Sectional Study

2022 ◽  
Vol 8 ◽  
pp. 233372142110573
Author(s):  
Mary L. Greaney ◽  
Zachary J. Kunicki ◽  
Meghan M. Drohan ◽  
Caitlin C. Nash ◽  
Steven A. Cohen
Keyword(s):  
United States ◽  
Sleep Quality ◽  
Caregiver Burden ◽  
Online Survey ◽  
Behavioral Science ◽  
Informal Caregivers ◽  
The United States ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
The Impact

Sleep is an integral component of health. The impact of the COVID-19 pandemic on sleep quality among informal caregivers, individuals who provide unpaid care or assistance to family members or friends, assisting older adults is not well understood. Therefore, informal caregivers in the United States providing care for individuals aged 50+ were recruited via Amazon’s Mechanical Turk, an online platform for enrolling study participants into social and behavioral science research, to complete an online survey. The sample of informal caregivers ( n = 835) was 69% male and 55% non-Hispanic. Multivariable linear regression models were constructed to assess the associations between sleep disturbance scores (SDS) and sleep-related impairment scores (SIS) and caregiving-related measures (hours caregiving/week, length of time spent caregiving, and caregiver burden), demographics, and region of the United States. The analysis determined that Black (β = 2.6, 95% CI [−4.3, −0.9]) and Asian informal caregivers (β = −1.8, 95% CI [−3.4, −0.3]) had lower mean SIS than White caregivers, the referent group. In addition, increasing caregiver burden was associated with increased SDS (β = 0.8, 95% CI [0.6, 1.0]) and SIS (β = 1.3, 95% CI [0.7, 1.6]). In conclusion, higher caregiver burden was associated with higher SIS and SDS, suggesting that informal caregivers' sleep should be assessed, and when needed interventions should be offered.

scholarly journals Storm Precipitation in the United States. Part II: Soil Erosion Characteristics

2005 ◽  
Vol 44 (6) ◽  
pp. 947-959 ◽  
Author(s):  
James R. Angel ◽  
Michael A. Palecki ◽  
Steven E. Hollinger
Keyword(s):  
United States ◽  
Soil Erosion ◽  
West Coast ◽  
The United States ◽  
Vegetative Cover ◽  
The West ◽  
South Central ◽  
Central United States ◽  
Storm Characteristics ◽  
The Impact

Abstract Soil erosion is a major global challenge. An increased understanding of the mechanisms driving soil erosion, especially the storms that produce it, is vital to reducing the impact on agriculture and the environment. The objective of this work was to study the spatial distribution and time trends of the soil erosion characteristics of storms, including the maximum 30-min precipitation intensity (I30), storm kinetic energy of the falling precipitation (KE), and the storm erosivity index (EI) using a long-term 15-min precipitation database. This is the first time that such an extensive climatology of soil erosion characteristics of storms has been produced. The highest mean I30, KE, and EI values occurred in all seasons in the southeastern United States, while the lowest occurred predominantly in the interior west. The lowest mean I30, KE, and EI values typically occurred in winter, and the highest occurred in summer. The exception to this was along the West Coast where winter storms exhibited the largest mean KE and EI values. Linear regression was used to identify trends in mean storm erosion characteristics for nine U.S. zones over the 31-yr study period. The south-central United States showed increases for all three storm characteristics for all four seasons. On the other hand, higher elevations along the West Coast showed strong decreases in all three storm characteristics across all seasons. The primary agricultural region in the central United States showed significant increases in fall and winter mean EI when there is less vegetative cover. These results underscore the need to update the storm climatology that is related to soil erosion on a regular basis to reflect changes over time.

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