scholarly journals Family Medicine Residents' Debt and Certification Examination Performance

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Julie P. Phillips ◽  
Lars E. Peterson ◽  
Iris Kovar-Gough ◽  
Thomas R. O'Neill ◽  
Michael R. Peabody ◽  
...  
Keyword(s):  
Family Medicine ◽  
The United States ◽  
Cross Sectional ◽  
Certification Examination ◽  
Debt Level ◽  
Examination Performance ◽  
Educational Debt ◽  
The Relationship ◽  
High Educational ◽  
Family Medicine Residents

Introduction: Previous studies have found that medical students and internal medicine residents with high educational debt perform less well on examinations. The purpose of this study was to examine the relationship between educational debt and family medicine residents’ performance on initial in-training and board certification examinations. Methods: Our study was a cross-sectional secondary analysis of American Board of Family Medicine (ABFM) data collected from residents (N=5,828) who registered for the Family Medicine Certification Examination (FMCE) in 2014 and 2015, representing 85.8% of graduating family medicine residents in the United States in those years. Multivariable linear and logistic regression modeling was used to examine the relationship between debt level and examination scores, and also to explore the relationship between debt level and passing the initial FMCE. Results: After controlling for demographic variables, residents with high debt ($150,000 to $249,999) and very high debt (more than $250,000) performed significantly worse than those with no debt on the initial in-training examination (score differences of 14.2 [CI 8.6, 19.8] and 15.8 [CI 10.3, 21.4] points, respectively) and FMCE (score differences of 19.3 points [CI 13.4, 25.3] and 30.4 points [CI 24.6, 36.3], respectively). Additionally, those with debt above $250,000 had half the odds of passing their initial FMCE (OR 0.45; CI 0.27-0.75). Conclusions: High educational debt is associated with lower examination performance among family medicine residents. This may be because residents with more debt have more stress or fewer day-to-day financial resources. However, confounding factors may also contribute to this association.

The Opioid Epidemic and Homicide in the United States

2021 ◽  
pp. 002242782098684
Author(s):  
Richard Rosenfeld ◽  
Joel Wallman ◽  
Randolph Roth
Keyword(s):  
United States ◽  
Death Rate ◽  
The United States ◽  
Opioid Epidemic ◽  
Drug Markets ◽  
Cross Sectional ◽  
Homicide Rates ◽  
Overdose Death ◽  
Sectional Analysis ◽  
The Relationship

Objectives: Evaluate the relationship between the opioid epidemic and homicide rates in the United States. Methods: A county-level cross-sectional analysis covering the period 1999 to 2015. The race-specific homicide rate and the race-specific opioid-related overdose death rate are regressed on demographic, social, and economic covariates. Results: The race-specific opioid-related overdose death rate is positively associated with race-specific homicide rates, net of controls. The results are generally robust across alternative samples and model specifications. Conclusions: We interpret the results as reflecting the violent dynamics of street drug markets, although more research is needed to draw definitive conclusions about the mechanisms linking opioid demand and homicide.

Examining the Relationship Between Food Insecurity and Academic Performance: Implications for Diversity and Equity in Higher Education

2021 ◽  
pp. 152102512110538
Author(s):  
Heather Mechler ◽  
Kathryn Coakley ◽  
Marygold Walsh-Dilley ◽  
Sarita Cargas
Keyword(s):  
Higher Education ◽  
United States ◽  
Food Insecurity ◽  
Educational Equity ◽  
The United States ◽  
Cross Sectional Study ◽  
Drop Out ◽  
Cross Sectional ◽  
Professional Students ◽  
The Relationship

In recent years, researchers have increasingly focused on the experience of food insecurity among students at higher education institutions. Most of the literature has focused on undergraduates in the eastern and midwestern regions of the United States. This cross-sectional study of undergraduate, graduate, and professional students at a Minority Institution in the southwestern United States is the first of its kind to explore food insecurity among diverse students that also includes data on gender identity and sexual orientation. When holding other factors constant, food-insecure students were far more likely to fail or withdraw from a course or to drop out entirely. We explore the role that higher education can play in ensuring students’ basic needs and implications for educational equity.

HUBUNGAN PENGGUNAAN KOMPUTER DENGAN KEJADIAN NYERI KEPALA TIPE TEGANG PADA PEKERJA

2020 ◽  
Vol 9 (1) ◽  
pp. 27-38
Author(s):  
Suryanti Suryanti ◽  
Andi Ipaljri
Keyword(s):  
Sampling Technique ◽  
The United States ◽  
Chi Square ◽  
Cross Sectional ◽  
Tension Headaches ◽  
Technological Developments ◽  
Tension Type Headaches ◽  
Chi Square Analysis ◽  
Relationship Of ◽  
The Relationship

In the current era of globalization, humans always interact with technological developments. One result of the development of technology is the use of computers. The use of computers that are not under the ergonomic position causes effects on health, one of them is tension-type headaches. In the United States, 1-4% of patients coming to the Emergency Care Unit complain of headache, 90% of them are tension-type headaches. The proportion of migraine and other headache syndromes in the hospital. Harapan Bunda in 2011 and RS. Camatha Sahidya in Batam in Batam was 5% and 0.7% respectively. Whereas the incidence of tension headaches in 5 puskesmas in Batam in 2014 ranged from 0.5% - 1.3%. The proportion of tension headaches at the BIP Clinic in the January-April 2018 period is 1.5%. Tension-type headaches that occur continuously can cause barriers to daily activities. The purpose of this study is to determine the relationship of computer use with the incidence of tension-type headaches in workers. This research uses a descriptive-analytic method with a cross-sectional approach. The sampling technique is purposive sampling. Of 97 respondents who visited the clinical BIP that met the criteria, it was found that computer user respondents experienced tension-type headaches of 18 people (42.9%) and not tension-type headaches of 24 people (57.1%). Whereas the respondents who were not computer users experienced tension-type headaches of 10 people (18.2%), and non-tension-type headaches of 45 people (81.8%). Bivariate chi-square analysis showed that p = 0.008 (p <0.05). This means that Ha is accepted and H0 is rejected.

scholarly journals Mediators of Food Insecurity and Obesity in Female Heads-of-Household with Children

2017 ◽  
Vol 1 (3) ◽  
pp. 1-10
Author(s):  
Emily Havrilla
Keyword(s):  
Food Insecurity ◽  
Perceived Stress ◽  
Vulnerable Populations ◽  
Self Efficacy ◽  
The United States ◽  
Mediation Model ◽  
Cross Sectional ◽  
Heads Of Household ◽  
The Relationship ◽  
General Self Efficacy

Background: The prevalence of obesity is a significant issue in the United States. Among vulnerable populations, obesity exists in the presence of household food insecurity; however the mechanisms of the relationship are not well understood. General perceived stress and general self-efficacy were evaluated as mediators of the relationship between food insecurity and obesity in female heads-of-household with children. Methods: A cross-sectional correlational design with mediation model testing was used. Subjects (N = 86) were recruited through convenience sampling. Data were collected using a demographic questionnaire, the Core Food Security Module (CFSM), the General Perceived Stress Questionnaire (PSQ), and the General Self-Efficacy Scale (SES). Body mass index and waist –to-hip circumference were calculated from measured data. Results: Significant relationships were found between food insecurity and general perceived stress, general perceived stress and obesity, and general self-efficacy and obesity. Mediation models’ testing was not completed due the lack of a significant correlation between food insecurity and obesity. Post hoc analysis was completed using bootstrapping and a revised mediation model process. Conclusion: General perceived stress and general self-efficacy are associated with obesity in female heads-of-household with children who are food insecure. Keywords: Food insecurity, Obesity, Stress, Self-efficacy, Vulnerable populations, Quantitative research, Socioeconomic factors

scholarly journals Differences in Gay Male Couples’ Use of Drugs and Alcohol With Sex by Relationship HIV Status

2014 ◽  
Vol 10 (4) ◽  
pp. 262-269 ◽  
Author(s):  
Jason W. Mitchell
Keyword(s):  
Strong Association ◽  
The United States ◽  
Gay Male Couples ◽  
Hiv Status ◽  
Cross Sectional ◽  
Male Couples ◽  
Gay Male ◽  
Sex With Men ◽  
Substance Use With Sex ◽  
The Relationship

Prior studies with men who have sex with men have documented a strong association between substance use with sex and risk for acquisition of HIV. However, few studies have been conducted about gay male couples’ use of substances with sex, despite the fact that between one third and two thirds of men who have sex with men acquire HIV from their relationship partners. The present study sought to (1) describe whether one or both partners in the male couple uses substances with sex—by substance type—within and/or outside of their relationship, and (2) assess whether differences exist in those who use substances with sex within and outside the relationship by the couples’ HIV status. Dyadic data for this analysis were collected in the United States from a nation-wide cross-sectional Internet study about male couples’ relationships and behaviors. Couple-level descriptive and comparative analyses were employed with 361 male couples. Except for alcohol, most couples did not use substances with sex. Of those who did, rates of who used it with sex and substance type within the relationship varied; most couples only had one partner who used substances with sex outside the relationship. Significantly higher proportions of concordantly HIV-negative and HIV-positive couples had both partners who used substances (all types) with sex within their relationship over discordant couples. Most couples had one partner who used outside the relationship; only marijuana and erectile dysfunction medication use with sex significantly differed by couples’ HIV status. Findings indicate the need to conduct additional research for prevention development.

Linguistic Integration and Immigrant Health: The Longitudinal Effects of Interethnic Social Capital

2018 ◽  
Vol 59 (2) ◽  
pp. 215-230 ◽  
Author(s):  
Mesay A. Tegegne
Keyword(s):  
Social Capital ◽  
Health Status ◽  
Immigrant Health ◽  
English Language ◽  
Language Use ◽  
The United States ◽  
Cross Sectional ◽  
Linguistic Integration ◽  
The Relationship

The literature on immigrant health has by and large focused on the relationship between acculturation (often measured by a shift in language use) and health outcomes, paying less attention to network processes and the implications of interethnic integration for long-term health. This study frames English-language use among immigrants in the United States as a reflection of bridging social capital that is indicative of social network diversity. Using longitudinal data on self-rated health and the incidence of chronic conditions from the New Immigrant Survey (2003, 2007), I examine the contemporaneous and longitudinal associations between interethnic social capital and health. The results show evidence for a positive long-term effect of linguistic integration on health status, but no cross-sectional associations were observed. Overall, these results highlight the possible role of network processes in linking English-language use with immigrant health and the time-dependent nature of the relationship between linguistic integration and health status.

Moral Injury during the COVID-19 pandemic: A delphi model survey of family medicine residents

2021 ◽  
pp. 009121742110543
Author(s):  
Sean B Ngo ◽  
Payson J Clark ◽  
Sarah E Parr ◽  
Abel R Thomas ◽  
Akshat Dayal ◽  
...  
Keyword(s):  
Family Medicine ◽  
Family Relationships ◽  
The United States ◽  
Moral Injury ◽  
Professional Relationships ◽  
Major Barrier ◽  
Model Study ◽  
Seeking Help ◽  
Patient Relationships ◽  
Family Medicine Residents

Objectives The objective is to investigate the primary factors that created experiences leading to moral injury in family medicine residents during the COVID-19 pandemic and also to identify any barriers keeping these residents from seeking or receiving help when they experienced moral injury. Method A DELPHI model study utilizing three rounds of surveys was conducted at four family medicine residency programs in the United States. Resident responses to Survey 1 generated factors perceived to be causing them moral injury or constituting barriers to their seeking help. Thematic analysis identified common themes which were presented to residents in Survey 2 for rating and justification. Results and feedback from Survey 2 were shared with residents in Survey 3, where residents were prompted to reevaluate their ratings for factors and barriers for the purpose of generating consensus among themselves. A ranked list of factors and barriers was thereby created for the participating sites. Results Residents shared several stories about the factors that most pressured them to violate their moral values. The most severe and frequent factors contributing to moral injury involved disruptions to doctor–patient relationships, patient–family relationships, and relationships with other healthcare professionals. Time was the major barrier to residents seeking help. Conclusion During times of crisis, moral injury among residents may be minimized by protecting and promoting important clinical and professional relationships with patients, colleagues, and other medical professionals. While residents report that lack of time was the most significant barrier to seeking help, it is unclear how this complicated and ubiquitous problem would be resolved or mitigated.

scholarly journals A survey of caregiver acculturation and acceptance of silver diamine fluoride treatment for childhood caries

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Anjali Kumar ◽  
Dana Cernigliaro ◽  
Mary E. Northridge ◽  
Yinxiang Wu ◽  
Andrea B. Troxel ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
The United States ◽  
Cross Sectional Study ◽  
Caries Experience ◽  
Cross Sectional ◽  
Silver Diamine Fluoride ◽  
Fluoride Treatment ◽  
Logistic Regression Models ◽  
Health Related ◽  
The Relationship

Abstract Background Interest in aqueous silver diamine fluoride (SDF) has been growing as a treatment for caries arrest. A cross-sectional study was conducted to identify factors associated with caregiver acceptance of SDF treatment for children presenting with caries at 8 Federally Qualified Health Centers. The study purpose was to examine associations between caregiver acceptance of SDF treatment for children with caries and (1) sociodemographic and acculturation characteristics of caregivers and (2) clinical assessments of the children by dentists. Methods A caregiver survey collected information on: sociodemographic characteristics; acculturation characteristics, measured using the validated Short Acculturation Scale for Hispanics (SASH); perceived benefits and barriers of SDF treatment, including caregiver comfort; and perceived health-related knowledge. Chart reviews were conducted to assess: the medical / dental insurance of pediatric patients; cumulative caries experience, measured using decayed, missing, filled teeth total scores (dmft / DMFT); whether operating room treatment was needed; and a record of caregiver acceptance of SDF treatment (the outcome measure). Standard logistic regression models were developed for caregiver acceptance of SDF treatment for their children as the binary outcome of interest (yes / no) to calculate unadjusted odds ratios (OR) and adjusted ORs for covariates of interest. Results Overall, 434 of 546 caregivers (79.5%) accepted SDF treatment for their children. A U-shaped relationship between caregiver odds of accepting SDF treatment and age group of pediatric patients was present, where caregivers were most likely to accept SDF treatment for their children who were either < 6 years or 9–14 years, and least likely to accept SDF treatment for children 6 to < 9 years. The relationship between acculturation and caregiver acceptance of SDF treatment depended upon whether or not caregivers were born in the United States: greater acculturation was associated with caregiver acceptance of SDF treatment among caregivers born in this country, and lower acculturation was associated with caregiver acceptance of SDF treatment among caregivers born elsewhere. Conclusions Caregiver acceptance of SDF treatment is high; child’s age and caregiver comfort are associated with acceptance. Providers need to communicate the risks and benefits of evidence-based dental treatments to increasingly diverse caregiver and patient populations.

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