The role of deviant peers in adolescent antisocial behavior has been well documented, but less is known about individual differences in susceptibility to negative peer influence. This study examined whether specific temperament dimensions moderate the prospective relationship between peer deviance and delinquent behavior in early adolescence. Participants included 704 adolescents recruited from the community. At baseline, parents provided information on adolescents' temperament and youth reported on their own and their friends' delinquent behavior. Selfreports of adolescents' delinquent behavior were collected again 16 months later. Peer deviance was related to delinquent behavior over time more strongly for adolescents with low levels of task orientation, flexibility, and positive mood, compared to youth with high levels of task orientation, flexibility, and positive mood. Analyses of gender differences indicated that low flexibility increased susceptibility to negative peer influence only for males, but not females. General activity level and sleep rhythmicity did not moderate the effect of peer behavior on delinquency.
Residency education has been disrupted by the coronavirus disease 2019 (COVID‐19) pandemic.
Programs in pandemic status, as designated by the "Accreditation Council for Graduate Medical Education (ACGME) in the US, have substantially modified or suspended traditional educational activities to adhere to physical distancing practices and allow residents to focus on patient care. This lapse in educational events is especially challenging now, as residents and other healthcare professionals are facing a previously undocumented illness and must stay current with the deluge of new information on the disease. Hence, there is a need for simple, digestible, up‐to‐date, and accurate information on COVID‐19 that is electronically disseminated and easy to obtain.
Medical education is faced with a growing number of challenges. The playing field that most of us know and recognize has been evolving over the past decade. Many of the truths we knew as educators are no longer accurate and we are faced with educating our learners in this new environment. Accreditation standards through national organizations are more rigorous and based on attainment of competency; therefore, outcome-based education has developed as a key factor. The Accreditation Council for Graduate Medical Education (ACGME) introduced the six domains of clinical competency to the profession, and in 2009 it began a multiyear process of restructuring its accreditation system to be based on educational outcomes in these competencies.1 The Liaison Committee on Medical Education in standard 6.1 of its Functions and Structure of a Medical School states that “the faculty of a medical school define its medical education program objectives in outcome-based terms that allow the assessment of medical students’ progress in developing the competencies that the profession and the public expect of a physician.”2 Both undergraduate and graduate medical education accreditation agencies are focusing on educational outcomes. It is no longer good enough to demonstrate that your learners performed the skills; now you must document achievement of those competencies. Our clinical environment is less conducive to concentrating on education due to documentation, billing requirements, and the sheer volume in our emergency room departments.3–4 Evolving educational pedagogy is more focused on small groups, simulation, and less on large-group formats. These challenges are opportunities for educators but require new strategies, which require research to determine the best approach.
Capstone is a cornerstone of undergraduate biomedical engineering (BME) programs. At the Georgia Institute of Technology, Capstone is a one-semester course covering the product development cycle. Curriculum includes clinical immersion and customer discovery, conversion of user needs to design inputs, concept ideation, patent analysis, prototyping, and engineering analysis (Fig. 1). Projects are often advised by clinical and industry experts, and topics tend to be geared towards high-tech devices to address US healthcare needs. Henceforth, the one-semester, US-focused Capstone is referred to as “traditional Capstone.”
Objective:
We sought to better understand the potential impact of the burgeoning neurohospitalist model of inpatient care on education of neurology residents and to better define possible roles for “neurohospitalists” in residency education.
Method:
We designed a brief qualitative open-ended survey directed toward academic leaders in neurology and distributed it by e-mail to every academic neurology department in the United States and Canada.
Results:
Of 83 respondents, 36 (43%) had an active neurohospitalist program and only 10% felt certain they would not have 1 within the next 5 years. All respondents expected to have residents continue to be involved with inpatient care. The main perceived advantage for resident education associated with neurohospitalists was inpatient care expertise, and the main expected disadvantage was decreased exposure to subspecialty attendings. The majority anticipated positive impact on all Accreditation Council for Graduate Medical Education core competencies predominantly based on neurohospitalists’ expertise in the inpatient setting.
Conclusion:
The majority of academic neurology departments are expected to have a neurohospitalist program within the next 5 years. There are several perceived advantages and disadvantages to such a program for education of neurology residents. In general, the impact of these programs is expected to improve resident education. Regardless of expectations, neurohospitalists will likely play a prominent role in the education of the next generation of neurologists.
Background
Low fruit and vegetable (FV) intake is a leading risk factor for chronic disease globally, but much of the world’s population does not consume the recommended servings of FV daily. It remains unknown whether global supply of FV is sufficient to meet current and growing population needs. We sought to determine whether supply of FV is sufficient to meet current and growing population needs, globally and in individual countries.
Methods and Findings
We used global data on agricultural production and population size to compare supply of FV in 2009 with population need, globally and in individual countries. We found that the global supply of FV falls, on average, 22% short of population need according to nutrition recommendations (supply:need ratio: 0.78 [Range: 0.05–2.01]). This ratio varies widely by country income level, with a median supply:need ratio of 0.42 and 1.02 in low-income and high-income countries, respectively. A sensitivity analysis accounting for need-side food wastage showed similar insufficiency, to a slightly greater extent (global supply:need ratio: 0.66, varying from 0.37 [low-income countries] to 0.77 [high-income countries]). Using agricultural production and population projections, we also estimated supply and need for FV for 2025 and 2050. Assuming medium fertility and projected growth in agricultural production, the global supply:need ratio for FV increases slightly to 0.81 by 2025 and to 0.88 by 2050, with similar patterns seen across country income levels. In a sensitivity analysis assuming no change from current levels of FV production, the global supply:need ratio for FV decreases to 0.66 by 2025 and to 0.57 by 2050.
Conclusion
The global nutrition and agricultural communities need to find innovative ways to increase FV production and consumption to meet population health needs, particularly in low-income countries.
Objective
To evaluate effects attributable to age, time period and birth cohort, on stroke mortality data from urban and rural regions in China between 1988 and 2013.
Methods
Mortality data were obtained from the Chinese Health Statistics Annual Report (1987–2001) and Chinese Health Statistics Yearbooks (2003–2014). Population data were obtained from population censuses (i.e. 1982, 1990, 2000 and 2010). Data were analysed using an age-period-cohort (APC) model and intrinsic estimation (IE) method.
Results
The age effect suggested that all older residents had higher stroke mortality risk than younger residents. Period effect showed that compared with figures for 1988, stroke mortality in 2013 was 1.8 times higher for urban regions and 2.4 times higher for rural regions. After controlling for age and period effects, cohorts born before the Chinese economic reform had a steady decline in stroke mortality. However, mortality rates increased and fluctuated in post-reform cohorts.
Conclusions
This APC-IE analysis identified a modest period effect with large age and cohort contributions to both the overall mortality and the disparity between urban and rural stroke mortality. Identifying early life and cumulative risk factors for stroke, improving equality in stroke prevention and care are needed to reduce the stroke mortality in China.
Current standards for identifying quality early childhood programs (e.g., NAEYC, ECERS) provide guidance on classroom play materials, but little research has focused on the interface between toy selection and arrangement and its effects on children’s behavior and social interactions. This study examined the effects of toy selection and arrangement on four positive and five negative social behaviors of 15 preschoolers in an inclusive classroom for children with autism and typically developing children. Three conditions were under investigation (a) conventional material package, featuring items recommended by teachers in NAEYC accredited programs, (b) systematic materials package developed to include sensory preferences and logistical considerations, and (c) enhanced materials package that featured more frequent rotation of items. Results indicate that systematic material selection and arrangement is significantly related to increased frequency of several positive social behaviors and decreased frequency of negative behaviors. The systematic and enhanced materials packages were superior to the conventional package for all variables studied. In summary, embedding systematic arrangements of toys and play materials into existing standards for high quality early childhood classrooms yielded desirable improvements in the social behaviors of all children in an inclusive classroom.
Ultrasound (US)-guided central venous catheter (CVC) insertion is a procedure that carries the risk of significant complications. Simulation provides a safe learning atmosphere, but most CVC simulators are not available outside of simulation centers. To explore longitudinal trends in US-guided CVC insertion competency in internal medicine (IM) interns, we studied the use of a low-fidelity, gelatin-based, US-guided CVC insertion simulation model combined with a simulation curriculum. This prospective observational study of IM interns was performed over the course of one academic year. Interns (n = 56) underwent model-based, US-guided procedure simulation training program and a repeated training course prior to their intensive care unit (ICU) rotation. CVC insertion competency at different timepoints was recorded. Survey data about intern experience and attitudes were also collected. Out of the 56 interns initially trained, 40 were included in the final analysis. Across all outcomes, interns experienced skill atrophy between initial training and the beginning of their ICU month. However, by the end of the month, there was a significant improvement in competency as compared to initial procedural training, which then waned by the end of the intern year. Attitudes toward the model were generally positive and self-reported confidence improved throughout the course of the year and correlated with objective measures of competency. Over the course of their intern year, which included simulation training using a gelatin-based model, interns demonstrated consistent competency trends. The use of a gelatin-based CVC insertion simulation model warrants further study as an adjunctive aid to existing simulation training.