Development of an Objective Structured Clinical Examination as a Component of Assessment for Initial Board Certification in Anesthesiology.

With its first administration of an Objective Structured Clinical Examination (OSCE) in 2018, the American Board of Anesthesiology (ABA) became the first US medical specialty certifying board to incorporate this type of assessment into its high-stakes certification examination system. The fundamental rationale for the ABA's introduction of the OSCE is to include an assessment that allows candidates for board certification to demonstrate what they actually "do" in domains relevant to clinical practice. Inherent in this rationale is that the OSCE will capture competencies not well assessed in the current written and oral examinations-competencies that will allow the ABA to judge whether a candidate meets the standards expected for board certification more properly. This special article describes the ABA's journey from initial conceptualization through first administration of the OSCE, including the format of the OSCE, the process for scenario development, the standardized patient program that supports OSCE administration, examiner training, scoring, and future assessment of reliability, validity, and impact of the OSCE. This information will be beneficial to both those involved in the initial certification process, such as residency graduate candidates and program directors, and others contemplating the use of high-stakes summative OSCE assessments

Indoor air quality in California homes with code-required mechanical ventilation.

Data were collected in 70 detached houses built in 2011-2017 in compliance with the mechanical ventilation requirements of California's building energy efficiency standards. Each home was monitored for a 1-week period with windows closed and the central mechanical ventilation system operating. Pollutant measurements included time-resolved fine particulate matter (PM2.5 ) indoors and outdoors and formaldehyde and carbon dioxide (CO2 ) indoors. Time-integrated measurements were made for formaldehyde, NO2 , and nitrogen oxides (NOX ) indoors and outdoors. Operation of the cooktop, range hood, and other exhaust fans was continuously recorded during the monitoring period. Onetime diagnostic measurements included mechanical airflows and envelope and duct system air leakage. All homes met or were very close to meeting the ventilation requirements. On average, the dwelling unit ventilation fan moved 50% more airflow than the minimum requirement. Pollutant concentrations were similar to or lower than those reported in a 2006-2007 study of California new homes built in 2002-2005. Mean and median indoor concentrations were lower by 44% and 38% for formaldehyde and 44% and 54% for PM2.5 . Ventilation fans were operating in only 26% of homes when first visited, and the control switches in many homes did not have informative labels as required by building standards

Cali’s food systems: A diagnostic synthesis to determine priority action areas for sustainable food systems

Food systems are complex and dynamic, and their governance and planning directly affect food security and nutritional outcomes across urban, peri-urban, and rural communities. The production, consumption, and disposal of food has profound effects on economic development, environmental sustainability, and public health. Among food systems, these three domains have important linkages and synergies which are conveyed through public goods and public policy. Identifying the components that make up food systems can be challenging, especially for decision makers who need to understand how changing individual components in the system may have broader implications on food security and public health. Without robust, generalizable data to explain the interconnectedness between these domains, policymakers cannot make evidence-based recommendations that foster sustainable practices. Thus, policymakers need decision support tools to identify specific problem and sites of action to develop sustainable solutions. This project compares the 44 Monitoring Framework Indicators from the Milan Urban Food Policy Pact (MUFPP) to existing indicators in Santiago de Cali’s Municipal Development Plan and other governmental reports to measure the city’s progress integrating sustainability in its food systems. The MUFPP is a non-binding international protocol aimed at tackling food- related issues at the urban level by having cities share best practices and monitor their progress towards achieving more sustainable foods systems. Preliminary results observed eight indicators that were measured, twenty-five indicators required review or fine tuning, and eleven indicators were missing altogether, pointing to gaps in data and knowledge and potential food system failures. Based on these gaps, a criteria and methodology were developed to determine priority action areas to improve and encourage the use of sustainable practices. (**includes results from methodology**) Cali is not a MUFPP signatory city, change tense but given the upcoming municipal and departmental elections, this rudimentary food systems assessment is an opportunity to present evidence and engage Cali’s decision makers and researchers as they develop future political and research agendas related to food security, environmental protection, and economic development