Addressing Burnout among Women Residents: Results from Focus Group Discussions

Introduction. Physician burnout has been described as more common among women than men.  Even if there are no gender-based differences in prevalence, risk factors, such as work/home integration/conflict and gendered biases, likely differ.  Prior administrations of an annual resident wellness survey at a single urban academic institution confirmed that rates of burnout were higher among women, especially during the PGY-2 year.  Methods.  A series of focus groups of women PGY-3 residents across specialties were organized in 2019 at a single urban academic medical center.  Given the number of participants, demographics were not collected to maintain participant anonymity.  The moderator for all groups used a discussion guide consisting of eight open-ended questions based on a review of the literature. Results.  Ten residents agreed to participate in one of four, hour-long focus group discussions.  While the residents identified some factors that were not gender-specific, they also discussed issues that they faced as women in medicine, including needing to work harder to prove themselves and unconscious gendered biases from faculty and patients.  The residents thought that their wellbeing would be improved if their training programs better understood the experiences and needs of women residents and recommended a series of interventions, including improved mentoring and networking opportunities.  Conclusions. Interventions to improve wellbeing need to consider gender-based differences.  While mentoring and networking can help all residents, these may be especially useful for women and should be considered as a component of an overarching plan to improve diversity, equity, inclusion, and belonging.    

Time and Financial Costs for Students Participating in the National Residency Matching Program (the Match©): 2015 to 2020

Introduction. The purpose of this study was to provide information to assist students, faculty, and staff in making critical career-determining decisions regarding the residency NRMP “Match©” process. Methods. A 47-item survey questionnaire was developed and piloted on a regional medical school campus in 2015. The revised questionnaire was distributed each year from 2016 to 2020 to fourth-year medical students after rank lists had been submitted. The questionnaire incorporated a request for comments about the interviewing experience and suggestions to improve the process. This narrative feedback was coded using a thematic analysis. Results. The overall response rate was 86.1% (897/1,042). Annual response rates ranged from 70.0% in 2020 to 97.0% in 2018. Respondents’ average age was 27.3 (± 2.7) years and 50.0% (448/897) were male. Most applied to family medicine (164/897; 18.2%) and internal medicine (140/897; 15.6%). Eight specialties had fewer than ten applicants over the six-year period. The number of students applying to individual specialties fluctuated annually, but no specialty showed a consistent upward or downward trend over the study period. Conclusions. This study found huge differences in numbers of applications, expenses, and days interviewing. Students crave more guidance, a more efficient system, transparent communication with programs, and less pressure during the process. Reducing escalating volumes of applications is central to improving the system. Despite efforts to inform applicants better, student behavior is unlikely to change until they feel safe in the belief that lower and more realistic numbers of applications and interviews are likely to result in securing an appropriate residency position

Spectral irradiance variations: Comparison between observations and the SATIRE model on solar rotation time scales

Aims: We test the reliability of the observed and calculated spectral irradiance variations between 200 and 1600 nm over a time span of three solar rotations in 2004. Methods: We compare our model calculations to spectral irradiance observations taken with SORCE/SIM, SoHO/VIRGO and UARS/SUSIM. The calculations assume LTE and are based on the SATIRE (Spectral And Total Irradiance REconstruction) model. We analyse the variability as a function of wavelength and present time series in a number of selected wavelength regions covering the UV to the NIR. We also show the facular and spot contributions to the total calculated variability. Results: In most wavelength regions, the variability agrees well between all sets of observations and the model calculations. The model does particularly well between 400 and 1300 nm, but fails below 220 nm as well as for some of the strong NUV lines. Our calculations clearly show the shift from faculae-dominated variability in the NUV to spot-dominated variability above approximately 400 nm. We also discuss some of the remaining problems, such as the low sensitivity of SUSIM and SORCE for wavelengths between approximately 310 and 350 nm, where currently the model calculations still provide the best estimates of solar variability.Comment: 15 pages, 11 figures, accepted by A&

Survey of Pest Management Practices on US Golf Courses

Integrated pest management (IPM) is an important component of golf course maintenance and includes conventional chemical pesticide use as well as nonchemical cultural management practices. Determining how frequent pest management practices are used on golf courses is critical when developing educational and outreach programs. The objective of this study was to determine the frequency of pest management practices and pesticide mixing and storage facilities on US golf courses. A survey was sent to 14,033 operational US golf facilities with 10% responding. Reliance on all conventional chemical pesticides increased from 2015 to 2021. The reliance on biological control products declined to 14% and reliance on the nonpesticide practice of using plant growth regulators remained equivalent to 2015. The most common pest management practices included monitoring weather patterns and scouting for pests, with 93% of golf facilities reporting the use of both. The use of written IPM and pesticide application plans increased from 44% to 63% of golf facilities between 2015 and 2021, respectively. Generally, mixing and storage facilities remained unchanged from 2015 to 2021. US golf facilities continue to use nonchemical pest management practices, but reliance on chemical pesticides has increased

Nutrient Use and Management Practices on United States Golf Courses

Nutrient use on United States golf courses increases management costs and has the potential to influence ecosystems. Therefore, it is critical to assess nutrient use and management practices to develop and teach best management practices. The objectives of this survey were to measure nutrient use and management practices on United States golf courses in 2021, and to determine if changes occurred since 2006. A survey was developed and distributed via e-mail to 14,033 United States golf facilities, with 1444 responding. From 2006 to 2021, the total projected nitrogen (N), available phosphorus (P2O5), and soluble potash (K2O) applied declined by 41%, 59%, and 54%, to 54,376, 13,761, and 41,386 tons, respectively. These reductions were attributed to course closures, reduced fertilized acres, reduced application rates, and nutrient use restrictions. The percentage of facilities that did not apply P2O5 increased to 21%, which is likely a result of P2O5 application restrictions. Soil testing was associated with greater application rates of N, P2O5, and K2O. Returning clippings, using precision fertilizer applications, reducing turfgrass acreage, and considering N release from soil organic matter were associated with reduced application rates of P2O5. Golf course superintendents have contributed to nationwide reductions in N, P2O5, and K2O, as evidenced by the reduction in fertilized acres and the reduction in nutrient use rates from 2006 to 2021

The effect of stellar contamination on low-resolution transmission spectroscopy: needs identified by NASA’s Exoplanet Exploration Program Study Analysis Group 21

Study Analysis Group 21 (SAG21) of NASA’s Exoplanet Exploration Program Analysis Group was organized to study the effect of stellar contamination on space-based transmission spectroscopy, a method for studying exoplanetary atmospheres by measuring the wavelength-dependent radius of a planet as it transits its star. Transmission spectroscopy relies on a precise understanding of the spectrum of the star being occulted. However, stars are not homogeneous, constant light sources but have temporally evolving photospheres and chromospheres with inhomogeneities like spots, faculae, plages, granules, and flares. This SAG brought together an interdisciplinary team of more than 100 scientists, with observers and theorists from the heliophysics, stellar astrophysics, planetary science, and exoplanetary atmosphere research communities, to study the current research needs that can be addressed in this context to make the most of transit studies from current NASA facilities like Hubble Space Telescope and JWST. The analysis produced 14 findings, which fall into three science themes encompassing (i) how the Sun is used as our best laboratory to calibrate our understanding of stellar heterogeneities (‘The Sun as the Stellar Benchmark’), (ii) how stars other than the Sun extend our knowledge of heterogeneities (‘Surface Heterogeneities of Other Stars’), and (iii) how to incorporate information gathered for the Sun and other stars into transit studies (‘Mapping Stellar Knowledge to Transit Studies’). In this invited review, we largely reproduce the final report of SAG21 as a contribution to the peer-reviewed literature

Creation and Implementation of a New Handoff System in the Electronic Medical Record at a Single Institution

Abstrac