Breastfeeding Policies of Otolaryngology Residency Programs

Background: Women entering surgical residencies must determine which programs best fit their career and family goals. The purpose of this study was to determine if breastfeeding policies are available on otolaryngology residency program websites. Methods: A total of 122 publicly available otolaryngology residency program websites were reviewed for the presence of a breastfeeding policy and lactation information. The percentage of residents and faculty that are women in each program as well as the program’s region, size, and affiliation with a top 50 hospital for ear, nose, and throat care were determined. Frequencies and nonparametric analyses were calculated when appropriate. Results: None of the otolaryngology residency programs had a breastfeeding policy posted directly on their website. A link to a Graduate Medical Education (GME) website that contained a breastfeeding policy was present on 20 (16.4%) program websites, and 31 websites (25.4%) had information about lactation facilities on the GME website or another page that could be found through the search bar; 17 (23.0%) of the large residency programs contained the link to the GME website, whereas only 3 (6.25%) of the small programs did (p = 0.015). Residency programs that were affiliated with a top 50 hospital for ear, nose, and throat care were more likely to have a link to the GME website with a breastfeeding policy than those not affiliated (13 [29.5%] vs. 7 [8.9%], respectively; p = 0.003). Conclusion: Otolaryngology residency programs do not provide breastfeeding policies directly on their websites

Salt marsh ecosystem restructuring enhances elevation resilience and carbon storage during accelerating relative sea-level rise

Salt marshes respond to sea-level rise through a series of complex and dynamic bio-physical feedbacks. In this study, we found that sea-level rise triggered salt marsh habitat restructuring, with the associated vegetation changes enhancing salt marsh elevation resilience. A continuous record of marsh elevation relative to sea level that includes reconstruction of high-resolution, sub-decadal, marsh elevation over the past century, coupled with a lower-resolution 1500-year record, revealed that relative sea-level rose 1.5 ± 0.4 m, following local glacial isostatic adjustment (1.2 mm/yr). As sea-level rise has rapidly accelerated, the high marsh zone dropped 11 cm within the tidal frame since 1932, leading to greater inundation and a shift to flood- and salt-tolerant low marsh species. Once the marsh platform fell to the elevation favored by low-marsh Spartina alterniflora, the elevation stabilized relative to sea level. Currently low marsh accretion keeps pace with sea-level rise, while present day high marsh zones that have not transitioned to low marsh have a vertical accretion deficit. Greater biomass productivity, and an expanding subsurface accommodation space favorable for salt marsh organic matter preservation, provide a positive feed-back between sea-level rise and marsh platform elevation. Carbon storage was 46 ± 28 g C/m2/yr from 550 to 1800 CE, increasing to 129 ± 50 g C/m2/yr in the last decade. Enhanced carbon storage is controlled by vertical accretion rates, rather than soil carbon density, and is a direct response to anthropogenic eustatic sea-level rise, ultimately providing a negative feedback on climate warming

Cultivating epizoic diatoms provides insights into the evolution and ecology of both epibionts and hosts

11 pages, 3 figures, 1 table, supplementary information https://doi.org/10.1038/s41598-022-19064-0.-- Data availability: DNA sequence data generated for this study are published on the NCBI GenBank online sequence depository under the accession numbers listed in Table S1. Additional micrographs and cleaned voucher material from the sequenced cultures are available from lead author MPAOur understanding of the importance of microbiomes on large aquatic animals—such as whales, sea turtles and manatees—has advanced considerably in recent years. The latest observations indicate that epibiotic diatom communities constitute diverse, polyphyletic, and compositionally stable assemblages that include both putatively obligate epizoic and generalist species. Here, we outline a successful approach to culture putatively obligate epizoic diatoms without their hosts. That some taxa can be cultured independently from their epizoic habitat raises several questions about the nature of the interaction between these animals and their epibionts. This insight allows us to propose further applications and research avenues in this growing area of study. Analyzing the DNA sequences of these cultured strains, we found that several unique diatom taxa have evolved independently to occupy epibiotic habitats. We created a library of reference sequence data for use in metabarcoding surveys of sea turtle and manatee microbiomes that will further facilitate the use of environmental DNA for studying host specificity in epizoic diatoms and the utility of diatoms as indicators of host ecology and health. We encourage the interdisciplinary community working with marine megafauna to consider including diatom sampling and diatom analysis into their routine practicesFinancial support for sequencing and SEM comes from the Jane and the Roland Blumberg Centennial Professorship in Molecular Evolution at UT Austin and the US Department of Defense (grant number W911NF-17-2-0091). Sampling in South Africa was done with partial financial support from The Systematics Association (UK) through the Systematics Research Fund Award granted to RM (2017 and 2020). Work in the Adriatic Sea was supported by Croatian Science Foundation, project UIP-05-2017-5635 (TurtleBIOME). KF has been fully supported by the “Young researchers' career development project – training of doctoral students” of the CSF funded by the EU from the European Social Fund. NJR was funded by the Spanish government (AEI) through the ‘Severo Ochoa Centre of Excellence’ accreditation (CEX2019-000928-S)Peer reviewe

Development of a Reproducible Behavior Assay to Screen for Chemical Effects

Presentation to the SETAC North America 42nd Annual meeting (November 2021)Search for CCTE records in EPA’s Science Inventory by typing in the title at this link.https://cfpub.epa.gov/si/si_public_search_results.cfm?advSearch=true&showCriteria=2&keyword=CCTE&TIMSType=&TIMSSubTypeID=&epaNumber=&ombCat=Any&dateBeginPublishedPresented=07/01/2017&dateEndPublishedPresented=&dateBeginUpdated=&dateEndUpdated=&DEID=&personName=&personID=&role=Any&journalName=&journalID=&publisherName=&publisherID=&sortBy=pubDate&count=25</div

Individual, interpersonal, and structural factors influencing college student healthcare disengagement

Poster was presented at the 2018 American College Health Association meeting in Washington D.C

Improving Representation of People With Disabilities in Health Education

Over the past two decades, there has been increasing recognition of the importance and merits of increasing representation of historically underrepresented minorities in the health professions. However, people with disabilities are less discussed in these efforts. More than one in four of U.S. adults have a disability; yet it seems that these individuals are less represented in the field of health education. This commentary discusses the merits of increasing representation of people with disabilities in the health education/promotion profession and calls for preparation programs and professional organizations to reduce systemic barriers and facilitate increased representation. </jats:p

Identifying and addressing health-related social needs: a Medicaid member perspective

Abstract Background Multiple state and national health care organizations have invested in activities to screen for and address the health-related social needs (HRSNs) of their patients. However, patient perspectives concerning HRSN screening discussions and facilitated referrals to supports are largely unexplored. The main objectives of this study were to explore the ways in which Massachusetts Medicaid (MassHealth) members engage with their health care clinicians to discuss HRSNs, to identify common needs discussed, and to describe whether members feel these needs are being addressed by health care clinicians and staff. Methods The study team performed a cross-sectional, qualitative research study that included in-depth, open-ended interviews with 44 adult MassHealth members. Interviews were conducted between June and October 2022. Interviews were recorded, transcribed, and systematically coded for analysis, and common themes were reported. The data collected for this study were part of a larger independent evaluation of MassHealth’s 2017-2022 Section 1115 Demonstration that granted authority from CMS to implement health care delivery system reforms in Massachusetts. Results In this qualitative study of Medicaid members, some reportedly felt comfortable freely discussing all of their clinical and social needs with their health care clinicians, while others noted feelings of apprehension. Several members recalled being asked about their HRSNs in various clinical or community settings, while others did not. The majority of members endorsed having an unmet HRSN, including housing, nutrition, financial, or transportation issues, and many barriers to addressing these HRSNs were discussed. Finally, many members cited a preference for discussing HRSNs with community-based care coordinators and social workers at the community partner organizations rather than with their health care clinicians. Community-based care coordinators were lauded as essential facilitators in making the connection to necessary resources to help address HRSNs. Conclusions Study results highlight an opportunity to increase the effectiveness of HRSN screening and referral practices within the health care setting through relationship building between Medicaid members and diverse interdisciplinary care teams that include staff such as community health workers. Continued investment in cross-sector partnerships, screening workflows, and patient-clinician relationships may contribute to establishing an environment in which members can comfortably discuss HRSNs and connect with needed services to improve their health

Competency Focused Versus Philosophically Grounded Health Promotion Practice: Impacts on Innovation and Addressing Health Inequities

The professionalization of the fields of health education and health promotion has largely coincided with the completion of job task analysis conducted by major organizations in the field (e.g., the National Commission for Health Education Credentialing, Society for Public Health Education). The process through which these job task analyses and skill-based competencies are implemented in professional preparation programs poses a risk to stifle advancement and innovation in health education and promotion. In this perspective, we discuss Competency Focused Practice (the current state of the field) to a goal of Philosophically Grounded Practice. We provide comparisons of the implications of these two schools of thought with respect to ethics, social determinants of health, and practical methods in health education and promotion. </jats:p