Analysis of Orthopaedic In-Training Examination Trauma Questions: 2017 to 2021

INTRODUCTION: The Orthopaedic In-Training Examination (OITE) is a multiple-choice examination developed by the American Academy of Orthopaedic Surgeons annually since 1963 to assess orthopaedic residents\u27 knowledge. This study\u27s purpose is to analyze the 2017 to 2021 OITE trauma questions to aid orthopaedic residents preparing for the examination. METHODS: The 2017 to 2021 OITEs on American Academy of Orthopaedic Surgeons\u27 ResStudy were retrospectively reviewed to identify trauma questions. Question topic, references, and images were analyzed. Two independent reviewers classified each question by taxonomy. RESULTS: Trauma represented 16.6% (204/1,229) of OITE questions. Forty-nine percent of trauma questions included images (100/204), 87.0% (87/100) of which contained radiographs. Each question averaged 2.4 references, of which 94.9% were peer-reviewed articles and 46.8% were published within 5 years of the respective OITE. The most common taxonomic classification was T1 (46.1%), followed by T3 (37.7%) and T2 (16.2%). DISCUSSION: Trauma represents a notable portion of the OITE. Prior OITE trauma analyses were published greater than 10 years ago. Since then, there has been an increase in questions with images and requiring higher cognitive processing. The Journal of Orthopaedic Trauma (24.7%), Journal of the American Academy of Orthopaedic Surgeons (10.1%), and Journal of Bone and Joint Surgery, American Volume (9.3%) remain the most cited sources

Differential livelihood adaptation to social-ecological change in coastal Bangladesh

Social-ecological changes, brought about by the rapid growth of the aquaculture industry and the increased occurrence of climatic stressors, have significantly affected the livelihoods of coastal communities in Asian mega-deltas. This paper explores the livelihood adaptation responses of households of different wealth classes, the heterogeneous adaptation opportunities, barriers and limits (OBLs) faced by these households and the dynamic ways in which these factors interact to enhance or impede adaptive capacities. A mixed methods approach was used to collect empirical evidence from two villages in coastal Bangladesh. Findings reveal that households’ adaptive capacities largely depend on their wealth status, which not only determine their availability of productive resources, but also empower them to navigate social-ecological change in desirable ways. Households operate within a shared response space, which is shaped by the broader socio-economic and political landscape, as well as their previous decisions that can lock them in to particular pathways. While an adaptive response may be effective for one social group, it may cause negative externalities that can undermine the adaptation options and outcomes of another group. Adaptation OBLs interact in complex ways; the extent to which these OBLs affect different households depend on the specific livelihood activities being considered and the differential values and interests they hold. To ensure more equitable and environmentally sustainable livelihoods in future, policies and programs should aim to expand households’ adaptation space by accounting for the heterogeneous needs and complex interdependencies between response processes of different groups

Challenges to adaptation: a fundamental concept for the shared socio-economic pathways and beyond

The framework for the new scenarios being developed for climate research calls for the development of a set of Shared Socioeconomic Pathways (SSPs), which are meant to differ in terms of their challenges to mitigation and challenges to adaptation. In order for the scenario process to fulfill its goals, the research and policy communities need to develop a shared understanding of these concepts. This paper focuses on challenges to adaptation. We begin by situating this new concept in the context of the rich literatures related to inter alia adaptation, vulnerability, and resilience. We argue that a proper characterization of challenges to adaptation requires a rich, exploration of the concept, which goes beyond mere description. This has a number of implications for the operationalization of the concept in the basic and extended versions of the SSPs. First, the elements comprising challenges to adaptation must include a wide range of socioeconomic and even some (non-climatic) biophysical factors. Second, careful consideration must be given to differences in these factors across scales, as well as cross-scale interactions. Third, any representation of the concept will require both quantitative and qualitative elements. The scenario framework offers the opportunity for the SSPs and full scenarios to be of greater value than has been the case in past exercises to both Integrated Assessment Modeling (IAM) and Impacts,Adaptation, and Vulnerability (IAV) researchers, but this will require a renegotiation of the traditional, primarily unidirectional relationship between the two communities