GEOSTATISTICAL ESTIMATION OF BLUE CRAB CALLINECTES SAPIDUS ABUNDANCE IN CHESAPEAKE BAY AT LOCAL SCALES

Increases in the sizes of container ships due to the expansion of the Panama Canal has increased the need for dredging activities in the Chesapeake Bay. Placement of dredged material in the Bay is restricted to winter months owing to concerns for threatened and endangered species. Placement of dredged material in the lower Chesapeake Bay in Wolf Trap Alternate Open Water Placement Site (WTAPS) overlaps with overwintering locations for mature female blue crab. To estimate the potential magnitude of winter mortality in WTAPS and WTAPS Northern Extension (WTAPSNE) resulting from placement of dredged material, a range of geostatistical tools (e.g., inverse distance weighting and kriging) were used to map the distribution and estimate the abundance of blue crab in Chesapeake Bay, WTAPS, and WTAPSNE (i.e., small-scale estimation) from 1990–2020 using data from the winter dredge survey. These analyses indicated that a low proportion of the age-1+ female blue crab population occurs within WTAPS and WTAPSNE (<1.18% and <1.5% respectively). Variability of abundance estimates was high when female age-1+ abundance was less than 150 million in the Chesapeake Bay. Therefore, we suggest the Port limit placement of dredged materials in WTAPS and WTAPSNE when female age-1+ abundance is less than 150 million; we recommend the Port not undertake placement activities when the stock is declared overfished (i.e., when female age-1+ abundance is less than 72.5 million)

Does Specialist Physician Supply Affect Pediatric Asthma Health Outcomes?

Background Pediatrician and pediatric subspecialist density varies substantially among the various Canadian provinces, as well as among various states in the US. It is unknown whether this variability impacts health outcomes. To study this knowledge gap, we evaluated pediatric asthma admission rates within the 2 Canadian provinces of Manitoba and Saskatchewan, which have similarly sized pediatric populations and substantially different physician densities. Methods This was a retrospective cross-sectional cohort study. Health regions defined by the provincial governments, have, in turn, been classified into “peer groups” by Statistics Canada, on the basis of common socio-economic characteristics and socio-demographic determinants of health. To study the relationship between the distribution of the pediatric workforce and health outcomes in Canadian children, asthma admission rates within comparable peer group regions in both provinces were examined by combining multiple national and provincial health databases. We generated physician density maps for general practitioners, and general pediatricians practicing in Manitoba and Saskatchewan in 2011. Results At the provincial level, Manitoba had 48.6 pediatricians/100,000 child population, compared to 23.5/100,000 in Saskatchewan. There were 3.1 pediatric asthma specialists/100,000 child population in Manitoba and 1.4/100,000 in Saskatchewan. Among peer-group A, the differences were even more striking. A significantly higher number of patients were admitted in Saskatchewan (590.3/100,000 children) compared to Manitoba (309.3/100,000, p \u3c 0.0001). Conclusions Saskatchewan, which has a lower pediatrician and pediatric asthma specialist supply, had a higher asthma admission rate than Manitoba. Our data suggest that there is an inverse relationship between asthma admissions and pediatrician and asthma specialist supply

Impostorism and anxiety contribute to burnout among resident physicians

Purpose: Physician burnout is an issue that has come to the forefront in the past decade. While many factors contribute to burnout the impact of impostorism and self-doubt has largely been ignored. We investigated the relationship of anxiety and impostorism to burnout in postgraduate medical learners. Materials and methods: Postgraduate learners in four diverse training programs: Family Medicine (FM), Paediatric Medicine (PM), Anesthesiology (AN), and General Surgery (GS) were surveyed to identify the incidence of impostorism (IP), anxiety, and burnout. IP, anxiety, and burnout were evaluated using the Clance Impostor Phenomenon Scale (CIPS), Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and the General Anxiety Disorder-7 (GAD-7) questionnaires, respectively. Burnout was defined as meeting burnout criteria on all three domains. Relationships between IP, anxiety, and burnout were explored. Results: Two hundred and sixty-nine residents responded to the survey (response rate 18.8%). Respondents were distributed evenly between specialties (FM = 24.9%, PM = 33.1%, AN = 20.4%, GS = 21.6%). IP was identified in 62.7% of all participants. The average score on the CIPS was 66.4 (SD = 14.4), corresponding to ‘frequent feelings of impostorism.’ Female learners were at higher risk for IP (RR = 1.27, 95% CI: 1.03–1.57). Burnout, as defined by meeting burnout criteria on all three subscales, was detected in 23.3% of respondents. Significant differences were seen in burnout between specialties (p = 0.02). GS residents were more likely to experience burnout (31.7%) than PM and AN residents (26.7 and 10.0%, respectively, p = 0.02). IP was an independent risk factor for both anxiety (RR = 3.64, 95% CI:1.96–6.76) and burnout (RR = 1.82, 95% CI: 1.07–3.08). Conclusions: Impostorism is commonly experienced by resident learners independent of specialty and contributes to learner anxiety and burnout. Supervisors and Program Directors must be aware of the prevalence of IP and the impact on burnout. Initiatives to mitigate IP may improve resident learner wellness and decrease burnout in postgraduate learners