Ophthalmic exam and ophthalmology residents’ subspecialty preference

AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.

Analysis of Influencing Factors on Fruit Consumption of Urban and Rural Residents in Beijing

In light of the rapid expansion of China s economy,there has been a notable shift in the consumption patterns of urban and rural residents.This is evident in the increased consumption of agricultural products,with fruit consumption representing a particularly pronounced trend.The 2023 Beijing Consumption Statistics indicate that demand for fruit is increasing,accompanied by heightened competition for quality and brands.The paper is based on research that examines the current situation of fruit consumption among urban and rural residents in Beijing.The results indicate that when urban and rural residents in Beijing purchase fruits,price is the most significant factor influencing fruit consumption.Taste,appearance,and variety are also considered to be important influencing factors,while the influence of factors such as fruit type,consumption pattern,and fruit brand is relatively minor.

The Impact of the Digital Economy on Rural Residents’Working Hours:Mechanisms and Empirical Evidence

The rapid development of the digital economy has provided a new impetus for rural residents to extend their working hours.Based on the data collected by the China Labor-force Dynamics Survey(CLDS)in 2014,2016,and 2018,this paper measured the development level of the digital economy in China from the perspectives of internet development and digital financial inclusion,and tested the mechanisms of how the digital economy affected rural residents’working hours.The results showed that the digital economy extended rural residents’working hours by expanding information channels and enhancing human capital,and this mechanism was affected by heterogeneity in rural residents’educational background,age,and social capital.Building on these findings,this paper holds that to increase rural residents’income by extending their working hours and achieving common prosperity for all,it is necessary to expand the opportunities for rural residents to participate in skills training and promote their accumulation of human capital.

Assessment of Online Transgender Healthcare Teaching Modules for Internal Medicine Residents and Fellows

Background: Transgender healthcare is not a formal learning requirement in Internal Medicine residency or fellowship. The National LGBTQ Task Force appealed to urgently train clinicians on the effective care of transgender patients. Few studies address the successful implementation of transgender healthcare teaching and education in graduate medical education. Purpose: The purpose was to design an online asynchronous curriculum to address the need for improved transgender healthcare education in graduate medical education and assess change in knowledge and comfort in transgender healthcare for residents and fellow learners. Methods: A 6-module curriculum was developed using established guidelines and ACGME competencies as a framework for content. To assess curriculum effectiveness, participants received anonymous pre- and post-curriculum surveys which included a multiple-choice knowledge assessment, Likert scale comfort questions focusing on healthcare skills, and open-ended feedback questions. Results: Twenty-six internal medicine residents and fellows participated in the curriculum (2022-2023). There was a 69% post-survey response rate. Participants improved their gender-affirming knowledge after completing the curriculum (p Conclusion: This online curriculum was successful in increasing knowledge and comfort in transgender care for IM residents and fellows. It provides a promising framework to address this gap in curricular content.

The Prediction for the Consumer Price Index of Residents in Perspective of Time Series Method in Case of Chongqing

The consumer price index (CPI) measures the relative number of changes in the price level of consumer goods and services over time, reflecting the trend and degree of changes in the price level of goods and services purchased by residents. This article uses the ARMA model to analyze the fluctuation trend of the CPI (taking Chongqing as an example) and make short-term predictions. To test the predictive performance of the model, the observation values from January to December 2023 were retained as the reference object for evaluating the predictive accuracy of the model. Finally, through trial predictions of the data from May to August 2023, it was found that the constructed model had good fitting performance.

Application of BOPPPS + Mind Maps to Improve Clinical Competence of General Practitioner Residents: Taking Cough as an Example

Objective:To analyze the importance of general practitioner residents using the combined teaching method(BOPPPS+mind maps).Methods:From September 2023 to August 2024,a study was conducted with 6 control group participants receiving traditional teaching and 6 observation group participants receiving the combined teaching method(BOPPPS+mind maps).The study analyzed various indicators between the two groups(including mind map scores and assessment results).Results:Compared with the control group,the assessment scores of the observation group were significantly higher(P<0.05).Conclusion:The application of the combined teaching method(BOPPPS+mind maps)by general practitioner residents can significantly improve their comprehensive abilities.

Exploration of the Integration of Curriculum Ideology and Politics into the Educational Pathway of Standardized Training for General Practice Residents

In recent years,the national higher education reform has proposed the concept of curriculum ideological and political education as a major element.This integration into the standardized training of general practice residents(commonly referred to as general resident training)is an unavoidable trend in the teaching field.Based on the actual situation of our unit at The First Affiliated Hospital of Xi’an Medical University,this paper emphasizes the necessity of incorporating ideological and political education into the general resident training curriculum,despite the absence of pertinent practical experience in how to effectively incorporate such courses into comprehensive residential training.In our hospital,we must assess the ideological and political education in the curriculum of general resident training,proposing a scientific,reasonable ideological and political education concept system for general practice courses,integrating ideological and political education with general practice resident training,and strengthening the team of ideological and political education physicians to teach them to carry out such education,this would foster enthusiasm and initiative.Strengthening admission education and training for general practice resident training,as well as regularly hosting symposiums to share ideas and understand the mission of doctors can provide effective experience for ideological and political education in general resident training courses.

Flipped classroom approach to global outreach:cross-cultural teaching of horizontal strabismus to Chinese ophthalmology residents

AIM:To evaluate the flipped classroom model for teaching horizontal strabismus didactics in an ophthalmology residency program in China as part of a visiting professorship from the United States.METHODS:Residents from an ophthalmology residency program in China were invited to participate in flipped classroom sessions taught by an experienced American ophthalmology faculty in 2018.Residents were instructed to watch a pre-class video lecture prior to the in-class-casebased activity.Content tests(5 Ophthalmic Knowledge Assessment Program style questions)and surveys were administered before and after the classroom sessions(100%response rate).These results were compared to that of an American cohort who were taught the same content.RESULTS:The Chinese cohort of 12 residents preferred the flipped classroom to the traditional classroom at higher rates than the American cohort of 40 residents(92%vs 55%,P=0.04)and felt that all ophthalmology topics would be appropriate for the flipped classroom teaching style(P-values between 0.008 and<0.001).In both Chinese and American cohorts,we found that the exotropia curriculum saw a small but significant improvement in performance following the flipped classroom session(P=0.025 for Chinese residents;P=0.001 for US residents),whereas scores in both groups for the esotropia course did not significantly improve.CONCLUSION:This is the first study to evaluate the flipped classroom model implemented by a visiting ophthalmology professor in a global outreach setting.The flipped classroom sessions are viewed favorably by the Chinese residents relative to the US cohort with a modest impact on knowledge.Decreased in-person interpreter requirement and increased student engagement make this model valuable in cross-cultural visiting professorship settings.Finally,the flipped classroom may lend itself well to a virtual format to prevent the transmission of COVID-19,although such a format requires further study.

Daily activities and training experiences of urology residents during the coronavirus disease 2019 pandemic in Indonesia: A nationwide survey

Objective:To explore the impact of the coronavirus disease 2019(COVID-19)pandemic on the training experiences of urology residents in Indonesia.Methods:A cross-sectional study using a web-based questionnaire(SurveyMonkey)involved all registered urology residents in Indonesia.The questionnaire was structured in Bahasa Indonesia,composed of 28 questions,and divided into three sections:demographic characteristics,current daily activities,and opinions regarding training experiences during the COVID-19 outbreak.The survey was distributed to all respondents via chief of residents in each urology center from May 26,2020 to Jun 2,2020.Results:Of the total 247 registered urology residents,243 were eligible for the study.The response and completeness rate for this study were 243/243(100%).The median age of respondents was 30(range:24e38)years old,and 92.2%of them were male.Among them,6(2.5%)respondents were confirmed as COVID-19 positive.A decrease in residents’involvement in clinical and surgical activities was distinguishable in endourological and open procedures.Most educational activities were switched to web-based video conferences,while others opted for the in-person method.Smart learning methods,such as joining a national or international speaker webinar or watching a recorded video,were used by 93.8%and 80.7%of the respondents,respectively.The respondents thought that educational activities using web-based video conferences and smart learning methods were effective methods of learning.Overall,the respondents felt unsure whether training experiences during the COVID-19 pandemic were comparable to the respective period before.Conclusion:The COVID-19 pandemic negatively affected urology residents’training experiences.However,it also opened up new possibilities for incorporating new learning methodologies in the future.

“There Are Many Cases That You Carry with You That Leave Scars”: Burnout and Secondary Trauma among Pediatric Residents in Routine and Covid Times

The current research joins previous studies in examining post-traumatic stress disorder (PTSD) and burnout among healthcare workers. The research focuses on the experiences of pediatric residents working in an emergency department both in normal times and during the Covid pandemic. Research conducted prior to and during the Covid pandemic outbreak shows negative psychological effects among healthcare workers. Most of that research was conducted within the positivistic-quantitative paradigm. The current study is qualitative and focuses on pediatric residents who provide medical services to a unique population in a peripheral region of Israel, namely the Bedouin-Arab population. The research questions are the following: What characterizes pediatric residents’ work, in general and during the pandemic? Do they show signs of burnout and secondary trauma? How do they perceive their work with the Bedouin-Arab population, especially during the pandemic? The study, conducted within the phenomenological genre, included 14 pediatric residents in a large hospital in Israel’s periphery. Semi-structured clinical interviews were employed, in addition to questionnaires that examined PTSD and burnout to enhance the reliability of the findings. The results show that all residents reported stressful incidents in which patients’ physical integrity was threatened. The residents described the special nature of the medical cases they treated in routine times and during the pandemic outbreak, which stems mostly from the specific characteristics the population of Israel’s periphery. While at the early stages of the pandemic, the residents experienced reduced work pressure, they reported substantial difficulties later in the crisis, which intensified their sense of physical and emotional stress. Most residents reported feeling inadequately prepared for dealing with traumatic events. According to the results, most residents displayed secondary trauma (12 participants in interviews and 11 in questionnaires), which can be classified into categories based on the DSM-5. In the interviews, all 14 participants reported various signs of burnout. The questionnaires indicated burnout symptoms among 10 participants. Giving a voice to pediatric residents, the study highlights the complexity of their routine work as well as their role during the Covid crisis. Based on the findings, recommendations have been made for policymakers. The study highlights the importance of raising awareness to the implications of the residents’ rough work conditions in routine and emergency times and to the need to develop social support and intervention programs that might improve their well-being during their professional work.

Research on the Influence of the Digital Economy on Transforming Consumption Behavior Among Residents

Drawing on the essence of Marxist consumer economy theory,this paper argues that the innovations of digital technology can effectively facilitate the integration of economies of scale,economies of scope,and long-tail economies.Through careful analysis of the practical case of Xiaomi’s business ecosystem,this paper highlights the notion that data serve as both a key production factor and a critical consumption carrier within the context of digital consumption.We thoroughly investigated the influence of the digital economy on transforming consumption behavior among residents by analyzing a range of typical business cases and the latest data that triggered this transformation.Based on the analysis,this paper argues that such transformation can lead to the platform agglomeration effect,the inclusive diffusion effect,and the push-pull effect by highlighting the specific ways in which the digital economy disrupts the consumption-production model and contributes to the upgrading and transformation of traditional industries.Additionally,this paper demonstrates how the digital economy can expand and promote emerging business forms,providing insights into the ways in which digital innovation is reshaping the contemporary economic landscape.This study intends to provide several policy suggestions that can expand domestic demand,promote consumption,drive the high-quality and integrated development of China’s digital and real economy,and position China as a strong cyber and consumer nation by using digitalized consumption as a starting point.

Study on the Perceived Value of Zhanjiang Residents to Mangrove Cuisine

Taking mangrove cuisine in Zhanjiang as an example,this paper investigates the residents’perceived value of mangrove cuisine through questionnaire survey.The results show that the overall satisfaction of residents on the mangrove cuisine in Zhanjiang is high.The highest satisfaction of residents on the perceived value of mangrove cuisine is the historical and cultural heritage,and the lowest satisfaction is the local characteristics.The main factor affecting the satisfaction is the utility value.Based on the analysis of the present situation and existing problems of mangrove cuisine resources in Zhanjiang,this paper puts forward some countermeasures and suggestions for the sustainable development of mangrove food in Zhanjiang in terms of strengthening government support,increasing public participation awareness,increasing publicity channels,enhancing popularity and reputation,and paying attention to the inheritance of characteristic food culture.

A Study of the Residents’Perception on the Socio-cultural Impact of Coastal Tourism

In the process of tourism development,destination residents,as an important interest group,their perception and attitude towards the impact of tourism has a vital significance to the success of the development of coastal tourism industry.This research studies the perception and attitude to the socio-cultural impact of community residents who live in coastal tourism destination Qingdao through an empirical case study.The results of the study draw that residents’perception of positive influences produce positive effects on their attitude while perception of negative impact generates negative effects.Cluster analysis and descriptive statistical analysis were used to divide Qingdao community residents into four types,namely optimistic supporters,pessimistic opponents,rational supporters,and neutral.Through the different categories of demographic analysis and logistic regression model analysis,the influence degree of residents’subjective factors posed on tourism effect perception has been explored.The research adds a new applied case study for a comprehensive understanding of impacts of coastal tourism destinations.

Understanding livelihood vulnerability:a perspective from Western Sichuan’s ethnic rural settings

To explore the livelihood status and key influencing factors of rural households in the minority areas,we collected flat data from 284 rural households in 32 villages across 12 counties of Western Sichuan from 2021 to 2022.We conducted participatory household survey on the livelihood status of the rural households and try to identify the key factors to influence their livelihood vulnerability using multiple linear regression.The results showed that:the livelihood situation of the rural households is relatively vulnerable.The vulnerability varies significantly with the income levels,education levels,and income sources.The vulnerability of farm households,categorized from low to high livelihood types,follows the sequence:non-agricultural dominant households,non-agricultural households,agricultural dominant households,and pure agricultural households.The degree of damage to the natural environment,education costs,loan opportunities,the proportion of agricultural income to annual household income,and the presence of sick people in the household have significant positive effects on the livelihood vulnerability index(LVI)of rural households;while help from relatives and friends,net income per capita,household size,household education,agricultural land area,participation in industrial organizations,number of livestock,purchase of commercial houses,drinking water source,and self-supply of food have significant negative effects.Based on the findings,we believe that local rural households operate in a complex livelihood system and recommend continuous interventions targeting key influences to provide empirical research support for areas facing similar situations.

The Changes in the Chinese Rural Residents' Residential Structure:Can People's Livelihood be Really Improved?

People's livelihood improvement is the prerequisite of social harmony.Food,clothing shelter and transportation are the direct manifestation of the people's livelihood.In China's vast rural areas,the most significant manifestation of people's livelihood improvement is the improvement of living conditions.Based on the data on two censuses,this paper analyzes the degree of improvement of rural residents'living conditions from the changes in the rural residents'residential structure.Finally this paper puts forth the following recommendations for improving the rural residents'residential structure:continuing to put farmers in the first place;taking truly improving the residential structure as a starting point,and prohibiting the"vanity project";taking preferential policies for the improvement of living conditions.

Geochemical and Isotopic Techniques Constraints on the Origin,Evolution,and Residence Time of Low-enthalpy Geothermal Water in Western Wugongshan,SE China

Geothermal resources are increasingly gaining attention as a competitive,clean energy source to address the energy crisis and mitigate climate change.The Wugongshan area,situated in the southeast coast geothermal belt of China,is a typical geothermal anomaly and contains abundant medium-and low-temperature geothermal resources.This study employed hydrogeochemical and isotopic techniques to explore the cyclic evolution of geothermal water in the western Wugongshan region,encompassing the recharge origin,water-rock interaction mechanisms,and residence time.The results show that the geothermal water in the western region of Wugongshan is weakly alkaline,with low enthalpy and mineralization levels.The hydrochemistry of geothermal waters is dominated by Na-HCO_(3)and Na-SO_(4),while the hydrochemistry types of cold springs are all Na-HCO_(3).The hydrochemistry types of surface waters and rain waters are NaHCO_(3)or Ca-HCO_(3).The δD and δ^(18)O values reveal that the geothermal waters are recharged by atmospheric precipitation at an altitude between 550.0 and 1218.6 m.Molar ratios of maj or solutes and isotopic compositions of^(87)Sr/^(86)Sr underscore the significant role of silicate weathering,dissolution,and cation exchange in controlling geothermal water chemistry.Additionally,geothermal waters experienced varying degrees of mixing with cold water during their ascent.Theδ^(13)C values suggest that the primary sources of carbon in the geothermal waters were biogenic and organic.Theδ^(34)S value suggests that the sulfates in geothermal water originate from sulfide minerals in the surrounding rock.Age dating using 3H and^(14)C isotopes suggests that geothermal waters have a residence time exceeding 1 kaBP and undergo a long-distance cycling process.

Livelihood Vulnerability and Adaptation for Households Engaged in Forestry in Ecological Restoration Areas of the Chinese Loess Plateau

Chinese Loess Plateau has achieved a win-win situation concerning ecological restoration and socio-economic development.However,synergistic development may not be realized at the local scale.In areas undergoing ecological restoration,livelihood vulner-ability may be more pronounced due to the inflexibility,policy protection,and susceptibility to climate and market changes in forestry production.Although this issue has attracted academic interest,empirical studies are relatively scarce.This study,centered on Jiaxian County,Shaanxi Province of China explored the households’livelihood vulnerability and coping strategies and group heterogeneity con-cerned with livelihood structures or forestry resources through field investigation,comprehensive index assessment,and nonparametric tests.Findings showed that:1)the percentage of households with high livelihood vulnerability indicator(LVI)(>0.491)reached 46.34%.2)Eight groups in livelihood structures formed by forestry,traditional agriculture,and non-farm activities were significantly different in LVI,land resources(LR),social networks(SN),livelihood strategies(LS),housing characteristics(HC),and socio-demo-graphic profile(SDP).3)The livelihood vulnerability of the groups with highly engaged/reliance on jujube(Ziziphus jujuba)forest demonstrated more prominent livelihood vulnerability due to the increased precipitation and cold market,where the low-engaged with reliance type were significantly more vulnerable in LVI,SDP,LR,and HC.4)The threshold of behavioral triggers widely varied,and farmers dependent on forestry livelihoods showed negative coping behavior.Specifically,the cutting behavior was strongly associated with lagged years and government subsidies,guidance,and high returns of crops.Finally,the findings can provide guidance on the dir-ection of livelihood vulnerability mitigation and adaptive government management in ecologically restored areas.The issue of farmers’livelihood sustainability in the context of ecological conservation calls for immediate attention,and eco-compensations or other forms of assistance in ecologically functional areas are expected to be enhanced and diversified.

Disparities across the CREOG Districts —Variations of Wellness and Inclusivity Efforts in Obstetrics & Gynecology Residency Websites between Two Consecutive Years

Background: Few studies have focused on the geographic and chronologic assessment of inclusivity and wellness in Obstetrics and Gynecology residency websites across the US. Objective: To identify variations in wellness and inclusivity website depictions across CREOG districts over the past two years. Methods: This is a cross-sectional analysis of the websites of ACGME-accredited OB/GYN residency programs across the United States between April 2022 and April 2023. The assessment was based on a compilation of 22 attributes devised and piloted by 49 medical students. A racially, geographically, and gender-diverse cohort of 11 students performed data collection. Results: A total of 560 websites were analyzed over two years. Wellness efforts remained unchanged in both years (website content, dedicated support personnel, and group activities). In 2023, a reduction in referencing of wellness (22%) and inclusivity (30%) occurred in leadership messaging. However, a 7% increase in the use of inclusive pronouns was noted. A reduction in gender diversity was identified (9% in faculty, 5% in residents), with programs favoring female-only teams. Similarly, a 7% reduction in the number of underrepresented in medicine faculty and residents was noted. A 15% reduction was noted in curricula referencing inclusivity in their mission statement and inclusivity focused research. Conclusions: This study suggests the variations across websites relative to inclusivity and wellness over the past two years. Updated websites may provide an accurate reflection of the offerings of programs and their investment in wellness and inclusivity across the nation.

Climatic and non-climatic factors driving the livelihood vulnerability of smallholder farmers in Ahafo Ano North District,Ghana

Smallholder farmers in Ahafo Ano North District,Ghana,face multiple climatic and non-climatic issues.This study assessed the factors contributing to the livelihood vulnerability of smallholder farmers in this district by household surveys with 200 respondents and focus group discussions(FGDs)with 10 respondents.The Mann–Kendall trend test was used to assess mean annual rainfall and temperature trends from 2002 to 2022.The relative importance index(RII)value was used to rank the climatic and non-climatic factors perceived by respondents.The socioeconomic characteristics affecting smallholder farmers’perceptions of climatic and non-climatic factors were evaluated by the binary logistic regression model.Results showed that mean annual rainfall decreased(P>0.05)but mean annual temperature significantly increased(P<0.05)from 2002 to 2022 in the district.The key climatic factors perceived by smallholder farmers were extreme heat or increasing temperature(RII=0.498),erratic rainfall(RII=0.485),and increased windstorms(RII=0.475).The critical non-climatic factors were high cost of farm inputs(RII=0.485),high cost of healthcare(RII=0.435),and poor condition of roads to farms(RII=0.415).Smallholder farmers’perceptions of climatic and non-climatic factors were significantly affected by their socioeconomic characteristics(P<0.05).This study concluded that these factors negatively impact the livelihoods and well-being of smallholder farmers and socioeconomic characteristics influence their perceptions of these factors.Therefore,to enhance the resilience of smallholder farmers to climate change,it is necessary to adopt a comprehensive and context-specific approach that accounts for climatic and non-climatic factors.

Effectiveness of Participatory Teaching Methods in the Standardized Training of Respiratory Medicine Residents

Objective:To explore and analyze the application effect of participatory teaching method in the standardized training of respiratory medicine residents.Methods:The study period was from May 2022 to May 2023.20 doctors in the standardized training of respiratory medicine residency in our hospital were taken as research subjects and grouped into the participatory group(n=10)and the routine group(n=10)by using the random number lottery method.The participatory group practised participatory teaching methods,and the routine group practised routine teaching methods.The results of discharge assessment,teaching evaluation,and mini-Clinical Evaluation Exercise(mini-CEX)assessment were compared between the groups.Results:The theoretical assessment,operational assessment,and total scores of the participatory group were significantly higher than those of the routine group,and the difference was statistically significant(P<0.05).The teaching evaluation of independent learning,theoretical mastery,teamwork,clinical thinking,communication,and learning interest of the participatory group was significantly higher than that of the routine group,and the difference was statistically significant(P<0.05).The mini-CEX assessments of history inquiry,organizational effectiveness,professionalism,physical examination,clinical diagnosis,communication skills,and overall clinical competence of the participatory group were significantly better than those of the routine group,and the difference was statistically significant(P<0.05).The teaching satisfaction of the participatory group was significantly higher than that of the routine group,the difference was statistically significant(P<0.05).Conclusion:Participatory teaching methods can improve the overall level of doctors in the respiratory medicine residency standardized training,and the teaching satisfaction is improved.