The coronavirus pandemic exposed the systemic issues faced by nursing homes with a higher percentage of Medicaid residents. By using the Brown University's Long-Term Care focus facility-level data and the Centers for Medicare and Medicaid Services data, the study examines the association between the nursing home and resident characteristics with Covid-19 cases in high-Medicaid nursing homes. Fifty-eight facilities in Florida were identified as having residents whose primary support was Medicaid. The findings from the study suggest a higher proportion of Medicaid residents, for-profit status, and chain affiliation status, were associated with a higher prevalence of Covid-19 cases among nursing home residents. Further research on related health policies is necessary to resolve the current disparities in nursing home care serving a higher proportion of Medicaid residents.

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京都大学 / 新制・課程博士 / 博士(地球環境学) / 甲第24062号 / 地環博第225号 / 新制||地環||43(附属図書館) / 京都大学大学院地球環境学舎地球環境学専攻 / (主査)講師 BAARS ROGER CLOUD, 教授 宇佐美 誠, 准教授 落合 知帆, 准教授 TRENCHER Gregory / 学位規則第4条第1項該当 / Doctor of Global Environmental Studies / Kyoto University / DFAM

Three years ago, our residency program began a new approach to teaching practice management to our second- and third-year residents. The underlying principles for the new curriculum involved a realization that our residents lacked basic business understanding and that they would likely learn more effectively through a hands-on approach.The newcurriculum, which we describe in this article, is in large part built around the establishment of a mockpractice during thesecond year ofresidency. Although the curriculum is still evolving, initial response and evaluation have been encouraging.

The memory of expulsions among the expelling groups has been fairly studied, and has potential to create new conflicts. This qualitative study uses in-depth interviews to describe the memory of the 6-7 September events and the Greek minority in Istanbul among a group of Turkish descent people living in Beyoglu, Istanbul. Further the study compares the memory with the written history and explains why the memories of the past are shaped according to the present. The Greek minority of Istanbul are remembered in words of friendship and neighbourliness, but these memories are rather a nostalgia of the past for present needs than an image of the past itself. The memories of the events among the studied group are dominated by the general destruction occasioned by the riots but tend to contradict the violence towards the Greek minority. There exists a discrepancy between the memory and the written history concerning the acts of violence during the riots, the underlying causes of the riots and the period after the events. This article explains the reconstructed memory as a product of strategies for avoiding the experience of collective guilt.

In the 1990's the Accreditation Council for Graduate Medical Education (ACGME) recognized a need to fully integrate learning outcomes assessment into the accreditation process for resident physician training programs. ACGME leaders had concluded that by increasing emphasis on curricular development and by evaluating student performance through measurement of learning outcomes, the accreditation process would become a more reliable predictor of the residency program's success. In 1994 the ACGME created an initiative that would transform the current accreditation model of minimum threshold requirements towards a student performance based model of improved learning outcomes based on curricular development. responsible for the accreditation of over 8037 physician residency training programs in the United States. One hundred fifty of these programs provide training in the specialty of pathology and its anatomic and clinical sub-disciplines (AMA , 2007). Concurrent with the beginning of the ACGME Outcomes Project (1994) , four major pathology education groups in North America entered into a collaboration to improve the quality of pathology resident training. Their focus encompassed improvements in both clinical and managerial skills . The findings of this joint study culminated in the publishing of the Graylyn Conference Report in 1995 (Smith et al., 2006). One of the major recommendations in the report was that resident training in clinical laboratory administration should be improved. National leaders in pathology education felt that these changes were necessary to accommodate the evolving role of the pathologist as a clinical and administrative leader in a rapidly changing health care delivery setting. Prior to this current investigation, no studies appear to exist that provide an in-depth analysis of the perceptions of the residency directors about the need of expanded training in laboratory administration. This quantitative study has evaluated the amount of time and priority given to managerial training, the inclusion of administration topics in the curriculum and the extent of learning outcomes assessment in administration that residency program directors believe are being linked to successful professional performance in recent graduates . / Educational Administration

Les résidents en chirurgie passent plus de la moitié de leur formation dans une salle d’opération dans le but d’acquérir les connaissances ainsi que les habiletés techniques nécessaires afin de développer l’autonomie la plus complète possible (Vollmer, Newman, Huang, Irish, Hurst, et Horvath, 2011). Cependant, certaines préoccupations sont éprouvées par ceux-ci face à la capacité d’effectuer certaines procédures de façon indépendante en fin de formation (Yeo, Viola, Berg, Lin, Nunez-Smith, Cammann, Bell, Sosa, Krumholz, Curry, 2009). Bien que les besoins en termes d’acquisition de techniques chirurgicales soient connus, les stratégies de supervision pour y arriver le sont moins. Certaines études ont d’ailleurs démontré une disparité dans la perception de l’enseignement et de la supervision entre les résidents chirurgicaux et les cliniciens enseignants (Levinson, Barlin et al. 2010, Vollmer, Newman et al. 2011, Snyder, Tarpley et al. 2012, Chen, Williams et al. 2014). Les différences entre les résidents chirurgicaux et les chirurgiens-enseignants des universités francophones québécoises dans la perception de la supervision ont donc été étudiées à différents niveaux et selon différentes dimensions pédagogiques, basé sur les modèles d’apprentissage cognitif ainsi que d’acquisition de compétence de Dreyfus & Dreyfus. Trente-quatre résidents et 59 chirurgiens de différents programmes chirurgicaux des universités francophones québécoises ont pris part à un questionnaire validé de type miroir basé sur une échelle de Likert. Les résultats obtenus démontrent une surestimation des chirurgiens quant à leur perception auto-évaluative de la supervision accordée en ce qui a trait à la sphère pré-opératoire. Ainsi, cela nous amène à croire qu’il y aurait potentiellement de lacunes en termes de supervision à ce niveau. / Surgical residents spend more than half of their training in an operating room with the goal of acquiring the knowledge and technical skills necessary to develop the most complete autonomy (Vollmer, Newman, Huang, Irish, Hurst, and Horvath, 2011). However, some residents express concerns about their ability to perform certain procedures independently at the end of their training (Yeo, Viola, Berg, Lin, Nunez-Smith, Cammann, Bell, Sosa, Krumholz, Curry, 2009). While the needs for acquiring surgical techniques are understood, the supervisory strategies for achieving them are less clear. Some studies have demonstrated a disparity in the perception of teaching and supervision between surgical residents and clinical supervisors (Levinson, Barlin et al. 2010, Vollmer, Newman et al. 2011, Snyder, Tarpley et al. 2012, Chen, Williams et al. 2014). Disparity between surgical residents and attendings in perception of surgical supervision was therefore studied at different surgical levels and according to various pedagogical dimensions, based on the cognitive companionship model as well as Dreyfus & Dreyfus’ competence acquisition learning model. Thirty-four residents and 59 surgeons from French affiliated surgical programs of Quebec participated in a validated mirror-type questionnaire based on a Likert scale. The results obtained show an overestimation by surgeons of their self-evaluative perception of the supervision provided in the preoperative sphere. Thus, this leads us to believe that there may potentially be gaps in supervision at this level that would benefit further exploration.