The Burden of Burnout: An Assessment of Burnout Among Internal Medicine Residents After the 2011 Duty Hour Changes.

This study sought to determine burnout prevalence and factors associated with burnout in internal medicine residents after introduction of the 2011 ACGME duty hour rules. Burnout was evaluated using an anonymized, abbreviated version of the Maslach Burnout Inventory. Surveys were collected biweekly for 48 weeks during the 2013-2014 academic year. Burnout severity was compared across subgroups and time. A score of 3 or higher signified burnout. Overall, 944 of 3936 (24%) surveys were completed. The mean burnout score across all surveys was 2.8. Categorical residents had higher burnout severity than noncategorical residents (2.9 vs 2.7, P = .005). Postgraduate year 2 residents had the highest burnout severity by year (3.1, P < .001). Residents on inpatient rotations had higher burnout severity than residents on outpatient or consultation rotations (3.1 vs 2.2 vs 2.2, P < .001). Night float rotations had the highest severity (3.8). Burnout remains a significant problem even with recent duty hour modifications.

Reporting on data monitoring committees in neonatal randomised controlled trials is inconsistent

Aim: To evaluate the reported use of Data Monitoring Committees (DMCs), the frequency of interim analysis, pre-specified stopping rules and early trial termination in neonatal randomised controlled trials (RCTs). Methods: We reviewed neonatal RCTs published in four high impact general medical journals, specifically looking at safety issues including documented involvement of a DMC, stated interim analysis, stopping rules and early trial termination. We searched all journal issues over an 11-year period (2003-2013) and recorded predefined parameters on each item for RCTs meeting inclusion criteria. Results: Seventy neonatal trials were identified in four general medical journals: Lancet, New England Journal of Medicine (NEJM), British Medical Journal and Journal of American Medical Association (JAMA). 43 (61.4%) studies reported the presence of a DMC, 36 (51.4%) explicitly mentioned interim analysis; stopping rules were reported in 15 (21.4%) RCTs and 7 (10%) trials were terminated early. The NEJM most frequently reported these parameters compared to the other three journals reviewed. Conclusion: While the majority of neonatal RCTs report on DMC involvement and interim analysis there is still scope for improvement. Clear documentation of safety related issues should be a central component of reporting in neonatal trials involving newborn infants.

Can Compensation Committees Effectively Mitigate the CEO Horizon Problem? The Role of Co-opted Directors

Extant research finds inconclusive evidence about the CEO horizon problem. One possibility is that compensation committees design CEO compensation in a way that discourages retiring CEOs from opportunistic earnings management and R&D reduction. However, compensation committees dominated by co-opted directors may not be as effective as those with fewer co-opted directors in mitigating the CEO horizon problem, because directors co-opted by the CEO tend to bias their decisions in favor of the CEO. I find that compensation committees dominated by co-opted directors are associated with higher CEO compensation packages. I document R&D reduction and accruals management in firms with retiring CEOs and compensation committees dominated by co-opted directors, and find that R&D reduction and income-increasing accruals are less discouraged by compensation committees dominated by co-opted directors when deciding CEO compensation. I also examine the effect of boards of directors and compensation committee characteristics on CEO compensation and on mitigating the CEO horizon problem. I find that CEO compensation positively associates with CEO power, director independence, and the percentage of busy directors, and negatively associates with board of directors and committee size and director ownership. Moreover, I find that retiring CEOs are more likely to reduce R&D expenditures when CEOs have more power, and director tenure is longer; retiring CEOs in firms with large boards of directors and compensation committees are less likely to manage accruals.

Circular migration and the Internet: The role of social networks in the sociocultural context of Mexican residents in Barcelona

This work focuses on the study of the circular migration between America and Europe, particularly in the discussion about knowledge transfer and the way that social networks reconfigure the form of information distribution among people, that due to labor and academic issues have left their own country. The main purpose of this work is to study the impact of social media use in migration flows between Mexico and Spain, more specifically the use by Mexican migrants who have moved for  multiple years principally for educational purposes and then have returned to their respective locations in Mexico seeking to integrate themselves into the labor market. Our data collection concentrated exclusively on a group created on Facebook by Mexicans who mostly reside in Barcelona, Spain or wish to travel to the city for economic, educational or tourist reasons.  The results of this research show that while social networks are spaces for exchange and integration, there is a clear tendency by this group to "narrow lines" and to look back to their homeland, slowing the process of opening socially in their new context.

Mental Health and Morbidity of Caregivers and Co-Residents of individuals with Dementia: A Quasi-Experimental Design

Objectives: To determine if providing informal care to a co-resident with dementia symptoms places an additional risk on the likelihood of poor mental health or mortality compared to co-resident non-caregivers.
Design: A quasi-experimental design of caregiving and non-caregiving co-residents of individuals with dementia symptoms, providing a natural comparator for the additive effects of caregiving on top of living with an individual with dementia symptoms. 
Methods: Census records, providing information on household structure, intensity of caregiving, presence of dementia symptoms and self-reported mental health, were linked to mortality records over the following 33 months. Multi-level regression models were constructed to determine the risk of poor mental health and death in co-resident caregivers of individuals with dementia symptoms compared to co-resident non-caregivers, adjusting for the clustering of individuals within households.
Results: The cohort consisted of 10,982 co-residents (55.1% caregivers), with 12.1% of non-caregivers reporting poor mental health compared to 8.4% of intense caregivers (>20 hours of care per week). During follow-up the cohort experienced 560 deaths (245 to caregivers). Overall, caregiving co-residents were at no greater risk of poor mental health but had lower mortality risk than non-caregiving co-residents (ORadj=0.93, 95% CI 0.79, 1.10 and ORadj=0.67, 95% CI 0.56, 0.81, respectively); this lower mortality risk was also seen amongst the most intensive caregivers (ORadj=0.65, 95% CI 0.53, 0.79).
Conclusion: Caregiving poses no additional risk to mental health over and above the risk associated with merely living with someone with dementia, and is associated with a lower mortality risk compared to non-caregiving co-residents.

Tourism Impacts of a Portuguese World Heritage Historic Center: Residents’ Perspectives

The World Heritage List (WHL) is widely considered a powerful tool for national tourism campaigns. Sites inscribed on the WHL by the United Nations Educational, Scientific, and Cultural Organization (UNESCO) are commonly treated as catholicons in promoting the tourism industry, which in turn helps to promote economic growth and development. This study analyzes local community perceptions of the importance of the World Heritage Site (WHS) classification of the historic center of the Portuguese city of E ́vora. The research also includes an analysis of the local residents’ perceived tourism impacts on the municipality of E ́ vora. The methodology consists of quan- titative research based on a self-administered survey applied to convenience sam- ples of local residents of the municipality of E ́ vora in the beginning of 2014. The local residents’ perceptions of the level of importance of the WHS classification to the municipality and its impact in the increase of tourists is analyzed. Positive and negative tourism impacts are then ranked and a principal components factor analysis is employed separately to the two groups of impacts in order to identify underlying dimensions associated with residents’ perceptions on tourism develop- ment. Based on the results of the factor analysis, independent sample t-tests are used to investigate differences regarding positive and negative tourism impacts between residents that live near and far from the historic center, and between residents who work/have worked in the tourism sector and residents that work/ have worked in other sectors.

Resident’s Perceptions on Impacts of Hosting the Guimaraes 2012 European Capital of Culture: Comparisons of the Pre- and Post Periods

Residents tend to have high expectations regarding the benefits of hosting a mega- event, in particular the creation of new infrastructure, growth in GDP and employ- ment, image enhancement and the spin-offs of attracting tourists and fostering sustainable growth of the cultural supply (Jeong and Faulkner 1996; Deccio and Baloglu 2002; Gursoy and Kendall 2006; Getz 2008; Langen and Garcia 2009; Ritchie et al. 2009; Gursoy et al. 2011; Palonen 2011). Nevertheless, they normally recognise that some costs will be incurred (Kim and Petrick 2005; Kim et al. 2006; Ritchie et al. 2009; Gursoy et al. 2011; Lee et al. 2013). So, it was not surprising that the nomination of Guimaraes, a small city in the northwest of Portugal, as one of the two European Capitals of Culture in 2012 (2012 ECOC), had raised great expectations in the local community vis- a-vis its socio-economic and cultural benefits. Our research was designed to examine the Guimar~aes residents’ perceptions of the impacts of hosting the 2012 ECOC, approached at two different times: before and after the event, to try and capture the evolution of the residents’ assessment of its impacts. From the empirical literature, we know that residents’ perceived impacts tend to change as time goes by (Kim et al. 2006; Ritchie et al. 2009; Gursoy et al. 2011; Lee et al. 2013). The data were gathered via two surveys applied to Guimaraes residents, one in 2011, before the event, and the other afterwards, in 2013. The Guimaraes residents’ assessment was thought to be essential to get an accurate appraisal of the impact of the mega-event as they were a main part of the hosting process. 2012 ECOC impacts were mainly felt by local people who, in most cases, will go on feeling them in the short and long term. The research was thought to be socially pertinent as the opinions collected through the surveys can help to prevent repeating mistakes when similar mega- events are organised in the future, and to increase the positive impacts derived from hosting them. When we talk about the social pertinence of the empirical results, we want to stress that the expertise acquired can be useful to any host city or country.

Motivating residents to combat invasive species on private lands: social norms and community reciprocity

Invasive species (IS) threaten biodiversity and ecosystem functioning. To achieve landscape-scale reductions in IS and the associated gains for biodiversity, IS control efforts must be expanded across private lands. Enhancing IS control across private lands requires an understanding of the factors that motivate residents to engage or prohibit residents from engaging in efforts to control IS. Drawing from the collective interest model and literature, we sought to understand how a wide range of interpersonal, intrapersonal, and contextual factors might influence resident action around combating the invasive tree albizia (Falcataria moluccana), in the Puna District of Hawaiʻi. To do so, we used a cross-sectional survey of 243 residents and elastic net regression techniques. We found that residents’ actions related to IS control were related to their perceptions of social norms and community reciprocity regarding albizia control, as well as their knowledge of effective control strategies and their risk perceptions regarding albizia. These findings suggest that, although common intervention approaches that focus on providing education or subsidies are important, they may be more effective at reducing the spread of IS if coupled with approaches that build community reciprocity and norms.

Rights of Residents in Long-Term Care Facilities, May 19, 2015

Explanation of the rights of resident in Long-Term care facilities.

Right of Long-Term Care Residents/Tenants to Participate in Research Studies, November 12, 2015

Explanation of the right of Long-Term Care residents or tenants to participate in research studies. Includes the guidelines for participation.

Sexual Expression among Long-Term Care Residents, September 27, 2013

Sexuality among the aging traditionally been overlooked. It is gaining recognition as an important factor in lives of older adults and part of the aging process. Preserving residents' right to freedom of sexual expression in the long-term care environment is important part of the resident-centered care & residents' rights

Nursing Home: Residents on Medicare, November 4, 2013

Important Information About Drug Coverage For Nursing Home Residents on Medicare. While you live in a nursing home you can enroll in, or change, Medicare drug plans at ANY TIME with SHIIP help.

Should data monitoring committees assess efficacy when considering safety in trails in acute stroke?

The primary role of a trials Data Monitoring Committee (DMC) is to ensure the safety of enrolled patients. In stroke trials, safety is monitored typically by comparing death and stroke specific events between treatment groups. DMCs may also have the remit for monitoring efficacy depending on the aims of the trial. We hypothesised that functional outcome at end of follow-up, a measure of efficacy, is also a powerful measure of safety and tested this in a systematic review