Sense of Belonging Among Medical Students, Residents, and Fellows: Associations With Burnout, Recruitment Retention, and Learning Environment.

Purpose: This study examines sense of belonging (belongingness) in a large population of medical students, residents, and fellows and associations with learner burnout, organizational recruitment retention indicators, and potentially modifiable learning environment factors.

Method: All medical students, residents, and fellows at Mayo Clinic sites were surveyed between October and November 2020 with items measuring sense of belonging in 3 contexts (school or program, organization, and surrounding community), burnout (2 Maslach Burnout Inventory items), recruitment retention indicators (likelihood of recommending the organization and accepting a job offer), potentially modifiable learning environment factors, and demographic factors (age, gender, race and ethnicity, LGBTQ+ identification, disability, and socioeconomic background).

Results: Of 2,257 learners surveyed, 1,261 (56%) responded.

Academic Promotions in Medicine: An Appraisal of Fairness.

Objective: To investigate whether the process of conferring academic rank or components of the promotion packet contribute to the lack of parity in academic advancement for women and individuals underrepresented in medicine (URMs).

Patients And Methods: We retrospectively reviewed prospective promotion applications to the position of associate professor or professor at Mayo Clinic from January 2, 2015, through July 1, 2019. Individuals with doctorate degrees who applied for either rank were included in the study.

Increasing Inclusion, Diversity, Antiracism, and Equity With a Medical School Curriculum Quality Improvement Project.

The students at Mayo Clinic Alix School of Medicine (MCASOM) wrote a call to action to medical school leadership in June 2020. The students requested help in navigating socio-political barriers that affected one another and contributed to healthcare inequities and mistrust. Using the Association of American Medical Colleges (AAMC) tool to assess cultural competence training, our team evaluated the baseline 2017-2018 MCASOM curriculum.

Mission Drift: Are Medical School Admissions Committees Missing the Mark on Diversity?

Diversity initiatives in U.S. medical education, following the passage of the Civil Rights Act of 1964, were geared toward increasing the representation of African Americans-blacks born in the United States whose ancestors suffered under slavery and Jim Crow laws.

Clinical decision support. How CDS tools impact patient care outcomes.

Clinical decision support tools are important components of the electronic health record and can directly improve patient care outcomes and the performance of healthcare organizations. These tools can be used within order sets, electronic alerts, reference materials that are readily available, reports related to patient data, as well as clinical guidelines that were developed by regulatory agencies The development and use of CDS tools at the point of care offers clinicians the ability to analyze and work with patient data in real-time while making critical decisions. In the future, CDS tools will be important when changes in financial reimbursement related to patient care outcomes become the primary focus for many insurance-related organizations.

Incidence and prognosis of early hepatic dysfunction in critically ill patients--a prospective multicenter study.

Objective: In critically ill patients, hepatic dysfunction is regarded as a late organ failure associated with poor prognosis. We investigated the incidence and prognostic implications of early hepatic dysfunction (serum bilirubin >2 mg/dL within 48 hrs of admission).

Design: Prospective, multicenter cohort study.

Predictors of early recovery of health status after intensive care.

Objective: To identify factors predictive of good or poor recovery of health status and health-related quality of life (HRQOL) 90 days after admission to an intensive care unit (ICU).

Design And Setting: Prospective international multicentre study in 19 ICUs participating in the HRQOL substudy of the SAPS 3 project.

Intervention: The EuroQol questionnaire (EQ) was administered to discharged ICU patients 90 days after admission.

Estrogen receptor alpha gene variation is associated with risk of myocardial infarction in more than seven thousand men from five cohorts.

Understanding the mechanisms by which estrogens affect cardiovascular disease risk, including the role of variation in the gene for estrogen receptor alpha (ESR1), may be key to new treatment strategies. We investigated whether the CC genotype at ESR1 c.454-397T>C is associated with increased risk among men.

SAPS 3--From evaluation of the patient to evaluation of the intensive care unit. Part 1: Objectives, methods and cohort description.

Objective: Risk adjustment systems now in use were developed more than a decade ago and lack prognostic performance. Objective of the SAPS 3 study was to collect data about risk factors and outcomes in a heterogeneous cohort of intensive care unit (ICU) patients, in order to develop a new, improved model for risk adjustment.

Design: Prospective multicentre, multinational cohort study.

SAPS 3--From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admission.

Objective: To develop a model to assess severity of illness and predict vital status at hospital discharge based on ICU admission data.

Design: Prospective multicentre, multinational cohort study.

Patients And Setting: A total of 16,784 patients consecutively admitted to 303 intensive care units from 14 October to 15 December 2002.

The effect of 6 months training on leg power, balance, and functional mobility of independently living adults over 70 years old.

Where strength training has been used in conjunction with functional-task training in older people, not only have there been improvements in leg strength but also improved function has been measured (e.g., Skelton & McLaughlin, 1996).

Improving risk adjustment in critically ill trauma patients: the TRISS-SAPS Score.

Objectives: To test (a) the prognostic performance of TRISS and SAPS II scoring systems in a large sample of trauma patients admitted to Austrian ICUs, and (b) the hypothesis that the prognostic performance of TRISS could be improved by adding SAPS II.

Methods: Prospective multicenter cohort study comprising 5,538 trauma patients out of 35,637 patients admitted to 31 ICUs in Austria over a 4-year period.

Results: Separately, TRISS and SAPS II showed lack of calibration in the cohort of trauma patients.

More interventions do not necessarily improve outcome in critically ill patients.

Objective: The organizational structure of health care facilities has been shown to affect outcome in critically ill patients. We evaluated the association between structures, treatments and outcomes in a large cohort of critically ill patients.

Design: Prospective multicentre cohort study.

Gender-related differences in intensive care: a multiple-center cohort study of therapeutic interventions and outcome in critically ill patients.

Objective: To determine whether gender-related differences exist in the provided level of care and outcome in a large cohort of critically ill patients.

Design: Prospective, observational cohort study with data collection from January 1, 1998, to December 31, 2000.

Setting: Thirty-one intensive care units in Austria.

Genetic diversity of Eurycoma longifolia inferred from single nucleotide polymorphisms.

Eurycoma longifolia Jack. is a treelet that grows in the forests of Southeast Asia and is widely used throughout the region because of its reported medicinal properties. Widespread harvesting of wild-grown trees has led to rapid thinning of natural populations, causing a potential decrease in genetic diversity among E.

Critically ill patients readmitted to intensive care units--lessons to learn?

Objective: To evaluate risk factors in critically ill patients who were readmitted to an intensive care unit (ICU) during their hospital stay.

Design: Prospective multicenter cohort study.

Patients And Setting: A total of 15180 patients discharged from 30 medical, surgical and mixed ICUs in Austria over a 2-year period.

Genome complexity reduction for SNP genotyping analysis.

Efficient single nucleotide polymorphism (SNP) genotyping methods are necessary to accomplish many current gene discovery goals. A crucial element in large-scale SNP genotyping is the number of individual biochemical reactions that must be performed. An efficient method that can be used to simultaneously amplify a set of genetic loci across a genome with high reliability can provide a valuable tool for large-scale SNP genotyping studies.