Academic Career Exploration: Learner Opportunities Through the Office of Faculty Affairs.

Introduction: Early exposure to medical school offices can help to facilitate interest in academic medicine and senior leadership positions. This workshop provides an overview of the roles, responsibilities, and activities within the Office of Faculty Affairs (OFA) and highlights opportunities for trainee engagement and leadership.

Methods: The Kern model was applied in the design of a 60-minute interactive module for medical students.

Public and Population Health in U.S. Medical Education: A Review of Guidance in Extraordinary Times.

Generations of medical educators have recommended including public and population health (PPH) content in the training of U.S. physicians.

Women and citizenship post-trafficking: the case of Nepal.

This article analyses the relationship between gender, sexuality and citizenship embedded in models of citizenship in the Global South, specifically in South Asia, and the meanings associated with having - or not having - citizenship. It does this through an examination of women's access to citizenship in Nepal in the context of the construction of the emergent nation state in the 'new' Nepal 'post-conflict'. Our analysis explores gendered and sexualized constructions of citizenship in this context through a specific focus on women who have experienced trafficking, and are beginning to organize around rights to sustainable livelihoods and actively lobby for changes in citizenship rules which discriminate against women.

Complications and Safety of Preconception Low-Dose Aspirin Among Women With Prior Pregnancy Losses.

Objective: To evaluate complications and safety of preconception low-dose aspirin in 1,228 U.S. women (2007-2011).

Expanded findings from a randomized controlled trial of preconception low-dose aspirin and pregnancy loss.

Study Question: What is the association between daily preconception-initiated low-dose aspirin (LDA) treatment and very early pregnancy losses or euploid (chromosomally normal) losses among women with one to two prior losses?

Summary Answer: Daily LDA initiated preconception was not associated with the rate or type of pregnancy loss among women with a history of one to two prior pregnancy losses.

What Is Known Already: LDA is often used to treat recurrent pregnancy loss with reductions in pregnancy loss generally only observed among women with antiphospholipid antibodies, and null associations observed among women without antiphospholipid antibodies. We previously evaluated the association between LDA and pregnancy loss overall among women with one to two prior losses in the Effects of Aspirin in Gestation and Reproduction (EAGeR) trial and found no association, though did not distinguish between potential effects at different stages of pregnancy loss, including implantation failure, or between euploid and aneuploid losses.

Promoting Faculty Scholarship - An evaluation of a program for busy clinician-educators.

Background: Clinician educators face barriers to scholarship including lack of time, insufficient skills, and access to mentoring. An urban department of family medicine implemented a federally funded Scholars Program to increase the participants' perceived confidence, knowledge and skills to conduct educational research.

Method: A part-time faculty development model provided modest protected time for one year to busy clinician educators.

Sex ratio following preconception low-dose aspirin in women with prior pregnancy loss.

Background: Several lines of evidence suggest that male embryos may have greater vulnerability than female embryos to disordered inflammation; therefore, antiinflammatory drugs, such as low-dose aspirin (LDA), may alter the sex ratio. Here, we assessed the effect of LDA on male live birth and male offspring, incorporating pregnancy losses (n = 56) via genetic assessment, as part of a parallel-design, block-randomized, placebo-controlled trial of preconception LDA.

Methods: Participants (615 treated with LDA, 613 treated with placebo) ranged in age from 18 to 40 years of age, with 1 to 2 prior pregnancy losses.

Low-dose aspirin and preterm birth: a randomized controlled trial.

Objective: To evaluate the association between low-dose aspirin initiated before conception and the risk of preterm birth.

Methods: This was a secondary analysis of the Effects of Aspirin in Gestation and Reproduction trial. Women with a history of pregnancy loss (original stratum: one loss less than 20 weeks of gestation during the previous year; expanded stratum: one or two losses with no restrictions on timing or gestational age of the losses) were randomized to either daily low-dose aspirin (81 mg, n=615) and folic acid or folic acid alone (placebo; n=613).

Preconception low dose aspirin and time to pregnancy: findings from the effects of aspirin in gestation and reproduction randomized trial.

Objective: The objective was to determine the effect of preconception-initiated daily low-dose aspirin (LDA; 81 mg/day) treatment on time to pregnancy in women with a history of pregnancy loss.

Design: This was a multicenter, block-randomized, double-blind, placebo-controlled trial. Participants were block-randomized by center and eligibility stratum.

Recruitment for longitudinal, randomised pregnancy trials initiated preconception: lessons from the effects of aspirin in gestation and reproduction trial.

Background: Recruitment into large, preconception randomised clinical trials (RCT) is challenging. We describe clinic and community-based preconception recruitment strategies for the Effects of Aspirin in Gestation and Reproduction (EAGeR) trial and highlight approaches that were and were not successful. This longitudinal RCT was conducted at four major sites in the US.

The effect of a very short interpregnancy interval and pregnancy outcomes following a previous pregnancy loss.

Objective: We sought to assess the relationship between a short interpregnancy interval (IPI) following a pregnancy loss and subsequent live birth and pregnancy outcomes.

Study Design: A secondary analysis of women enrolled in the Effects of Aspirin in Gestation and Reproduction trial with a human chorionic gonadotropin-positive pregnancy test and whose last reproductive outcome was a loss were included in this analysis (n = 677). IPI was defined as the time between last pregnancy loss and last menstrual period of the current pregnancy and categorized by 3-month intervals.

Preconception low-dose aspirin and pregnancy outcomes: results from the EAGeR randomised trial.

Background: Preconception-initiated low-dose aspirin might positively affect pregnancy outcomes, but this possibility has not been adequately assessed. Our aim was to investigate whether low-dose aspirin improved livebirth rates in women with one to two previous pregnancy losses.

Methods: In this multicentre, block-randomised, double-blind, placebo-controlled trial, women aged 18-40 years who were attempting to become pregnant were recruited from four medical centres in the USA.

A randomised trial to evaluate the effects of low-dose aspirin in gestation and reproduction: design and baseline characteristics.

Background: Low-dose aspirin (LDA) has been proposed to improve pregnancy outcomes in couples experiencing recurrent pregnancy loss. However, results from studies of LDA on pregnancy outcomes have been inconsistent, perhaps because most studies evaluated LDA-initiated post-conception. The purpose of the Effects of Aspirin in Gestation and Reproduction (EAGeR) trial was to determine whether preconception-initiated LDA improves livebirth rates in women with one to two prior losses.

Public health and medical education: a natural alliance for a new regional medical school.

A century ago, the Flexner Report challenged U.S. medical schools to critically evaluate their curricula in order to nurture physicians equipped to meet the needs of an evolving society.

New medical school engages rural communities to conduct regional health assessment.

Background And Objectives: Engaging communities in authentic partnerships is increasingly accepted as best practice in both medicine and public health, despite the many barriers to doing so. New medical schools have an opportunity to incorporate community engagement into their very foundation. In rural northeast Pennsylvania, a new medical school used a regional health assessment to engage community partners across the 16 counties it serves.

One last question: opening Pandora's box?

Family physicians are oriented and trained to inquire about the meaning of patients' symptoms and to recognize when major concerns or worry are present. Yet, in the context of busy practices and the many interruptions of our workday, we may concentrate too much on efficiency in conducting visits and completing tasks for patients, with a resulting narrow focus on the medical or biological aspects of the patient's complaint. This essay tells the story of 2 patient encounters in which I, an experienced family physician, almost missed noticing deep fears experienced by each patient.

The residency program in social medicine of Montefiore Medical Center: 37 years of mission-driven, interdisciplinary training in primary care, population health, and social medicine.

Founded in 1970 to train physicians to practice in community health centers and underserved areas, the Residency Program in Social Medicine (RPSM) of Montefiore Medical Center, Bronx, New York, has graduated 562 board-eligible family physicians, general internists, and pediatricians whose careers fulfill this mission. The RPSM was a model for federal funding for primary care residency programs and has received Title VII grants during most of its history. The RPSM has tailored its mission and structured its curriculum to promote a community and population orientation and to provide the requisite knowledge and skills for integrating social medicine into clinical practice.