Correlation of Milestone Ratings and Family Physicians' Early Diabetes Management.

Background And Objectives: Family physicians manage the treatment of patients with chronic illnesses like type 2 diabetes mellitus (T2DM). During residency, trainees are assessed on their management of chronic disease under the Accreditation Council for Graduate Medical Education patient care (PC) milestone. Residency programs are expected to ensure that trainees are prepared to meet patients' needs; however, evidence is mixed as to whether milestone evaluations predict how well a physician will perform in early unsupervised practice.

Does Resident Gender or Race/Ethnicity Affect Orthopaedic Surgery Case Volume During Residency Training?

Introduction: Disparities in case volumes have been reported in some surgical specialties. The objective of this study was to evaluate whether gender or racial/ethnicity disparities exist during orthopaedic surgery residency surgical case log volume.

Methods: Accreditation Council for Graduate Medical Education Case Log Database for orthopaedic surgery residents for 9 years of cohorts graduating in academic years 2013-2014 to 2021-2022 were analyzed to compare case logs between men and women, as well as race/ethnicity, defined by Association of American Medical Colleges as underrepresented in medicine (URiM) and non-URiM groups.

Community Racial and Ethnic Representation Among Physicians in US Internal Medicine Residency Programs.

Importance: Increasing underrepresented in medicine (URIM) physicians among historically underserved communities helps reduce health disparities. The concordance of URIM physicians with their communities improves access to care, particularly for American Indian and Alaska Native, Black, and Hispanic or Latinx individuals.

Objectives: To explore county-level racial and ethnic representation of US internal medicine (IM) residents, examine racial and ethnic concordance between residents and their communities, and assess whether representation varies by presence of academic institutions or underserved settings.

Longitudinal Reliability of Milestones Learning Trajectories during Anesthesiology Residency.

Background: Longitudinal Milestones data reported to the Accreditation Council for Graduate Medical Education (ACGME) provide a structured framework for assessing the developmental progression of residents in key competencies and subcompetencies. This study aims to investigate the previously underexplored longitudinal reliability of Milestones data, with the goal of identifying patterns in learning trajectories that can inform targeted interventions for residents and programs.

Methods: We conducted a retrospective cohort study with national anesthesiology Milestones data collected from 2014 to 2020.

Delineating Neurosurgery Resident Development: Insights from a 10-Year National Accreditation Council for Graduate Medical Education Milestones and Learning Trajectories.

Background And Objectives: The Accreditation Council for Graduate Medical Education Milestones assessment system provides a structured framework for evaluating the developmental progression of neurosurgery residents. Understanding the variability in learning trajectories and identifying critical intervention points are essential for refining educational strategies and enhancing training outcomes. In this article, we aim to identify learning trajectories of neurosurgery residents and pinpoint pivotal junctures for potential interventions to aid residents struggling to meet expected competency levels.

Multispecies pasture diet and cow breed affect the functional lipid profile of milk across lactation in a spring-calving dairy system.

This study compared the effect of 2 pasture-based feeding systems, namely a traditional perennial ryegrass (PRG) diet, and a recently introduced, more sustainable multispecies swards (MSS) diet, on the functional lipid profile of raw milk. In addition to the 2 pasture diets, the study uniquely examined the combined effects of breed, namely Holstein Friesian (HF) or Jersey Holstein Friesian (JFX), and lactation stage in Ireland, spanning from March to November. Bulk milk samples (n = 144 yearly) for the 4 groups examined were collected for 4 wk per each of the 9 mo specified.

The Continuity of Adversity: Negative Emotionality Links Early Life Adversity With Adult Stressful Life Events.

Adversity that exhibits continuity across the life course has long-term detrimental effects on physical and mental health. Using 920 participants from the Dunedin Study, we tested the following hypotheses: (1) children (ages 3-15) who experienced adversity would also tend to experience adversity in adulthood (ages 32-45), and (2) interim personality traits in young adulthood (ages 18-26) would help account for this longitudinal association. Children who experienced more adversity tended to also experience more stressful life events as adults, β=.

Prepartum supplementation of dairy cows with inorganic selenium, organic selenium or rumen-protected choline does not affect carotenoid composition or colour characteristics of bovine colostrum or transition milk.

Minerals are supplemented routinely to dairy cows during the dry period to prevent metabolic issues postpartum. However, limited information exists on the impacts of mineral supplementation on colostrum carotenoids. This study aimed to determine the effects of prepartum supplementation with three micro-nutrients; inorganic selenium (INORG), organic selenium (ORG) or rumen-protected choline (RPC) on the carotenoid content of bovine colostrum and transition milk (TM) from pasture-based dairy cows.

The Impact of Varying Pasture Levels on the Metabolomic Profile of Bovine Ruminal Fluid.

A pasture or concentrate-based dietary regime impacts a variety of factors including both ruminal health and function, and consequently milk production and quality. The objective of this study was to examine the effect of feeding differing pasture levels on the metabolite composition of bovine ruminal fluid. Ruminal fluid was obtained from rumen-cannulated spring-calving cows (N = 9, Holstein-Friesian breed, average lactation number = 5) fed one of three diets across a full lactation season.

An estimate of the longitudinal pace of aging from a single brain scan predicts dementia conversion, morbidity, and mortality.

To understand how aging affects functional decline and increases disease risk, it is necessary to develop accurate and reliable measures of how fast a person is aging. Epigenetic clocks measure aging but require DNA methylation data, which many studies lack. Using data from the Dunedin Study, we introduce an accurate and reliable measure for the rate of longitudinal aging derived from cross-sectional brain MRI: the Dunedin Pace of Aging Calculated from NeuroImaging or DunedinPACNI.

Are They Prepared? Comparing Intern Milestone Performance of Accelerated 3-Year and 4-Year Medical Graduates.

Purpose: Accelerated 3-year programs (A3YPs) at medical schools were developed to address student debt and mitigate workforce shortage issues. This study investigated whether medical school length (3 vs 4 years) was associated with early residency performance. The primary research question was as follows: Are the Accreditation Council for Graduate Medical Education Milestones (MS) attained by A3YP graduates comparable to graduates of traditional 4-year programs (T4YPs) at 6 and 12 months into internship?

Method: The MS data from students entering U.

Impact of dietary regime on the metabolomic profile of bovine buttermilk and whole milk powder.

Introduction: Bovine milk contains a rich matrix of nutrients such as carbohydrates, fat, protein and various vitamins and minerals, the composition of which is altered by factors including dietary regime.

Objectives: The objective of this research was to investigate the impact of dietary regime on the metabolite composition of bovine whole milk powder and buttermilk.

Methods: Bovine whole milk powder and buttermilk samples were obtained from spring-calving cows, consuming one of three diets.

Application of in-line Raman spectroscopy to monitor crystallization and melting processes in milk fat.

Anhydrous milk fat (AMF) and its fractions are used as ingredients in a wide range of food applications. Obtaining the appropriate solid fat content (SFC) is essential to achieve the desired product texture. At present, in-line monitoring techniques to control milk fat crystallization and melting are largely unavailable.

Trends in Operative Case Logs of Chief Residents in Surgery by Sex and Race: A 5-year National Study.

Objective: To examine case logs reported by general surgery residents and identify potential disparities in operative experience.

Background: A recent study of 21 institutions noted significant differences between the number of cases reported during general surgery residency by trainees who are underrepresented in medicine (URiM) versus trainees who are not URiM (non-URiM). This study also identified differences between female residents and male residents.

Trajectories of Hearing From Childhood to Adulthood.

Objectives: The Dunedin Multidisciplinary Health and Development Study provides a unique opportunity to document the progression of ear health and hearing ability within the same cohort of individuals from birth. This investigation draws on hearing data from 5 to 13 years and again at 45 years of age, to explore the associations between childhood hearing variables and hearing and listening ability at age 45.

Design: Multiple linear regression analyses were used to assess associations between childhood hearing (otological status and mid-frequency pure-tone average) and (a) age 45 peripheral hearing ability (mid-frequency pure-tone average and high-frequency pure-tone average), and (b) age 45 listening ability (listening in spatialized noise and subjective questionnaire on listening experiences).

Pasture feeding improves the nutritional, textural, and techno-functional characteristics of butter.

There is an increasing consumer desire for pasture-derived dairy products, as outdoor pasture-based feeding systems are perceived as a natural environment for animals. Despite this, the number of grazing animals globally has declined as a result of the higher milk yields achieved by indoor TMR feeding systems, in addition to the changing climatic conditions and lower grazing knowledge and infrastructure. This has led to the development of pasture-fed standards, stipulating the necessity of pasture and its minimum requirements as the primary feed source for products advertising such claims, with various requirements depending on the region for which it was produced.

Dementia, dementia's risk factors and premorbid brain structure are concentrated in disadvantaged areas: National register and birth-cohort geographic analyses.

Introduction: Dementia risk may be elevated in socioeconomically disadvantaged neighborhoods. Reasons for this remain unclear, and this elevation has yet to be shown at a national population level.

Methods: We tested whether dementia was more prevalent in disadvantaged neighborhoods across the New Zealand population (N = 1.

A blood biomarker of the pace of aging is associated with brain structure: replication across three cohorts.

Biological aging is the correlated decline of multi-organ system integrity central to the etiology of many age-related diseases. A novel epigenetic measure of biological aging, DunedinPACE, is associated with cognitive dysfunction, incident dementia, and mortality. Here, we tested for associations between DunedinPACE and structural MRI phenotypes in three datasets spanning midlife to advanced age: the Dunedin Study (age=45 years), the Framingham Heart Study Offspring Cohort (mean age=63 years), and the Alzheimer's Disease Neuroimaging Initiative (mean age=75 years).

Systems-Based Practice 20 Years On: Navigating the System for Better Care.

Systems-based practice (SBP) was introduced as 1 of 6 core competencies in 1999 because of its recognized importance in the quality and safety of health care provided to patients. Nearly 25 years later, faculty and learners continue to struggle with understanding and implementing this essential competency, thus hindering the medical education community's ability to most effectively teach and learn this important competency.Milestones were first introduced in 2013 as one effort to support implementation of the general competencies.

Learner Assessment and Program Evaluation: Supporting Precision Education.

Precision education (PE) systematically leverages data and advanced analytics to inform educational interventions that, in turn, promote meaningful learner outcomes. PE does this by incorporating analytic results back into the education continuum through continuous feedback cycles. These data-informed sequences of planning, learning, assessing, and adjusting foster competence and adaptive expertise.

Who Australasians trusted during COVID-19: lessons from the pandemic response.

Aim: Public trust in authoritative information sources is a key element of a successful public health response to a pandemic. This study investigated which sources of COVID-19 advice were most trusted by a primarily New Zealand-based cohort and considers implications for policy and practice regarding future pandemics.

Method: Data were from a COVID-19 vaccine intention survey presented to Australia- and New Zealand-based members of the longitudinal Dunedin Study (n=832) between ages 48 and 49, immediately before vaccines became available for the general population within New Zealand.

Transition to Residency: National Study of Factors Contributing to Variability in Learner Milestones Ratings in Emergency Medicine and Family Medicine.

Purpose: The developmental trajectory of learning during residency may be attributed to multiple factors, including variation in individual trainee performance, program-level factors, graduating medical school effects, and the learning environment. Understanding the relationship between medical school and learner performance during residency is important in prioritizing undergraduate curricular strategies and educational approaches for effective transition to residency and postgraduate training. This study explores factors contributing to longitudinal and developmental variability in resident Milestones ratings, focusing on variability due to graduating medical school, training program, and learners using national cohort data from emergency medicine (EM) and family medicine (FM).

Industry Payments Received by Residents During Training.

Importance: Those responsible for medical education-specialties, sponsoring institutions, and program directors (PD)-are independently associated with the professional identity formation of the trainees with respect to potential conflicts of interest.

Objective: To identify the relative degree to which factors in the training environment are associated with resident acceptance of payments from pharmaceutical and medical device companies.

Design, Setting, And Participants: Cross-sectional, retrospective study of residents enrolled in the 3 largest primary-care specialties (internal medicine [IM], family medicine [FM], obstetrics and gynecology [OBGYN]) and 3 largest surgical disciplines (general surgery [GS], orthopedic surgery, and urology) during academic year 2020 to 2021.