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  1. Article ; Online: Efforts to Recruit Diverse Resident Complements in Family Medicine.

    Hogan, Sean O / Sangha, Sonia / Mason, Bonnie S

    Family medicine

    2023  Volume 55, Issue 8, Page(s) 518–524

    Abstract: Background and objectives: Family medicine is the most demographically diverse specialty in medicine today. Specialty associations and the Accreditation Council for Graduate Medical Education (ACGME) urge residency programs to engage in systematic ... ...

    Abstract Background and objectives: Family medicine is the most demographically diverse specialty in medicine today. Specialty associations and the Accreditation Council for Graduate Medical Education (ACGME) urge residency programs to engage in systematic efforts to recruit diverse resident complements. Using responses from program directors to the ACGME's mandatory annual update, we enumerate the efforts in resident recruiting. This allows us to compare these statements to the recommendations of two highly respected commissions: the Sullivan Commission on Diversity in the Healthcare Workforce and the Institute of Medicine's In the Nation's Compelling Interest: Ensuring Diversity of the Healthcare Workforce.
    Methods: We compiled the annual updates from 689 family medicine programs and analyzed them using a qualitative method called template analysis. We then classified the efforts and compared them to the recommendations of the Sullivan Commission and Institute of Medicine (IOM).
    Results: Nearly all (98%) of the programs completed the portion of the annual update inquiring about recruiting residents. The Sullivan Commission and IOM recommended 23 steps to diversify workforce recruiting. We found that programs engaged in all but one of these recommendations. Among the most frequently employed recommendations were doing holistic reviews and using data for planning. None mentioned engaging in public awareness campaigns. Programs also implemented eight strategies not suggested in either report, with staff training in nondiscrimination policies being among the most frequently mentioned. Among program efforts not included in the Sullivan Commission or IOM recommendations were extracurricular activities; appointing diversity, equity, and inclusion (DEI) committees or advocates; subinternship (Sub-I) experiences; recruiting at conferences; blind reviews; legal compliance; and merit criteria. In total, we found 31 interventions in use.
    Conclusions: The Sullivan Commission's guidance, IOM recommendations, and program-developed initiatives can be combined to create a comprehensive roster of diversity recruiting initiatives. Programs may use this authoritative resource for identifying their next steps in advancing their recruiting efforts.
    MeSH term(s) United States ; Humans ; Family Practice ; Accreditation ; Education, Medical, Graduate ; Health Personnel ; Internship and Residency
    Language English
    Publishing date 2023-06-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639374-3
    ISSN 1938-3800 ; 0742-3225
    ISSN (online) 1938-3800
    ISSN 0742-3225
    DOI 10.22454/FamMed.2023.664616
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2327: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Qualitative Study of Orthopedic Surgery Milestones 1.0: Burdens and Benefits.

    Balach, Tessa / Conforti, Lisa N / Sangha, Sonia / Edgar, Laura / Ames, Elizabeth

    Journal of surgical education

    2022  Volume 79, Issue 5, Page(s) 1259–1269

    Abstract: Objective: The purpose of this study was to explore the context and mechanisms by which the first set of Milestones impacted the processes of the Clinical Competency Committee, how programs have incorporated the Milestones into their program, and to ... ...

    Abstract Objective: The purpose of this study was to explore the context and mechanisms by which the first set of Milestones impacted the processes of the Clinical Competency Committee, how programs have incorporated the Milestones into their program, and to understand more about the resident perspective in order to improve Orthopedic Surgery Milestones.
    Design, setting, and participants: In 2020 all 201 accredited orthopedic surgery residency programs were invited to participate in qualitative telephone interviews to assess their experience with the Milestones and complete a supplemental online survey about their Clinical Competency Committee. Participants were comprised of a self-selected sample and complemented by a purposeful sample to ensure a breadth of perspectives. Interview data were analyzed using template analysis. Survey data were analyzed with descriptive statistics.
    Results: Interviews were completed with 101 individuals from 47 programs (23% of all programs). The two overarching themes were implementation and impact of Milestones. Subthemes within implementation were substantial variability in approaches to Milestone use in curriculum and assessment, faculty development, and methods to introduce residents to the Milestones assessment framework. The large number of subcompetencies created a significant burden for almost all programs. The structure of the Milestones was also viewed as poorly aligned with the variable design of rotation schedules across programs. Milestones have the potential to offer valuable feedback for trainees and programs overall.
    Conclusions/application: While some benefits were noted and most programs appreciated the intent, the structure and design of the initial set of orthopedic surgery Milestones created substantial challenges for these programs. The results of this study helped guide a revision of the Orthopedic Surgery Milestones. These results can also be used by program leadership to encourage reflection around past, current, and future utilization of the Milestones framework. Further research will be needed to determine the impact of the revision on programs.
    MeSH term(s) Accreditation ; Clinical Competence ; Competency-Based Education/methods ; Education, Medical, Graduate/methods ; Humans ; Internship and Residency ; Orthopedic Procedures
    Language English
    Publishing date 2022-06-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2022.05.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uk I Zs.230: Show issues Location:
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  3. Article ; Online: Human duodenum responses to vitamin D metabolites of TRPV6 and other genes involved in calcium absorption.

    Balesaria, Sara / Sangha, Sonia / Walters, Julian R F

    American journal of physiology. Gastrointestinal and liver physiology

    2009  Volume 297, Issue 6, Page(s) G1193–7

    Abstract: Calcium absorption by the intestine is necessary for bone mineralization. Much has been learned about this process and the role of vitamin D metabolites in gene transcription from animal studies, but the molecular mechanisms in humans are less well ... ...

    Abstract Calcium absorption by the intestine is necessary for bone mineralization. Much has been learned about this process and the role of vitamin D metabolites in gene transcription from animal studies, but the molecular mechanisms in humans are less well understood. We have used samples of normal human duodenal mucosa, obtained at endoscopy, to investigate the effects of the vitamin D metabolites, 1alpha-dihydroxycholecalciferol [1,25(OH)(2)D(3)] and 25-hydroxycholecalciferol (25OHD), on transcripts on genes involved in calcium absorption and vitamin D metabolism. TRPV6 transcripts were significantly higher after incubation for 6 h with 1,25(OH)(2)D(3) (10(-9) mol/l) than after control incubations (median difference 3.1-fold, P < 0.001). Unexpectedly, TRPV6 expression was also higher (2.4-fold, P < 0.02) after incubation with 25OHD (10(-7) mol/l). Transcripts for the calcium-ATPase, PMCA1, were significantly higher with 1,25(OH)(2)D(3); CYP24 transcripts were reliably detected after incubation with either metabolite, but calbindin-D9k transcripts were unaffected. The response of TRPV6 to 25OHD and the expression of transcripts for CYP27B1, the 25OHD-1alpha-hydroxylase, were significantly correlated (r = 0.82, P < 0.02). Basal duodenal expression of TRPV6 and CYP27B1 were significantly associated (r = 0.72, P < 0.001) in a separate previously reported series of subjects. Multiple regression analysis of the associations with basal duodenal TRPV6 expression identified CYP27B1 expression and serum 1,25(OH)(2)D as major factors. Expression of the CYP27B1 protein was demonstrated immunohistochemically in duodenal mucosa. This study has shown that human duodenal TRPV6, PMCA1, and CYP24 transcripts respond rapidly to 1,25(OH)(2)D(3) and provides evidence suggesting that local duodenal production of 1,25(OH)(2)D(3) by 25OHD-1alpha-hydroxylase may have a role in human calcium absorption.
    MeSH term(s) 25-Hydroxyvitamin D3 1-alpha-Hydroxylase/genetics ; Adult ; Aged ; Aged, 80 and over ; Calcifediol/metabolism ; Calcitriol/metabolism ; Calcium/metabolism ; Calcium Channels/genetics ; Duodenoscopy ; Duodenum/enzymology ; Duodenum/metabolism ; Humans ; Intestinal Absorption/genetics ; Intestinal Mucosa/enzymology ; Intestinal Mucosa/metabolism ; Middle Aged ; Organ Culture Techniques ; Plasma Membrane Calcium-Transporting ATPases/genetics ; RNA, Messenger/metabolism ; Steroid Hydroxylases/genetics ; TRPV Cation Channels/genetics ; Up-Regulation ; Vitamin D3 24-Hydroxylase ; Young Adult
    Chemical Substances ATP2B1 protein, human ; Calcium Channels ; RNA, Messenger ; TRPV Cation Channels ; TRPV6 protein, human ; Steroid Hydroxylases (EC 1.14.-) ; Vitamin D3 24-Hydroxylase (EC 1.14.15.16) ; 25-Hydroxyvitamin D3 1-alpha-Hydroxylase (EC 1.14.15.18) ; Plasma Membrane Calcium-Transporting ATPases (EC 3.6.3.8) ; Calcitriol (FXC9231JVH) ; Calcifediol (P6YZ13C99Q) ; Calcium (SY7Q814VUP)
    Language English
    Publishing date 2009-09-24
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 603840-2
    ISSN 1522-1547 ; 0193-1857
    ISSN (online) 1522-1547
    ISSN 0193-1857
    DOI 10.1152/ajpgi.00237.2009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uc I Zs.89: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  4. Article: The effects of Vitamin D metabolites on expression of genes for calcium transporters in human duodenum.

    Walters, Julian R F / Balesaria, Sara / Khair, Umma / Sangha, Sonia / Banks, Linda / Berry, Jacqueline L

    The Journal of steroid biochemistry and molecular biology

    2007  Volume 103, Issue 3-5, Page(s) 509–512

    Abstract: The role of Vitamin D in the regulation of calcium absorption in the intestine is well recognized but the mechanisms of the effects on human genes are surprisingly poorly understood. We have determined the expression of transcripts of the apical membrane ...

    Abstract The role of Vitamin D in the regulation of calcium absorption in the intestine is well recognized but the mechanisms of the effects on human genes are surprisingly poorly understood. We have determined the expression of transcripts of the apical membrane calcium transporter TRPV6, the cytoplasmic calcium binding protein calbindin-D9k, the basolateral plasma membrane Ca(2+)-ATPase (PMCA1) and the Vitamin D receptor (VDR) in normal endoscopic duodenal mucosal biopsies using quantitative real-time RT-PCR and related baseline expression to Vitamin D metabolites. TRPV6 transcript levels have been shown to be significantly correlated with serum 1,25(OH)(2)D levels in men, but not overall in women, where negative effects of age predominate. TRPV6 and VDR expression were significantly related in both men and women, but were significantly lower in older women. Associations with bone mineral density and fractional calcium absorption were also studied. In a second series of subjects, duodenal biopsies were incubated in organ culture for 6h with Vitamin D metabolites. TRPV6 expression was significantly increased by 1,25(OH)(2)D(3) (10(-9)mol/l) as was PMCA1 to a much smaller extent. TRPV6 expression also increased with 25(OH)D(3). CYP27B1 expression was found in all samples, and CYP24 transcripts were detected after incubation with 1,25(OH)(2)D(3) or 25(OH)D(3).
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Bone Density/drug effects ; Calcium/metabolism ; Calcium Channels/genetics ; Duodenum/drug effects ; Duodenum/metabolism ; Female ; Gene Expression Regulation/drug effects ; Humans ; Male ; Middle Aged ; Vitamin D/metabolism ; Vitamin D/pharmacology
    Chemical Substances Calcium Channels ; Vitamin D (1406-16-2) ; Calcium (SY7Q814VUP)
    Language English
    Publishing date 2007-03
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1049188-0
    ISSN 1879-1220 ; 0960-0760
    ISSN (online) 1879-1220
    ISSN 0960-0760
    DOI 10.1016/j.jsbmb.2006.11.013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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