Littérature scientifique sur le sujet « United States. National Advisory Council for Career Education »

The national mandate to improve health equity in the United Sates is advancing. Racial and ethnic disparities in various aspects of health care have been clearly delineated, and sources of such disparities have been identified. However, implementing solution-focused interventions to eradicate such disparities, thereby achieving health equity in all US communities, has remained a daunting challenge, and no area more so, than with neurologic diseases. To assure success with bridging prominent disparities in neurologic outcomes, the pipeline of neurologic disparities researchers needs to be broadened, numbers of mid-career and senior disparities scientists sustained, partnerships with community stakeholders enhanced, incentivization of academic organizations pursued, education of all neurologic researchers conducted, and exemplary training of funding agency staff prioritized. To improve the current state of neurologic disparities, the National Institute of Neurological Disorders and Stroke assembled a working group of its advisory council. (2020–2022) to examine the state of health disparity training and research. Through consensus building, we present identified gaps and recommendations to the current state of underrepresented groups in medicine in health disparity research and its training and curricula in the United States.

Retaining high quality school-based agricultural education teachers is a growing concern across the United States. This study focused on mid-career agricultural education teachers’ perceptions of job stress, burnout, job satisfaction, and professional development needs related to National Quality Program Standards for Secondary Agriculture Education (The National Council for Agricultural Education, 2009). The target population for this study was participants in the 2013 NAAE eXcellence in Leadership for Retention (XLR8) professional development program. Overall, XLR8 participants indicated the highest levels of job stress related to Standard 2 – Experiential Learning and Standard 7 – Program Planning and Evaluation. Participants were least stressed over Standard 6 – Certified Agriculture Teachers and Professional Growth, which also ranked lowest in terms of desired professional development. The most sought-after area of professional development included Standard 2 – Experiential Learning and Standard 1 – Program Planning and Instruction. Findings suggest XLR8 participants experience “moderate” levels of burnout in each of three categories measured by the Maslach Burnout Inventory for Educators, however are generally satisfied with their job.

Abstract Pamela W Duncan, PT, PhD, FAPTA Dr Duncan has actively participated in and contributed to physical therapist practice, physical therapist professional education, professional preparation of other health care providers, national policy development related to rehabilitation after stroke and aging, and scientific investigation. She has served several government appointments and provides leadership within several organizations. She served as co-chair of the Consensus Panel on Establishing Guidelines for Stroke Rehabilitation for the Agency for Health Care Policy, Research, and Education. She was a panel member on the National Institutes of Health's Total Hip Replacement Consensus Conference and served on the Strategic Planning Group for Stroke Research for the National Institute of Neurological Disorders and Stroke. She recently was appointed to serve on the Steering Committee of the Department of Education's National Institute on Disability and Rehabilitation Research and is currently on the Executive Leadership Council of the American Stroke Foundation and the Advisory Committee of the Canadian Stroke Network. She has served on committees and panels for the American Heart Association and was president of APTA's Neurology section. Dr Duncan's research activities focus on geriatric rehabilitation, stroke rehabilitation, and health outcomes measurement. She developed the Functional Reach Test, used to assess balance in older adults. In the past 20 years, she has received $13 million in research awards as principal investigator or co-investigator from agencies such as the National Institutes of Health, National Institute on Aging, American Heart Association, Department of Veteran's Affairs, and National Center for Medical Rehabilitation Research and from multiple private funding sources. Dr Duncan has disseminated her research findings in more than 80 peer-reviewed articles in 20 different journals, and she has written a book and 12 book chapters. Dr Duncan's work has influenced the care and rehabilitation of patients in the United States and worldwide. Physical therapy education programs across the country incorporate her findings and professional vision into the preparation of the next generation of physical therapists. APTA has awarded Dr Duncan the Marian Williams Award for Research in Physical Therapy, the Catherine Worthingham Fellowship Award, and the Mary McMillan Scholarship Award. She has also received research awards from the APTA Neurology Section, Sports Physical Therapy Section, and Section on Geriatrics, as well as a service award from the Neurology Section. She is an elected fellow of the Stroke Council of the American Heart Association and has given 8 invited lectureships at universities across the United States.

Abstract Background The Coronavirus disease of 2019 (COVID-19) global health crisis has resulted in an unprecedented strain on healthcare systems, reorganization of medical training programs and disruption in professional and personal lives of medical trainees. The impact of COVID-19 on infectious disease (ID) fellows, who are frontline healthcare professionals, has not been assessed. Methods We conducted a national survey of adult and pediatric ID fellows to assess impact on educational activities, availability of personal protective equipment (PPE), well-being, and career prospects. Anxiety and burnout were assessed by 7-item generalized anxiety disorder scale and abbreviated Maslach burnout inventory respectively. Invitations to participate in the survey were sent via email to all ID fellows through Accreditation Council for Graduate Medical Education (ACGME) fellowship directors. Survey responses collected from August 1 to September 30, 2020 have been reported. Results 136 fellows completed the survey (Table 1). 84% reported their institution had provided evidence-based didactics for management of COVID-19 and 53% indicated their general ID didactics were affected by the pandemic. 86% of fellows were involved in care of patients with COVID-19, and 31% reported a shortage of PPE affecting their clinical duties. Those living in highly impacted states (CA, FL, NY, TX) at the time of the survey were 1.70 times as likely to experience moderate to severe anxiety (vs. minimal to moderate) than those in other states; similarly, those who saw ≥11 COVID-19 patients weekly and reported PPE shortages were 2.5 and 2.0 times as likely, respectively, to experience moderate to severe anxiety compared to their peers who took care of 10 or fewer COVID-19 patients and did not experience PPE shortages. Burnout scores were not significant (Table 2). Table 1. Demographics, Responses to Personal Exposure, Educational Activities and Career Prospects Table 2. Stress, Burnout, Anxiety , Sleep and Quality of Life Among Survey Participants. Conclusion It is imperative that ID fellows feel adequately protected and supported during this pandemic. Pandemic preparedness should be included in the ID fellowship curriculum. Interventions for anxiety and burnout reduction should be implemented. ID fellowship programs should continue to accept feedback from fellows to ensure their ongoing safety, well-being, and education as we navigate this pandemic. Disclosures All Authors: No reported disclosures

It has been four decades since the beginning of undergraduate medical education in Nepal and more than three decades of postgraduate medical education.1 Currently, Institute of Medicine of Tribhuwan University and Kathmandu University are major institutions providing medical education in Nepal with the help of their affiliated medical colleges. Two other deemed universities, B P Koirala Institute of Health Sciences and Patan Academy of Health Sciences also have major contributions in producing medical doctors in Nepal. National Academy of Medical Sciences (NAMS) provides postgraduate and super specialty training for doctors. Nepal Medical Council is the regulatory body that lays down the guidelines, provides accreditation and supervises to ensure that the regulations are being followed.2 It also conducts licensing examination for medical doctors.Educationalists worldwide vary in their opinions on the aim of education3-8 but Salomon precisely includes almost all of them as “The aim (of education) is to equip the learner with portable chunks of knowledge, skill, and understandings that can serve in other contexts.”9 Adkoli has analyzed migration of health workers in south Asia 10 and found that there was no systematically collected data regarding the extent of migration of healthcare workers and its possible impact on health care in Nepal. Nepal government spends a significant chunk of its financial resources to train doctors but many students who avail this benefit of ‘scholarship’ take part in the migration described in the article. Ironically, many doctors who are currently serving their motherland were either trained overseas or the ones who did study within Nepal but without availing any support from the government. When the first medical school was established in Nepal, the idea was to develop doctors who can prevent, diagnose and treat medical ailments prevalent in Nepal (Community based curriculum) and the career planning was designed in such a way that doctors were inevitably retained in Nepal. The philosophy of this system was contrary to the definition laid down by Salomon9 but it did benefit the society and the country in the long run11. Things changed gradually over time and currently the doctors produced by oldest and state funded medical colleges of Nepal are ideal for health job markets of first world countries. This suitability coupled with adverse socieo-economic and political factors of our country has led most students who become doctors by state funding opting to serve in first world countries like United States, United Kingdom, Australia and Canada.Brain drain in Health sector is a global phenomenon12, 13, but developing countries like Nepal receive maximum brunt. Lately, Nepalese medical education sector has been receiving a fair share of attention from all including media. However, it is saddening that this issue of ‘brain drain’ is something that had not gained any attention. Coming back to Adkoli’s work, we don't even have a data on how many doctors we are losing every year?10 There have been certain restrictions and bondages but these sorts of legislations have been seen to work contrarily. What is found to be lacking is the sense of belonging and development of the feeling that ‘I am important to this society and I must work for its betterment’. Most young doctors have a feeling that ‘there is no one taking me seriously anyway and it doesn't really matter weather I stay or Leave’.It is high time policy makers ensure that the medical doctors that we produce from the common men’s hard earned money serve the country. In addition to the legislations in the form of bondage, we should be able to install the feeling of belonging and sense of importance in the hearts and minds of these young doctors. To begin with, it would be a good idea if we start maintaining the database of the medical graduates that were and will be produced from Nepalese medical colleges; taking examples from many colleges from other countries that are doing it currently.14-16 Zimmerman’s study cited earlier provides an interesting insight that medical students with pre-medical education as paramedics were twice as likely to be working in Nepal and 3.5 times as likely to be in rural Nepal, compared with students with a college science background.11 We can also include into the undergraduate medical curriculum the concepts of social ethics, moral values, social justice and the long-term benefits of serving the society and the country that has invested so much for their education.

Background Acute painful vasoocclusive episodes (VOEs) are the most common reason for hospitalization for adults with sickle cell disease (SCD) and significant predictors of mortality. The facilitators and barriers to providing quality care for adults with SCD in the inpatient setting are largely unknown. We aimed to explore inpatient SCD delivery models in the US, including access (or lack thereof) to quality care and sickle cell disease expertise. Methods We conducted a multi-site rapid qualitative research study in order to evaluate a construct informed by literature review and clinical experience: variability between hospitals in the characteristics on models of inpatient SCD care delivery. We used virtual focus groups of practicing hospitalists in partnership with the Hospital Medicine Reengineering Network from across the United States. We developed an interview guide with open-ended questions and prompts through an iterative process to explore how inpatient SCD care is currently delivered in US hospitals with a focus on how these models of care delivery affect hospitalist practice (Figure). The open-ended questions explored topics ranging from hospitalists' training and experienceto the design of the health care system. Trained facilitators conducted four semi-structured focus groups with 11 hospitalists and one patient and family advisory council member. The facilitators took observation notes. Moderators summarized their group's overall findings for report to the larger group, serving as an opportunity for member checking and pattern identification. The focus groups lasted 35 minutes and report-out summaries lasted an additional 15 minutes. Recordings were de-identified and transcribed. We used rapid qualitative methods to explore perspectives of hospital-based healthcare providers including: having facilitators with expertise in the content area, collecting and analyzing data via multiple team members, and using templated summaries for each focus group question. Group summaries and transcripts were analyzed with thematic coding by two independent coders with feedback from the focus group moderators. Results Participants were from 12 adult university-based or university-affiliated hospitals. All hospitalists had experience taking care of hospitalized patients with SCD during their career, but many described how a change in practice location resulted in only seeing 1-2 patients with SCD per year. Hospitalists described a range of inpatient SCD care models from no specific model to a specific cohorted unit with associated providers. Participants unanimously expressed having provider and unit continuity of SCD care, and having accessible SCD expertise, as an ideal state. Individualized care plans were cited as a helpful tool for inpatient SCD care, but there were considerable challenges to their routine use. Primary themes are presented in the Table with explanations and correlative illustrative quotes. Discussion and Future Directions Hospitalists described wide variation in inpatient SCD care models. More inpatient SCD care support and infrastructure like individualized care plans were more commonly referenced by those hospitalists whose patients had access to a sickle cell center or SCD expert. We are using these data to inform a national survey to further describe and understand inpatient SCD care, if and how care plans are used, and determine next steps for improving inpatient SCD care quality.

Abstract Background The pathogenesis of inflammatory bowel disease (IBD) which includes Crohn’s disease (CD) and ulcerative colitis (UC), is believed to involve activation of the intestinal immune system in response to the gut microbiome among genetically susceptible hosts. IBD has been historically regarded as a disease of developed nations, though in the past two decades there has been a reported shift in the epidemiological pattern of disease. High-income nations with known high prevalence of disease are seeing a stabilization of incident cases, while a rapid rise of incident IBD is being observed in developing nations. This suggests that environmental exposures may play a role in mediating the risk of developing IBD. The potential environmental determinants of IBD across various regions is vast, though medications have been increasingly recognized as one broad category of risk factors. Purpose Several medications have been considered to contribute to the etiology of IBD. This study assessed the association between medication use and risk of developing IBD using the Prospective Urban Rural Epidemiology (PURE) cohort. Method This was a prospective cohort study of 133,137 individuals between the ages of 20-80 from 24 countries. Country-specific validated questionnaires documented baseline and follow-up medication use. Participants were followed prospectively at least every 3 years. The main outcome was development of IBD, including CD and UC. Short-term (baseline but not follow-up use) and long-term use (baseline and subsequent follow-up use) was evaluated. Results are presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Result(s) During the median follow-up of 11.0 years [interquartile range (IQR) 9.2-12.2], we recorded 571 incident cases of IBD (143 CD and 428 UC). Higher risk of incident IBD was associated with baseline antibiotic use [aOR: 2.81 (95% CI: 1.67-4.73), p=0.0001] and hormonal medication use [aOR: 4.43 (95% CI: 1.78-11.01), p=0.001]. Among females, previous or current oral contraceptive use was also associated with IBD development [aOR: 2.17 (95% CI: 1.70-2.77), p=5.02E-10]. NSAID users were also observed to have increased risk of IBD [aOR: 1.80 (95% CI: 1.23-2.64), p=0.002], which was driven by long-term users [aOR: 5.58 (95% CI: 2.26-13.80), p<0.001]. All significant results were consistent in direction for CD and UC with low heterogeneity. Conclusion(s) Antibiotics, hormonal medications, oral contraceptives, and long-term NSAID use were associated with increased odds of incident IBD after adjustment for covariates. Please acknowledge all funding agencies by checking the applicable boxes below Other Please indicate your source of funding below: Salim Yusuf is supported by the Heart & Stroke Foundation/Marion W. Burke Chair in Cardiovascular Disease. The PURE Study is an investigator-initiated study funded by the Population Health Research Institute, the Canadian Institutes of Health Research (CIHR), Heart and Stroke Foundation of Ontario, support from CIHR’s Strategy for Patient Oriented Research (SPOR) through the Ontario SPOR Support Unit, as well as the Ontario Ministry of Health and Long-Term Care and through unrestricted grants from several pharmaceutical companies, with major contributions from AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, and GlaxoSmithkline, and additional contributions from Novartis and King Pharma and from various national or local organisations in participating countries; these include: Argentina: Fundacion ECLA; Bangladesh: Independent University, Bangladesh and Mitra and Associates; Brazil: Unilever Health Institute, Brazil; Canada: Public Health Agency of Canada and Champlain Cardiovascular Disease Prevention Network; Chile: Universidad de la Frontera; China: National Center for Cardiovascular Diseases; Colombia: Colciencias, grant number 6566-04-18062; India: Indian Council of Medical Research; Malaysia: Ministry of Science, Technology and Innovation of Malaysia, grant numbers 100 -IRDC/BIOTEK 16/6/21 (13/2007) and 07-05-IFN-BPH 010, Ministry of Higher Education of Malaysia grant number 600 -RMI/LRGS/5/3 (2/2011), Universiti Teknologi MARA, Universiti Kebangsaan Malaysia (UKM-Hejim-Komuniti-15-2010); occupied Palestinian territory: the UN Relief and Works Agency for Palestine Refugees in the Near East, occupied Palestinian territory; International Development Research Centre, Canada; Philippines: Philippine Council for Health Research & Development; Poland: Polish Ministry of Science and Higher Education grant number 290/W-PURE/2008/0, Wroclaw Medical University; Saudi Arabia: the Deanship of Scientific Research at King Saud University, Riyadh, Saudi Arabia (research group number RG -1436-013); South Africa: the North-West University, SANPAD (SA and Netherlands Programme for Alternative Development), National Research Foundation, Medical Research Council of SA, The SA Sugar Association (SASA), Faculty of Community and Health Sciences (UWC); Sweden: grants from the Swedish state under the Agreement concerning research and education of doctors; the Swedish Heart and Lung Foundation; the Swedish Research Council; the Swedish Council for Health, Working Life and Welfare, King Gustaf V’s and Queen Victoria Freemasons Foundation, AFA Insurance, Swedish Council for Working Life and Social Research, Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning, grant from the Swedish State under the Läkar Utbildnings Avtalet agreement, and grant from the Västra Götaland Region; Turkey: Metabolic Syndrome Society, AstraZeneca, Turkey, Sanofi Aventis, Turkey; United Arab Emirates (UAE): Sheikh Hamdan Bin Rashid Al Maktoum Award For Medical Sciences and Dubai Health Authority, Dubai UAE. Disclosure of Interest C. Pray: None Declared, N. Narula Grant / Research support from: Neeraj Narula holds a McMaster University Department of Medicine Internal Career Award. Neeraj Narula has received honoraria from Janssen, Abbvie, Takeda, Pfizer, Merck, and Ferring, E. C. Wong: None Declared, J. K. Marshall Grant / Research support from: John K. Marshall has received honoraria from Janssen, AbbVie, Allergan, Bristol-Meyer-Squibb, Ferring, Janssen, Lilly, Lupin, Merck, Pfizer, Pharmascience, Roche, Shire, Takeda and Teva., S. Rangarajan: None Declared, S. Islam: None Declared, A. Bahonar: None Declared, K. F. Alhabib: None Declared, A. Kontsevaya: None Declared, F. Ariffin: None Declared, H. U. Co: None Declared, W. Al Sharief: None Declared, A. Szuba: None Declared, A. Wielgosz: None Declared, M. L. Diaz: None Declared, R. Yusuf: None Declared, L. Kruger: None Declared, B. Soman: None Declared, Y. Li: None Declared, C. Wang: None Declared, L. Yin: None Declared, M. Erkin: None Declared, F. Lanas: None Declared, K. Davletov: None Declared, A. Rosengren: None Declared, P. Lopez-Jaramillo: None Declared, R. Khatib: None Declared, A. Oguz: None Declared, R. Iqbal: None Declared, K. Yeates: None Declared, Á. Avezum: None Declared, W. Reinisch Consultant of: Speaker for Abbott Laboratories, Abbvie, Aesca, Aptalis, Astellas, Centocor, Celltrion, Danone Austria, Elan, Falk Pharma GmbH, Ferring, Immundiagnostik, Mitsubishi Tanabe Pharma Corporation, MSD, Otsuka, PDL, Pharmacosmos, PLS Education, Schering-Plough, Shire, Takeda, Therakos, Vifor, Yakult, Consultant for Abbott Laboratories, Abbvie, Aesca, Algernon, Amgen, AM Pharma, AMT, AOP Orphan, Arena Pharmaceuticals, Astellas, Astra Zeneca, Avaxia, Roland Berger GmBH, Bioclinica, Biogen IDEC, Boehringer-Ingelheim, Bristol-Myers Squibb, Cellerix, Chemocentryx, Celgene, Centocor, Celltrion, Covance, Danone Austria, DSM, Elan, Eli Lilly, Ernest & Young, Falk Pharma GmbH, Ferring, Galapagos, Genentech, Gilead, Grünenthal, ICON, Index Pharma, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, LivaNova, Mallinckrodt, Medahead, MedImmune, Millenium, Mitsubishi Tanabe Pharma Corporation, MSD, Nash Pharmaceuticals, Nestle, Nippon Kayaku, Novartis, Ocera, Omass, Otsuka, Parexel, PDL, Periconsulting, Pharmacosmos, Philip Morris Institute, Pfizer, Procter & Gamble, Prometheus, Protagonist, Provention, Robarts Clinical Trial, Sandoz, Schering-Plough, Second Genome, Seres Therapeutics, Setpointmedical, Sigmoid, Sublimity, Takeda, Therakos, Theravance, Tigenix, UCB, Vifor, Zealand, Zyngenia, and 4SC, Advisory board member for Abbott Laboratories, Abbvie, Aesca, Amgen, AM Pharma, Astellas, Astra Zeneca, Avaxia, Biogen IDEC, Boehringer-Ingelheim, Bristol-Myers Squibb, Cellerix, Chemocentryx, Celgene, Centocor, Celltrion, Danone Austria, DSM, Elan, Ferring, Galapagos, Genentech, Grünenthal, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, MedImmune, Millenium, Mitsubishi Tanabe Pharma Corporation, MSD, Nestle, Novartis, Ocera, Otsuka, PDL, Pharmacosmos, Pfizer, Procter & Gamble, Prometheus, Sandoz, Schering-Plough, Second Genome, Setpointmedical, Takeda, Therakos, Tigenix, UCB, Zealand, Zyngenia, and 4SC, P. Moayyedi: None Declared, S. Yusuf: None Declared

Executive Summary 1 This report analyzes the US Refugee Admissions Program (USRAP), leveraging data from a national survey of resettlement stakeholders conducted in 2020. 2 The survey examined USRAP from the time that refugees arrive in the United States. Its design and questionnaire were informed by three community gatherings organized by Refugee Council USA in the fall and winter of 2019, extensive input from an expert advisory group, and a literature review. This study finds that USRAP serves important purposes, enjoys extensive community support, and offers a variety of effective services. Overall, the survey finds a high degree of consensus on the US resettlement program’s strengths and objectives, and close alignment between its services and the needs of refugees at different stages of their settlement and integration. Because its infrastructure and community-based resettlement networks have been decimated in recent years, the main challenges of subsequent administrations, Congresses, and USRAP stakeholders will be to rebuild, revitalize, and regain broad and bipartisan support for the program. This article also recommends specific ways that USRAP’s programs and services can be strengthened. Among the study’s findings: 3 Most refugee respondents identified USRAP’s main purpose(s) as giving refugees new opportunities, helping them to integrate, offering hope to refugees living in difficult circumstances abroad, and saving lives. High percentages of refugees reported that the program allowed them to support themselves soon after arrival (92 percent), helped them to integrate (77 percent), and has a positive economic impact on local communities (71 percent). Refugee respondents also reported that the program encourages them to work in jobs that do not match their skills and credentials (56 percent), does not provide enough integration support after three months (54 percent), does not offer sufficient financial help during their first three months (49 percent), and reunites families too slowly (47 percent). Respondents identified the following main false ideas about the program: refugees pose a security risk (84 percent), use too many benefits and drain public finances (83 percent), and take the jobs of the native-born (74 percent). Refugee respondents reported using public benefits to meet basic needs, such as medical care, food, and housing. Non-refugee survey respondents believed at high rates that former refugees (69 percent) and refugee community advocate groups (64 percent) should be afforded a voice in the resettlement process. Non-refugee respondents indicated at high rates that the program’s employment requirements limit the time needed for refugees to learn English (65 percent) and limit their ability to pursue higher education (59 percent). Eighty-six percent of non-refugee respondents indicated that the Reception and Placement program is much too short (56 percent) or a little too short (30 percent). Respondents identified a wide range of persons and institutions as being very helpful to refugees in settling into their new communities: these included resettlement staff, friends, and acquaintances from refugees’ country of origin, members of places of worship, community organizations led by refugees or former refugees, and family members. Refugee respondents identified finding medical care (61 percent), housing (52 percent), and a job (49 percent) as the most helpful services in their first three months in the country. Refugees reported that the biggest challenge in their first year was to find employment that matched their educational or skill levels or backgrounds. The needs of refugees and the main obstacles to their successful integration differ by gender, reflecting at least in part the greater childcare responsibilities borne by refugee women. Refugee men reported needing assistance during their first three months in finding employment (68 percent), English Language Learning (ELL) courses (59 percent), and orientation services (56 percent), while refugee women reported needing orientation services (81 percent) and assistance in securing childcare (64 percent), finding ELL courses (53 percent), and enrolling children in school (49 percent). To open-response questions, non-refugee respondents identified as obstacles to the integration of men: digital literacy, (lack of) anti–domestic violence training, the need for more training to improve their jobs, the new public benefit rule, transportation to work, low wages, the need for more mental health services, cultural role adjustment, and lack of motivation. Non-refugee respondents identified as obstacles to the integration of women: lack of childcare and affordable housing, the different cultural roles of women in the United States, lack of affordable driver’s education classes, a shortage of ELL classes for those with low literacy or the illiterate, digital literacy challenges, difficulty navigating their children’s education and school systems, transportation problems, poorly paying jobs, and lack of friendships with US residents. Non-refugee respondents report that refugee children also face unique obstacles to integration, including limited funding or capacity to engage refugee parents in their children’s education, difficulties communicating with refugee families, and the unfamiliarity of teachers and school staff with the cultures and backgrounds of refugee children and families. LGBTQ refugees have many of the same basic needs as other refugees — education, housing, employment, transportation, psychosocial, and others — but face unique challenges in meeting these needs due to possible rejection by refugees and immigrants from their own countries and by other residents of their new communities. Since 2017, the number of resettlement agencies has fallen sharply, and large numbers of staff at the remaining agencies have been laid off. As a result, the program has suffered a loss in expertise, institutional knowledge, language diversity, and resettlement capacity. Resettlement agencies and community-based organizations (CBOs) reported at high rates that to accommodate pre-2017 numbers of refugees, they would need higher staffing levels in employment services (66 percent), general integration and adjustment services (62 percent), mental health care (44 percent) and medical case management (44 percent). Resettlement agencies indicated that they face immense operational and financial challenges, some of them longstanding (like per capita funding and secondary migration), and some related to the Trump administration’s hostility to the program. Section I introduces the article and provides historic context on the US refugee program. Section II outlines the resettlement process and its constituent programs. Section III describes the CMS Refugee Resettlement Survey: 2020. Section IV sets forth the study’s main findings, with subsections covering USRAP’s purpose and overall strengths and weaknesses; critiques of the program; the importance of receiving communities to resettlement and integration; the effectiveness of select USRAP programs and services; integration metrics; and obstacles to integration. The article ends with a series of recommendations to rebuild and strengthen this program.

BACKGROUND AND OBJECTIVES: The Accreditation Council for Graduate Medical Education has approved 117 neurological surgery residency programs which develop and educate neurosurgical trainees. We present the current landscape of neurosurgical training in the United States by examining multiple aspects of neurological surgery residencies in the 2022–2023 academic year and investigate the impact of program structure on resident academic productivity. METHODS: Demographic data were collected from publicly available websites and reports from the National Resident Match Program. A 34-question survey was circulated by e-mail to program directors to assess multiple features of neurological surgery residency programs, including curricular structure, fellowship availability, recent program changes, graduation requirements, and resources supporting career development. Mean resident productivity by program was collected from the literature. RESULTS: Across all 117 programs, there was a median of 2.0 (range 1.0-4.0) resident positions per year and 1.0 (range 0.0-2.0) research/elective years. Programs offered a median of 1.0 (range 0.0-7.0) Committee on Advanced Subspecialty Training–accredited fellowships, with endovascular fellowships being most frequently offered (53.8%). The survey response rate was 75/117 (64.1%). Of survey respondents, the median number of clinical sites was 3.0 (range 1.0-6.0). Almost half of programs surveyed (46.7%) reported funding mechanisms for residents, including R25, T32, and other in-house grants. Residents received a median academic stipend of $1000 (range $0-$10 000) per year. Nearly all programs (93.3%) supported wellness activities for residents, which most frequently occurred quarterly (46.7%). Annual academic stipend size was the only significant predictor of resident academic productivity (R2 = 0.17, P = .002). CONCLUSION: Neurological surgery residency programs successfully train the next generation of neurosurgeons focusing on education, clinical training, case numbers, and milestones. These programs offer trainees the chance to tailor their career trajectories within residency, creating a rewarding and personalized experience that aligns with their career aspirations.

In this study, we explored how high school students’ participation in a local history research project about a historically Black cemetery in the Southeast United States contributed to their demonstration of historical empathy. Major findings show that students displayed historical empathy in research activities that occur beyond the traditional classroom through their examination of perspectives concerning representations of race and diversity in the social studies curriculum, the historical contexts about the impact of enslavement and Jim Crow segregation in their community, and affective connections they made to their identities as citizens. We recommend that future studies focus on how social studies teachers, community organizations, and other educational providers can collaborate to promote historical empathy in and outside of schools with equity frameworks and curricular initiatives such as the National Council for the Social Studies College, Career, and Civic Life (C3) Framework.

Geography Today: An Encyclopedia of Concepts, Issues, and Technology approaches the study of geography by concept, in contrast to most other works, which are organized by world region. Geography curriculums have been moving away from teaching the topic on a regional basis and toward teaching it through broader concepts. This is modeled by the National Geography Standards, the National Council for Geographic Education’s Roadmap for 21st Century Geography Education, Texas Essential Knowledge and Skills Resource System, and ABC-CLIO’s own geography advisory board, comprised of high school geography teachers from across the United States. By introducing geography concepts, Geography Today sets the foundation for readers to understand why certain geographies may be the way they are. It further helps high school geography students to apply concepts to different contexts with 101 geography terms, themes, and concepts for quick-reference research and study.

The same skills and strategies can propel an aspiring executive to the top of any organization, be it the Podunk High School Student Council, the Acme Xylophone Corporation, or the government of the United States of America. The student council president may be an unpaid volunteer, and the Acme CEO may bark out orders in an office that is rectangular, not oval. But the paths that lead to those positions are remarkably similar to the trail that ends so gloriously at the front door of the White House. Author G. Scott Thomas spent two years examining the lives of nearly two hundred presidential candidates—winners and losers, the famous and the obscure—with an eye for the tactics and qualities that served their careers well or damaged them beyond repair. He has distilled their experiences into a comprehensive guide to success, Advice from the Presidents. Thomas's book offers a wealth of advice, quotations, and anecdotes that are pertinent to any up-and-coming young man or woman. Which strategies for advancement are effective and which are doomed to fail? Which personal traits should be emulated and which are detrimental? Presidential candidates have learned the answers the hard way, earning the education of a lifetime in the gritty, cutthroat arena of national politics, a field as competitive as any to be found in corporate America. And now, for the first time, their valuable knowledge will be made available to ambitious executives and eager students across the country. Readers will learn the seven time-tested steps that can transform a would-be chief executive or U.S. President into the real thing: Decide upon your long-term goal. Develop your skills and interests. Polish your image and your people skills. Organize a network of mentors and helpers. Control your inner demons and your opponents. Maneuver to improve your position. Succeed with grace and serenity. In this book, readers will follow the career paths of famous American politicians. There have been smart presidents and unintelligent ones, honest and dishonest ones, diligent and lazy ones. But all of these master politicians have remarkably different skills and personalities but had one thing in common. They all followed the same seven-step career plan detailed in Advice from the Presidents. And so can any ambitious person in any walk of life.

In light of a projected shortage of registered nurses, nurses trained overseas may present a viable solution. However, these nurses will likely need to surmount many obstacles in order to integrate into the profession in the United States. This chapter reviews the barriers faced by internationally trained nurses to entering the nursing profession. Secondly, it argues for the importance of addressing and facilitating personal and professional transitions in helping deskilled nurses as they pursue nursing licensure. In doing so, it will reflect on the researcher's research with internationally educated nurses and their experiences in a National Council Licensure Examination (NCLEX) preparation program. Finally, implications for adult education practitioners who help internationally educated nurses, as well as other deprofessionalized immigrants rebuild their careers in the United States are discussed.

Abstract Irving Greenberg was born in 1933 in Brooklyn, New York. His father was the rabbi of the Chevra Shas (a talmudic study group) in Boro Park. As a child, he received an Orthodox day school education that was enriched by active involvement in the Zionist youth movement Hashomer Hadati (known today as Bnai Akiva). He continued his Jewish education at the Beth Joseph Rabbinical Seminary and his secular education at Brooklyn College. In 1953, he received his B.A. in history from Brooklyn College and continued on to a doctoral program in intellectual history at Harvard. He received his Ph.D. from Harvard in 1960. Eschewing an academic career, he became a communal rabbi in Boston where he came under the influence of Rabbi Joseph B. Soloveitchik. This encounter caused a change of career plans, and Greenberg began to teach Jewish history at Yeshiva University in New York City. In 1961-1962, he was a Fulbright scholar at Tel Aviv University and while in Israel turned to deep reading about both the Holocaust and the State of lsrael. Upon his return to the United States, he became involved in Holocaust education which, in turn, led him to leave Yeshiva University in 1965 in order to accept a rabbinical position in Riverdale, New York. After seven years in this post, he once again entered academic life, accepting the chairmanship of the Department of Jewish Studies at the City University of New York. In 1979 he made another turn, leaving the university to become the director of CLAL, the National Jewish Center for Learning and Leadership, an organization that aimed to bring intense, advanced, Jewish education to the wider Jewish community. During the 1970s, Greenberg also teamed with Elie Wiesel and others to create the U.S. Holocaust Memorial Museum, and from 2000 to 2002 he served as chairman of the museum’s council.