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Background The importance of effective leadership for improving patient care and physician well-being is gaining increased attention in medicine. Despite this, few residency programs have formalized education on leadership in medicine. The most effective ways to train graduate medical education (GME) trainees in leadership are unclear. Methods Our large internal medicine residency program implemented a book club to develop leadership skills in residency. Through independent reading of the selected book and resident-led small group discussions, we facilitated dialogue on the challenges of leading effectively. Results A survey-based curricular evaluation demonstrated that 61% of respondents felt that the book club influenced their thoughts about leadership and that 66% of participants would recommend the book club to other residency programs. Lack of time was the main barrier to participation while addition of complementary media or alternative book formats were identified as possible solutions to increase engagement. Conclusions Leadership book clubs are a practical and effective way to teach leadership during residency. More research is needed to identify the best formats for book club discussion and to develop additional tools to foster future physician leaders.

Utilization of a smart phone application paired with a time-spaced learning curriculum was investigated to determine its impact on antimicrobial stewardship practice among internal medicine trainees. Stewardship behaviors increased, barriers decreased, and trainees had increased confidence in managing common infectious disease syndromes after the intervention.

This paper examines patterns of seasonal variation in food consumption and responses to food stress in the highland community of Nuñoa, Peru. Dietary and anthropometrie data collected from January through August of 1985 on a sample of 26 households (127 individuals) are analyzed. This study finds sharp seasonal differences in energy intake (pre-harvest = 1150 calories/day; post-harvest = 1519/day; p < 0.01) associated with variation in the availability of locally-produced products (e.g., tubers and cereals). Seasonal energy reduction, however, does not uniformly affect all sectors of this population. Children experience little seasonal change in energy intake and have a more adequate pre-harvest diet and better nutritional status than adults. The responses used to \"protect\" children from energy stress and minimize the overall impact of seasonal food scarcity on this community include: 1) reduction of pre-harvest household caloric needs through emigration of adolescent and adult males, 2) preferential allocation of food to children during the pre-harvest period, 3) seasonal reduction of activity levels and the year-round use of children for many productive activities, and 4) seasonal changes in meal patterns that minimize post-prandial energy loss during periods of stress. Evaluation of similar data from other anthropological populations underscores the diversity of responses to seasonal change in food availability. Moreover, these data indicate that the protection of children from seasonal energy stress is more common than previously thought. Variation in adaptive responses to food stress appears to be dependent upon 1) the nature of the subsistence economy, 2) the relative contributions of children and adults to household production, and 3) the demographic structure of the population.

Among 2,616 men measured at Harvard College between 1880 and 1912, the 1,511 who subsequently married and had children were 0.8 cm taller than the 578 men who remained single, and 1.0 cm taller than the 527 men who married but had no children. The three groups of men did not differ in weight or in ponderal index, height/\\sqrt[3]{{weight}}. The 1,511 fathers showed no association between ultimate fertility and height, weight, or ponderal index.

This chapter provides an overview of the development of the biocultural approach during the twentieth and twenty‐first centuries. Through a case study focused on a predominantly Quechua population in the high Andes of southern Peru, it demonstrates how biocultural anthropology has evolved over the past several decades in its investigations of social and environmental transformation. The chapter shows how misunderstanding, trial and error, and analytically running in place to keep up with a constantly changing political and cultural landscape drove changes in his thinking, and how these mirror the same processes in the overall discipline of anthropology as it progressively produced the biocultural approach. The case study also demonstrates how a biocultural approach can be broadened by integrating adaptive and political economic perspectives in a complementary manner.

The present paper examines the use of dung for two essential human resources, fuel and fertilizer, in a highland community of southern Peru. The limited energy availability and the poor soils of the region, primarily the result of high-altitude climate and topography, necessitate this practice. Alternatives to dung use are costly or unavailable. Grazing herbivores transform the widely dispersed puna grasses into a compact and easily gathered source of energy and nutrients. Native choice among available dungs corresponds to their qualities: sheep dung, richest in nutrients, is applied as fertilizer; llama and cattle dungs, each with a high caloric value, are burned as fuels. Dung use is interpreted as an energetically efficient response to the highland environment and as central to the subsistence pattern in the area.

As stated in the introductory chapter, the goal of this volume is to expand the scope of research in physical anthropology by explicitly incorporating political-economic analyses into the assessment of human biological well-being. The goal is twofold. First is to explore a reformulation of the adaptation concept, which constitutes the theoretical core of biological anthropology. By broadening the scope of adaptive theory and adopting a perspective that more accurately acknowledges social and political realities, physical anthropologists can more comprehensively address a set of prevalent problems compromising the human condition. Such a perspective would provide valuable insights, for instance, into why