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A shortage of primary care physicians exists in the US, and medical schools are investigating factors that influence specialty choice. To better understand the factors associated with medical students choosing primary care specialties, a longitudinal annual survey from 2013 to 2019 was administered to students at the University of Iowa Carver College of Medicine, starting pre-matriculation. A logistic regression model examined factors of interest. Matching into a primary care specialty (family medicine, internal medicine, pediatrics) for residency was the primary outcome. Our study compared factors students reported in annual surveys: demographics, mentorship, debt, and lifestyle. Factors significantly associated with primary care specialty included pre-medical and medical school research, a family member in primary care, student age and gender. 28% of men chose primary care, and 47% of women. Although there was no gender difference in rates of medical education debt (N = 286,χ2(1) = 0.28, p = 0.60), men were more likely to report being influenced by debt (N = 278, χ2(1) = 10.88, p = 0.001), and students who reported debt-influenced specialty choice were one-third as likely to enter primary care (N = 189, 95% CI [0.11-1.06], p = 0.06). For men, potential salary was negatively associated with entering primary care (p = 0.03). Women were more likely to have a mentor in primary care (N = 374, χ2(1) = 13.87, p < 0.001), but this was not associated with an increased likelihood of entering primary care for men or women. Having a family member who practices primary care was associated with a 2.87 times likelihood of entering primary care (N = 303, 95% CI [1.14-7.19], p = 0.03). The decision to enter primary care is influenced by many factors; a key gender differentiator is that men's specialty choice is more negatively influenced by financial concerns.

When Morris Fox was introduced to goth subculture as a high-school student in Toronto, he became a part of an alternative community that offered protection from the outside forces that he was confronting as a teenager. Turning to the anachronistic modes of dress associated with gothic style, Fox quickly came to appreciate chainmail. He would routinely construct squares of the intricate metal textile while riding the subway. Although chainmail is synonymous with distant fantasies of medieval knights, chivalry, and even toxic masculinities, his practice demonstrates that it is a material porous with new possibilities. Fox's plastic chainmail objects subvert the notion that it is an indestructible substance. Despite plastic's promise as a durable or protective material, these objects are not made to withstand force. Instead, the plasticized loops are lightweight, brittle, and quite delicate. In Retiarius (Net Fighter), a crystal-adorned chainmail fishing net is coupled with an armored vest made of iridescent bubble-wrap envelopes. In place of kevlar, anonymous letters from intergenerational queer folks are placed within, transforming the armor into a vessel of vulnerability. Its metallic shimmer demands a level of attention: look, but don't touch.

Background Dietary interventions are used for the treatment of hypertension. We evaluated the cost-efficacy of delivering boxes of healthy, culturally tailored foods and checks that can only be spent on produce in a Native American population. Methods We conducted a group randomized controlled trial from 2018 to 2020 with N  = 2 treatment counties and N  = 2 control counties and a total of N  = 160 Native American adults with baseline stage 1 or stage 2 hypertension. Participants in the intervention group received monthly boxes of food that adheres to the Dietary Approaches to Stop Hypertension diet as well as checks that could only be spent on produce for 6 months. We measured blood pressure and quality of life at baseline and at a 6-month follow-up in both intervention and control groups. We used ordered logistic regression to estimate the effect of treatment on probability of blood pressure improvements. We then conducted a cost-efficacy analysis. Results We found that treatment was effective in reducing blood pressure in women with stage 1 hypertension at baseline. Based on this finding, we also estimate that this intervention satisfies normative cost-effectiveness thresholds, even when lifetime treatment is needed to preserve the impact, so long as treatment is only continued in those who respond to treatment. Conclusions Direct delivery of healthy foods and checks that can only be spent on produce are a potentially cost-effective intervention for the management of hypertension among Native American women with stage 1 hypertension. Further research is needed to understand why we found an impact only for this group.

Displayed upon a shelf in my family's cottage are two group photos housed in plain black frames. On the left is the paternal side of my family (Henderson) and on the right, my Greek-Canadian maternal family (Lakas). Both taken during the summer in the early 1950s, the photographs are set in parks during annual family reunions.

Henderson discusses family portraits by several artists including JJ Levine, Jamie Diamond, and Naima Green. Using the family portrait as a foundation in their respective lens-based practices, Levine, Diamond, and Green expand upon the traditional classifications of \"family\" to portray the multitude of family structures that exist in queer communities. Not only does their work exceed the limitations inherent to conventional photographic practices, but they also contribute to the countless definitions of family in order to reveal the promises for queer familial futures. Both Levine and Green stand in support of their fellow LGBTQIA2S+ communities while representing them as authentically as possible, whereas Diamond's practice subverts the normative understanding of a family unit.

Objectives Home blood pressure monitoring (HBPM) is crucial for managing hypertension, but there is a potential trade-off between measurement accuracy and health/economic outcomes due to asymmetric costs associated with misclassifying an individual as having hypertension or not. We assessed whether adjustments to device readings that increased overall accuracy produced net health and economic benefits. Methods We analyzed data from N  =  89 Alaska Native individuals who used 2 HBPM devices and a standard aneroid sphygmomanometer. We modeled changes in expected costs associated with individuals being misclassified as hypertensive or not under 3 different models of adjusting HBPM device readings. Results The gains in accuracy produced by adjusting HBPM readings decreased the overall rate of hypertension misclassification but increased the rate of false-negative readings. Adjusting readings led to a net increase in expected health and economic costs. Discussion Ignoring asymmetric costs of misclassification can escalate overall costs and worsen uncontrolled hypertension. Home blood pressure monitoring algorithms must be cautiously designed, considering both false negatives and positives. Greater transparency in HBPM algorithms is needed for effective coordination among manufacturers, clinicians, and patients.

At a moment when going to the movies is difficult or altogether impossible, The Musical Years: 1920-2020 at VOX, centre de l'image contemporaine in Montréal offers a unique glimpse into the art of experimental filmmaking. With their perpetual flickering of light and colour, the gallery's exhibition spaces emulate a movie theatre dedicated to exploring the relationship between image and sound. When the terms \"musical\" and \"cinema\" are presented together, one might think of the dazzling extravaganzas produced by the wizards of Hollywood during the so-called Golden Age of American filmmaking, but that is not the focus of this exhibition. Rather, The Musical Years showcases innovations in audiovisual production, making it possible for viewers to trace the evolution of music's relationship to moving images, and vice versa. With too many works to adequately describe here, The Musical Years is a reminder of cinema's affinities with other artforms.

I don't think it is possible to create anything that will be impactful entirely by yourself. As the artist, I am the main filter through which the project is conceived, but I carry the responsibility of appropriately representing the community or field that I am collaborating with.1