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\"It is the wrong time to get sick. Speeding down the highway on the way to work, her two little girls sleeping in the back seat, medical resident Claire Rawlings doesn't have time for the nausea overtaking her. But as the world tilts sideways, she pulls into a gas station, runs to the bathroom, and passes out. When she wakes up minutes later, her car--and her daughters--are gone. The police have no leads, and the weight of guilt presses down on Claire as each hour passes with no trace of her girls. All she has to hold on to are her strained marriage, a potentially unreliable witness who emerges days later, and the desperate but unquenchable belief that her daughters are out there somewhere. As hopeful and uplifting as it is devastating, Little Lovely Things is the story of a family shattered by unthinkable tragedy, and the unexpected intersection of heartbreak and hope.\"-- Provided by publisher.

This study aims to investigate the relationships of the residents’ empowerment and support for tourism development with the perceived contribution of sustainable tourism and to identify precise attributes among different resident age groups, which can be used to improve the residents’ perceived contribution of sustainable tourism. Research was conducted on a convenience sample of adult Croatian residents using a survey method. The results reveal that empowerment and support for tourism development are essential predictors of perceived sustainable tourism contribution in the group of residents older than 36 years of age. Furthermore, support for tourism development positively affects the perceived contribution of sustainable tourism among younger residents. In addition, the correlation analysis identified stronger relationships between all empowerment attributes and the perceived contribution of sustainable tourism among older residents. In both agegroups of residents, all tourism support attributes are positively correlated with a perceived contribution of sustainable tourism. These findings give a comprehensive framework for understanding how the residents’ empowerment and tourism support development shape perceived sustainable tourism outcomes while considering age-related variations in community responses. Cilj je ovog rada istražiti odnose osnaživanja i podrške stanovnika razvoju turizma s percipiranim doprinosom održivog turizma, te identificirati atribute među različitim dobnim skupinama stanovnika, koji se mogu upotrebljavati za poboljšanje percepcije stanovnika o doprinosu održivog turizma. Istraživanje je provedeno na prigodnom uzorku punoljetnih stanovnika Hrvatske metodom anketiranja. Rezultati ukazuju na to da su osnaživanje i potpora razvoju turizma ključni prediktori percipiranog doprinosa održivog turizma u skupini stanovnika starijih od 36 godina. Nadalje, podrška razvoju turizma pozitivno utječe na percipirani doprinos održivog turizma među mlađim stanovnicima. Dodatno, korelacijskom analizom utvrđena je snažnija povezanost između svih atributa osnaživanja i percipiranog doprinosa održivog turizma za skupinu stanovnika stariju od 36 godina. U objema dobnim skupinama stanovnika svi atributi podrške turizmu pozitivno su povezani s percipiranim doprinosom održivog turizma. Ovi rezultati daju sveobuhvatan okvir za razumijevanje kako osnaživanje stanovnika i potpora razvoju turizma oblikuju percipirane rezultate održivog turizma, uzimajući u obzir varijacije reakcije lokalne zajednice povezane s dobi stanovnika

This study explores residents’ perceptions of a sporting event’s impacts and identifies which factors most influence their support for the event. It introduces residents’ awareness of the event as a variable affecting both their impact perceptions and support. Using social exchange theory and the CRO Race cycling event in Croatia as a case, the study analyzed data from 1,191 respondents through exploratory factor analysis, structural equation modeling (SEM), and bivariate statistical tests. The findings indicate a multidimensional structure of event impacts, with perceived benefits such as increased destination visibility, enhanced image, and knowledge and entertainment opportunities having the greatest influence on support. While bivariate tests revealed significant differences in perceived impacts and support between “aware” and “unaware” groups, multigroup analysis found no significant differences in how awareness influences the relationship between impacts and support. By examining event awareness as a key factor in residents’ perceptions, this study contributes to event management research and offers practical insights for event organizers and policymakers.

Resident satisfaction is a key performance metric for surgery programs; we studied factors influencing resident satisfaction in operative cases, and the concordance of faculty and resident perceptions on these factors. Resident and faculty were separately queried on satisfaction immediately following operative cases. Statistical significance of the associations between resident and faculty satisfaction and case-related factors were tested by Chi-square or Fisher's exact test. Residents and faculty were very satisfied in 56/87 (64%) and 36/87 (41%) of cases respectively. Resident satisfaction was associated with their perceived role as surgeon (p < 0.04), performing >50% of the case (p < 0.01), autonomy (p < 0.03), and PGY year 4–5(p < 0.02). Faculty taking over the case was associated with both resident and faculty dissatisfaction. Faculty satisfaction was associated with resident preparation (p < 0.01), faculty perception of resident autonomy (p < 0.01), and faculty familiarity with resident's skills (p < 0.01). Resident and faculty satisfaction are associated with the resident's competent performance of the case, suggesting interventions to optimize resident preparation for a case or faculty's ability to facilitate resident autonomy will improve satisfaction with OR experience.

Introduction Extended-duration work shifts (≥ 24 hours), the cornerstone of medical education, have been associated with reduced sleep first-year resident physicians in a single-site study. We compared more senior resident physician work hours and sleep habits in a multi-center clustered-randomized crossover clinical trial that randomized resident physicians to an Extended Duration Work Roster (EDWR) with extended-duration (≥24 hours) shifts or a Rapidly Cycling Work Roster (RCWR) where scheduled shift lengths were limited to no more than 16 consecutive hours. Methods Across six U.S. academic medical centers, we enrolled 302 resident physicians in their second or more senior postgraduate year. They completed 370 one-month pediatric intensive care unit rotations. Sleep was objectively estimated with wrist-worn actigraphs. Work hours and subjective sleep duration were reported in an electronic daily diary. Results Resident physicians work hours were reduced by 10% during the RCWR (61.9 ± 4.8 hours compared to 68.4 ± 7.4 hours during the EDWR; p<0.0001). During the RCWR, 73% of work hours occurred within shifts of ≤16 consecutive hours. In contrast, during the EDWR 38% of work hours occurred on shifts of ≤16 consecutive hours. Resident physicians obtained significantly more sleep per week on the RCWR (52.9 ± 6.0 hours) compared to the EDWR (49.1 ± 5.8 hours, p<0.0001). The percentage of 24-hour intervals with less than 4 hours of actigraphically measured sleep was 9% on the RCWR and 25% on the EDWR (p<0.0001). During the RCWR, 4% of work hours were preceded by two or fewer hours of sleep in the preceding 24 hours, as compared to 10% of work hours during the EDWR (p<0.0001). Conclusion: RCWRs were effective in reducing weekly work hours and the occurrence of >16 consecutive hour shifts in more senior resident physicians. Sleep duration was increased and resident physicians were more rested while caring for patients. Additional research is needed to optimize scheduling practices that ensure sufficient sleep prior to all work shifts. Support (If Any) ROSTERS supported by National Heart, Lung, and Blood Institute (U01-HL-111478, U01-HL-111691).

From Residency to Retireme nt tells the stories of twenty American doctors over the last half century, which saw a period of continuous, turbulent, and transformative changes to the U.S. health care system. The cohort's experiences are reflective of the generation of physicians who came of age as presidents Carter and Reagan began to focus on costs and benefits of health services. Mizrahi observed and interviewed these physicians in six timeframes ending in 2016. Beginning with medical school in the mid-1970s, these physicians reveal the myriad fluctuations and uncertainties in their professional practice, working conditions, collegial relationships, and patient interactions. In their own words, they provide a \"view from the front lines\" both in academic and community settings. They disclose the satisfactions and strains in coping with macro policies enacted by government and insurance companies over their career trajectory. They describe their residency in internal medicine in a large southern urban medical center as a \"siege mentality\" which lessened as they began their careers, in Getting Rid of Patients , the title of Mizrahi's first book (1986). As these doctors moved on in their professional lives more of their experiences were discussed in terms of dissatisfaction with financial remuneration, emotional gratification, and intellectual fulfillment. Such moments of career frustration, however, were also interspersed with moments of satisfaction at different stages of their medical careers. Particularly revealing was whether they were optimistic about the future at each stage of their career and whether they would recommend a medical career to their children. Mizrahi's subjects also divulge their private feelings of disillusionment and fear of failure given the malpractice epidemic and lawsuits threatened or actually brought against so many doctors. Mizrahi's work, covering almost fifty years, provides rarely viewed insights into the lives of physicians over a professional life span.

Residents-as-teachers (RaT) is a theoretical framework emphasizing the significance of the similar learning background of teachers and learners. In Japan, community-based medical education (CBME) is a practical approach to teaching family medicine. This study aimed to investigate the impact and challenges of RaT on the learning of medical students and residents in CBME at a rural community hospital in Japan. Over the course of a year, the researchers conducted one-on-one interviews with three residents and ten medical students participating in family medicine training at the hospital. The interviews were recorded and transcribed verbatim. Grounded theory was used in the data analysis to clarify the findings. Three key themes emerged from the research: lack of educational experience with RaT, effectiveness of RaT, and challenges of RaT. Although participants were prejudiced against RaT, they felt its implementation could facilitate the establishment of beneficial relationships between learners and teachers. They were also able to participate in medical teams effectively. The findings suggest that the increased participation of senior doctors in RaT could strengthen its learning effects. RaT in rural CBME should be applied in various contexts, and its effectiveness should be further investigated both qualitatively and quantitatively.

In recent years, several international-comparative studies have analyzed the relationship between migration and native populations' decreasing support for redistributive policies. However, these studies use cross-sectional designs and aggregate the number of foreign-born residents at the national level. Both aspects are theoretically and methodologically problematic. We address these shortcomings by investigating cross-sectional as well as longitudinal effects in the case of Germany, using a combination of individual- and regional-level data for several time points from 1994 to 2010. Our results suggest that native-born populations become more reluctant to support welfare programs when the proportion of foreigners at the regional level increases. This effect is particularly strong in the initial phase of immigration, and it is further moderated by the economic context: the higher the unemployment rate, the more negative is the effect of foreigners on natives' attitude toward providing welfare.

This study explores residents' perceptions of a sporting event???s impacts and identifies which factors most influence their support for the event. It introduces residents' awareness of the event as a variable affecting both their impact perceptions and support. Using social exchange theory and the CRO Race cycling event in Croatia as a case, the study analyzed data from 1,191 respondents through exploratory factor analysis, structural equation modeling (SEM), and bivariate statistical tests. The findings indicate a multidimensional structure of event impacts, with perceived benefits such as increased destination visibility, enhanced image, and knowledge and entertainment opportunities having the greatest influence on support. While bivariate tests revealed significant differences in perceived impacts and support between \"aware\" and \"unaware\" groups, multigroup analysis found no significant differences in how awareness influences the relationship between impacts and support. By examining event awareness as a key factor in residents' perceptions, this study contributes to event management research and offers practical insights for event organizers and policymakers.