Employment benefits across U.S. allopathic medical schools: National norms and relationships with institutional wealth.

This study summarizes employment benefits from across 155 U.S. allopathic medical schools, investigates differences in employment benefits according to institutional characteristics, and explores possible connections between employment benefits and institutional wealth. Employment benefits data were extracted from institutions' websites across four categories: time-off, time-away, retirement contributions, and Employee Assistance Programs (EAPs)/family benefits. This dataset was mixed with other publicly available datasets sourced through the Association of American Medical Colleges (AAMC), the American Council on Education (ACE), and the American Association of University Professors (AAUP) to conduct additional analyses. Nationally, medical schools offered an average of 31 vacation/sick days and 12 paid holidays. Schools typically offered 4 out of 8 time-away benefits. Employers' retirement contributions ranged from 3.0% to 15.5%, with a mean contribution of 8.5%. A total of 43.2% (67 of 155) of medical schools offered a pension. Collectively, private medical schools offered fewer time-away benefits and more EAP/family benefits compared to public schools. Universities with larger endowments per student were associated with a higher number of EAP/family benefits offerings (r = 0.543, p < 0.001). Institutional wealth did not influence other benefits offerings. The quantity/quality of most employment benefits offered at allopathic medical schools were wide-ranging, tended not to vary by region or school control, and were not a function of institutional wealth.

Interdisciplinary Quality Improvement Project Increases Vitamin D Supplementation in Infants.

BACKGROUND: American Academy of Pediatrics guidelines recommend 400 IU of vitamin D supplementation daily for certain infants <1 year of age. We aimed to increase the proportion of reported appropriate vitamin D supplementation for infants born at our institution and those who followed up in our resident clinic through 6 months from 49% to 80% over 24 months. METHODS: Our interdisciplinary quality improvement effort included vitamin D medication delivery before nursery discharge and family and staff education. The process measure was the percentage of families discharged from birth hospitalization with vitamin D and teaching. The outcome measure was the percentage of families reporting appropriate vitamin D supplementation at 2-, 4-, and 6-month well child visits. The balancing measure was the percentage of infants discharged from the nursery by 2 pm. Data were displayed on Statistical Process Control p charts and established rules for detecting special causes were applied. RESULTS: Baseline and improvement data were collected for 587 hospital discharges and 220 outpatient encounters. The percentage of families discharged with vitamin D increased from 24.8% to 98% from 2016 to 2018. Percent of families reporting appropriate vitamin D supplementation at well child visits increased from 49% to 89% from 2016 to 2018. Overall, the percentage of discharges by 2 pm remained stable at 60%. CONCLUSION: Bedside medication delivery and education in the newborn nursery improved reported vitamin D supplementation rates in the first 6 months of life. The intervention did not delay newborn hospital discharge.

Maternal holding during therapeutic hypothermia for infants with neonatal encephalopathy is feasible.

AIM: Concerns for infant destabilisation often prohibit parental holding of infants during therapeutic hypothermia (TH). We assessed the feasibility of maternal holding during TH, as the inability to hold can impede bonding. METHODS: Vital signs were assessed in stable infants before, at two-minute intervals during and 30 minutes after a single 30-minute holding session. The infant remained on the blanket throughout holding, and both infant and blanket were placed into the mother's arms on top of a thin foam insulating barrier. Mothers and nurses were surveyed about their experience. RESULTS: Ten infants undergoing TH for neonatal encephalopathy had no equipment malfunctions or dislodgement. The mean temperature was 33.4°C prior to and 33.5°C (p = 0.18) after holding. There was no significant bradycardia (heart rate <80 beats per minute), hypotension (mean arterial pressure <40 mm Hg) or oxygen desaturation (<93%). Nurses either strongly agreed (75%) or agreed (25%) with the statement 'After assisting with the holding protocol, I feel that holding during cooling is safe'. Mothers (100%) strongly agreed that other parents would benefit from holding. CONCLUSION: In a small sample of ten stable infants treated with TH for neonatal encephalopathy, holding resulted in no adverse events and positive feedback from mothers and nurses.

Access to transportation for Chittenden County Vermont older adults.

BACKGROUND: Aging often leads to decreased independence and mobility, which can be detrimental to health and well-being. The growing population of older adults will create a greater need for reliable transportation. AIMS: Explore whether and how lack of transportation has compromised areas of daily lives in older adults. METHODS: 1221 surveys with 36 questions assessing transportation access, usage, and impact on activities were distributed to Chittenden County, Vermont older adults; 252 met criteria for analysis. RESULTS: Older adults reported overwhelming difficulty getting to activities considered important, with 69 % of participants delaying medical appointments due to transportation barriers. Although family and friends represent a primary method of transportation, older adults reported difficulty asking them for help. DISCUSSION: Lack of accessible transportation leads to missed healthcare appointments and social isolation, which may have detrimental effects on older adults' quality of life. CONCLUSION: Many older adults face significant transportation challenges that negatively affect their health and well-being.