Patient inequities in affording surgical resident operative autonomy at Veterans Affairs teaching hospitals, does it extend to female patients?

BACKGROUND: Examining surgical resident operative autonomy within the Veterans Affairs (VA) System, we previously showed residents were afforded autonomy more frequently on Black patients. We hypothesized that, compared to males, female surgical patients receive less attending involvement and more resident autonomy during surgery. METHODS: Retrospective review of all general/vascular surgeries performed at teaching VA hospitals from 2004 to 2019. Operative procedures are coded at the time of surgery as attending primary surgeon (AP), attending with resident (AR), or resident primary surgeon--attending not scrubbed (RP). The primary outcome was the difference in supervision rates between patient sexes. RESULTS: 618,578 operations were examined-24.9% AP, 68.9% AR, and 6.2% RP. Overall, 5.9% of cases were performed on women. The rate of RP cases was higher in males compared to females (6.3% vs 5.3%, p < 0.001). CONCLUSION: Female veterans are less likely to have residents operate on them autonomously. Reasons for this require further characterization.

An analysis of the perception of stop consonants in bilinguals and monolinguals in different phonetic contexts: A range-based language cueing approach.

Bilinguals' observed perceptual shift across language contexts for shared acoustic properties between their languages supports the idea that bilinguals, but not monolinguals, develop two phonemic representations for the same acoustic property. This phenomenon is known as the double phonemic boundary. This investigation replicated previous findings of bilinguals' double phonemic boundary across a series of go/no-go tasks while controlling for known confounding effects in speech perception (i.e., contrast effects) and differences in resource allocation between bilinguals and monolinguals (i.e., left-hand or right-hand response). Using a range-base language cueing approach, we designed 2 experiments. The first experiment tested whether a voice onset time (VOT) range representative of either Spanish or English phonetic categories can cue bilinguals, but not monolinguals, to use language-specific perceptual routines. The second experiment tested a VOT range with a mixture of Spanish and English phonetic categories to determine whether directing attention to a specific phonetic category can disambiguate the competition of the nonattended category. The results for Experiment 1 showed that bilinguals can rely on the distributional patterns of their native phonetic categories to activate specific language modes. Experiment 2 showed that attention can change the weight given to a native phonetic distinction. However, this process is restricted by the internal phonetic composition of the native language(s).