Experiencing homelessness is associated with poor health, high levels of chronic disease and high premature mortality. Experiencing homelessness is known to be socially stigmatised and stigma has been suggested as a cause of health inequalities. No previous review has synthesised the evidence about stigma related to homelessness and the impact on the health of people experiencing homelessness. The present mixedmethods review systematically searched four databases and retrieved 21 original articles with relevant data around stigma, homelessness and health. Across all studies, there was broad agreement that some people experiencing homelessness experience significant stigma from providers when accessing health care and this impacts on general health and service access. There is also evidence that perceived stigma related to homelessness correlates with poorer mental and physical health.

Background community-based complex interventions for older adults have a variety of names, including Comprehensive Geriatric Assessment, but often share core components such as holistic needs assessment and care planning. Objective to summarise evidence for the components and effectiveness of community-based complex interventions for improving older adults’ independent living and quality of life (QoL). Methods we searched nine databases and trial registries to February 2022 for randomised controlled trials comparing complex interventions to usual care. Primary outcomes included living at home and QoL. Secondary outcomes included mortality, hospitalisation, institutionalisation, cognitive function and functional status. We pooled data using risk ratios (RRs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs). Results we included 50 trials of mostly moderate quality. Most reported using holistic assessment (94%) and care planning (90%). Twenty-seven (54%) involved multidisciplinary care, with 29.6% delivered mainly by primary care teams without geriatricians. Nurses were the most frequent care coordinators. Complex interventions increased the likelihood of living at home (RR 1.05; 95% CI 1.00–1.10; moderate-quality evidence) but did not affect QoL. Supported by high-quality evidence, they reduced mortality (RR 0.86; 95% CI 0.77–0.96), enhanced cognitive function (SMD 0.12; 95% CI 0.02–0.22) and improved instrumental activities of daily living (ADLs) (SMD 0.11; 95% CI 0.01–0.21) and combined basic/instrumental ADLs (SMD 0.08; 95% CI 0.03–0.13). Conclusions complex interventions involving holistic assessment and care planning increased the chance of living at home, reduced mortality and improved cognitive function and some ADLs.

Background Aesthetic surgery fellowship applications were consolidated under the San Francisco Match in 2018. The impact of these changes on aesthetic program and applicant numbers has not yet been investigated. Objectives This study sought to evaluate changes in programs, positions, applications, match rates, and fill rates since aesthetic surgery joined the San Francisco Match. It also aimed to compare these trends to craniofacial surgery, microsurgery, and hand surgery fellowships over this same time period. Methods San Francisco and National Resident Matching Program (NRMP) Match data for aesthetic, craniofacial, microsurgery, and hand fellowships were obtained from 2018 to 2022, and the number of applications, positions, programs, and successful matches were evaluated. Results The number of aesthetic fellowship positions increased from 17 to 41 (141%) over the period studied. This resulted in increased match rates and more unfilled positions. Over the same period, fellowship positions for craniofacial, hand, and microsurgery increased by 3.4%, 6%, and 2.5% respectively. There was no increase in applications to any post-graduate subspecialty, nor was there any change in the number of residents pursuing fellowship. Similarly, there was no change in the percentage of fellowship-bound residents applying to any given discipline. Conclusions The increase in aesthetic fellowship programs and positions did not generate an increase in applications. Applications to other plastic surgery sub-specialties also failed to increase. Unlike aesthetic fellowships, their program numbers have remained stable. Given the limited fellowship applicant pool, our focus should be on enhancing the quality of existing aesthetic programs rather than continuing to increase the number of aesthetic positions.

Background: Applying to craniofacial surgery fellowship is a competitive process, and applicants may find it challenging to determine which programs are the best fit. We sought to evaluate the quality of information available on craniofacial surgery fellowship websites (CFWs), identify areas for improvement, and evaluate social media presence. Methods: Individual CFWs were identified from the ASCFS directory and Google search. Demographic information was collected from the ASCFS directory, and CFWs were evaluated for qualitative information. Social media presence was assessed by querying Facebook, Instagram, and Twitter for official and active accounts. Results: Thirty-one programs were identified. While most ASCFS listings included addresses (93.6%) and program coordinator contact (87.1%), only half included program director contact. The majority of CFWs included a procedure list (71.0%), research opportunities (58.1%), current fellows (56.7%), and didactic schedules (71.0%). Few CFWs included case logs (16.1%), call schedule (22.6%), salary/benefits (25.8%), and alumni information (38.7%). Regarding social media presence, only 3 craniofacial fellowship programs were on Facebook (9.7%), 2 on Instagram (6.5%), and none on Twitter. In comparison, affiliated plastic surgery residencies were more active on Instagram (64.5%), Facebook (38.7%), and Twitter (25.8%). Conclusion: There are several potential areas for improvement of CFWs, including maintaining an updated ASCFS directory of CFWs. Programs may consider adding information about case logs, call schedule, and alumni career path. Creating comprehensive websites and increasing social media presence would provide a valuable source of information to potential applicants and serve as an effective tool for recruitment.