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The rigorous demands of medical education create circumstances that can make it challenging to maintain a healthy diet. Evaluations from students at an urban medical school in the northeast U.S. regarding their surgery clerkship highlighted the difficulty of finding healthy snacks or meals between operations and patient care obligations. In response, we implemented the Nutritional Wellness Initiative, a pilot program designed to offer accessible, healthy snacks to medical students during their surgery clerkship. We conducted a 3-month pilot program at three hospital sites and surveyed participants. Responses were compared to controls who completed their surgery rotation before initiation of the pilot program. Both groups emphasized the importance of having access to food during the workday for student wellness, with less than 50% of students in either group eating lunch daily during the surgery rotation. Of students who participated in the pilot program, 63% used the provided snacks at least once per week. This model offers one approach to improving student access to nutritious snacks during the busy surgery workday. To improve our program going forward, we have engaged the Director of Lifestyle Medicine and Wellness in the Department of Surgery to help optimize nutritional delivery and to create student education resources regarding healthy snacking habits and choices. [ABSTRACT FROM AUTHOR]

Introduction: Surgical outcomes and healthcare utilization have been shown to vary based on patient insurance status. We analyzed whether patients' insurance affects case urgency for and readmission after craniotomy for meningioma resection, using benign meningioma as a model system to minimize confounding from the disease-related characteristics of other neurosurgical pathologies., Methods: We analyzed 90-day readmission for patients who underwent resection of a benign meningioma in the Nationwide Readmission Database from 2014-2015., Results: A total of 9783 meningioma patients with private insurance (46%), Medicare (39%), Medicaid (10%), self-pay (2%), or another scheme (3%) were analyzed. 72% of all cases were elective; with 78% of cases in privately insured patients being elective compared to 71% of Medicare (p > 0.05), 59% of Medicaid patients (OR 2.3, p < 0.001), and 49% of self-pay patients (OR 3.4, p < 0.001). Medicare (OR 1.5, p = 0.002) and Medicaid (OR 1.4, p = 0.035) were both associated with higher likelihood of 90-day readmission compared to private insurance. In comparison, 30-day analyses did not unveil this discrepancy between Medicaid and privately insured, highlighting the merit for longer-term outcomes analyses in value-based care. Patients readmitted within 30 days versus those with later readmissions possessed different characteristics., Conclusions: Compared to patients with private insurance coverage, Medicaid and self-pay patients were significantly more likely to undergo non-elective resection of benign meningioma. Medicaid and Medicare insurance were associated with a higher likelihood of 90-day readmission; only Medicare was significant at 30 days. Both 30 and 90-day outcomes merit consideration given differences in readmitted populations.