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1.
Harefuah ; 163(2): 79-84, 2024 Feb.
Artigo em Hebraico | MEDLINE | ID: mdl-38431854

RESUMO

INTRODUCTION: Drug therapy is a central pillar in the provision of medical care. A significant number of doctor-patient encounters conclude with a prescription for a drug. These are subsequently followed by a pharmacist-patient interaction that ends with the dispensing of prescription drugs and/or a recommendation for an over-the-counter drug and other products. In Israel, the fields of medicine and pharmacy are highly regulated with extensive legislation.


Assuntos
Medicina , Humanos , Israel , Farmacêuticos , Prescrições
2.
Harefuah ; 163(2): 102-108, 2024 Feb.
Artigo em Hebraico | MEDLINE | ID: mdl-38431859

RESUMO

INTRODUCTION: Translational research in medicine has undergone significant changes in the last decade, primarily due to the remarkable technological advancements made during this period. Oncology research is at the forefront of translational research in medicine and is heavily influenced by these changes. In this article, we briefly review the technologies that form the basis for the "next generation of translational research" in oncology in the coming decades, as well as the emerging trends in translational research in oncology through the implementation of these technologies.


Assuntos
Medicina , Pesquisa Translacional Biomédica , Humanos , Oncologia
3.
Harefuah ; 163(2): 125-132, 2024 Feb.
Artigo em Hebraico | MEDLINE | ID: mdl-38431863

RESUMO

INTRODUCTION: Translational medicine is a relatively new field, bridging between basic research and the practice of medicine, resulting in improved patient management. The outcomes of science are applied in methods of disease prevention, diagnosis and treatment of various diseases. Malignant hematology is among the fields in which translational medicine has significantly contributed to the current practice.


Assuntos
Hematologia , Medicina , Humanos , Ciência Translacional Biomédica
4.
Mayo Clin Proc ; 99(3): 424-434, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38432747

RESUMO

OBJECTIVE: To investigate whether the process of conferring academic rank or components of the promotion packet contribute to the lack of parity in academic advancement for women and individuals underrepresented in medicine (URMs). PATIENTS AND METHODS: We retrospectively reviewed prospective promotion applications to the position of associate professor or professor at Mayo Clinic from January 2, 2015, through July 1, 2019. Individuals with doctorate degrees who applied for either rank were included in the study. Data collected included demographic characteristics, curriculum vitae at time of application, committee score sheets, and deferral and approval decisions. Deferral rates for women compared with men and for URMs compared with non-URMs was the primary outcome. RESULTS: Of 462 people who applied for associate professor, 10% (n=46) were deferred. Those promoted had worked longer at Mayo Clinic (median, 6 years vs 2 years; P=.01), had more mentees (median, 6 vs 4; P=.02), authored more publications (median [interquartile range (IQR)], 39 [32-52] vs 30 [24-35]; P<.001), and were more likely to be on a National Institutes of Health or institutional grant (P<.05). Of the 320 people who applied for professor, 8.8% (n=28) were deferred. Those promoted had authored more publications (median [IQR], 77 [60-99] vs 56 [44-66]; P<.001) and were less likely to hold an elected office to a professional society (22.6% vs 39.3%; P=.05). There was no significant association between deferral status and sex (P>.4) or race/ethnicity (P>.9) for either rank. CONCLUSION: The process for academic advancement for professorships does not contribute to the gap in promotion rates for women and URMs.


Assuntos
Sucesso Acadêmico , Medicina , Estados Unidos , Masculino , Gravidez , Humanos , Feminino , Estudos Prospectivos , Estudos Retrospectivos , Instituições de Assistência Ambulatorial
5.
Yakugaku Zasshi ; 144(3): 329-338, 2024.
Artigo em Japonês | MEDLINE | ID: mdl-38432942

RESUMO

Although the issue of home medical care and pharmacists remains widespread, much of the discussion has concentrated on its state in urban areas. We believe that it is necessary to consider the state of home health care in medium-sized regions, that is separate from its urban form, with a population of approximately 100000. Thus, we conducted a qualitative study in Hikone City, Shiga Prefecture, to identify factors that impede pharmacists involved in home medical care. We conducted a questionnaire-based survey in an area of the same size to verify the generality of the concepts obtained from the qualitative study and validate the concepts using quantitative analyses. Two questionnaires on the role of community health care and home health care practice based on the concepts obtained from the qualitative study was sent to 342 pharmacies located in five regions. The number of valid responses was 170, and the data collection rate was 49.4%. We identified nine factors from the former and five from the latter. The current status of pharmacists in home health care in a medium-sized region, as identified by the quantitative study, was similar to that of the conceptual picture obtained from the qualitative study. Furthermore, the high versatility of the extracted concepts was verified.


Assuntos
Serviços de Assistência Domiciliar , Medicina , Farmácias , Humanos , Farmacêuticos , Serviços de Saúde Comunitária
6.
WMJ ; 123(1): 29-33, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38436636

RESUMO

INTRODUCTION: Pediatric hospitalized patients often are discharged before all lab tests are completed. Given the risk of medical errors related to inadequate test follow-up, we piloted a collaborative initiative to address tests pending at discharge (TPAD) within our pediatric hospital medicine section. Our objectives were to delineate the responsibilities of case managers and pediatric hospital medicine clinicians in addressing these tests and to establish a communication process. METHODS: We formed an interprofessional team and performed a current state assessment, including a survey to pediatric hospital medicine clinicians to assess time spent following up TPAD and confidence that results were followed up in a timely and appropriate manner. We obtained a list of 1450 individual TPAD for the previous 9 months using an electronic health record data query, from which a list of 26 common and straightforward labs were identified for case manager follow-up. A shared case manager Epic Inbasket for TPAD was created and was checked twice daily. We developed a phased approach to establish a workflow for follow-up. DISCUSSION: The case manager partnership was launched in 4 phases for the duration of the 6-month pilot. However, due to duplication of work and less value of case managers addressing straightforward labs, the pilot was stopped. A more effective and mutually beneficial role for pediatric hospital medicine attendings and case managers may be to have the case managers address complex TPAD and communicate with primary care clinicians and families.


Assuntos
Medicina Hospitalar , Medicina , Humanos , Criança , Alta do Paciente , Comunicação , Erros Médicos
7.
BMC Med Educ ; 24(1): 213, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38429703

RESUMO

BACKGROUND: Many UK junior doctors are now taking a year out of the traditional training pathway, usually before specialty training, and some choose to work as a clinical teaching fellow (CTF). CTFs primarily have responsibility for delivering hospital-based teaching to undergraduate medical students. Only a very small amount of literature is available regarding CTF posts, none of which has explored why doctors choose to undertake the role and their expectations of the job. This study aimed to explore the expectations and experiences of CTFs employed at NHS hospital Trusts in the West Midlands. METHODS: CTFs working in Trusts in the West Midlands region registered as students on the Education for Healthcare Professionals Post Graduate Certificate course at the University of Birmingham in August 2019 took part in a survey and a focus group. RESULTS: Twenty-eight CTFs participated in the survey and ten participated in the focus group. In the survey, participants reported choosing a CTF role due to an interest in teaching, wanting time out of training, and being unsure of which specialty to choose. Expectations for the year in post were directly related to reasons for choosing the role with participants expecting to develop teaching skills, and have a break from usual clinical work and rotations. The focus group identified five main themes relating to experiences starting their job, time pressures and challenges faced in post, how CTF jobs differed between Trusts, and future career plans. Broadly, participants reported enjoying their year in a post at a mid-year point but identified particular challenges such as difficulties in starting the role and facing time pressures in their day-to-day work. CONCLUSION: This study has provided a valuable insight into the CTF role and why doctors choose a CTF post and some of the challenges experienced, adding to the sparse amount of literature. Understanding post holders' experiences may contribute to optimisation of the role. Those employing CTFs should consider ensuring a formal handover process is in place between outgoing and incoming CTFs, having a lead person at their Trust responsible for evaluating changes suggested by CTFs, and the balance of contractual duties and personal development time.


Assuntos
Medicina , Médicos , Humanos , Motivação , Inquéritos e Questionários , Grupos Focais
8.
J Am Board Fam Med ; 37(1): 134-136, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38467430

RESUMO

Patient-physician race concordant dyads have been shown to improve patient outcomes; the race and ethnicity of family physicians providing women's health procedures has not been described. Using self-reported data, this analysis highlights the racial disparities in scope of practice; underrepresented in medicine (URiM) females are less likely to perform women's health procedures which may lead to disparities in care received by minority women.


Assuntos
Medicina , Médicos de Família , Feminino , Humanos , Saúde da Mulher , Etnicidade , Relações Médico-Paciente
9.
Zhonghua Yi Shi Za Zhi ; 54(1): 23-28, 2024 Jan 28.
Artigo em Chinês | MEDLINE | ID: mdl-38475682

RESUMO

There is a kind of historical relics called "Angdi moniu" in the Palace Museum, which looks like metal and appears frequently in the archives of the Qing Dynasty as a foreign medicine.It is stated that it can treat sores and pus in the HanXiu CaoTang Biji and it was also found in the archives of the Palace Office. However, no researcher in the academic community has yet conducted an in-depth research of what exactly is it. Through the investigation of cultural relics, in-depth research of Chinese and foreign literature, and the use of linguistic methods, this paper examines "Angdi Moniu" and its related items, and clarifies that "Angdi Moniu" is antimony, related items are antimonials and antimony cup.


Assuntos
Antimônio , Medicina , Museus , Internacionalidade , China , Medicina Tradicional Chinesa
10.
BMC Med Educ ; 24(1): 275, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38481201

RESUMO

BACKGROUND: With the transition away from traditional numerical grades/scores, residency applicant factors such as service, research, leadership, and extra-curricular activities may become more critical in the application process. OBJECTIVE: To assess the importance of residency application factors reported by program directors (PDs), stratified by director demographics and specialty. METHOD: A questionnaire was electronically distributed to 4241 residency PDs in 23 specialties during spring 2022 and included questions on PD demographics and 22 residency applicant factors, including demographics, academic history, research involvement, and extracurricular activities. Responses were measured using a Likert scale for importance. Descriptive statistics and Chi-square and Fisher exact test analysis were performed. RESULTS: 767 questionnaires were completed (19% response rate). Across all specialties, the factor considered most important was the interview (99.5%). When stratified by specialty, surgical PDs were more likely to characterize class rank, letters of recommendation, research, presenting scholarly work, and involvement in collegiate sports as extremely important/very important (all p < 0.0001). In contrast, primary care PDs favored the proximity of the candidate's hometown (p = 0.0002) and community service (p = 0.03). Mean importance of applicant factors also differed by PD age, gender, and ethnicity. CONCLUSION: We have identified several residency application factors considered important by PDs, stratified by their specialty, demographics, and previous experiences. With the transition away from numerical grades/scores, medical students should be aware of the factors PDs consider important based on their chosen specialty. Our analysis may assist medical students in understanding the application and match process across various specialties.


Assuntos
Internato e Residência , Medicina , Estudantes de Medicina , Humanos , Estados Unidos , Inquéritos e Questionários
11.
Rev Med Suisse ; 20(865): 557-561, 2024 Mar 13.
Artigo em Francês | MEDLINE | ID: mdl-38482764

RESUMO

The future of a machine writing our reports for us could also lead to it carrying out our consultations, a scenario whose relevance is open to debate. Nevertheless, the present offers us new artificial intelligence tools that can support us in our daily activities. The publication in 2017 of Transformers initiated a disruptive revolution by enabling the emergence of major language models, of which ChatGPT is the best known. In view of their growing adoption, the authors felt it would be useful to offer some pragmatic advice on how to improve the use of these tools. In this article, we first look at how ChatGPT works and its potential applications in medicine, before providing a practical guide to using it to get the best results.


Le futur d'une machine rédigeant nos rapports à notre place pourrait également l'amener à effectuer nos consultations, un scénario dont la pertinence reste à débattre. Le présent nous offre néanmoins de nouveaux instruments d'intelligence artificielle qui peuvent nous soutenir dans nos activités quotidiennes. La publication en 2017 des Transformers a initié une révolution disruptive en permettant l'émergence de grands modèles de langages, dont ChatGPT est le plus connu. Face à leur adoption grandissante, il est apparu utile aux auteurs d'apporter quelques conseils pragmatiques pour améliorer l'utilisation de ces outils. Dans cet article, nous abordons d'abord le fonctionnement de ChatGPT, ses applications potentielles en médecine avant de fournir un guide pratique d'utilisation pour en tirer les meilleurs résultats.


Assuntos
Inteligência Artificial , Medicina , Humanos , Emoções , Idioma , Encaminhamento e Consulta
13.
Cells ; 13(5)2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38474376

RESUMO

There is no choice other than rehabilitation as a practical medical treatment to restore impairments or improve activities after acute treatment in people with spinal cord injury (SCI); however, the effect is unremarkable. Therefore, researchers have been seeking effective pharmacological treatments. These will, hopefully, exert a greater effect when combined with rehabilitation. However, no review has specifically summarized the combinatorial effects of rehabilitation with various medical agents. In the current review, which included 43 articles, we summarized the combinatorial effects according to the properties of the medical agents, namely neuromodulation, neurotrophic factors, counteraction to inhibitory factors, and others. The recovery processes promoted by rehabilitation include the regeneration of tracts, neuroprotection, scar tissue reorganization, plasticity of spinal circuits, microenvironmental change in the spinal cord, and enforcement of the musculoskeletal system, which are additive, complementary, or even synergistic with medication in many cases. However, there are some cases that lack interaction or even demonstrate competition between medication and rehabilitation. A large fraction of the combinatorial mechanisms remains to be elucidated, and very few studies have investigated complex combinations of these agents or targeted chronically injured spinal cords.


Assuntos
Medicina , Traumatismos da Medula Espinal , Humanos , Traumatismos da Medula Espinal/terapia , Neuroproteção
14.
Exp Biol Med (Maywood) ; 249: 10069, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38463388

Assuntos
Medicina , Biologia
15.
Health Aff (Millwood) ; 43(3): 354-362, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38437602

RESUMO

Private equity (PE) firms have been acquiring physician practices at an increasing rate, raising concerns about such firms' penetration at the physician level into local markets and the impact on health care quality and prices. However, limited knowledge exists about the extent of PE firms' control in local markets. By linking data on PE acquisitions to physician data and using full-time-equivalent physicians as the base of assessment, we estimated the local market share of each PE firm within ten physician specialties at the Metropolitan Statistical Area (MSA) level. PE-acquired physician practice sites increased from 816 across 119 MSAs in 2012 to 5,779 across 307 MSAs in 2021. Single PE firms had significant market share, exceeding 30 percent in 108 MSA specialty markets and exceeding 50 percent in 50 of those markets. The findings raise concerns about competition and call for closer scrutiny by the Federal Trade Commission, state regulators, and policy makers.


Assuntos
Medicina , Médicos , Estados Unidos , Humanos , Pessoal de Saúde , Pessoal Administrativo , Qualidade da Assistência à Saúde
17.
BMC Bioinformatics ; 25(1): 94, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38438850

RESUMO

BACKGROUND: Analysis of time-resolved postprandial metabolomics data can improve the understanding of metabolic mechanisms, potentially revealing biomarkers for early diagnosis of metabolic diseases and advancing precision nutrition and medicine. Postprandial metabolomics measurements at several time points from multiple subjects can be arranged as a subjects by metabolites by time points array. Traditional analysis methods are limited in terms of revealing subject groups, related metabolites, and temporal patterns simultaneously from such three-way data. RESULTS: We introduce an unsupervised multiway analysis approach based on the CANDECOMP/PARAFAC (CP) model for improved analysis of postprandial metabolomics data guided by a simulation study. Because of the lack of ground truth in real data, we generate simulated data using a comprehensive human metabolic model. This allows us to assess the performance of CP models in terms of revealing subject groups and underlying metabolic processes. We study three analysis approaches: analysis of fasting-state data using principal component analysis, T0-corrected data (i.e., data corrected by subtracting fasting-state data) using a CP model and full-dynamic (i.e., full postprandial) data using CP. Through extensive simulations, we demonstrate that CP models capture meaningful and stable patterns from simulated meal challenge data, revealing underlying mechanisms and differences between diseased versus healthy groups. CONCLUSIONS: Our experiments show that it is crucial to analyze both fasting-state and T0-corrected data for understanding metabolic differences among subject groups. Depending on the nature of the subject group structure, the best group separation may be achieved by CP models of T0-corrected or full-dynamic data. This study introduces an improved analysis approach for postprandial metabolomics data while also shedding light on the debate about correcting baseline values in longitudinal data analysis.


Assuntos
Medicina , Metabolômica , Humanos , Simulação por Computador , Análise de Dados , Nível de Saúde
18.
BMC Med Educ ; 24(1): 225, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38438987

RESUMO

BACKGROUND: Interest in mixed methods methodology within medical education research has seen a notable increase in the past two decades, yet its utilization remains less prominent compared to quantitative methods. This study aimed to investigate the application and integration of mixed methods methodology in medical education research, with a specific focus on researchers' perceptions, strategies, and readiness, including the necessary skills and expertise. This study adheres to the COREQ guidelines for reporting qualitative research. METHODS: Faculty members from King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Saudi Arabia, across its three campuses in Riyadh, Jeddah, and Al Ahsa, participated in this study during the 2021-2022 academic year. We conducted 15 in-depth, one-on-one interviews with researchers who had previously used mixed methods in their medical education research. Theoretical saturation was reached with no refusals or dropouts. Data were collected using a semi-structured interview guide developed from literature review and mixed methods guidelines. Thematic analysis was employed to analyze the data, enabling a comprehensive understanding of the participants' perspectives. RESULTS: The thematic analysis of the interviews yielded three key themes. The first theme, 'Understanding and Perceptions of Mixed Methods in Medical Education Research,' delved into researchers' depth of knowledge and conceptualization of mixed methods. The second theme, 'Strategies and Integration in Mixed Methods Implementation,' explored how these methodologies are applied and the challenges involved in their integration. The final theme, 'Mastery in Mixed Methods: Prerequisites and Expert Consultation in Research,' highlighted the gaps in readiness and expertise among researchers, emphasizing the importance of expert guidance in this field. CONCLUSION: Findings indicate a varied understanding of mixed methods among participants. Some lacked a comprehensive grasp of its application, while others perceived mixed methods primarily as a means to enhance the publication prospects of their studies. There was a general lack of recognition of mixed methods as a guiding methodology for all study aspects, pointing to the need for more in-depth training and resources in this area.


Assuntos
Pesquisa Biomédica , Educação Médica , Medicina , Humanos , Escolaridade , Pesquisa Qualitativa
19.
BMC Health Serv Res ; 24(1): 295, 2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38448927

RESUMO

BACKGROUND: Physiotherapy is a growing profession in Nepal. Despite efforts to promote strengthening and development, there are still challenges in providing equitable access and availability to services, particularly in underserved areas. Updated information is needed to address challenges to provide proper planning for resource allocation. OBJECTIVE: To assess implementation of physiotherapy services and to explore plans, policies and the general status of physiotherapy in Nepal. METHOD: Implementation was assessed with a cross-sectional survey conducted in Province III containing closed-ended questions addressing physiotherapy services, human resources, charging and record-keeping systems, and accessibility. Stratified purposive sampling was used to select eligible facilities from the list of Department of Health Services. Official records were explored through visits to governing institutions and by reviews of registers and reports to obtain data and information on status, plans and policy. RESULTS: The survey included 25 urban and 4 rural facilities, covering hospitals and rehabilitation centres; both public (37.9%) and non-public (62.1%). Most facilities (79.3%) employed physiotherapists with bachelor's degrees. Average number of visits were 29.55 physiotherapy outpatients and 14.17 inpatients per day. Patient records were mainly paper based. Most (69%) used the hospital main card, while others (31%) had their own physiotherapy assessment card. Most referrals came from doctors. The most offered services were musculoskeletal, neurological, and paediatric physiotherapy. Daily basis charging was common. A single visit averaged 311 Nepalese rupees ≈ 2.33 US$. Convenience for persons with disabilities was reported as partial by 79% of outpatient departments. Official register data showed 313 master's and 2003 bachelor's graduates. Six colleges offered physiotherapy bachelor's degree, whereof one also offered a master's program. Government records revealed significant progress in physiotherapy in Nepal. CONCLUSION: The study highlights variations in physiotherapy services within a province owing to type, size and location, but also unwarranted variations. Despite the progress, implementation of physiotherapy services in the perspective of official records imply a need of systems for proper planning and monitoring. Physiotherapy provision in underserved areas warrants further attention.


Assuntos
Medicina , Humanos , Criança , Estudos Transversais , Nepal , Povo Asiático , Modalidades de Fisioterapia
20.
BMJ ; 384: q551, 2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38453242

Assuntos
Medicina , Humanos
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