Medical students' attitudes towards well-being and welfare: a systematic review protocol.

INTRODUCTION: Medical education poses serious stressors on medical students, as they report overall higher rates of psychiatric comorbidities compared with students enrolled in other university-level courses. The high rates of poor well-being reported should be considered a concern, as students represent the future workforce of healthcare professionals. Although there has been an increased interest towards well-being and burn-out in medical students, there is still much to be elucidated. Indeed, there is an overall lack of understanding of which attitudes medical students have towards well-being and welfare, something that could be used to develop targeted practice to improve medics' quality of life and reduce overall burn-out.This review will aim at evaluating and reporting the current research available on medical students' attitudes towards well-being and welfare. We will take into account which countries have published data on the topic, and we will analyse papers written during the COVID-19 period separately, giving this particular time frame a separate outlook. METHODS AND ANALYSIS: This systematic review protocol has been developed following Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. A systematic search including "medical students" AND "wellbeing" AND "perceptions" was carried out on MEDLINE, Embase and Scopus databases. The Mixed Method Appraisal Tool will be used to assess the quality of the available studies and risk of bias. Studies will be screened using predetermined inclusion and exclusion criteria. Data will be summarised narratively and in tabular forms. A narrative subgroup analysis of the COVID-19 period will be carried out, and a country-wise approach will be used to describe which areas have published relevant studies. ETHICS AND DISSEMINATION: This will be the first systematic review looking at the reported attitudes that medical students have towards well-being and welfare. This will provide an account of the available data on the topic, and a starting point to understand where further research is needed in the future. PROSPERO REGISTRATION NUMBER: CRD42023471022.

Lazarus effect in a patient initially empirically treated with osimertinib for EGFR L858R mutant non-small cell lung cancer with leptomeningeal disease: a case report.

Osimertinib has been shown to be effective for patients with non-small cell lung cancer (NSCLC) with activating EGFR mutations, and these patients are at risk for leptomeningeal disease. In this report, we present a patient of East Asian descent whose initial presentation included severe, progressive leptomeningeal carcinomatosis and a small lung mass, with limited tissue available for molecular testing. She responded to empiric, urgent initiation of osimertinib, repeat tissue sampling revealed an EGFR L858R mutation, and she has experienced durable disease improvement for 18 months on osimertinib monotherapy.

Ayurveda and Yoga management of chronic alcoholism sequelae - A case report.

Alcohol has always been a component in the dietary pattern of human civilization. It is widely used in society for celebration and socialization. Alcohol abuse is among the most serious problems in public health characterized by uncontrolled drinking which causes physical and emotional dependence on alcohol. Chronic alcoholics are at a higher risk of developing vitamin B1 deficiency due to malabsorption, poor diet, and an increased demand for nutrition. Vitamin B1(Thiamine) is an essential nutrient required for the body's energy metabolism and proper functioning of the nervous system. A person who excessively consumes madya (alcohol) and then abruptly discontinues drinking and takes recourse to drinking excess madya once again, suffers from Madatyaya Upadrava(chronic alcoholism) that is Vikshay. Here is a case report of an alcoholic patient who ceased drinking and then resumed alcohol in large amounts. He presented with symptoms of generalized weakness, body ache, aphasia, confusion, fever (on and off), thirst, cough, headache, and numbness. The patient underwent a two-month treatment regimen that combined Satvavajay Chikitsa, Yoga, and Shaman Chikitsa involving Rasayana medications and procedures including snehan (Oleation), swedan (fomentation), nabhi puran (filling oil with navel), nasya (nasal administration), shirodhara (continuous flow of liquid on head) and basti (medicated enema). The intervention outcome showed relief from the aforementioned symptoms and improvement in both symptoms and GCS(Glasgow coma scale) score. This treatment approach aimed to promote vitality, longevity, and an overall sense of balance and well-being. There are not many corroborating cases being reported and managed with Ayurveda. This case report highlights transforming health through the cumulative effects of Rasayana medicines, panchakarma, and yoga.

Clinical practice guidelines on the use of deep brain stimulation for the treatment of obsessive-compulsive disorder: systematic review.

BACKGROUND: Deep brain stimulation (DBS) has been proposed to improve symptoms of obsessive-compulsive disorder (OCD) but is not yet an established therapy. AIMS: To identify relevant guidelines and assess their recommendations for the use of DBS in OCD. METHOD: Medline, Embase, American Psychiatric Association PsycInfo and Scopus were searched, as were websites of relevant societies and guideline development organisations. The review was based on the PRISMA recommendations, and the search strategy was verified by a medical librarian. The protocol was developed and registered with PROSPERO (CRD42022353715). The guidelines were assessed for quality using the AGREE II instrument. RESULTS: Nine guidelines were identified. Three guidelines scored >80% on AGREE II. 'Scope and Purpose' and 'Editorial Independence' were the highest scoring domains, but 'Applicability' scores were low. Eight guidelines recommended that DBS is used after all other treatment options have failed to alleviate OCD symptoms. One guideline did not recommend DBS beyond a research setting. Only one guideline performed a cost-effectiveness analysis; the other eight did not provide details on safe or effective DBS protocols. CONCLUSION: Despite a very limited evidence base, eight of the nine identified guidelines supported the use of DBS for OCD as a last line of therapy; however, multiple aspects of DBS provision were not addressed.

The Impact of Error-Consequence Severity on Cue Processing in Importance-Biased Prospective Memory.

Prospective memory (PM) enables people to remember to complete important tasks in the future. Failing to do so can result in consequences of varying severity. Here, we investigated how PM error-consequence severity impacts the neural processing of relevant cues for triggering PM and the ramification of that processing on the associated prospective task performance. Participants role-played a cafeteria worker serving lunches to fictitious students and had to remember to deliver an alternative lunch to students (as PM cues) who would otherwise experience a moderate or severe aversive reaction. Scalp-recorded, event-related potential (ERP) measures showed that the early-latency frontal positivity, reflecting the perception-based neural responses to previously learned stimuli, did not differ between the severe versus moderate PM cues. In contrast, the longer-latency parietal positivity, thought to reflect full PM cue recognition and post-retrieval processes, was elicited earlier by the severe than the moderate PM cues. This faster instantiation of the parietal positivity to the severe-consequence PM cues was then followed by faster and more accurate behavioral responses. These findings indicate how the relative importance of a PM can be neurally instantiated in the form of enhanced and faster PM-cue recognition and processing and culminate into better PM.

Content analysis of patient material resources on the internet for oral cancer-An exploratory study.

BACKGROUND: Oral cancer is one of the leading causes of mortality in the world over and is a major public health problem. There are numerous resources on the internet which provide information related to oral cancer. However, they may not be optimal and standardized. The present study was conducted to assess the quality, readability, and content of the online resources for oral cancer. METHODS: The content analysis approach was employed for the present study. Google search engine was employed to search for various online resources on oral cancer. The first 50 websites were evaluated for their quality and readability. Flesch-Kincaid readability tests were used to assess the readability of the internet material and consisted of Flesch reading ease and Flesch-Kincaid grade level. The quality of websites was assessed by Journal of American Medical Association (JAMA) benchmarks and HONcode (Health Over Net code). RESULTS: A total of 12 (32.43%) of the websites were fairly difficult to comprehend, while none of the websites were easy/very easy to comprehend. A total of 8 (21.62%) websites were readable by only college-level graduates. Overall, 21 (56.76%) of the websites did not have HONcode certification. CONCLUSION: The present study revealed that a majority of the websites were fairly difficult to comprehend and readable by college-level graduates. There is a definite need to monitor the quality of the websites on oral cancer. The present study highlights the need for stringent norms and regulations regarding oral cancer made available to the common man on the internet.

Awareness of family health history in a predominantly young adult population.

Family health history (FHH) is a key predictor of health risk and is universally important in preventive care. However, patients may not be aware of the importance of FHH, and thus, may fail to accurately or completely share FHH with health providers, thereby limiting its utility. In this study, we conducted an online survey of 294 young adults and employees based at a US university setting regarding their knowledge, sharing behaviors, and perceived importance of FHH, and use of electronic clinical tools to document and update FHH. We also evaluated two educational interventions (written and video) to promote knowledge about FHH and its importance to health. We found that 93% of respondents were highly aware of their FHH, though only 39% reported collecting it and 4% using an online FHH tool. Seventy-three percent of respondents, particularly women, had shared FHH with their doctor when prompted, and fewer had shared it with family members. Participants in the video group were significantly more likely to understand the benefits of FHH than those in the written group (p = 0.02). In summary, educational resources, either video or written, will be helpful to promote FHH collection, sharing, and use of online FHH tools.