Assuntos
Carcinoma Basocelular , Neoplasias Orbitárias , Neoplasias Cutâneas , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Basocelular/patologia , Carcinoma Basocelular/terapia , Terapia Combinada , Neoplasias Orbitárias/patologia , Neoplasias Orbitárias/terapia , Equipe de Assistência ao Paciente , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/terapia , Neoplasias Cutâneas/diagnósticoRESUMO
Despite recent developmental screening guidelines, rates of neurodevelopmental disorders (NDDs) remain lower than expected in children with sickle cell disease (SCD). A retrospective chart review identified 276 eligible patients; 214 charts were available for developmental screening and 207 charts for autism-specific screening. Developmental surveillance/screening was conducted in 70% of charts and autism-specific screening in 19% of charts. Validated tools were used in 32% of developmental screenings and 92% of autism-specific screenings. Many children (57%) were screened outside recommended ages. In conclusion, children with SCD are not regularly receiving appropriate developmental screening and surveillance by their healthcare providers.
Assuntos
Anemia Falciforme , Transtornos do Neurodesenvolvimento , Humanos , Criança , Pré-Escolar , Estudos Retrospectivos , Anemia Falciforme/diagnóstico , Anemia Falciforme/epidemiologia , Programas de RastreamentoRESUMO
OBJECTIVE: Examine trends in the proportion of underrepresented minority (URM) residents from 2011 to 2019 across all specialties and investigate differences between surgical and non-surgical specialties. DESIGN: Cross-sectional study. SETTING: N/A. PARTICIPANTS: The authors extracted data on the proportion of URM residents in all specialties from the Accreditation Council for Graduate Medical Education yearly reports. RESULTS: There was a statistically significant decline in the proportion of URM residents in surgical specialties (p < 0.01) from 2011 (9.9%) to 2019 (9.1%) and a significant increase in the proportion of URM residents in non-surgical specialties (p < 0.01) from 2011 (9.6%) to 2019 (10.2%). CONCLUSIONS: This study emphasizes the need to increase recruitment of URMs in medicine, especially in surgical specialties. Findings from this study can inform much-needed initiatives to address barriers to entry for diverse applicants within specialties that lack diversity and have shown minimal improvement over time.
Assuntos
Internato e Residência , Estudos Transversais , Diversidade Cultural , Educação de Pós-Graduação em Medicina , Etnicidade , Humanos , Estados UnidosRESUMO
Introduction: COVID-19 led to rapid policy changes to expand telemedicine adoption. We examined rates of early telemedicine adoption among surgical departments at a large academic institution and compared provider characteristics associated with teleophthalmology. Methods: With data from departmental and electronic medical records across surgical departments at Johns Hopkins Medicine, we performed a retrospective analysis using the Fisher test and binomial logistic regression. Results: Telemedicine adoption in ophthalmology was disproportionately lower than other surgical departments. Providers who were female [odds ratio, OR, 2.42 (95% confidence interval, CI, 1.03-5.67)], clinical assistants, clinical associates, or instructors [OR 12.5 (95% CI 2.63-59.47)], associate professors [OR 4.38 (95% CI 1.42-13.52)], practiced for ≥36 years [OR 0.20 (95% CI 0.06-0.66)], cornea [OR 0.13 (95% CI 0.04-0.47)], glaucoma [OR 0.18 (95% CI 0.04-0.93)] or retina [OR 0.04 (95% CI 0.01-0.17)] specialists, or had a MD/MBBCh/MBBS [OR 0.30 (95% CI 0.10-0.94)] or second degree [OR 0.28 (95% CI 0.08-0.99)] were significantly more or less likely to adopt. When adjusted, cornea [adjusted OR 0.10 (95% CI 0.02-0.57)] or retina [adjusted OR 0.01 (95% CI 0.002-0.12)] specialists or providers who practiced for 12-18 years [adjusted OR 0.22 (95% CI 0.05-0.91)] or ≥36 years [adjusted OR 0.13 (95% CI 0.03-0.68)] were significantly more or less likely to adopt. Discussion: Subspecialty among other provider characteristics influences the likelihood of teleophthalmology adoption. As the pandemic continues, strategies to reduce adoption barriers are needed to ensure the provision of health care services.