Evaluation of the reliability and quality of YouTube videos as a source of information for transcutaneous electrical nerve stimulation.

Background: YouTube plays an influential role in disseminating health-related information in the digital age. This study aimed to evaluate YouTube videos on transcutaneous electrical nerve stimulation (TENS) in terms of their information value and quality. Methods: In this descriptive study, we ranked the first 100 videos that met the inclusion criteria using the search term "transcutaneous electrical nerve stimulation" on October 30, 2022. These videos were classified according to the number of views, likes, dislikes, comments, duration, popularity and content categories. Reliability, quality, and accuracy of the videos were assessed using the Journal of American Medical Association (JAMA) Benchmark Criteria and Modified DISCERN Questionnaire and Global Quality Score (GQS). Video popularity were calculated by the Video Power Index (VPI). Results: Based on the GQS results, we found that 59, 27, and 14 videos had low, intermediate, and high quality, respectively. In addition, based on the JAMA results, 79 and 21 videos had poor and high reliability, respectively. No statistically significant difference was found between the JAMA, modified DISCERN and GQS scores in terms of the sources of videos (p = 0.226, p = 0.115, p = 0.812). Notably, there was a weak positive correlation between the JAMA scores and the number of views (r = 0.204, p = 0.041). Conclusion: According to our study results, most YouTube videos on TENS were of low quality and reliability. Additionally, most videos were uploaded from sources created by doctors; the most frequently found content was about the TENS procedure, and content on complications of the procedure became less frequent as the videos became more recent. In particular, it was found that videos uploaded by academics have longer duration. It has been found that reliable videos with high JAMA scores also have high number of views. Accordingly, it can be concluded that videos with higher quality and more reliability that are created by healthcare providers will be more useful for patients seeking information about TENS.

Building Equity, Inclusion, and Diversity Into the Fabric of a New Medical School: Early Experiences of the Kaiser Permanente Bernard J. Tyson School of Medicine.

In July 2020, the Kaiser Permanente Bernard J. Tyson School of Medicine opened in Pasadena, California, with an inaugural class of 50 students. The school endeavors to address systemic barriers that have contributed to health care and educational disparities in the United States. To realize its vision for change, equity, inclusion, and diversity (EID) have been woven throughout the school. Board members were chosen in part based on their commitment to the core values of EID. The board developed mission, vision, and values statements that explicitly avow a commitment to EID and recruited a dean (and the dean recruited leaders) who espoused and evinced these values. Leaders, faculty, and staff received training to foster an inclusive environment and ensure accountability. The school developed a curriculum that has been thoroughly evaluated for its representative and inclusive content by a team drawn from all departments. The diverse first class, selected through a holistic admissions approach, has access to student support systems that emphasize an appreciation of the distinct experiences and context of each student. The school plans a rigorous evaluation program to assess its performance in EID. Although the school may well fall short of achieving all of its EID objectives, by learning from its experiences and from evidence of others in academic medicine, the school recognizes its opportunity to continue to come closer to achieving its goals and to help shape and contribute to the national and international discourse on EID.

Chiropractic students' perceptions of barriers and facilitators to joining a professional association".

Background: In Australia, about 1 in 3 chiropractors choose not to belong to either of the two professional associations and this is considerably lower compared to other health professional organisations in this country. The reasons for this remain unknown. We sought to explore possible reasons by asking chiropractic students their perceptions of barriers and facilitators to joining a professional association. However, we were unable to identify validated survey instruments that could be used to obtain information about reasons for joining health professional associations. Aim: Therefore, the objectives of this study were to: 1) develop a survey instrument that captures information about what influences chiropractic students in joining professional association; and 2) identify factors that promote association membership among chiropractic students. Methods: A literature review was undertaken to identify known determinants of professional association membership and were used to construct a preliminary survey instrument, which comprised 47 items. Six fourth-year chiropractic students assessed the preliminary survey instrument's content validity. Principal components analysis was used to establish the structure of the scales. Cronbach's alpha was derived to determine whether all items in each scale tapped a discrete construct. Logistic regression was used to examine the association between the scale scores and having joined a chiropractic professional association. Results: In March 2019, 348 chiropractic students from Murdoch University (71.0%) responded to a voluntary, anonymous questionnaire. Principal components analysis resulted in the retention of 21 items that strongly loaded onto 6 factors. Internal consistency was found to be adequate. The results of the logistic regression analysis demonstrated that only "development of the profession" was significantly associated with have joined a professional chiropractic association (p = 0.049, OR = 2.22; 95% CI = 1.26-3.40). Conclusion: Chiropractic organisations can probably most effectively increase membership numbers through raising awareness of their contribution to the development of the profession.

Ads and Labels From Early 20th-Century Health Fraud Promotions.

Ten advertisements and labels from the American Medical Association (AMA) Historical Health Fraud and Alternative Medicine Collection illustrate false health beliefs perpetuated in 20th-century medical quackery promotions. This article canvasses some of the claims made and responses to these ads and labels.

[Comment on the two randomized clinical trials on acupuncture from Journal of the American Medical Association].

In June 27, 2017, there were two acupuncture clinical trials published in Journal of the American Medical Association (JAMA). The conclusions were that electroacupuncture could relieve the leakage of urine of female stress urinary incontinence and that acupuncture with clomiphene or not could not improve the live birth rate of female with polycystic ovarian syndrome, compared with shallow insertion at non-acupoint combined with clomiphene placebo. The Youth Committee of the China Association of Acupuncture-Moxibustion held an academic salon about the above two trials on September 7, 2017. It is considered that rigorous design is key to clinical acupuncture-moxibustion trial, that acupuncture-moxibustion therapy is with psychosomatic medicine theory. The clinical acupuncture-moxibustion research method was discussed, including study group selection, acupuncture control, the primary outcome, the interpretation of result, etc.

[Comments on "Effect of Acupuncture vs Sham Acupuncture on Live Births Among Women Undergoing In Vitro Fertilization: A Randomized Clinical Trial " from Journal of the American Medical Association].

In recent years, acupuncture has been used widely as an adjuvant treatment for the in vitro fertilization (IVF). "Effect of Acupuncture vs Sham Acupuncture on Live Births Among Women Undergoing In Vitro Fertilization: A Randomized Clinical Trial " published in Journal of the American Medical Association (JAMA) on May 15, 2018, the research findings do not support the use of acupuncture to improve the rate of live births among the women undergoing IVF. In order to avoid the misunderstanding of the scholars at home and abroad for the clinical effects of acupuncture on IVF assistance, the authors put forward the doubts after the analysis from the following 3 aspects, including the acupuncture scheme, outcomes and result explanation. Additionally, the thinking and suggestions are proposed for the future development of the clinical trials of acupuncture IVF assistance in terms of selecting the proper participants, being abided by the standards of the evidence-based medicine, designing multi-acupuncture schemes and setting up the rational control, as well as conducting the overall analysis of the trial data.

Comments on " " from / 中国针灸

In recent years, acupuncture has been used widely as an adjuvant treatment for the in vitro fertilization (IVF). " " published in on May 15, 2018, the research findings do not support the use of acupuncture to improve the rate of live births among the women undergoing IVF. In order to avoid the misunderstanding of the scholars at home and abroad for the clinical effects of acupuncture on IVF assistance, the authors put forward the doubts after the analysis from the following 3 aspects, including the acupuncture scheme, outcomes and result explanation. Additionally, the thinking and suggestions are proposed for the future development of the clinical trials of acupuncture IVF assistance in terms of selecting the proper participants, being abided by the standards of the evidence-based medicine, designing multi-acupuncture schemes and setting up the rational control, as well as conducting the overall analysis of the trial data.

Comment on the two randomized clinical trials on acupuncture from / 中国针灸

In June 27, 2017, there were two acupuncture clinical trials published in (). The conclusions were that electroacupuncture could relieve the leakage of urine of female stress urinary incontinence and that acupuncture with clomiphene or not could not improve the live birth rate of female with polycystic ovarian syndrome, compared with shallow insertion at non-acupoint combined with clomiphene placebo. The Youth Committee of the China Association of Acupuncture-Moxibustion held an academic salon about the above two trials on September 7, 2017. It is considered that rigorous design is key to clinical acupuncture-moxibustion trial, that acupuncture-moxibustion therapy is with psychosomatic medicine theory. The clinical acupuncture-moxibustion research method was discussed, including study group selection, acupuncture control, the primary outcome, the interpretation of result, etc.

[Comments on "Effect of acupuncture and clomiphene in Chinese women with polycystic ovary syndrome: a randomized clinical trial" published in Journal of the American Medical Association].

In recent years, more and more patients of polycystic ovary syndrome (PCOS) have strong desire to be treated with acupuncture. In "Effect of acupuncture and clomiphene in Chinese women with polycystic ovary syndrome: a randomized clinical trial" published in Journal of the American Medical Association (JAMA) on June 27, 2017, the finding of this research does not support acupuncture for such infertility women. The questions and doubts are proposed in the paper from the regimen of acupuncture treatment, the determination of primary outcome and the explanation of the results. It is found by comparison that the trigger point treatment in the article is different from traditional acupuncture, there is doubt in live birth rate as the primary outcome, 4-month treatment is not enough for the change of live birth rate, difference without statistic significance between acupuncture and control acupuncture does not mean invalid acupuncture because the control acupuncture is not invalid, the research and statistic method are not those planned. As a result, we consider that the conclusion is unreasonable.

Back to the future: The AMA and religion, 1961-1974.

U.S. medical scholarship and education regarding religion and spirituality has been growing rapidly in recent years. This rising interest, however, is not new; it is a renewal of significant interweavings that date back to the mid-20th century. In this Perspective, the authors draw attention to the little-known history of organized medicine's engagement with religion from 1961 to 1974. Relying on primary source documents, they recount the dramatic rise and fall of the Committee on Medicine and Religion (CMR) at the American Medical Association (AMA). At its height, there were state-level committees on medicine and religion in 49 states, the District of Columbia, and Puerto Rico, and there were county-level committees in over 800 county medical societies. Thousands of physicians attended annual conferences for clinicians and clergy, and direct outreach to patients included a film viewed by millions. The CMR arose in the context of rapid medical advances, the growth of professional chaplaincy, and concern for declining "humanism" in medicine-conditions with parallels in medicine today. The CMR was brought to a puzzling end in 1972 by the AMA's Board of Trustees. The authors argue that this termination was linked to the AMA's long and contentious debate on abortion. They conclude with the story's significance for today's explorations of the intersection of spirituality, religion, and medicine, focusing on the need for mutual respect, transparency, and dialogue around the needs of patients and physicians.

The Rashomon effect: another view of medicine, religion, and the American Medical Association.

What is the story of medicine and religion at the American Medical Association (AMA)? Where did the Department of Medicine and Religion originate? What did the program accomplish? Why was it all but completely discontinued after scarcely a decade? The surviving records support more than one interpretation. Exploring the broader organizational context helps tell a richer story.In this issue of Academic Medicine, Daniel Kim and colleagues open a window on a fascinating bit of history: that of the AMA's formal experience with religion and medicine during the 1960s and early 1970s; however, reconstructing the story of a program from documentary records is always something of an uncertain proposition. Equally important is taking account of such factors as the role of the AMA's House of Delegates in policy making, of state and county medical societies in carrying out program activities, and of the influence of charismatic individuals on decisions regarding programs and activities. Before the medical community decides what lesson(s) to draw from the story of the AMA's Department of Medicine and Religion, it should try to understand that story as completely as possible.As Kim et al note, the available materials leave out much that historians might wish to know. Records preserve the substance of decisions taken, but are largely silent about the reasoning behind those decisions. Relevant information is scattered through multiple record systems, making it difficult to find. Inevitably, historians have to read between the lines.

Deliberation at the hub of medical education: beyond virtue ethics and codes of practice.

Although both codes of practice and virtue ethics are integral to the ethos and history of "medical professionalism", the two trends appear mutually incompatible. Hence, in the first part of the paper we explore and explicate this apparent conflict and seek a direction for medical education. The theoretical and empirical literature indicates that moral deliberation may transcend the incompatibilities between the formal and the virtuous, may enhance moral and other aspects of personal sensitivity, may help design and improve other parts of the curricula, and may foster self-awareness and clarification of the professional role. Not only are these goals essential for good and conscientious doctoring, but they may also reduce physicians' "burn-out". We argue that medical education should focus on the ubiquitous practice of deliberation in contemporary medicine, and especially the practice of moral deliberation.

Deep hope: a song without words.

Hope helps alleviate suffering. In the case of terminal illness, recent experience in palliative medicine has taught physicians that hope is durable and often thrives even in the face of imminent death. In this article, I examine the perspectives of philosophers, theologians, psychologists, clinicians, neuroscientists, and poets, and provide a series of observations, connections, and gestures about hope, particularly about what I call "deep hope." I end with some proposals about how such hope can be sustained and enhanced at the end of life. Studies of terminally ill patients have revealed clusters of personal and situational factors associated with enhancement or suppression of hope at the end of life. Interpersonal connectedness, attainable goals, spiritual beliefs and practices, personal attributes of determination, courage, and serenity, lightheartedness, uplifting memories, and affirmation of personal worth enhance hope, while uncontrollable pain and discomfort, abandonment and isolation, and devaluation of personhood suppress hope. I suggest that most of these factors can be modulated by good medical care, utilizing basic interpersonal techniques that demonstrate kindness, humanity, and respect.

[Conceptualization of the preventive theories]. / Concepts théoriques en prévention: heurs et malheurs.

In front of the explosion of the costs of the curative care, the conceptualization of the preventive theories and methodologies, and the shown efficiency of the actions of prevention, this one acquires with evolving time a growing importance and a development desired with the eyes of the doctors, but also of the patients, policy decision makers and insurers. This article intends to approach and clarify the positive contributions but also the multiple limits of the preventive steps.