Addressing medical student burnout through informal peer-assisted learning: a correlational analysis.

BACKGROUND: Despite the recognized advantages of Peer-Assisted Learning (PAL) in academic settings, there is a notable absence of research analyzing its effects on students' Academic Burnout. This study aims to cover this gap by assessing the underlying effectiveness of Informal Peer-Assisted Learning (IPAL) as a cooperative learning method, focusing on its potential to mitigate academic burnout among medical students. METHODS: In 2022, a cross-sectional study was conducted at the School of Medicine, Universidad Central del Caribe, in Puerto Rico. The research team gathered data from 151 participants, 49.19% of 307 total student body. This cohort included 76 female students, 71 male students, and 4 individuals saying other. The School Burnout Inventory questionnaire (SBI-9) was employed to assess Academic Burnout, along with an added query about self-reported IPAL. The SBI-9 underwent validation processes to ascertain its reliability and validity, incorporating the Exploratory Factor Analysis and Confirmatory Factor Analysis. Following this, the investigators conducted an analysis to determine the correlation between academic burnout levels and involvement in IPAL. RESULTS: The validation process of the questionnaire affirmed its alignment with an eight-item inventory, encapsulating two principal factors that elucidate academic burnout. The first factor pertains to exhaustion, while the second encompasses the combined subscales of cynicism and inadequacy. The questionnaire shows high reliability (Cronbach's alpha = 0.829) and good fit indices (Comparative Fit Index = 0.934; Tucker-Lewis Index = 0.902; Standardized Root Mean Squared Residual = 0.0495; Root Mean Squared Error of Approximation = 0.09791; p-value < 0.001). The factors proven in the selected model were used to evaluate the correlation between Academic Burnout and IPAL. Students engaged in IPAL showed significantly lower academic burnout prevalence compared to those who never participated in such practices, with a mean academic burnout score of 44.75% (SD 18.50) for IPAL engaged students versus 54.89% (SD 23.71) for those who never engaged in such practices (p-value < 0.013). Furthermore, within the group engaged in IPAL, students displayed lower levels of cynicism/inadequacy 41.98% (SD 23.41) compared to exhaustion 52.25% (SD 22.42) with a p-value < 0.001. CONCLUSIONS: The results of this study underscore a notable issue of academic burnout among medical students within the surveyed cohort. The investigation reveals a significant correlation between Academic Burnout and IPAL, suggesting that incorporating IPAL strategies may be beneficial in addressing burnout in medical education settings. However, further research is needed to explore potential causal mechanisms.

Biomicroscopic Findings and Management of Anterior Stromal Necrosis After Long-term Implantation of Intacs.

PURPOSE: We sought to evaluate the visual, refractive, and biomicroscopic findings pre- and posttreatment of observed anterior stromal necrosis (ASN) after long-term Intacs intracorneal ring segment (ICRS) implantation. DESIGN: Consecutive interventional case series. METHODS: All consecutive patients implanted with Intacs ICRS at a single center by 1 of the authors between October 2006 and October 2011 with a minimum follow-up time of 5 years were included. All Intacs were implanted using the Prolate system console and instrumentation from Addition Technology Inc (Chicago, Illinois, USA). The slit lamp, refractive, and visual findings and the management of those patients are described in detail. The primary outcome measures included the size of the epithelial defect overlying the Intacs body, the intended implantation depth measured by high-magnification slit lamp photography, and the management of the cases described in detail. The percentage of eyes with ASN out of those that reached the 5-year follow-up is reported. RESULTS: One hundred twenty-seven eyes (84 patients) were implanted with 215 ICRSs during the study period, and 77.16% (98/127) eyes had a follow-up of ≥5 years, out of which 9 eyes (7 patients) had ASN corresponding to at least 9.18% (95% confidence interval 4.29%-16.72%). The mean ± standard deviation time between implantation and ASN diagnosis was 10.5 ± 1.3 years. CONCLUSION: After 5 years of implantation, INTACS-treated eyes could present with an ASN over the ICRS body. Longer-term follow-up of patients implanted with INTACS is important to monitor if this complication keeps occurring over time.

Snakebites and ethnobotany in the Eastern region of Antioquia, Colombia--the traditional use of plants.

ETHNOPHARMACOLOGY RELEVANCE: Every year, over 4000 ophidian accidents take place in Colombia. The poor distribution and limited availability of antivenom have perpetuated the use of traditional medicine especially in rural communities. The medical care starts with the affected people receiving treatment by healers or shamans who use medicinal plants prepared in different ways. METHODS: This investigation was undertaken by conducting enquiries to the renowned healers or plants connoisseurs about the ethnobotany of the ophidian accident. In addition, this study included their experience and the time they have used plants in curing bites or stings by poisonous animals. Furthermore, it embraced the plant species used and the amount applied, the ways of their preparation (maceration or decoction), some application techniques (beverage, bathing, poultice, vapors), and duration of treatment. RESULTS: 29 species of plants were collected and identified. 82.7% of them were native, 27.5% had not been previously reported as antiophidian, and 38% had been employed for this purpose in other geographical areas. Leaves (43.59%) and stems (23.08%) were the components most frequently used in the medicinal preparation, which is usually done by maceration (51.92%) or decoction (25.00%). CONCLUSIONS: Throughout this study related to the treatment of snakebite accident, species have been found without any ethnobotanical reports. Moreover, plants being described as new specie and herbs such as Plantago major (Plantaginaceae) used in the treatment of snakebites by many ethnic groups have been found. In addition, herbaceous such as Renealmia alpinia (Zingiberaceae), whose antiophidian activity has been experimentally proven through in vivo and in vitro assays, have been discovered too.

SOLUCIONES TERAPÉUTICAS PARA LA RECONSTRUCCIÓN DE LA DERMIS Y LA EPIDERMIS. OPORTUNIDADES EN EL MEDIO ANTIOQUEÑO

En Antioquia, es necesario buscar una solución disponible, efectiva y económicamente viable para afrontar los problemas de la piel de los pacientes que, por accidentes o enfermedades, han disminuido su calidad de vida y se encuentran aislados a la espera de tratamientos que les permitan recuperar la funcionalidad de su cuerpo y les reduzcan los riesgos por la exposición de los tejidos internos. Las diferentes soluciones existentes en el mercado todavía no han llegado a superar algunos obstáculos tales como el cubrimiento de todas las extensiones, los altos costos, la funcionalidad de los tejidos restaurados, los rechazos de tipo inmune y la escasez de los sitios donantes. Este artículo presenta una revisión literaria que busca mostrar las diferentes alternativas de solución para pacientes con problemas de piel, dando énfasis en las soluciones clásicas aplicables y económicamente viables desde la ingeniería de tejidos en el sector antioqueño.

In Antioquia (Colombia), there are many patients who suffer dermal injuries caused by accident or disease. Therefore, it is necessary to pursue available, effective and affordable solutions to overcome dermal problems. Physicians and patients are both expecting corrective treatments that can reduce inner tissue exposition and allow the possibility of recovering skin functionality. Although there are many solutions for skin replacement, some obstacles remain, such as: high costs, limited availability of skin for implantation in extended areas, adequate functionality of the restored tissue and immunological rejection. Due to these issues, this article presents some of the existing alternative solutions for patients with skin injuries, considering the histology and physiology of the skin, and regarding the classical and economically attainable solutions to be used in Antioquia.