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1.
J Surg Res ; 282: 254-261, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36332304

RESUMO

INTRODUCTION: The taxonomy code(s) associated with each National Provider Identifier (NPI) entry should characterize the provider's role (e.g., physician) and any specialization (e.g., orthopedic surgery). While the intent of the taxonomy system was to monitor medical appropriateness and the expertise of care provided, this system is now being used by researchers to identify providers and their practices. It is unknown how accurate the taxonomy codes are in describing a provider's true specialization. METHODS: Department websites of orthopedic surgery and general surgery from three large academic institutions were queried for practicing surgeons. The surgeon's specialty and subspeciality information listed was compared to the provider's taxonomy code(s) listed on the National Plan and Provider Enumeration System (NPPES). The match rate between these data sources was evaluated based on the specialty, subspecialty, and institution. RESULTS: There were 295 surgeons (205 general surgery and 90 orthopedic surgery) and 24 relevant taxonomies (8 orthopedic and 16 general or plastic) for analysis. Of these, 294 surgeons (99%) selected their general specialty taxonomy correctly, while only 189 (64%) correctly chose an appropriate subspecialty. General surgeons correctly chose a subspecialty more often than orthopedic surgeons (70 versus 51%, P = 0.002). The institution did not affect either match rate, however there were some differences noted in subspecialty match rates inside individual departments. CONCLUSIONS: In these institutions, the NPI taxonomy is not accurate for describing a surgeon's subspecialty or actual practice. Caution should be taken when utilizing this variable to describe a surgeon's subspecialization as our findings might apply in other groups.


Assuntos
Medicina , Procedimentos Ortopédicos , Ortopedia , Cirurgiões , Humanos , Especialização
3.
BMC Med Educ ; 22(1): 824, 2022 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-36451194

RESUMO

BACKGROUND: There is little existing research investigating SH/SA specifically from patients to students. This study aims to assess the prevalence and impact of SH and SA from patient to medical student. METHODS: A cross-sectional survey study was administered via electronic email list to all current medical students at the University of Washington School of Medicine (n = 1183) over a two-week period in 2019. The survey questions addressed respondents' experiences with SH/SA from patients, frequency of reporting, and impact on feelings of burnout. RESULTS: Three hundred eleven responses were received for a response rate of 26%; 268 complete responses were included in the final analysis. Overall, 56% of respondents reported ever experiencing SH from a patient. SH from a patient was reported by significantly more of those who identify as female compared to male (66% vs 31%; p < .001). Similar frequency of experiencing SH within the last year were reported by females and males (90% vs 88%; p = .96). Clinical students were more likely to have ever experienced SH compared to preclinical students (61% vs 39%; p < .001). The majority (86%) of respondents who experienced SH/SA did not report it in an official capacity. Those who identify as female were more likely to report that SH from a patient contributed to feelings of burnout (21% vs 5% for male; p = .02). Behaviors consistent with SA were experienced by 16% of respondents, with similar frequency between females and males. CONCLUSIONS: This study demonstrates that patient to medical student SH/SA is a common occurrence, particularly among students identifying as female. It also highlights the significant impact of SH/SA incidents on feelings of burnout.


Assuntos
Medicina , Assédio Sexual , Estudantes de Medicina , Humanos , Feminino , Masculino , Estudos Transversais , Esgotamento Psicológico
5.
Br J Hosp Med (Lond) ; 83(11): 1-6, 2022 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-36454063

RESUMO

Paediatrics is one of the most useful rotations for junior doctors to undertake, allowing them to learn and develop the skills necessary to provide child-centred care. As with any speciality, it can be daunting to cover on-calls with no previous experience, so guidance for those starting paediatric placements can be valuable. This article provides up-to-date information and preparation strategies for all junior doctors, whether they are considering undertaking a paediatric rotation as a trainee or in a trust post, or are already in training, such as on general practitioner vocational schemes.


Assuntos
Clínicos Gerais , Medicina Hospitalar , Medicina , Criança , Humanos , Hospitais Pediátricos , Corpo Clínico Hospitalar
6.
Br J Hosp Med (Lond) ; 83(11): 1-3, 2022 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-36454072

RESUMO

Medicine research and development has been instrumental in improving outcomes for countless individuals, but women, especially pregnant women, have been left behind. Disadvantaged during pregnancy as a result of apprehension over drug use for new or existing conditions, women face worse outcomes for under- or untreated disease. Solving this problem will require input from regulators, the pharmaceutical industry and clinicians.


Assuntos
Medo , Medicina , Gravidez , Criança , Feminino , Humanos , Indústria Farmacêutica
7.
PLoS One ; 17(12): e0278284, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36454876

RESUMO

BACKGROUND: Although muscle strength training is a prevalent treatment for patients with functional ankle instability (FAI), previous investigations on the efficacy have yielded conflicting results. OBJECTIVE: This study aims to compare the efficacy of 6-week isokinetic strength training and Thera-Band strength training on improving ankle strength, dynamic balance ability, and function in individuals with FAI. METHODS: Fifty-two FAI patients were randomized into two treatment groups: an isokinetic strength training (IST, n = 26) group and a Thera-Band resistance training (TBT, n = 26) group. The IST group engaged in isokinetic concentric strength training with inversion, eversion, dorsiflexion, and plantar flexion, whereas the TBT group engaged in progressive resistance training with Thera-Band three times per week for six weeks. Before and after the training, an isokinetic concentric strength test of the involved ankle joint, Star Excursion Balance Test (SEBT), and Cumberland Ankle Instability Tool (CAIT) function assessment were performed. RESULTS: After six weeks of intervention, the strength of inversion and eversion was significantly improved in both the IST and TBT groups (p < 0.05), with the IST group exhibiting a significant (p < 0.05) improvement when compared to the TBT group. The SEBT and CAIT results were significantly (p < 0.05) improved in the IST group compared to the TBT group. CONCLUSIONS: The six-week of isokinetic strength training is more effective than the Thera-Band progressive resistance training in improving the physical function of FAI patients. CLINICAL TRIAL REGISTRATION NUMBER: This randomized controlled clinical trial has been registered in the China Clinical Trial Registry (ChiCTR2100044444) https://www.google.com/search?client=firefox-b-d&q=ChiCTR2100044444.


Assuntos
Instabilidade Articular , Medicina , Treinamento de Força , Humanos , Tornozelo , Terapia por Exercício , Instabilidade Articular/terapia , Inversão Cromossômica
9.
BMC Health Serv Res ; 22(1): 1460, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36456971

RESUMO

AIM: To explore whether physiotherapy use is increased after hospitalization with COVID-19 with or without respiratory support vs. other respiratory tract infections (RTI). METHODS: In all Norwegian residents aged 18-80 years who were hospitalized with COVID-19 (N = 5,344) or other RTI (N = 82,235) between July 1st 2017 and August 1st 2021, we used a pre-post study design to explore the weekly individual average physiotherapy use in community care from 12 weeks prior to hospital admission, to 36 weeks (9 months) after hospital discharge for individuals who received and who did not receive respiratory support. RESULTS: Prior to the hospital stay, COVID-19 patients and patients with other RTI had ~ 40-60 physiotherapist consultations per 1000 inpatients per week. COVID-19 patients on respiratory support had a higher increase in physiotherapy use after discharge than persons with other RTI on respiratory support (an additional 27.3 (95% confidence interval = 10.2 to 44.4) consultations per 1000 for men, and 41.8 (13.7 to 69.9) per 1000 for women)). The increase in physiotherapy use lasted for 6 months for men, and 9 months for women. COVID-19 inpatients without respiratory support had a similar up-to-9-months-change post-discharge physiotherapy use as inpatients with other RTI without respiratory support (-0.2 (-0.7 to 0.2) for men, and 0.09 (-6.4 to 6.6) for women). CONCLUSION: The need for physiotherapy was increased for up to 9 months after having COVID-19 requiring respiratory support vs. other RTI requiring respiratory support. No difference between diseases was seen for individuals who were hospitalized but not on respiratory support.


Assuntos
COVID-19 , Medicina , Infecções Respiratórias , Masculino , Humanos , Feminino , COVID-19/epidemiologia , COVID-19/terapia , Assistência ao Convalescente , Alta do Paciente , Modalidades de Fisioterapia
10.
BMJ ; 379: o2879, 2022 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-36455928

Assuntos
Medicina , Humanos
11.
Perspect Biol Med ; 65(4): 637-645, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36468392

RESUMO

COVID-19 revealed health-care systems in crisis. Intersecting crises of stress, overwork, and poor working conditions have led to workforce strain, under-staffing, and high rates of job turnover. Bioethics researchers have responded to these conditions by investigating the ethical challenges of pandemic response for individuals, institutions, and health systems. This essay draws on pandemic findings to explore how empirical bioethics can inform post-pandemic translational bioethics. Borrowing from the concept of translational science in medicine, this essay proposes that translational bioethics should communicate knowledge about ethical challenges in health-care work to support health systems change. The authors draw from their experience with the Study to Examine Physicians' Pandemic Stress (STEPPS), an interdisciplinary research project that investigates physicians' experiences at the front lines of the COVID-19 pandemic. Using STEPPS as an example of empirical bioethics with potential for translation, the authors review their research and discuss the ongoing process for translating their findings, focusing on how bioethics research and practice can contribute to supporting the health-care workforce.


Assuntos
Bioética , COVID-19 , Medicina , Humanos , COVID-19/epidemiologia , Pandemias , Pessoal de Saúde
12.
Perspect Biol Med ; 65(4): 694-709, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36468398

RESUMO

Datafication has allowed us to quantify every facet of the corona-virus pandemic. A significant quantity of data sets on infection and recovery rates, mortality, comorbidities, the intensity of symptoms, region-by-region statistics, vaccination, and virus variants, among other things, has been made publicly available. However, these data sets relentlessly reduce human beings to mere numbers and graph points. The present study employs a close reading of comic panels to demonstrate how graphic medicine uses data to critique, supplement, and expose its lacunae. The article draws from graphic medical narratives and panels such as Andy Warner's "The Nib Bureau of Statistics" (2020), Sarah Firth's "State of Emergency" (2021), and Randall Munroe's "Statistics" (2020). Though data visualizations and comics are both graphical representations, their treatment of COVID-19-related issues is radically different. Graphic medicine "re-draws" data visualizations through imitation, subversion, and displacement to showcase multiple temporalities, marginal agencies, and the affective nature of human existence. Furthermore, the humanistic intervention of graphic medicine deftly reclaims individual lives and attendant stories in a world dominated by technologically mediated data. This essay does not dismiss the performative force of data; instead, it insists on humanizing and contextualizing a sensitive presentation of data to convey our entangled existence and collective states.


Assuntos
COVID-19 , Medicina , Humanos , Pandemias , Vacinação , Existencialismo
13.
Neurologia (Engl Ed) ; 37(9): 767-780, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36468429

RESUMO

INTRODUCTION: Many studies have described the presence of difficulty processing and generating social behaviour in patients who have suffered a traumatic brain injury (TBI). These difficulties in social cognition (SC) deteriorate personal relationships in the family, at work, or in the community. However, therapeutic programmes aiming to improve SC continue to be an outstanding issue in clinical practice. We performed a systematic review of the existing literature on the recovery of SC in patients with TBI, assessing the methodological quality of the included studies and the therapeutic effectiveness of the rehabilitation strategies used. DEVELOPMENT: We performed a bibliographic search of papers published before June 2018 in the Medline/PubMed, Google Scholar, PsycINFO, and ClinicalTrials.gov databases. Of the 198 potentially relevant articles, 10 met our eligibility criteria. Two of the authors independently and blindly assessed the methodological quality of these studies using the PEDro scale. CONCLUSIONS: The articles included in this systematic review essentially studied the effect of different interventions aimed at the rehabilitation of SC in patients with chronic TBIs. The analysis showed adequate methodological quality and an acceptable level of evidence. Future research should analyse the effect of these interventions in patients with TBIs in the sub- and post-acute phases.


Assuntos
Lesões Encefálicas Traumáticas , Medicina , Humanos , Cognição Social , Lesões Encefálicas Traumáticas/complicações
14.
Natl Med J India ; 35(2): 100-104, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36461856

RESUMO

Background Empathy is one of the pillars of professionalism in the medical field associated with better patient satisfaction and outcome. This study aimed to assess and compare the empathy score with other institutes within and outside India using the Jefferson Scale of Empathy-Student version (JSE-S). Methods We did a cross-sectional study for undergraduate medical students and interns of Pramukhswami Medical College, Karamsad, for 4 months from October 2019. Voluntary participants completed the JSE-S, an internationally validated 20-item survey questionnaire. Results The mean empathy score of 575 voluntary participants out of 631 was 100.75, with women having higher and significant scores than men (F 102.1 [11.5]; M 98.3 [12.5]; p<0.001). The highest empathy score was observed in the first year (102 [10.8]), which increased and decreased in different years of medical education with a maximum dip in the second year (99.4 [11.5]). The choice of specialty of participants showed a lower significant difference as per the JSE-S score. A lower empathy score was identified among participants compared to medical students studying in international medical institutes. Conclusion There is a need to organize workshops with training modules to cater to the empathy aspect of professional care, as a continuous process, starting from the first year till the completion of internship.


Assuntos
Educação Médica , Medicina , Estudantes de Medicina , Masculino , Feminino , Humanos , Empatia , Estudos Transversais
15.
Lancet ; 400(10367): 1920-1921, 2022 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-36463900
16.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 34(5): 445-452, 2022 Nov 14.
Artigo em Chinês | MEDLINE | ID: mdl-36464265

RESUMO

Since the global pandemic of coronavirus disease 2019 (COVID-19) in late 2019, artificial intelligence technology has shown increasing values in the research and control of tropical infectious diseases. The introduction of artificial intelligence technology has shown remarkable effectiveness to reduce the diagnosis and treatment burdens, reduce missing diagnosis and misdiagnosis, improve the surveillance and forecast ability and enhance the medicine and vaccine development efficiency. This paper summarizes the current applications of artificial intelligence in tropical infectious disease control and research and discusses the important values of artificial intelligence in disease diagnosis and treatment, disease surveillance and forecast, vaccine and drug discovery, medical and public health services and global health governance. However, artificial intelligence technology suffers from problems of single and inaccurate diagnosis, poor disease surveillance and forecast ability in open environments, limited capability of intelligent system services, big data management and model interpretability. Hereby, we propose suggestions with aims to improve multimodal intelligent diagnosis of multiple tropical infectious diseases, emphasize intelligent surveillance and forecast of vectors and high-risk populations in open environments, accelerate the research and development of intelligent management system, strengthen ethical security, big data management and model interpretability.


Assuntos
COVID-19 , Medicina , Estados Unidos , Humanos , Inteligência Artificial , COVID-19/diagnóstico , Controle de Doenças Transmissíveis , Pandemias
18.
Afr Health Sci ; 22(Spec Issue): 68-70, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36321124

RESUMO

Background: Makerere University College of Health Sciences has been collaborating with the Uganda Heart Institute to build capacity for research, training and clinical care in cardiovascular medicine for the last 34 years to appropriately respond to rising societal needs for advanced cardiovascular care which was lacking before this period. Aim: To describe the major milestones in the MakCHS-UHI cardiovascular training collaboration and chart way for future collaborations. Method: This short communication highlights some of the salient features and important milestones in the collaboration journey of the two institutions. Conclusion: Clinical centres of excellence in specialised fields of health care, such as the Uganda Heart Institute for Cardiology, provide a conducive academic environment for MakCHS clinical scientists to provide high quality evidence-based care to meet societal needs.


Assuntos
Doenças Cardiovasculares , Medicina , Humanos , Universidades , Uganda , Atenção à Saúde
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