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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
2.
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
3.
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
4.
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
5.
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
7.
BMJ ; 379: o2879, 2022 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-36455928

Assuntos
Medicina , Humanos
8.
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
11.
Arch Iran Med ; 25(7): 473-479, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-36404515

RESUMO

Testing physicians and determining their professional qualifications have been significant issues in the educational and medical system of the Islamic civilization. The purpose of this study is to explain the views of Rhazes on how to test physicians in the book Al-Hawi Fi Al-Tibb. This library study has been done with descriptive-analytical method and using the keywords of medical test, medical ethics and medical history. Rhazes emphasizes various criteria by holding a comprehensive test to determine the competence of physicians with the aim of evaluating different aspects of their knowledge and attitude. He enumerates the provisions of the test in three sections: individual characteristics, theoretical and practical medical sections. The results show that Rhazes paid attention to all aspects related to a doctor's personal and social habits and behavior and his relationship with the patients. A number of post-Rhazes physicians have also mentioned to the test of physician before hiring them but their content does not have the coherence of Rhazes' statements. Most of the material mentioned in Al-Hawi Fi al-Tibb is still worth rethinking after hundreds of years. It is suggested that medical students and physicians use the ethical and professional points mentioned by this great scientist in his valuable book in order to make the high position of medical science more visible.


Assuntos
Medicina , Médicos , Humanos , Masculino , Ética Médica , Islamismo
12.
Acute Med ; 21(3): 124-125, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36427209

RESUMO

The screen time app on my iPhone tells me that I spend over ten hours a week on Twitter. And I'm not alone. As Netflix's The Social Dilemma illustrated, social media platforms are designed to keep us scrolling for hours, even if we only opened the app for a second. Thousands of UK healthcare workers use Twitter every day, discussing everything from cutting edge COVID treatments to staff room fridge etiquette. As strange as it sounds, this esoteric little corner of the internet - affectionately if unoriginally nicknamed "MedTwitter" - has become a thriving online community.


Assuntos
COVID-19 , Medicina , Mídias Sociais , Humanos , COVID-19/epidemiologia , Internet , Pessoal de Saúde
14.
PLoS One ; 17(11): e0276389, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36318574

RESUMO

INTRODUCTION: Obtaining a tenure track faculty position (TTFP) after postdoctoral appointment (PDA) completion is considered an indicator of successful transition to independence (TTI). Whether cross-institutional mobility (CIM)-moving to a different institution from that of the PDA-contributes to TTI is unclear, as data evaluating retention and mobility is lacking. We tested the hypothesis that, for postdocs (PDs) at R1 institutions, CIM is a significant predictor of successful TTI defined as TTFP-status 3 years post-PDA. MATERIALS AND METHODS: Using University of Pittsburgh data for health sciences PDs we tested the association of CIM at PDA completion (moved to a different institution (CIM = 1) or retained at Pitt (CIM = 0)) with TTFP-status 3 years post-PDA (TTFP, non-TTFP, or left faculty position) using multinomial logistic regression models. RESULTS: Among all 622 Pitt PDs, 3-year retention in a faculty position at Pitt was 21%, while 14% had a faculty position outside of Pitt. Among the analytic sample of PDs with an academic career outcome during the study period (N = 238; 50% women, 8% underrepresented minorities (URM)), at baseline PDA completion 39% moved to a different institution (CIM = 1), and 61% remained at Pitt (CIM = 0) in any job type. Those with CIM = 1 had greater odds of having a TTFP at follow-up than those with CIM = 0 [adjusted OR (95% CI): 4.4 (2.1, 9.2)]. DISCUSSION: One fifth of Pitt PDs were retained by Pitt as faculty. While Pitt PDs were equally likely to get a faculty position whether they were retained at Pitt or left, those who left had greater odds of obtaining a TTFP. Future work with longer follow-up times, expanded markers of TTI, and samples from other R1 institutions is needed to better understand the reason for these results. This knowledge can lead to better support for the next generation of PDs as they successfully transition to faculty.


Assuntos
Medicina , Grupos Minoritários , Humanos , Feminino , Masculino , Docentes , Pesquisadores , Conhecimento , Mobilidade Ocupacional , Docentes de Medicina
15.
Hist Philos Life Sci ; 44(4): 60, 2022 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-36357643

RESUMO

Our goal in this paper is to reassess the relationship between norms and life by drawing on the philosophy of Georges Canguilhem, particularly some of his unpublished lectures about teratology and sexual determination. First, we discuss the difficulties Canguilhem identified in the introduction of life and sexuality as objects of philosophical reflection. Second, we reassess Canguilhem's understanding of normativity as rooted in life and the axiological activity of the living. Third, we analyze how Canguilhem drew from past and contemporary teratology to conceive of the notions of anomaly and abnormality. Finally, we reconstruct Canguilhem's analysis of a case of hermaphroditism, highlighting how he presented it as evidence that sexual determination is the result of a normative choice. One of the key contributions of the paper to scholarly literature on Canguilhem is a better understanding of his notion of choice, which was considered not the conscious and intentional act of a subject but rather an axiological activity of the living. We conclude by positioning Canguilhem's concept of normativity and his belief that norms are produced by the living in relation to the naturalist/normativist divide in medicine.


Assuntos
Medicina , Filosofia , Masculino , Humanos , Comportamento Sexual , Motivação
16.
East Mediterr Health J ; 28(10): 743-750, 2022 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-36382729

RESUMO

Background: Little is known about gender disparity in the surgery specialty in Lebanon. Aims: To assess the status of female surgeons and possible gender gaps in surgery specialty in Lebanon. Methods: The study was conducted in May 2021. Data were retrieved from the Lebanese Order of Physicians website, indicating the number of physicians in the different specialties, their gender, hospitals, and locations. The c2 test of homogeneity was used to establish whether the gender distribution was equal. Results: Women only accounted for 21.84% (3,370) of physicians in Lebanon, with surgery having the lowest number of female physicians in (n = 65; 2.30%). Women accounted for 1.63% of all surgeons in Lebanese hospitals, there were more female plastic and reconstructive surgeons (n = 12; 7.14%), while neurosurgery, oncological surgery and vascular surgery had no females. There was no significant difference in gender between academic and non-academic institutions (χ2 = 2.164, P = 0.149), or between public and private hospitals (χ2 = 1.277, P = 0.234). Conclusion: The surgical specialty had the widest gender gap among all the medical fields in Lebanon. Therefore, the healthcare systems, including public and private hospitals, have a long and difficult road in narrowing the gender gap. Different strategies to incorporate women into surgery should be explored to assure equitable opportunities for all physicians, based on competency rather than gender.


Assuntos
Medicina , Médicas , Especialidades Cirúrgicas , Cirurgiões , Feminino , Humanos , Fatores Sexuais
18.
Croat Med J ; 63(5): 407-409, 2022 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-36325663
19.
PLoS One ; 17(11): e0276586, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36395114

RESUMO

BACKGROUND AND OBJECTIVE: There has been growing emphasis on increasing impacts of academic health research by integrating research findings in healthcare. The concept of knowledge translation (KT) has been widely adopted in Canada to guide this work, although lack of recognition in tenure and promotion (T&P) structures have been identified as barrier to researchers undertaking KT. Our objective was to explore how KT is considered in institutional T&P documentation in Canadian academic health sciences. METHODS: We conducted content analysis of T&P documents acquired from 19 purposively sampled research-intensive or largest regional Canadian institutions in 2020-2021. We coded text for four components of KT (synthesis, dissemination, exchange, application). We identified clusters of related groups of documents interpreted together within the same institution. We summarized manifest KT content with descriptive statistics and identified latent categories related to how KT is considered in T&P documentation. RESULTS: We acquired 89 unique documents from 17 institutions that formed 48 document clusters. Most of the 1057 text segments were categorized as dissemination (n = 851, 81%), which was included in 47 document clusters (98%). 15 document clusters (31%) included all four KT categories, while one (2%) did not have any KT categories identified. We identified two latent categories: primarily implicit recognition of KT; and an overall lack of clarity on KT. CONCLUSIONS: Our analysis of T&P documents from primarily research-intensive Canadian universities showed a lack of formal recognition for a comprehensive approach to KT and emphasis on traditional dissemination. We recommend that institutions explicitly and comprehensively consider KT in T&P and align documentation and procedures to reflect these values.


Assuntos
Medicina , Ciência Translacional Biomédica , Humanos , Política Organizacional , Canadá , Pesquisadores
20.
Biosensors (Basel) ; 12(11)2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36421153

RESUMO

Near-infrared-excited upconversion nanoparticles (UCNPs) have multicolor emissions, a low auto-fluorescence background, a high chemical stability, and a long fluorescence lifetime. The fluorescent probes based on UCNPs have achieved great success in the analysis of different samples. Here, we presented the research results of UCNPs probes utilized in analytical applications including environment, biology, food and medicine in the last five years; we also introduced the design and construction of upconversion optical sensing platforms. Future trends and challenges of the UCNPs used in the analytical field have also been discussed with particular emphasis.


Assuntos
Medicina , Nanoestruturas , Alimentos , Corantes Fluorescentes , Biologia
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