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1.
Zhongguo Zhen Jiu ; 43(1): 36-9, 2023 Jan 01.
Artigo em Chinês | MEDLINE | ID: mdl-36633237

RESUMO

OBJECTIVE: To compare the effect of electroacupuncture at Tinghui (GB 2) and Benshen (GB 13) combined with routine rehabilitation training and simple routine rehabilitation training on abnormal auditory response in children with autism spectrum disorder (ASD). METHODS: A total of 70 children with ASD were randomly divided into an observation group and a control group, 35 cases in each group. The control group was given routine rehabilitation training. On the basis of the treatment in the control group, the observation group was given electroacupuncture at Tinghui (GB 2) and Benshen (GB 13), disperse-dense wave, frequency in 2 Hz/10 Hz, 20 min each time, and 1 day off after 6 days of treatment. Both groups were treated for 12 weeks. The incidence of abnormal auditory response, the scores of childhood autism rating scale (CARS) and autism behavior checklist (ABC) were compared between the two groups before and after treatment. RESULTS: After treatment, the total incidences of abnormal auditory response in the two groups and the incidences of dull and hypersensitive auditory response in the observation group were lower than those before treatment (P<0.05). The total incidence of abnormal auditory response and the incidence of hypersensitive auditory response in the observation group were lower than those in the control group (P<0.05). After treatment, CARS and ABC scores of both groups were lower than those before treatment (P<0.05), and those in the observation group were lower than the control group (P<0.05). CONCLUSION: Electroacupuncture at Tinghui (GB 2) and Benshen (GB 13) combined with routine rehabilitation training can reduce the incidence of abnormal auditory response and improve the core symptoms in children with ASD, and the clinical effect is better than the simple routine rehabilitation training.


Assuntos
Transtorno do Espectro Autista , Eletroacupuntura , Medicina , Humanos , Criança , Transtorno do Espectro Autista/terapia , Pontos de Acupuntura , Dor
2.
Zhongguo Zhen Jiu ; 43(1): 31-5, 2023 Jan 01.
Artigo em Chinês | MEDLINE | ID: mdl-36633236

RESUMO

OBJECTIVE: To compare the clinical efficacy and safety between syndrome-differentiation acupuncture combined with rehabilitation training and simple rehabilitation training for children with autism spectrum disorder (ASD). METHODS: A total of 60 children with ASD were randomly divided into an observation group and a control group, 30 cases in each group. In the control group, routine rehabilitation training was applied; in the observation group, syndrome-differentiation acupuncture (the main points were Baihui [GV 20], Dingshenzhen, Niesanzhen, etc., the supplementary acupoints were selected according to syndrome-differentiation) combined with rehabilitation training were applied, all the treatments were given once a day, 5-day continuous treatment with 2-day interval, 12 weeks were required. Before treatment and after 6, 12 weeks of treatment, the autism treatment evaluation checklist (ATEC), childhood autism rating scale (CARS) and autism behavior checklist (ABC) scores were observed, the therapeutic effect and safety were evaluated in the two groups. RESULTS: After 6 and 12 weeks of treatment, except for the sensory perception score after 6 weeks of treatment in the control group, the item scores and total scores of ATEC, CARS scores and ABC scores were decreased compared with those before treatment in the two groups (P<0.05). After 6 weeks of treatment, the social score and total score of ATEC, CARS score in the observation group were lower than those in the control group (P<0.05); after 12 weeks of treatment, the item scores and total score of ATEC, CARS score and ABC score in the observation group were lower than those in the control group (P<0.05). The total effective rate in the observation group was 80.0% (24/30), which was higher than 56.7% (17/30) in the control group (P<0.05). There was no serious adverse reactions in the two groups, and there was no significant difference in the incidence rate of adverse reactions between the two groups (P>0.05). CONCLUSION: Syndrome-differentiation acupuncture combined with rehabilitation training could improve the core symptoms in children with ASD, especially sensory perception and social ability, and with good safety, which is superior to simple rehabilitation training.


Assuntos
Terapia por Acupuntura , Transtorno do Espectro Autista , Medicina , Criança , Humanos , Transtorno do Espectro Autista/terapia , Resultado do Tratamento , Pontos de Acupuntura
3.
Subst Abuse Treat Prev Policy ; 18(1): 2, 2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-36609268

RESUMO

BACKGROUND: Research indicates that stigma impacts the care provided to individuals with Substance Use Disorders (SUDs), but perceptions of SUDs in various healthcare training programs are not well known. We aimed to characterize perceptions of faculty, staff, and students about SUD stigma in professional healthcare training programs. METHODS: We conducted a cross-sectional survey of faculty, staff, and students employed at or enrolled in one of six health-related colleges at one Mid-South health science center in the United States, including medicine, pharmacy, dentistry, nursing, health professions, and graduate health sciences. Data collection occurred between February and March 2021. We used descriptive and frequency statistics to assess the constructs within the survey instrument. RESULTS: A total of 572 respondents participated in this study (response rate = 9%; students, n = 428, 75%; faculty, n = 107, 19%; staff, n = 32, 6%). Most respondents reported interacting with persons with a SUD, cited challenges with the interaction, and perceived SUDs to be mental health condition (n = 463) or biological disease (n = 326). Most respondents believed that their college: emphasizes learning about SUDs; promotes an accurate perception of SUDs; and fosters respect for persons with. Few respondents reported they hear faculty, staff, or students express negative comments about persons with SUDs, but they were sometimes expressed by students. CONCLUSIONS: Most faculty, staff, and students reported experiencing challenges when interacting with a person with a SUD, mainly communication, but few recalled hearing negative comments from their peers. Whether interventions tailored towards improving communication in academic healthcare training settings could minimize challenges experience by faculty, staff, and students when serving individuals with SUDs should be further evaluated.


Assuntos
Medicina , Transtornos Relacionados ao Uso de Substâncias , Humanos , Estados Unidos , Estudos Transversais , Estudantes , Docentes
4.
BMC Prim Care ; 24(1): 1, 2023 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-36588155

RESUMO

BACKGROUND: In Canada, the demand for mental health care exceeds the provision of services. This exploratory study aimed to assess the feasibility and impact of a new service delivery model for psychological consultations in primary care settings: the Single-Session Intervention (SSI), inspired by Advanced Access (AA) principles for appointment scheduling. The specific objectives were to examine whether the SSI increases accessibility to psychological consultations, to measure the effects of the intervention on different self-reported measures, and to assess users' consultation experiences. METHODS: Participants were recruited in a University Family Medicine Group in Quebec (Canada), and the SSI was delivered by the on-site psychologist. No referral or formal diagnosis was needed to attend, and participants could promptly obtain an appointment. Participants rated the intensity of their problem, their level of psychological distress and their well-being, before and after the SSI. They also rated their satisfaction with their consultation experience. There was a follow-up 4 to 6 weeks later. RESULTS: Of the N = 69 participants who received SSI, 91% were able to obtain an appointment in less than 7 working days. The number of patients who were able to benefit from a psychological consultation was about 7 times higher after the implementation of SSI compared to previous years, when a traditional model of service delivery was in place. After SSI, participants felt that the intensity of their problem and psychological distress were lower, and that their well-being was increased, as indicated by significant pre-post test clinical measures (p < 0.0001). The observed effects seemed to be sustained at follow-up. Moreover, 51% of participants said that one session was sufficient to help them with their problem. Participants rated SSI as a highly satisfying and helpful consultation experience (92,9% overall satisfaction). CONCLUSIONS: SSI, offered in a timely manner, could be an innovative and cost-effective intervention to provide mental health services on a large scale in primary healthcare. Further research is needed to replicate the results, but these preliminary data seem to indicate that psychological distress may be quickly addressed by SSI, thereby preventing further deteriorations in patients' mental health. TRIAL REGISTRATION: 2019-393, 26 March 2019.


Assuntos
Medicina , Serviços de Saúde Mental , Atenção Primária à Saúde , Humanos , Saúde Mental , Serviços de Saúde Mental/tendências , Autorrelato , Canadá , Inovação Organizacional
5.
BMJ ; 380: 106, 2023 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-36657789
6.
Artigo em Inglês | MEDLINE | ID: mdl-36673778

RESUMO

The main purpose of this study is to explore the application of the balanced scorecard (BSC) to service performance measurements of medical institutions using the analytic hierarchy process (AHP) and decision making and trial evaluation laboratory (DEMATEL). According to the concept of BSC, a total of four evaluation dimensions and twenty-two indicators of medical service performance measurements were developed. To collect data, this study delivered expert questionnaires to medical-related professional supervisors, deans, and heads of medical institutions in Taiwan. By combining the AHP and DEMATEL, the priority and causality of service performance standards in medical institutions were obtained. The results of this study show that the customer dimension is the most important service performance measurement dimension for medical institutions. The seven key service performance measurement indicators that are most important for medical institutions, in order, are "complete and comfortable equipment", "competitiveness of the medical profession", "continuity of patient-to-hospital treatment", "classification of medical profession according to customers (VIP system)", "complete medical service", "complete salary, remuneration, and policy", and "medical incomes of institutions". In terms of causality, provided the complete services of medical institutions are improved, the continuity of patient-to-hospital treatment, the competitiveness of the medical profession, and the medical incomes of institutions would be influenced.


Assuntos
Administração Hospitalar , Medicina , Humanos , Processo de Hierarquia Analítica , Hospitais , Inquéritos e Questionários
7.
J Coll Physicians Surg Pak ; 33(1): 79-83, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36597240

RESUMO

OBJECTIVES: To determine the change in empathy levels of medical students during their progress in professional years internship, and to examine change in empathy after targeted empathy enhancing activities during the course of medical school. STUDY DESIGN: Longitudinal Study. PLACE AND DURATION OF STUDY: Shifa College of Medicine/ Shifa Tameer-e-Millat University, Islamabad, from January 2015 to December 2019. METHODOLOGY: Student version of Jefferson Scale of Physician Empathy was administered sequentially from 2015 to 2019 which evaluated the change in empathy of medical students in a class of 2019. Targeted empathy-enhancing activities included patient-centered module in year-three and stress management workshops in the final year of medical school. RESULTS: Empathy scores rose from the first year of study (4.27 ±0.38) to the third year (4.52 ±0.70). It fell over the next two years of study (4.25 ±0.62 & 4.21 ±0.40) before rising again during the internship (4.39 ±0.43) with focused empathy-enhancing activities. CONCLUSION: Patient-centered module which focused on activities that help develop empathy may have been a factor in the increase of empathy scores in the third year and internship. Placing recurring formal activities throughout all clinical years may help in enhancing empathy in medical students. KEY WORDS: Medical student empathy, Empathy enhancing targeted activities, JSPE.


Assuntos
Medicina , Estudantes de Medicina , Humanos , Empatia , Estudos Longitudinais , Fatores Sexuais , Relações Médico-Paciente
8.
J Med Internet Res ; 25: e43521, 2023 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-36656626

RESUMO

BACKGROUND: An increasing number of medical journals are using social media to promote themselves and communicate with their readers. However, little is known about how medical journals use Twitter and what their social media management strategies are. OBJECTIVE: This study aimed to understand how medical journals use Twitter from a global standpoint. We conducted a broad, in-depth analysis of all the available Twitter accounts of medical journals indexed by major indexing services, with a particular focus on their social networks and content. METHODS: The Twitter profiles and metadata of medical journals were analyzed along with the social networks on their Twitter accounts. RESULTS: The results showed that overall, publishers used different strategies regarding Twitter adoption, Twitter use patterns, and their subsequent decisions. The following specific findings were noted: journals with Twitter accounts had a significantly higher number of publications and a greater impact than their counterparts; subscription journals had a slightly higher Twitter adoption rate (2%) than open access journals; journals with higher impact had more followers; and prestigious journals rarely followed other lesser-known journals on social media. In addition, an in-depth analysis of 2000 randomly selected tweets from 4 prestigious journals revealed that The Lancet had dedicated considerable effort to communicating with people about health information and fulfilling its social responsibility by organizing committees and activities to engage with a broad range of health-related issues; The New England Journal of Medicine and the Journal of the American Medical Association focused on promoting research articles and attempting to maximize the visibility of their research articles; and the British Medical Journal provided copious amounts of health information and discussed various health-related social problems to increase social awareness of the field of medicine. CONCLUSIONS: Our study used various perspectives to investigate how medical journals use Twitter and explored the Twitter management strategies of 4 of the most prestigious journals. Our study provides a detailed understanding of medical journals' use of Twitter from various perspectives and can help publishers, journals, and researchers to better use Twitter for their respective purposes.


Assuntos
Medicina , Mídias Sociais , Humanos , Fator de Impacto de Revistas , Metadados , Rede Social
9.
PLoS One ; 18(1): e0279867, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36656810

RESUMO

We investigated the social relations shaping the reproductive health care experiences of women with female genital cutting (FGC) in Toronto, Canada. Using Institutional Ethnography, we interviewed eight women with FGC and seven obstetrician/gynecologists (OB/GYN). We found a disjuncture between women's needs during appointments that extended beyond the reproductive body and range of care that doctors were able to provide. Women engaged in emotional healthwork during appointments by explaining FGC to doctors, reading doctors' body language, and getting through vulvar/vaginal examinations. Women reported that if they had emotional reactions during appointments, they were often referred to a mental health specialist, a referral on which they did not act. OB/GYNs described their specialty as "surgical"-training centered around treating reproductive abnormalities and not mental health issues. Therefore, the disjuncture between women's needs and OB/GYNs' institutional training highlights the difficulties inherent when bodies of "difference" encounter the reproductive health care system.


Assuntos
Circuncisão Feminina , Ginecologia , Medicina , Obstetrícia , Gravidez , Humanos , Feminino , Saúde Reprodutiva , Canadá
10.
J Clin Ultrasound ; 51(1): 131-133, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36639847

RESUMO

Sonoelastography is a powerful method available to observe the musculoskeletal system, and appears particularly valuable in detecting early tendinopathies, pursuing complaints of localized musculoskeletal pain, analyzing soft tissue masses, and research applications in musculoskeletal medicine.


Assuntos
Técnicas de Imagem por Elasticidade , Medicina , Humanos , Técnicas de Imagem por Elasticidade/métodos
11.
Trials ; 24(1): 40, 2023 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-36658610

RESUMO

INTRODUCTION: Nearly one in seven women worldwide suffers from chronic pelvic pain syndrome (CPPS) each year. Often, CPPS necessitates a combination of treatments. Studies have shown the good therapeutic effects of repetitive transcranial magnetic stimulation (rTMS) upon CPPS. We wish to undertake a randomized controlled trial (RCT) to observe the effect of high-frequency rTMS at different intensities upon CPPS. METHODS AND ANALYSES: In this prospective, double-blinded RCT, 63 female CPPS participants will be recruited and randomized (1:1:1) to high-intensity rTMS, low-intensity rTMS, or sham rTMS. The control group will receive a 10-day course of conventional pelvic floor (PF) rehabilitation (neuromuscular stimulation, magnetic therapy, or light therapy of the PF). On the basis of conventional treatment, participants in the high-intensity rTMS group will receive pulses of 10 Hz with a resting motor threshold (RMT) of 110% for a total of 15,000 pulses. Participants in the low-intensity rTMS group will receive pulses of 10 Hz with an RMT of 80% with 15,000 pulses. The sham rTMS group will be subjected to sham stimulation with the same sound as produced by the real magnetic stimulation coil. The primary outcome will be determined using a visual analog scale, the Genitourinary Pain Index, Zung Self-Rating Anxiety Scale, and Zung Self-Rating Depression Scale. The secondary outcome will be determined by electromyography of the surface of PF muscles at baseline and after treatment completion. ETHICS AND DISSEMINATION: This study is approved by the Ethics Committee of Bao'an People's Hospital, Shenzhen, Guangdong Province (approval number: BYL20211203). The results will be submitted for publication in peer-reviewed journals and disseminated at scientific conferences (Protocol version 1.0-20220709). TRIAL REGISTRATION: Chictr.org.cn, ID: ChiCTR2200055615. Registered on 14 January 2022, http://www.chictr.org.cn/showproj.aspx?proj=146720 . Protocol version 1.0-20220709.


Assuntos
Dor Crônica , Medicina , Feminino , Humanos , Estimulação Magnética Transcraniana/efeitos adversos , Estimulação Magnética Transcraniana/métodos , Dor Crônica/diagnóstico , Dor Crônica/terapia , Dor Pélvica/diagnóstico , Dor Pélvica/terapia , Manejo da Dor/métodos , Resultado do Tratamento , Método Duplo-Cego , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
JAMA Netw Open ; 6(1): e2250957, 2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36689232

Assuntos
Medicina , Humanos
13.
Probl Endokrinol (Mosk) ; 68(6): 168-169, 2023 Jan 12.
Artigo em Russo | MEDLINE | ID: mdl-36689723

RESUMO

On January 1, 2023, at the age of 59, the head of the Diabetes Prediction and Innovation Department of the Diabetes Institute of the State Scientific Center-FGBU «NMITs of Endocrinology¼ of the Ministry of Health of Russia, the president of the All-Russian Public Organization of the Disabled «Russian Diabetes Association¼ endocrinologist and diabetologist, doctor of medical sciences, died suddenly Professor Mayorov Alexander Yurievich.


Assuntos
Diabetes Mellitus , Medicina , Médicos , Humanos , Federação Russa , Academias e Institutos
14.
CMAJ ; 195(3): E138-E142, 2023 Jan 23.
Artigo em Francês | MEDLINE | ID: mdl-36690367
16.
BMC Med Inform Decis Mak ; 23(1): 17, 2023 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-36691014

RESUMO

BACKGROUND: Breast cancer is one of the most common cancers diagnosed worldwide and the second leading cause of death among women. Virtual reality (VR) has many opportunities and challenges for breast cancer patients' rehabilitation and symptom management. The purpose of this systematic review is to look into the benefits and drawbacks of VR interventions for breast cancer patients. METHODS: A systematic search was conducted on PubMed, Web of Science, Scopus, IEEE, and the Cochrane Library, from inception until February 6, 2022. The inclusion criteria were: (1) original studies without restriction in study design; (2) a study population consisting of patients with breast cancer; (3) any type of VR-based interventions (immersive and non-immersive); and (5) studies published in English. To assess the risk of bias, the Effective Public Health Practice Project (EPHPP) Tool was used. RESULTS: Eighteen articles were included in this systematic review. The result showed that VR could provide many opportunities for patients with breast cancer, including reducing anxiety, time perception, pain, fatigue, chemotherapy-related symptom distress levels, and depression severity, as well as improvement in the range of motion, strength, and function. Cybersickness symptoms, the weight of headsets and helmets, the quality of the visual image, and the cost of the equipment are some of the challenges in using this technology on these patients. CONCLUSIONS: The systematic review showed that VR interventions have opportunities and challenges for patients with breast cancer. VR can be effective for rehabilitation and symptom management and is used in different stages of treatment to improve the condition of patients with breast cancer. However, before using it, the researcher should consider its challenges.


Assuntos
Neoplasias da Mama , Medicina , Realidade Virtual , Humanos , Feminino , Cuidados Paliativos , Qualidade de Vida
17.
Am J Phys Med Rehabil ; 102(2): 159-165, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36634238

RESUMO

ABSTRACT: Environmental scans determine trends in an organization's or field's internal and external environment. The results can help shape goals, inform strategic decision making, and direct future actions. The Association of Academic Physiatrists convened a strategic planning group in 2020, composed of physiatrists representing a diversity of professional roles, career stages, race and ethnicity, gender, disability status, and geographic areas of practice. This strategic planning group performed an environmental scan to assess the forces, trends, challenges, and opportunities affecting both the Association of Academic Physiatrists and the entire field of academic physiatry (also known as physical medicine and rehabilitation, physical and rehabilitation medicine, and rehabilitation medicine). This article presents aspects of the environmental scan thought to be most pertinent to the field of academic physiatry organized within the following five themes: (1) Macro/Societal Trends, (2) Technological Advancements, (3) Diversity and Global Outreach, (4) Economy, and (5) Education/Learning Environment. The challenges and opportunities presented here can provide a roadmap for the field to thrive within the complex and evolving healthcare systems in the United States and globally.


Assuntos
Internato e Residência , Medicina , Medicina Física e Reabilitação , Humanos , Estados Unidos , Educação de Pós-Graduação em Medicina , Atenção à Saúde
18.
Am J Phys Med Rehabil ; 102(2): 166-168, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36634239

RESUMO

ABSTRACT: In the April 1930 issue of the journal, Founding Editor-in-Chief William Rush Dunton, Jr, MD, initiated a new series: Museum Meanderings. Eleven installments of the series ran intermittently until December 1931. Here, a 12th installment, an e-museum "tour" of paintings by the great American artist Jacob Lawrence (1917-2000) relevant to rehabilitation medicine, is offered. In particular, his Occupational Therapy No. 1 (1949) is a most thought-provoking and inspiring masterpiece. The painting depicts five women performing various sewing activities with space in the painting brilliantly divided. The painting has been discussed by art critics, but it has not been appreciated that all the women appear actually to be the same person! Thus, the painting shows the stages or cycle of rehabilitation. Echoing Rush Dunton's thoughts in 1930, we invite further contributions to the series.


Assuntos
Medicina , Terapia Ocupacional , Pinturas , Humanos , Feminino , Museus , Pinturas/história
19.
Artif Intell Med ; 135: 102471, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36628785

RESUMO

Increasingly complex learning methods such as boosting, bagging and deep learning have made ML models more accurate, but harder to interpret and explain, culminating in black-box machine learning models. Model developers and users alike are often presented with a trade-off between performance and intelligibility, especially in high-stakes applications like medicine. In the present article we propose a novel methodological approach for generating explanations for the predictions of a generic machine learning model, given a specific instance for which the prediction has been made. The method, named AraucanaXAI, is based on surrogate, locally-fitted classification and regression trees that are used to provide post-hoc explanations of the prediction of a generic machine learning model. Advantages of the proposed XAI approach include superior fidelity to the original model, ability to deal with non-linear decision boundaries, and native support to both classification and regression problems. We provide a packaged, open-source implementation of the AraucanaXAI method and evaluate its behaviour in a number of different settings that are commonly encountered in medical applications of AI. These include potential disagreement between the model prediction and physician's expert opinion and low reliability of the prediction due to data scarcity.


Assuntos
Cognição , Medicina , Reprodutibilidade dos Testes , Aprendizado de Máquina
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