ResearchPad - medical-humanities https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Associations between demographic factors and the academic trajectories of medical students in Japan]]> https://www.researchpad.co/article/elastic_article_15714 Group-based trajectory modeling is a useful tool for categorizing students’ academic trajectories and their determinants. Using insights gained from the analyses, we can identify students at risk for poor academic performance and monitor them to provide support. To date, studies investigating the associations between demographic factors and academic performance trajectories among medical students are scarce. The study objective was to examine the associations between demographic factors and academic performance trajectories in medical students using group-based trajectory modeling.MethodsParticipants included all medical students admitted to Tokyo Medical and Dental University in Japan in 2013 and 2014 (n = 202). Academic performance was evaluated by biannual grade point average (GPA) scores in preclinical years. We used group-based trajectory modeling to categorize students into GPA trajectories. Multinomial logistic regression was used to examine the association between the odds of being in a certain GPA trajectory group and demographic factors such as high school type, high school geographical area, admission test type, high school graduation year, whether the student was a biology major, and sex.ResultsStudents’ GPA trajectories were classified into four trajectory groups as well as another group that consisted of students who withdrew or repeated years. We found that students whose high school geographical area was outside the National Capital Region were 7.2 times more likely to withdraw or repeat years in comparison with students whose school was inside the National Capital Region (OR: 7.21, 95% CI: 1.87, 27.76). In addition, admission test type, high school graduation year, and sex were associated with GPA trajectories.ConclusionsHigh school geographical area, admission test type, high school graduation year, and sex were associated with GPA trajectories. These findings provide important insights into identifying students at risk for poor academic performance and strategies for monitoring them to provide adequate and timely support. ]]> <![CDATA[Exploring the knowledge and attitudes of Cameroonian medical students towards global surgery: A web-based survey]]> https://www.researchpad.co/article/elastic_article_11233 Global surgery is a growing field studying the determinants of safe and affordable surgical care and advocating to gain the global health community's attention. In Cameroon, little is known about the level of knowledge and attitudes of students. Our survey aimed to describe the knowledge and attitudes of Cameroonian medical students towards global surgery.Materials and methodsWe performed an anonymous online survey of final-year Cameroonian medical students. Mann-Whitney U test and Spearman correlation analysis were used for bivariate analysis, and the alpha value was set at 0.05. Odds ratios and their 95% confidence intervals were calculated.Results204 respondents with a mean age of 24.7 years (±2.0) participated in this study. 58.3% were male, 41.6% had previously heard or read about global surgery, 36.3% had taken part in a global surgery study, and 10.8% had attended a global surgery event. Mercy Ships was well known (46.5%), and most students believed that surgical interventions were more costly than medical treatments (75.0%). The mean score of the global surgery evaluation was 47.4% (±29.6%), and being able to recognize more global surgery organizations was correlated with having assumed multiple roles during global surgery studies (p = 0.008) and identifying more global surgery indicators (p = 0.04). Workforce, infrastructure, and funding were highlighted as the top priorities for the development of global surgery in Cameroon.ConclusionMedical students are conscious of the importance of surgical care. They lack the opportunities to nurture their interest and should be taught global surgery concepts and skills. ]]> <![CDATA[Prevalence of depressive symptoms among Italian medical students: The multicentre cross-sectional “PRIMES” study]]> https://www.researchpad.co/article/N89095419-220d-4d38-944c-d00bb778cf6f

Background

Four percent of the world’s population suffers from depression, which is a major public health issue. Medical students are at risk, as their depressive symptoms (DS) prevalence is reported to be approximately 27% worldwide. Since few data on Italian medical students exist, this study aimed to estimate their DS prevalence and assess risk and protective factors.

Methods

The PRIMES was a multicentre cross-sectional study performed in 12 Italian medical schools. Questionnaires were self-reported and included 30 sociodemographic items and the Beck Depression Inventory-II (BDI-II). The primary outcome was the presence of DS (BDI-II score≥14). The main analyses were chi-squared tests and multivariable logistic regressions with a p-value<0.05 considered significant.

Results

The number of collected questionnaires was 2,513 (117 BDI-II incomplete). Females accounted for 61.3% of the respondents, and the median age was 22 years (IQR = 4). The prevalence of DS was 29.5%. Specifically, 14.0% had mild depression, 11.1% had moderate depression, and 4.5% had severe depression. The main risk factors for DS were age, being female, bisexual/asexual orientation, living with partner/housemates, poor economic status (worsened by living far from home), less than 90 min of weekly exercise, relatives with psychiatric disorders, personal chronic disease, judging medical school choice negatively, unsatisfying friendships with classmates, competitive and hostile climate among classmates, thinking that medical school hinders specific activities and being worried about not measuring up to the profession. Protective factors included family cohesion, hobbies, intellectual curiosity as a career motivation and no worries about the future.

Conclusion

Italian medical students are at high risk of reporting DS, similar to the global population of medical students’. Medical schools must make efforts to implement preventive and treatment interventions by offering counselling and working on modifiable factors, such as lifestyle and learning climate.

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<![CDATA[Readiness to prescribe: Using educational design to untie the Gordian Knot]]> https://www.researchpad.co/article/Nd54ed6a5-cf2b-4df7-b723-1be3eaed6fb5

Introduction

Junior residents routinely prescribe medications for hospitalised patients with only arms-length supervision, which compromises patient safety. A cardinal example is insulin prescribing, which is commonplace, routinely delegated to very junior doctors, difficult, potentially very dangerous, and getting no better. Our aim was to operationalise the concept of ‘readiness to prescribe’ by validating an instrument to quality-improve residents’ workplace prescribing education.

Methods

Guided by theories of behaviour change, implementation, and error, and by empirical evidence, we developed and refined a mixed-methods 24-item evaluation instrument, and analysed numerical responses from Foundation Trainees (junior residents) in Northern Ireland, UK using principal axis factoring, and conducted a framework analysis of participants’ free-text responses.

Results

255 trainees participated, 54% women and 46% men, 80% of whom were in the second foundation year. The analysis converged on a 4-factor solution explaining 57% of the variance. Participants rated their capability to prescribe higher (79%) than their capability to learn to prescribe (69%; p<0.001) and rated the support to their prescribing education lower still (43%; p<0.001). The findings were similar in men and women, first and second year trainees, and in different hospitals. Free text responses described an unreflective type of learning from experience in which participants tended to 'get by' when faced with complex problems.

Discussion

Operationalising readiness to prescribe as a duality, comprising residents’ capability and the fitness of their educational environments, demonstrated room for improvement in both. We offer the instrument to help clinical educators improve the two in tandem.

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<![CDATA[Student engagement, assessed using heart rate, shows no reset following active learning sessions in lectures]]> https://www.researchpad.co/article/Nf5514316-08af-4907-81a8-d6c8d0a0ef3a

Heart rate can be used as a measure of cognitive engagement. We measured average student heart rates during medical school lecture classes using wristwatch-style monitors. Analysis of 42 classes showed a steady decline in heart rate from the beginning to end of a lecture class. Active learning sessions (peer-discussion based problem solving) resulted in a significant uptick in heart rate, but this returned to the average level immediately following the active learning period. This is the first statistically robust assessment of changes in heart rate during the course of college lecture classes and indicates that personal heart rate monitors may be useful tools for assessment of different teaching modalities. The key findings suggest that the value of active learning within the classroom resides in the activity itself and not in an increase in engagement or reset in attention during the didactic period following an active learning session.

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<![CDATA[The beginning of smallpox vaccination in the Duchy of Parma*]]> https://www.researchpad.co/article/N5229c82a-7fc6-4d9f-be98-5fc2a4ec6693

Maria Luigia (Marie Louise) of Habsburg, daughter of the Austrian Emperor and, as Napoleon Bonaparte’s second wife, Empress of the French, after the defeat of the husband in 1814 was relegated to role of Duchesse of Parma, Piacenza and Guastalla. She arrived in Parma in 1816 accompanied by several Austrian army and administrative officials, which were instructing and controlling her, and, willingly, she left to them most of the political and administrative decisions. On the contrary, since the first years she was interested and wanted to take decisions in the field of public health and charity. She opened new specialized hospitals and hospices for poor people, orphans and abandoned children, and, in February of 1820, promulgated the new «Regulations of the vaccinations», an exhaustive and specific code, that was taking into consideration the times, the places, and the people who had to vaccinate or to be vaccinated. Moreover, she fixed the modalities, the incentives, the sanctions, and she also nominated a series of people who had to publicize vaccinations and to help the general population inovercoming fears, prejudices and other causes of distrust. The new dispositions increased the number of vaccinated people in the Duchy, saving it from several epidemics that appeared in the following decades in the neighboring regions (Tuscany, Lombardy). In 1831 and 1832 she issued other two ordinances in which she urged the populations and the doctors to increase the vaccinations, probably after a decrease in interest of both, and introduced new practical arrangements to simplify and to facilitate the practice, ensuring and verifying the outcome. The effectiveness of the provisions of Maria Luigia has been shown by the marked decrease in smallpox epidemics throughout her whole reign, until 1847. Meanwhile after the end of the reign, in the second part of the nineteenth century, there was an increase of epidemics, because the following governments of the Bourbons Duchy (1847-1860) and of the united Italy after 1860 were not as diligent and active on spreading vaccinations. (www.actabiomedica.it)

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<![CDATA[Is there an association between consent rates in Swiss hospitals and critical care staffs' attitudes towards organ donation, their knowledge and confidence in the donation process?]]> https://www.researchpad.co/article/5c6730d8d5eed0c484f38205

This study investigated the critical care staff’s attitude, knowledge and involvement with donation, skills and confidence with donation-related tasks and their association with consent rates at the hospital level. In 2015, we conducted a cross-sectional survey among critical care staff of hospitals involved in organ donation using an anonymous online questionnaire with a response rate of 56.4% (n = 2799). The hospital level consent rate was obtained from the Swiss Monitoring of Potential Donors database (2013–2015). For each hospital, we calculated a mean score for each predictor of interest of the Hospital Attitude Survey and investigated the association with hospital consent rates with generalized linear mixed-effect models. In univariable analysis, one score point increase in doctors' confidence resulted in a 66% (95% CI: 45%–80%) reduction in the odds to consent, and one score point increase in nurses' attitudes resulted in a 223% (95% CI: 84%–472%) increase in the odds to consent. After simultaneously adjusting for all major predictors found in the crude models, only levels of education of medical and nursing staff remained as significant predictors for hospital consent rates. In Switzerland, efforts are needed to increase consent rates for organ donation and should concentrate on continuous support as well as specific training of the hospital staff involved in the donation process.

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<![CDATA[Strategies to improve dietary, fluid, dialysis or medication adherence in patients with end stage kidney disease on dialysis: A systematic review and meta-analysis of randomized intervention trials]]> https://www.researchpad.co/article/5c59feacd5eed0c4841352cc

Background

In patients with end stage kidney disease (ESKD) on dialysis, treatment non-adherence is common and results in poor health outcomes. However, the clinical benefits of interventions to improve adherence in dialysis patients are difficult to evaluate since trialled interventions and reported outcomes are highly diverse/ heterogeneous. This review summarizes existing literature on randomized controlled trials (RCTs) evaluating adherence interventions in ESKD patients focusing on the intervention category, outcome efficacy and persistence of benefit beyond the intervention.

Methods

We performed electronic database searches in Medline, Embase & Cochrane CENTRAL upto 1st July 2018 for RCTs evaluating interventions to improve diet, fluid, medication or dialysis adherence in ESKD patients. Study characteristics including category of interventions, outcomes, efficacy and follow-up were assessed. Meta-analysis was used to compute pooled estimates of the effects on the commonest reported outcome measures.

Results

From 1311 citations, we included 36 RCTs (13 cluster-randomized trials), recruiting a total of 3510 dialysis patients (mean age 55.1 ± 5.8 years, males 58.1%). Overall risk of bias was ‘high’ for 24 and of ‘some concern’ for 12 studies. Most interventions (33 trials, 92%) addressed patient related factors, and included educational/cognitive (N = 11), behavioural / counselling (N = 4), psychological/affective (N = 4) interventions or a combination (N = 14) of the above. A majority of (28/36) RCTs showed improvement in some reported outcomes. Surrogate measures like changes in phosphate (N = 19) and inter-dialytic weight gain (N = 15) were the most common reported outcomes and both showed significant improvement in the meta-analysis. Sixteen trials reported follow-up (1–12 months) beyond intervention and the benefits waned or were absent in nine trials within 12 months post-intervention.

Conclusions

Interventions to improve treatment adherence result in modest short-term benefits in surrogate outcome measures in dialysis patients, but significant improvements in trial design and outcome reporting are warranted to identify strategies that would achieve meaningful and sustainable clinical benefits.

Limitations

Poor methodological quality of trials. Frequent use of surrogate outcomes measures. Low certainly of evidence.

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<![CDATA[Physician characteristics associated with proper assessment of overstated conclusions in research abstracts: A secondary analysis of a randomized controlled trial]]> https://www.researchpad.co/article/5c6448e6d5eed0c484c2f14b

Objectives

Little is known about the physician characteristics associated with appraisal skills of research evidence, especially the assessment of the validity of study methodology. This study aims to explore physician characteristics associated with proper assessment of overstated conclusions in research abstracts.

Design

A secondary analysis of a randomized controlled trial.

Setting and participants

We recruited 567 volunteers from the Japan Primary Care Association.

Methods

Participants were randomly assigned to read the abstract of a research paper, with or without an overstatement, and to rate its validity. Our primary outcome was proper assessment of the validity of its conclusions. We investigated the association of physician characteristics and proper assessment using logistic regression models and evaluated the interaction between the associated characteristics and overstatement.

Results

We found significant associations between proper assessment and post-graduate year (odds ratio [OR] = 0.67, 95% confidence interval [CI] 0.49 to 0.91, for every 10-year increase) and research experience as a primary investigator (PI; OR = 2.97, 95% CI 1.65 to 5.34). Post-graduate year and PI had significant interaction with overstatement (P = 0.015 and < 0.001, respectively). Among participants who read abstracts without an overstatement, post-graduate year was not associated with proper assessment (OR = 1.04, 95% CI 0.82 to 1.33), and PI experience was associated with lower scores of the validity (OR = 0.58, 95% CI 0.35 to 0.96).

Conclusion

Physicians who have been in practice longer should be trained in distinguishing overstatements in abstract conclusions. Physicians with research experience might be informed that they tend to rate the validity of research lower regardless of the presence or absence of overstatements.

Trial registration

UMIN000026269.

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<![CDATA[Safe and effective person- and family-centered care practices during transitions from hospital to home—A web-based Delphi technique]]> https://www.researchpad.co/article/5c50c44dd5eed0c4845e8496

Background

Research has shown that adverse events during care transitions from hospital to home can have a significant impact on patients’ outcomes, leading to readmission, delayed healing or even death. Gaps exist in the ways of monitoring care during transition periods and there is a need to help organizations better implement and monitor safe person-and family-centered care. Value statements are a way to obtain narratives in lay terms about how well care, treatment and support is organized to meet the needs and preferences of patients/families. The purpose of this study was to identify the value statements that are perceived by decision-makers and patients/families to best signify safe person- and family-centered care during transitions from hospital to home.

Methods

Between January and September 2017, a web-based Delphi was used to survey key stakeholders in acute care and home care organizations across Canada.

Results

Decision-makers (n = 22) and patients/families (n = 24) from five provinces participated in the Delphi. Following Round 1, 45 perceived value statements were identified. In Round 2, consensus was received on 33/45 (73.3%) by decision-makers, and 30/45 (66.7%) by patients/families. In Round 3, additional value statements reached consensus in the decision-makers’ survey (3) and in the patients/families’ survey (2). A total of 30 high priority value statements achieved consensus derived from both the decision-makers’ and patients/families’ perspectives.

Conclusion

This study was an important first step in identifying key consensus-based priority value statements for monitoring care transitions from the perspective of both decision-makers and patients/families. Future research is needed to test their usability and to determine whether these value statements are actually suggestive of safe person-and family-centered care transition interventions from hospital to home.

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<![CDATA[Pharmacist-participated medication review in different practice settings: Service or intervention? An overview of systematic reviews]]> https://www.researchpad.co/article/5c40f7b2d5eed0c484386669

Introduction

Medication review (MR) is a pharmacy practice conducted in different settings that has a positive impact on patient health outcomes. In this context, systematic reviews on MR have restricted the assessment of this practice using criteria such as methodological quality, practice settings, and patient outcomes. Therefore, expanding research on this subject is necessary to facilitate the understanding of the effectiveness of MR and the comparison of its results.

Aim

To examine the panorama of systematic reviews on pharmacist-participated MR in different practice settings.

Methods

A literature search was undertaken in Biblioteca Virtual em Saúde (BVS), Embase, PubMed, Scopus, The Cochrane Library, and Web of Science databases through January 2018 using keywords for "medication review", "systematic review", and "pharmacist". Two independents investigators screened titles, abstracts, full texts; assessed methodological quality; and, extracted data from the included reviews.

Results

Seventeen systematic reviews were included, of which sixteen presented low to moderate methodological quality. Most of reviews were conducted in Europe (n = 7), included controlled primary studies (n = 16), elderly patients (n = 9), and long-term care facilities (n = 8). Seven reviews addressed MR as an intervention and thirteen reviews cited collaboration between physicians and pharmacists in the practice of MR. In addition, thirteen terminologies for MR were used and the main objective was to identify and solve drug-related problems and/or optimize the drug use (n = 11).

Conclusion

There is considerable heterogeneity in practice settings, population, definitions, terminologies, and approach of MR as well as poor description of patient care process in the systematic reviews. These facts may limit the comparison, summarization and understanding of the results of MR. Furthermore, the methodological quality of most systematic reviews was below ideal. Thus, international agreement on the MR process is necessary to assess, compare and optimize the quality of care provided.

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<![CDATA[Migrant physicians’ conceptions of working in rural and remote areas in Sweden: A qualitative study]]> https://www.researchpad.co/article/5c466519d5eed0c4845176b9

Objective

To explore migrant physicians’ conceptions about working in rural and remote areas in Sweden to understand what influences their motivation to work in these areas.

Method and material

The study employed a qualitative approach with semi-structured interviews with 24 migrant physicians. Transcripts were thematically analysed.

Results

Conceptions were identified about foremost work content and tasks, and about living in rural and remote areas. Work content and tasks related to the health care systems, type of health care facility, duties, specialty, resources, patient population, colleagues, and professional development. Conceptions about living concerned geographical characteristics, people living in rural and remote areas, opportunities for travelling, family, leisure activities, social life, and language skills. Conceptions seemed to be influenced by individual, professional and societal aspects from both previous countries and Sweden. Conceptions and biographical aspects both appeared to affect motivation.

Discussion

Motivation regarding working in rural and remote areas appeared to be influenced by conceptions of these areas. A specific type of place could be understood as being able to provide (or not) the external conditions needed for fulfilling needs and reaching goals, whether professional or personal, and as a tool for reaching or facilitating the achievement of these. Conceptions of an area can hence affect motivation and choices for where to work and live. However, biographical aspects also impact motivation. Our results indicate that positive rural experience in the recipient country might be a predictor for motivation.

Conclusion

Professional and personal life and are intertwined. Conceptions about an area influence willingness to work there. Willingness is also affected by, and intertwined with, other aspects such as previous experiences, age, marital status and family circumstances.

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<![CDATA[Interprofessional education in medical schools in Japan]]> https://www.researchpad.co/article/5c605a00d5eed0c4847cc638

Interprofessional education (IPE) for medical students is becoming increasingly important, as reflected in the increasing number of medical schools adopting IPE. However, the current status of and barriers to pre-registration IPE implementation in Japanese medical schools remain unknown. The purpose of this study was to clarify the status and barriers of IPE implementation in medical schools in Japan. We conducted a curriculum survey from September to December 2016 of all 81 medical schools in Japan. We mailed the questionnaire and asked the schools’ undergraduate education staff to respond. The survey items were the IPE implementation status and barriers to program implementation. Sixty-four of the 81 schools responded (response rate 79.0%), of which 46 (71.9%) had implemented IPE, 42 (89.1%) as compulsory programs. Half of IPE programs were implemented in the first 2 years, while less than 10% were implemented in the latter years of medical programs. As part of the IPE programs, medical students collaborated with a wide range of professional student groups. The most common learning strategy was lectures. However, one-third of IPE programs used didactic lectures without interaction between multi-professional students. The most common perceived major barrier to implementing IPE was adjustment of the academic calendar and schedule (82.8%), followed by insufficient staff numbers (73.4%). Our findings indicate that IPE is being promoted in undergraduate education at medical schools in Japan. IPE programs differed according to the circumstances of each school. Barriers to IPE may be resolved by improving learning methods, introducing group discussions between multi-professional students in lectures or introducing IPE programs using team-based learning. In summary, we demonstrated the current status and barriers of IPE implementation in Japanese medical schools. Our findings will likely lead to the promotion of IPE programs in Japan.

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<![CDATA[Development of a short and universal learning self-efficacy scale for clinical skills]]> https://www.researchpad.co/article/5c3d012fd5eed0c484039070

Background

Learning self-efficacy, defined as learners’ confidence in their capability to learn specific subjects, is crucial for the enhancement of academic progress, because it is positively correlated with academic achievements and effective learning strategy use. In this study, we developed a universal scale called the Learning Self-Efficacy Scale (L-SES) for Clinical Skills for undergraduate medical students and validated it through item analysis and content validity index (CVI) calculation.

Design

The L-SES was developed based on the framework of Bloom’s taxonomy, and the questions were generated through expert consensus and CVI calculation. A pilot version of the L-SES was administered to 235 medical students attending a basic clinical skills course. The collected data were then examined through item analysis.

Results

The first draft of the L-SES comprised 15 questions. After expert consensus and CVI calculation, 3 questions were eliminated; hence, the pilot version comprised 12 questions. The CVI values of the 12 questions were between .88 and 1, indicating high content validity. Moreover, the item analysis indicated that the quality of L-SES reached the qualified threshold. The results showed that the L-SES scores were unaffected by gender (t = −0.049; 95% confidence interval [−.115, .109], p > .05).

Conclusion

The L-SES is a short, well-developed scale that can serve as a generic assessment tool for measuring medical students’ learning self-efficacy for clinical skills. Moreover, the L-SES is unaffected by gender differences. However, additional analyses in relevant educational settings are needed.

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<![CDATA[Depressive symptoms as a barrier to engagement in physical activity in older adults with and without Alzheimer’s disease]]> https://www.researchpad.co/article/5c141ec9d5eed0c484d283cf

Objectives

Physical activity shows promise for reduced risk of Alzheimer’s disease (AD) and protection against cognitive decline among individuals with and without AD. Older adults face many barriers to adoption of physically active lifestyles and people with AD face even further challenges. Physical activity is a promising non-pharmacological approach to improve depressive symptoms, but little is known about the impact of depressive symptoms as a potential barrier to engagement in physical activity. The present study aimed to investigate depressive symptoms as a potential barrier for participation in physical activity across a range of dementia severity.

Method

We used longitudinal structural equation modelling to investigate the bi-directional relationship between depressive symptoms and physical activity in 594 older adults with and without AD over a 2 year longitudinal follow up. Participants ranged from no cognitive impairment to moderately severe AD.

Results

We found that depressive symptoms predicted reduced engagement in subsequent physical activity, but physical activity did not predict subsequent reductions in depressive symptoms.

Conclusion

We conclude that depressive symptoms may be an important barrier to engagement in physical activity that may be addressed in clinical practice and intervention research.

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<![CDATA[Patients’ sense of responsibility to healthcare providers and its predictors: A national cross-sectional survey in China]]> https://www.researchpad.co/article/5c117b71d5eed0c4846993d1

Objectives

To evaluate patients’ sense of responsibility to healthcare providers and to determine its predictors using on a national sample in China.

Methods

We conducted a national cross-sectional survey in China with a stratified cluster sample of patients treated in 77 hospitals between July 2014 and April 2015. Patients’ sense of responsibility to healthcare providers was measured with four questions assessing patients’ perceptions regarding their responsibilities to respect doctors, respect nurses, coordinate with health professionals, and comply with hospital rules. Predictors included patient sociodemographic characteristics and their past hospitalization experience.

Results

Small proportions of respondents reported that they perceived having no responsibility to respect doctors (8.9%), respect nurses (7.9%), comply with hospital rules (6.7%), or coordinate with health professionals (6.3%). Multivariate regression analyses showed that the strongest predictor of patients’ sense of responsibility to healthcare providers was patinets’ trust in health professionals, followed by patients’ education level. Familiarity with healthcare professionals and past hospitalization frequency were inversely associated with patients’ sense of responsibility to healthcare providers.

Conclusions

Although only a small proportion of the patients reported feeling no or low sense of responsibility to healthcare providers, the lack of respect and collaboration from these patients can negatively affect patient-provider relationships. Healthcare administrators need to communicate clearly with the patients and the public about the role of patients and the limitations of medicine in order to instill a sense of patients’ responsibility.

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<![CDATA[Long-term impact of a faculty mentoring program in academic medicine]]> https://www.researchpad.co/article/5c2400c7d5eed0c4840990e8

The authors conducted a prospective longitudinal study from 2009 to 2016 to assess the short and long-term impact of a formal mentorship program on junior faculty satisfaction and productivity. Junior faculty mentees enrolled in the program and junior faculty without formal mentorship were administered surveys before and after the program to assess satisfaction with their mentoring experiences. Long-term retention, promotion, and funding data were also collected. Twenty-three junior faculty mentees and 91 junior faculty controls were included in the study. Mentees came from the Departments of Radiation Oncology and Anesthesia, Critical Care, and Pain Management. After participating in the mentorship program, mentees demonstrated an increase in satisfaction from baseline in five of seven domains related to mentoring, while controls experienced no significant change in satisfaction in six of the seven domains. At long-term follow up, mentees were more likely than controls to hold senior faculty positions (percent senior faculty: 47% vs. 13%, p = 0.030) despite no difference in initial administrative rank. When comparing the subset of faculty who were Instructors at baseline, mentees were more likely to be funded and/or promoted than controls (p = 0.030). A majority of mentees reported that the program strengthened their long-term success, and many maintained their original mentoring relationships and formed new ones, highlighting the strong culture of mentorship that was instilled. Several short-term and long-term benefits were fostered from this formal mentorship program. These findings highlight the potential impact of mentorship programs in propagating a culture of mentorship and excellence.

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<![CDATA[Medical student preferences for the internal medicine residency interview day: A cross-sectional study]]> https://www.researchpad.co/article/5b4a28a1463d7e4513b89810

Background

Applicant recruitment is an essential part of a residency program’s activities with valuable resources dedicated to ensuring its success. Most programs design interview days based on a mix of tradition, budget availability and perception of applicant preferences. There is a paucity of available data on preferences of applicants for interview days.

Objective

We sought to investigate Internal Medicine applicant preferences for a residency recruitment day in aggregate and stratified by medical school background: United States vs. International Medical School Graduate.

Methods

A survey was developed and used in a cross-sectional study of Internal Medicine categorical and preliminary medicine candidates. Applicants ranked different facets of the interview day using a Likert scale. Variables included interview type, start time, length of interview day, number of interviews, length of each interview, background of interviewers, types of questions, interaction time with residents, month of interview, and components of interview day.

Results

265 applicants received the surveys and 215 completed them correctly (81%). Overall, applicants tended to favor an 8–9 am start time (81.9%) and an optimal duration of four hours (82.8%). The interview was the most preferred component of the day (80.0%) with one-on-one (98.1%) and 15–30 min (95.3%) interviews preferred. Several statistically significant differences were found between the United States and International students as well as Categorical and Preliminary applicants.

Conclusion

Our findings offer insights into various factors of the interview day that may appeal to Internal Medicine candidates. This information will be useful to graduate medical education departments engaged in recruitment.

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<![CDATA[The increased purchase of asthma medication for individuals born preterm seems to wane with age: A register-based longitudinal national cohort study]]> https://www.researchpad.co/article/5b4a1933463d7e428027f894

Introduction

Preterm birth is associated with increased risk of respiratory symptoms in childhood, often treated with asthma medication. We designed a follow-up study to previous research and investigated whether the association of gestational age with purchasing asthma medication diminishes in adulthood.

Methods

We conducted a register-based study of a national cohort of all infants born in Denmark in 1980–2009 evaluating longitudinal data on individually prescribed asthma medication (both inhaled ß-2 receptor agonist and different controller treatment over 2-year periods) available from 1995–2011. We analyzed the effect of gestational age considering age, birth year, and perinatal variables using logistic regression with a Generalized Estimating Equations model. All data were unambiguously linked through the Civil Registration System.

Results

We included 1,819,743 individuals in our study population. We found an inverse dose-response relationship between gestational age and asthma medication in earlier age-groups with a gradual decrease in odds ratios with increasing age and loss of statistical significance in early adulthood (18–31 years). For our oldest generations, there was a significant effect of gestational age (p-value = 0.04), which became insignificant when adjusting for confounding and mediating factors (p = 0.44). There were significant interactions between gestational age and age (p<0.0001) and gestational age and birth year, but these were most important during childhood (0–11 years) and for our youngest generations (born after 1995).

Conclusion

The strong association between gestational age and purchase of prescription asthma medication weakens with age into early adulthood, in consistence with the results from our previous study. The risk for purchasing medication to treat asthma-like symptoms was higher in more recent birth years, but the effect of gestational age was small beyond 11 years of age. Gestational age per se did not seem to be significant for the development of asthma-like symptoms: most of its effect could be explained by other perinatal factors.

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<![CDATA[Consequences of the Trans-Atlantic Slave Trade on Medicinal Plant Selection: Plant Use for Cultural Bound Syndromes Affecting Children in Suriname and Western Africa]]> https://www.researchpad.co/article/5989daf3ab0ee8fa60bc1fdd

Folk perceptions of health and illness include cultural bound syndromes (CBS), ailments generally confined to certain cultural groups or geographic regions and often treated with medicinal plants. Our aim was to compare definitions and plant use for CBS regarding child health in the context of the largest migration in recent human history: the trans-Atlantic slave trade. We compared definitions of four CBS (walk early, evil eye, atita and fontanels) and associated plant use among three Afro-Surinamese populations and their African ancestor groups in Ghana, Bénin and Gabon. We expected plant use to be similar on species level, and assumed the majority to be weedy or domesticated species, as these occur on both continents and were probably recognized by enslaved Africans. Data were obtained by identifying plants mentioned during interviews with local women from the six different populations. To analyse differences and similarities in plant use we used Detrended Component Analysis (DCA) and a Wald Chi-square test. Definitions of the four cultural bound syndromes were roughly the same on both continents. In total, 324 plant species were used. There was little overlap between Suriname and Africa: 15 species were used on two continents, of which seven species were used for the same CBS. Correspondence on family level was much higher. Surinamese populations used significantly more weedy species than Africans, but equal percentages of domesticated plants. Our data indicate that Afro-Surinamers have searched for similar plants to treat their CBS as they remembered from Africa. In some cases, they have found the same species, but they had to reinvent the largest part of their herbal pharmacopeia to treat their CBS using known plant families or trying out new species. Ideas on health and illness appear to be more resilient than the use of plants to treat them.

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