scholarly journals Back to the medical classes-Part I- Strategy for return to the presential practices during COVID-19 pandemics in a Brazilian Medical School

2021 ◽  
Author(s):  
Maria Auxiliadora Nogueira Saad ◽  
Vinicius Cesar Jardim Pereira ◽  
Arnaldo Costa Bueno ◽  
Alan Araujo Vieira ◽  
Maria de Fatima Pombo March ◽  
...  
Keyword(s):  
Medical Students ◽  
Small Groups ◽  
Private Health Insurance ◽  
Protective Equipment ◽  
Face To Face ◽  
Standardized Protocol ◽  
Symptomatic Case ◽  
Remote Training ◽  
The Mean

Introduction: In Brazil, practices of medical students have been interrupted due to COVID-19 to meet emergency demands. Aim: To describe a strategy for a controlled return to the presential practices for medical students. Methods: We developed a standardized protocol to be applied before and during the return of the practical classes in medical students of Universidade Federal Fluminense, in the follow months after COVID-19 pandemic beginning. The protocol was comprised in three parts: Remote training on COVID-19 prevention; Face-to-face training focused in COVID-19 prevention, handwashing and personal protective equipment use; Investigation of students COVID-19 status before starting practical activities and weekly monitoring for COVID-19 during seven weeks. The training was done by medical teachers in small groups for medical students of the last lective semester. Results: The classes were interrupted on March 12, 2020 and returned in August 10, 2020. Seventy-one students were trained and followed. The mean age was 26.6 years (26.7 +/- 0.835) and 54% were female. Forty-nine (69%) students over 71 had a private health insurance, 60 (84.5%) shared a house/apartment with one or more person and 12(16.9%) reported a previous comorbidity. Eighteen (25.4%) over 71 reported previous symptoms of COVID-19, being positive in two students. During the follow-up, fourteen (19.7%) over 71 students were placed in quarantine due to signals/symptoms compatible with COVID-19 or contact with symptomatic case. Only two cases (2.8%) were confirmed and occurred in Brazilian epidemiological week 37. Conclusion: The protocol was successful in minimizing COVID-19 acquisition during practical classes of medical students.

Analysis of live interactive teledermatologic consultations for prisoners in Korea for 3 years

2017 ◽  
Vol 24 (9) ◽  
pp. 623-628 ◽  
Author(s):  
Jung Eun Seol ◽  
So Hee Park ◽  
Hyojin Kim
Keyword(s):  
Infectious Disease ◽  
Clinical Outcome ◽  
Medical Records ◽  
Underserved Populations ◽  
Common Type ◽  
Face To Face ◽  
Different Types ◽  
The Mean ◽  
Dermatologic Disease

Introduction Teledermatology has contributed to the enhanced accessibility of underserved populations. This study investigated the prevalence and clinical outcomes of dermatologic diseases in prisoners in Korea through live interactive teledermatology (LITD) Method The medical records of patients in a Busan prison, who interacted with a dermatologist using LITD from July 2013 to August 2016, were reviewed retrospectively. Results The mean age of the 406 patients enrolled in the study was 39.0 years and 91.4% were male. Infectious disease (42.8%) was the most common type of disease, followed by eczematous disease (29.4%) and diseases of the skin appendages (14.5%). Among the 187 (38.2%) patients who had a follow-up consultation, 162 (86.7%) showed clinical improvement, whereas 21 showed either no change or a worse clinical outcome. Twenty patients were diagnosed with different types of dermatologic disease at follow-up consultations. Discussion LITD can contribute to a favourable clinical outcome and may thus be an effective alternative to face-to-face consultation in prisoners and other underserved populations.

scholarly journals The Rural Clinical School of Western Australia Mindfulness Project

2020 ◽  
Vol 7 (1) ◽  
pp. 51
Author(s):  
Sarah Moore ◽  
Rita Barbour ◽  
Hanh Ngo ◽  
Craig Sinclair ◽  
Richard Chambers ◽  
...  
Keyword(s):  
Medical Students ◽  
Training Program ◽  
Perceived Stress ◽  
Western Australia ◽  
Mindfulness Meditation ◽  
Mindfulness Training ◽  
Face To Face ◽  
Self Compassion ◽  
Professional Impact

Background: Medical students experience high levels of stress during their training. Literature suggests that mindfulness can reduce stress and increase self-compassion levels in medical students. Most mindfulness training programs are delivered face-to-face and require significant time commitments, which can be difficult to achieve for rurally-based students with heavy academic workloads.Aim: We sought to determine the feasibility and effectiveness of a mindfulness training program delivered online to medical students at a Rural Clinical School.Methods: An 8-week online training program was delivered to third year medical students at the Rural Clinical School of Western Australia in 2016.Using quantitative-qualitative mixed-methods approach, we measured the frequency and duration of the participants’ mindfulness meditation practice, and assessed changes in their perceived stress, self-compassion and compassion levels, as well as personal and professional attitudes and behaviours.Results: 47 students were recruited to the study. 50% of participants were practising at least weekly by the end of the 8-week program, and 32% of responding students reported practising at least weekly 6 months following the intervention. There was a statistically significant reduction in participants’ perceived stress levels and a significant increase in self-compassion at 6 month follow up. Participants reported qualitative insights about the personal and professional impact of mindfulness meditation training as well as barriers to practice.

Use of telephone interviews to follow up patients after total hip replacement

2005 ◽  
Vol 11 (4) ◽  
pp. 211-214 ◽  
Author(s):  
Sanjeev Sharma ◽  
Ravi Shah ◽  
Kingsley Paul Draviraj ◽  
M S Bhamra
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Harris Hip Score ◽  
Face To Face ◽  
Total Hip ◽  
Telephone Interviews ◽  
Significant Difference ◽  
The Mean ◽  
The Individual

We studied the feasibility of telephone interviews to assess hip function in patients who had had a total hip replacement. One hundred patients attending the orthopaedic clinic for follow-up after undergoing total hip replacement were studied. A modified Harris hip score was used. Since range of motion and deformity cannot be assessed by telephone, only pain and function were assessed. The maximum possible score was 100. Patients attending follow-up clinics were contacted by telephone one to two weeks prior to their appointment and a telephone assessment was completed. This was then compared with a face-to-face assessment in the subsequent clinic. The mean hip score obtained with the telephone interview was 85.2 and the mean hip score at face-to-face assessment was 86.1. The mean of the differences between the individual scores was −0.9 (SD 5.5). This difference was not significant ( P=0.11). Only three patients had a clinically significant difference (>20 points) between the two methods. Telephone questionnaires may be a useful adjunct to face-to-face assessment for patient follow-up after total hip replacement.

scholarly journals Arthroscopically Assisted Treatment of Complex Ankle Fractures

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0038
Author(s):  
Hans Polzer ◽  
Sebastian Baumbach ◽  
Mareen Braunstein
Keyword(s):  
Ankle Fractures ◽  
Secondary Outcome ◽  
Chondral Lesions ◽  
Standardized Protocol ◽  
Trimalleolar Fractures ◽  
Arthroscopic Findings ◽  
Arthroscopically Assisted ◽  
The Mean ◽  
Lost To Follow Up

Category: Arthroscopy Introduction/Purpose: Especially after complex ankle fractures, patients suffer from residual pain, swelling and stiffness. Evidence suggests that this poor outcome might be related to occult intraarticular injuries. Recent studies documented chondral lesions in up to 89%. Therefore, many authors emphasize the value of ankle arthroscopy in acute fracture treatment (AORIF). Only few studies reported on the findings of AORIF, even less documented the subjective and objective outcome thereafter. Aim of this study was to evaluate the intraarticular lesions and the results following AORIF for complex ankle fractures after 1-year of follow-up. Methods: Patients presenting with closed, complex ankle fractures were included. AORIF was performed following a standardized protocol. Primary outcome was the AOFAS Score. Secondary outcome parameters were the Olerud and Molander Score, Tegner activity scale, arthroscopic findings, functional assessment and complications. Statistical analysis was performed using SSPS 22.0 (IBM). Results: Between 05/13-12/14, 32 patients were enrolled (56% female, 45±16 years). Three patients were lost to follow-up. 16% suffered from uni-, 22% from bi- and 62% from trimalleolar fractures. Chondral lesions were observed in 91% (ICRS 2.9±0.9). In 34% micro fracturing was performed. Full thickness lesions were observed exclusively in in bi- and trimalleolar fractures. Three patients suffered from minor complications. After 1 year, the mean AOFAS was 93±6 and the mean OMAS was 88±8. Linear regression revealed no significant variables affecting the outcome. Conclusion: Intra-articular injuries are common in complex ankle fractures requiring chondral therapy in 34%. AORIF leads to good-excellent results in all but one patient, including those with bi- and trimalleolar fractures without increasing the risk for complications.

Symptoms Experienced by Women at Home and Self-Care Agency after Breast-Conserving Surgery

2021 ◽  
pp. 108482232110117
Author(s):  
Gul Cankaya ◽  
Rabia Saglam
Keyword(s):  
Self Care ◽  
Breast Conserving Surgery ◽  
Wound Area ◽  
Face To Face ◽  
Symptom Check List ◽  
The Mean ◽  
Description Form ◽  
Care Agency ◽  
At Home

This study was conducted to determine the symptoms experienced by women at home and self-care agency after breast-conserving surgery. The study was carried out in a public hospital in Istanbul between January and June 2018. The sample of the study consisted of 65 women. The data were collected through face-to-face interviews using Patient Description Form, Symptom Check List and Self-Care Agency Scale during outpatient check-ups in the first and third weeks following discharge. The mean age of the women was 52.68 ± 13.24. Fatigue, weakness, pain and insomnia were mostly experienced symptoms in the first and third weeks after discharge while fever, discharge from the wound area and nausea-vomiting symptoms were the least experienced symptoms in these weeks. It was determined that women had moderate self-care agency in the first and third weeks of discharge. Women who were married and whose income was equal to their expenses had higher self-care agency, and those living alone had lower self-care agency than those living with their spouses and children ( p < 0.05). The self-care agency scores of those who did not have a chronic disease were higher than those with chronic diseases ( p < 0.05). It is found that women with breast-conserving surgery experience symptoms related to the operation in the first and third weeks of discharge. Women’s self care agency was moderate during the follow up period, meaning that these patients should be supported by nurses with regard to self care agency and symptoms experienced at home.

A Novel Protocol for Reducing Intensive Care Utilization After Craniotomyh

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Arjun V Pendharkar ◽  
Maryam Nour Shahin ◽  
Allen L Ho ◽  
Eric S Sussman ◽  
Gordon Li ◽  
...  
Keyword(s):  
Intensive Care ◽  
Cavernous Malformation ◽  
Care Utilization ◽  
Neurosurgical Procedures ◽  
Exclusion Criteria ◽  
Standardized Protocol ◽  
Female Predominance ◽  
The Mean ◽  
Care Requirements

Abstract INTRODUCTION There is increasing evidence that ICU admission may be unnecessary for all craniotomy patients. However, there are no guidelines for level of care requirements in this population. We sought to devise and implement a standardized protocol for craniotomy patients who would be eligible to transition directly to the ward the NonIntensive CarE (NICE) protocol. METHODS We preoperatively identified patients undergoing elective craniotomy for simple neurosurgical procedures with the age <65 criterion and ASA Class of 1, 2, or 3. Postoperative eligibility was confirmed by the surgical and anesthesia teams and each patient was observed in the post-anesthesia care unit for stable hemodynamics and satisfactory pain control. Exclusion criteria included surgical/anesthetic concerns as well as need for significant pain, blood pressure or blood sugar management. Upon arrival to the ward, patients were staffed with a neuroscience nurse for hourly neurological examinations. A retrospective review of the prospectively enrolled cohort was conducted. Demographics, clinical characteristics and surgical outcomes were collected. RESULTS From February 2018 to 2019, 63 patients were included in the NICE protocol with a mean age of 45 yr and 65% female predominance. ASA Class breakdown was as follows: ASA1 9/5%, ASA2 57.1% and ASA3 33.3%. Of the operations performed, 38% were microvascular decompressions, 31.7% were craniotomy for tumor and 15.9% were cavernous malformation resections. About 7 operations were redos. Overall, no patients required transfer to the intensive care unit. Mean length of stay was 1.8 d (range 1-5 d) and 96.8% of patients went home. There was an 11.1% overall readmission rate within the mean follow-up period of 74.2 d. About 3 patients required reoperation (postoperative subdural hematoma, pseudomeningocele, and wound infection). CONCLUSION Appropriately selected craniotomy patients may be safely transferred to a neurosurgical ward with low risk of transfer to intensive care.

scholarly journals Practicing What You Preach

2019 ◽  
Vol 34 (s1) ◽  
pp. s159-s159
Author(s):  
Mario Raviiolo ◽  
Eli Jaffe ◽  
Raphael Herbst
Keyword(s):  
Medical Students ◽  
Self Efficacy ◽  
Sense Of Self ◽  
Real Life ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Self Confidence ◽  
The Mean ◽  
Time Frames

Introduction:During a mass casualty incident (MCI) seminar in Rome, Italy a survey was used to gauge the self-efficacy and confidence of the participants in managing an MCI. Following the course, a follow-up presentation was held by the Torino EMS Medical Director to evaluate and debrief the Torino Railway incident that occurred one day prior. Students partook in a seminar on MCI management, as well as a debriefing of the Turin Railway accident in which they evaluated the skills used by teams on the scene to manage the incident.Methods:Medical students partook in a seminar to learn to manage an MCI scene, as well as a debriefing of the Turin Railway accident. Following both seminars, the students were given a survey to assess their sense of self-confidence in managing such a situation.Results:The mean level of self-efficacy prior to the MCI training (M=3.43, SD+0.42) increased after the training (M=3.71, SD+0.37) and remained at the same higher level (M=3.71, SD+0.51) after the medical students were exposed to the details of the Turin train accident. The overall difference between the mean self-efficacy scores in the three time frames was not found to be significant. The mean level of confidence in managing MCIs prior to the training (M=2.83; SD+0.89) increased after the training (M=3.56; SD+0.53) and remained higher following the presentation of the Turin train accident, despite a slight decrease (M=3.52, SD+0.63).Discussion:The participants’ surveys showed an increase in their self-efficacy and confidence following the course and follow-up presentation. It is our professional recommendation that real-life events be used in such seminars to increase self-efficacy and confidence. The topic will continue to be evaluated further.

scholarly journals STUDENTS PERSPECTIVE ON ONLINE MEDICAL EDUCATION DURNG LOCKDOWN AS A RESULT OF COVID-19 PANDEMIC

2021 ◽  
Vol 12 (2) ◽  
Author(s):  
Muhammad Sajid Mehmood ◽  
Wajahat Sultan Baig ◽  
Sadia Azam Khan Baig ◽  
Fauzia Khan ◽  
Shakil Ahmad Awan ◽  
...  
Keyword(s):  
Medical Students ◽  
Online Teaching ◽  
Online Classes ◽  
Health Issues ◽  
Undergraduate Medical Students ◽  
Face To Face ◽  
E Learning ◽  
The Mean ◽  
Study Type ◽  
Medical Colleges

ABSTRACT: Objective: In this study the perceptive of undergraduate medical students regarding e-learning were explored in the MBBS students across various medical colleges in Pakistan during COVID pandemic. Study type, settings and duration: It was descriptive study conducted as multisite survey in medical students of Pakistan. The study was conducted from 1st October to 30th October 2020. Methodology: A questionnaire was developed and disseminated via what’s app to MBBS students of medical institutes in Pakistan. The data was cleaned and study sample was selected from ten medical colleges with maximum response rates. The responses of 10 students from each professional year were selected randomly for even distribution of students in the MBBS course. Out of 500 students, 492 students’ replied with valid data. The percentages of the responses were calculated and data was analyzed graphically. Results: The mean age of respondents was 22± 2.1. 64.4% of respondents were female and 43.6% male. Only 5 % of total students were of the opinion that online teaching was good substitute for learning than face to face sessions. 43% students responded that ZOOM software was major platform used for e-learning during lockdown. Internet connectivity was the major hurdle in e-learning and health issues in family (27%) was major stress factor. 31% students responded that online classes were not effective and 29 % responded that they were about 25 % effective while 21% were of the opinion that these were 50% effective as compared to face to face campus learning. Conclusion: The perception of medical students regarding online teaching was not promising in our study. Most of the indicators were negative.

Client satisfaction in a feasibility study comparing face-to-face interviews with telepsychiatry

2002 ◽  
Vol 8 (4) ◽  
pp. 217-221 ◽  
Author(s):  
J E Bishop ◽  
R L O'Reilly ◽  
K Maddox ◽  
L J Hutchinson
Keyword(s):  
Patient Satisfaction ◽  
Client Satisfaction ◽  
Psychiatric Patients ◽  
Policy Makers ◽  
Satisfaction Questionnaire ◽  
Face To Face ◽  
The Mean ◽  
The Difference ◽  
Lost To Follow Up

We carried out a pilot study comparing satisfaction levels between psychiatric patients seen face to face (FTF) and those seen via videoconference. Patients who consented were randomly assigned to one of two groups. One group received services in person (FTF from the visiting psychiatrist) while the other was seen using videoconferencing at 128 kbit/s. One psychiatrist provided all the FTF and videoconferencing assessment and follow-up visits. A total of 24 subjects were recruited. Three of the subjects (13%) did not attend their appointments and two subjects in each group were lost to follow-up. Thus there were nine in the FTF group and eight in the videoconferencing group. The two groups were similar in most respects. Patient satisfaction with the services was assessed using the Client Satisfaction Questionnaire (CSQ-8), completed four months after the initial consultation. The mean scores were 25.3 in the FTF group and 21.6 in the videoconferencing group. Although there was a trend in favour of the FTF service, the difference was not significant. Patient satisfaction is only one component of evaluation. The efficacy of telepsychiatry must also be measured relative to that of conventional, FTF care before policy makers can decide how extensively telepsychiatry should be implemented.

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