scholarly journals Does empathy really decline during residency training? A longitudinal look at changes in measured empathy in a community program

2021 ◽  
Vol 4 (4) ◽  
Author(s):  
William J. Crump ◽  
Craig Ziegler ◽  
Steve Fricker
Keyword(s):  
Residency Training ◽  
Rural Community ◽  
Narrow Range ◽  
Conflicts Of Interest ◽  
Resident Training ◽  
Training Experience ◽  
Training Environment ◽  
Cross Sectional ◽  
Wide Range ◽  
Medical Educators

Introduction Some studies, most cross sectional and urban, have shown a decline in empathy during residency training prompting medical educators to consider changes in curriculum or training environment. Our aim was to determine if there was a decline using a longitudinal, paired annual empathy measure across three years of a family medicine residency in a rural community hospital.   Methods We administered a validated measure from 2015 through 2020 and of the 116 opportunities for survey completion, 112 from 48 residents were available for scoring. We also asked our residents to rank 10 factors that affected their empathy scores. The Baptist Health Madisonville IRB approved the protocol as exempt and the authors have no conflicts of interest.. Results With a response rate of 97%, we found no statistically significant decrease in our resident scores across the three years. Scores after our PG-1 year were significantly lower than two previous comparable studies. The longitudinal, paired study design revealed very wide ranges among individual residents even when group means indicated a statistical difference. Residents also differed widely on their rankings of factors that could affect the score, with only outlook on life showing a narrow range and high ranking. Conclusions The very wide range of individual paired scores as well as the broad range of factors the residents thought affected their scores indicate that empathy is a very individual concept. Some of our residents actually increased scores leading to resilience and others declined toward cynicism. Those seeking to make changes to curriculum or training environment to facilitate empathy during residency should consider this diversity of individual resident training experience.

scholarly journals Combined Effect of Daily Physical Activity and Social Relationships on Sleep Disorder Among Older Adults: A Cross-Sectional Study Based on Data From The Kasama Study

2021 ◽  
Author(s):  
Jaehoon Seol ◽  
Jaehee Lee ◽  
Koki Nagata ◽  
Yuya Fujii ◽  
Kaya Joho ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Sleep Quality ◽  
Sleep Disorder ◽  
Social Relationships ◽  
Narrow Range ◽  
Daily Physical Activity ◽  
Combined Effect ◽  
Cross Sectional ◽  
Wide Range

Abstract Background: This cross-sectional study investigated whether the daily physical activity of older adults, combined with social relationships, is associated with the risk of sleep disorder. Further, it determined whether a high level of one variable with a low level of the other leads to a significantly lower risk of sleep disorder than low levels of both. Methods: The sample comprised 988 community-dwelling older Japanese adults (mean age: 73.1 ± 5.5 years). The level of daily physical activity and range of social relationships were assessed using the Physical Activity Scale for the Elderly and the Lubben Social Network Scale, respectively. The Pittsburgh Sleep Quality Index was used to assess sleep disorder. To test linear trends and the combined effect of the two variables, both variable values were divided into tertiles. To test the combined effects, medians were calculated for the respective scores, based on which the participants were categorized into the following groups: (1) inactive with a narrow range of social relationships (n = 307), (2) inactive with a wide range of social relationships (n = 183), (3) active with a narrow range of social relationships (n = 205), and (4) active with a wide range of social relationships (n = 293). After adjusting for potential confounders, a logistic regression analysis was conducted. Results: Participants who were more physically active (odds ratio [OR]: 0.694, 95% confidence interval [CI]: 0.484–0.997) and those with a wide range of social relationships (OR: 0.690, 95% CI: 0.481–0.988) showed a lower prevalence of sleep disorder than those in the first tertile; these effects were independent of each other. The combined effect analysis revealed that the active group with a wide range of social relationships showed a significantly lower prevalence of sleep disorder (OR: 0.585, 95% CI: 0.404–0.847) than the inactive group with a narrow range of social relationships.Conclusions: Our findings suggest that being physically active with a wide range of social relationships is favorably associated with sleep quality. However, a high level of one variable with a low level of the other is inefficient in improving sleep quality among older adults.

scholarly journals D.07 Clinical electromyography training in Canada: The experience of neurology and physiatry residents

2016 ◽  
Vol 43 (S2) ◽  
pp. S14-S15
Author(s):  
MJ Berger ◽  
AG Florendo-Cumbermack ◽  
DA Gray ◽  
É Côté-Mantha ◽  
K Chapman ◽  
...  
Keyword(s):  
Residency Training ◽  
Online Survey ◽  
Qualitative Data ◽  
Resident Training ◽  
Senior Resident ◽  
National Standards ◽  
Training Experience ◽  
Training Standards ◽  
National Training ◽  
Emg Training

Background: There are currently no national standards for clinical electromyography (EMG) training for residents in neurology and physiatry in Canada. The purpose of this study was to obtain demographic and qualitative data pertaining to EMG residency training in Canada, with the goal of facilitating discourse that could lead to national standards for EMG training. Methods: An online survey was distributed to senior neurology and physiatry residents (post-graduate years 3-5), at seven tertiary Canadian centres. The study authors, who are trainees and consultants with a broad range of EMG expertise (junior and senior resident, clinical neuromuscular fellows, senior physiatrist and neuromuscular neurologists), developed pertinent demographic and qualitative questions. Results: Thirty-eight residents completed the survey (23 neurology, 15 physiatry). There was inter-program variation in quantity of the training experience, content of the curriculum, access to expertise (including technologists) and goals for future training and practice. Similarly, differences were identified between the training experiences of neurology and physiatry residents. Conclusions: Inter-program variability in EMG training was identified. Additionally, differences were identified between neurology and physiatry resident training. This data provides evidence of training discrepancies across the country and can be used to establish national training standards for EMG in Canada.

A Cross Sectional Survey of Chicken Astroviruses Antibody in Broiler and Sonali (Cross-Bred) Chickens in Selected Areas in Bangladesh

2020 ◽  
Vol 43 (1) ◽  
pp. 75-80
Author(s):  
Md Zulfekar Ali ◽  
Mohammad Moktader Moula ◽  
Zafar Ahmed Bhuiyan ◽  
Muhammad Tariq Javed
Keyword(s):  
Age Groups ◽  
Winter Season ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Blood Samples ◽  
Elisa Kit ◽  
Published Report ◽  
Poultry Birds ◽  
Wide Range ◽  
Group B

AbstractChicken astroviruses (CAstV) are enteric viruses of poultry causing gastroenteritis, malabsorption, gout and white chick disease commonly known as runting-stunting syndrome (RSS). It can affect the wide range of poultry birds, especially chicken, turkey and duck worldwide. To our best knowledge there is no published report on presence of antibodies against CAstV in Bangladesh. Therefore, the study aimed to detect the presence of CAstV antibodies in broilers and sonali chickens (a cross-bread) in Bangladesh through a cross-sectional survey. A total of 454 blood samples from 66 flocks of broiler (n=343) and sonali chickens (n=111) of different ages were obtained during 2017 from four districts. The birds were healthy but were not vaccinated against CAstV. The samples were tested for specific antibodies against CAstV Group B by using commercially available ELISA kit. Overall, 16.74% (76/454) samples and 34.84% (23/66) flocks were positive for CAstV antibodies. The seroprevalence of CAstV was significantly (p=0.001) higher in sonali chickens (36.96%) than broiler (10.20%), while it was significantly higher (p=0.001) in birds of Bogura district (36.94%) than the other three districts. Regarding the age groups, seroprevalence was insignificantly (p=0.192) higher in sonali chicken before laying age (45%) than during laying age (27.45%). Regarding the seasons, CAstV infection was prevalent significantly (p=0.001) higher in winter season. Thus, the present study indicated the presence of CAstV in poultry in Bangladesh, so further studies are required to find out the magnitude of the problem in the country.

Celiac Disease in Kosovar Albanian Children: Evaluation of Clinical Features and Diagnosis

2020 ◽  
Vol 16 (3) ◽  
pp. 241-247
Author(s):  
Atifete Ramosaj-Morina ◽  
Alije Keka-Sylaj ◽  
Arbana Baloku Zejnullahu ◽  
Lidvana Spahiu ◽  
Virgjina Hasbahta ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Dominant Mode ◽  
Primary School Children ◽  
Cross Sectional ◽  
Classical Form ◽  
Wide Range ◽  
The Mean

Background: Celiac disease is an immune-mediated disorder characterized by variable clinical manifestations, specific antibodies, HLA-DQ2/DQ8 haplotypes, and enteropathy. Objectives: The aim of this study was to present the clinical spectrum and patterns of celiac disease in Kosovar Albanian children. Methods: A cross-sectional retrospective study was performed with Albanian children aged 0-18 years, treated for celiac disease in the Pediatric Clinic, University Clinical Center of Kosovo from 2005 to 2016. Results: During the study period, 63 children were treated for celiac disease. The mean age at diagnosis was 5.5 years (SD ± 3.31). The mean age at celiac disease onset was 3.3 years (SD ± 2.02), while the mean delay from the first symptoms indicative of celiac disease to diagnosis was 2.2 years (SD ± 2.09). More than 70% of the patients were diagnosed in the first 7 years of life, mainly presented with gastrointestinal symptoms, while primary school children and adolescents mostly showed atypical symptoms (p<0.001). The classical form of celiac disease occurred in 78% of the cases. Sixty (95%) patients carried HLA-DQ2.5, DQ2.2 and/or HLA-DQ8 heterodimers, and only three of them tested negative. Conclusions: Kosovo, as the majority of developing countries, is still facing the classical form of celiac disease as the dominant mode of presentation; as a result, most children with other forms of the celiac disease remain undiagnosed. : Physicians should be aware of the wide range of clinical presentations and utilize low testing thresholds in order to prevent potential long-term problems associated with untreated celiac disease.

Soames' & Southam's Oral Pathology

2018 ◽  
Author(s):  
Max Robinson ◽  
Keith Hunter ◽  
Michael Pemberton ◽  
Philip Sloan
Keyword(s):  
Skin Diseases ◽  
Oral Pathology ◽  
Pathological Features ◽  
Oral Diseases ◽  
Oral Medicine ◽  
Cross Sectional ◽  
Facial Region ◽  
Wide Range ◽  
Cross Sectional Imaging ◽  
Key Aspects

A sound understanding of clinical oral pathology is essential if a dental clinician is to navigate successfully through clinical guidelines, make timely referrals to specialists, and provide good care for patients. This new edition of Soames' & Southam's Oral Pathology provides a clear and friendly guide for students, practitioners, and the whole dental team. Thoroughly updated for today's clinical practice, this textbook covers 'must-know' oral pathology and integrates key aspects of oral medicine. It begins by explaining the principles of clinical assessment, the synthesis of a differential diagnosis, and the selection of further investigations including laboratory tests. Ten chapters bring this theory to life by looking at the clinical and pathological features of a wide range of common oral diseases including oral cancer, salivary gland disorders, and diseases of the jaws. Two new chapters address skin diseases affecting the oro-facial region and neck lumps. A final chapter highlights the importance of clinical oral pathology in the context of systemic human disease. New radiology content includes examples of cross-sectional imaging. Photomicrographs have been replaced with carefully selected images to illustrate key pathological features. Each chapter includes key points boxes and tables to aid learning. Written by experts in both oral pathology and oral medicine, this new edition is a must-have for dentistry students, and those working in the field, providing current and trustworthy information.

scholarly journals Oxidative status in plasma, urine and saliva of girls with anorexia nervosa and healthy controls: a cross-sectional study

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Alexandra Gaál Kovalčíková ◽  
Ľubica Tichá ◽  
Katarína Šebeková ◽  
Peter Celec ◽  
Alžbeta Čagalová ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Anorexia Nervosa ◽  
Redox Homeostasis ◽  
Oxidative Status ◽  
Carbonyl Stress ◽  
Healthy Controls ◽  
Psychosomatic Disorder ◽  
Cross Sectional ◽  
Wide Range ◽  
Markers Of Oxidative Stress

Abstract Background Anorexia nervosa (AN) is a serious psychosomatic disorder with unclear pathomechanisms. Metabolic dysregulation is associated with disruption of redox homeostasis that might play a pivotal role in the development of AN. The aim of our study was to assess oxidative status and carbonyl stress in plasma, urine and saliva of patients with AN and healthy controls. Methods Plasma, spot urine, and saliva were collected from 111 girls with AN (aged from 10 to 18 years) and from 29 age-matched controls. Markers of oxidative stress and antioxidant status were measured using spectrophotometric and fluorometric methods. Results Plasma advanced oxidation protein products (AOPP) and advanced glycation end products (AGEs) were significantly higher in patients with AN than in healthy controls (by 96, and 82%, respectively). Accordingly, urinary concentrations of AOPP and fructosamines and salivary concentrations of AGEs were higher in girls with AN compared with controls (by 250, and 41% in urine; by 92% in saliva, respectively). Concentrations of thiobarbituric acid reactive substances (TBARS) in saliva were 3-times higher in the patients with AN than in the controls. Overall antioxidants were lower in plasma of girls with AN compared to the controls, as shown by total antioxidant capacity and ratio of reduced and oxidized glutathione (by 43, and 31%, respectively). Conclusions This is the first study assessing wide range of markers of oxidative status in plasma, urine and saliva of the patients with AN. We showed that both, higher levels of markers of oxidative stress and lower antioxidants play a role in redox disruption. Restoration of redox homeostasis might be of the clinical relevance

scholarly journals Kinematic Analysis of Lower Limb Joint Asymmetry during Gait in People with Multiple Sclerosis

Symmetry ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 598
Author(s):  
Massimiliano Pau ◽  
Bruno Leban ◽  
Michela Deidda ◽  
Federica Putzolu ◽  
Micaela Porta ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Lower Limb ◽  
Sagittal Plane ◽  
Cross Sectional Study ◽  
Camera Motion ◽  
Cross Sectional ◽  
Temporal Parameters ◽  
Wide Range ◽  
Edss Score ◽  
Spatio Temporal

The majority of people with Multiple Sclerosis (pwMS), report lower limb motor dysfunctions, which may relevantly affect postural control, gait and a wide range of activities of daily living. While it is quite common to observe a different impact of the disease on the two limbs (i.e., one of them is more affected), less clear are the effects of such asymmetry on gait performance. The present retrospective cross-sectional study aimed to characterize the magnitude of interlimb asymmetry in pwMS, particularly as regards the joint kinematics, using parameters derived from angle-angle diagrams. To this end, we analyzed gait patterns of 101 pwMS (55 women, 46 men, mean age 46.3, average Expanded Disability Status Scale (EDSS) score 3.5, range 1–6.5) and 81 unaffected individuals age- and sex-matched who underwent 3D computerized gait analysis carried out using an eight-camera motion capture system. Spatio-temporal parameters and kinematics in the sagittal plane at hip, knee and ankle joints were considered for the analysis. The angular trends of left and right sides were processed to build synchronized angle–angle diagrams (cyclograms) for each joint, and symmetry was assessed by computing several geometrical features such as area, orientation and Trend Symmetry. Based on cyclogram orientation and Trend Symmetry, the results show that pwMS exhibit significantly greater asymmetry in all three joints with respect to unaffected individuals. In particular, orientation values were as follows: 5.1 of pwMS vs. 1.6 of unaffected individuals at hip joint, 7.0 vs. 1.5 at knee and 6.4 vs. 3.0 at ankle (p < 0.001 in all cases), while for Trend Symmetry we obtained at hip 1.7 of pwMS vs. 0.3 of unaffected individuals, 4.2 vs. 0.5 at knee and 8.5 vs. 1.5 at ankle (p < 0.001 in all cases). Moreover, the same parameters were sensitive enough to discriminate individuals of different disability levels. With few exceptions, all the calculated symmetry parameters were found significantly correlated with the main spatio-temporal parameters of gait and the EDSS score. In particular, large correlations were detected between Trend Symmetry and gait speed (with rho values in the range of –0.58 to –0.63 depending on the considered joint, p < 0.001) and between Trend Symmetry and EDSS score (rho = 0.62 to 0.69, p < 0.001). Such results suggest not only that MS is associated with significantly marked interlimb asymmetry during gait but also that such asymmetry worsens as the disease progresses and that it has a relevant impact on gait performances.

scholarly journals The impact of COVID-19 pandemic on training and mental health of residents: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eman Alshdaifat ◽  
Amer Sindiani ◽  
Wasim Khasawneh ◽  
Omar Abu-Azzam ◽  
Aref Qarqash ◽  
...  
Keyword(s):  
Mental Health ◽  
Residency Training ◽  
Training Programs ◽  
Cross Sectional Study ◽  
Protective Equipment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Surgical Residents ◽  
Tertiary Center ◽  
The Impact

Abstract Background Residency programs have been impacted by the Coronavirus disease 2019 (COVID-19) pandemic. In this study we aim to investigate and evaluate the impact of the pandemic on residents as well as residency training programs. Methods This was a cross-sectional study including a survey of 43 questions prepared on Google forms and electronically distributed among a convenience sample of residents training at a tertiary center in North Jordan during the COVID-19 pandemic. Data were collected in the period between October 30th and November 8th of 2020. The survey included questions that addressed the impact of the pandemic on residents’ health as well as training programs. The study participants included residents in training at KAUH in 2020 and were stratified according to the type of residency program (surgical residents (SRs) and non-surgical residents (NSRs)). Statistical methods included descriptive analysis, Chi-square or Fisher’s exact test, Mann Whitney U test, and Cramer’s V and r statistics as measures of effect sizes. Results Of all 430 residents, 255 (59%) responded to the survey. A total of 17 (7%) of residents reported being infected with COVID-19 and a significant difference was reported between SRs and NSRs (10% vs 4%, V = .124 “small effect” (95% CI; .017–.229), p = 0.048). Approximately, 106 (42%) reported a decrease in the number of staff working at the clinic and 164 (64%) reported limited access to personal protective equipment during the pandemic. On a 4-point Likert scale for the feeling of anxiety, the median was 2 (2–3 IQR) in the NSRs group, vs 2 (1–2 IQR) in the SRs groups, with the NSRs being more likely to feel anxious (r = 0.13 “small effect” (95% CI; 0.007–0.249), p = .044). Similarly, the proportion of residents who reported feeling anxious about an inadequacy of protective equipment in the work area was significantly greater in the NSRs group (90.3% vs 75.2%; V = .201 “small effect” (95% CI; .078–.313), p = .001), as well as the proportion of residents who reported feeling increased stress and anxiety between colleagues being also significantly higher in the NSRs group (88.1% vs 76%; V = .158 “small effect” (95% CI; .032–.279), p = .012). Conclusion The burden of the ongoing pandemic on the mental health status of residents is very alarming and so providing residents with psychological counseling and support is needed. Also, critical implications on the flow of residency training programs have been noticed. This necessitates adapting and adopting smart educational techniques to compensate for such limitations.

scholarly journals Minimum acceptable diet among children aged 6–23 months in South Kivu, Democratic Republic of Congo: a community-based cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Richard Mbusa Kambale ◽  
Gaylord Amani Ngaboyeka ◽  
Joe Bwija Kasengi ◽  
Sarah Niyitegeka ◽  
Boss Rutakaza Cinkenye ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Feeding Practices ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Republic Of Congo ◽  
Wide Range ◽  
South Kivu

Abstract Background Suboptimal child nutrition remains the main factor underlying child undernutrition in Democratic Republic of Congo (DRC). This study aimed to assess the prevalence of minimum acceptable diet and associated factors among children aged 6–23 months old. Methods Community-based cross-sectional study including 742 mothers with children aged 6–23 months old was conducted in 2 Health Zones of South Kivu, Eastern DRC. WHO indicators of Infant and Young Child Feeding (IYCF) regarding complementary feeding practices were used. Logistic regression analysis was used to quantify the association between sociodemographic indicators and adequate minimum acceptable diet for both univariate and multivariate analysis. Results Overall, 33% of infants had minimum acceptable diet. After controlling for a wide range of covariates, residence urban area (AOR 2.39; 95% CI 1.43, 3.85), attendance postnatal care (AOR 1.68; 95% CI 1.12, 2.97), education status of mother (AOR 1.83; 95% CI 1.20, 2.77) and household socioeconomic status (AOR 1.72; 95% CI 1.14, 2.59) were factors positively associated with minimum acceptable diet. Conclusion Actions targeting these factors are expected to improve infant feeding practices in South Kivu.

scholarly journals The Uncertainty of COVID-19 Inducing Social Fear and Pressure on the Continuity of Rural, Community-Based Medical Education: A Thematic Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 223
Author(s):  
Ryuichi Ohta ◽  
Yoshinori Ryu ◽  
Chiaki Sano
Keyword(s):  
Medical Education ◽  
Direct Observation ◽  
Rural Community ◽  
Thematic Analysis ◽  
Community Based ◽  
Postgraduate Students ◽  
Medical Trainees ◽  
Rural Settings ◽  
Social Fear ◽  
Medical Educators

Rural community-based medical education (CBME) enriches undergraduate and postgraduate students’ learning but has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. We identified the challenges faced by stakeholders as well as the relevant solutions to provide recommendations for sustainable CBME in community hospitals during the COVID-19 pandemic. A total of 31 pages of field and reflection notes were collated through direct observation and used for analysis. Five physicians, eight nurses, one clerk, fourteen medical trainees, and three rural citizens were interviewed between 1 April and 30 September 2020. The interviews were recorded and their contents were transcribed verbatim and analyzed using thematic analysis. Three themes emerged: uncertainty surrounding COVID-19, an overwhelming sense of social fear and pressure within and outside communities, and motivation and determination to continue providing CBME. Rural CBME was impacted by not only the fear of infection but also social fear and pressure within and outside communities. Constant assessment of the risks associated with the pandemic and the implications for CMBE is essential to ensure the sustainability of CBME in rural settings, not only for medical educators and students but also stakeholders who administrate rural CBME.

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