Using Technology for Prescription and Adherence in an Alzheimer’s Prevention Program

Healthy lifestyle change is difficult to adopt and maintain without support. Often physicians recommend exercise to their patients, but have limited means to support this change. A major goal of our study is to provide physicians with a simple method of referring patients to a program that supports adoption and maintenance of exercise that meets recommended guidelines for older adults. The Lifestyle Empowerment for Alzheimer’s Prevention program (LEAP! Rx) is a yearlong intervention to support cognitively normal older adults in adoption and maintenance of moderate to vigorous exercise, a key prevention factor for Alzheimer’s disease. The program uses the electronic medical record and builds relationships with physicians to identify patients eligible to participate. It electronically communicates about patients’ progress back to referring physicians to facilitate ongoing physician-patient interaction. Participants receive exercise coaching to reach their weekly exercise goals and have access to online lifestyle education classes (e.g., nutrition, sleep, stress management). The study is currently enrolling (n= 121 enrolled; mean age 71.4; 12% non-white, 4% Hispanic/Latino, and 83% female). Physician referrals originate from five clinics represented by 48 physicians. The study design will actively compare the physician referral process to self-referrals from the community (n=20). We have adapted the protocol to the conditions of the pandemic including online exercise coaching and support. This presentation will discuss successes and lessons learned from this novel method of recruitment and adherence to exercise.

Bronisława Fejgin (1883–1943): Forgotten Important Contributor to International Microbiology and Phage Therapy

Bronisława Brandla Fejgin was a Polish-born Jewish female physician. Among Fejgin’s numerous articles in the field of microbiology, her later work was almost entirely devoted to phage research. Although not equally famous as the phage pioneers from Western Europe, F.W. Twort and F. d’Herelle, Fejgin’s contribution to phage research deserves proper recognition. Her studies on phages resulted in the publication of numerous original scientific reports. These articles, published mostly in French, constitute an important source of information and expertise on early attempts towards therapeutic use of phages in humans. The interwar period marks the most intense years in Bronisława Fejgin’s research activity, brutally interrupted by her death in the Warsaw Ghetto in 1943. Her microbiology contributions have not been analyzed so far. Thus, the aim of this article is to fill the existing gap in the history of microbiology and phage therapy.

Kornelija Rakić: A Woman Doctor for Women and Children in Serbia and Bosnia and Herzegovina

<p>This short biography focuses on the life and medical activities of Kornelija Rakić (1879–1952), a Serbian female pioneer of medicine from the then Hungarian province of Vojvodina, who acquired an MD from the University of Budapest in 1905. Rakić came from a humble background, and a Vojvodina Serbian women’s organization enabled her to become a physician and pursue her social medicine mission. After a futile attempt to open a private practice as a “woman doctor for women” in Novi Sad in 1906, she successfully applied to the Austro-Hungarian provincial government in Sarajevo for the position of an official female physician in occupied Bosnia. Rakić began her career as an Austro-Hungarian (AH) official female physician in Bihać (1908–1912) and was transferred to Banja Luka in 1912 and to Mostar in 1917–1918. Kornelija Rakić stayed in Mostar after the monarchy collapsed in 1918 and continued to work as a public health officer in the service of the Kingdom of Serbs, Croats and Slovenes, founded in 1918. Subsequently, she served as the head of the “dispensary for mothers and children” at the Public Health Centre in Mostar, founded in 1929, where she practiced until her retirement in 1949. After World War II, Rakić served as Vice President of the Red Cross Society in Mostar. She received numerous awards and medals from the Austro-Hungarian Empire, the Kingdom of Yugoslavia and the Federal People’s Republic of Yugoslavia. Kornelija Rakić died in Mostar in 1952 and was buried at the local Orthodox cemetery of Bjelušine.</p><p><strong> Conclusion</strong>. Kornelija Rakić (1879–1952) was the first Serbian female physician in Novi Sad, Vojvodina, and she was employed as an AH official female physician in Bihać (1908–1912), Banja Luka (1912–1917) and Mostar (1917–1918). After World War I, she participated in the establishment and expansion of public health institutions in Mostar and Herzegovina from 1918–1949 against the backdrop of the devastation of the two World Wars.</p>

Rosa Einhorn (1872–1950): A Woman Pioneer in Medicine between Bosnia (1902–1913), New York, and Palestine

<p>This short biography details the life and medical activities of Rosa Einhorn, mariée Bloch (1872–1950), who practised as an Austro-Hungarian (AH) official female physician in Travnik in occupied Bosnia and Herzegovina (BH) from 1902 to 1904, and as a semi-official private physician from 1905 to 1912/13. Born in Hrodna district in the Russian Pale of Crescent, Einhorn had qualified and practised as a “<em>feldsheritsa</em>” in Russia and went to Switzerland to study medicine in 1896. Upon receiving her medi­cal doctorate from the University of Lausanne in 1901, she became recommended as a particularly adequate candidate for the not-yet-created position of an AH official female physician in BH. After Einhorn functioned as a general practitioner for women and children in Travnik and the adjacent districts for two years, the AH public health authorities officially dismissed her due to her engagement and marriage to the AH judiciary Sigismund Bloch (1850–1927). However, she obtained a right to private practice in 1905 and was employed as a private physician in AH anti-syphilis campaigning. Struggling for her reinstatement as an official female physician in Travnik, she also strove for the accreditation of her Swiss diploma in Austria, though in vain. After two attempts to emigrate to the United States in 1904 and 1913, Rosa Einhorn finally left Europe to work as a physician in the United States and Mandatory Palestine/Eretz Israel in 1923. She died in New York on May 27, 1950.</p><p><strong>Conclusion. </strong>Rosa Einhorn was employed as a provisory official female physician in Travnik in 1903/1904, the AH authorities accepting her only as a lo­cal private female physician after her marriage in 1905. Struggling in vain for her reinstatement, she finally left Bosnia in 1913.</p>

Bilateral pneumothorax after acupuncture treatment

A 31-year-old female physician was diagnosed with bilateral pneumothorax a day after her acupuncture treatment. Her body mass index was 16.9 and she did not have a prior history of respiratory disease or smoking. Acupuncture needles may easily reach the pleura around the end of the suprascapular angle of the levator scapulae muscle where the subcutaneous tissue is anatomically thin. In our patient, the thickness between the epidermis and the visceral pleura in this area was only 22 mm as confirmed by an ultrasound scan. Although she felt chest discomfort 30 min after the procedure, she assumed the symptom to be a reaction to the acupuncture. In light of our case, we advise practitioners to select appropriate acupuncture needles for patients based on the site of insertion and counsel them regarding the appearance of symptoms such as chest pain and dyspnoea immediately after the procedure.

The geographical maldistribution of obstetricians and gynecologists in Japan

Background In Japan, there is a large geographical maldistribution of obstetricians/gynecologists, with a high proportion of females. This study seeks to clarify how the increase in the proportion of female physicians affects the geographical maldistribution of obstetrics/gynecologists. Methods Governmental data of the Survey of Physicians, Dentists and Pharmacists between 1996 and 2016 were used. The Gini coefficient was used to measure the geographical maldistribution. We divided obstetricians/gynecologists into four groups based on age and gender: males under 40 years, females under 40 years, males aged 40 years and above, and females aged 40 years and above, and the time trend of the maldistribution and contribution of each group was evaluated. Results The maldistribution of obstetricians/gynecologists was found to be worse during the study period, with the Gini coefficient exceeding 0.400 in 2016. The contribution ratios of female physicians to the deterioration of geographical maldistribution have been increasing for those under 40 years and those aged 40 years and above. However, there was a continuous decrease in the Gini coefficient of the two groups. Conclusions The increase in the contribution ratio of the female physician groups to the Gini coefficient in obstetrics/gynecology may be due to the increased weight of these groups. The Gini coefficients of the female groups were also found to be on a decline. Although this may be because the working environment for female physicians improved or more female physicians established their practice in previously underserved areas, such a notion needs to be investigated in a follow-up study.

Inequality in Pay Ranks Among Factors Impacting Job Satisfaction Among Female Physicians

Job satisfaction has fallen among doctors, and beyond lack of pay parity that averages 25%, female physician job satisfiers differ from male colleagues. Health systems can build upon female physicians' confidence in their abilities to communicate with patients, show empathy, build trust, and elicit patient compliance with treatment plans. Systems must attend to work conditions for young and female cohorts, thereby retaining half of the workforce offering critical care to 7.8 billion people. Ordinal logistic regression was used to analyze data gathered in the U.S. by the Center for Studying Health System Change. Data were used to build a predictive statistical model in concert with independent variables linked to generational and job satisfaction literature. This study revealed statistically significant correlations between factors not only by gender, but also by generational membership. Statistically significant factors affecting job satisfaction among female physicians include provision of quality care to all patients, adequate time spent with patients and income.