A study of defensive-coping behavior in medical students with different levels of sociability

В статье анализируются результате особенностей защитно-совладающего поведения у студентов медицинского вуза с различным уровнем общительности. В исследовании особое внимание уделено уровню общительности, поскольку данный компонент включен в профессионально важное качество личности врача и от данного компонента зависит эффективность лечебного взаимодействия. В исследовании приняли участие студенты 5 курса лечебного факультета в количестве 55 человек. Методиками обследования послужили: 1) оценка уровня общительности (В.Ф. Ряховский); 2) методика измерения психологической защиты (Е.Р. Пилюгина, Р.Ф. Сулейманов). Доминирующими копинг стратегиями в поведении студенты-медики используют: «подавление», «проекция» и «юмор». У студентов медицинского вуза первой и второй группы преобладают адаптивные типы защитно-совладающего поведения. Эмпирически доказано различие в сформированности копинг стратегий по уровню общительности, используемых студентами медицинских специальностей. Нами были обнаружены различия в уровнях психологических защит между данными группами, а именно по шкалам «диссоциация», «изоляция» Полученные результаты исследования могут применяться психологами образовательных учреждений при составлении программ психологического сопровождения с целью коррекции совладающего поведения. The article analyzes the result of the peculiarities of defensive-coping behavior among medical students with different levels of sociability. In the study, special attention is paid to the level of sociability, since this component is included in the professionally important quality of the doctor's personality and the effectiveness of the therapeutic interaction depends on this component. The study involved 55 students of the 5th year of the Faculty of General Medicine. The survey methods were: 1) assessment of the level of sociability (V.F. Ryakhovsky); 2) a technique for measuring psychological defense (E.R. Pilyugina, R.F. Suleymanov). The dominant coping strategies in behavior are used by medical students: "suppression", "projection" and "humor". Among students of a medical university of the first and second groups, adaptive types of defensive-coping behavior prevail. The difference in the formation of coping strategies by the level of sociability used by students of medical specialties has been empirically proven. We found differences in the levels of psychological defenses between these groups, namely on the scales of "dissociation", "isolation". The obtained results of the study can be used by psychologists of educational institutions when drawing up programs of psychological support in order to correct coping behavior.

Multimorbidity in the Elderly: A Systematic Bibliometric Analysis of Research Output

Objective: This study aimed to analyze the progression and trends of multimorbidity in the elderly in China and internationally from a bibliometric perspective, and compare their differences on hotspots and research fronts. Methods: Publications between January 2001 and August 2021 were retrieved from WOS and CNKI databases. Endnote 20 and VOSviewer 1.6.8 were used to summarize bibliometric features, including publication years, journals, and keywords, and the co-occurrence map of countries, institutions, and keywords was drawn. Results: 3857 research papers in English and 664 research papers in Chinese were included in this study. The development trends of multimorbidity in the elderly are fully synchronized in China and other countries. They were divided into germination period, development period, and prosperity period. Research literature in English was found to be mainly focused on public health, and the IF of the literature is high; In China, however, most research papers are in general medicine and geriatrics with fewer core journals. Co-occurrence analysis based on countries and institutions showed that the most productive areas were the United States, Canada, the United Kingdom, and Australia, while the Chinese researchers have made little contribution. The clustering analysis of high-frequency keywords in China and around the globe shows that the hotspots have shifted from individual multimorbidity to group multimorbidity management. Sorting out the top 10 highly cited articles and highly cited authors, Barnett, K’s article published in Lancet in 2012 is regarded as a milestone in the field. Conclusion: Multimorbidity in the elderly leads to more attention in the world. Although China lags behind global research the research fronts from disease-centered to patient-centered, and individual management to population management is consistent.

Facilitating family needs and support at the end of life in hospital: A descriptive study

Background: Caring for family members of dying patients is a vital component of end-of-life care, yet family members’ needs at the end of life may be unmet. Aim: To explore hospital clinician assessment and facilitation of family needs and practices to support families at the end of life. Design: Descriptive study utilising a retrospective medical record audit. Setting and Sample: Undertaken in a large public hospital, the sample included 200 deceased patients from four specialities; general medicine ( n = 50), intensive care ( n = 50), inpatient palliative care ( n = 50) and aged rehabilitation ( n = 50). Data were analysed according to age; under 65-years and 65-years or over. Results: Deceased patients’ mean age was 75-years, 60% were Christian and Next-of-Kin were documented in 96% of cases. 79% spoke English, yet interpreters were used in only 6% of cases. Formal family meetings were held in 64% of cases. An assessment of family needs was undertaken in 52% of cases, and more likely for those under 65-years ( p = 0.027). Cultural/religious practices were supported/facilitated in only 6% of all cases. Specialist palliative care involvement was more likely for those aged 65-years or over ( p = 0.040) and social work involvement more likely for those under 65-years ( p = 0.002). Pastoral care and bereavement support was low across the whole sample. Conclusions: Prioritising family needs should be core to end-of-life care. Anticipation of death should trigger routine referral to support personnel/services to ensure practice is guided by family needs. More research is needed to evaluate how family needs assessment can inform end-of-life care, supported by policy.

Analysing student achievement of advanced pharmacy practice experience learning outcomes

Objectives: To assess the learning outcome achievement of the required Advanced Pharmacy Practice Experiences (APPE) for the purposes of accreditation, quality improvement, and practice readiness. Methods: At the end of each APPE rotation, students were evaluated on 11 professionalism criteria and 25 skills criteria via a rubric. For the four required rotations (ambulatory patient care, community pharmacy, inpatient general medicine patient care and hospital/health system pharmacy), professionalism and skills outcomes data for the class of 2020 were analysed. Results: A total of 6,293/6,303 (99.84%) of the professionalism ratings met expectations (received a score > 2). The median professionalism rating was 3. A total of 14,286/14,325 (99.7%) of the skills ratings met expectations (received a score > 3). The median skills rating was 4. Conclusion: Calculating and analysing APPE student achievement of learning outcomes supports accreditation standards, can be used for quality improvement and measures practice readiness.

Study of clinical profile and outcome of patients with acute non-traumatic paraparesis

Background: The following study is about the clinical profile and outcome of patients with acute non traumatic paraparesis. It includes the aetiology, clinical presentation and the outcome of various cases of acute non traumatic paraparesis. Paraplegia or paraparesis could be defined as loss of function of both legs as a result of disease or injury of the spinal cord, spinal roots, peripheral nerves or myopathies. Acute non-traumatic paraparesis is a neurological emergency. Reversible causes of acute paraplegia can be treated successfully if diagnosed early.Methods: The observational study was done in the department of general medicine at D. Y. Patil Hospital, Navi Mumbai with sample size of 75 patients over 1 year.Results: With early diagnosis prognosis of acute non traumatic paraparesis can be improved which was evaluated over period of 3 months.Conclusions: Acute non-traumatic paraparesis is a neurological emergency. Reversible causes of acute paraplegia can be treated successfully if diagnosed early. It is important to diagnose and classify all cases into compressive and non-compressive lesions based on presenting symptoms because the management of the two differs.

An observational and cross-sectional study of prescribing pattern of antifungal drugs in a tertiary care center of Bihar

Fungal infections take a toll on the health of all individuals, irrespective of ages, gender, ethnicity etc. But still major researchers have focused on antibacterial rather than antifungal till recent past, when the limelight has moved to antifungal medicines. Adding to the gravity of the situation, is the growing resistance against these drugs. Keeping these facts in mind, this study was planned to delineate the prescribing pattern of antifungal drugs by the various specialty in a tertiary care center in the eastern part of the country. This was an observational and cross-sectional hospital-based study. The study incorporated 218 patients from various departments of the hospital during the study duration that was from March 2021 to September 2021. Descriptive statistics was performed using SPSS ver 20.0. Results has been depicted in formof text and table. Antifungal medicines prescribed mostly for leukemia and other immunocompromised status. Most of the patients came from the department of general medicine. Majority of the patients had hematological disorders followed by infections. Anidulafungin was reported to have been prescribed most commonly by the department of surgery in patients with solid tumors. Patients with lung infections also received this drug by physicians. This use can be justified by its action against invasive aspergillosis, oesophageal candidiasis and peritonitis and intraabdominal abscess caused by candida species. Ketoconazole and clotrimazole were the least used antifungal agents in our study. These two agents are mainly indicated for topical use The current report will aid in understanding antifungal prescription practices. This will also form a basis for future researches and formulating guidelines for rational use of these drugs.

Circulatory Glutathion S Transferases Estimation in Chronic Alcoholics Vising Urban and Rural Health Center

Introduction: Excessive alcohol consumption is a global healthcare problem with enormous social, economic, and clinical consequences, accounting for 3.3 million deaths in 2012. Glutathione (GSH) is tri-peptide thiol with chemical name γ glutamyl-cysteinyl-glycine the properties of glutathione are conferred to it by highly reactive thiol present in one of its constituent amino acids- cysteine, hence they referred as GSH. Xenobiotics form thioether (-S) linkage with GSH. The reaction is catalysed by enzyme known as glutathione S Transferases (GSTs). The cytoplasmic GSTs are important in the xenobiotic metabolism and are present in higher concentration in liver. Materials and Methods: The present study was conducted in the Dept. of Biochemistry in collaboration with Dept. of General Medicine at Datta Meghe Medical College, Nagpur. In present study includes 40 diagnosed alcoholic liver disease patients and 40 non-alcoholic healthy subjects as control group who are permanent nt of study area. Results: The level of GST was raised in chronic alcoholic patients i.e. study group (43.25±15.94) as compare to control group (1.57±0.55). At the other hand the level of total thiol were decreased in study group (3.12±0.55) as compare to control group. Conclusions: The strong negative association between glutathione-s-transferase (GST) and total thiol (T-SH) levels suggested that as the concentration of total thiol (T-SH) decreased, glutathione-s-transferase activity increased (GST). This may be attributed to an increase in alcohol-induced oxidative stress and increased T-SH utilization from thiols.