Postgraduate Medical Journal最新文献

Purpose: Patient care ownership (PCO) is a critical component of medical professionalism. Although various determinants of PCO among medical residents have been investigated, the impact of workplace social capital (WSC; a social resource concerning employees' perceptions of trust, reciprocity, and network interactions within the workplace) remains unclear. Here, we aimed to examine the association of WSC and PCO.

Methods: This nationwide cross-sectional study was conducted using an anonymous online survey from January to February 2025. The participants were residents who participated in the General Medicine In-Training Examination. The primary and secondary outcomes were PCO and its four dimensions (i.e. assertiveness, sense of ownership, diligence, and being the "go-to" person), measured using the Japanese version of the PCO Scale, respectively. We adopted WSC and its two dimensions (i.e. horizontal and vertical trust) as the primary and secondary explanatory variables, assessed using the Japanese medical resident version of the WSC Scale, respectively.

Results: A total of 2811 residents were analyzed. On multivariable linear regression analysis, WSC total score was positively associated with PCO total score after adjustment for possible confounders. WSC total score was also positively associated with all PCO dimension scores. Additionally, we observed a positive association between each WSC domain score, PCO total score, and each PCO domain score.

Conclusions: Our study revealed a significant and consistent association between WSC and PCO. These findings emphasize the importance of fostering a trusting workplace environment, given that PCO constitutes a pivotal component of professionalism and is likely associated with quality patient care.

As healthcare becomes increasingly globalized, postgraduate medical education must evolve to prepare clinicians for an increasingly interconnected, diverse, and intercultural healthcare landscape. This article offers nine practical tips for designing and sustaining global learning networks-virtual, collaborative frameworks that connect trainees, educators, and institutions across borders. The recommendations are organized under four themes: (1) designing equitable curricula, (2) facilitating global collaboration, (3) developing culturally competent educators and learners, and (4) sustaining and evaluating learning networks. These recommendations are grounded in the theoretical frameworks of systems thinking and communities of practice. We emphasize co-created curricula, digital platforms for international engagement, culturally responsive pedagogy, inclusive assessment strategies, and decentralized leadership models. Each tip is grounded in peer-reviewed literature, international case studies, and lessons from our collaborative experiences. We address barriers such as time zones, resource inequities, and quality assurance. By embedding global perspectives into postgraduate programmes, global learning networks strengthen intercultural competence, enhance professional identity formation, expand access to medical education in low-resource settings, and foster mutual learning across diverse health systems. This guide supports postgraduate medical educators in cultivating culturally competent clinicians and advancing a more equitable, collaborative, and resilient global healthcare workforce.

Background: While the non-conventional tobacco products have recently gained popularity among young adults, the link between occupational exposures and tobacco use behaviors has been scarcely explored. We investigated the association of long working hours with tobacco product use in young adults.

Methods: A nationwide sample of 10 451 young workers in South Korea aged 19-34 years was analyzed. Weekly working hours and the consumption of combustible cigarettes, electronic cigarettes, and heated tobacco products were assessed. Logistic regressions were employed to determine the relation between working hours and tobacco products use, with odds ratios (ORs) and 95% confidence intervals (CIs).

Results: Among the participants, 20.9%, 55.8%, 12.7%, 5.9%, and 4.6% reported working <35, 35-40, 41-48, 49-54, and ≥ 55 h/week, respectively. Compared to working 35-40 h/week, working 49-54 h/week (OR: 1.48; 95% CI: 1.21-1.82) and ≥ 55 h/week (OR: 1.41; 95% CI: 1.13-1.77) were associated with using combustible cigarettes. Similarly, working 49-54 h/week (OR: 1.39; 95% CI: 1.05-1.81) and ≥ 55 h/week (OR: 1.43; 95% CI: 1.06-1.90) were linked to using electronic cigarettes. Additionally, working ≥55 h/week was associated with using heated tobacco products (OR: 2.07; 95% CI: 1.43-1.93) compared to working 35-40 h/week. Furthermore, compared to working 35-40 h/week, working ≥55 h/week was linked to the use of multiple tobacco products (OR: 2.00; 95% CI: 1.28-3.13).

Conclusion: Long working hours is linked to the use of various forms of tobacco products among young adults.

Interindividual variability in the efficacy of various glucose-lowering drugs has been previously reported and partly explained by genetic variants. The aim of this review was to summarize currently available information on pharmacogenetic studies of the efficacy of incretin-based therapies such as glucagon-like peptide 1 (GLP-1) receptor agonists (GLP1RA) and dipeptidyl peptidase 4 (DPP-4i) inhibitors. Several missense variants of the GLP1R gene have been associated with the effects of GLP1RA or DPP-4 inhibitors on glycaemic compensation or weight. Pharmacogenetic effects have also been reported for several type 2 diabetes-associated loci, such as TCF7L2, THADA, MTNR1B, CDKAL1, KCNQ1, KCNJ11, and PAM in candidate gene approach studies. Genome-wide pharmacogenetic studies have identified new genes with potentially relevant pharmacogenetic effects (CTRB1/2, ARRB1, PRKD1). Although none of these genetic associations are currently used in guiding the treatment choices in clinical practice, they offer valuable insights bringing us a little closer to precision medicine.

The prevalence of thyroid dysfunction is rising in India and thus so is Graves' disease (GD). The phenotype of Indian GD is different than in Caucasians and is characterized by lower age at onset, lower female to male ratio, delayed diagnosis, more signs and symptoms, lower body mass index (BMI) and weight, lower prevalence of Graves' orbitopathy (GO), more inactive GO, lower doses of carbimazole being more effective, different markers of remission, and other things. Mechanistic studies are urgently needed to characterize the pathophysiology of Indian GD. Prevention, early diagnosis, and adequate treatment of GD should become urgently a public health priority in India.

Despite several studies affirming the safety of mesh hernia repairs, over 26 000 mesh-related lawsuits are pending in the USA as of July 2025. These lawsuits stem from alleged design flaws, lack of proper warnings, and severe postoperative complications. While mesh has revolutionized hernia surgery, the surge in litigation and multi-million-dollar out-of-court settlements by mesh manufacturers raise serious ethical, clinical, and legal concerns. This article examines the root causes behind this paradox, outlines strategies for surgeons and manufacturers to mitigate harm and restore trust, and explores the role of emerging mesh-free techniques and artificial intelligence-driven risk prediction tools in shaping the future of hernia repair.

The term "clinimetrics" indicates a domain concerned with indexes, rating scales and other expressions that are used to describe or measure symptoms, physical signs and other clinical variables. Clinimetrics, the science of clinical measurements, has a set of rules that govern the structure of indexes and their consistency, validity and discrimination properties, as well as the choice of component variables. A unique feature of clinimetric indexes are broad global ratings of clinical manifestations that would otherwise be scattered, such as in the case of comorbidity (e.g. the Charlson Comorbidity Index). There have been major developments in the assessment of subjective health status and of psychosocial aspects. The use of indexes may improve the quality of data collection both in medical practice and clinical trials. Clinimetrics enlarges the scientific basis of clinical practice and provides an intellectual home for clinical judgment. Bullet PointsThe term clinimetrics indicates a domain concerned with indexes, rating scales, and other measurements of clinical phenomena.Clinimetrics has a set of rules that help selecting the most suitable clinical measurements.Clinimetrics may improve the scientific quality of data and illness configuration.