Journal of Osteopathic Medicine最新文献_第9页

COVID-19 scent dog research highlights and synthesis during the pandemic of December 2019-April 2023. 新冠肺炎香狗研究在2019年12月至2023年4月大流行期间的重点和合成。

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Osteopathic Medicine

Pub Date : 2023-07-17 eCollection Date: 2023-10-02 DOI: 10.1515/jom-2023-0104

Tommy Dickey, Heather Junqueira

Context: This review was undertaken to provide information concerning the advancement of research in the area of COVID-19 screening and testing during the worldwide pandemic from December 2019 through April 2023. In this review, we have examined the safety, effectiveness, and practicality of utilizing trained scent dogs in clinical and public situations for COVID-19 screening. Specifically, results of 29 trained scent dog screening peer-reviewed studies were compared with results of real-time reverse-transcription polymerase chain reaction (RT-PCR) and rapid antigen (RAG) COVID-19 testing methods.Objectives: The review aims to systematically evaluate the strengths and weaknesses of utilizing trained scent dogs in COVID-19 screening.Methods: At the time of submission of our earlier review paper in August 2021, we found only four peer-reviewed COVID-19 scent dog papers: three clinical research studies and one preprint perspective paper. In March and April 2023, the first author conducted new literature searches of the MEDLINE/PubMed, Google Scholar, and Cochrane Library websites. Again, the keyword phrases utilized for the searches included "COVID detection dogs," "COVID scent dogs," and "COVID sniffer dogs." The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 Checklist was followed to ensure that our review adhered to evidence-based guidelines for reporting. Utilizing the results of the reviewed papers, we compiled statistics to intercompare and summarize basic information concerning the scent dogs and their training, the populations of the study participants, the types of sampling methods, the comparative tests utilized, and the effectiveness of the scent dog screening.Results: A total of 8,043 references were identified through our literature search. After removal of duplicates, there were 7,843 references that were screened. Of these, 100 were considered for full-text eligibility, 43 were included for qualitative synthesis, and 29 were utilized for quantitative analysis. The most relevant peer-reviewed COVID-19 scent dog references were identified and categorized. Utilizing all of the scent dog results provided for this review, we found that 92.3 % of the studies reached sensitivities exceeding 80 and 32.0 % of the studies exceeding specificities of 97 %. However, 84.0 % of the studies reported specificities above 90 %. Highlights demonstrating the effectiveness of the scent dogs include: (1) samples of breath, saliva, trachea-bronchial secretions and urine as well as face masks and articles of clothing can be utilized; (2) trained COVID-19 scent dogs can detect presymptomatic and asymptomatic patients; (3) scent dogs can detect new SARS-CoV-2 variants and Long COVID-19; and (4) scent dogs can differentiate SARS-CoV-2 infections from infections with other novel respiratory viruses.Conclusions: The

背景：本综述旨在提供有关2019年12月至2023年4月全球大流行期间新冠肺炎筛查和检测领域研究进展的信息。在这篇综述中，我们研究了在临床和公共场合使用经过训练的气味狗进行新冠肺炎筛查的安全性、有效性和实用性。具体而言，将29项经过训练的气味狗筛查同行评审研究的结果与实时逆转录聚合酶链反应（RT-PCR）和快速抗原（RAG）新冠肺炎检测方法的结果进行了比较。目的：该综述旨在系统评估在新冠肺炎筛查中使用经过训练的气味狗的优势和劣势。方法：在2021年8月提交我们早期的综述论文时，我们只发现了四篇同行评议的新冠肺炎气味狗论文：三篇临床研究和一篇预印透视论文。2023年3月和4月，第一作者在MEDLINE/PubMed、Google Scholar和Cochrane图书馆网站上进行了新的文献搜索。同样，用于搜索的关键词短语包括“新冠病毒检测犬”、“新冠肺炎气味犬”和“新冠嗅探犬”。遵循了系统评价和荟萃分析（PRISMA）2020检查表的首选报告项目，以确保我们的审查遵守循证报告指南。利用综述的论文结果，我们编制了统计数据，以相互比较和总结有关气味狗及其训练、研究参与者的群体、采样方法的类型、使用的比较测试以及气味狗筛查的有效性的基本信息。结果：通过文献检索，共检索到8043篇参考文献。去除重复项后，共筛选出7843篇参考文献。其中，100个被视为全文合格，43个被纳入定性综合，29个被用于定量分析。确定并分类了最相关的同行评议新冠肺炎气味狗参考文献。利用本综述提供的所有气味狗结果，我们发现92.3 % 其中的研究灵敏度分别超过80和32.0 % 超过特异性97的研究 %. 然而，84.0 % 报告特异性超过90的研究 %. 证明气味狗有效性的亮点包括：（1）可以使用呼吸、唾液、气管支气管分泌物和尿液样本，以及口罩和衣物；（2）经过训练的新冠肺炎气味狗可以检测症状前和无症状患者；（3）气味狗可以检测新的SARS-CoV-2变种和长期新冠肺炎；和（4）气味狗可以区分严重急性呼吸系统综合征冠状病毒2型感染和其他新型呼吸道病毒感染。结论：经过训练的气味狗方法的有效性与实时RT-PCR测试和RAG测试相当，或在某些情况下优于实时RT-PCR测试。经过训练的气味狗可以有效地在公共场合提供快速（几秒到几分钟）、不干扰和准确的结果，从而减少新冠肺炎病毒或其他病毒的传播。最后，本文所述的气味犬研究可以提高医学界和公众对医学气味犬的了解和接受程度，使其成为全球抗击疾病的主要贡献者。

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引用次数: 0

A student-driven mindfulness curriculum for first-year osteopathic medical students: a pilot study. 一项针对整骨医学一年级学生的学生主导的正念课程：一项试点研究。

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Osteopathic Medicine

Pub Date : 2023-07-12 eCollection Date: 2023-09-01 DOI: 10.1515/jom-2022-0246

Christina Nielsen, Sabrina Katz, Meriah Parker, Janelle Trefsgar, Hend Bcharah, Jacob Kalin, Desiree Delavary, Mark Brunk-Grady, Breanne Jaqua

Context: Medical education is stressful and can adversely affect the health and well-being of students. Although mindfulness-based interventions (MBIs) have been successfully utilized in other settings, little is known about the use of student-led interventions in undergraduate medical education.Objectives: The objectives of this study are to assess student satisfaction with four student-selected and student-led mindfulness activities incorporated into mandatory small-group sessions, the immediate impact of these activities on student stress levels, and student use of these activities outside the mindfulness sessions.Methods: First-year osteopathic medical students voluntarily participated in weekly student-selected and student-led mindfulness activities once a week for 8 consecutive weeks during regularly scheduled class time. Activities included yoga postures, the 4-7-8 breathing technique, progressive muscle relaxation (PMR), and values affirmation. Each activity was completed twice during the 8 weeks. After each session, students could anonymously complete an electronic survey assessing participation, change in stress level, satisfaction with the activity, and mindfulness activities practiced outside the session. Survey questions included dichotomous, Likert-like, and multiple-choice responses. A chi-square test was utilized to analyze student responses from each week about the decrease in stress level, and satisfaction with the mindfulness activity, and student use of the activities outside the classroom. Wilcoxon rank sum tests were utilized to determine associations between outcomes, and a logistic regression model was utilized to determine relationships between the change in stress levels and other outcomes.Results: Of the 154 first-year medical students initially enrolled in the 2021-2022 academic year, 14 (9.1 %) to 94 (61.0 %) actively participated in the weekly mindfulness activities. Students indicated that the 4-7-8 breathing technique was the activity most practiced outside the mindfulness sessions (32.3 %, 43/133 total responses) across all weeks. The mindfulness activity with the highest percentage of reported decrease in stress level was the yoga postures in week 5 (94.8 %, 36/38), and both weeks of the yoga activities had the highest reported student satisfaction (95.7 %, 90/94 for week 1; 92.1 %, 35/38 for week 5). For students who answered the change in stress level question, the stress level decrease was related to participation in the weekly activity for weeks 1 through 7 (all p<0.03). For students who participated in mindfulness sessions, the odds of reporting a reduction in the stress level were 16.6 times (95 % CI, 6.8-47.2; p<0.001) that of students who did not participate. For those satisfied with the activities, the odds of reporting a reduction in stress level were 6.7 (95 % CI, 3.3-13.9; p<0.001).Conclusions: <

背景：医学教育压力很大，会对学生的健康和幸福产生不利影响。尽管基于正念的干预措施（MBI）已在其他环境中成功使用，但对在本科生医学教育中使用学生主导的干预措施知之甚少。目的：本研究的目的是评估学生对纳入强制性小组会议的四项学生选择和学生主导的正念活动的满意度，这些活动对学生压力水平的直接影响，以及学生在正念会议之外使用这些活动的情况。方法：整骨医学一年级学生在定期安排的上课时间内，每周自愿参加一次由学生选择和学生主导的正念活动，连续8周。活动包括瑜伽姿势、4-7-8呼吸技巧、渐进式肌肉放松（PMR）和价值观肯定。每项活动在8周内完成两次。每次课程结束后，学生可以匿名完成一项电子调查，评估参与度、压力水平的变化、对活动的满意度以及课程外练习的正念活动。调查问题包括二分法、Likert式和多项选择题。卡方测试用于分析学生每周对压力水平下降、对正念活动的满意度以及学生对课堂外活动的使用情况的反应。Wilcoxon秩和检验用于确定结果之间的相关性，逻辑回归模型用于确定压力水平变化与其他结果之间的关系。结果：在2021-2022学年最初入学的154名一年级医学生中，14人（9.1 %) 至94（61.0 %) 积极参加每周的正念活动。学生们表示，4-7-8呼吸技巧是在正念课程之外练习最多的活动（32.3 %, 43/133份回复）。据报道，压力水平下降百分比最高的正念活动是第5周的瑜伽姿势（94.8 %, 36/38），两周的瑜伽活动都有最高的学生满意度（95.7 %, 第1周90/94；92.1 %, 第5周为35/38）。对于回答压力水平变化问题的学生，压力水平的降低与参加第1周至第7周的每周活动有关（所有结论：结果表明，学生选择和学生主导的正念活动可以成功地减轻积极参与的医学生的压力。然而，还需要进一步的研究来确定如何优化正念课程的实施。

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引用次数: 0

Effects of a focused training on first-year osteopathic medical students' ability to incorporate point-of-care ultrasound in assessment of the anterior knee. 重点训练对整骨医学一年级学生将护理点超声纳入前膝评估能力的影响。

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Osteopathic Medicine

Pub Date : 2023-07-07 eCollection Date: 2023-09-01 DOI: 10.1515/jom-2022-0186

Christina Weaver, Deborah M Heath, Inder Raj S Makin, Kamalani Hanamaika'i, Raghu Kanumalla, Starr Matsushita, Payush Chatta, Srikar Adhikari

Context: Patients frequently present to the outpatient clinic, urgent care, or emergency department with a painful, swollen knee. Differentiating the underlying etiology can be a challenge for both medical students and seasoned clinicians alike. Because this scenario can represent a time-sensitive emergency, developing skills to diagnose the underlying cause quickly and accurately is essential for proper management, whether the patient would benefit from osteopathic manipulation, prompt administration of antibiotics, or a more invasive procedure like joint aspiration or surgery.Objectives: The objectives are to determine the effects of a focused ultrasound training on first-year osteopathic medical students' ability to identify normal sonographic anatomy of the anterior knee and to differentiate between three common pathologies: joint effusion, prepatellar bursitis, and cellulitis.Methods: First-year osteopathic medical students voluntarily participated in this cross-sectional study. The study protocol included a focused ultrasound training (online materials, brief didactic and single hands-on sessions) followed by a hands-on assessment. A written test and 5-point Likert scale questionnaire were administered before and after the focused training. Nine weeks later, students completed a follow-up written test. The proportion of students who correctly identified common pathologies on written tests before (pretest) and after (posttest) training and on the follow-up written test were compared utilizing the Fisher's exact test. A t test was utilized to compare data from the pretraining and posttraining questionnaires.Results: Of 101 students completing the written pretest and pretraining questionnaire, 95 (94.1 %) completed the written posttest and posttraining questionnaire, and 84 (83.2 %) completed the follow-up written test. Students had limited previous experience with ultrasound; 90 (89.1 %) students had performed six or fewer ultrasound examinations before the focused ultrasound training. On written tests, students accurately identified joint effusion (22.8 % [23/101] pretest, 65.3 % [62/95] posttest, 33.3 % [28/84] follow-up test), prepatellar bursitis (14.9 % [15/101] pretest, 46.3 % [44/95] posttest, 36.9 % [31/84] follow-up test), and cellulitis (38.6 % [39/101] pretest, 90.5 % [86/95] posttest, 73.8 % [62/84] follow-up test). Differences were found between pretest and posttest for identification of all three pathologies (all p<0.001) and between the pretest and 9-week follow-up test for identification of prepatellar bursitis and cellulitis (both p≤0.001). For questionnaires, (where 1=strongly agree, 5=strongly disagree), the mean (standard deviation [SD]) confidence for correctly identifying normal sonographic anatomy of the anterior knee was 3.50 (1.01) at pretraining and 1.59 (0.72) at posttraining. Student confidence in the ability to differentiat

背景：患者经常出现在门诊、急诊或急诊科，膝盖疼痛、肿胀。区分潜在的病因对医学生和经验丰富的临床医生来说都是一个挑战。由于这种情况可能代表一种时间敏感的紧急情况，因此培养快速准确诊断潜在原因的技能对于正确管理至关重要，无论患者是否会从整骨手术、及时使用抗生素或更具侵入性的手术（如关节抽吸或手术）中受益。目的：目的是确定集中超声训练对骨科医学一年级学生识别膝前正常超声解剖结构的能力以及区分三种常见疾病的影响：关节积液、髌前滑囊炎和蜂窝组织炎。方法：骨科医学一年级学生自愿参加本横断面研究。研究方案包括重点超声波培训（在线材料、简短的教学和单独的实践课程），然后进行实践评估。在重点训练前后进行书面测试和Likert量表5分问卷调查。九周后，学生们完成了后续的书面测试。使用Fisher精确测试比较了在训练前（前测）和训练后（后测）的书面测试以及后续书面测试中正确识别常见病理的学生比例。t检验用于比较训练前和训练后问卷的数据。结果：在完成书面预测试和预训练问卷的101名学生中，95名（94.1 %) 完成书面的后测和训练后问卷，84（83.2 %) 完成后续笔试。学生以前使用超声波的经验有限；90（89.1 %) 在进行聚焦超声训练之前，学生们进行了六次或更少的超声检查。在书面测试中，学生们准确地识别了关节积液（22.8 % [23/101]预测试，65.3 % [62/95]后测，33.3 % [28/84]随访检查），髌前滑囊炎（14.9 % [15/101]预测试，46.3 % [44/95]后测，36.9 % [31/84]随访试验）和蜂窝组织炎（38.6 % [39/101]预测试，90.5 % [86/95]后测，73.8 % [62/84]随访测试）。在识别所有三种病理的前测和后测之间发现了差异（所有结论：我们的重点训练有效地立即提高了基础知识，以及骨科医学一年级学生在用护理点超声评估膝前关节时的信心。然而，间隔时间的重复和深思熟虑的练习可能有助于学习保持。

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引用次数: 0

Potential therapeutic effects of adjunct osteopathic manipulative treatments in SARS-CoV-2 patients. 辅助骨科手法治疗对SARS-CoV-2患者的潜在治疗效果。

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Osteopathic Medicine

Pub Date : 2023-07-01 DOI: 10.1515/jom-2022-0207

Benna Jacob, Mehak Sawhney, Aarthi Sridhar, Berlin Jacob, Jeffrey Muller, Reem Abu-Sbaih, Sheldon C Yao

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) affects various human organ systems, including the lymphatic, pulmonary, gastrointestinal, and neurologic systems. The utilization of osteopathic manipulative treatment (OMT) techniques has been clinically effective in the alleviation of various upper respiratory infection symptoms. Consequently, the use of osteopathic manipulative medicine (OMM) in SARS-CoV-2 patients as adjunct treatment can be beneficial in promoting overall recovery. This paper attempts to address the pathophysiology of SARS-CoV-2 infection at the cellular level and its downstream effects. Subsequently, osteopathic principles were investigated to evaluate potential therapeutic effects, providing a holistic approach in the SARS-CoV-2 treatment. Although the association between the benefits of OMT on clinical improvement during the 1918 Spanish influenza pandemic can be seen, further investigation is required to establish a direct correlation between OMT and symptom management in SARS-CoV-2.

严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)会影响人体各种器官系统，包括淋巴系统、肺系统、胃肠道系统和神经系统。利用骨疗法手法治疗(OMT)技术在临床上有效缓解各种上呼吸道感染症状。因此，在SARS-CoV-2患者中使用整骨手法医学(OMM)作为辅助治疗可有利于促进整体康复。本文试图从细胞水平探讨SARS-CoV-2感染的病理生理及其下游效应。随后，研究了整骨疗法原理以评估潜在的治疗效果，为SARS-CoV-2治疗提供了一种整体方法。虽然可以看到在1918年西班牙流感大流行期间，OMT对临床改善的益处之间存在关联，但需要进一步调查以确定OMT与SARS-CoV-2症状管理之间的直接相关性。

引用次数: 0

Systolic blood pressure in acute ischemic stroke and impact on clinical outcomes. 收缩压对急性缺血性脑卒中临床预后的影响。

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Osteopathic Medicine

Pub Date : 2023-07-01 DOI: 10.1515/jom-2022-0191

Michelle Wallen, Paul Banerjee, Amanda Webb-McAdams, Amber Mirajkar, Tej Stead, Latha Ganti

Context: Stroke is one of the largest healthcare burdens in the United States and globally. It continues to be one of the leading causes of morbidity and mortality. Patients with acute ischemic stroke (AIS) often present with elevated blood pressure (BP).

Objectives: The objective of our study was to evaluate the association of systolic blood pressure (SBP) in the emergency department (ED) with stroke severity in patients with AIS.

Methods: This observational study was conducted at an ED with an annual census of 80,000 visits, approximately half (400) of which are for AIS. The cohort consisted of adult patients who presented to the ED within 24 h of stroke symptom onset. BP was measured at triage by a nurse blinded to the study. Stroke severity was measured utilizing the National Institutes of Health Stroke Scale (NIHSS). Statistical analyses were performed utilizing JMP 14.0. This study was approved by our medical school's institutional review board.

Results: Patients with higher SBP had significantly lower NIHSS scores (p=0.0038). This association was significant even after adjusting for age and gender. By contrast, diastolic blood pressure (DBP) did not appear to impact stroke severity. There was no difference in the DBP values between men and women. Higher SBP was also significantly associated with being discharged home as well as being less likely to die in the hospital or discharged to hospice. The DBP did not demonstrate this association. Neither the SDP nor the DBP were significantly associated with the hospital length of stay (LOS). In multivariate models that included age, gender, basal metabolic index (BMI), comorbidities, and ED presentation, elevated SBP was associated with better prognosis.

Conclusions: In this cohort of patients presenting with stroke-like symptoms to the ED, higher SBP was associated with lower stroke severity and higher rates of being discharged to home rather than hospice or death.

背景:中风是美国乃至全球最大的医疗负担之一。它仍然是发病率和死亡率的主要原因之一。急性缺血性脑卒中(AIS)患者通常表现为血压升高。目的:本研究的目的是评估急诊科(ED)收缩压(SBP)与AIS患者卒中严重程度的关系。方法:这项观察性研究是在一个每年有8万人次就诊的ED进行的，其中大约一半(400)是针对AIS的。该队列包括在卒中症状出现24小时内到急诊科就诊的成年患者。在分诊时，由一名对研究不知情的护士测量血压。卒中严重程度采用美国国立卫生研究院卒中量表(NIHSS)进行测量。采用jmp14.0进行统计分析。这项研究得到了我们医学院机构审查委员会的批准。结果:收缩压升高的患者NIHSS评分明显降低(p=0.0038)。即使在调整了年龄和性别后，这种关联也很显著。相比之下，舒张压(DBP)似乎对中风的严重程度没有影响。男性和女性的DBP值没有差异。较高的收缩压也与出院、在医院死亡或出院到临终关怀的可能性较低显著相关。DBP没有显示出这种关联。SDP和DBP与住院时间(LOS)均无显著相关性。在包括年龄、性别、基础代谢指数(BMI)、合并症和ED表现在内的多变量模型中，收缩压升高与更好的预后相关。结论:在急诊科表现为卒中样症状的患者队列中，较高的收缩压与较低的卒中严重程度和较高的出院率相关，而不是临终关怀或死亡。

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引用次数: 0

Surgical simulation in osteopathic medical schools. 骨科医学院的手术模拟。

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Osteopathic Medicine

Pub Date : 2023-07-01 DOI: 10.1515/jom-2023-0024

Kevin D Seely, Maxwell Hansen, Sarin N Paluri, Kodee Rasmussen, Susan Carter, Andrew Nigh

引用次数: 0

Comments on "Is cadaveric dissection essential in medical education? A qualitative survey comparing pre-and post-COVID-19 anatomy courses". 《尸体解剖在医学教育中必不可少吗?》一项比较covid -19前后解剖学课程的定性调查”。

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Osteopathic Medicine

Pub Date : 2023-07-01 DOI: 10.1515/jom-2023-0008

Nastassja K Michel, Julianne E G McGough

引用次数: 0

Haglund deformity of the posterior heel. 后脚跟Haglund畸形

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Osteopathic Medicine

Pub Date : 2023-07-01 DOI: 10.1515/jom-2023-0022

Mackenzie Pargeon, Lindsay Tjiattas-Saleski

引用次数: 0

Physician stress in the era of COVID-19 vaccine disparity: a multi-institutional survey. COVID-19疫苗差异时代的医生压力:一项多机构调查

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Osteopathic Medicine

Pub Date : 2023-07-01 DOI: 10.1515/jom-2022-0194

Sarah Zahl, Debasis Mondal, David Tolentino, Jennifer A Fischer, Sherry Jimenez

Context: Healthcare workers are at a high risk of infection during infectious disease outbreaks, such as the COVID-19 pandemic. Despite the availability of several vaccines against COVID-19, the absence of vaccination in patients and colleagues remains a continuous source of stress in healthcare workers. We conducted a survey of physician preceptors, both MDs and DOs, to explore the impact of differences in the patients' and colleagues' vaccination status on their well-being, stress, and burnout.

Objectives: The objective of this study is to determine whether exposure to unvaccinated patients and/or colleagues increases stress and burnout in physician preceptors by utilizing a self-reported survey.

Methods: This multi-institutional study was carried out in the United States in 2022. An online survey questionnaire was utilized to collect data from physicians working as preceptors for multiple academic institutions. The anonymous Qualtrics^® survey utilized a modified version of the questionnaire from the expanded Physician Well-being Index (ePWBI) designed by MedEd Web Solutions (MEWS). Statistical analysis on both descriptive and qualitative data were performed. Utilizing a threshold of p≤0.05, data analysis revealed many statistically significant relationships between the variables.

Results: A total of 218 physician preceptors completed the survey. The survey results showed that physicians overwhelmingly (p < 0.001) felt that all patients (and healthcare workers) should be vaccinated. The results also indicated that physicians experienced more stress when working with unvaccinated patients (p<0.001), and these stressors were often associated with the physician's gender and age. Furthermore, physicians stated that both their assessment and treatment plans were significantly different for vaccinated vs unvaccinated patients (p=0.039 and p=0.0167, respectively). Most importantly, stress levels (p<0.001) and burnout characteristics (p=0.024) were noted by physicians, both in themselves and in their colleagues.

Conclusions: Findings suggest that physician stress and burnout is a common theme due to the differences in vaccination status of patients admitted to COVID-19 clinics. Due to a more rapid progression of COVID-19 in unvaccinated patients, treatment plans for vaccinated vs unvaccinated patients were also considerably different.

背景:在2019冠状病毒病大流行等传染病暴发期间，卫生保健工作者面临感染的高风险。尽管有几种针对COVID-19的疫苗，但患者和同事缺乏疫苗接种仍然是卫生保健工作者的持续压力来源。我们对医学博士和医学博士进行了一项调查，以探讨患者和同事接种疫苗状况的差异对他们的幸福感、压力和倦怠的影响。目的:本研究的目的是通过自我报告调查，确定接触未接种疫苗的患者和/或同事是否会增加医师辅导员的压力和倦怠。方法:这项多机构研究于2022年在美国进行。使用在线调查问卷收集来自多个学术机构担任导师的医生的数据。匿名Qualtrics®调查使用了MedEd Web Solutions (MEWS)设计的扩展医师幸福指数(ePWBI)问卷的修改版本。对描述性和定性数据进行统计分析。利用p≤0.05的阈值，数据分析显示变量之间有许多统计学上显著的关系。结果:共有218名医师辅导员完成调查。结论:研究结果表明，由于COVID-19门诊入院患者疫苗接种状况的差异，医生的压力和倦怠是一个共同的主题。由于未接种疫苗的患者的COVID-19进展更快，接种疫苗和未接种疫苗的患者的治疗计划也有很大不同。

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引用次数: 0

Osteopathic manipulative treatment for the allopathic resident elective: does it change practice after graduation? 骨科手法治疗对症住院医师选修课:毕业后会改变实践吗?

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Osteopathic Medicine

Pub Date : 2023-07-01 DOI: 10.1515/jom-2022-0219

Andrew H Slattengren, Mary E Wootten, Caroline S Carlin, Tanner J Nissly

Context: Osteopathic manipulative treatment (OMT) for the allopathic resident is an elective at the University of Minnesota North Memorial Residency that engages the resident in the basic tenants of osteopathic medicine, with exposure to the vast application of OMT with a curricular focus on low back pain management. Implementing an elective curriculum is a feasible way to improve attitudes in OMT for MDs in a Family Medicine residency, and residents can learn OMT in an elective rotation.

Objectives: This article aims to determine if MDs who complete an OMT for the allopathic physician elective rotation have higher comfort caring for patients with back pain compared to those who do not complete the elective. Further, this article is designed to evaluate if these MDs continue to incorporate OMT into the care they provide once they graduate from their residency programs.

Methods: Graduates from the University of Minnesota North Memorial Family Medicine Residency (2013 to 2019) were sent an email invitation in August 2020 to complete a Qualtrics survey regarding their comfort with caring for patients with back pain, referral patterns for these patients, and the ongoing use of OMT in their practices. Doctor of Osteopathic Medicine (DO) graduates who responded to the survey were removed from the analysis.

Results: Among emailed graduates, 61.8% (42/68) completed the survey, with representation from each class ranging from 1 to 7 years postresidency. The five DO graduates who responded were removed from the analysis. Among the remaining 37 respondents, 27 had completed the OMT for the allopathic rotation ("elective participants") during their residency training and 10 had not ("control"). Half (50.0%) of the control group provide OMT care compared to 66.7% of the elective participants, with a comfort score of 22.6 (standard deviation [SD] 32.7) in the control group vs. 34.0 (SD 21.0) in elective participants (on a 0-100 scale; 100 being completely comfortable; p=0.091). Among the control group, 40.0% regularly refer to a DO provider compared to 66.7% of those who completed the elective (p=0.257). The mean comfort score for performing a physical examination on patients presenting with back pain was 78.7 (SD 13.1) and 80.9 (SD 19.3) in the control and elective participants groups, respectively (p=0.198).

Conclusions: Allopathic Family Medicine residents who completed an elective rotation in OMT have a slight increase in frequency of referring to DOs. They also have a meaningful increase in comfort performing OMT. With the limited number of DOs being a common barrier to OMT care, more widely implemented training in OMT for allopathic Family Medicine residents may be a reasonable intervention to improve the care of patients with back pain.

背景:针对对抗疗法住院医师的整骨疗法手法治疗(OMT)是明尼苏达大学北纪念住院医师的一门选修课，该课程让住院医师了解整骨疗法医学的基本原理，并接触到OMT的广泛应用，课程重点是腰痛管理。实施选修课程是改善家庭医学住院医师对OMT态度的可行方法，住院医师可以在选修轮转中学习OMT。目的:这篇文章的目的是确定完成对症治疗医师选择性轮转OMT的医学博士是否比没有完成选择性轮转OMT的医学博士更能舒适地照顾背痛患者。此外，本文旨在评估这些医学博士毕业后是否继续将OMT纳入他们提供的护理中。方法:于2020年8月向明尼苏达大学北纪念家庭医学住院医师(2013年至2019年)的毕业生发送电子邮件邀请，以完成一项关于他们照顾背痛患者的舒适度、这些患者的转诊模式以及在实践中持续使用OMT的Qualtrics调查。回复调查的骨科医学博士(DO)毕业生从分析中删除。结果:在收到邮件的毕业生中，61.8%(42/68)完成了调查，每个班级的代表都在毕业后1至7年之间。回应的五名DO毕业生被从分析中删除。在其余37名受访者中，27人在住院医师培训期间完成了对抗疗法轮转的OMT(“选择性参与者”)，10人没有(“对照组”)。对照组的一半(50.0%)提供OMT护理，而选择性参与者的这一比例为66.7%，对照组的舒适评分为22.6(标准差[SD] 32.7)，而选择性参与者的舒适评分为34.0 (SD 21.0)(0-100分;100是完全舒适;p = 0.091)。在对照组中，40.0%的患者定期向DO提供者求助，而完成选修课的患者中这一比例为66.7% (p=0.257)。在对照组和选择性参与者组中，对背痛患者进行体格检查的平均舒适评分分别为78.7 (SD 13.1)和80.9 (SD 19.3) (p=0.198)。结论:在OMT完成选择性轮转的对抗疗法家庭医学住院医师，其转诊DOs的频率略有增加。他们在进行OMT时的舒适度也有了显著的提高。由于DOs数量有限是OMT护理的常见障碍，更广泛地实施对抗性家庭医学住院医师的OMT培训可能是改善背痛患者护理的合理干预措施。

{"title":"Osteopathic manipulative treatment for the allopathic resident elective: does it change practice after graduation?","authors":"Andrew H Slattengren, Mary E Wootten, Caroline S Carlin, Tanner J Nissly","doi":"10.1515/jom-2022-0219","DOIUrl":"https://doi.org/10.1515/jom-2022-0219","url":null,"abstract":"Context: Osteopathic manipulative treatment (OMT) for the allopathic resident is an elective at the University of Minnesota North Memorial Residency that engages the resident in the basic tenants of osteopathic medicine, with exposure to the vast application of OMT with a curricular focus on low back pain management. Implementing an elective curriculum is a feasible way to improve attitudes in OMT for MDs in a Family Medicine residency, and residents can learn OMT in an elective rotation.Objectives: This article aims to determine if MDs who complete an OMT for the allopathic physician elective rotation have higher comfort caring for patients with back pain compared to those who do not complete the elective. Further, this article is designed to evaluate if these MDs continue to incorporate OMT into the care they provide once they graduate from their residency programs.Methods: Graduates from the University of Minnesota North Memorial Family Medicine Residency (2013 to 2019) were sent an email invitation in August 2020 to complete a Qualtrics survey regarding their comfort with caring for patients with back pain, referral patterns for these patients, and the ongoing use of OMT in their practices. Doctor of Osteopathic Medicine (DO) graduates who responded to the survey were removed from the analysis.Results: Among emailed graduates, 61.8% (42/68) completed the survey, with representation from each class ranging from 1 to 7 years postresidency. The five DO graduates who responded were removed from the analysis. Among the remaining 37 respondents, 27 had completed the OMT for the allopathic rotation (\"elective participants\") during their residency training and 10 had not (\"control\"). Half (50.0%) of the control group provide OMT care compared to 66.7% of the elective participants, with a comfort score of 22.6 (standard deviation [SD] 32.7) in the control group vs. 34.0 (SD 21.0) in elective participants (on a 0-100 scale; 100 being completely comfortable; p=0.091). Among the control group, 40.0% regularly refer to a DO provider compared to 66.7% of those who completed the elective (p=0.257). The mean comfort score for performing a physical examination on patients presenting with back pain was 78.7 (SD 13.1) and 80.9 (SD 19.3) in the control and elective participants groups, respectively (p=0.198).Conclusions: Allopathic Family Medicine residents who completed an elective rotation in OMT have a slight increase in frequency of referring to DOs. They also have a meaningful increase in comfort performing OMT. With the limited number of DOs being a common barrier to OMT care, more widely implemented training in OMT for allopathic Family Medicine residents may be a reasonable intervention to improve the care of patients with back pain.","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":"123 7","pages":"337-341"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9686065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1