Contrast-enhanced computed tomography revealed spontaneous spinal epidural hematoma, which mimicked aortic dissection.
Contrast-enhanced computed tomography revealed spontaneous spinal epidural hematoma, which mimicked aortic dissection.
Diffuse panbronchiolitis (DPB) is an idiopathic chronic inflammatory pulmonary disease clinically characterized by cough, sputum, and chronic sinusitis. Although the average age of onset is 40 years, DPB occasionally occurs in children and is often misdiagnosed as asthma. Long-term therapy with macrolide antibiotics significantly improves survival in DPB. Herein, we report the case of a 16-year-old man who had been treated for asthma and was referred to our department as transition from the Department of Pediatrics. Adequate auscultation to detect squawks and history taking of purulent sputum led to the correct diagnosis and appropriate treatment, which improved his quality of life.
Healthcare workers (HCWs) caring for patients with coronavirus disease-2019 (COVID-19) can experience physical and mental health burdens. It is imperative that hospitals reduce such burdens on frontline HCWs, protect them, and support their healthcare. This study aimed to investigate the association between occupation and the manifestation of physical or psychological symptoms among HCWs during the current COVID-19 pandemic.
A twice-weekly survey using questionnaires targeting HCWs who care for COVID-19 patients was performed at Osaka Metropolitan University Hospital (tertiary hospital). The demographic characteristics of the participants, exposure level, and physical and psychological complaints were evaluated.
Seventy-one HCWs participated in this study, of whom 27 (38.0%) were doctors, 25 (35.2%) were nurses, and 19 (26.8%) were technicians. Among the HCWs, the proportions of those who experienced any physical or psychological symptoms were 28.2% and 31.0%, respectively. The frequency of depression and anxiety was obviously higher among the nurses than that among the doctors (both p < 0.01). Multivariate analysis revealed that being a nurse (odds ratio 4.90; p = 0.04) and having physical complaints (odds ratio 4.66; p = 0.02) might be independent predictors of the manifestation of psychological symptoms.
Our results indicate that the follow-up of HCWs experiencing physical symptoms, especially nurses engaged in the care of COVID-19 patients, may require more careful management to improve the psychological outcomes. We believe that this study is the first step toward establishing a psychological health management strategy for HCWs caring for COVID-19 patients.
Primary care physicians (PCPs) play a critical role in disaster medicine. However, it is unclear how PCPs who provide chronic support to disaster-affected areas learn from their experiences.
This qualitative study investigates the learnings of young PCPs who provided medical care during the chronic phase of the Great East Japan Earthquake disaster.
Thematic analysis of interviews with five physicians revealed the challenges faced by them and their learnings in providing medical support to disaster-affected areas.
They not only learned medical skills but also humanistic aspects such as empathizing with the survivors' loss.
Health and social care professionals experience high-stress levels during end-of-life care. Various intervention programs have been proposed to reduce stress and prevent burnout among physicians and nurses, including arts-based activities that have shown potential. However, it is unclear how art programs can alleviate stress among healthcare professionals providing end-of-life care. This study aimed to explore the potential of Clinical Art programs to alleviate distress in professionals providing end-of-life care.
Two Clinical Art workshops, held in October and November 2020, were attended by local health and social care professionals. Focus groups were conducted with those who attended and consented to participate in the study. Verbatim transcripts were made, and a qualitative analysis of the text was conducted.
Thirteen health and social work professionals participated in the study. Perceived difficulties in end-of-life care included the complexity and uncertainty of end-of-life care services, the approaches to patients and families, and the difficulties due to human aspects of healthcare providers. The positive effects of Clinical Art included pure enjoyment of art, empathic communication with patients and families and the application of an ontological view of human beings, which were identified as reasons for Clinical Art's effectiveness and applicability to care.
The results suggest that the Clinical Art program has a psychosocial moderating effect on health and social work professionals and can be used for empathic communication with patients and families in end-of-life care and for applying an ontological view of human beings in caring for patients.
Few studies have examined whether family caregivers' own primary care providers can affect caregiving-specific well-being, such as caregiver stress. In this pilot study, we explored whether primary care experiences when family caregivers report as patients were associated with the stress of caregiving.
We used cross-sectional data from a survey conducted in Japan between November and December 2020. We recruited family caregivers aged 40–74 years who were caring for community-dwelling adults with chronic conditions. We assessed primary care experience using the Japanese version of the Primary Care Assessment Tool Short Form (JPCAT-SF) and caregiver stress using the Japanese short version of the Zarit Caregiver Burden Interview.
In total, 406 family caregivers were included in the analysis. The mean JPCAT-SF total score was 42.1 out of 100 points. The proportion of caregivers who had higher caregiver stress was 48.8%. After adjusting for possible confounders, the JPCAT-SF score was found to be significantly associated with caregiver stress (lower stress = 0 vs. higher stress = 1; adjusted prevalence ratio per 1 SD increase in JPCAT-SF score = 0.89; 95% CI 0.80–0.98). Among the subscales of the JPCAT-SF, longitudinality, and comprehensiveness (services available) were associated with caregiver stress.
Better primary care experiences when family caregivers reported as patients were associated with lower caregiver stress. Longitudinality, which includes focusing attention on the individual as a whole person, and comprehensiveness in the context of building provider-patient relationships that make consultation easier when needed, were associated with lower stress.
A 76-year-old woman with cervical cancer was treated with nedaplatin, a platinum-based drug. After the initiation of the treatment, she became aware of numbness, dizziness, and loss of appetite. Exploration of the causes revealed no clues, but blood tests revealed hypocalcemia and hypomagnesemia. She was treated with intravenous calcium and magnesium, which resolved calcium, magnesium levels, and her symptoms. She was diagnosed with hypomagnesemia because of nedaplatin. Regular follow-up is necessary for patients during or after nedaplatin. Awareness of electrolyte disturbances may elucidate the accurate diagnosis even in patients with obscure symptoms, particular in undergoing or following anticancer therapies.
Dramatical increase in articles mentioning “directed acyclic graph.”
A 33-year-old hospitalized patient felt itching around his anus. Tiny white thread-like worms were observed around his perinatal region. Microscopic examination revealed the presence of elongated, one-sided, flattened eggs inside the worm.
Globalization increased the demand for medical English education among health professionals, emphasizing the need to motivate medical students and residents to learn medical English.1 Traditional medical English classes have emphasized basic medical terminology and reading and writing in English. Although this teacher-centered approach provides medical knowledge to students, it can compromise their motivation.2
The United States Medical Licensing Examination Study Group of Tokushima, launched in 2016, addresses this issue by adopting near-peer teaching as a learner-centered approach. This group aimed to promote student motivation and curiosity; cultivate their initiative, self-efficacy, and English-learning goals in a safe environment; and nurture self-regulated lifelong English learners. A comprehensive depiction of the group is provided in a separate publication.2 The group expanded to the point of being able to conduct a monthly activity with different topics since 2022. During each session, one or two volunteers presented medical English-related topics, including clinical rotation experience abroad. When no one had a topic, YH, HT, YT, and HM, who were medical students in 2016, shared their experiences to prepare for working in the United States. This helped participants visualize future opportunities and develop an international posture, thereby encouraging them to connect to the international community by learning English.
A survey using a seven-point Likert scale (1 = strongly disagree, 7 = strongly agree) evaluated motivation, curiosity, initiative, self-efficacy, learning goals, and psychological safety. The survey was conducted in May 2022 to evaluate the teacher-centered approach and in March 2023 to evaluate the near-peer teaching approach. Behavioral changes were analyzed in the second survey.
Fifty-three members (25 students and 28 residents; response rate: 70.7%) who attended at least one session responded to the questionnaire. The mean motivation, curiosity, initiative, self-efficacy, learning goals, and psychological safety were higher in the near-peer teaching group than those in the teacher-centered group (5.8 ± 1.2 vs. 3.9 ± 1.7, 5.8 ± 1.2 vs. 4.1 ± 1.7, 5.6 ± 1.3 vs. 4.0 ± 1.8, 5.2 ± 1.4 vs. 3.1 ± 1.6, 5.4 ± 1.4 vs. 3.7 ± 1.6, and 5.7 ± 1.4 vs. 3.9 ± 1.7, respectively; p < 0.01; Mann–Whitney U test). Forty-seven participants (88.7%) exhibited at least one behavioral change (Table 1).
Near-peer teaching, in which non-professional teachers in a similar social group help each other learn and learn by teaching themselves, improves participants' performance in various medical curricula.3, 4 This approach enhances tutors' and tutees' intrinsic motivation, which is essential in continuing to study the subject.5 It also creates a comfortable and safe educational environmen
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：