University of Ottawa Journal of Medicine最新文献

{"title":"Using POV Wearable Technology as a Tool in Virtual Teaching Sessions to Supplement Clinical Skills Training: a Medical Student Perspective","authors":"Alicia Sheng, Adam Chubbs-Payne, Ellias Horner, Mariam Issa, Fok-Han Leung, Michael Malek","doi":"10.18192/uojm.v14i1.6483","DOIUrl":"https://doi.org/10.18192/uojm.v14i1.6483","url":null,"abstract":"The COVID-19 pandemic has led to many undergraduate medical programs shifting their preclinical curricula online— reducing access to clinical skills sessions and ultimately causing gaps in students’ knowledge. \u0000This study sought to better understand the impact and role of virtual clinical skills training sessions, using point-of-view (POV) livestreaming wearable technology, in supplementing medical students’ learning. \u000038 University of Ottawa medical students were recruited to participate in a 1.5-hour virtual clinical teaching session. An abdominal physical examination was broadcasted through two views (chest-mounted smartphone, room overview). Participants completed pre- and post-event questionnaires on their overall impression, satisfaction/challenges, and platform efficacy compared to other learning modalities. \u0000Improvements were noted in participants’ perspectives towards event engagement (p=0.042, Cohen’s d=0.48), comparability to in-person encounters (p=<0.001, Cohen’s d=0.75), and confidence performing a physical exam (p=<0.001, Cohen’s d=1.35). Participants found events were relevant to curriculum objectives (4.55±0.69), engaging and interactive (4.50±0.65), and reported good visualization (4.61±0.59). All participants were interested in attending a subsequent event. \u0000Virtual clinical skill teaching sessions using POV technology were enjoyable and helpful in combating current COVID-related gaps in medical education, adding to the growing literature on the beneficial role of innovative virtual learning opportunities within the medical school curricula. Future research should look to evaluate the use of POV wearable technology in settings beyond the classroom.","PeriodicalId":30662,"journal":{"name":"University of Ottawa Journal of Medicine","volume":"112 27","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141822321","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}

{"title":"Quality improvement opportunities for urine culture follow-up in a tertiary care emergency department: A pilot study","authors":"Akshay Rajaram, G. Clapham, M. Nemnom, Venkatesh Thiruganasambandamoorthy","doi":"10.18192/uojm.v14i1.6502","DOIUrl":"https://doi.org/10.18192/uojm.v14i1.6502","url":null,"abstract":"Institutional quality assurance processes have been developed to address the follow up of abnormal test results ordered in the emergency department (ED). We conducted a health records review at an academic tertiary care ED to understand the process and times taken to follow up post-discharge urine culture results transferred to physicians for review. \u0000All patients (age ≥18 years) who were seen and discharged between July 1, 2020 and June 30, 2021 and had a positive urine culture were eligible for inclusion. We randomly selected 100 patients, abstracted follow-up times, and reported descriptive statistics. \u000065 were initially identified as requiring further follow-up for their culture results. Nearly 80% of these patients required new, additional, or revised antimicrobial therapy. Overall, the mean time from ED discharge to follow-up completion was 3.4 days (SD 2.1 days). The longest contributor was the time for transfer of results from nurses to physicians for review at 1.4 days (SD 1.2 days). \u0000We demonstrated considerable delay in the follow-up of urine culture results requiring physician review. Future work should address opportunities for reducing times to follow-up, including semi-automation of benign culture results and capture of key patient demographic information in the electronic medical record.","PeriodicalId":30662,"journal":{"name":"University of Ottawa Journal of Medicine","volume":"120 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141820814","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}

{"title":"Non-Pharmacological Interventions for the Treatment of Raynaud’s phenomenon—A Systematic Review","authors":"Farhan Mahmood, Helena Chase, Sandrine Soucy, Stephanie Perron, Mohamad Ahmad, Peter Tugwell, N. Maltez","doi":"10.18192/uojm.v13i1.6175","DOIUrl":"https://doi.org/10.18192/uojm.v13i1.6175","url":null,"abstract":"Objective: The objective of this systematic review is to describe existing literature pertaining to the use of non-pharmacological interventions (NPIs) for the management of primary or secondary Raynaud’s Phenomenon (RP) compared to placebo. \u0000Methods: The Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE were searched from their inception to the present for randomized controlled trials and clinical trials for studies assessing the therapeutic effects NPIs in primary or secondary RP. The studies were screened, and data were extracted by two reviewers. The major outcomes assessed included frequency (per week) and duration (minutes) of attacks and pain. \u0000Results: We found 23 parallel or crossover RCTs, 5 of which were not discussed in this review. The categories of NPIs included acupuncture and other needling techniques (n=4), temperature biofeedback (n=4), lasers and electrotherapy (n=5), exercise therapy (n=2), gas therapy (n=1), therapeutic gloves (n=1), and ischemic preconditioning (n=1). Most studies demonstrated trends towards therapeutic benefit; however, there was substantial heterogeneity amongst the studies. Laser therapy had the most consistent evidence; 60% and 75% of the studies reported significant improvements in frequency of attacks per week and pain. Acupuncture therapies had minimal statistically significant benefits and the data for temperature biofeedback were inconsistent and of low quality. Exercise therapy is more recently being explored showing a marked therapeutic benefit for pain. \u0000Conclusion: The evidence is limited and inconsistent; however, the studies demonstrated a trend towards therapeutic benefits, with laser and electrotherapy having the most consistent evidence. Further high-quality and multi-center RCTs are required.","PeriodicalId":30662,"journal":{"name":"University of Ottawa Journal of Medicine","volume":" February","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141823866","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}

{"title":"Communication Barriers and Challenges for Accessing Autism Care: Conventional Versus Alternative Medicine","authors":"Marie Dominique Antoine","doi":"10.18192/uojm.v13i1.6430","DOIUrl":"https://doi.org/10.18192/uojm.v13i1.6430","url":null,"abstract":"Background: Despite the widespread use of complementary and alternative medicine (CAM) for autistic children, little is known about the communication flow between the different parties involved in the care (i.e., parents/caregivers, conventional providers, alternative practitioners). This study aimed to describe how communication occurs through the first year of care to identify challenges and potential barriers to communication that may affect the care of autistic children. \u0000Methods: From an ecological perspective, we collected qualitative data through 12 semi-structured interviews with six parents/caregivers, three conventional providers (family doctor, neurodevelopmental pediatrician, psychologist), and three alternative practitioners (naturopath, occupational therapist, speech and language pathologist) operating in Ottawa, Canada. The data was interpreted using thematic analysis.  \u0000Results: Findings revealed that parents/caregivers are the only links between the health professionals of both streams. The communication between parents/caregivers and conventional providers faces a perceived lack of knowledge of these professionals relating to CAM, a lack of care integration, flexibility, and time constraints. In alternative care settings, care integration and time constraints are an issue. From the five contexts examined, only the organizational and interpersonal contexts influence communication flow within the system. \u0000Conclusions: The increasing interest in alternative medicine is forcing changes in the healthcare system. Within the identified themes in the current study, the necessity for communication between all parties involved in the care of autistic children is evident. More ASD and CAM-related training for providers and openings for information-sharing between the two streams would support effective parent/caregiver-care provider communication. These findings contribute to a better understanding of the role of communication in the care management of autism, which has implications for effective autism care.","PeriodicalId":30662,"journal":{"name":"University of Ottawa Journal of Medicine","volume":"101 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141821707","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}

{"title":"Isopropyl alcohol as anti-emetic therapy in the emergency department: study protocol for a multi-center randomized controlled trial","authors":"Alexandra Hamelin, Ali Shahbaz Syed, Venkatesh Thiruganasambandamoorthy","doi":"10.18192/uojm.v13i1.6100","DOIUrl":"https://doi.org/10.18192/uojm.v13i1.6100","url":null,"abstract":"  \u0000Background: Nausea and vomiting is a common and distressing presenting complaint in Emergency Departments (EDs). There is no definite evidence to support the superiority of any anti-emetic therapy over another, or over placebo. Identification of an effective anti-emetic therapy in the ED setting with minimal side effects would be of great benefit. Isopropyl alcohol inhalation has been reported to be an effective treatment for post-operative nausea and vomiting, with no reported adverse events. The objective of this study is to determine if nasally inhaled isopropyl alcohol swabs are effective in alleviating nausea and/or vomiting in patients presenting to the ED with a chief complaint of nausea and/or vomiting. \u0000  \u0000Methods: We will conduct a randomized, controlled, multicenter trial with three subject arms: 1) nasally inhaled isopropyl alcohol swabs every 10 minutes for a total of one hour, 2) nasally inhaled isopropyl alcohol swabs every 20 minutes for a total of one hour, or 3) no intervention. 135 participants ≥18 years old and presenting to the ED with a chief complaint of nausea and/or vomiting with a level of 3 or greater on a verbal numeric rating scale (NRS) will be recruited for a duration of two hours. The primary outcome measure is the mean reduction in nausea scores comparing the pre-intervention score to the lowest post-intervention nausea score. The secondary outcome measures will be participant satisfaction scores using a verbal NRS, receipt of any rescue anti-emetic medications, ED length of stay, and participant disposition (admission or discharge home). \u0000  \u0000Discussion: This study will determine the efficacy of inhaled isopropyl alcohol swabs by determining the optimal dosing frequency achieving adequate anti-emetic action. This has the potential to guide future triage protocols to incorporate this therapy to provide earlier symptomatic relief to patients, and also has the potential to prevent morbidity suffered by patients in the emergency department and improving patient satisfaction and efficiently use in-patient resources. We strongly suspect that once this study is performed, it will be useful for ED physicians in treating nausea and vomiting in the ED.","PeriodicalId":30662,"journal":{"name":"University of Ottawa Journal of Medicine","volume":"101 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141821831","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}

{"title":"Environmental sustainability of air travel for conferences : a commentary","authors":"Alexie Leclerc, San Ahn, Husein Moloo","doi":"10.18192/uojm.v13i02.6605","DOIUrl":"https://doi.org/10.18192/uojm.v13i02.6605","url":null,"abstract":"Conferences are important to share ideas and meet with colleagues. Because many people fly to attend, the carbon footprint of conferences is massive. As healthcare workers it is important to evaluate how we contribute to the climate crisis. In this commentary the environmental impact of air travel to conferences is discussed and potential options to mitigate this.\u0000RÉSUMÉLes conférences sont importantes pour partager des idées et rencontrer des collègues. En raison du grandnombre de participants qui prennent l’avion pour participer aux conférences, l’empreinte carbone est nonnégligeable. En tant que professionnels de la santé, il est important de se pencher sur la manière dont nouscontribuons à la crise climatique. Ce commentaire traite de l’impact environnemental des voyages en avionpour se rendre à des conférences et des options potentielles pour atténuer cet impact.","PeriodicalId":30662,"journal":{"name":"University of Ottawa Journal of Medicine","volume":"5 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141684071","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}

{"title":"COVID-19 Dermatologic Manifestations: Issues More Than Skin-deep","authors":"E. Pastukhova","doi":"10.18192/uojm.v13i01.6269","DOIUrl":"https://doi.org/10.18192/uojm.v13i01.6269","url":null,"abstract":"Cutaneous manifestations of COVID-19 have become increasingly more reported. These dermatoses can either precede, accompany, or follow respiratory symptoms of COVID-19, and some have also been correlated with COVID-19 severity. Although COVID-19-related skin changes are relatively rare, there is an even greater paucity of such data in skin of colour. While research into the pathophysiology into this phenomenon is in its nascency, it is paramount to recognize the need for diversification, especially considering the racial disparities of COVID-19. The present discussion raises a deeper reflection of teaching and understanding dermatology of skin of colour in the medical profession. ","PeriodicalId":30662,"journal":{"name":"University of Ottawa Journal of Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41318790","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}

{"title":"Insufficient Ophthalmology Exposure in Canadian Medical Schools","authors":"R. Gupta","doi":"10.18192/uojm.v13i01.6482","DOIUrl":"https://doi.org/10.18192/uojm.v13i01.6482","url":null,"abstract":"Ophthalmological education is crucial for physicians of all fields and the current medical school education system in Canada does not provide students with sufficient training to adequately address certain common ocular conditions. Students can graduate their medical school with often one to two weeks of exposure to ophthalmology over the course of their three to four-year degree. A method to improve the ophthalmological training involves implementing established guidelines from the International Council of Ophthalmology, which lists attainable and specific objectives for medical students to complete by graduation.","PeriodicalId":30662,"journal":{"name":"University of Ottawa Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43837996","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}

{"title":"Telemedicine Management of COPD: Advancements in Chronic Disease Treatment and Implications for Medical Education","authors":"Mario Corrado","doi":"10.18192/uojm.v13i01.6463","DOIUrl":"https://doi.org/10.18192/uojm.v13i01.6463","url":null,"abstract":"Social determinants of health are non-medical, social and economic factors that influence health. The practice of telemedicine enables physicians to virtually connect patients with healthcare resources. Throughout the COVID-19 pandemic, healthcare providers have increasingly utilized telemedicine as a method to provide appropriate care to patients with chronic diseases, including Chronic Obstructive Pulmonary Disease (COPD). COPD is a progressive obstructive lung disorder which is substantially impacted by social determinants of health including access to healthcare. The successful utilization of telemedicine in the care of patients with chronic diseases, including COPD, highlights its emerging importance in healthcare. However, many Canadian medical schools have yet to implement a formalized telemedicine curriculum, and most Canadian students do not feel adequately prepared for virtual healthcare delivery. Here, we outline the utilization of telemedicine in COPD management and advocate for the rapid introduction of a formalized telemedicine curriculum at the undergraduate and postgraduate levels.","PeriodicalId":30662,"journal":{"name":"University of Ottawa Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47488757","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}

{"title":"On a Positive Note: Current Genetic Strategies Promises a Revolutionary Transformation for the Future of Medicine","authors":"P. Serrano","doi":"10.18192/uojm.v12is1.6575","DOIUrl":"https://doi.org/10.18192/uojm.v12is1.6575","url":null,"abstract":"","PeriodicalId":30662,"journal":{"name":"University of Ottawa Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47125229","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}