International Journal of Academic Medicine最新文献

{"title":"COVID-19 clinical course and outcomes in a predominantly black, vulnerable patient population in New York City","authors":"Priyanka Parmar, Alecia James, Sabrina Rosengarten, Alvin Oommen, M. Joseph, Clara Wilson, Rohan Maini, Max Mecklenburg, J. Kim, J. Edwards, M. Nakeshbandi, Igal Breitman, B. Arquilla, Pia Daniel","doi":"10.4103/IJAM.IJAM_116_20","DOIUrl":"https://doi.org/10.4103/IJAM.IJAM_116_20","url":null,"abstract":"Introduction: A study examining the impact of social determinants of health on COVID-19 outcomes is necessary to identify which aspects of a vulnerable population make it more susceptible. We describe the epidemiological and clinical characteristics of a patient population disproportionately impacted by COVID-19 and situate the findings within the broader context of health determinants. Materials and Methods: A descriptive study of 527 laboratory-confirmed COVID-19 patients hospitalized from March 12 to April 13, 2020, evaluated patient demographics, comorbidities, presentation, and outcomes. The study took place at an academic medical center serving a low-income, Black community (predominantly Caribbean-born) in Brooklyn, New York. Results: Compared to previous studies, we report a higher median age of 70 (interquartile range 59–80), a higher percentage of Blacks (91%), a higher prevalence of comorbidities (hypertension [83%], diabetes [53%], and obesity [42%]), a higher prevalence of abnormal findings on presentation (altered mental status [30%], Quick sequential organ failure assessment score ≥2 [27%], elevated random-glucose [77%], elevated creatinine [57%]), and a higher incidence of negative in-hospital outcomes (intensive care unit admission [21%], mechanical ventilation [21%], acute kidney injury [31%], acute respiratory distress syndrome [17%] and acute cardiac injury [18%], and age-adjusted fatality rate [40%.]). Conclusions: This study shows the characteristics of a patient population disproportionately impacted by COVID-19. The intersectionality of the Black race, older age, a high prevalence of comorbidities, and residency in a locale severely affected by COVID-19, deserves further consideration to better address health outcomes in vulnerable patient groups. The following core competencies are addressed in this article: Practice-based learning and improvement, Patient care and Procedural skills, Systems-based practice.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"7 1","pages":"81 - 88"},"PeriodicalIF":0.6,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41378652","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":"Knowledge, attitude, and practices regarding COVID-19 outbreak among the personnel providing emergency services in India","authors":"V. Bhushan, Shilpa Rai","doi":"10.4103/IJAM.IJAM_2_21","DOIUrl":"https://doi.org/10.4103/IJAM.IJAM_2_21","url":null,"abstract":"Introduction: The threat of contracting coronavirus persists among individuals constantly coming in direct or indirect contact with positive cases. Therefore, this study was conducted to assess the knowledge, attitude, and practices (KAPs) regarding the COVID19 outbreak among the personnel providing emergency services in India and also assess their perception toward government measures during this pandemic. Materials and Methods: An online survey was conducted among individuals providing services during the period of COVID-19 outbreak. A total of 234 people consented to continue with the survey. Data collection was carried out from April 2020 to June 2020. Data analysis was carried out using Chi-square statistics and Fisher-Freeman-Halton test. The level of statistical significance was set at 0.05 with a confidence interval of 95%. Results: Majority of the participants were male and belonged to the age group of 18–54 years. Almost all were aware that COVID-19 is a virus and had knowledge regarding its mode of spread and modes of prevention. Precautions such as covering face with mask, avoiding shaking hands, and washing hands before touching the eyes, nose, and mouth were undertaken by 34.6% of the total participants. Around 70.5% of the males, 53.7% of the females, and 33.3% of the participants from the others' category felt that the funds released by the government to combat corona were efficiently reaching the poor or the needy. Some of the barriers preventing the fair distribution of funds/services to the poor and needy as reported by the participants were corruption, lack of knowledge, delay in delivery and lack of personal protective kits, limited workforce, and no bank account of poor people. Conclusion: KAP of personnel providing emergency services is crucial to the containment of this disease. Understanding of the barriers shall aid policymakers to assess the impact of their preventive programs and also take crucial decisions toward its management. The following core competencies are addressed in this article: Medical knowledge, practice-based learning and improvement, and systems-based practice.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"7 1","pages":"107 - 112"},"PeriodicalIF":0.6,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47331030","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":"How do physicians and nurses assess and support patient medication adherence? An examination of a rural secondary care hospital in Delhi, India","authors":"S. Basu, Ruchira Pangtey, B. Banerjee, Saurabh Kumar","doi":"10.4103/IJAM.IJAM_155_20","DOIUrl":"https://doi.org/10.4103/IJAM.IJAM_155_20","url":null,"abstract":"Introduction: Suboptimal medication adherence contributes enormously to patient mortality, morbidity, and related health-care costs. Health-care providers (HCPs) have a pivotal role in supporting medication adherence in their patients through appropriate health communication. We assessed the perspectives and practices of medical doctors and nurses toward the assessment and support for patient medication adherence in Indian health settings. Materials and Methods: We conducted a cross-sectional study at a secondary-care hospital in Delhi. Data were collected from medical doctors, interns, and nursing staff using a self-administered questionnaire on the following domains: Medication Adherence, frequency, methods and tools of assessment, high-risk patient identification and interventions applied to promote adherence. Results: We recruited a total of 117 HCPs. The common modes of assessment of medication adherence used by the HCPs included a general question (78.6%), observing missed appointments (43.6%), and querying for forgetfulness (29.9%). However, none of the HCPs were aware of validated questionnaire (scales) for the assessment of medication adherence. Drug-related adverse effects as a cause of nonadherence were evaluated by 38.3% HCPs only. Conclusions: The development of simple and validated methods for assessing medication adherence applicable in resource-constrained settings along with the curricular training of HCPs on patient adherence and related know-how needs urgent prioritization. The following core competencies are addressed in this article: Practice-based learning and improvement, Systems-based practice, and Interpersonal and communication skills.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"7 1","pages":"120 - 125"},"PeriodicalIF":0.6,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48502866","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":"Nutrition, COVID-19, and vaccines","authors":"H. Gillis, T. Papadimos","doi":"10.4103/IJAM.IJAM_13_21","DOIUrl":"https://doi.org/10.4103/IJAM.IJAM_13_21","url":null,"abstract":"","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"7 1","pages":"71 - 72"},"PeriodicalIF":0.6,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47278424","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":"Effectiveness of school-based dental health education on knowledge and practices related to emergency management of dental trauma and tooth avulsion: An educational intervention study","authors":"Y. Srilatha, B. Shekar, N. Krupa","doi":"10.4103/IJAM.IJAM_56_19","DOIUrl":"https://doi.org/10.4103/IJAM.IJAM_56_19","url":null,"abstract":"Introduction: Trauma to teeth and jaws are considered major public health problems. The school environment is the most susceptible place for children, to encounter trauma to teeth. Materials and Methods: This interventional study was conducted to evaluate the effectiveness of school-based dental health education (DHE) on knowledge and practices related to emergency management of dental trauma and tooth avulsion among students and teachers of three government and three private schools each selected from two mandals (Mandal is a sub-district which comprises of a cluster of villages and village is the lowest level of administrative sub-division in rural areas of India) of Guntur district. Baseline information was collected from participants using a validated structured questionnaire. DHE on “Dental Trauma and Emergency Management of Tooth Avulsion” was offered using audiovisual aids (Flip charts, Slideshow) by a qualified Public Health Dentist. Subsequently, trained science teachers in each school were requested to undertake health education sessions at monthly interval for the next 3 months. Postintervention data were collected 1 week after initial DHE by public health dentist and 1 week after last reinforcement session by the teacher. Mean knowledge and practice scores were compared using independent sample t-test and Repeated Measures Analysis of Variance. Results: A total of 1180 children (570 males and 602 females, age range: 12–16 years) and 54 teachers (24 males and 30 females, age range: 20–56 years) were included. Mean scores for knowledge and practices increased among students and teachers following intervention with no difference between flipchart and slideshow method. Conclusion: Teachers (preferably science teachers) could be effectively used for DHE provided that they receive proper training and continued education on dental trauma. The following core competencies are addressed in this article: Medical knowledge, Practice-based learning and improvement, Systems-based practice.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"7 1","pages":"39 - 61"},"PeriodicalIF":0.6,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47385995","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":"What's new in academic medicine? Focus on evolving models of competence in Graduate Medical Education","authors":"Nicholas Taylor, N. Defenbaugh, Alaa-Eldin A. Mira, Erin Bendas","doi":"10.4103/IJAM.IJAM_30_21","DOIUrl":"https://doi.org/10.4103/IJAM.IJAM_30_21","url":null,"abstract":"","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"7 1","pages":"1 - 4"},"PeriodicalIF":0.6,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49648346","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":"De-emphasizing time-based training in the delivery of competency-based medical education for undergraduates in India: Justification, challenges, and potential solutions","authors":"S. Shrivastava, P. Shrivastava","doi":"10.4103/IJAM.IJAM_71_19","DOIUrl":"https://doi.org/10.4103/IJAM.IJAM_71_19","url":null,"abstract":"In the conventional medical curriculum in India, the duration of medical graduation is 4.5 years, excluding internship. The limitation of time-based advancement can be understood in two ways, either a student is sent to next professional year without attainment of the desired course outcomes or that students spend unnecessary time in a specific professional even after gaining the required outcomes. Acknowledging these limitations and also after realizing the multiple benefits attributed to Competency Based Medical Education (CBME), the same has been implemented in the Indian set-up for undergraduate courses from 2019 batch onwards. In general, CBME advocates against time-based training, especially because not every student can learn at an identical pace. However, adoption of the same strategy (time-variable) in imparting medical education has its own challenges. In India, even though, in principle, we have adopted all principles of CBME, except the time-variability of the course. However, now the same question arises, if all students learn at varying pace, how can we ensure that within a specified time duration, all the students will attain the desired outcomes? Even though, the task at hand is difficult, it can be accomplished, if we all work together in a planned and coordinated manner. In the mission to produce a competent medical graduate within a defined time interval, there is an immense need for better planning, support from administration, active participation of faculty members, involvement of the students, and better collaboration between departments.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"7 1","pages":"66 - 67"},"PeriodicalIF":0.6,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41579125","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":"Pandemic and psychological outcomes among health-care practitioners: A cross-sectional study based on current evidence in Indian context amidst COVID-19","authors":"S. Garg, A. Chauhan, D. Sharma, Sanjeet Singh, K. Bansal","doi":"10.4103/IJAM.IJAM_138_20","DOIUrl":"https://doi.org/10.4103/IJAM.IJAM_138_20","url":null,"abstract":"Introduction: The dramatic spread of SARS-Cov-2 and the following fatalities put the health-care practitioners under high pressure and increased workload. Coping mechanisms adapted by health-care practitioners represent a challenge to their psychological resilience. This type of pandemic produces fearful behavior and increases the risk of adverse psychological responses. The aim was to study the prevalence of psychological outcomes and exploring the associated factors among health-care practitioners amidst COVID-19. Materials and Methods: This is a cross-sectional, online survey of 588 health-care practitioners who were fighting against the COVID-19. The survey was applied in August, 2020, using a questionnaire that measures depression, anxiety, and stress. Survey included two sections, sociodemographic characteristics and Depression Anxiety Stress Scale-21 (DASS-21) scale. SPSS 22.0 software package was used for statistical analysis. Binary logistic regression analysis was used to assess the factors associated with psychological problems. Pearson's correlation was also used to assess the correlation among the psychological outcomes themselves. Results: Out of 588 health-care practitioners, 49.65% had depressive symptoms, 41.15% had anxiety symptoms, and 30.95% were distressed. Around 25%–35% of health-care practitioners had moderate-to-severe symptoms. Mean age was 28.78 years, and mean score of DASS-21 was 31.29 (standard deviation SD = 27.07). Binary logistic regression analysis revealed that working as specialists and as frontline workers was significantly associated with different psychological outcomes (anxiety and stress). A statistically significant correlation was found between stress, anxiety, and depression. Conclusions: This study revealed that a large number of health-care practitioners were affected severely by psychological morbidities, which required a mental health professional consultation. These negative outcomes were invisible, inconvenient, and frightening in reality. Therefore, recognition of other risk factors and planning of interventions would be beneficial in reducing the damage to psychological well-being of these practitioners. The following core competencies are addressed in this article: Clinical knowledge, Practice-based learning and improvement, System-based practice.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"7 1","pages":"15 - 21"},"PeriodicalIF":0.6,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45032490","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":"Emergency mental health calls to first responders following a natural disaster: Examining the effects from Hurricane Harvey","authors":"J. Saunders, Deepa Dongarwar, J. Salemi, J. Schulte, David Persse, A. Matin, Sophia Banu, Asim A. Shah","doi":"10.4103/IJAM.IJAM_71_20","DOIUrl":"https://doi.org/10.4103/IJAM.IJAM_71_20","url":null,"abstract":"Introduction: Hurricane Harvey which made landfall on August 25, 2017 was a devastating storm that dumped unprecedented amount of rainfall on the area including Houston, Texas, United States of America. There are limited data about emergency service mental health utilization following disaster events. The goal for this project was to examine mental health calls to emergency medical services (EMS) and to the Houston Police Department following Hurricane Harvey. An analysis looking at this utilization following a natural disaster represents an understudied area and can potentially provide information about city services and community psychiatric services in the acute period following the event. Materials and Methods: Total number of calls to the police department and mental health calls to the police department described as crisis intervention calls (Crisis Intervention Team) were obtained from August 1, 2016 to October 31, 2016 and January 1, 2017 to December 31, 2017. Emergency detention orders (EDO) per date were obtained from January 1, 2017 to December 31, 2017. Data for mental health calls based on the primary impression of mental health complaint were obtained from the Houston Fire Department for EMS from January 1, 2016 to December 31, 2017. Results: There was a statistically significant increase in the number of mental health calls to the police following Hurricane Harvey. When comparing the prestorm, active storm, and poststorm period, there was not a statistically significant difference in the number of EDOs or the number of EMS mental health calls. Conclusions: The increase in police mental health calls suggests that there may have been an increase in the acuity of the mental health calls to EMS around in evaluating calls surrounding the period of Hurricane Harvey. The following core competencies are addressed in this article: Medical Knowledge and Patient Care.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"7 1","pages":"22 - 29"},"PeriodicalIF":0.6,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49537776","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":"Subgingival temperature: A forgotten cardinal sign of gingival inflammation","authors":"D. Singh, G. Kumar","doi":"10.4103/ijam.ijam_147_20","DOIUrl":"https://doi.org/10.4103/ijam.ijam_147_20","url":null,"abstract":"","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"37 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70738959","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}