Health Open Research最新文献

{"title":"Medical Education in Bangladesh and the United States: A Comparative Overview","authors":"Mohammad Muntakim, Shahrin Khan, Mahfujul Z. Haque, Ferdous Nipu","doi":"10.12688/healthopenres.13530.1","DOIUrl":"https://doi.org/10.12688/healthopenres.13530.1","url":null,"abstract":"This manuscript presents an overview of Bangladesh medical education system with a brief comparison to the United States. Despite differences in origins and structures, both share similarities and differences in their medical curricula and examination-driven approaches. The paper employs a non-systematic comparative review methodology, gathering information from diverse sources including government websites, educational institutions, and published articles. Medical education in Bangladesh traces its roots back to the mid-20th century, initially influenced by British educational practices. The country now boasts 76 medical colleges—23 public and 53 private—admitting approximately 7,156 students annually for the MBBS degree. The admission process is competitive, with strict eligibility criteria including completion of prerequisite courses and a minimum grade-point average. The five-year MBBS program followed by a one-year clinical internship is a standard pathway in Bangladeshi medical education, with further specialization achieved through fellowship training. In terms of structure, curriculum, and training programs, the Bangladesh medical education system aligns with a lecture-based, examination-focused approach. However, research initiatives are limited due to resource constraints, impacting the quality and quantity of publications. Financially, both public and private medical institutions in Bangladesh charge similar tuition fees ranging from $33,000 to $48,000 USD for the entire MBBS degree, with limited scholarship opportunities. Upon graduation, physicians often opt for private practice, contributing to concerns about retaining qualified medical professionals within the country, particularly in rural areas. Comparatively, the United States has a longstanding history of medical education dating back over two centuries. The American system, encompassing diverse nomenclature for medical schools and varying degrees, presents differences in the application process, structure, and postgraduate training compared to Bangladesh. This comprehensive review highlights the distinctions and commonalities between the medical education systems of the United States and Bangladesh, serving as a resource for prospective students, current practitioners, and residency program directors.","PeriodicalId":481972,"journal":{"name":"Health Open Research","volume":"57 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141017933","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":"Has COVID-19 affected the publication productivity of neurosurgeons in UK and Republic of Ireland? A bibliometric analysis","authors":"Hariss G Paremes Sivam, J. Moudgil-Joshi, Chadrasekaran Kaliaperumal","doi":"10.12688/healthopenres.13445.1","DOIUrl":"https://doi.org/10.12688/healthopenres.13445.1","url":null,"abstract":"Background Our aim was to determine the impact of the COVID-19 pandemic on the publication productivity of neurosurgeons in the United Kingdom and Republic of Ireland. Methods Using bibliometric data we quantified and analysed the academic output of neurosurgeons in England, Scotland, Northern Ireland, Wales, and the Republic of Ireland, between two time periods i.e., January 2017 to December 2019 and January 2020 to March 2022, as a representative capture of the academic climate before and after the start of the COVID-19 pandemic. The consultant neurosurgeons were grouped according to their departments, title, sex, subspecialities and additional research qualifications. Using data charts on Scopus author directory, the total number of publications, citations and h-indices of each neurosurgeon were obtained over the two time periods. The median and mean of these 3 parameters were computed and the median values were analysed and tested for significance using a Mann Whitney-U test according to the groups. Results Our analysis conveyed a statistically significant increase (p<0.05) in the total number of publications after the start of the COVID-19 pandemic compared to before. There was a statistically significant decrease in the median number of citations, after the start of the COVID-19 pandemic. This trend was observed in both sexes, in authors without an additional MD/PhD and in authors who sub-specialized in neuro-oncology. Overall, there was a significant decrease in H-index after the start of the pandemic compared to before (median h-index:1.00 and 2.00; mean h-index:1.8 and 3.4 respectively). Conclusions There appears to be an apparent increase in total number of publications after the start of the COVID-19 pandemic, most authors have registered a reduction in citations and h-indices, suggesting a lower impact and unequal distribution of the abovementioned increase.","PeriodicalId":481972,"journal":{"name":"Health Open Research","volume":"60 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138998110","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":"Protocol for the development and validation of a patient reported measure (PRM) of treatment burden in stroke","authors":"Katie I Gallacher, Martin Taylor-Rowan, David T Eton, Hamish McLeod, Lisa Kidd, Karen Wood, Aleema Sardar, Terry J Quinn, Frances S Mair","doi":"10.12688/healthopenres.13334.2","DOIUrl":"https://doi.org/10.12688/healthopenres.13334.2","url":null,"abstract":"<ns3:p>Background Treatment burden is the workload of healthcare for people with long-term conditions and the impact on wellbeing. A validated measure of treatment burden after stroke is needed. We aim to adapt a patient-reported measure (PRM) of treatment burden in multimorbidity, PETS (Patient Experience with Treatment and Self-Management version 2.0), to create a stroke-specific measure, PETS-stroke. We aim to examine content validity, construct validity, reliability and feasibility in a stroke survivor population. Methods 1) Adaptation of 60-item PETS to PETS-stroke using a taxonomy of treatment burden. 2) Content validity testing through cognitive interviews that will explore the importance, relevance and clarity of each item. 3) Evaluation of scale psychometric properties through analysis of data from stroke survivors recruited via postal survey (n=340). Factor structure will be tested with confirmatory factor analysis and Cronbach’s alpha will be used to index internal consistency. Construct validity will be tested against: The Stroke Southampton Self-Management Questionnaire; The Satisfaction with Stroke Care Measure; and The Shortened Stroke Impact Scale. We will explore known-groups validity by exploring the association between treatment burden, socioeconomic deprivation and multimorbidity. Test-retest reliability will be examined via re-administration after 2 weeks. Acceptability and feasibility of use will be explored via missing data rates and telephone interviews with 30 participants. Conclusions We aim to create a validated PRM of treatment burden after stroke. PETS-stroke is designed for use as an outcome measure in clinical trials of stroke treatments and complex interventions to ascertain if treatments are workable for patients in the context of their everyday lives.</ns3:p>","PeriodicalId":481972,"journal":{"name":"Health Open Research","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136012615","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":"Fitness AfteR Oesophagectomy (FARO): study protocol for an external pilot trial of the impact of rehabilitation on quality of life after surgery for oesophageal cancer","authors":"Pooja Prasad, Jillian Macdonald, Rebecca Maier, Svetlana Cherlin, Julie Maxwell, Crystal-Mira Aure, Jeremy Daly, Shajahan Wahed, Alastair Greystoke, Alexander W. Phillips","doi":"10.12688/healthopenres.13330.1","DOIUrl":"https://doi.org/10.12688/healthopenres.13330.1","url":null,"abstract":"<ns3:p><ns3:bold>Introduction</ns3:bold></ns3:p><ns3:p> Curative treatment of gastro-oesophageal cancer encompasses surgery and peri-operative chemo(radio)therapy. Oesophagectomy carries significant morbidity and mortality with an adverse impact upon patients’ quality of life (QoL). Advancements in oncological treatment and surgical techniques have resulted in incremental prognostic gains with increasing focus on survivorship and optimising QoL. Despite enhanced recovery pathways, patients receive no assistance to improve physical functioning and QoL in the recovery period following hospital discharge. Post-operative rehabilitation has demonstrated improvement in physical fitness and psychosocial wellbeing among other cancer subtypes. There is a need to develop rehabilitative interventions that improve and restore patients’ QoL following an oesophagectomy. The aim of the FARO (Fitness AfteR Oesophagectomy) pilot trial is to determine if a pragmatic, patient-directed rehabilitation programme following oesophagectomy improves patients’ QoL.</ns3:p><ns3:p> <ns3:bold>Methods</ns3:bold></ns3:p><ns3:p> The FARO study is a prospective, single-centre, parallel group, open-label, two-arm pragmatic randomised controlled external pilot trial that will run over 24 months. The trial aims to recruit 60 patients undergoing oesophageal cancer surgery. Patients will be randomized to receive standard clinical care or post-operative rehabilitation (alongside standard clinical care) in a 1:1 ratio. The rehabilitation intervention encompasses a 12-week home-based programme with weekly step-count targets, completion of resistance exercises and dietary monitoring. The primary outcome is patients’ health-related quality of life (assessed by the EORTC QLQ-C30 and OG-25 questionnaires). Secondary outcomes include cardiopulmonary fitness, functional impact of sarcopenia and biochemical nutritional markers. Outcomes are measured at baseline (at discharge from hospital post-oesophagectomy), 6 weeks, 3- and 6 months post-surgery.</ns3:p><ns3:p> <ns3:bold>Discussion</ns3:bold></ns3:p><ns3:p> This external pilot trial aims to assess if a patient-directed rehabilitation programme following oesophagectomy restores and improves patients’ HR-QOL and recovery of physical functioning. Further, the trial aims to obtain adequate pilot data to plan a future definitive UK-wide trial of perioperative rehabilitation following oesophagectomy.</ns3:p><ns3:p> <ns3:bold>Trial registration number:</ns3:bold> ISRCTN Registry ISCRTN73024784; Pre-results</ns3:p>","PeriodicalId":481972,"journal":{"name":"Health Open Research","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135644873","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":"Manual cervical therapy and vestibular migraine: A case series","authors":"Roger O'Toole, Dean Watson","doi":"10.12688/healthopenres.13319.3","DOIUrl":"https://doi.org/10.12688/healthopenres.13319.3","url":null,"abstract":"<ns4:p><ns4:bold>Background:</ns4:bold> Vestibular migraine (VM) is a relatively new diagnostic entity with incomplete knowledge regarding pathophysiological mechanisms and therapeutic guidelines. By reporting the effect of manual cervical therapy (MCT) on people with VM, we suggest a possible role for upper cervical afferents in VM treatment and/or pathogenesis.<ns4:bold> </ns4:bold>The objective was to describe the change in clinical presentation and self-reported symptoms of VM corresponding to MCT and followed up to six months.</ns4:p><ns4:p> <ns4:bold>Methods:</ns4:bold> A nonrandomised *ABA design was utilised to consecutively and prospectively evaluate selected patients with diagnosed VM. Symptom characteristics (frequency and intensity) were recorded along with standardised patient-reported outcomes (PROs) to document the response to MCT.</ns4:p><ns4:p> <ns4:bold>Results:</ns4:bold> Three patients were recruited who met the diagnostic criteria for VM. All three patients demonstrated improvement in both migraine attack and interictal symptom frequency. These improvements mirrored changes in PROs and were sustained over a six-month follow-up period.</ns4:p><ns4:p> <ns4:bold>Conclusions:</ns4:bold> The improvement that coincided with the intervention including MCT was rapid, observable and sustained. This suggests that the upper cervical spine could be a therapeutic target in VM and may have implications for future research into the pathogenesis of VM.</ns4:p>","PeriodicalId":481972,"journal":{"name":"Health Open Research","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135671653","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":"Symptom burden of people with progressive ataxia, and its wider impact on their friends and relatives: a cross-sectional study","authors":"Anja Lowit, Julie Greenfield, Emily Cutting, Ruby Wallis, Marios Hadjivassiliou","doi":"10.12688/amrcopenres.13036.2","DOIUrl":"https://doi.org/10.12688/amrcopenres.13036.2","url":null,"abstract":"<ns4:p><ns4:bold>Background: </ns4:bold>Progressive ataxias are complex disorders that result in a wide variety of symptoms. Whilst we currently have a relatively good understanding of the spectrum of symptoms associated with the various types of ataxia, and their progression over time, their impact on the person with ataxia is less well understood. In addition, little is known about how carers, friends and relatives are affected by them. This paper aims to provide information on the presence and impact of medical symptoms and day-to-day challenges on people with ataxia and their friends and relatives.</ns4:p><ns4:p> <ns4:bold>Method: </ns4:bold>Data were extracted from a survey by Ataxia UK done for their members. The views of 366 people with ataxia and 52 friends and relatives are reported. Data were analysed for the entire group, as well as for the three most common ataxia types represented in the sample, Friedreich’s ataxia, inherited ataxia (excluding Friedreich’s ataxia), and cerebellar ataxia of unknown cause.</ns4:p><ns4:p> <ns4:bold>Results: </ns4:bold>The survey confirmed the symptom patterns described in previous research, but further showed that the impact of these symptoms can vary across ataxia populations. Similar findings were observed for day-to-day challenges. Friends and relatives experienced similar challenges to people with ataxia, indicating that support provided has to consider those supporting people with ataxia as well as the patient. Respondents also highlighted limitations in terms of accessing support services, and not all services were able to cater fully to their specific needs.</ns4:p><ns4:p> <ns4:bold>Conclusion: </ns4:bold>This study begins to provide information that can be used in further research to explore the needs of people with ataxia and their carers, friends, and relatives. Such research will support treatment trial design, ensuring patients’ needs are considered, help to tailor support services to their needs, and ensure health care professionals have the necessary skills to fully address them.</ns4:p>","PeriodicalId":481972,"journal":{"name":"Health Open Research","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135260667","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":"The impact of Covid-19 pandemic on hospices: A systematic integrated review and synthesis of recommendations for policy and practice","authors":"Shalene van Langen-Datta, Helen Wesson, Joanna Fleming, Abi Eccles, Catherine Grimley, Jeremy Dale, Kathryn Almack, Catriona Mayland, Sarah Mitchell, Ruth Driscoll, Lynn Tatnell, Lesley Roberts, John I. MacArtney","doi":"10.12688/amrcopenres.13105.2","DOIUrl":"https://doi.org/10.12688/amrcopenres.13105.2","url":null,"abstract":"<ns4:p><ns4:bold>Background: </ns4:bold>The Covid-19 pandemic resulted in the development of numerous recommendations for practice and policy for specialist palliative care provided by hospices in United Kingdom (UK), as hospices were significantly affected by the pandemic and protections put in place.</ns4:p><ns4:p> The aim of this review is to identify and synthesise recommendations or implications for policy and practice that have been generated for adult hospice specialist palliative care during the first 24 months of the Covid-19 pandemic.</ns4:p><ns4:p> <ns4:bold>Methods: </ns4:bold>AMED, BNI, CINAHL, EMBASE, EMCARE, HMIC, Medline, PsycINFO, PubMed databases were searched for peer-reviewed papers, as well as hand searches for grey literature. Literature relating to hospices and Covid-19 in the UK were included and a thematic synthesis of recommendations for hospice policy and practice was undertaken.</ns4:p><ns4:p> <ns4:bold>Results: </ns4:bold>858 articles were identified with 12 meeting the inclusion criteria. Fifty-eight recommendations or implications were identified: 31 for policy, 27 for practice, and 10 covering both. Recommendations were organised under ten themes. There were several recommendations seeking to secure hospice resources to mitigate the short-term impact of the pandemic, as well as those focused on longer-term implications such as core funding. The impact of the pandemic on the quality of hospice care was the focus for numerous recommendations around improving integration of hospice care in the community, provision of bereavement support and better use of Advance Care Plans (ACP). However, there were significant gaps related to carer visitation in hospices, inequities of palliative care, or hospice-at-home services.</ns4:p><ns4:p> <ns4:bold>Conclusion: </ns4:bold>The Covid-19 pandemic and protections exposed several ongoing policy and practice needs, especially around hospice resources, while generating novel issues for hospices to address. Significant policy gaps remain to be addressed to mitigate the impact of the pandemic on the quality of hospice specialist palliative care.</ns4:p>","PeriodicalId":481972,"journal":{"name":"Health Open Research","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135367979","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}