Effective Patient Care Research Articles

Management of COVID-19 in Universitas Gadjah Mada (UGM) Academic Hospital: Balancing to save the patients and protect the staffs

The Coronavirus Disease 2019 (COVID-19) is a worldwide outbreak disease caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Indonesia is the fourth most populous country in the world and is predicted to be affected significantly over a more extended period. Universitas Gadjah Mada (UGM) Academic Hospital is one of the COVID-19 referral hospitals located in the Yogyakarta Special Region, Indonesia. Since the early months of the pandemic, the hospital has prepared strategies to provide effective and efficient patient care. The focus has been safety for both patients and healthcare staff. Here, we will share our experiences activating a Hospital Incident Command System (HICS) as a hallmark for preparedness and response to the COVID-19 pandemic disaster so it can be adopted in other hospitals nationwide or worldwide. The HICS in the UGM Academic Hospital includes 1) surge capacity for isolation rooms, 2) infection prevention and control, 3) human resources, 4) continuity of essential health services and patient care, 5) communication, 6) logistics and management of supplies including pharmaceuticals, 7) essential support services, 8) case management system, 9) surveillance early warning and monitoring, 10) laboratory services, and 11) additional programs including community service programs. Based on our experiences, early preparedness with a proactive response, and adapting plans to local needs, the national and global current situation are the keys to managing patient care. Implementing all levels of the hierarchy of control infection and keeping the human resources adequate also could protect staff

Changes in Time Perception and Coping Strategies in Young Adults With Cancer: A Qualitative Study.

A cancer diagnosis is a traumatic event. Youths, in the most crucial stage in a person's life course, are more susceptible to the influence of cancer. The diagnosis disrupts the original life and time plans of young adults with cancer, resulting in a reconstruction of time perception and changes in coping strategies. The aim of this study was to explore the changes in time perception and coping strategies in young adults with cancer. A phenomenological research methodology was used in the qualitative study. Thirty-one young adults with cancer were recruited. Semistructured interviews were conducted with them, and the interview data were analyzed using Colaizzi's 7-step analysis method. The study revealed 3 themes related to changes in time perception: perceived alterations in the speed of time, changes in remaining available time, and shifts in time preferences. Five themes were identified regarding coping strategies for changes in time perception: self-regulation of emotions, establishing spiritual beliefs, planning time effectively, returning to family life, and closure of the inner self. Identifying changes in time perception among young adults with cancer through the speed of time, remaining available time, and time preference and guiding patients in adopting positive coping strategies can offer more effective cancer support and care for patients. Healthcare professionals should pay attention to the changes in time perception in young adults with cancer and guide them to cope positively.

Artificial intelligence to assist decision-making on pharmacotherapy: A feasibility study

BackgroundArtificial intelligence (AI) has the capability to analyze vast amounts of data and has been applied in various healthcare sectors. However, its effectiveness in aiding pharmacotherapy decision-making remains uncertain due to the intricate, patient-specific, and dynamic nature of this field. ObjectiveThis study sought to investigate the potential of AI in guiding pharmacotherapy decisions using clinical data such as diagnoses, laboratory results, and vital signs obtained from routine patient care. MethodsData of a previous study on medication therapy optimization was updated and adapted for the purpose of this study. Analysis was conducted using R software along with the tidymodels extension packages. The dataset was split into 74% for training and 26% for testing. Decision trees were selected as the primary model due to their simplicity, transparency, and interpretability. To prevent overfitting, bootstrapping techniques were employed, and hyperparameters were fine-tuned. Performance metrics such as areas under the curve and accuracies were computed. ResultsThe study cohort comprised 101 elderly patients with multiple diagnoses and complex medication regimens. The AI model demonstrated prediction accuracies ranging from 38% to 100% for various cardiovascular drug classes. Laboratory data and vital signs could not be interpreted, as the effect and dependence were unclear for the model. The study revealed that the issue of AI lag time in responding to sudden changes could be addressed by manually adjusting decision trees, a task not feasible with neural networks. ConclusionIn conclusion, the AI model exhibited promise in recommending appropriate medications for individual patients. While the study identified several obstacles during model development, most were successfully resolved. Future AI studies need to include the drug effect, not only the drug, if laboratory data is part of the decision. This could assist with interpreting their potential relationship. Human oversight and intervention remain essential for an AI-driven pharmacotherapy decision support system to ensure safe and effective patient care.

Entry-to-Practice Rehabilitation Competencies and the Rehabilitation Competency Framework: A Gap Analysis

ObjectivesThe demand for rehabilitation services is rising globally, necessitating a well-prepared and diverse rehabilitation workforce. The World Health Organization developed the Rehabilitation Competency Framework (RCF) to guide the development of contextually based competencies for various rehabilitation professions. This study systematically compared the entry-level competencies of different rehabilitation professions with the RCF, thereby discerning commonalities and gaps. By exploring these comparisons, the aim was to identify overlapping competencies and areas for collaboration, potentially informing the creation of unified educational materials to support the development of rehabilitation professionals. DesignThe competence frameworks of audiology, occupational therapy, physical and rehabilitation medicine, psychology, physiotherapy, prosthetics and orthotics, rehabilitation nursing, and speech and language therapy were researched online. In cases where international standards or competencies were unavailable online, expert colleagues in the related field were consulted to confirm the absence of an international document. A nationally recognized and freely available document was selected to represent the profession if no international document was found. The frameworks were then mapped to the RCF domains. SettingDesk-based research. ParticipantsNot applicable. InterventionsNot applicable. Main Outcome MeasuresNot applicable. ResultsThe professional documents demonstrated a stronger alignment with the competencies outlined in the RCF activities. The practice and professionalism domains showed the greatest congruence with profession-specific competencies, whereas the learning and development, management and leadership, and research domains had varying levels of alignment. This consistency in mapping may be attributed to the profession-specific competencies’ focus on the fundamental entry-level knowledge, skills, values, and abilities essential for delivering safe and effective patient care. ConclusionsThe mapping exercise revealed that competencies in the profession-specific frameworks primarily focused on individual-level skills for effective patient care rather than societal-level impact, such as acting as rehabilitation advocates. The study provides valuable insights into the alignment between profession-specific competencies among the rehabilitation professions. Identifying commonalities and gaps can facilitate the development of shared educational resources for foundational support across diverse rehabilitation disciplines. This effort can contribute to building a robust and unified rehabilitation workforce capable of meeting the emerging health needs of diverse populations worldwide.

Can we do better supporting young adults with cerebral palsy as they navigate adulthood? A review of current and future transitional practices.

Patients with cerebral palsy (CP) face lifelong consequences of their condition, and their healthcare needs evolve as they age. Transitional care for these patients is not universally available and various models have been described. In this article, the authors review the current literature surrounding transitional care for patients with CP, focusing predominantly on the neurosurgical aspects of transitional care, and they describe current approaches adopted by programs in North America. They further describe their own experience developing a transitional care clinic for patients with CP, as well as the integration of this program with a multidisciplinary clinic to address the specific challenges that growing patients face in our region. The authors performed a literature review to identify models, barriers, and assessments of effective transitional care for CP patients. They also reviewed the recommendations of various professional societies regarding transitional care practices. They performed qualitative analysis of the relevant literature. Transitional care has been broadly categorized into transitional care clinics with multidisciplinary teams and facilitator-led transitional care. CP patients have to overcome a variety of barriers, including those from within the healthcare system as well as environmental and personal, during the period of their transition. These challenges are all interconnected, and navigation requires healthcare professionals to work closely with patients and their caregivers. Multiple instruments are described to measure successful transition, which is likely a reflection of the unique needs that a patient may require. Current guidelines recommend that neurosurgeons select a suitable model of care based on their own local practice and available services, develop a well-defined transition plan, and identify a primary transition facilitator or care coordinator. Providing effective transitional care to CP patients remains challenging given the different models of care and the barriers faced by them during the period of transition. In developing a transitional care program for these patients, attention must be given to the resources that are available regionally, with an effort to incorporate the best practices from successful transitional care programs.

Shared care for patients with a left ventricular assist device: a scoping review.

Left ventricular assist devices (LVADs) are increasingly implanted in patients with advanced heart failure. Currently, LVAD care is predominantly concentrated at specialized tertiary care hospitals. However, the increasing workload and logistical burden for implanting centres pose significant challenges to accessing care for individual patients in remote areas. An emerging approach to LVAD patient management is the use of a shared care model (SCM), which facilitates collaboration between implanting centres and local non-implanting hospitals. This scoping review explores and synthesizes the current scientific evidence on the use of SCMs in LVAD care management. Eligible studies were identified in EMBASE, PubMed MEDLINE, Web of Science, Cochrane and Google Scholar. Findings were synthesized in accordance with PRISMA-ScR guidelines. Of the 950 records screened, five articles met the inclusion criteria. Four review articles focused on the proposed benefits and challenges of using SCMs. Main benefits included improved patient satisfaction and continuity of care. Important challenges were initial education of non-implanting centre staff and maintaining competency. One prospective study showed that absence of LVAD-specific care was associated with impaired survival and higher rates of pump thrombosis and LVAD-related infections. The use of SCMs is a promising approach in the long-term management of LVAD patients. However, sufficient evidence about the impact of SCMs on patients and the healthcare system is not currently available. Standardized protocols based on prospective studies are needed to develop safe and effective shared care for LVAD patients.

Assessing the Efficacy of the Spectrum-Aided Vision Enhancer (SAVE) to Detect Acral Lentiginous Melanoma, Melanoma In Situ, Nodular Melanoma, and Superficial Spreading Melanoma.

Skin cancer is the predominant form of cancer worldwide, including 75% of all cancer cases. This study aims to evaluate the effectiveness of the spectrum-aided visual enhancer (SAVE) in detecting skin cancer. This paper presents the development of a novel algorithm for snapshot hyperspectral conversion, capable of converting RGB images into hyperspectral images (HSI). The integration of band selection with HSI has facilitated the identification of a set of narrow band images (NBI) from the RGB images. This study utilizes various iterations of the You Only Look Once (YOLO) machine learning (ML) framework to assess the precision, recall, and mean average precision in the detection of skin cancer. YOLO is commonly preferred in medical diagnostics due to its real-time processing speed and accuracy, which are essential for delivering effective and efficient patient care. The precision, recall, and mean average precision (mAP) of the SAVE images show a notable enhancement in comparison to the RGB images. This work has the potential to greatly enhance the efficiency of skin cancer detection, as well as improve early detection rates and diagnostic accuracy. Consequently, it may lead to a reduction in both morbidity and mortality rates.

Physical therapists’ perceptions and attitudes towards artificial intelligence in healthcare and rehabilitation: A qualitative study

Artificial intelligence (AI) is being introduced to rehabilitation practices, and it can optimize the patient's outcome through their ability to design personalized care strategies and interventions. To understand the attitudes and perceptions of physical therapy professionals on the use of AI in rehabilitation in regard to treatment planning, diagnosis, outcome prediction, and advantages and disadvantages. This paper followed an exploratory, qualitative research design. Semi-structured, one-to-one interviews were conducted with participants of different experience levels and specialties in physical therapy. Results were evaluated using thematic analysis. Four themes were identified: (i) perceptions of AI and its applications in healthcare services, (ii) impact on the workforce (iii) considerations around implementing AI within rehabilitation and (iv) AI, and the fast-approaching future. Participants shared views on the potential impact of AI on rehabilitation practices, such as aiding the decision-making process, saving time and effort of both the therapist and patients. Participants have stressed on potential pitfalls that still need to be considered, such as patient data privacy, potential loss of patient-healthcare practitioner relationship, ethical concerns regarding overreliance on these applications and how that might hinder effective patient care. The findings add to the literature about physical therapists' understanding regarding the use of AI in patient care. Several concerns were raised to the adoption of AI, including concerns about patient privacy, and ethical concerns. Based on the study findings, researchers emphasize the importance of establishing guidelines when incorporating AI in rehabilitation to improve the therapist's knowledge and skills.

Implementation of the use of active methodologies used by preceptors of the pain outpatient clinic of the University Hospital of the Federal University of Juiz de Fora: Experience report

Introduction: The Multiprofessional Pain Outpatient Clinic (AMD) was created at the University Hospital of the Federal University of Juiz de Fora (HU-UFJF) to offer an integrated and interprofessional approach to the treatment of chronic pain, in line with the Multiprofessional Residency in Adult Health. To face the complex demands of AMD and promote more engaged and meaningful learning, the need arose to use Active Methodologies (AM) in the teaching-learning process of residents. Objective: To report the creation of a preceptorship plan for the implementation of active methodologies in the teaching-learning process of AMD, with the objective of developing critical, communication and teamwork skills in health professionals and promoting more effective and integrated care for patients with chronic pain. Experience Report: The study adopted the format of an experience report and took place at AMD, involving an interprofessional team composed of residents and preceptors. Several active methodologies were used, such as case studies, problem-based learning, interprofessional teaching, experiential learning, among others. The implementation of active methodologies in AMD demonstrated significant potentialities, including improvements in resident performance, development of communication and teamwork skills, favoring interdisciplinary practices, and academia-service integration. A more active and engaged participation of students in the discussions of clinical cases was observed, resulting in a deeper understanding of the clinical concepts presented. Conclusion: Active methodologies represent an effective strategy to promote learning and professional development in AMD, contributing to a more integrated and efficient care for patients with chronic pain. The study highlights the importance of continuous training of health professionals and the search for innovative practices in the context of chronic pain.

Evaluation of Turnaround Times of Diagnostic Biopsies: A Metric of Quality in Surgical Pathology.

Introduction. Timely and accurate diagnosis of diseases is crucial for effective patient care. Turnaround time (TAT) in surgical pathology, defined as the time between accessioning the sample and reporting results, is a key performance indicator reflecting quality and efficiency. This study explores factors affecting TAT for diagnostic biopsies in a tertiary oncology hospital. Methods. A 1-month pilot study was conducted, focusing on 695 in-house diagnostic biopsies. Biopsies were categorized as routine (requiring only hematoxylin and eosin (H&E) staining) or complex cases (requiring additional tests). TAT was defined as the time between sample accessioning and report availability in the electronic medical record, with delays defined as exceeding 3 days for routine cases and 4 days for complex cases. Survival analysis using Kaplan-Meier plots was utilized to analyze TAT. Results. The overall mean TAT was 3.7 ± 2 days, with routine cases at 3.1 ± 2 days and complex cases at 4.8 ± 2 days (P < 0.001). Survival analysis revealed prolonged TAT for complex cases. Organ-specific analysis highlighted variations in TAT, with brain biopsies presenting the highest complexity and longest TAT. Surprisingly, malignant cases demonstrated slightly shorter TATs compared to benign cases (P = 0.026). Delays were observed in 34% of all cases. Conclusions. Laboratory TAT is crucial and is frequently used as a performance benchmark. We analyzed the various causes of delayed TAT in our hospital's histopathology department, with an emphasis on variables in the analytical phase. The results of this study demonstrate that cases involving ancillary techniques had significantly longer TATs compared to routine H&E cases.

Decreased Completion of Ordered Laboratories and Imaging in Telehealth Compared With In-person Hepatology Encounters.

To evaluate order completion after telehealth compared with in-person encounters. Completion of ordered testing, including laboratories and imaging, is an important aspect of successful outpatient care of patients with liver disease. Whether the completion of orders from telehealth encounters differs from in-person visits is unknown. Completion of ordered laboratories and imaging from hepatology encounters at our center from 2021 to 2022 were evaluated and compared between video telehealth and in-person visits. Laboratory completion was evaluated at 14 days, 30 days, and 90 days, and imaging completion was assessed at 1 year. Telehealth encounters were significantly less likely to have laboratories completed at all evaluated time points (14 d: 40.7% vs 90.9%; 30 d: 50.9% vs 92.2%; 90 d: 63.9% vs 94.3%, P< 0.001 for all). Among telehealth encounters, encounters in patients more remote from the center were less likely to have laboratories completed. Imaging ordered at telehealth encounters was also less likely to be completed within 1 year (62.5% vs 70.1%, P< 0.001), including liver ultrasounds (59.1% vs 67.6%, P= 0.001), which persisted when limited to encounters for cirrhosis (55.8% vs 66.4%, P= 0.01). Telehealth encounters were significantly less likely to have ordered laboratories and imaging completed compared with in-person visits, which has important clinical implications for effective outpatient care of patients with liver disease. Further research is needed to better understand the barriers to order completion for telehealth visits and ways to optimize this to improve the effectiveness of this visit modality.

Interplay between Comorbidities and Long COVID: Challenges and Multidisciplinary Approaches.

Long COVID, a name often given to the persistent symptoms following acute SARS-CoV-2 infection, poses a multifaceted challenge for health. This review explores the intrinsic relationship between comorbidities and autoimmune responses in shaping the trajectory of long COVID. Autoantibodies have emerged as significant players in COVID-19 pathophysiology, with implications for disease severity and progression. Studies show immune dysregulation persisting months after infection, marked by activated innate immune cells and high cytokine levels. The presence of autoantibodies against various autoantigens suggests their potential as comorbid factors in long COVID. Additionally, the formation of immune complexes may lead to severe disease progression, highlighting the urgency for early detection and intervention. Furthermore, long COVID is highly linked to cardiovascular complications and neurological symptoms, posing challenges in diagnosis and management. Multidisciplinary approaches, including vaccination, tailored rehabilitation, and pharmacological interventions, are used for mitigating long COVID's burden. However, numerous challenges persist, from evolving diagnostic criteria to addressing the psychosocial impact and predicting disease outcomes. Leveraging AI-based applications holds promise in enhancing patient management and improving our understanding of long COVID. As research continues to unfold, unravelling the complexities of long COVID remains paramount for effective intervention and patient care.

The Quality of Family Medicine Team Conferences Through the Lens of a Director: An Autoethnography.

Introduction In rural medical settings, team conferences are essential for effective patient care, especially given the challenges of limited resources and personnel. These conferences promote collaborative discussions on patient management and serve as vital educational sessions. This study explores the dynamics and efficacy of team conferences in the family medicine department of a rural hospital to optimize patient care and educational outcomes. Methods This qualitative study used autoethnography at Unnan City Hospital, Unnan, Japan. Data collection included semi-structured interviews, direct observation, reflective field notes, and informal conversations with medical students, junior residents, and general medicine trainees. The focus was on conference interactions, educational content, and operational challenges. Data analysis involved coding and theming, with ongoing discussions among researchers and participants to refine findings. Results Three key themes emerged. First, patient outcomes suffered from a lack of professional awareness. Second, mutual understanding and individual autonomy enhanced team quality. Third, team healthcare quality improved through diverse and inclusive learning experiences. Effective facilitation, structured time management, and integrating practical bedside learning with theoretical discussions were crucial for optimizing team conferences. Psychological safety, respect for individual differences, and maintaining motivation were essential for productive team interactions. Conclusion The study highlights the importance of effective facilitation, time management, and integrating practical and theoretical learning in enhancing team conferences in rural medical settings. Psychological safety and mutual respect are vital for fostering a collaborative and motivated team environment. Addressing these factors can improve patient care and educational experiences. Future research should include diverse settings and quantitative measures to validate and refine these insights, enhancing team conferences in rural healthcare environments.

Perspectives on Drug Development for the Treatment of Chronic Myeloid Leukemia in Pregnant Patients and Patients Who Are Breastfeeding.

Tyrosine kinase inhibitors (TKI) have improved the outcome and life expectancy of patients with chronic myeloid leukemia (CML). Patients are diagnosed with CML at younger ages, and patients treated for CML may become pregnant or choose to breastfeed. The information available to date on the safety of TKIs during pregnancy and lactation and the optimal management of these patients is largely anecdotal, based on personal or small-group experience, and heterogeneous. A panel of interested parties was convened by U.S. Food and Drug Administration to analyze the current data and discuss possible solutions. Possible solutions include prospective data collection, in clinical trials and in routine clinical practice, a more uniform and specific data collection, and greater coordination among involved entities. As patients with cancer are living longer, frequently receiving therapies for extended periods of time (or for life), data on appropriate management of patients through different reproductive phases of life are needed. It is thus time to change our approach for how to study treatment of cancer (including CML) during pregnancy or breastfeeding to develop evidence-based guidelines for safe and effective patient care.

Case Study on Analysing the Early Disease Detection of Pancreatic Ductal Adenocarcinoma in Korean Association for Clinical Oncology.

Pancreatic ductal adenocarcinoma (PDAC) is the most pervasive sort of pancreatic malignant growth. Due to the lack of early symptoms and effective methods for early detection and screening, the majority of patients (80% to 85%) are diagnosed with advanced metastatic or locally advanced disease, resulting in a low 5-year survival rate of 12%. The case study represents a comprehensive investigation into the intricate landscape of pancreatic cancer diagnosis within the Korean population. Grounded in epidemiological bits of knowledge, the review plans to disentangle the particular examples, commonness, and segment attributes of PDAC in Korea. By scrutinizing current diagnostic modalities, including conventional imaging techniques, molecular markers, and emerging technologies, the research seeks to evaluate the strengths and limitations of existing approaches within the Korean clinical context. Central to the study is an exploration of the collaborative initiatives spearheaded by the Association of Clinical Oncology in Korea in the domain of PDAC early detection. Analysing research projects, clinical trials, and interdisciplinary collaborations, the case study sheds light on the association's pivotal role in driving innovation and progress in oncology. The goal is to offer a detailed analysis of how the association helps in furthering knowledge and enhancing results in the management of PDAC. The case study delves into the implications of early PDAC detection for patient outcomes, emphasizing the significance of timely interventions and tailored treatment strategies. By outlining the potential benefits and challenges associated with early diagnosis, the study aims to inform health care policies, shape clinical guidelines, and guide future research priorities. Through a holistic approach, the case study endeavours to offer important experiences into the multifaceted landscape of PDAC early detection within the Korean health care system, contributing to the broader discourse on effective oncological practices and patient care.

Body Dysmorphic Disorder in Aesthetic and Reconstructive Plastic Surgery-A Systematic Review and Meta-Analysis.

(1) Background: Body dysmorphic disorder (BDD) presents significant challenges in aesthetic and reconstructive plastic surgery, impacting patient outcomes and well-being. Understanding its prevalence and associated factors is crucial for effective patient care. (2) Methods: A systematic review of national and international databases on body dysmorphic disorder, plastic surgery, cosmetic surgery, reconstructive surgery, and prevalence yielded 999 studies between 1878 and April 2024. Inclusion criteria focused on studies reporting prevalence while excluding those with small sample sizes (<20 participants), unclear diagnostic criteria for BDD, and non-English accessibility. (3) Results: A meta-analysis using a random effects model was conducted on 65 studies involving 17,107 patients to estimate the prevalence of BDD. The overall estimated prevalence of BDD was 18.6%; 10,776 (62.9%) were females, with a mean age of 35.5 ± 11.7 years. Subgroup meta-analysis found significant variability in effect sizes across countries and types of specialty, of which Brazil showed the highest proportion and dermatology exhibited the smallest. Meta-regression analysis found no significant relationship between the year of publication and prevalence rates. (4) Conclusions: Our findings update the current literature on BDD prevalence in aesthetic and reconstructive plastic surgery. We emphasize the importance of proactive screening and multidisciplinary care approaches to address the complex challenges posed by patients with BDD. Further research is needed to explore evolving trends in BDD prevalence and factors influencing its expression across different cultural contexts.

Exercise and recovery after surgery in patients with breast cancer: An analysis of the literature

This review explores the impact of exercise on post-surgical recovery in breast cancer patients. Breast cancer, the most prevalent cancer globally, necessitates treatments beyond conventional modalities such as surgery, chemotherapy, radiotherapy, and immunotherapy. While exercise as an adjuvant therapeutic tool is not novel, it is generally accepted for improving cancer outcomes. Yet, it is not included in current treatment guidelines. This study reviews literature using the FACT-B (Functional Assessment of Cancer Therapy – Breast) tool to evaluate quality of life in breast cancer patients undergoing exercise interventions post-surgery. Despite mixed results, with some studies showing significant improvements and others indicating no notable benefits, the general consensus suggests potential advantages of integrating structured exercise programs into recovery protocols. Standardizing the use of quality of life measures like FACT-B could enhance future research and clinical practices, leading to more effective patient care strategies.

Algorithmic Approach to Benign Prostatic Hyperplasia: An Indian Perspective.

Benign prostatic hyperplasia (BPH) is a prevalent condition affecting aging men, necessitating a comprehensive and evidence-based approach to diagnosis and management. This manuscript, through the summarization of the latest evidence, aims to establish a consensus among clinicians regarding optimal strategies for diagnosing and managing BPH, to improve patient care and outcomes in clinical practice. A panel of urologists conducted a comprehensive review of the literature by searching various databases and search engines (PubMed, Google Scholar, and Cochrane databases). They identified relevant studies on the diagnosis and management of BPH. The literature was summarized and analyzed to develop 14 statements. The panel utilized a Delphi methodology over two rounds (R1 and R2) to reach a consensus on the statements, considering both the literature evidence and expert opinions. The expert panel reached a consensus on 14 statements addressing diverse aspects of BPH, including tailored therapies for different patient profiles and the necessity for a unified diagnosis and management algorithm to enhance patient outcomes. In conclusion, a unified approach to diagnosing and managing BPH promotes consistent and effective patient care. Proper drug selection, considering factors like efficacy and patient-specific characteristics, is crucial for managing BPH. This approach optimizes treatment outcomes and improves the quality of life for BPH patients.

Trust Development Between Speech-Language Pathologists and Laryngologists: A Thematic Analysis

ObjectivesSpeech language pathologists (SLPs) and laryngologists often work closely in interdisciplinary settings evaluating and treating patients with voice, swallowing, and airway disorders. This collaboration is integral to providing optimum patient care. We theorize that trust is an essential component of this relationship and contributes to effective patient care and professional satisfaction. There is currently no literature that explores the development and role of trust in this unique interprofessional relationship. We aim to explore the SLP and laryngologist interprofessional relationship and the development and role of trust in that relationship. Study DesignQualitative Realist Thematic Analysis MethodsThematic analysis of semi-structured qualitative interviews was performed to explore the relationship between SLPs and laryngologists. Through purposive sampling from November 2022 – January 2023, we recruited SLPs (n=10) and laryngologists (n=10) from 12 centers with varying years of practice, practice setting (academic or private), geographic location, and team structures. ResultsTrust between SLPs and laryngologists is comprised of confidence in 1) ability (clinical judgment, technical skill), 2) benevolence, and 3) integrity. Trust formation is enhanced by frequency and quality of communication, physical proximity, and reduction of practical barriers (scheduling, billing, departmental structure). Role negotiation was not identified as a factor. The presence of all three components of trust contributes to job satisfaction, perceptions of patient experience and care outcomes, and the willingness to collaborate in academic areas beyond clinical care. ConclusionsAll three elements (ability, benevolence, integrity) must be present for trust in an interprofessional relationship between SLPs and laryngologists, and formation of trust is facilitated by robust communication, physical proximity, and reduction of practical barriers to collaboration. The lack of these elements and lack of trust between the two professions can negatively impact collaboration, job satisfaction, and patient care outcomes, contributing to inefficiencies in patient care.

ChatGPT in orthodontics: limitations and possibilities

Abstract Artificial Intelligence (AI) simulates human intelligence in machines capable of rational response and actions. AI’s growth in healthcare, particularly in dentistry, has been remarkable in aiding clinical practices from appointment scheduling to treatment outcome predictions. In orthodontics, AI effectively handles tasks such as automated landmark detection, diagnosing orthodontic needs, assessing maxillary constriction, and selecting appliances. ChatGPT, an AI-based program by OpenAI, excels in generating human-like responses, making it useful across many applications, including those in dentistry. AI enhances personalised patient communication, supports diagnosis and decision-making, digitises patient data, and aids in disease prevention and treatment. In addition, ChatGPT offers support in personalised care, billing, and patient health monitoring. Patients benefit from its help in finding providers, scheduling initial appointments, accessing health information, improving healthcare access and service effectiveness. However, there are limitations. ChatGPT sometimes produces nonsensical responses and poses privacy risks associated with patient data. Generated medical advice might not therefore match professional expertise. Despite these issues, if trained properly, ChatGPT could significantly enhance medical knowledge dissemination. Future studies should weigh the benefits of AI against its risks, and users must verify AI-generated information with reliable sources to ensure effective patient care.