Experience Of Doctors Research Articles

“Helping Mentally Ill, a Reward Both in this Life and After”: A Qualitative Study Among Community Health Professionals in Somaliland

This study aimed to describe the experiences of community mental health workers, predominantly female, nurses and doctors providing community-based mental health services in Borama, Somaliland. A qualitative explorative study using focus group discussions was conducted. Data were collected from three focus group discussions with 22 female community health workers, two medical doctors, and two registered nurses and analyzed using content analysis with an inductive approach. Three main categories were identified from the analysis: (1) bridging the mental health gap in the community; (2) working in a constrained situation; and (3) being altruistic. Overall, the community mental health workers felt that their role was to bridge the mental health gap in the community. They described their work as a rewarding and motivated them to continue despite challenges and improving community healthcare workers’ work conditions and providing resources in mental health services will contribute to strengthening mental health services in Somaliland.

Proximal femur parameter measurement via improved PointNet+.

Femoral morphological studies and parameter measurements play a crucial role in diagnosing hip joint disease, preoperative planning for total hip arthroplasty, and prosthesis design. Doctors usually perform parameter measurements manually in clinical practice, but it is time-consuming and labor-intensive. Moreover, the results rely heavily on the doctor's experience, and the repeatability is poor. Therefore, the accurate and automatic measurement methods of proximal femoral parameters are of great value. We collected 300 cases of clinical CT data of the femur. We introduced the adaptive function adjustment module to the neural network PointNet++ to strengthen the global feature extraction of the point cloud for improving the accuracy of femur segmentation. We used the improved PointNet++ network to segment the femur into three parts: femoral head, femoral neck, and femoral shaft. We evaluated the segmentation accracy using Dice Coefficient, MIoU, recall, and precision indicators. We achieved the automatic measurement of the proximal femoral parameters using the shape fitting algorithms, and compared the automatic and manual measurement results. The Dice, MIoU, recall and precision indicator of the improved segmentation algorithm reached 98.05%, 96.55%, 96.63%, and 96.03%, respectively. The comparison between automatic and manual measurement results showed that the mean accuracies of all parameters were above 95%, the mean errors were less than 5mm and 3°, and the ICC values were more than 0.8, indicating that the automatic measurement results were accurate. Our improved PointNet++ network provided high-precision segmentation of the femur. We further completed automatic measurement of the femur parameters and verified its high accuracy. This method is of great value for the diagnosis and preoperative planning of hip diseases.

Relationships are the key to a successful publicly funded homebirth program, a qualitative study

BackgroundIn Australia, publicly-funded homebirth is a relatively new option for women and their families. Two years after the inception of two publicly funded homebirth services in Victoria in 2009, a study found that midwives’ experiences were more positive than doctors. There is no recent evidence on the perspectives of midwives and doctors of publicly-funded homebirth programs. AimTo explore the experiences of midwives and doctors participating in or supporting one publicly-funded homebirth program in Australia. MethodsAn interpretive descriptive approach was used following individual in-depth interviews via ‘Zoom’. Participants included midwives and doctors who provide or support the homebirth service at a large metropolitan health service in Melbourne’s western suburbs. Data were thematically analysed. FindingsInterviews were conducted with 16 homebirth midwives, six hospital-based midwives, and nine doctors. One central theme and three sub-themes demonstrate that effective relationships are critical to a successful publicly-funded homebirth program. Collaboration, teamwork, and mutual respect across professions were reported to be integral to success. The midwife-woman relationship was highly valued and especially important to provide continuity during transfers to the hospital where this occurred. DiscussionEffective relationships underpin collaborative practice and are critical for safe healthcare. Shared common learning opportunities such as simulation training sessions and multi-professional forums to discuss cases were perceived to assist the development of these relationships. ConclusionEffective relationships within and between midwives and doctors are key to collaborative practice, which underpins a successful publicly-funded homebirth service. Health services can support this by maintaining a respectful and supportive culture amongst staff.

Care coordination: an analysis based on the experiences of primary care doctors

Resumo O objetivo é analisar a experiência de médicos da Atenção Primária à Saúde (APS) sobre conhecimento, uso e reflexões para melhoria da coordenação do cuidado. Foi realizado estudo transversal com utilização do COORDENA-BR com médicos da APS, em Niterói/RJ/BR. Os profissionais reconheciam a importância da coordenação, ainda que não ocorresse, e confiavam nas habilidades clínicas dos médicos da Atenção Especializada (AE). Não havia indicação de seguimento e reconhecimento da centralidade da APS pelos pares da AE. O envio da referência, o recebimento do resumo de alta hospitalar e o uso de protocolos foram recorrentes, o recebimento da contrarreferência não. Não eram realizadas sessões clínicas compartilhadas e os médicos da APS não consultavam os especialistas para esclarecimento de dúvidas. Os resultados expressam a insuficiência de condições tecnológicas, organizacionais e de valores para que a APS assuma a coordenação do cuidado no SUS.

Development of intelligent acupuncture applications and related technologies

The study focuses on developing mobile applications based on intelligent acupuncture, classified into education and intelligent diagnosis and treatment. The mobile application function is divided into two directions: assisting acupoint positioning and perfecting acupoint knowledge system. The study does a relative review on Android and IOS, showing that the number of Android users is rather more prevailing than IOS. It suggests that intelligent acupuncture mobile applications should comply with the trend of acupuncture globalization in the future, developing multilingual versions. Further, the content should be characterized by the experience of different famous doctors to avoid homogenization. Technically, intelligent applications should continue to develop three-dimensional and augmented reality technology, to optimize the accuracy of acupoint positioning.

Three-Stream Convolutional Neural Network for Depression Detection With Ocular Imaging.

Depression is a prevalent and severe mental disorder that significantly affects both mind and body, leading to persistent feelings of sadness, despair, and impaired functionality. Diagnosis of depression primarily relies on clinical assessment and observation of symptoms. However, due to the lack of objective indicators, the experience and skills of doctor may lead to misdiagnosis. Current researches indicate that eye movement patterns and pupil dilation can serve as potential biomarkers for emotional and cognitive dysregulation in individuals with depression. However, most studies are based on manually extracted eye movement features, overlooking a significant portion of information available in ocular imaging. This paper proposes Three-Stream Convolutional Neural Network (TSCNN) for detecting depression, leveraging both spatio-temporal information of raw ocular imaging and paradigmatic semantic features. We suggest using optical flow with different sampling intervals to capture temporal features. In the third stream, we employ an encoder to learn semantic information from paradigm images and use it as prior knowledge. Finally, we utilize a fully connected network for classification, achieving an accuracy of 79.3% on our self-collected dataset. The proposed method may demonstrate significant clinical utility in the future.

Impact of SARS, H1N1, and COVID-19 on Medical Trainees' Academic and Personal Experience: A Systematic Search and Narrative Review.

The SARS-CoV-2 pandemic is a destabilizing experience for medical students and resident doctors and troubles their training in the hospital setting. This narrative review aims to identify the effect of health crises on the academic and personal lives of medical trainees and to develop solutions to support them. EducationSource, MedLine and PsychInfo were consulted on June 30th and December 16th, 2020 to identify the articles explaining the effect of SARS-CoV-1 (2002), A/H1N1 (2009) or SARS-CoV-2 (ongoing) on medical learners. Exclusion criteria included policy papers, letters to the editor or articles detailing the impact on undergraduate medical curricula, on nonmedical trainees, on the residency application process, or the physical impact of the disease. The quality of the selected papers was appraised using CASP for qualitative studies and NHLBI-NIH for cross-sectional studies. Ninety-four manuscripts were initially generated and 229, secondarily, of which respectively 14 and 16 were included in the final analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and reviewed qualitatively. It was found that the learners consider their education compromised by exam delays, the suspension of academic activities, and elective surgeries. Anxiety associated with this academic disruption developed. Burnout is exacerbated by the heightened workload. The main difference between the two searches was the long-term effect of COVID-19, including the opportunity for didactic innovation, the worry regarding professional identity formation and the development of mental health issues. The proposed solutions varied from continuous access to mental health resources to the follow-up of learners' well-being. It would be interesting to assess the impact of medical trainees' specialty and country's development on their experience with COVID-19.

Recontextualising "Doing a doctoral degree" as a social practice complex: Evidence from Malaysia

The current study is part of a longitudinal research project into the relationship between students’ ways of recontextualising their doctoral degree experience and eventual programme completion. Building on earlier findings reported in De Rycker (2014, 2022), the objective is to examine the hidden ontology of “doing a doctoral degree”. The primary data consist in structured interviews conducted with 20 doctoral students at the Universiti Malaya, Kuala Lumpur, Malaysia. Using Van Leeuwen’s (2008) socio-semantic model for the critical study of discourse, the analysis of the interviews produced two major empirical findings. First, doctoral students’ discourse is characterised by a strong sense of personal agency but also a lack of specificity and a simplification of the overall practice complex, in which doing research seems to be reduced to mere semiotic actions. Secondly, students construe “doing a doctoral degree” as a mystifying process replete with paradoxes. Further interpretative analysis suggests that semiotic action representations play a significant role as self-enhancing metonyms for “doing research”, helping students to demystify the academic practice and resolve some of its inherent contradictions. Implications for supervisory practice as well as the larger research project will be discussed.

Mitigating Ceiling Effects in a Longitudinal Study of Doctoral Engineering Student Stress and Persistence

Aim/Purpose: The research reported here aims to demonstrate a method by which novel applications of qualitative data in quantitative research can resolve ceiling effect tensions for educational and psychological research. Background: Self-report surveys and scales are essential to graduate education and social science research. Ceiling effects reflect the clustering of responses at the highest response categories resulting in non-linearity, a lack of variability which inhibits and distorts statistical analyses. Ceiling effects in stress reported by students can negatively impact the accuracy and utility of the resulting data. Methodology: A longitudinal sample example from graduate engineering students’ stress, open-ended critical events, and their early departure from doctoral study considerations demonstrate the utility and improved accuracy of adjusted stress measures to include open-ended critical event responses. Descriptive statistics are used to describe the ceiling effects in stress data and adjusted stress data. The longitudinal stress ratings were used to predict departure considerations in multilevel modeling ANCOVA analyses and demonstrate improved model predictiveness. Contribution: Combining qualitative data from open-ended responses with quantitative survey responses provides an opportunity to reduce ceiling effects and improve model performance in predicting graduate student persistence. Here, we present a method for adjusting stress scale responses by incorporating coded critical events based on the Taxonomy of Life Events, the application of this method in the analysis of stress responses in a longitudinal data set, and potential applications. Findings: The resulting process more effectively represents the doctoral student experience within statistical analyses. Stress and major life events significantly impact engineering doctoral students’ departure considerations. Recommendations for Practitioners: Graduate educators should be aware of students’ life events and assist students in managing graduate school expectations while maintaining progress toward their degree. Recommendation for Researchers: Integrating coded open-ended qualitative data into statistical models can increase the accuracy and representation of the lived student experience. The new approach improves the accuracy and presentation of students’ lived experiences by incorporating qualitative data into longitudinal analyses. The improvement assists researchers in correcting data with ceiling effects for use in longitudinal analyses. Impact on Society: The method described here provides a framework to systematically include open-ended qualitative data in which ceiling effects are present. Future Research: Future research should validate the coding process in similar samples and in samples of doctoral students in different fields and master’s students.

Doctoral: A smartphone-based decision support tool for the early detection of oral potentially malignant disorders.

Oral potentially malignant disorders can be defined as mucosal lesions and conditions with an increased risk of malignant transformation. Oral potentially malignant disorders are a significant health burden, and they are often diagnosed late due to scant attention to routine dental practice and the low number of specialized oral medicine centres. This report summarizes the DoctOral experience, a research initiative, providing a free smartphone-based decision support tool for the general medical/dental practitioner; the tool is based on the clinical appearance of oral lesions. Captured, oral pictures can be immediately examined via interactive decision trees and constructed on the smartphone. Such decision trees are expressed in standard formats, and they are readily accessible for facilitating the completion of a hypothetical diagnostic path. Since October 2017 the DoctOral mobile app has been downloaded by 10K + users, achieving a score of 4.8 out of 5. DoctOral also supports an unfolding joint initiative, called DoctOralAI: this involves selecting reference images, with which to create an open-source model, and perform a Case-Based Reasoning method, both of which are combined with machine learning. The DoctOral mobile app has revolutionized oral pathology by providing dental students and professionals with an interactive platform for recognizing and diagnosing oral lesions.

Trải nghiệm của người bệnh điều trị nội trú tại một số khoa lâm sàng, bệnh viện 198 Bộ Công an năm 2022

Patient experience is one of the key dimensions of patient-centered care and is consistently linked to patient safety and healthcare quality. Objectives: This study aimed to describe the patients’ experience among inpatients at some clinical departments at 19-8 Hospital - Ministry of Public Security, in 2022. Methods: A cross-sectional study was conducted by using the patient experience tool from the American Agency for Health Quality Research (AHQR). Quantitative research was carried out on 252 inpatients at 10 clinical departments at 19-8 Hospital - Ministry of Public Security. Results: The study showed that the overall positive patients’ experience among inpatients at 10 clinical departments was 82.5%. In which, the positive patients’ experience of doctor's care was the highest proportion (96.9%), followed by the hospital environment (94.1%); nursing care (93.5%); explaining the drug side-effects (57.3%); providing information for inpatients before discharging from the hospital (79.8%); asking about the patients’ needs and supports after discharging from the hospital (55.2%). Conclusion: To improve the positive patients’ experiences, healthcare workers need to strengthen the explanation and counseling of patients, especially regarding drug information. Moreover, to identify the patient's needs after discharge from the hospital, as well as provide information on medical issues that could support patients and their families. Keywords: Patient experience, inpatient, hospital, 198 Hospital- Ministry of Public Security.

Towards a Conflict Period Theory of adolescents’ addictive behaviours

ABSTRACT The Conflict Period Theory (CPT), based on the author’s doctoral fieldwork experiences, intends to analyze addictive behaviors related to alcohol consumption by Indian adolescents. The CPT has four postulates: (i) Positive expectancies influence experimentations with alcohol, (ii) Subjective norms build a defense mechanism against experimentation, (iii) Experimentation with positive expectancies and defense mechanism based on subjective norms produces an inner conflict or dilemma, (iv) This conflict springs with the initiation of alcohol use, fluctuates as the using stages upgrade and stabilizes at a low by reaching the dependency stage. Once the dependency stage is reached, the user finds it challenging to quit the alcohol use, as intrapsychic conflict stops rendering the opportunity for self-regulation of behavior.

Australian and New Zealand doctors' experiences of disciplinary notifications, investigations, proceedings and interventions relating to alleged mental health impairment: a qualitative analysis of interviews

When poor mental health impairs a doctor's ability to safely practise medicine, poor patient outcomes can result. Medical regulators play a critical role in protecting the public from impaired doctors, by requiring monitoring and treatment. However, regulatory processes may paradoxically harm doctors, with potential adverse implications for the community. There is little prior research examining the experiences of doctors with prior mental health or substance use challenges who are subject to regulatory notifications and processes relating to their health. Therefore, we explored this issue through the thematic analysis of semi-structured qualitative interviews. Participants reported that mandated treatment improved aspects of their health, but that fear of regulatory processes delayed them seeking treatment. Participants recognised being significantly unwell at the time of regulatory notification. Participants told us that regulatory processes triggered psychological distress, symptom relapse, and adverse financial and vocational implications. They also told us that these processes eroded their trust in regulators and regulatory processes. To improve health outcomes for unwell doctors and to create safer healthcare for the community, we propose: 1) greater awareness and education of the medical profession about the thresholds and requirements for mandatory reporting of health impairment; 2) better integrating specialised doctors' health services into existing regulatory pathways; and 3) adoption of a more therapeutic approach to regulation by medical regulators.

Vaccination in aged patients: breaking barriers. The impact of educational programs

Background. Prevention of the diseases is the cornerstone of medicine. Preventing of the diseases improves the quality and life expectancy, and also reduces the costs for the diagnosis and treatment of diseases. The main preventive measures include maintaining a healthy lifestyle (proper nutrition and regular exercise) and vaccination. Purpose: to study the influence of distance learning programs on the knowledge of doctors about the vaccination. Materials and methods: a distance learning cycle of lectures was conducted on the vaccination of elderly patients. Before and after the course of lectures, an anonymous voluntary survey of the course participants was conducted. The questionnaires included questions for free completion, questions for assessing attitudes on a scale from 0 to 10 (where 0 strongly disagree and 10 strongly agree) and multiple choices questions. Physicians were informed before the survey that the data would be subsequently analyzed and published. Results: 556 people took part in the first stage of the survey, of which 469 (84.3%) were women. 328 people took part in the second stage of the survey, of which 271 (82.6%) were women. The experience of doctors was on average 27±11,8 years, specialists from 72 specialties took part. Before the course of the lecture, on average, the opinion of doctors on vaccination was 8.7±0.1 out of 10, after the course of the lecture it became 9.1±0.1 out of 10 (p < 0.05). Before the start of the course, on average, doctors assessed their knowledge at 6.9±0.1, after the end of the course 7.7±0.1 (p < 0.05). After a course of lectures, 95% of the respondents answered that they would recommend vaccination to their older patients and relatives. Conclusion: on-line learning course of lectures has been shown to be an effective method of improving the quality of doctors' knowledge about the importance and safety of vaccination of people of older and senile age.

Dissertation Writing During COVID-19: Student Anxiety and Productivity

Many students across all levels of education experienced disruptions due to stay-at-home orders as part of the response to the COVID-19 pandemic. The purpose of our qualitative study was to specifically explore the doctoral student experience managing the writing of a dissertation amid stay-at-home orders during COVID-19. The majority of participants reported experiencing anxiety more frequently during stay-at-home orders and more productivity before stay-at-home orders. Reasons for decreased productivity during stay-at-home orders included reduced motivation, distractions, and lack of access to outside services and support.

Evaluation of the Degree of Interventional Embolization by Measuring Local Arterial Blood Pressure

Embolization is a common treatment method for tumor targeting, antiorgan hyperfunction, as well as hemostasis. However, the injection of embolic agents largely depends on the experiences of doctors, and doctors need to work in an X-ray environment that hurts their health. Furthermore, even for a well-trained doctor, complications, such as ectopic embolism caused by excessive embolic agents, are always inevitable. This article proposes a method for quantitatively evaluating the degree of interventional embolization by using local arterial blood pressure. Flow simulation and in vitro experiments were conducted in which the end vascular network was treated as porous media and simulated by sponges. The results show that local blood pressure is strongly related to the degree of embolism. This relationship was also confirmed by an animal experiment in which the renal artery of a pig was embolized. The feasibility of this method in clinical surgery is discussed. It is concluded that local arterial blood pressure can be used as a criterion for judging the degree of embolization, especially in determining the endpoint of embolization.

Constructing a Multilevel Modeling to High-Resolution CT (HRCT) Lung in Patients with COVID-19 Infection

The coronavirus disease, also called COVID-19 is caused by the SARS-CoV-2 virus. Most the people contaminated with the virus will experience mild to moderate symptoms of respiratory diseases. The aim of this paper is constructing a model by multilevel modeling for these patients who sufferers by coronaviruses, we got seven hospitals which totals (636) patients in private and public that 27% from Erbil, 26% from Sulaimani, 23% from Duhok and 24% from Halabja from the period (September 1th, 2019 to February 1th, 2022). In these modelling of multilevel restricted maximum likelihood estimation (RMLE) and full maximum likelihood (FML) acclimate estimate the parameters of multilevel models (fixed and random). The application was on the HRCT lungs of patients, seven hospitals were selected randomly among the county in Kurdistan region of Iraq. The result shows that all three variables are significant at the hospital level, but in the two final models add level-2 predictor (Doctor Experience) that interaction with level-1 predictor (smoker), which is far from significant. However, there is a significant relationship between being a diabetic and having a CT scan, but the relationship between smoking and having a CT scan is not significant.

Qualitative study to explore UK medical students’ and junior doctors’ experiences of occupational stress and mental health during the COVID-19 pandemic

ObjectivesThis qualitative study aimed to explore the occupational experiences of medical students and junior doctors working during the COVID-19 pandemic. In particular, the research sought to identify factors which mediated...

Academic Acculturation of International Doctoral Students in the U.S.: A Qualitative Inquiry

The aim of this phenomenological inquiry is to explore the academic acculturation experiences of international kinesiology professionals during their doctoral programs in higher education institutions in the U.S. Purposive sampling technique was used which include six study participants. The data collected from a demographic questionnaire and a focused interview. Using acculturation theory as a conceptual framework, the subjects' academic acculturation as former international PhD students were described. There are three subthemes: (1) graduate program and requirements, (2) the academic environment of graduate program, and (3) professional development for a career in kinesiology. Findings are discussed in light of academic acculturation with a focus on assimilation (proactive adaptation in a new environment), and integration (flexibly to embrace the life experiences, learning experiences, and current experiences of the students in a new context). Particularly, findings examine how international kinesiology professionals perceived their doctoral degree experiences and sustained academic acculturation, pertaining to research and professional development at their programs. Exploring the academic acculturation of international PhD students is crucial for diversity awareness in higher education in the U.S. Often described as a minority with a narrower status, these international students undergoing academic acculturation should be assisted with aligning to their contextual frames, in terms of degree level and its characteristics in their field of study.

Geographical views in traditional Chinese medicine

Interdisciplinary integration is a major feature of current scientific and technological development and also an inherent demand of economic and social development. The classic works in traditional Chinese medicine(TCM), such as Huangdi's Internal Classic(Huang Di Nei Jing) and Shennong's Classic of Materia Medica(Shen Nong Ben Cao Jing), contain rich and distinctive geographic ideas about the origin of Chinese medicine and prescriptions. There are many TCM schools and the distribution of each school has obvious geographical characteristics. The difference in geographical space is a major factor causing the difference in schools. There have been records of drugs and places of origin in previous documents of the Han Dynasty. Many drug names in Shennong's Classic of Materia Medica begin with ancient country names or ancient place names, indicating that the compilers attached great importance to the relationship between drugs and places of origin. Doctors in the Tang Dynasty have realized that the quality of medicinal materials was closely related to the place of origin, and each place of origin had herbalists to support the harvesting. The national yearly harvested drugs were all distributed with the places of origin. In the Song Dynasty, there were more records about the origin of drugs than in the Tang Dynasty, and the drawings attached to the Materia Medica Arranged According to Pattern(Zheng Lei Ben Cao) were titled with the names of the origins. In the Jin and Yuan dynasties, the literature on Chinese materia medica inherited the relationship between the origin and quality of drugs and contained rich geographical views in the "medication method". In the Ming Dynasty, the literature on Chinese materia medica was the first to clearly label the Daodi origin, and recognized the differences in quality and application of drugs between different origins. In the Qing Dynasty, doctors realized that there were variations and differences in the origins of drugs used by doctors in different periods, and the problem of origin was one of the reasons for the ineffectiveness of drugs. During the period of the Republic of China, doctors also paid great attention to the relationship between the origin of drugs and the quality of drugs, and the changes in the origin of drugs. TCM and geography share a common philosophical foundation. To inherit and develop the experience of doctors in the past dynasties on the relationship between drugs and origins, it is necessary to combine "Chinese materia medica" with "geography" to carry out the research on the geography of Chinese medicine, conduct multidisciplinary integration, build a new way to inherit and innovate the essence of TCM, promote the connection between philosophy of Yi, medical science, pharmacology, and geography, better serve the production practice of TCM, and promote the solution of problems related to the development of the Chinese medicine industry.