Medical Institutions Research Articles

Assessing public health service capability of primary healthcare personnel: a large-scale survey in Henan Province, China

BackgroundThe public health service capability of primary healthcare personnel directly affects the utilization and delivery of health services, and is influenced by various factors. This study aimed to examine the status, factors, and urban-rural differences of public health service capability among primary healthcare personnel, and provided suggestions for improvement.MethodsWe used cluster sampling to survey 11,925 primary healthcare personnel in 18 regions of Henan Province from 20th to March 31, 2023. Data encompassing demographics and public health service capabilities, including health lifestyle guidance, chronic disease management, health management of special populations, and vaccination services. Multivariable regression analysis was employed to investigate influencing factors. Propensity Score Matching (PSM) quantified urban-rural differences.ResultsThe total score of public health service capability was 80.17 points. Chronic disease management capability scored the lowest, only 19.60. Gender, education level, average monthly salary, professional title, health status, employment form, work unit type, category of practicing (assistant) physician significantly influenced the public health service capability (all P < 0.05). PSM analysis revealed rural primary healthcare personnel had higher public health service capability scores than urban ones.ConclusionsThe public health service capability of primary healthcare personnel in Henan Province was relatively high, but chronic disease management required improvement. Additionally, implementing effective training methods for different subgroups, and improving the service capability of primary medical and health institutions were positive measures.

Retrospective analysis of diagnosis and treatment of tuberculosis in designated medical institutions in China from 2017 to 2022

Objective: To understand the status of tuberculosis diagnosis and treatment capacity and the development and changes of tuberculosis diagnosis and treatment in provincial and municipal designated medical institutions in China from 2017 to 2022, so as to provide a basis for the formulation of relevant policies for the improvement and development of designated medical institutions for tuberculosis and the tuberculosis prevention and treatment service system, and to provide reasonable support for further strengthening the capacity of designated medical institutions for tuberculosis. Methods: This study was initiated and carried out by Beijing Chest Hospital affiliated to Capital Medical University/Clinical Center for Tuberculosis Prevention and Control of China CDC (hereinafter referred to as "Clinical Center") by means of questionnaire survey, and the investigation was carried out from March to November 2023. During this period, the clinical center distributed questionnaires to the hospital member units of "Beijing Tuberculosis Diagnosis and Treatment Technology Innovation Alliance", retrospectively collected their tuberculosis-related diagnosis and treatment data from 2017 to 2022, and used descriptive statistical methods to analyze the number of tuberculosis beds, outpatients and hospitalizations in medical institutions. The results were expressed in absolute numbers (percentages), and three-line tables, bar charts and line charts were drawn to describe the analysis results and changing trends. Results: The 54 medical institutions surveyed in this survey included 21 provincial-level designated medical institutions and 33 prefecture-level designated medical institutions. Most medical institutions have set up clinical departments, auxiliary departments and functional departments to undertake public health tasks of infectious diseases. The tuberculosis laboratory in the hospital has a comprehensive ability and has the detection technology needed for most tuberculosis diagnosis; The number of tuberculosis beds, children's tuberculosis beds and ICU beds all showed an increasing trend from 2017 to 2022. The proportion of tuberculosis beds in the hospital decreased slightly, from 39.31% in 2017 to 34.76% in 2022, showing a slight downward trend. Compared with the hospital surveyed, the number of tuberculosis outpatients in 2019 was 562 029, and the number of outpatients in 2020-2022 was 462 328, 519 630 and 424 069 respectively, which was significantly lower than that in 2019. The number of tuberculosis outpatients in medical institutions decreased significantly from 2020 to 2022. By analyzing the proportion of patients with different types of tuberculosis, the proportion of sensitive tuberculosis outpatients in 2017-2022 decreased from 84.49% in 2017 to 78.05% in 2022, showing a downward trend year by year. The proportion of patients with multidrug-resistant/ rifampin-resistant tuberculosis increased from 2.03% in 2017 to 7.18% in 2022. From 2017 to 2019, the total number of inpatients with tuberculosis showed an upward trend. Compared with 2019, the number of inpatients in 2020, 2021 and 2022 showed a downward trend, and the decline in 2020 was large (down 14.94% compared with 2019). Among the inpatients, the absolute number and proportion of patients with sensitive pulmonary tuberculosis remained relatively stable, and the number and proportion of inpatients with multidrug-resistant/rifampin-resistant pulmonary tuberculosis increased year by year. Conclusions: Most medical institutions have the capacity to carry out routine diagnosis and treatment of tuberculosis, but the public health function needs to be strengthened. The transformation of medical institutions requires proper guidance and adequate support. During 2019-2022, most medical institutions were affected by the COVID-19 epidemic, and their tuberculosis diagnosis and treatment work also changed to varying degrees. During this period, hospitals took various measures to overcome difficulties and tried their best to maintain the normal development of tuberculosis diagnosis and treatment, and the tuberculosis diagnosis and treatment work of various institutions gradually resumed in 2022.

Application of autogenous dentinal block to increase alveolar bone volume: a clinical case

Introduction. Materials based on extracted teeth in various studies have been radiographically and histologically proven to be effective in osteoplastic operations. These materials can be used in the form of crushed dentin matrix, a fragment of the tooth’s root and an autogenous dentin block. The purpose of this clinical case was to evaluate the effectiveness of using an autogenous dentin block to increase the alveolar process of the jaws in the preimplantation period.Description of a clinical case. Patient F., 30 years old, applied to the clinic of the Clinical Center of Maxillofacial, Plastic Surgery and Dentistry Russian University of Medicine with a complaint of a missing tooth in the frontal region of the lower jaw. At the time of treatment, the patient was already undergoing orthodontic treatment in another medical institution in Moscow. The patient underwent a clinical and radiological examination together with a prosthodontst. A diagnosis of «partial secondary adentia», «atrophy of the alveolar ridge in the frontal part of the lower jaw» and «dystopia of teeth 1.8, 2.8, 3.8, 4.8» was established. A comprehensive treatment plan has been drawn up. At the first stage, the patient underwent extraction of teeth 1.8, 2.8, 3.8, 4.8 for orthodontic indications with simultaneous bone grafting of the alveolar ridge in the area of the missing tooth 3.1. At the second stage, the patient underwent a trephine biopsy in the area of augmentation and installation of a dental implant in the area of missing tooth 3.1. The third stage was rational prosthodontic treatment on a dental implant in the department of prosthodontics.Results. The present study showed that autogenous dentinal block can serve as an alternative material for alveolar ridge augmentation.

Proposing the Community Triad Model to action social accountability in medical schools

This article is the third in a series exploring drivers of social accountability (SA) in medical schools across Canada. Findings from the two previous articles have highlighted a central relationship between community, students, and faculty at medical schools, and led to the emergence of a new social accountability model– the Community Triad Model (CTM). The CTM proposes an interconnectedness between community, students, faculty, and the broader institution, and the pathways through which community-based learning directly and indirectly influences decision-making in medical institutions. This article explores the relationships between the three arms of the CTM by examining the literature on community engagement and SA, as well as by revisiting popular models and foundational SA reports to garner insights into authentic community engagement in health professions education. While there is an abundance of literature demonstrating the impact of community placements on students, there are limited studies describing the influence of communities on faculty and the broader institution either directly, or indirectly via students. The authors recommend that institutions be more intentional in engaging students and faculty, and learn from their experiences with community to shape curriculum, practices, policies, and culture of the broader institution. This study offers an operational model of SA that is easy to adopt and implement. It intends to demonstrate how the components of the triad (students, faculty/leadership, community) function together in the community engagement and social accountability of medical schools.

Quantitative Analysis of Epicardial Adipose Tissue: 120K Shades of Heart

Background: Epicardial adipose tissue (EAT) is the fat deposited between the myocardium and epicardium. Due to its unique anatomical position, EAT has both protective and harmful effects on the heart, influencing conditions such as coronary artery disease, atrial fibrillation, and heart failure. This study aimed to quantify the amount of EAT by analyzing the color shades of the heart's anterior surface during coronary artery bypass grafting (CABG) procedures. Objective: To assess the number of color shades in different sub-regions of the heart and quantify EAT using real-time 2D images captured during CABG procedures, and to correlate these findings with clinical conditions and risk factors. Methods: The study was conducted at Rehman Medical Institute, Peshawar, from October 2023 to April 2024. Images were captured using an iPhone 11 with a 12-megapixel camera during CABG procedures, specifically before cannulation, after opening the pericardium, and tucking the pericardium to the skin on a beating heart. Photographs were taken at a 90-degree angle and one-foot distance during systole, including surrounding tissues and a self-retaining retractor with a ruler for measurement reference. The images from three patients were processed to form the "HEART ANTERIOR VIEW THROUGH STERNOTOMY (HATS)" dataset. The data were cleaned and standardized for consistency. The surgical team annotated and labeled the images using the LabelMe tool, identifying the full heart region and its sub-regions: Aorta, Right Ventricle (RV) Myocardium, RV and Pulmonary Artery (PA) Epicardial Fat, and Right Atrium (RA) Appendage. Image segmentation techniques isolated the heart region and identified fat deposits. The total area of fat on the anterior surface of RV, PA, and RA was quantified using appropriate algorithms. Pixel analysis was conducted to determine the color shades, with each pixel having three color channels (Red, Green, Blue) and 256 intensity values per channel. Results: The total pixel count for the full image (heart and surrounding region) was 1600x1200 for Patient 1, 480x624 for Patient 2, and 480x848 for Patient 3. The heart regions contained 218,864 pixels (Patient 1), 44,020 pixels (Patient 2), and 77,919 pixels (Patient 3). The EAT areas were found to be 158,213 pixels (Patient 1), 35,608 pixels (Patient 2), and 52,723 pixels (Patient 3). The percentage areas of the sub-regions varied, with RV and PA Epicardial Fat comprising 72.3%, 80.9%, and 67.7% of the heart regions for Patients 1, 2, and 3, respectively. The top 100 color shades were identified, with unique colors in the Aorta (23,323), Appendage (7,030), Epicardial Fat (80,257), and Myocardium (10,131). Conclusion: The study demonstrated that EAT and the color shades of heart sub-regions could be accurately quantified using advanced imaging and computational techniques. These findings provide valuable insights into the correlation between EAT and cardiac risk factors, enhancing the ability to predict postoperative morbidity and mortality and enabling early interventions to improve patient outcomes.

On Seeing Long Shadows: Is Academic Medicine at its Core a Practice of Racial Oppression?

Suggestions that academic medicine is systemically racist are increasingly common in the medical literature. Such suggestions often rely upon expansive notions of systemic racism that are deeply controversial. The author argues for an empirical concept of systemic racism and offers a counter argument to a recent suggestion that academic medicine is systemically racist in its treatment of medical trainees: Anderson et al.'s(Academic Medicine, 98(8S), S28-S36, 2023) "The Long Shadow: a Historical Perspective on Racism in Medical Education." Contra the authors of "The Long Shadow," the author argues that racial performance disparities in medical education cannot be validly attributed to racism without careful empirical confirmation; he further argues that standards of assessment in medical education cannot be properly deemed racist merely because minority trainees are disproportionately disadvantaged by them. Furthermore, the history of medicine and society in the Anglo-European West is not, as argued by the authors of "The Long Shadow," best viewed as one long tale of racial oppression culminating in the present day pervasive racism of academic medicine in the United States. Racism is a deplorable stain on our history and our present but it is not the historical essence of Christianity, European civilization, Western medicine, or contemporary academic medical institutions.

Internet of Medical Things (IoMT) optimization for healthcare: A deep learning-based interference avoidance model

The Internet of Medical Things (IoMT) is a significant component of the broader Internet of Things (IoT), IoMT is responsible for monitoring, collecting, and transmitting critical medical data to central medical computer centers. IoMT faces significant challenges, including energy efficiency, interference from other devices in the spectrum, latency, and security and privacy concerns. As a result, in hospital settings, the development of a precise and dependable IoMT system is crucial. Consequently, this investigation offered an innovative, accurate, and dependable IoMT method. The suggested model intends to reduce or eliminate interference caused by other transmitting devices sharing the same IoMT spectrum within hospitals or medical institutions. It also presents an interference-avoidance distributed deep learning model for IoMT to medical receptionists. This model uses data from the Lagrange optimization technique to determine the ideal distance between interfering devices and medical receptions. As a result, the required system signal-to-interference-plus-noise (SINRth) is met while maintaining the highest energy efficiency (EE) and system achievable data rate (R). The proposed analytical model and deep learning model demonstrate the efficacy of the proposed approach by achieving the required system signal-to-interference-plus-noise (SINRth) with the best energy efficiency (EE) and system achievable data rate (R) while suppressing interference to any medical receptions.

Rational or altruistic: the impact of social media information exposure on Chinese youth’s willingness to donate blood

BackgroundNon-remunerated blood donation is the main approach for various medical institutions to get the source of blood supply, but the blood supply shortage is still a problem in today’s society. Social media has become the main approach of information acquisition for youth groups nowadays, and the information on social media will have an impact on people’s behavioral decisions. The objective of this study was therefore to investigate the correlation between social media exposure to relevant information about blood donation and the willingness of youths to donate blood.MethodsWe collected data from 455 questionnaires through an online questionnaire and structural equation modeling was constructed for validation. Data were analyzed for reliability, validity, and demographic differences using IBM-SPSS 26.0, and IBM-SPSS-AMOS 26.0 was used for model fit analysis and path analysis.ResultsThe results of the study showed that there was a positive correlation between social media exposure to relevant blood donation information and willingness to donate blood (β = 0.262, p &amp;lt; 0.001), altruism (β = 0.203, p &amp;lt; 0.001) and self-efficacy (β = 0.170, p &amp;lt; 0.001). While there was also a positive correlation between attitude toward blood donation and self-efficacy (β = 0.560, p &amp;lt; 0.001), there was no positive correlation between it and willingness to donate blood (β = −0.180, p = 0.786). There was also a positive correlation between altruism and willingness to donate blood (β = 0.150, p &amp;lt; 0.05) and attitude toward blood donation (β = 0.150, p &amp;lt; 0.001). Similarly, there was a positive correlation between self-efficacy and willingness to donate blood (β = 0.371, p &amp;lt; 0.001).ConclusionExposure to more information related to blood donation on social media can increase the willingness of the youth population to donate blood, while exposure to information related to altruism and self-efficacy on social media can also enhance young people’s attitudes toward blood donation, while further strengthening their willingness to donate.

Method for Detecting Pathology of Internal Organs Using Bioelectrography

This article considers the possibility of using the bioelectrography method to identify the pathology of internal organs. It is shown that with the currently existing methods, there is no possibility of the automatic detection of diseases or abnormalities in the functioning of a particular organ, or of the definition of combined pathology. It has been revealed that the use of various classifiers makes it possible to expand the field of pathology and choose the most optimal method for determining a particular disease. Based on this, a method for detecting the pathology of internal organs is developed, as well as a software package that allows the detection of diseases of the internal organs based on the bioelectrography results. Machine-learning models such as logistic regression, decision tree, random forest, xgboost, KNN, SVM and HyperTab are used for this purpose. HyperTab, logistic regression and xgboost turn out to be the best among them for this task, achieving a performance according to the f1-score metric in the order of 60–70%. The use of the developed method will, in practice, allow us to switch to combining various machine-learning models for the identification of certain diseases, as well as for the identification of combined pathology, which will help solve the problem of detecting pathology during screening studies and lead to a reduction in the burden on the staff of medical institutions.

Genomic and spatial analysis reveal the transmission dynamics of tuberculosis in areas with high incidence of Zhejiang, China: A prospective cohort study

In the mountainous, rural regions of eastern China, tuberculosis (TB) remains a formidable challenge; however, the long-term molecular epidemiological surveillance in these regions is limited. This study aimed to investigate molecular and spatial epidemiology of TB in two mountainous, rural counties of Zhejiang Province, China, from 2015 to 2021, to elucidate the recent transmission and drug-resistance profiles. The predominant Lineage 2 (L2) Beijing family accounted for 80.1% of total 532 sequenced Mycobacterium tuberculosis (Mtb) strains, showing consistent prevalence over seven years. Gene mutations associated with drug resistance were identified in 19.4% (103/532) of strains, including 47 rifampicin or isoniazid-resistant strains, eight multi-drug-resistant (MDR) strains, and five pre-extensively drug-resistant (pre-XDR) strains. Genomic clustering revealed 53 distinct clusters with an overall transmission clustering rate of 23.9% (127/532). Patients with a history of retreatment and those infected with L2 strains had a higher risk of recent transmission. Spatial and epidemiological analysis unveiled significant transmission hotspots, especially in densely populated urban areas, involving various public places such as medical institutions, farmlands, markets, and cardrooms. The study emphasizes the pivotal role of Beijing strains and urban-based TB transmission in the western mountainous regions in Zhejiang, highlighting the urgent requirement for specific interventions to mitigate the impact of TB in these unique communities.

"Lord Knows What's Being Done with My Blood!": Black Women's Perceptions of Biospecimen Donation for Clinical Research in the United States.

Black women are underrepresented in clinical research and clinical trials. Knowledge gaps lead to biased clinical practice and care. There is a small but growing body of literature on Black women's perceptions about participation when biospecimen donation is sought by researchers. This is the first known study to investigate willingness to participate in clinical research involving biospecimen donation among Black women of reproductive age in the United States. This cross-sectional study recruited 496 Black women (ages 18-49) from a research crowdsourcing platform. Participants completed a 46-item online survey which asked about their willingness to provide blood samples for clinical health research and reasons for their willingness or for any unwillingness. Descriptive statistics and thematic analysis method were used to analyze the data. Less than half (44%) of participants reported willingness to provide blood samples for clinical research. The most common concerns of those expressing unwillingness to provide samples were "fear of blood sample being misused" and "distrust with the health researchers handling the samples." We identified six qualitative themes from the analysis of participants' open-ended responses. The most important factors include a desire for integrity and transparency in research, institutional racism contributing to mistrust, and adequate compensation and clearly defined benefits to participation. The recruitment and engagement of Black women in clinical biospecimen research should involve transparent, trustworthy, and anti-racist practices and informed respect for Black women's autonomy. There is a need to address Black women's concerns about exploitative profits and mistrust of academic and medical institutions.

TIMING OF THE STOMA REVERSAL, WHAT IS THE SAFE PERIOD?: A RETROSPECTIVE OBSERVATIONAL STUDY

Objective: The objective of the study is to determine the most suitable timing for the reversal of enteric stomas and to investigate the complications associated with the presence and reversal of stomas among different age groups and genders. Methods: This was a retrospective study conducted in the Department of General Surgery of a tertiary care medical institute. The institutional ethical committee approved the study. We reviewed the digitally recorded data of patients who had undergone both the creation and reversal of stomas at our institution over various time intervals spanning from January 2017 to December 2022. Beyond the electronically stored clinical data encompassing patient demographics, stoma type, and complications encountered between stoma insertion and reversal, we conducted a thorough review of the database containing information on outpatient follow-ups for a month. The gender and age distribution, indications for surgery, type of stoma, and its correlation with age and gender were analyzed. Duration from surgery to stoma reversal and complications were also analyzed. Categorical data were presented as frequency and percentage, whereas quantitative data were summarized using the mean and standard deviation. Closure of the stoma after surgery was compared based on age and sex, employing an independent t-test. Results: In this study 82 patients undergoing stoma surgery, 68.29% were male and 31.71% were female. The mean age of male and female patients was found to be 44.26 and 35.96 years, respectively. Males had a higher median duration for ileostomy and jejunostomy reversals at 14 and 17 weeks, respectively, whereas females showed longer durations for ileostomy at 15 weeks. Common indications for surgery included intestinal obstruction (32.9%) and peritonitis (20.7%). Post-stoma closure 50% of the patients experienced complications, with 24% occurring within 1 month of reversal. Major complications occurred in 41% of cases, including parastomal hernia and suspected anastomotic leaks. Minor complications were observed in 28 patients, representing 35% of all surgeries. Conclusion: Stoma reversal between 8 and 12 weeks post-surgery is recommended for minimizing complications and avoiding psychological burden. While early closure may reduce hospital stay, it increases the risk of infections. Optimal timing for stoma closure is complex, requiring personalized, collaborative decision-making.

The Safety of Outpatient Health Care : Review of Electronic Health Records.

Despite considerable emphasis on delivering safe care, substantial patient harm occurs. Although most care occurs in the outpatient setting, knowledge of outpatient adverse events (AEs) remains limited. To measure AEs in the outpatient setting. Retrospective review of the electronic health record (EHR). 11 outpatient sites in Massachusetts in 2018. 3103 patients who received outpatient care. Using a trigger method, nurse reviewers identified possible AEs and physicians adjudicated them, ranked severity, and assessed preventability. Generalized estimating equations were used to assess the association of having at least 1 AE with age, sex, race, and primary insurance. Variation in AE rates was analyzed across sites. The 3103 patients (mean age, 52 years) were more often female (59.8%), White (75.1%), English speakers (90.8%), and privately insured (70.4%) and had a mean of 4 outpatient encounters in 2018. Overall, 7.0% (95% CI, 4.6% to 9.3%) of patients had at least 1 AE (8.6 events per 100 patients annually). Adverse drug events were the most common AE (63.8%), followed by health care-associated infections (14.8%) and surgical or procedural events (14.2%). Severity was serious in 17.4% of AEs, life-threatening in 2.1%, and never fatal. Overall, 23.2% of AEs were preventable. Having at least 1 AE was less often associated with ages 18 to 44 years than with ages 65 to 84 years (standardized risk difference, -0.05 [CI, -0.09 to -0.02]) and more often associated with Black race than with Asian race (standardized risk difference, 0.09 [CI, 0.01 to 0.17]). Across study sites, 1.8% to 23.6% of patients had at least 1 AE and clinical category of AEs varied substantially. Retrospective EHR review may miss AEs. Outpatient harm was relatively common and often serious. Adverse drug events were most frequent. Rates were higher among older adults. Interventions to curtail outpatient harm are urgently needed. Controlled Risk Insurance Company and the Risk Management Foundation of the Harvard Medical Institutions.

Development of an assessment tool for designated medical institutions in China——Based on the application of an online assessment system

BackgroundDue to the expanding coverage of medical insurance and the growth of medical expenses, the ability to assess the performance of designated medical institutions (DMIs) in supporting the delivery of high-quality patient care and the standardized use of funds represents a priority in China. Despite such interest, there has yet to be an operable standard and labor-saving method for assessing DMIs in China.ObjectiveThe main objectives include two aspects: (1) establishing an evaluation index system for DMIs based on contracts; (2) designing and developing an online evaluation platform.MethodsA group of 20 experts with theoretical and practical expertise in medical insurance regulation and performance evaluation were invited to select available indicators. A combination weighting method based on analytic hierarchy process and entropy method was used to determine the weight coefficient. Shanghai was taken as the sample area, and 760 DMIs were included in the empirical research. The test-retest reliability method and criterion-related validity method was used to test the reliability and the validity of the evaluation result.ResultsAn assessment index system that included 6 domains and 56 indicators was established in this study. Furthermore, we developed an online platform to assist in the implementation of the assessment. The results showed that the average score of assessment was 94.39, the median was 96.92. The test-retest reliability value was 0.96 (P ≤ 0.01), which indicated high stability of the assessment. In addition, there was a significant negative relationship between assessment score and the penalty amount of DMIs (R = −0.133, P &amp;lt; 0.001). After adjusting for the basic characteristics of medical institutions, the number of visits and revenue, the negative relationship was still significant (B = −0.080, P &amp;lt; 0.05). These results are consistent with expectations, indicating that the assessment had good criterion-related validity.ConclusionsThis study established an operable assessment measure and developed an online platform to assess the performance of DMIs. The results showed good feasibility and reliability in empirical research. Our research findings provided an operable Chinese solution for DMI assessment that saves manpower and time, which would have good enlightening significance in other regions of China and in low-income and middle-income countries internationally.

Optimizing Doctor Availability and Appointment Allocation in Hospitals through Digital Technology and AI Integration

Many patients miss their appointments all around the world and many of them don't even cancel at all or don't do so in time due to several reasons. In order to address the widespread issue of medical no-shows, this paper proposes a solution that involves building a machine learning model utilizing patient datasets that are already available. This model will identify patterns and links between various patient factors and the patients' propensity to miss appointments. As a result, based on their information, it is possible to anticipate the chance of a patient appearing. Based on the Support Vector Machines classification technique, the machine learning model created the solution predictive model. Effective healthcare services are vital in today's fast-paced environment. This strategy aims to reduce the distance between patients and medical professionals by offering a workable and friendly solution. For certain medical institutions, such as clinics and hospitals, this initiative makes it easier for patients and customers to schedule doctor appointments online. Using this technology, patients may easily browse a database of doctors' biographies, specializations, and availability. Even the day and time of their choosing can be chosen for appointments. Each patient's appointment request will be scheduled by this doctor's appointment system and forwarded to the physician. The system administrator will update the list of doctors, including their specialties, personal information, and system access credentials. Patients will look for a physician who specializes in their requirements by exploring the doctor's appointment system online. Before making their request, the patient can browse the doctor's weekly schedule to choose a day and time that works best for them. Following that, the physicians have access to all of their appointments as well as the patients' appointment requests, which are prioritized according to their availability. It gives medical professionals a strong tool for successfully managing the schedules, which reduces administrative strain and ensures a positive patient experience.

Trends in the mobility of primary healthcare human resources in underdeveloped regions of western China from 2000 to 2021: Evidence from Nanning

ObjectiveThis research aimed to identify the fundamental and geographic characteristics of the primary healthcare personnel mobility in Nanning from 2000 to 2021 and clarify the determinants that affect their transition to non-primary healthcare institutions.MethodsThrough utilizing the Primary Healthcare Personnel Database (PHPD) for 2000–2021, the study conducts descriptive statistical analysis on demographic, economic, and professional aspects of healthcare personnel mobility across healthcare reform phases. Geographic Information Systems (QGIS) were used to map mobility patterns, and R software was employed to calculate spatial autocorrelation (Moran’s I). Logistic regression identified factors that influenced the transition to non-primary institutions.ResultsPrimary healthcare personnel mobility is divided into four phases: initial (2000–2008), turning point (2009–2011), rapid development (2012–2020), and decline (2021). The rapid development stage saw increased mobility with no spatial clustering in inflow and outflow. From 2016 to 2020, primary healthcare worker mobility reached its peak, in which the most significant movement occurred between township health centers and other institutions. Aside from their transition to primary medical institutions, the primary movement of grassroots health personnel predominantly directs towards secondary general hospitals, tertiary general hospitals, and secondary specialized hospitals. Since 2012, the number and mobility distance of primary healthcare workers have become noticeably larger and remained at a higher level from 2016 to 2020. The main migration of primary healthcare personnel occurred in their districts (counties). Key transition factors include gender, education, ethnicity, professional category, general practice registration, and administrative division.ConclusionsThis study provides evidence of the features of primary healthcare personnel mobility in the less developed western regions of China, in which Nanning was taken as a case study. It uncovers the factors that impact the flow of primary healthcare personnel to non-primary healthcare institutions. These findings are helpful to policy refinement and support the retention of primary healthcare workers.

A Scoping Review of Mental Health Needs and Challenges among Medical Students within South African Universities

A Scoping Review of Mental Health Needs and Challenges among Medical Students within South African Universities

Relationship between Illness Perception and the need for Professional Medical Interpretation for International Patients in Japan.

This study aimed to conduct a cross-sectional questionnaire survey of foreign patients to analyze the impact of patients' illness perceptions on their need for professional medical interpreters. From February 2022 to May 2023, an online questionnaire was distributed to 4,962 individuals aged 18 years or older who were non-native speakers of Japanese. These individuals were enrolled in organizations such as international exchange associations and Japanese language support classes and had utilized medical institutions in Japan due to their own illness or injury or that of their children. Among the 312 valid responses, international patients with a high score for illness perception were more likely to want to utilize professional medical interpreters than those with a low score for illness perception (odds ratio, 1.968; 95% confidence interval, 1.044-3.709; P = 0.036). Our findings suggest that hospitals should be better prepared to meet the potential language needs of international patients with a higher illness perception.

Microwave-assisted intralesional curettage combined with other adjuvant methods for treatment of Campanacci III giant cell tumor of bone in distal radius: a multicenter clinical study

ObjectiveTo compare the clinical outcomes of microwave-assisted intralesional curettage(MAIC) with those of en bloc resection and autogenous fibular reconstruction (EBR-AFR) for treating grade III giant cell tumor of the bone (GCTB) of the distal radius and to elucidate the indications for wrist preservation surgery.Materials and methodsIn this retrospective study, 19 patients with grade III GCTB of the distal radius who underwent surgery at three medical institutions were included and categorized based on their surgical pattern. Seven patients underwent MAIC and internal fixation with bone cement (MAIC group) and 12 underwent EBR-AFR (EBR-AFR group). To evaluate the function of the affected limb postoperatively, wrist range of motion, grip strength, Musculoskeletal Tumor Society (MSTS) scores were recorded.ResultsThe follow-up time of the MAIC group was 73.57 ± 28.61 (36–116) months, with no recurrence or lung metastasis. In contrast, the follow-up time of the EBR-AFR group was 55.67 ± 28.74 (36–132) months, with 1 case of local recurrence (8.3%, 1/12) and 1 case of lung metastasis (8.3%, 1/12). The wrist flexion, extension, supination, pronation, grip strength were better in the MAIC group than in the EBR-AFR group. Although there was no statistically significant difference in the MSTS score between the two groups, it is noteworthy that the MAIC group exhibited significantly superior emotional acceptance and hand positioning compared to the EBR-AFR group(p &amp;lt; 0.05).ConclusionThe functional outcomes of the MAIC group are better. The treatment strategy for grade III GCTB of the distal radius should be determined based on the specific preoperative imaging findings. Nevertheless, MAIC can be the preferred surgical approach for most patients with grade III GCTB of the distal radius, particularly for young patients.

Assessing Chaplaincy Ministry as a Christ-Woven Nest in Times of Disaster

The Chaplaincy Ministry is practised in most closed communities, such as uniformed forces, medical institutions, funeral homes, educational institutions and orphan and vulnerable communities. Its relevance in Zimbabwe has been critiqued as it has not been able to demonstrate itself as God’s presence during disasters such as cyclones. The displacement of people in Chimanimani and Chipinge communities in the Eastern side of Zimbabwe, the death of their relatives and the destruction of their properties brought some traumatic experiences that the Church was not able to deal with. Churches in Zimbabwe joined the government and civic organisations to provide humanitarian aid to the distressed communities but unfortunately missed the primary aim of the church journeying along with the distressed. This qualitative research paper argued that, unlike the government and civic organisations that give humanitarian aid and leave the devasted areas, the role of chaplaincy ministry was for the church to commit itself to the daily struggles of the traumatised populace. The paper challenged the churches in Zimbabwe to be like a Christ-woven nest that protects, provides, and prays for communities grappling with the omnipotence of God in times of disaster. The paper concluded by proffering a challenge to the church in Zimbabwe to either function as a centre of God’s presence in the shattered communities or be like a charity organisation in humanitarian aid alongside the non-governmental organisations and the government which is not her call. This paper contributes significantly to scholarship as there is limited literature on chaplaincy from an African genre and more importantly resources that define the role of the church in troubled communities. This paper provides a solution for churches struggling with the approach to take when disasters loom and people are questioning the omnipotence of God during a crisis. Keywords: Chaplaincy Ministry, Woven Nest, Disaster, Cyclone Idai