Medical Perspective Research Articles

Importance of Education in Radiation Safety During Medical School: A Medical Student's Perspective.

Importance of Education in Radiation Safety During Medical School: A Medical Student's Perspective.

Application of the international classification of functioning, disability, and health in autism and attention-deficit hyperactivity disorder: A scoping review.

The International Classification of Functioning, Disability, and Health (ICF) is a framework designed by the World Health Organization (WHO) to help different sectors, such as healthcare, social services, education, and policy, understand how people with health-related issues function (do the things they want to and need to do) in their daily lives. This framework has also been used to guide clinical practice and research in autism and attention-deficit hyperactivity disorder (ADHD). To make it more practical, shorter versions of the ICF called Core Sets have been developed. We wanted to explore how the ICF and the ICF Core Sets have been used in research relating to autism and ADHD. We looked at the research that had been previously published on this topic by conducting a systematic search and review. Seventy-eight studies meeting our criteria were included in our review. Results show that the ICF has been applied in many ways across various contexts. However, most of the research has focused on autism, mainly involving children. The review highlights that although the ICF was used in some studies, the underlying philosophies of the framework were not always followed. The medical perspective still influenced the way research was done and interpreted. Nevertheless, using the ICF in the right way can help shift research on neurodevelopmental conditions like autism and ADHD toward a more holistic approach, moving away from solely focusing on medical aspects.

AI-Enhanced ECG Applications in Cardiology: Comprehensive Insights from the Current Literature with a Focus on COVID-19 and Multiple Cardiovascular Conditions.

The application of artificial intelligence (AI) in electrocardiography is revolutionizing cardiology and providing essential insights into the consequences of the COVID-19 pandemic. This comprehensive review explores AI-enhanced ECG (AI-ECG) applications in risk prediction and diagnosis of heart diseases, with a dedicated chapter on COVID-19-related complications. Introductory concepts on AI and machine learning (ML) are explained to provide a foundational understanding for those seeking knowledge, supported by examples from the literature and current practices. We analyze AI and ML methods for arrhythmias, heart failure, pulmonary hypertension, mortality prediction, cardiomyopathy, mitral regurgitation, hypertension, pulmonary embolism, and myocardial infarction, comparing their effectiveness from both medical and AI perspectives. Special emphasis is placed on AI applications in COVID-19 and cardiology, including detailed comparisons of different methods, identifying the most suitable AI approaches for specific medical applications and analyzing their strengths, weaknesses, accuracy, clinical relevance, and key findings. Additionally, we explore AI's role in the emerging field of cardio-oncology, particularly in managing chemotherapy-induced cardiotoxicity and detecting cardiac masses. This comprehensive review serves as both an insightful guide and a call to action for further research and collaboration in the integration of AI in cardiology, aiming to enhance precision medicine and optimize clinical decision-making.

The curfew bell and the COVID-19 pandemic: A historical–medical perspective based on the Italian case

The present communication examines the phenomenon of curfew in relation to the COVID-19 pandemic with special attention being laid on the management of the epidemic by Italian health authorities. A literature review and a historical–medical analysis were performed. A historical–medical excursus on the word curfew is offered and a comparison between military and health scenarios is given. Finally, this article stresses how words connected with wartime events should be contextualized when adopted in unmilitary scenarios such as pandemic emergencies and related public health responses.

Assessment of national reimbursement anticancer medications availability in China: based on a medical institution perspective

BackgroundHigh clinical value national reimbursement anticancer medications (NRAMs) are pivotal treatments for patients with cancer. However, the availability of NRAMs in medical institutions is unknown. This study aimed to assess the availability of NRAMs in national and provincial medical institutions.MethodsThis cross-sectional study utilized national health insurance data to access the availability of NRAMs in national and provincial medical institutions. Further statistical analyses and visualizations were conducted in terms of medical institution level and daily cost. Using the Spearman’s rank correlation test (α = 0.05), we calculated the correlation between the availability rates of NRAMs and their negotiation access time, daily cost, per capita disposable income, provincial gross product, and number of policy releases.ResultsOverall, 81 NRAMs, with an average availability rate of approximately 1.01% nationwide, were included. There were significant differences between provinces for each drug, and the availability of NRAMs gradually decreased in tertiary (13.41%), secondary (1.58%), and primary medical institutions (< 0.05%). Differences were also observed in the availability rate of NRAMs in various daily drug cost ranges. Among the factors examined, negotiation access time (r1 = 0.425), daily cost (r2 = − 0.326), per capita disposable income (r3 = 0.645), provincial gross product (r4 = 0.433), and number of policy releases (r5 = 0.461) were all correlated with the availability of NRAMs.ConclusionsThe low availability of NRAMs in national and provincial medical institutions indicates that their willingness to equip NRAMs needs to be improved. All factors examined in this study affected the availability of NRAMs. Our findings can guide policymakers in improving relevant policies.

A comparison of written case notes and the delivery of care in dementia specialist mental health wards.

Introduction: Stigmatising language concerning people living with dementia can cause potentially harmful and dehumanising consequences. Language used about people living with dementia in mental health wards may focus on medical perspectives and suggest custodial relationships with patients rather than person-centred accounts of individuals. This language could have a devastating impact on the provision of person-centred care. This study investigated the relationship between accounts of people living with dementia written in healthcare case notes and clinical practice at three dementia specialist wards in Wales, UK. Language guidance was provided to ward staff to assess whether stigmatising language could be reduced and whether this influenced the provision of person-centred care.Methodology: Dementia Care Mapping was adapted to analyse case note entries for enhancing and detracting accounts of people living with dementia at three data collection points. These were compared to the results of routine DCM observations of care across the three wards. The healthcare case notes of 117 people living with dementia, encompassing 4, 522 entries over ten months were analysed. DCM observations of 38 people living with dementia within the three wards were compared against the case note results. Person-centred language guidance was shared with care staff following each data collection point.Results: Following the provision of person-centered language guidance, the use of personally enhancing language was observed to increase across all three wards. Non-person-centred case note entries predominantly focussed on Labelling language, whilst language concerning Invalidation and Objectification also occurred frequently compared to other DCM domains. Person centred language typically concerned Acknowledgement. A relationship between case note entries and practice was evident in some domains although findings were inconsistent.Discussion and Implications: The findings highlight the importance of addressing stigmatising language in healthcare and suggest that further studies to support the anti-stigma agenda in dementia care are required.

Postgraduate Year Two Medical Residents' Awareness of Personal Development as a Physician during the Management of Inpatients: A Qualitative Study.

Clinical experiences, helping relationships, and reflection are key factors for personal development for physicians. However, few studies have shown which experiences are important for personal growth and how medical residents specifically use their experiences for personal growth. The aim of this study was to identify from the medical residents' perspective which clinical experiences contribute to their personal development. We employed a qualitative design, conducting semi-structured interviews with ten postgraduate year two medical residents at a Japanese teaching hospital. The interviews were transcribed in interview memos, anonymized, and subjected to reflective thematic analysis to generate themes relevant to personal and professional development. Successful clinical experiences with autonomy and responsibility in clinical management were shown to be essential points for personal development as a physician. Autonomy in this study was the attitude of making one's own choices when managing patients. Responsibility was the obligation of the resident to take charge of a patient. Instructing junior trainees, appreciation received from patients, and approval granted by attending physicians reinforced their feelings of personal growth. The realization of what experiences and concepts influence medical residents' personal growth and development will make their professional development more effective.

Navigating the shadows: medical professionals' values and perspectives on end-of-life care within pediatric intensive care units in Croatia.

This study explores healthcare professionals' perspectives on end-of-life care in pediatric intensive care units (ICUs) in Croatia, aiming to illuminate their experiences with such practices, underlying attitudes, and major decision-making considerations. Amid the high variability, complexity, and emotional intensity of pediatric end-of-life decisions and practices, understanding these perspectives is crucial for improving care and policies. The study utilized a cross-sectional survey intended for physicians and nurses across all pediatric ICUs in Croatia. It included healthcare professionals from six neonatal and four pediatric ICUs in total. As the data from neonatal and pediatric ICUs were examined jointly, the term pediatric ICU was used to denominate both types of ICUs. A statistical analysis was performed using Python and JASP, focusing on professional roles, professional experience, and regional differences. The study included a total of 103 participants (with an overall response rate-in relation to the whole target population-of 48% for physicians and 29% for nurses). The survey revealed diverse attitudes toward and experiences with various aspects of end-of-life care, with a significant portion of healthcare professionals indicating infrequent involvement in life-sustaining treatment (LST) limitation discussions and decisions, as well as somewhat ambiguous attitudes regarding such practices. Notably, discrepancies emerged between different professional roles and, in particular, regions, underscoring the high variability of LST limitation-related procedures. The findings highlight a pressing need for more straightforward guidelines, legal frameworks, support mechanisms, and communication strategies to navigate the complex terrain of rather burdensome end-of-life pediatric care, which is intrinsically loaded with profound ethical quandaries.

Medical Coders' Use of the ICD-10-CM "Unspecified" Codes for Head and Brain Injury in Emergency Department Settings.

In the emergency department (ED) setting, prioritizing triage and patient care may lead to challenges in capturing detailed documentation necessary for specific International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) coding in medical records. Consequently, the prevalent use of the "unspecified head injury" code poses concerns about the precision of ED-based administrative billing claims data when analyzed for public health surveillance of nonfatal traumatic brain injuries (TBIs). Understanding the perspective of medical coders can illuminate coding processes and opportunities to enhance coding accuracy for TBI and other head injuries in the ED. This evaluation explores medical coders' perspectives and challenges when assigning ICD-10-CM codes to head injuries in the ED. This qualitative evaluation utilized a phenomenological approach, which employed semi-structured interviews to understand medical coders' perspectives, processes, and coding determinations for head injuries in the ED. Interviews were conducted using a HIPAA-compliant video-based platform between July 2022 and January 2023. Seventeen medical coders with ED coding experience were interviewed. Their backgrounds were diverse, though most had more than 15years of experience. Four qualitative themes emerged, which highlighted challenges with lack of detailed documentation, defaulting to unspecified codes, time, and productivity pressure, and additional insights into coders' assumptions and code determination processes. Medical coders expressed challenges assigning ICD-10-CM codes to the highest level of specificity, citing issues including insufficient documentation by ED providers and terminology variations. Workplace time constraints and pressure for expedited claims also led to defaulting to unspecified codes. This evaluation highlights the need for improved documentation consistency and detail in ED records to facilitate accurate ICD-10-CM coding. Alleviating time pressures, improving algorithms, and offering specialized training opportunities to medical coders could be helpful steps to improve coding specificity and data accuracy for head injuries in the ED.

Attitudes and Knowledge of Electroconvulsive Therapy: An Exploration of Medical Students' Perspectives.

To explore knowledge and attitudes of medical students before and after exposure to a technology-enhanced learning and teaching (TELT) session about electroconvulsive therapy (ECT). Adequate knowledge of and attitudes toward ECT is essential for medical students. However, the impact of teaching on knowledge and attitudes is infrequently studied. Fourth- and fifth year medical students at the University of Glasgow were provided with an online questionnaire before and after engaging in a remote TELT session, led by a consultant psychiatrist with expertise in ECT. The online teaching session used resources developed by a multidisciplinary team who specialize in ECT. The teaching session lasted around 1 hour. The questionnaire contained 3 sections: baseline demographics, knowledge of ECT, and attitudes toward ECT. Changes in scores were analyzed. Sixty-seven students completed the teaching session. Response rate to the precourse questionnaire was 68.7% (n = 46), and the postcourse questionnaire was 44.8% (n = 30). Prior to engaging with the learning materials, 9 students reported no knowledge of ECT and a third believed that ECT did not cause a seizure. In general, students who had personal experience of mental illness (friend, relative, or self) had more positive attitudes toward ECT and higher knowledge scores. In general, an increase in knowledge and attitude scores was found in the postcourse questionnaire. Exposing medical students to a TELT session focused on ECT during their psychiatric placement appeared to improve knowledge and attitudes surrounding ECT.

Medical perspectives on Israeli children after their release from captivity - A retrospective study.

Following the Hamas terror attack on Israeli towns on October 2023, 250 individuals were taken into captivity. On November-December 2023, during the cease-fire deal, 26 women and children were released. This study is the first to describe the physical and behavioural findings in children and their mothers in the immediate phase of returning home from captivity. This is a retrospective study describing the clinical characteristics of the returnees after 49-53 days in captivity. Patients were admitted to a designated unit in the Schnieder Children's Medical Center of Israel on November-December 2023. The hospitalisation duration was 1-9 days. All patients were evaluated according to a detailed protocol and were treated respectively. Patient population included 19 children (ranged 2-18 years old) and 7 women (ranged 34-78 years old). The most common clinical findings upon return included significant weight loss, psychological trauma, complications of poor hygiene and complications of recent shrapnel injuries. Microbiology tests were positive for multiple gastrointestinal pathogens. Serologic screening tests were positive for various infectious diseases. Clinical findings in this time period were diverse and required the attention of a multidisciplinary team. Long term clinical and psychological effects are yet to be known.

The environmental model of mindfulness

This paper introduces the environmental model of mindfulness, a novel perspective that conceptualizes mindfulness as an adaptive set of cognitive styles influenced by specific socioecological contexts. Extending upon existing conceptualizations of mindfulness as a cultivated trait or practice, the environmental model describes how mindfulness can also result from cognitive adaptations to immediate-return environments. Through an interdisciplinary synthesis of cognitive psychology, anthropology, and environmental studies, four key factors are identified that foster mindful cognitive styles in immediate-return environments: immediate feedback, observational learning, nature exposure, and interconnected self-construal. By examining Indigenous communities living in immediate-return environments, this paper demonstrates how modern, delayed-return environments may inadvertently suppress innate mindful awareness, suggesting that mindfulness practices might be attempts to recalibrate toward more natural cognitive styles. The environmental model bridges Western medical and Eastern ethical perspectives on mindfulness, offering a unifying framework that acknowledges cognitive, environmental, and cultural influences. This approach not only enriches our understanding of human cognitive functioning but also broadens cultural perspectives on mindfulness, highlighting its manifestations across diverse sociocultural contexts. The model has profound implications for mindfulness research and interventions, providing a foundation for more ecologically valid and culturally sensitive approaches to fostering wellbeing. It invites a fundamental reconsideration of the relationship between human cognition and the environment, potentially revolutionizing our approach to mental health and cognitive enhancement in an increasingly complex world. This paper stands as a call to action for researchers, clinicians, and policymakers to rethink fundamental assumptions about human cognition and design environments that support our innate capacity for mindful awareness.

Protamine: Current Insights and Evolving Applications in Medical and Dental Perspectives

Protamine: Current Insights and Evolving Applications in Medical and Dental Perspectives

Treatment of Canine Intervertebral Disc Disease with Traditional Chinese Veterinary Medicine

Intervertebral disc disease (IVDD) in dogs is a common medical problem encountered by small animal practitioners. It normally occurs in both small and large canine breeds. From a conventional medical perspective there are two treatment options available for these patients, conservative medical management, or surgical intervention. There is, however, an effective third option available, traditional Chinese veterinary medicine (TCVM). This article will discuss how to use TCVM in the treatment of canine IVDD patients, results that can be expected, and a case series of 12 dogs affected with IVDD.

How materialities and space–time travellings in class can breathe new life into Swedish secondary school Natural Science sexuality education

In this study, we investigate the phenomenon of Swedish Natural Science sexuality education. These classes tend to provide factual knowledge, focus on the negative outcomes of sexuality, be heteronormative and include little time for discussion—like much school sexuality education across the world—and this study aims to contribute ideas about new becomings of Natural Science sexuality education. Baradian theorising was used to explore how materialities and space and time travels within the classroom can challenge often-dominant perspectives. Data were produced in a secondary school and consist of teacher-researcher discussions and participatory observations in class. A futuristic case introduced students to spaces, times and materialities that not only helped the group move beyond a medical focus but also made the sexuality education more student centred. The participating teachers suggested imaginary lust-oriented scenarios for the 15–16-year-old students as an entrance to more preventive messages in teaching. A taken-for-granted heterosexual premise was also challenged with gender-neutral words and pronouns, an exercise on how to use both condoms and dental dams, and a time travel into future possibilities for reproduction and parenting. The acknowledgement of spacetimematter intra-activity in teaching thereby enabled new becomings of Swedish Natural Science sexuality education. However, although this study suggests how dominant medical and heterosexual perspectives can be challenged, it also made visible the absence of cultural, religious, asexuality and disability perspectives in Swedish sexuality education.

CONCEPTUAL, LEGAL, AND ETHICAL CONSIDERATIONS IN PHYSICIAN-ASSISTED SUICIDE: AN OVERVIEW

Physician-assisted suicide (PAS) remains a contentious and highly debated topic within medical, legal, and ethical spheres. The complex issue of (PAS) raises significant inquiries regarding patient autonomy and societal norms. Ambiguities in conceptual, legal, and ethical aspects impede policy formulation, leading to unequal access and apprehensions about patient welfare and confidence. This article provides a thorough examination of assisted suicide, exploring its legal, ethical, and medical dimensions. It aims to facilitate informed dialogue and stimulate further investigation into the legal framework and ethical considerations surrounding this contentious issue. Through a library-based research approach and qualitative analysis of existing literature, this study delves into the diverse facets of assisted suicide. The article begins with a definition and contextualisation of assisted suicide, distinguishing it from related end-of-life practices. It then delves into the legal landscape, discussing different legal frameworks and regulations across various jurisdictions, and significant legal cases that have shaped the current discourse. From an ethical standpoint, this article explores the ethical considerations involved in assisted suicide, including autonomy, dignity, and the sanctity of life, and presents the perspectives of different stakeholders. The medical perspective examines the role of healthcare professionals, the criteria for assisted suicide, and empirical research on its effectiveness and safety. Realworld case studies are presented to illustrate the complexities of assisted suicide. Furthermore, this article analyses public opinion and ongoing debates on the topic. Ultimately, this analysis aims to provide readers with a comprehensive understanding of assisted suicide, fostering informed discussions and encouraging further exploration of this contentious issue.

The notion of excessive childhood restlessness in Spain at the beginning of the twentieth century.

This study delves into the historical documentation from 1900 to 1936 by Spanish doctors and educators concerning children's hyperactivity. By focusing on medical perspectives of the time, we aim to explore the conceptualisation of childhood phenomenology within the context of significant international literature of that era. The publications of doctors Jerónimo Moragas and Gonzalo Rodríguez Lafora, along with educators Augusto Vidal Perera and José Sarmiento Lausén, will be examined to understand the medical and educational approaches to childhood restlessness. Additionally, the study will review diverse perspectives on this disorder. The research also highlights a noticeable gap in the assistance provided to these children. Ultimately, the article provides insights into how society and childcare professionals addressed the phenomenon of childhood hyperactivity.

A real-world observational study on the effect of Qingre Lishi decoction on glycemic profile using continuous glucose monitoring in obese type 2 diabetes adults.

To observe the clinical efficacy and safety of the Qingre Lishi decoction in treating of newly diagnosed overweight and obese patients with type 2 diabetes mellitus (T2DM) from an evidence-based medical perspective. 70 cases of overweight and obese patients with newly diagnosed T2DM treated in the outpatient clinic of the Department of Endocrinology of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from December 2021 to November 2022 were selected, of which 35 cases were in the observation group and 35 cases were in the control group. The observation group was treated with the Qingre Lishi decoction add lifestyle intervention, and the control group was treated with lifestyle intervention only. We compared and analyzed the fasting blood glucose (FPG), 2-hour postprandial glucose (2hPG), the occurrence of adverse reactions, and the related indexes provided by wearing the CGM device during the observation period of the patients in the two groups. 53 participants completed the clinical trial. In relation of glycemic control, a decreasing trend has shown in both groups, with the decreases in FPG, 2hPG, eHbA1c, and MG in the observation group being higher than those in the control group (P<0.05). In regard to blood glucose attainment, at the 28d, the attainment rate of patients in the observation group with TIR>80% was 87.10%, and the magnitude of changes in the rise of TIR and the fall of TAR was significantly better than that in the control group (P<0.01). In terms of blood glucose fluctuation, CV and SD of the patients in the observation group decreased compared with the 0d; the magnitude of daytime blood glucose fluctuation was significantly alleviated compared with that of the control group. The degree of decrease in LAGE, MAGE, and MODD was significantly lower than that of the control group (P<0.01). The Qingre Lishi decoction can effectively improve the hyperglycemic condition of overweight and obese patients with newly diagnosed T2DM. It can reduce blood glucose, alleviate blood glucose fluctuations, reduce the incidence of hypoglycemia, and improve patients' adherence and self-confidence in controlling blood glucose. https://itmctr.ccebtcm.org.cn/, identifier ITMCTR2024000006.

Using POV Wearable Technology as a Tool in Virtual Teaching Sessions to Supplement Clinical Skills Training: a Medical Student Perspective

Using POV Wearable Technology as a Tool in Virtual Teaching Sessions to Supplement Clinical Skills Training: a Medical Student Perspective

Coca in history and the future

Purpose This study aims to question the psychiatric framework currently adopted by governments toward the traditional plants of great cultures, stigmatized by the paradigm of the unfounded psychiatric doctrine and to propose the need for a change of outlook. Design/methodology/approach Documentary research of the “black history” of coca. Documentary research on academic contributions to the revaluation of coca. Findings This brief chronicle of the coca leaf in history, duly documented, proves that its medicinal and energetic prestige was proven and praised by the naturalistic and experimental medicine of the 19th century, a precedent buried by the psychiatric pathologizing version that invented “drug addictions” without any experimental support. Research limitations/implications Psychiatry can be revealed as the authoritarian and unpunished inquisition of the 20th century, in its arbitrary pathologizing version of coca leaf consumption and in most of its professional work. A scientific revolution is taking place (Kuhn, 1962), given that the psychopathological paradigm does not respond to the facts surrounding coca leaf consumption and virtues. The medical perspective must replace the negative psychiatric perspective that the law maintains Practical implications The author concludes that the way out would be to denounce before the Social and Economic Council of the United Nations, with evidence in hand, the fraud in the 1950 UN Commission on Coca Report, due to concealment on information. Social implications Taking advantage of the hygienic and medicinal virtues of plants stigmatized by psychiatry, such as the coca leaf, would put an end to an omnipresent war and give way to peace in the producing areas. Originality/value The questioning of the psychiatric frame of reference adopted by governments to deal with coca leaf consumption has led to the “war on drugs.”