Personal Physician Research Articles

The outbreak of new diseases in an era of religious and spiritual crisis:

The paper examines how the humanist physician and later professor of medicine at the great Universities of Italy, Girolamo Mercuriale of Forlì (1530-1606), addressed the issue of new diseases in medical as well as religious-social terms in his medical book De arte gymnastica (Venice, 1569), while he served as the personal physician of Cardinal Alessandro Farnese (1520-1589). Mercuriale's medical gymnastics, as a medical method for the treatment of new diseases, stands out as paradigmatic, on the one hand, of the scientific-medical culture of mid-sixteenth century Rome and, on the other hand, the political-religious strategies of the Catholic Church regarding the control of body culture in the context of the Counter-Reformation.

Visualizing Household Health: Medieval Women, Art, and Knowledge in the Régime du corps by Jennifer Borland

Reviewed by: Visualizing Household Health: Medieval Women, Art, and Knowledge in the Régime du corps by Jennifer Borland Winston Black Jennifer Borland. Visualizing Household Health: Medieval Women, Art, and Knowledge in the Régime du corps. University Park: Pennsylvania State University Press, 2022. xv + 219 pp., 85 color and black and white illustrations. $114.95. ISBN: 978-0271090597. Like many teachers of the history of medicine, I have resorted to online searches for "medieval medicine" or "medieval health" to find engaging images for my slides and handouts. One of the most common results of these searches is a historiated initial V showing a bloodletting procedure in action: a barber-surgeon is incising a vein on the inner arm of a rosy-cheeked man, who looks away as his blood flows out into a bowl. This image comes from British Library Sloane MS 2435, the oldest copy of the popular health-care manual Régime du corps (hereafter Rdc), attributed to Aldobrandino of Siena, personal physician to Countess Beatrice of Savoy. Written in French around 1256, the Rdc is noteworthy as an early example of the vernacularization of learned medicine in later medieval European society. Seventy-five medieval copies of Rdc survive, of which twenty-three are illustrated with various depictions of medical treatments, copulation, breastfeeding, drunkenness, clothing, and food. Not surprisingly, many of these illustrations have been reproduced widely to educate, amuse, and titillate modern audiences, but rarely with any documentation or contextualization, leaving students and untrained professors to assume that such illustrations are typical of medieval medical thought and health practices. [End Page 160] Art historian Jennifer Borland seeks to remedy these oversights by exploring the meaning, purpose, and inspirations for the illuminations in manuscripts of Rdc in her book Visualizing Household Health. Central to her argument is that an analysis of gender is essential for understanding the Rdc and its illustrated copies, for many of the historiated initials show women as the agents of health care and bearers of medical knowledge in elite households. To support this argument, Borland focuses on a core group of seven deluxe manuscripts of Rdc that include historiated initials at the start of most chapters (from 37 to 147 in total). These historiated initials might seem shocking to modern audiences, as they share the format, appearance, and luxury of initials in contemporary Bibles and literary manuscripts but are used to depict earthy and even crude subjects such as cheese making and vomiting. But it is exactly this "juxtaposition of mundane topics and ostentatious manuscript design" that makes these elite copies of the Rdc fascinating subjects for research (123). This is not, however, a book about the text of Rdc; Borland rarely quotes from the text and remains dependent on the conclusions of Louis Landouzy and Roger Pépin in their 1911 edition and study of the work. However, because she refers several times to the prologue of the Rdc in her arguments, it would have been helpful to include a translation of that text (only a few pages in length) as one of her appendices. Borland provides a detailed analysis of the provenance and codicology of her seven core manuscripts. She divides them logically into an earlier and a later group (three manuscripts from ca. 1265–1350 and four from ca. 1450–1500), based on changes in the illustration program and in the potential audience, from royal patrons to the wealthy bourgeoisie. Other manuscripts include illustrated frontispieces or single illuminated initials, but she does not address these, as one of her guiding concerns is to explore the narrative and educational role of the longer series of historiated initials in the deluxe manuscripts. These illustrated copies provided medieval owners and still provide modern scholars a window onto an idealized domestic environment, where birth and childcare, food and clothing, the bodies of nobility and servants, and all facets of household management were governed by a simple yet comprehensive health regimen, or régime du corps. Although many scholars have studied these initials individually and used them as evidence for medical [End Page 161] ideas and procedures in the later Middle Ages, nobody until Borland has studied the initials in sequence and as a...

Intention to vaccinate against COVID-19 and potential outreach strategies for a residential research university in Northeastern Ohio.

A university's understanding of student, faculty, and staff members' intention to vaccinate against COVID-19 has been vital in returning safely to in-person education, research, and engagement with communities and professions. We employed a novel survey to describe intentions across subpopulations of one campus and consider key issues in their rationales for intentions and hesitancies. 1,077 surveys based on Theory of Planned Behavior were completed from randomly selected pools of undergraduate students, graduate students, part-time faculty, full-time faculty, and staff. Chi-Squared Automated Interaction Detection algorithm analysis provided paths for evaluation. 83 percent of respondents said they would receive the vaccine at their first opportunity, while 5 percent said they would never get the vaccine; the remaining 12 percent wanted more evidence before getting the vaccine. Findings included negative health perceptions of the vaccine, misinformation on the process, as well as negative rhetorical responses differentiated between political partisanship and membership within the campus community, eg, faculty, staff, or student. Universities seeking to raise campus vaccination rates should concentrate limited resources on the largest populations with the most opportunity to vaccinate. In this study, newer students, with conservative political views, represented a population of opportunity. Their formative beliefs may be influenced by messaging and in collaboration with students' personal physician and/or friend groups. A theory-based approach leads to focused efforts for safer campuses and resumption/continuation of face-to-face interactions for students, faculty, and staff.

Perceptions, insights, and attitudes (P.I.A.) of selected filipino female physicians on cardiovascular risks and diseases

Abstract Funding Acknowledgements Type of funding sources: None. Introduction In 2012, coronary heart disease and stroke are the leading causes of death worldwide, accounting for more than 31% of deaths from all causes. In 2020, PH statistics showed that ischemic heart diseases were the leading causes of death in the Philippines (PH), responsible for 17.3% of the total deaths. Objective To determine the knowledge, perceptions, insights and attitudes on cardiovascular disease (CVD) prevention, personal health-related lifestyle practices, and lifestyle counseling practices of selected female physicians who are practicing or training in the PH through an online survey. Methods A descriptive ambispective cross-sectional study where the survey questionnaire of Ameh, et al. (2019) was modified with the authors' permission, was conducted online and answered by consenting female physicians. 484 participants’ data were collated and analyzed. Results Majority had accurate responses for the CVD prevention knowledge items (Figures 1 and 2). Among the participants, 36.98% had hypertension, 32% were obese, 28.5% had dyslipidemia, and 17.2% had diabetes mellitus. Sleep of 6-8 hours is practiced by 60.33%, 53.51% eat vegetables and fruits daily, 55.79% prefer fish and seafood, 89.05% do not smoke, 61.2% take coffee or black tea daily, 84.51% have no regular exercise, and 30.79% of those who do only exercise for 10-20 minutes. Moreover, 67.98% add salt, soy or fish sauce to their meals, and 72.73% do not drink enough water daily. In addition, 44.42% do not undergo annual general check-up and 58.06% do not have a personal physician. Limitations due to COVID-19 pandemic, lack of education, and expensive screening tests are perceived to be major barriers to CVD screening. More than 90% of our participants practice health teachings on diabetes mellitus prevention, high blood pressure screening, cholesterol screening and management, nutrition, and weight management. Counseling on regular exercise, smoking, and alcohol abuse are being practiced by 88.02%, 85.74%, and 83.88% of our respondents, respectively. Conclusion There are female physicians who are not aware of the World Health Organization’s recommendations on the prevention of CVD, who do not do health teaching and counseling, and who practice unhealthy lifestyle. Changing physicians’ knowledge and behavior towards CVD prevention is a great challenge to improve standards of CVD prevention. Improvement and enhancement in education of both physicians and patients, together with more consultation time, financing for CVD prevention, and comprehensive, multidisciplinary preventive cardiology programs supported by government and societies in favor of prevention are some of the best ways to improve management of CVD risk factors and prevention.

The Case for Needed Financial Literacy Curriculum During Resident Education

Personal physician finance is an overlooked source of stress that negatively impacts resident wellbeing with formal financial education often left out of medical training. This study attempts to (1) evaluate the perceptions of financial literacy, (2) determine the level of financial education incorporated across residency programs, and (3) evaluate the resources that residents utilize to obtain information about managing their personal finances. A systematic literature search of articles published between January 2012 to January 2022, in the MEDLINE, EMBASE, and Cochrane databases was performed during February 2022]. The combination of search terms included: (financial literacy OR debt) AND (residency OR graduate medical education). The primary outcome measures included the perception of financial literacy during residency and the type of financial education incorporated during residency. Secondary outcomes included resources utilized to obtain financial education. Twenty-three studies evaluating a total of 5146 residents were included in this systematic review. The 42% to 79% of residents responded in surveys that they had "below average" understanding of finance, investing, and savings and that they felt unprepared to handle future financial decisions. 79% to 95% of respondents agreed that personal finance should be taught during residency training. The included studies also demonstrate that residents seek education through personal research, through a family member, or through attending outside financial planning seminars or courses. This study demonstrates that the majority of residents feel underprepared when making financial decisions and that formal financial education should be incorporated during their residency training. Educating residents can help mitigate financial stress which can improve physician well-being, reduce attrition, and result in better patient care. IV.

Patient Experiences With Thyroid Nodules: A Qualitative Interview Survey.

To qualitatively explore the broad set of preferences and attitudes patients have about thyroid nodules, which influence the decision-making process. A descriptive survey design was administered as interviews. Outpatient thyroid surgery clinic. Semistructured interviews were conducted with 20 patients presenting for initial evaluation of thyroid nodules at a surgeon's office. Probative, open-ended questions were posed regarding diagnosis, treatment, risk attitudes, and the decision-making process. Thematic analysis was used to develop code-transcribed interviews, and an iterative refinement resulted in underlying themes. During the diagnostic process, patients integrated emotional responses (fear, anxiety, and shock) with rationale concerns (likelihood of cancer, risk assessment), and ultimately relied heavily on expert opinion and recommendation. Contextualization with other personal or familial health problems served as helpful touchstones for decision-making. Overtreatment and overdiagnosis were not commonly discussed. When thinking about potential therapies, there was a strong bias to action rather than surveillance among patients. Surgical risk and the possibility of lifelong medication, however, were strong motivators for a subset of patients to seek nonsurgical alternatives. Patients describe a decision-making process that incorporates emotional response and rational consideration of risks, contextualized within the personal experience and physician expertise. The bias for action and intervention is strong, and most patients strongly weighted physicians' recommendations. Themes from this qualitative analysis may serve as the backbone for future stated preference research pertaining to thyroid disease.

Using the Caprini Risk Score to Increase Awareness of Venous Thrombus Embolism in the Community: Know Your Score II.

To assess individual participants' baseline thrombosis risk calculated by Caprini Risk Score (CRS) before injury, illness, or hospitalization occur, to increase the awareness of venous thromboembolism (VTE) by viewing 2 short videos. A cross-sectional study was conducted online between August 2022 and January 2023 in the USA, UK, and India to assess the risk of thrombosis of individuals as a baseline. One nursing practitioner and 4 high school students were on the research team. Descriptive statistical methods were used in data analysis. A total of 928 usable completed questionnaires from 945 participants were analyzed. The mean CRS was 4.93 ± 3.175; 0 to 4 (N = 460, 49.6%), 5 to 8 (N = 394, 42.5%), and 9 (N = 74: 8.0%). History of blood clots (N = 247, 26.6%), <40 years old (N = 133, 52.6%); women on oral contraceptives (N = 324, 34.9%), history of smoking (30%), diabetes (26%), and inflammatory bowel disease (IBD; 17.3%). Top-level findings: High incidence of family history of thrombosis (26.6%), smoking, diabetes, contraceptives, and IBD. The average CRS (7.9) in patients over 75 years indicates that even a minor surgical procedure may be associated with significant VTE risk. We achieved an important goal by increasing awareness of VTE using this unique method involving high school students and a nurse working with friends and families to complete the CRS assessment. Encouraging the respondents to share information with their personal physicians prior to the event and keep these data in their medical file is a potential valuable source of saving time. This study emphasizes the importance of individuals collecting baseline information prior to illness or hospitalization.

PLACE-BASED HEALTH DISPARITIES: FUNCTIONAL DISABILITY IN APPALACHIAN WEST VIRGINIA

Abstract Place-based health disparities contribute to disability across the lifespan. Additional examinations of contributors to morbidity and disability at mid-and late-life are needed to inform policies and programs. Using data from the 2020 Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System (BRFSS), we examine some of the social determinants of health (e.g., age, gender, education, income) as predictors of access to health care and predictors of functional ability. The study included 5,880 adults living in West Virginia all between the ages of 18 to 65+ years. Access to healthcare was indexed by three variables, including whether one had medical insurance, saw personal physicians, and avoided medical treatment due to cost. Functional ability was indexed by reports of difficulty in three ADLs and the number of chronic health conditions. Although most paths were significant, our initial model fit the data poorly, X2 (DF = 39, N =5880) = 2503.6, p &amp;lt; .001, CFI = .70, RMSEA = 1.0. We re-ran the model, using age as a moderator. In this set of analyses, the model fit well for middle-aged and older adults, but a different set of predictors characterized the relations for younger adults. Our results suggest that policies and programs that increase medical access for current middle-aged and older adults might decrease functional disability. Moreover, as younger adults age into midlife, they enter with lower economic and educational resources, further exacerbating their lack of access to health care and increasing disability.

Understanding and preference toward DOs and OMT before and after an osteopathic principles and practice fellow lecture series.

One of the two major pathways to become a physician in the United States is the Doctor of Osteopathic Medicine (DO) degree. A major distinctive feature is often perceived as the addition of manual training in osteopathic manipulative treatment (OMT) in the DO education. However, the profession also has a distinct philosophy imbedded in the curriculum of all osteopathic medical schools. Many medical schools offer professional degrees with graduates who may choose to continue their education in medicine, such as the Master of Science in Biomedical Sciences (MSBS). At our institution, there is no formal exposure to the differences between osteopathic and allopathic medicine in the MSBS curriculum, and most of this understanding is gained through out-of-classroom conversations. During the SARS-CoV-2 pandemic, virtual learning prohibited the usual gathering and discourse that occurs when students are learning on campus. The objective of this study is to create a curriculum in the form of a seminar series to assist premedical students in making an informed choice about which profession is the best fit for their own education and to gain an appreciation for osteopathic medicine. This appreciation could also aid in the future collaboration of premedical students with osteopathic providers, recommendations to patients, and potentially their own medical care. Questionnaires were utilized to determine if our osteopathic seminar series was effective at changing the preferences and understanding of MSBS students. We also sought to determine the effectiveness of virtual vs. in-person delivery of our curriculum. A seminar series with pre-established objectives was developed and presented to MSBS students at an osteopathic institution during the Fall of 2020 and 2021. The 2020 seminar was delivered through a virtual conference platform, and the 2021 seminar was delivered in-person. An eight question pre-and postquestionnaire was given to participants to evaluate their preferences and understanding. Internal validity and differences between delivery formats were assessed. Both seminar series produced equally effective, significant changes in the preferences and perceptions of osteopathic medicine in both virtual and in-person delivery formats. Differences in pre-vs. post understanding across both seminar series were not consistently significant and were smaller than those observed in preferences and perceptions. Positive changes included an increased willingness to see a DO and to recommend a loved one see a DO as their personal physician. Preference changes between the in-person vs. virtual delivery platforms did not show significant differences; however, understanding did show some inconsistent differences. This study demonstrates the utility of a virtual or in-person seminar to improve the preferences and perceptions of the osteopathic profession in MSBS students. The seminar series was successful in its goal of offering formal exposure to the osteopathic profession. The improved preferences and perceptions will have potential substantial benefits to the field of osteopathic medicine in the future. Further research is warranted to determine the most effective way to increase understanding of the osteopathic profession.

The Life path of the Italian Doctor, Anatomist, Surgeon and Theoretician of Medicine Guido Guidi

The name of Guido Guidi appears in the histories of medicine as that of the author of a beautifully illustrated book on surgery and as one of the innumerable anatomical eponyms. Guido Guidi practiced medicine and surgery in his native city Florence and made such a reputation that he was in 1542 invited by Francis I, King of France, to come to Paris. The King appointed him one of his personal physicians and permitted him to give public lectures in medicine and surgery at the newly founded College de France. Guidi was about to publish a surgical treatise, based on a Greek manuscript of the tenth century preserved in the Laurenzian Library at Florence. Among the notable features of this manuscript were thirty full-sized plates illustrating the commentary of Apollonius of Kitium on the Hippocratic treatise on dislocations and other pictures accompanying a copy of Galen's treatise on bandaging. These illustrations represented the genuine Hippocratic traditions of surgical practice as transmitted through later Greek channels to Byzantium. In Paris, Guidi lived with Benvenuto Cellini, who became his friend and who has many laudatory references to him in his autobiography. In 1544 Guidi's book on surgery appeared. It is a splendid folio volume, beautifully printed and containing remarkable woodcut copies, or rather adaptations, of the original tenth-century drawings. Guidi's Chirurgia was the best illustrated work on surgery that had appeared up to its date. It comprises translations of six works by Hippocrates, one by Galen and two by Oribasius, together with commentaries by Galen and by Guidi himself. The treatment of all varieties of fractures and dislocations is described in great detail and is very clearly illustrated. Some three years after the publication of his Chirurgia Guidi was recalled to Italy to become chief personal physician to Cosimo de Medici. He practiced and taught medicine at Pisa, took Holy Orders, received high' ecclesiastical preferment, and was in 1557 raised to the nobility. He died at the height of his renown on 26 May 1569 and was buried in the tomb of his ancestors in Florence. For some years before his death he had been occupied in writing a comprehensive work on medicine. This great work was completed and published by his nephew in three huge volumes between 1596 and 1611. This study is based on original research and it corrects many errors that have been perpetuated in standard reference books.

Association between COVID-19 vaccine hesitancy and trust in the medical profession and public health officials

One's personal physician, national and state or local public health officials, and the broader medical profession play important roles in encouraging vaccine uptake for COVID-19. However, the relationship between trust in these experts and vaccine hesitancy has been underexplored, particularly among racial/minority groups where historic medical mistrust may reduce uptake.Using an April 2021 online sample of US adults (n = 3041) that explored vaccine hesitancy, regression models estimate levels of trust in each of these types of experts and between trust in each of these experts and the odds of being COVID-19 vaccine takers vs refusers or hesitaters. Interaction terms assess how levels of trust in the medical profession by race/ethnicity are associated with vaccine hesitancy. Trust in each expert is positively associated with trust in other experts, except for trust in the medical profession. Only trust in one's own doctor was associated with trust in the medical profession, as measured by factor scores derived from a validated scale. Lower levels of trust in experts were significantly associated with being either a hesitater or a refuser compared to being a taker. Black respondents had higher odds of being either a hesitater or a refuser compared to white respondents but the interaction with trust was insignificant. For Hispanic respondents only, the odds of being a hesitater declined significantly when trust in the medical profession rose. Mistrust in the medical profession, one's doctor and national experts contributes to vaccine hesitancy. Mobilizing personal physicians to speak to their own patients may help.

Scope of Practice and Location of 3- Versus 4-Year Family Medicine Residency Graduates.

The John Peter Smith (JPS) Family Medicine Residency Program participated in two national experiments: Preparing the Personal Physician for Practice (P4, 2007-2012) and the Length of Training Pilot, which began in 2013. In these experiments, JPS created optional integrated 4-year areas of emphasis (AOE). The objective of this study was to examine the career outcomes of JPS graduates differentiated by those who completed a 4-year AOE, versus traditional fourth-year fellowship, vs 3-year only. We surveyed each graduate who started residency from 2007-2016 on their scope of practice. We also searched each graduate via Google to identify each of their practice sites and ascertain their status as a Health Professional Shortage Area (HPSA) or Medically Underserved Area for primary care (MUA-P). Of the 220 residents who entered the program as interns, 70 completed an integrated AOE (31.8%), 54 completed 3 years of training with a traditional fourth-year fellowship (24.5%, 40 at JPS, 14 at another location), and 93 completed only 3 years of training (42.3%). The overall percentage of JPS graduates who work in the United States (n=201) in HPSAs or MUA-Ps is similar to national numbers (45.3% vs 43.5% for HPSAs, 35.3% vs 33.3% for MUA-Ps). Graduates of a JPS integrated AOE track were more likely to work in a HPSA or MUA-P than other graduates (81.4% vs 38.5% traditional fellowship vs 45.6% 3-year only, P<.001; US practice sites only). Graduates of sports medicine fellowships were particularly less likely to work in HPSAs/MUA-Ps than other graduates (26.1%). Graduates of integrated AOEs provided much broader scopes of cognitive and procedural services than fellowship or 3-year graduates. In JPS graduates, 4 years of training with an integrated AOE had a large association with serving vulnerable populations, and providing broader cognitive and procedural services.

Pap Smear Screening: Deterrents among the At-Risk Population in Trinidad

Cervical cancer is a condition that affects many women globally. The WHO recommends Papanicolaou (Pap) smear screening, a method by which abnormal cervical cells can be detected and aid in preventing malignant progression. However, despite the availability of this test, uptake remains low among many Caribbean countries, including Trinidad. Objective: A literature review on cervical cancer screening and barriers to getting tested in Trinidad. Study Design: The study design chosen was a narrative literature review. This paper sought to assess available literature centered around reasons for lack of screening and how it may contribute to the current prevalence rates of cervical cancer. Methods: Data was obtained from online articles via Google Scholar, Pubmed, ScienceDirect, and Scopus from 1987 to 2022. The focus was on publications detailing lifestyle and factors influencing Pap smear testing and follow-up. Results: Results showed that personal understanding, accessibility, physician perception, and socioeconomic disadvantages can deter pap smear screening. Conclusions: Addressing these issues and how they can influence screening uptake is key to increasing detection and decreasing cervical cancer deaths.

Would you zoom with your doctor? A discrete choice experiment to identify patient preferences for video and in-clinic consultations in German primary care.

The popularity of video consultations in healthcare has accelerated during the COVID-19 pandemic. Despite increased availability and obvious benefits, many patients remain hesitant to use video consultations. This study investigates the relative importance of the consultation mode compared to other attributes in patients' appointment choices in Germany. A discrete choice experiment was conducted to examine the influence of appointment attributes on preferences for video over in-clinic consultations. A total of 350 participants were included in the analysis. The level of continuity of care (46%) and the waiting time until the next available appointment (22%) were shown to have higher relative importance than consultation mode (18%) and other attributes. Participants with fewer data privacy concerns, higher technology proficiency, and more fear of COVID-19 tended to prefer video over in-clinic consultations. The predicted choice probability of a video over a typical in-clinic consultation and opting out increased from <1% to 40% when the video consultation was improved from the worst-case to the best-case scenario. This study provides insight into the effect of the consultation mode on appointment choice at a time when telemedicine gains momentum. The results suggest that participants preferred in-clinic over video consultations. Policymakers and service providers should focus on increasing the level of continuity of care and decreasing the time until the next available appointment to prompt the adoption of video consultations. Although participants preferred to talk to their physician in person over consulting via video per se, the demand for video consultations can be increased significantly by improving the other appointment attributes of video consultations such as the level of continuity of care.

How Collaboration Between Private Practice and University Programs Can Benefit You

Successful private practice owners recognize the need to offer more than a device. Providing a patient experience that cannot be replicated by an online, retail, or big-box provider is essential for today’s private practice. Providing an aural rehabilitation program is one way to add value to the patient experience. However, having the resources such as time, space, and energy to implement on your own is unlikely.www.shutterstock.com.We found a collaboration between private practice and a university program to be the answer. Combining an academic and research background with a patient-centered, service-oriented, business-focused background turned out to provide the framework, innovation, and resources that benefitted both collaborators. Our goal in designing and implementing this program was to provide a community program for adult learners that also served as an instructional opportunity for graduate students. We designed the materials to be accessible and reproducible for other university programs and private practice partnerships. As a private practice owner, the recognition that the program granted me as the hearing expert in the community resulted in extremely effective marketing. The participants were the most successful hearing aid users for the following reasons: they were eager and enthusiastic advocates of hearing healthcare because of the knowledge gained in our seminar; they had a solid understanding of the expectations for a device; they were eager and prepared to implement the communication strategies taught; and they saw the importance of seeking help from an audiologist. Not only were they now part of the practice, but these participants also helped spread the word in the community. They could not wait to share their new knowledge with others. This organic, enthusiastic, and earnest marketing led to qualified and educated referrals who were all successful hearing aid users. THE APPROACH We, a private practice owner and a university assistant professor, designed and led a four-part seminar that met once a week for 90 minutes for four weeks. The participants were members of the university campus’s lifelong learning program. The program was offered twice a year. We started this program through in-person classes before transitioning to an online format very effortlessly during the COVID-19 pandemic. We typically had 10 older-adult participants in our seminar, and classes were held in a large room in the on-campus speech and hearing clinic. A PA system and a large display monitor were used to increase accessibility. Masters in speech-language pathology students led small breakout sessions on lipreading, clear speech, communication strategies, and auditory training following the lecture. Our lecture topics included hearing loss, how we hear, audiogram interpretation, tinnitus, auditory training, psychosocial exercises, expectations for hearing aids, ototoxicity, hearing aids, assistive technology, smartphone apps, over-the-counter devices, and how to choose an audiologist. We also provided training on strategies for communicating with a hearing loss and facilitated discussions that resulted in group dynamics and sharing of shared experiences that were powerful to witness for the students and participants. THE BENEFITS Benefits to private practice audiologists This program established the private practice audiologist as an expert in aural rehabilitation, setting the practice apart from others who offered only a device. The increased visibility led to new referrals. These referrals were more likely to be satisfied and successful because they embraced the limitations of their devices. Seminar participants took responsibility for implementing communication strategies rather than blaming the audiologist or hearing devices. Benefits to a university program Seeking experiential opportunities for students as they explore career interests or enroll in classes is an ongoing process. The seminar provided a unique experience for students to participate and help facilitate the sessions. The participants enjoyed hearing about the students’ studies, relating them to fellow lifelong learners. Students applied what they learned in their introductory AR course in one-on-one and small group work. They had positive reflections on their experiences, as the interactions gave them insight into interacting with older adults with hearing loss. A SUCCESSFUL COLLABORATION Working together, we considered the program successful. It met the participants’ needs, provided a hands-on training opportunity for students, and established the private practice owner as an expert in the community. This mutually beneficial collaboration resulted in highly qualified new referrals for the private practice and a rich experience in creating and delivering content for students. Offering aural rehabilitation in a scalable format that was readily available and reproducible resulted in a benefit to the university students and in the organic marketing of the practice with participants who were eager and enthusiastic advocates of the importance of hearing aids, understood the importance of regular use, expectations, implementation of strategies for hearing, and the importance of seeking health from an audiologist. These participants spread the word in the community, specifically to their friends and family, medical professionals, and personal physicians. This organic, enthusiastic, earnest marketing led to precious and educated referrals.

Nestor Maksimovich-Ambodik»s contribution to the art of healing

Nestor Maksimovich Maksimovich-Ambodik is considered one of the founders of obstetrics, it was he who came up with the idea of using obstetric forceps. Maksimovich-Ambodik was the first to prepare and publish the well-known treatise "The Art of Midwifery, or the Science of Women's Business". More than one generation of students studied according to his textbooks. It is noteworthy that he was the first to start teaching at a medical university in Russian; before that, all lectures were given in Latin. However, few people know that this scientist was also seriously involved in the issues of herbal medicine. In 1784, the scientist published the book "Encyclopedia of Nutrition and Healing, compiled by the personal physician of Her Imperial Majesty Catherine II in 1784, professor N. Ambodik", which is the richest collection of descriptions of medicinal plants. In his medical practice, this scientist and doctor gave preference to medicinal herbs, believing that the more complete the unity of an individual with nature is, the faster s/he will be able to achieve harmony and defeat the disease. Thus, Nestor Maksimovich-Ambodik can rightfully be considered the founder of not only obstetrics, but also herbal medicine.

Virtual Specialist Care During the COVID-19 Pandemic: Multimethod Patient Experience Study.

BackgroundTransitioning nonemergency, ambulatory medical care to virtual visits in light of the COVID-19 global pandemic has been a massive shift in philosophy and practice that naturally came with a steep learning curve for patients, physicians, and clinic administrators.ObjectiveWe undertook a multimethod study to understand the key factors associated with successful and less successful experiences of virtual specialist care, particularly as they relate to the patient experience of care.MethodsThis study was designed as a multimethod patient experience study using survey methods, descriptive qualitative interview methodology, and administrative virtual care data collected by the hospital decision support team. Six specialty departments participated in the study (endoscopy, orthopedics, neurology, hematology, rheumatology, and gastroenterology). All patients who could speak and read English and attended a virtual specialist appointment in a participating clinic at St. Michael’s Hospital (Toronto, Ontario, Canada) between October 1, 2020, and January 30, 2021, were eligible to participate.ResultsDuring the study period, 51,702 virtual specialist visits were conducted in the departments that participated in the study. Of those, 96% were conducted by telephone and 4% by video. In both the survey and interview data, there was an overall consensus that virtual care is a satisfying alternative to in-person care, with benefits such as reduced travel, cost, time, and SARS-CoV-2 exposure, and increased convenience. Our analysis further revealed that the specific reason for the visit and the nature and status of the medical condition are important considerations in terms of guidance on where virtual care is most effective. Technology issues were not reported as a major challenge in our data, given that the majority of “virtual” visits reported by our participants were conducted by telephone, which is an important distinction. Despite the positive value of virtual care discussed by the majority of interview participants, 50% of the survey respondents still indicated they would prefer to see their physician in person.ConclusionsPatient experience data collected in this study indicate a high level of satisfaction with virtual specialty care, but also signal that there are nuances to be considered to ensure it is an appropriate and sustainable part of the standard of care.

#34 Evaluation of surgical antibiotic prophylaxis at tertiary level pediatric hospital in Mexico City

Abstract Background There is certainty that surgical antibiotic prophylaxis is useful in the prevention of surgical site infection. However, it should be chosen with a spectrum aimed at microorganisms that, due to the type of surgery, could cause an infection and reduce events should be prescribed at correct doses and with the minimum duration. Surgical services are in constant change, it seems that the demands on the personal physician to be in the surgery room and to attend to those worrisome needs of the patient make the responsibility for making decisions about antibiotics uncoordinated. For this reason, the prescription of antimicrobials can be perceived as a secondary task and one that is even delegated to young surgical members. The objective of this study was to describe the most frequent errors in surgical prophylaxis prescription. Method This is an analytic transverse study in a six-month period (November 2020-March2021), that includes antibiotic prescriptions on surgical departments (orthopedics, general surgery, urology, plastic surgery, neurosurgery, oncologic surgery, otorhinolaryngology). For variable analysis, a Chi-square test, odds ratio and etiological fraction among exposed will be performed. Results 423 antibiotic prescriptions were analyzed, 210 achieved inclusion criteria and 190 were indicated as surgical antibiotic prophylaxis, 118 of these have at least one error in prescription. The odds ratio for prescription errors and the indication of antibiotics as prophylaxis (Pearson chi square test 16.442 p 0.00) were 9.29 (CI 95% 2.63-32.8), etiological fraction among exposed were 89.23%. Table 1 shows surgical antibiotic prescriptions for services in descending order, although the patients were from surgery services, the prescriptions were not always made form the same service (for example anesthesiology) and the number error prescriptions to show which areas should be trained in prescribing antibiotics. The most frequent errors in the initial prescription of antibiotics that were documented corresponded to not indicating the time of administration of the antibiotic in the case of surgical prophylaxis and dosage. After applying the “Time out” strategy, the most documented error was the prolongation of antibiotic prophylaxis. The most frequently prescribed pharmacological group of antibiotics corresponded to cephalosporins. Conclusion Antimicrobial education or restriction strategies are required to correct the high percentage of errors observed in antibiotic prescriptions. Knowing this baseline state is the initial step for the formulation of antimicrobial use optimization programs that reduce adverse events, costs, and local antimicrobial resistance rates. Despite having statistically significant data between prescription errors and the indication of antibiotics as prophylaxis, the heterogeneity of the services prescribed does not make a conclusion of the probability of occurrence of the event possible, however it shows the services that need more training in the prescription of antibiotics.

Evaluating the Psychometric Properties of the eHealth Literacy Scale (eHEALS) among Polish Social Media Users.

Social media have become mainstream online tools that allow individuals to connect and share information. Such platforms also influence people’s health behavior in the way they communicate about personal health, treatment, or physicians. Individuals’ ability to find and apply online health information on specific health problems can be measured using a valid and reliable instrument, the eHealth Literacy Scale (eHEALS). The objective of this study was to evaluate the psychometric aspects of the Polish version of this instrument (eHEALS-Pl) among social media users, which has not been explored so far. We examined the translated version of the eHEALS in a representative sample of Polish social media users (n = 1527). CAWI (computer-assisted web interviews) was a method to collect data. The reliability of the eHEALS-Pl was measured by calculating the Cronbach alpha coefficients and analyzing the principal components. Exploratory factor analysis and hypothesis testing was used to assess the construct validity of the instrument. The internal consistency of the eHEALS-Pl was sufficient: Cronbach alpha = 0.84. The item-to-total correlations ranged from r = 0.514 to 0.666. EFA revealed a single structure explaining 47.42% of the variance, with high factor loadings of the item ranging from 0.623 to 0.769. Hypothesis testing also supported the validity of eHEALS-Pl. The eHEALS-Pl evaluation supported by social media users reviled its equivalence to the original instrument developed by Norman and Skinner in 2006 and it can be used to measure e-health literacy. Since there is no prior validation of the eHEALS among social media users, these findings may indicate important directions in evaluating digital skills, especially in relation to the current challenges related to the COVID-19 pandemic.

Cardiology is Born in 1749 Under the Pen of Jean- Baptiste Sénac

In the year 1749, in Paris, a work entitled “Textbook on the structure of the heart, its action and its diseases” [1] was published. It is written in French. Its author is Jean-Baptiste Sénac, personal physician to the King, Louis XV.