Medical Providers Research Articles

Changes in healthcare seeking behaviors among caretakers of children in the previously occupied ISIS territory: Hadeetha, Anbar, Iraq: a cross-sectional survey of 415 households.

The western province of Anbar, and the district of Hadeetha, have suffered direct impacts from the second United States led invasion (2003) through the ISIS invasion (2014-2017). With the primary health care centers being closed or inaccessible, the remaining population experienced changes in health seeking. The area of Anbar, Iraq remains largely remote from the discourse of health system recovery post-conflict. The objective of this study was to describe changes in health seeking behaviors of caregivers of children ages 12-72months of age in Hadeetha, Anbar, Iraq from the conflict period of ISIS (Islamic State of Syria and Iraq), 2014-2017, to the post-conflict period, 2021. This was a mixed-methods study composed of a cross-sectional 415 household survey and focus groups in Hadeetha, Anbar, Iraq. Caretakers of children were interviewed from February to April 2021. Children were sampled from a list of children who missed at least one vaccination appointment without a return for follow-up from the birth cohorts of 2014 to 2020. Healthcare workers focus groups and key informant interviews occurred from 2019 to 2021 centered around experiences from the 2014 to 2021 period. In the post-conflict period, there were no differences in health seeking based upon provider type between respondents. Physicians were primary healthcare providers in the post-conflict period for 79% of respondents versus only 47% in the conflict period. Healthcare workers described major barriers to delivering services in Hadeetha during the ISIS occupation due to infrastructure damage, threats of violence, decreased medical personnel, lack of compensation and disruptions in medical supplies from 2014 to 2017. This study provides insight into health seeking challenges among the many individuals who remained in Hadeetha during the ISIS occupation. Health use patterns by provider type mirror the concerns the healthcare providers shared: limited availability, efflux of professional workers, limited resources and security challenges to providing care. Positive trends toward increased access to physicians during periods of peace are an encouraging marker for continued population resilience during the post-conflict period. Recovery efforts continue to be hampered by internal sectarian discord within Iraq as well as insufficient resources to maintain health services as well as provide catch-up health services, such as immunizations.

Spanish Terms for Cleft Lip Within the United States.

To examine Spanish terms used for “cleft lip” within the United States. Perceived acceptability of these terms was also considered. An online survey was distributed to Spanish-speaking medical interpreters, clinicians, and parents of children with cleft lip. Survey questions probed demographics, language use, preferred term for “cleft lip,” and perceived acceptability of terms for cleft lip. There were 158 respondents. Significant differences were observed with profession ( P < .001) as 62.5% of medical providers used labio hendido, while 71.8% of interpreters preferred labio leporino. Perceived acceptability of terms was consistent with the term use patterns reported by respondent groups. Significant differences were also observed with geographical region ( P = .001) as 90% of respondents from the Northeast United States employed labio leporino, compared to 60% to 70% of respondents from other regions. Selection and perception of Spanish terms for “cleft lip” may differ across regions and professions. Cleft teams should invite stakeholders to discuss what terms best suit their community.

Enhancing disaster management through multi-objective water wave optimization for medical supplies storage and distribution

This paper conducts a comparative analysis of advanced methodologies aimed at addressing the intricate task of scheduling medical supplies in both civilian and military sectors for epidemic prevention and control. This study introduces a multi-objective water wave optimization (MOWWO) algorithm and enhance its efficacy by incorporating a dynamically adjusted component to the metaheuristic approach (DAMOWWO). The primary goal of this research is to assess the proposed approach in contrast to established state of the art methods with similar objectives. The aim of this study is to optimize multiple aspects simultaneously, including the overall satisfaction rates of medical supply delivery and the reduction of scheduling costs, while ensuring a minimum military supply reservation ratio. This paper offers a comprehensive evaluation of the MOOW algorithm, emphasizing its potential applications in emergency response scenarios.

Nursing Care and Ethical Challenges in the COVID-19 Pandemic: A Review

The COVID-19 pandemic has placed unprecedented pressures on healthcare systems across the globe, with nurses playing a pivotal role in managing patient care during this crisis. As front-line caregivers, nurses were not only responsible for delivering essential medical care but also found themselves navigating a series of ethical challenges that were often fraught with complexity. This review delves into the multifaceted role of nursing during the pandemic, focusing on both the clinical care provided and the significant ethical dilemmas faced by nurses. One of the most pressing ethical challenges was the allocation of scarce medical resources. The surge in COVID-19 cases led to critical shortages of ventilators, ICU beds, personal protective equipment (PPE), and other medical supplies. Nurses, often collaborating with multidisciplinary teams, were forced to make difficult decisions regarding which patients would receive these limited resources, raising profound ethical concerns about fairness and equity in healthcare. The review highlights the need for transparent, consistent decision-making frameworks that prioritize justice and equity. Such frameworks help ensure that resource allocation is guided by ethical principles rather than subjective judgments, thus fostering a fairer and more consistent approach to patient care. Another significant ethical issue addressed in this review is the balance between personal safety and professional duty. Nurses were often placed in situations where they had to weigh their commitment to patient care against the risks posed to their own health, particularly when faced with shortages of adequate PPE. This balancing act between personal safety and professional obligation introduced ethical dilemmas, such as the extent to which nurses were adequately informed of the risks they faced and whether healthcare institutions fulfilled their responsibility to provide a safe working environment. The review underscores the importance of developing robust infection control measures and ensuring the continuous supply of PPE to safeguard the health and well-being of healthcare workers. Patient autonomy and consent were also critical concerns during the pandemic. The urgency of care for critically ill COVID-19 patients, combined with isolation protocols that restricted family involvement, made it challenging to uphold patients' decision-making rights. The review explores how informed consent processes were affected by the rapid progression of illness and the necessity for immediate medical interventions, often with limited patient or family input. This issue further underscores the need for ethical guidelines that protect patient rights while ensuring timely and effective care. The psychological impact of the pandemic on nurses is another key focus of this review. Nurses faced not only physical exhaustion from long hours of work but also significant emotional strain from witnessing high mortality rates and making difficult ethical decisions. The review emphasizes the need for mental health resources, such as counseling and support groups, to help nurses cope with the emotional toll of their work. Addressing issues such as moral injury, compassion fatigue, and burnout is essential to maintaining a resilient nursing workforce. In conclusion, this review provides a comprehensive examination of the ethical challenges faced by nurses during the COVID-19 pandemic. It highlights the critical need for clear ethical guidelines, transparent resource allocation frameworks, protective measures, and mental health support systems. The lessons learned from this pandemic are invaluable for shaping future responses to global health crises, ensuring that nurses and other healthcare professionals are better equipped to navigate the ethical complexities of emergency care.

"Hanging on by a Thread": The Lived Experience of Parents of Children with Medical Complexity.

Families with children with medical complexity endure high levels of chronic and toxic stress, impacting the overall health and wellbeing of all family members and the system as a whole. The purpose of this study was to examine the lived experiences of parents/caregivers with children with medical complexity. The lived experiences of 15 parents of children with complex medical needs were explored using focus group discussions. Focus group discussions were recorded, transcribed, and analyzed using van Manen's 6-step process for hermeneutic phenomenology. Aligned with the research questions, the analysis draws on van Manen's four lived existential analytical categories. Themes include: (1) lived body, the psychological and physiological effect; (2) lived time and space, the immediate impact on the there, now, and then; (3) lived relationships, social life and family relational effect; (4) risk factors; and (5) protective factors. Caregivers of children with medical complexity have a unique experience of trauma and resilience. This study will inform interdisciplinary medical providers about the mental health and resiliency experiences of this population to support more effective healthcare practices.

Beliefs surrounding the use of inhaled asthma medication in The Gambia: a qualitative study of asthma patients and healthcare workers

Asthma-related mortality is high in low- and middle-income countries. Little is known about public perceptions of inhaled medicines. We conducted semi-structured interviews with asthma patients and healthcare workers at three secondary care facilities in The Gambia, between August and November 2022. Thematic analysis was used to interpret these data. A total of 20 patients and 15 healthcare workers were interviewed. Both groups noted limited access to inhalers was an issue resulting in continued use of oral medications. Some patients recognised the benefits of inhalers, yet beliefs that inhalers were dangerous were common. Reliance on oral short-acting beta agonists meant patients saw asthma as a recurrent acute condition resulting in an emphasis on hospital management with little awareness of inhaled preventative medicines. Increasing access to inhaled medicines has the potential to reduce costly avoidable admissions, but socio-cultural factors, in addition to medication supply, need addressing.

Psychological Impact of Covid-19 Pandemic on Health Care Workers of a Field Hospital in UN Peacekeeping Mission

Background: The Covid-19 pandemic has significantly affected the healthcare system worldwide as well as the psychological state of all. The objective of the current study was to assess the psychological conditions of the healthcare workers in Enhanced Level 1+ Hospital, Bouar, Central African Republic (CAR). This assessment can help in the guideline development and implication psychological interventions which in turn can improve the quality of life, working environment and decision-making capabilities of health care workers during widespread pandemic. Methods: This descriptive cross-sectional study was conducted on 40 medical personnel working in Enhanced Level 1+ Hospital, Bouar, Central African Republic. The study was performed from June 2022 to August 2022. Assessment of psychological status of military healthcare providers was done by analyzing the results derived from the Mental health survey, Perceived Stress Scale (PSS-10), Generalized Anxiety Disorder scale (GAD-7) and Patient Health Questionnaire (PHQ-9). Hospital records were analyzed to assess the changes in workload. Results: The working hour increased significantly from Pre Covid to Post Covid period (1920±34.1 hours/week to 2120±67.3 hours/week) although the number of weekly patients in OPD and Emergency decreased slightly from 51.9 to 40.6. Elevated mental stress was observed during outbreak (average PSS-10 score in June 22 was 20.4 which reduced to 9.7 in August). The same pattern was observed in case of GAD-7 score (15.6 to 10.8) and PHQ-9 score (12.4 to 6.1). The percentage of concerns regarding Covid19 was high during the outbreak, 37/40 (92.5%), which decreased after wards to 18/40 (45%). Conclusion: The UN field hospitals are inadequate to support mass outbreak like COVID 19 in the context of both staff and medical supplies. During Covid 19 outbreak, sharp rise of workload and difficulties in restocking of essential medical items played a vital role in the mental state of the medical professionals. The field hospitals in UN peacekeeping missions require intensive effort especially on disaster and epidemic management during pre-deployment training. Moreover, reconsidering distribution of human resources in field hospitals is also required. Bangladesh Armed Forces Med J Vol 57 No (1) June 2024, pp 35-42

Advanced supply chain optimization for emerging market healthcare systems

The complexities of pharmaceutical supply chains in emerging markets present significant challenges that directly impact healthcare outcomes, particularly in underserved regions. This research focuses on the optimization of supply chain systems for the healthcare sector, with an emphasis on enhancing pharmaceutical delivery. By leveraging data analytics and innovative procurement strategies, the study seeks to improve efficiency, reduce operational costs, and ensure the timely distribution of essential medications. Drawing on practical experiences at eMedic Technologies Africa, the research highlights the need for advanced models that integrate real-time data to optimize inventory management, forecast demand, and address bottlenecks in last-mile delivery. The study proposes a multi-faceted approach to addressing common challenges in emerging market supply chains, including unreliable infrastructure, fluctuating demand, and limited access to technology. By utilizing predictive analytics, the proposed models aim to improve accuracy in demand planning, reducing stockouts and overstock situations. Additionally, innovative procurement strategies, such as centralized procurement and strategic partnerships with local suppliers, are explored as key methods for enhancing cost-effectiveness and streamlining supply chain operations. A critical component of the research is the focus on last-mile delivery, which remains a significant hurdle in rural and underserved areas. The study advocates for the use of digital platforms and mobile technologies to enhance delivery tracking and coordination, ensuring that essential medications reach their destination efficiently. Furthermore, it emphasizes the importance of fostering collaboration between governments, non-governmental organizations, and private sector stakeholders to build resilient supply chain systems capable of adapting to local conditions. By providing actionable insights and scalable models for supply chain optimization, this research aims to contribute to improved healthcare delivery in emerging markets. The proposed strategies not only reduce costs and improve efficiency but also ensure a reliable and consistent supply of medications, ultimately leading to better health outcomes in regions most in need. Keywords: Supply Chain Optimization, Data-Driven Procurement, Last-Mile Delivery, Healthcare Efficiency, Emerging Markets

Co-evolution, organizational capacity building, logistics capabilities and operational agility during health emergencies

PurposeGlobally, health care facilities often fail to respond quickly to health emergencies, resulting in significant deaths. Thus, the study examines the mediating effect of logistics capabilities in the relationship between co-evolution, organization capacity building and operational agility.Design/methodology/approachSmartPLS 4.0.8.3, variance-based structural equation models (VB-SEM) were used to test direct and indirect hypotheses across 45 health facilities. The respondents were 140 nurses and doctors. Disproportionate stratified simple random sampling was used based on government and private health facilities in Kampala City, Uganda.FindingsA significant and positive relationship exists between logistics capability and operational agility. However, co-evolution and organizational capacity are intimately linked to operational agility via logistics capability.Research limitations/implicationsA quantitative cross-sectional survey was conducted using self-administered questionnaires. The results did not show any variation in the operational agility of health facilities during emergency management; thus, qualitative approaches are needed.Practical implicationsDuring emergency management, health facilities need to cooperate by sharing information, building capacity to increase their responsiveness and flexibility. This should be done by sharing equipment, tools, drugs and medical supplies, and we hope to encourage joint medical research.Originality/valueA complex adaptive systems (CAS) framework is used in this study to examine how co-evolution, organizational capacity building and logistical capability relate to the operational agility of healthcare during times of emergency.

Physical activity in the Fontan population: provider recommendations and patient actions.

Emerging evidence suggests that routine physical activity may improve exercise capacity, long-term outcomes, and quality of life in individuals with Fontan circulation. Despite this, it is unclear how active these individuals are and what guidance they receive from medical providers regarding physical activity. The aim of this study was to survey Fontan patients on personal physical activity behaviours and their cardiologist-directed physical activity recommendations to set abaseline for future targeted efforts to improve this. An electronic survey assessing physical activity habits and cardiologist-directed guidance was developed in concert with content experts and patients/parents and shared via a social media campaign with Fontan patients and their families. A total of 168 individuals completed the survey. The median age of respondents was 10 years, 51% identifying as male. Overall, 21% of respondents spend > 5 hours per week engaged in low-exertion activity and only 7% spend > 5 hours per week engaged in high-exertion activity. In all domains questioned, pre-adolescents reported higher participation rates than adolescents. Nearly half (43%) of respondents reported that they do not discuss activity recommendations with their cardiologist. Despite increasing evidence over the last two decades demonstrating the benefit of exercise for individuals living with Fontan circulation, only a minority of patients report engaging in significant amounts of physical activity or discussing activity goals with their cardiologist. Specific, individualized, and actionable education needs to be provided to patients, families, and providers to promote and support regular physical activity in this patient population.

Early identification and communication in cerebral palsy: Navigating a collaborative approach for neonatal follow-up programmes.

This article will provide a clinical case demonstrating the implementation of early identification and review the tools and findings and the diagnostic approach. We will review highlighted literature on the subject of communicating a diagnosis. While improved function is a critical goal, the process of communicating the diagnosis of CP can be challenging for both parents and providers. It aims to provide insights on the evidence supporting early identification and discusses strategies for effective communication of crucial information. The article reviews the literature on communication of a diagnosis. Thirteen articles were identified relating to the communication of a diagnosis of CP and parent experience. We examine this evidence, leveraging the knowledge of an interdisciplinary team and incorporating feedback from parents. Strategies for effective communication include engagement with families, community therapy teams and all medical providers. Consistent, individualised, collaborative communication is critical. Awareness of ableism and use of balanced, value-neutral terminology is recommended.

Urban-rural differences in preferences for traditional Chinese medicine services among chronic disease patients: a discrete choice experiment

BackgroundWith the increasing prevalence of chronic diseases, the demand for medical services from chronic disease patients has become diversified and personalized. The advantages and role of traditional Chinese medicine in the prevention and treatment of chronic diseases gradually emerging. The preferences and willingness to pay for traditional Chinese medicine services (TCMS) among patients with chronic diseases, as well as any disparities between urban and rural patients, have not been examined in past studies.ObjectiveThis study aimed to investigate the preferences of chronic disease patients for TCMS, explore the value/importance that patients place on different treatment attributes, and evaluate whether there are urban-rural differences in their preferences and willingness to pay for TCMS.MethodsA total of 317 patients from Jiangsu Province, China participated in a discrete choice experiment that elicited the preferences for TCMS. The choice questions were constructed by six attributes: out-of-pocket (OOP) cost, institution, medical provider, treatment method, treatment duration, treatment efficacy. Mixed logit models were used to estimate the stated preference and marginal willingness to pay for each attribute.ResultsThe choice preferences of chronic disease patients for TCMS in this study were influenced by the four attributes: institution, treatment method, and treatment efficacy, and OOP cost. Improvements in treatment efficacy were the most concerning, followed by being treated in traditional Chinese medicine (TCM) hospital. Patients were willing to pay more to get better treatment outcomes. Compared with primary care institutions, patients were willing to pay more for treatment in TCM hospitals. The preferences for economic attribute (OOP cost) varied between urban and rural areas, and rural patients tended to favor scenarios that imposed a lower economic burden on them.ConclusionThe chronic disease patients’ preferences for TCMS were determined mainly by treatment efficacy but also by institution, treatment method and OOP cost. The urban-rural difference in preference identified in this study highlights that effective policy interventions should consider the characteristics of patients’ demand in different regions.

The preparation of polyaniline/graphene/polypropylene nanocomposite and its novel antibacterial activity

AbstractThe demand for polymers with antibacterial properties is increasing in food packaging industry and medical supplies. Antibacterial additives without toxic metal ion release are crucial for health and safety but still have challenges. Herein, polypropylene (PP) nanocomposite was prepared with polyaniline/graphene nanocomposite (PANI/GNP) as a green antibacterial additive due to its electrostatic, free radical, and nanoknife effect synergistic antibacterial mechanisms. To improve the dispersibility of PANI/GNP, nanosilica coating on PANI/GNP was constructed successfully with in situ condensation polymerization of epoxy functionalized ethyl orthosilicate to obtain EP‐nSiO2‐PANI/GNP. EP‐nSiO2‐PANI/GNP with a thin nanosilica coating has a significantly improved thermal stability as compared with that of PANI/GNP characterized by TGA. The EP‐nSiO2‐PANI/GNP presents a nanoscale disperse state in PP nanocomposite and thus enhances the melt viscosity and storage modulus accordingly characterized by TEM and Rheology. The EP‐nSiO2‐PANI/GNP/PP filled with 0.5 wt% of EP‐nSiO2‐PANI/GNP demonstrates antibacterial activity of 100% against both Escherichia coli and Staphylococcus aureus.Highlights In situ condensation polymerization to prepare EP‐nSiO2‐PANI/GNP. EP‐nSiO2‐PANI/GNP has enhanced dispersion stability. EP‐nSiO2‐PANI/GNP with a thin nanosilica coating has a good thermal stability. PP nanocomposite with 0.5 wt% filler has excellent antibacterial activity. The electrostatic, free radical, and nanoknife effect antibacterial mechanism.

An exploratory examination of medical and nursing students’ intentions to discuss body image, weight, and eating disorders with their patients

BackgroundAlthough many people have concerns about their body image, weight, and eating behaviors these issues are not usually discussed in a productive manner with medical providers. Thus, we examined nursing and medical students’ willingness to discuss patients’ weight, body image, and eating disorders and reasons why they may do so.MethodOne hundred and eighty-three nursing and medical students (Mage = 25.06, SD = 5.43) participated in this study. Participants completed open-ended questions pertaining to their willingness to discuss body image, eating, and weight-related issues with future patients. We further queried students’ perspective on body mass index (BMI) as a measure of weight status and sought to determine if participants’ own weight, weight concerns, appearance evaluation, body appreciation, and experiences of stigma were associated with their willingness to discuss weight-related issues with prospective patients.ResultsCoding of qualitative data indicated that nursing and medical students were “sometimes” willing to discuss prospective patients’ weight, body image, and eating disorders, especially if a health concern was evident. Nursing students seemed somewhat more willing to discuss weight issues than medical students and willingness to discuss one of these issues (e.g., body image) was positively associated with willingness discuss the others. Plans for future discussions of body image and weight were marginally associated with personal experiences of weight stigma. The majority of participants indicated that BMI was not a valid measure of health.ConclusionsTaken together, findings suggest that future providers’ conversations with patients about these sensitive topics are less likely to be associated with their own experiences and more with the relevance of these topics to specific patients.

Social networks and stigma: The experiences of African immigrants living with HIV in the United States

Over the past two decades, research on the conceptualization, measurement, and refinement of stigma has grown extensively due to increasing recognition of stigma as a driver of adverse health outcomes. While these lines of research have generally recognized that stigma is enacted in social relationships, few analysts have characterized how the structure and composition of these relationships influence stigma, particularly among immigrant populations. In response, this paper integrates data from social network analysis and in-depth interviews to explore the experiences of and responses to stigma by African immigrants living with HIV in the United States.All participants reported that they anticipated, experienced, and internalized stigma within their personal networks. Many concealed their status and disclosed to only trusted associates, family members, and medical providers. Building on findings from previous studies, we found that the meanings and belief systems (particularly African cultural discourses that link HIV with mortality, immorality, retribution, and silence) matter for how stigma is assigned, enacted, experienced, and resisted. Our analyses also revealed that the structure of participants personal networks (i.e, the extent to which their associates were connected to each other, and how integrated/involved they were in these network relationships) intensified or diluted their exposure to stigmatizing discourses, depending on the composition (resourcefulness/quality) of their personal networks. Such network connections (i.e., social capital) translate into rewards if they are supportive and accepting, and costs if they stigmatize.By showing how individuals can use their social networks to stigmatize or support their peers, this study advances theoretical expositions on (1) how the meanings and belief systems held by individuals matter for understanding social network/structural processes,(2) how social networks shape how stigma is assigned, enacted, experienced and resisted,(3) the costs and downsides of social capital, which are often neglected through emphasis on its salutary impacts. Our findings underscore the need for interventions that leverage the salient properties of personal networks to understand, conceptualize, measure, and reduce stigma.

Disclosing Personal Health Information to Emotional Human Doctors or Unemotional AI Doctors? Experimental Evidence Based on Privacy Calculus Theory

The commercialization of artificial intelligence (AI) in healthcare is accelerating, yet academic research on its users remains scarce. To what extent are they willing to disclose personal health privacy to AI doctors compared to traditional human doctors? What factors are shaping these decisions? The lack of user research has left these questions unanswered. This article, based on privacy calculus theory, conducted a multi-factorial between-subjects online experiment (N = 582) with a 2 (medical provider: AI vs. human) × 2 (emotional support: low vs. high) × 2 (information sensitivity: low vs. high) design. The results indicated that AI doctors lead participants to perceive both lower health benefits and privacy risks. Emotional support is not always beneficial. On one hand, high emotional support can provide patients with more health benefits, but on the other hand, it also poses higher levels of privacy risks. Additionally, high emotional support responses from AI doctors could enhance patients’ health benefits, trust, and willingness to disclose health privacy, while the opposite was observed for human doctors.

The Moderating Role of Proposed External Incentives on COVID-19 Vaccination Intentions in an Emerging Economy Context

The COVID-19 pandemic has highlighted the critical need for widespread vaccination to combat the spread of the virus and protect public health. This study aims to investigate the factors that influence COVID-19 vaccination intentions and examine the moderating role of proposed external incentives in an emerging economy context. Specifically, the study explores the impact of attitude, subjective norms (SN) and perceived behavioural (PB) control on vaccination intentions and examines how external incentives interact with these factors to strengthen vaccination intentions. Data was collected through 318 structured self-report questionnaires administered to individuals. The collected data underwent statistical analysis using partial least squares structural equation modelling (PLS-SEM) with SmartPLS 3.0. The analysis fulfilled all the necessary assumptions and criteria for data quality and model robustness. The findings indicate that attitude, SN and PB control significantly influence individuals’ intentions to get vaccinated against COVID-19. However, the main contribution of this study lies in its revelation that proposed external incentives positively impact the relationship between attitude and vaccination intentions. This suggests that external factors, such as monetary and non-monetary incentives, play a crucial role in attracting individuals towards preventive vaccination. The findings hold practical implications for policymakers and medical service providers, as they highlight the importance of external incentives in positively influencing vaccination intentions. These insights can aid in designing effective strategies to encourage vaccine uptake and reduce the likelihood of future pandemics.

Incorporating the Pillars of Lifestyle Medicine into Physician Assistant/Associate Education: A Benefit for Patients, Physician Assistants/Associate Education, and Physician Assistants/Associates.

The value of using lifestyle medicine (LM) to prevent disease is well established, yet medical education about LM is inconsistent, for both physicians and physician assistants/associates (PAs). As medical providers, PAs are uniquely positioned, with careers in a variety of disciplines from primary care to intensive care, as well as an ability to move across disciplines throughout their career lifespan. Therefore, the addition of LM principles in PA education can affect patients across the lifespan and in a wide variety of clinical settings. In addition, with burnout prevalent among PA students, the addition of LM to PA education may be able to give these future clinicians the tools they need to manage stress and improve overall wellness. The purpose of this study was to share with PA educators the valuable lessons learned when introducing LM into PA curriculum in hopes of broader adoption. The American College of Lifestyle Medicine (ACLM) provides modules for teaching LM to medical providers which was adopted into the Northeastern University PA Program's didactic curriculum in the summer of 2023. An online survey was administered to first-year PA students in July 2023 to evaluate the PA students' perspectives on the value of adding a LM curriculum as part of their education to care for patients and the content provided through ACLM and to determine their perceived value in using the information for themselves as part of preventing future provider burnout. Most respondents (91%) indicated that they were either "likely" or "very likely" to use the information learned in the LM modules as part of their future patient care, and 86.4% indicated that they would use the information as part of their own self-care. Most PA student respondents (88.6%) thought that the components of LM complemented the existing PA curriculum in primary care and (86.4%) indicated that they will use the information as part of their own self-care. However, given the intense volume of information provided to PA students for their general primary care education, it was suggested to pare down the volume of materials to streamline the curriculum. Overall, these PA students believe that LM should comprise a portion of their PA medical education curricula for their patients and for themselves.

Randomness suppress backward bifurcation in an epidemic model with limited medical resources

This paper delves into the dynamic features of a stochastic SIR epidemic model featuring a perturbed transmission rate influenced by white noise. Our primary aim is to unravel the intricate interplay between restricted medical resources, their supply efficiency, and environmental stochasticity, shedding light on their collective impact on the transmission dynamics of infectious diseases. Our findings bring to light a notable distinction from the deterministic counterpart of the model. Specifically, under varying scenarios of medical resource availability and supply efficiency, the stochastic model exhibits a departure from bifurcation phenomena. This stands in contrast to the deterministic model, which is characterized by the presence of both backward bifurcation and Hopf bifurcation phenomena. To complement and validate our theoretical findings, numerical simulations are employed, providing concrete illustrations of the dynamical phenomena discussed in the paper. This research contributes to a nuanced understanding of the intricate interplay between stochastic environmental factors, medical resource constraints, and disease transmission dynamics, offering valuable insights for public health management and epidemic control strategies.

The Potential of Tele-Ultrasound, Handheld and Self-Operated Ultrasound in Pregnancy Care: A Systematic Review.

To explore the use of tele-ultrasound and handheld or self-operated ultrasound in pregnancy. A systematic search provided 31 studies. The risk of bias for each study was assessed. Results were analyzed and presented in a narrative overview in four domains: tele-ultrasound, patient-operated ultrasound, handheld devices and low- and middle-income countries (LMIC). The quality of studies was generally low or fair based on the NIH Quality Assessment Tools. Fetal tele-ultrasound services (11 studies) are feasible and especially helpful in rural areas or with increased centralization of specialist care. Three studies with patient-operated ultrasound concluded its feasibility with good-to-high experiences. The use of handheld devices in pregnancy (eight studies) showed similar ultrasound results when compared to standard devices. In LMICs, innovative use of ultrasound (nine studies) can facilitate access to obstetric care performed by trained as well as unskilled caregivers combined with remote evaluation by an expert. Innovations in ultrasound in pregnancy care have shown promising results for application. Although most studies demonstrated benefits for pregnant women or care providers, high-level evidence is scarce. High-quality studies on innovations are needed to assess medical outcomes, patient and provider experiences and costs.