Pandemi Döneminde Çocuk ve Ergen Psikiyatrisi Polikliniğine Başvuran Çocuklarda Uyku Bozukluğu ve Ílişkili Faktörler

Objective: This study determined whether children have sleep disorders during the Coronavirus disease-2019 (COVID-19) pandemic restriction process, and if they do, to determine in which areas they have problems with sleep, as well as to examine the relationship of sleep disorder with chronotype and coronavirus anxiety. Materials and Methods: In April-November 2020, 98 patients attending Kocaeli University Child Psychiatry clinics and attending primary school 1-4th grade were recruited. "Sociodemographic Form", "Child Sleep Habits Questionnaire", and "Children's Chronotype Questionnaire" were applied to the parents. The short form of the "Coronavirus Anxiety Scale" and the information form about the pandemic process were applied to the children. Results: According to the sleep habits questionnaire, 70.4% of the group had clinically significant sleep problems. The most common sleep disorders observed in our study;are bedtime resistance, delayed falling asleep, and nighttime awakenings. A significant relationship was found between physical illness in the family (p=0.019), smoking (p=0.032), sleep pattern change during the pandemic (p=0.002), sleep change of the mother (p=0.006) and/or father (p=0.035), change in appetite (p=0.010), and sleep disorder. According to the chronotype scale, 66 children were morning and children's anxiety toward coronavirus was low. Conclusion: Our study shows that sleep disturbance in children is marked during the pandemic period, but this is due to changes in sleep patterns and parents' sleep rather than problems related to anxiety or chronotype associated with the pandemic. It will be useful to question these factors and make arrangements in this direction when evaluating the sleep-related problems of patients who apply to outpatient clinics. Amaç: Bu çalışmada, Koronavirüs hastalığı-2019 (COVID-19) pandemisi kısıtlama sürecinde çocukların uyku bozukluğu yaşayıp yaşamadığının, eğer yaşıyorlarsa uyku ile ilgili hangi alanlarda sorun yaşadıklarının saptanması, ayrıca uyku bozukluğunun kronotip ve Koronavirüs anksiyetesi ile ilişkisinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Nisan-Kasım 2020 tarihleri arasında Kocaeli Üniversitesi Çocuk ve Ergen Psikiyatri polikliniklerine başvuran;ilkokul 1-4. sınıfa giden 98 hasta çalışmaya dahil edilmiştir. Ebeveynlere "Sosyodemografik Bilgi Formu", "Çocuk Uyku Alışkanlıkları Anketi", "Çocukluk Dönemi Kronotip Anketi";çocuklara ise "Koronavirus Anksiyete Ölçeği Kısa Formu" ve pandemi süreci ile ilgili beş maddeden oluşan bilgi formu uygulanmıştır. Bulgular: Uyku alışkanlıkları anketi toplam puanına bakıldığında, grubun %70,4'ünün klinik olarak anlamlı düzeyde uyku sorunu yaşadığı saptanmıştır. Çalışmamızda gözlenen en yaygın uyku bozuklukları;yatma zamanı direnci, uykuya dalmanın gecikmesi ve gece uyanmalarıdır. Ailede fiziksel hastalık (p=0,019), sigara kullanımı (p=0,032), pandemide uyku düzen değişikliği (p=0,002), annenin uyku değişimi (p=0,006), babanın uyku değişimi (p=0,035), ve iştah değişimi (p=0,010) ile uyku bozukluğu arasında anlamlı ilişki saptanmıştır. Kronotip ölçeğine göre 66 çocuğun sabahçı, 31 çocuğun ara form, bir çocuğun ise akşamcı olduğu gözlenmiştir. Çocukların Koronavirüse yönelik anksiyetesinin düşük olduğu saptanmıştır. Sonuç: Çalışmamız, çocuklarda pandemi döneminde uyku bozukluğunun belirgin düzeyde olduğunu ancak bu durumun pandemi ile ilişkili anksiyete ya da kronotip ile ilgili sorunlardan çok, uyku düzenlerindeki değişiklik ve ebeveynlerin uykusundaki değişimlerden kaynaklandığını göstermektedir. Polikliniklere başvuran hastaların uyku ile ilgili sorunları değerlendirilirken bu faktörlerin sorgulanması ve bu yönde düzenlemeler yapılması yararlı olacaktır.

Sleep Disorders and Associated Factors in Children Who Admitted to the Child and Adolescent Psychiatry Outpatient Clinics During the Pandemic.

Objective: This study determined whether children have sleep disorders during the Coronavirus disease-2019 (COVID-19) pandemic restriction process, and if they do, to determine in which areas they have problems with sleep, as well as to examine the relationship of sleep disorder with chronotype and coronavirus anxiety. Materials and Methods: In April-November 2020, 98 patients attending Kocaeli University Child Psychiatry clinics and attending primary school 1-4th grade were recruited. "Sociodemographic Form", "Child Sleep Habits Questionnaire", and "Children's Chronotype Questionnaire" were applied to the parents. The short form of the "Coronavirus Anxiety Scale" and the information form about the pandemic process were applied to the children. Results: According to the sleep habits questionnaire, 70.4% of the group had clinically significant sleep problems. The most common sleep disorders observed in our study;are bedtime resistance, delayed falling asleep, and nighttime awakenings. A significant relationship was found between physical illness in the family (p=0.019), smoking (p=0.032), sleep pattern change during the pandemic (p=0.002), sleep change of the mother (p=0.006) and/or father (p=0.035), change in appetite (p=0.010), and sleep disorder. According to the chronotype scale, 66 children were morning and children's anxiety toward coronavirus was low. Conclusion: Our study shows that sleep disturbance in children is marked during the pandemic period, but this is due to changes in sleep patterns and parents' sleep rather than problems related to anxiety or chronotype associated with the pandemic. It will be useful to question these factors and make arrangements in this direction when evaluating the sleep-related problems of patients who apply to outpatient clinics. (English) [ FROM AUTHOR] Amaç: Bu çalışmada, Koronavirüs hastalığı-2019 (COVID-19) pandemisi kısıtlama sürecinde çocukların uyku bozukluğu yaşayıp yaşamadığının, eğer yaşıyorlarsa uyku ile ilgili hangi alanlarda sorun yaşadıklarının saptanması, ayrıca uyku bozukluğunun kronotip ve Koronavirüs anksiyetesi ile ilişkisinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Nisan-Kasım 2020 tarihleri arasında Kocaeli Üniversitesi Çocuk ve Ergen Psikiyatri polikliniklerine başvuran;ilkokul 1-4. sınıfa giden 98 hasta çalışmaya dahil edilmiştir. Ebeveynlere "Sosyodemografik Bilgi Formu", "Çocuk Uyku Alışkanlıkları Anketi", "Çocukluk Dönemi Kronotip Anketi";çocuklara ise "Koronavirus Anksiyete Ölçeği Kısa Formu" ve pandemi süreci ile ilgili beş maddeden oluşan bilgi formu uygulanmıştır. Bulgular: Uyku alışkanlıkları anketi toplam puanına bakıldığında, grubun %70,4'ünün klinik olarak anlamlı düzeyde uyku sorunu yaşadığı saptanmıştır. Çalışmamızda gözlenen en yaygın uyku bozuklukları;yatma zamanı direnci, uykuya dalmanın gecikmesi ve gece uyanmalarıdır. Ailede fiziksel hastalık (p=0,019), sigara kullanımı (p=0,032), pandemide uyku düzen değişikliği (p=0,002), annenin uyku değişimi (p=0,006), babanın uyku değişimi (p=0,035), ve iştah değişimi (p=0,010) ile uyku bozukluğu arasında anlamlı ilişki saptanmıştır. Kronotip ölçeğine göre 66 çocuğun sabahçı, 31 çocuğun ara form, bir çocuğun ise akşamcı olduğu gözlenmiştir. Çocukların Koronavirüse yönelik anksiyetesinin düşük olduğu saptanmıştır. Sonuç: Çalışmamız, çocuklarda pandemi döneminde uyku bozukluğunun belirgin düzeyde olduğunu ancak bu durumun pandemi ile ilişkili anksiyete ya da kronotip ile ilgili sorunlardan çok, uyku düzenlerindeki değişiklik ve ebeveynlerin uykusundaki değişimlerden kaynaklandığını göstermektedir. Polikliniklere başvuran hastaların uyku ile ilgili sorunları değerlendirilirken bu faktörlerin sorgulanması ve bu yönde düzenlemeler yapılması yararlı olacaktır. (Turkish) [ FROM AUTHOR] Copyright of Journal of Turkish Sleep Medicine is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The Effect of SIRT1 activation on Cyclooxygenase enzyme activity in COVID-19 patients

For the third year COVID-19 pandemic is still a global health challenge, despite the availability of vaccines and protection methods, treatment protocols still being updated continuously to observe the optimum management for patients. Cyclooxegynase (COX) enzymes are involved in inflammation and thrombosis related to COVID-19. COX-Thromboxane2 pathway is one of the important pathways that results in thrombus formation. In this study the COX activity level changes were measured by ELISA technique in COVID-19 plasma samples that treated with SIRT1 activators resveratrol and linear BAS SIRT1 aptamer, a significant lowering in COX activity was observed with promising potential atrithrombotic action in COVID-19 to be further investigated in future.

Increasing the Level of Neopterin in patients infected with SARS-CoV-2 Indicates Fatal Mortality

Background: The severity of Coronavirus Disease-2019 (COVID-19) cases is associated with hyperinflammation. Patients with critical and severe COVID-19 have been observed to have high amounts of circulating cytokines. Neopterin, a crucial cytokine in the antiviral immune response that is released by macrophages upon stimulation with interferon-gamma, can be utilized to forecast the severity of illness in COVID-19 patients. Methods: The study included 185 patients with COVID-19. The patients with COVID-19 were divided into three groups according to disease severity as critical disease (n=51), severe disease (n=81), and moderate disease (n=53). All basic demographic and clinical data of the patients were recorded and blood samples were collected. Results: Neopterin levels were significantly higher in critical COVID-19 patients compared with severe and moderate COVID-19 patients (p < 0.0001). Further, neopterin showed significantly higher levels in the age group >50 years of patients with COVID-19 than in the age group <50 years. Neopterin levels were correlated with WBCs, Platelet, CRP, D-Dimer, Ferritin, Fibrinogen, IL-6, and Procalcitonin levels positively (ρ= 0.569, 0.474, 0.338, 0.696, 0.605, 0.77, 0.727, and 0.585;p < 0.01 respectively), and correlated with BMI, SpO2, and lymphocyte negatively (ρ= - 0.165;p < 0.05, p= - 0.754, - 0. 548;p < 0.01 respectively). A cutoff value of 23.62 nmol/L for neopterin predicted COVID-19 with a sensitivity of 95.7% and a specificity of 95.5% (AUC: 0.986;p < 0.0001). Conclusion: Neopterin may be a useful prognostic biomarker for assessing the severity of COVID-19.

COVID-19 pandemic vaccination acceptance among Basrah Medical College staff: A pilot study

Background: The COVID-19 pandemic, which was caused by a coronavirus that causes severe acute respiratory syndrome, continued as a danger to the healthcare system, with worldwide financial, educational, and societal ramifications. Vaccines are an important new tool in the COVID-19 fight. Vaccine reluctance and skepticism among the global population was a key impediment to achieving an adequate coverage rate. Method: A cross-sectional study was conducted among Medical College staff, special questionnaire was used for this proposes, consisted of questions covering socio demographic data that included age, gender and education, Also questions related to whether persons have ever had COVID-19 infection at personal and family level, questions about the means of prevention of COVID-19 and questions about acceptance of COVID-19 vaccine were also included . Results: Out of the 114 participants, a total of 98 candidates completed responses and were used in the analysis, the vast majority of those who responded were from younger age groups (33.7±14.9) years, the COVID-19 vaccine's acceptance rate among Medical College staff was 45.3%, much lower than the hesitance rate (54.7%). About 26.6%of participant got infected with Corona virus and from them 3%were severe and admitted to hospital, and about 73.4% did not get the disease. Regarding their family members 8.2%of the family members got severe infection with COVID 19 and admitted to hospital and 30.6 % of them treated in outpatient, more than half of participants reported that mask, social distancing, hand washing and avoiding of overcrowding with case isolation are most preventive measures, while only 34.7% of participant reported that immunization against Corona Virus as preventive measure. Conclusion: The results indicated a low rate of acceptance of the COVID-19 vaccine among medical college staff, emphasizing the importance of addressing any concerns regarding vaccine's skeptics by providing accurate knowledge about the vaccine's efficacy and safety.

The reduction of SARS-Cov-2 S1-RBD IgG after four months of covid-19 infection of the medical staff at the Neurosurgery Teaching in Baghdad

Background The SARS-CoV-2 pandemic continues to negatively impact the healthcare system globally despite the availability of vaccination since late 2020.Until July 2022, Iraq registered 2,438,101 million COVID-19 cases and 25,304 deaths putting Iraq in third place among the Eastern Mediterranean Sea countries. Methods This study included ninety volunteered medical staff whois working in the Neurosurgery Teaching Hospital and were diagnosed with COVID-19 by PCR and accepted to give 5 ml of their blood.The medical staff was categorized into two groups and every group containforty-five, we collected bloodfrom the first group after one month (30 days) from the day of COVID-19 infection diagnosis while the second group after 4 months (120 days).We used an ELISA kit (Diacino R: cat.No. DS 207704, china) which is an indirect ELISAto estimate Cov-19 -SI-RBD(anti-spike). Results the independent two-sample Mann-Whitney test was used which showed that there was a significant decrease (P<0.05) in the SARS Cov-2 S1-RBD serum levels of the volunteered medical staff after 4 months compared to the one month. Conclusion SARS - CoV-2 S1- RBD IgGsignificantly decreasedafter 4 months (120 days).

Methodology for a Mental Health Plan for Health Care Workers

The risk and prevalence of mental health concerns for health care workers has been exacerbated by the Covid-19 pandemic. Frontline health care workers are particularly vulnerable to professional burnout, anxiety, depression, substance use, and trauma. Although health care organizations have responded rapidly to the health and well-being needs of the patients and communities they serve, swiftly adapting to increased patient volumes, new protocols, resource shortages, and other needs as driven by the volatile environment, a similarly agile and robust effort is essential to support the mental and emotional well-being of health care workers. This article outlines the agile methodology used to mobilize a multidisciplinary team at a large academic medical center to amplify mental health support options for its workers and address barriers that prevent them from seeking that help. With the support of the Mayo Clinic Board of Governors and the People and Culture Committee through active executive sponsorship and funding, an internal team strategized and swiftly activated procedures to deal with urgent mental health barriers for frontline workers, despite the compounding challenges caused by the pandemic. This systematic approach to modeling a mental health strategic plan for health care workers featured engaging stakeholder teams through active listening, collective goal setting, and delineated short-term and long-term objectives while leveraging values-aligned and employee-centric principles. After 1 year, employees have increased the use of mental health services by as much as 14%-26%.

Development of a digital pre-assessment pathway for patients starting systemic anticancer therapy

AUTH Why you should read this article: • To understand the clinical reasons for pre-treatment assessment of patients undergoing systemic anticancer therapy (SACT) • To appreciate the benefits of a digital SACT pre-assessment pathway for cancer patients • To familiarise yourself with the challenges of providing a digital service During the coronavirus disease 2019 (COVID-19) pandemic measures have been implemented in healthcare systems to reduce transmission of the infection. People with cancer are immunocompromised and at higher risk of contracting infections, therefore many cancer services have been conducting routine reviews and pre-treatment assessments remotely through telephone and video consultations during the pandemic. Patients who are to receive systemic anticancer therapy (SACT) should have an additional consultation to provide them with specific information about the therapy, including side effects and who to contact for advice if they develop these at home. This article describes the development and implementation of a digital SACT pre-assessment pathway in a large university hospital during the COVID-19 pandemic, which aimed to deliver information to groups of patients remotely. The article explores the challenges to implementation and discusses some of the findings of a patient feedback survey, which suggest that the digital SACT pre-assessment sessions have been successful overall.

Home denosumab self-administration: a service development project

AUTH Why you should read this article: • To learn about the experience of two trusts that set up a home denosumab self-administration service for patients during the coronavirus disease 2019 (COVID-19) pandemic • To recognise the need for a robust, comprehensive and consistent training process for patients to self-administer denosumab at home safely • To identify the benefits for patients and their families of a home denosumab self-administration service In October 2012 the National Institute for Health and Care Excellence approved the use of subcutaneous denosumab for the management of bone metastases from solid tumours. For patients receiving intravenous chemotherapy, denosumab can be administered in parallel with this, obviating the need for additional hospital visits. However, patients receiving oral chemotherapy or denosumab alone often must attend hospital solely for a subcutaneous injection of the latter. This article describes the experience of two NHS trusts in setting up a home self-administration service for denosumab during the coronavirus disease 2019 (COVID-19) pandemic. The service development project took place during 2020-2021. The article explores the barriers to and facilitators of this project and reports the results of a patient feedback survey which showed that all respondents wished to continue self-administration of denosumab at home.

Academic Medical Centers Experienced Higher Rates of Post-Operative Health-Care-Associated Infections during the COVID-19 Pandemic: A Post Hoc Analysis of an Eastern Association for the Surgery of Trauma Multicenter Trial.

Background: We sought to examine health-care-associated infections (HAIs) among patients undergoing an appendectomy at academic medical centers (AMCs) and non-AMCs during the coronavirus disease 2019 (COVID-19) peri-pandemic. We hypothesized that AMCs would have higher rates of post-operative HAIs during the first wave of the pandemic. Patients and Methods: We performed a post hoc analysis of a prospective, observational, multi-center study of patients aged >18 years who underwent an appendectomy for acute appendicitis before (pre-CoV), during (CoV), and after pandemic restrictions were lifted (post-CoV). Patients were grouped according to hospital type (AMC vs. non-AMC). Our primary outcome was the incidence of post-operative HAIs. Results: There were 1,003 patients; 69.5% (n = 697) were treated at AMCs and 30.5% (n = 306) at non-AMCs. Patients at AMCs had greater rates of concomitant COVID-19 infections (5.5% vs. 0.7%; p < 0.0001) and worse operative appendicitis severity (p = 0.01). Greater rates of HAIs were seen at AMCs compared with non-AMCs (4.9% vs. 2%; p = 0.03). Surgical site infections were the most common HAI and occurred more often at AMCs (4.3% vs. 1.6%; p = 0.04). Only during CoV were there more HAIs at AMCs (5.1% vs. 0.3%; p = 0.02). Undergoing surgery at an AMC during CoV was a risk factor for HAIs (adjusted odds ratio [aOR], 8.55; 95% confidence interval [CI], 1.03-71.03; p = 0.04). Conclusions: During the COVID-19 pandemic, appendectomies performed at AMCs were an independent risk factor for post-operative HAIs. Our findings stress the importance of adherence to standard infection prevention efforts during future healthcare crises.

A 360 degree mixed-methods evaluation of a specialized COVID-19 outpatient clinic and remote patient monitoring program.

BACKGROUND: Our goals are to quantify the impact on acute care utilization of a specialized COVID-19 clinic with an integrated remote patient monitoring program in an academic medical center and further examine these data with stakeholder perceptions of clinic effectiveness and acceptability. METHODS: A retrospective cohort was drawn from enrolled and unenrolled ambulatory patients who tested positive in May through September 2020 matched on age, presence of comorbidities and other factors. Qualitative semi-structured interviews with patients, frontline clinician, and administrators were analyzed in an inductive-deductive approach to identify key themes. RESULTS: Enrolled patients were more likely to be hospitalized than unenrolled patients (N = 11/137 in enrolled vs 2/126 unenrolled, p = .02), reflecting a higher admittance rate following emergency department (ED) events among the enrolled vs unenrolled, though this was not a significant difference (46% vs 25%, respectively, p = .32). Thirty-eight qualitative interviews conducted June to October 2020 revealed broad stakeholder belief in the clinic's support of appropriate care escalation. Contrary to beliefs the clinic reduced inappropriate care utilization, no difference was seen between enrolled and unenrolled patients who presented to the ED and were not admitted (N = 10/137 in enrolled vs 8/126 unenrolled, p = .76). Administrators and providers described the clinic's integral role in allowing health services to resume in other areas of the health system following an initial lockdown. CONCLUSIONS: Acute care utilization and multi-stakeholder interviews suggest heightened outpatient observation through a specialized COVID-19 clinic and remote patient monitoring program may have contributed to an increase in appropriate acute care utilization. The clinic's role securing safe reopening of health services systemwide was endorsed as a primary, if unmeasured, benefit.

Anesthesiologists With Advanced Degrees in Education: Qualitative Study of a Changing Paradigm.

BACKGROUND: Anesthesiology education has undergone profound changes over the past century, from a pure clinical apprenticeship to novel comprehensive curricula based on andragogic learning theories. Combined with institutional and regulatory requirements, these new curricula have propagated professionalization of the clinician-educator role. A significant number of clinician-educator anesthesiologists, often with support from department chairs, pursue formal health professions education (HPE) training, yet there are no published data demonstrating the benefits or costs of these degrees to educational leaders. OBJECTIVE: This study aims to collect the experiences of anesthesiologists who have pursued HPE degrees to understand the advantages and costs of HPE degrees to anesthesiologists. METHODS: Investigators performed a qualitative study of anesthesiologists with HPE degrees working at academic medical centers. Interviews were thematically analyzed via an iterative process. They were coded using a team-based approach, and representative themes and exemplary quotations were identified. RESULTS: Seven anesthesiologists were interviewed, representing diverse geographic regions, subspecialties, and medical institutions. Analyses of interview transcripts resulted in the following 6 core themes: outcomes, extrinsic motivators, intrinsic motivators, investment, experience, and recommendations. The interviewees noted the advantages of HPE training for those wishing to pursue leadership or scholarship in medical education; however, they also noted the costs and investment of time in addition to preexisting commitments. The interviewees also highlighted the issues faculty and chairs might consider for the optimal timing of HPE training. CONCLUSIONS: There are numerous professional and personal benefits to pursuing HPE degrees for faculty interested in education leadership or scholarship. Making an informed decision to pursue HPE training can be challenging when considering the competing pressures of clinical work and personal obligations. The experiences of the interviewed anesthesiologists offer direction to future anesthesiologists and chairs in their decision-making process of whether and when to pursue HPE training.

Association of Women Leaders with Women Program Director and Trainee Representation Across US Academic Internal Medicine.

BACKGROUND: Women are underrepresented within internal medicine (IM). Whether women leaders attract women trainees is not well explored. OBJECTIVE: To characterize leader and trainee gender across US academic IM and to investigate the association of leader gender with trainee gender. DESIGN: Cross-sectional study. PARTICIPANTS: Leaders (chairs, chiefs, program directors (PDs)) in 2018 and trainees (residents, fellows) in 2012-2016 at medical school-affiliated IM and seven IM fellowship programs. EXPOSURE: Leadership (chair/chief and program director; and, for resident analyses, fellow) gender. MAIN MEASURES: Our primary outcome was percent women trainees (IM residents and, separately, subspecialty fellows). We used standard statistics to describe leadership and trainee gender. We created separate multivariable linear regressions to evaluate associations of leader gender and percent women fellows with percent women IM residents. We then created separate multivariable multilevel models (site as a random effect) to evaluate associations of leader gender with percent women subspecialty fellows. KEY RESULTS: Our cohort consisted of 940 programs. Women were 13.4% of IM chairs and <25% of chiefs in each fellowship subspecialty (cardiology: 2.6%; gastroenterology: 6.6%; pulmonary and critical care: 10.7%; nephrology: 14.4%; endocrinology: 20.6%; hematology-oncology: 23.2%; infectious diseases: 24.3%). IM PDs were 39.7% women; fellowship PDs ranged from nearly 25% (cardiology and gastroenterology) to nearly 50% (endocrinology and infectious disease) women. Having more women fellows (but not chairs or PDs) was associated with having more women residents (0.3% (95% CI: 0.2-0.5%) increase per 1% fellow increase, p<0.001); this association remained after adjustment (0.3% (0.1%, 0.4%), p=0.001). In unadjusted analyses, having a woman PD (increase of 7.7% (4.7%, 10.6%), p<0.001) or chief (increase of 8.9% (4.6%, 13.1%), p<0.001) was associated with an increase in women fellows; after adjustment, these associations were lost. CONCLUSIONS: Women held a minority of leadership positions in academic IM. Having women leaders was not independently associated with having more women trainees.

Sexual medicine programs for women across the life span: Lessons learned from a new initiative in a US-based academic medical center

In a self-report study of women presenting to a gynecological clinic, 9 out of 10 women reported a sexual health concern (Nusbaum 2003). These concerns are best addressed using a biopsychosocial approach to assessment, treatment and prevention drawing on medical, behavioral and psychological science. At an academic health center in the United States, The Women's Sexual Health Consultation Service was launched in 2019 to provide evaluation, education, treatment and prevention interventions using an integrated practice model. The interdepartmental program currently includes an Advanced Practice Nurse from the Department of Obstetrics and Gynecology as well as two clinical health psychologists from the Department of Psychiatry all with expertise in women's health and women's sexual medicine. Our interprofessional team collaborates closely with providers in women's primary care, medical, gynecologic and radiation oncology, urogynecology, colorectal surgery, among others. Review lessons learned from interdepartmental program design, funding, implementation, and evaluation of the Women's Sexual Health Consultation Service in an academic health center, summarize the types of sexual health concerns among women who presented to the integrated service, and highlight recommendations to generalize and/or adjust the program model to other types of health settings. Review the program implementation and evaluation process for the Women's Sexual Health Consultation Service, summarize the data on the women seen for care from April 23 2019 through June, 2021 (e.g., the number of unduplicated patients evaluated, their age, sexual health concerns, and treatment offered, etc), and outline program challenges and strategies to sustain and expand the initiative during and following the COVID-19 pandemic through virtual and in-person care. The Women's Sexual Health Consultation Service saw 198 women from April 23 2019 through June, 2021. Patients ranged in age from 21 to 72 (mean: 45 years). While most patients (33%) referred themselves to this program, other women were referred by obgyns, medical oncologists, women's primary care providers and gynecologic oncologists. Primary sexual health concerns included one or more of the following issues: pain (100), low desire (76), difficulty with orgasm (19), difficulty with arousal (12) and other (55). Additional findings will be presented on the types of treatment offered as well as patient and referring provider satisfaction with the new integrated sexual health consult service. Our interdepartmental Women's Sexual Health Consultation Service implemented a highly successful program that integrates sexual medicine, behavioral health, health psychology and sexual therapy to ensure access to state-of-the-art interprofessional education and care for women across the life span in all their diversities. We were able to sustain and expand this program through telehealth and in-person visits during the COVID-19 pandemic, and anticipate further growth in patient referrals and treatment modalities moving forward. Providers across disciplines also routinely refer to and collaborate with the program. Several components of the model are generalizable or adjustable to other women's health settings. Work supported by industry: no. [ FROM AUTHOR] Copyright of Journal of Sexual Medicine is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

A Framework for the Virtual Medical Interview Process: Considerations for the Applicant and the Interviewer.

Background: Videoconferencing platforms are being used for the purposes of interviewing in academic medicine because of the coronavirus disease 2019 pandemic. We present considerations applicable to interviewers and interviewees in the virtual space, with a focus on medical school and residency applicants. Methods: We reviewed the literature regarding the virtual interview process for medical school and residency by searching PubMed using the following keywords and terms: "interview," "academic medicine," "medical school application," "residency application," "virtual interviews," and "videoconferencing." Our search identified 701 results, from which we selected 36 articles for review. Results: The garnered information focuses on strategies for optimizing the virtual interview process from the standpoint of both the interviewer and the interviewee. We discuss the advantages and disadvantages of the virtual interview process and present recommendations. Conclusion: While the future of the interview process for medical school and residency is uncertain, virtual interviewing is a common and growing practice that will continue to be at least part of the medical interview process for years to come. Interviewers and interviewees should prepare to adapt to the evolving changes in the process.

How to resume safe access to a medical simulation center at the time of COVID-19 pandemic: The proposal of a protocol from a university institution in North-Eastern Italy.

INTRODUCTION: The Covid-19 global pandemic has suspended thousands of clinical education programs around the world. Also in Italy, as in the rest of the world, frontal teaching activities and internships in the medical field have been suspended. At the university hospital of Udine (North-Eastern Italy) it was decided to strengthen the use of simulation in all training stages to get over the block of training activities. METHODS: A protocol has been drawn up with the aim of providing training in safety for every student of the degree courses in medicine and health area and for doctors in residency training. In this way it was possible to carry out training sessions with a maximum of 6 students engaged in the simulation activities offered by the Center (3D) virtual cadaver, laparoscopic pelvic trainer stations, ultrasound laboratory, microsurgery, etc.). The key points of the protocol were represented by i) internet booking of the training activity; ii) respect of safety measures (hand hygiene, safe distance, restricted total number of presences, constant use of the surgical mask) and iii) reorganization of the material and cleaning of the rooms. RESULTS: Our educational strategy allowed to resume training activity maintaining adequate levels of safety for students and teachers. Applying our protocol, it was possible to guarantee safe access to our Medical Simulation Center (MSC) to a total of about 1400 students from different course of study during the period between June 2020 and February 2021. CONCLUSIONS: Our protocol could represent a practical tool in the management of resuming the activity at a MSC.

Partnerships to Care for Our Patients and Communities During COVID-19.

The Coronavirus disease 2019 (COVID-19) pandemic forced not only rapid changes in how clinical care and educational programs are delivered but also challenged academic medical centers (AMCs) like never before. The pandemic made clear the need to have coordinated action based on shared data and shared resources to meet the needs of patients, learners, and communities. Family medicine departments across the country have been key partners in AMCs' responses. The Duke Department of Family Medicine and Community Health (FMCH) was involved in many aspects of Duke University's and Health System's responses, including leadership contributions in delivering employee health and student health services. The pandemic also surfaced the biological and social interactions that reveal underlying socioeconomic inequalities, for which family medicine has advocated since its inception. Key to success was the department's ability to integrate "horizontally" with the broader community, thereby accelerating the institution's response to the pandemic.