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Collaboration and teamwork are well-established cornerstones of modern clinical and academic medicine as well as research, including radiology. Mentorship is also part and parcel of daily medical practice and training. As it is, there is a wide range of opinions on the effectiveness of standard mentorship models. In some cases, academic departments may offer mentorship to fulfill a requirement rather than as a sign of commitment to ensuring that all mentees receive the guidance they seek. Although mentor-mentee relationships might have arisen organically, and such situations are still possible, the overall lack of face-to-face interactions in many departments in the COVID era suggests the need to emphasize formal mentoring programs. We appreciate the overall successes of mentorship in medicine as well as radiology, while acknowledging that, like anything, it is not perfect. Because the processes of decision making and career planning are similar across fields, a peer-to-peer cross-specialty mentorship model could yield untold benefits to early-career radiologists who may receive valuable advice from friends or colleagues outside of medicine, or simply outside of radiology, at crucial points in their careers. There is no ideal formula or format for mentoring, however. We endorse the theory or intentions of mentorship and believe that its effectiveness can take several forms. Having a formal program in place, with built-in flexibility to address our rapidly changing times, remains highly desirable. Our proposal is to expand this notion to a "whatever works,” "anything goes,” or, in the spirit of the COVID era, a hybrid model. © 2022 Elsevier Inc.
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Introduction: Dengue viral infection is an arboviral disease which is transmitted by Aedes aegypti and Aedes albopictus. Dengue cases are now increasing a global burden especially in tropical and subtropical countries.1 The patients with dengue fever have high levels of nonstructural protein-1 (NS1) protein in their serum after onset till <5 days. The present study aims to establish most sensitive and reliable method for the early diagnosis of dengue infection. Materials & Methods: Total 110 patients were screening who were having <5 days of history of dengue like fever at NIMS Medical College, NIMS University, Jaipur from June 2020 to Oct 2022. For Dengue NS1 ICT & ELISA J. Mitra Pvt Ltd. Kits were used. Dengue RTPCR was done by TRU PCR 3B Black Bio kits as per standard protocol.5 Results: Out of 110, total 72 (65.45%) cases were positive (either by ICT, ELISA & RTPCR). Among 72 dengue positive cases 48 (66.6%) were male while 24 (33.4%) were females. Male: female ratio was 2:1 observed. 55 patients were positive by Dengue NS1 ICT, 59 were positive by NS1 ELISA while 72 cases were positive by RTPCR. Conclusion: Early detection and diagnosis are very important in the case of dengue infection as if it is not treated it may lead to many complications. RTPCR is the most sensitive and specific method for the early diagnosis of dengue. After this covid pandemic most hospitals have RTPCR lab facilities which can be utilized for dengue detection by RTPCR.
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Introduction: Research on Coronavirus Disease-2019 (COVID-19) seroprevalence in children and adolescent population across the globe is quite limited. In India, there is a dearth of data on COVID-19 seropositivity, especially in unvaccinated paediatric population, particularly in the Himalayan region. Aim: To estimate the seroprevalence of COVID-19 in children presenting in a tertiary care health institution. Materials and Methods: A hospital-based cross-sectional serosurvey was conducted on 500 children, from October 2021 to March 2022 in paediatric age group, attending Indira Gandhi Medical College Shimla, Himachal Pradesh, India, for various health related concerns such as fever, cough, loose stools, vomiting and fast breathing using convenience sampling. Socio-demographic profile was recorded and blood sample was drawn for COVID-19 antibody titre estimation. Chi-squared and Fisher's-exact tests for proportions was used for testing statistical significance. Results: A total of 500 children, age ranged from 12 hours to 17 years 7 months were enrolled with maximum children belonging to 01-05 years age group and there was slight male preponderance. Seropositivity in males (27.3%) was significantly higher than females (8.3%). Highest (42.3%) seropositivity was seen in age group of 06 months to 01 year. About 10.8% of cases were positive for Immunoglobulin (Ig) G antibody, 4.4% were positive for IgM antibody, while about 6.6% cases were positive for both antibodies. Conclusion: The seroprevalence status of children and adolescents is quite low in this region, revealing the high susceptibility of children to SARS-CoV-2 in the study region. It further emphasises benefits of serological testing in children for SARS-CoV-2 as well as the need of safe and effective vaccination for the unimmunised, unprotected and vulnerable paediatric age group.
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In recent years, the logistical challenges posed by the Covid-19 pandemic have prompted medical educators teaching gross anatomy to explore an expanded use of online instructional modalities. There is concern that this shift to online anatomy education in medical schools could affect long-term learning outcomes for future healthcare providers. In this systematic review, the educational effectiveness of online anatomy teaching is compared with traditional ("face-to-face") teaching methods, specifically in terms of students' academic performance and satisfaction. A search of four databases identified and screened 162 studies. Subsequently, 31 studies were analyzed, including both (a) teaching outcome measures (test scores) and (b) student satisfaction ratings. Authors chose studies, extracted data, assessed quality and examined risk of bias. Nineteen studies compared students' academic performances between online and face-to-face teaching methods. Twenty-six studies measured students' levels of satisfaction in both teaching methods. Both qualitative and quantitative analyses of the data revealed comparable academic performances with no statistical difference between the two teaching methods, but a higher level of satisfaction with face-to-face teaching. The findings confirm that students can learn from online teaching but are more satisfied with face-to-face teaching. The authors conclude that online teaching cannot replace traditional teaching and there is no preference for one type of modality over the other. Therefore, a multi-modal learning approach combining online with face-to-face educational modalities for medical students could be efficient and successful.
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Aims: Medical students belong to frontline health care providers of future. Risk of COVID 19 exposure is more among medical students, and COVID 19 vaccination plays very crucial role for controlling COVID 19 pandemic. Hence, this study was planned with the objective to evaluate attitude of medical students towards COVID 19 pandemic and their vaccination status. Material(s) and Method(s): We conducted an online web-based survey among medical students of Madhya Pradesh, India. Online Google form-based Questionnaire was sent through WhatsApp groups, and responses were collected and analysed. Voluntary consent was obtained through from all the participants. Finding(s): A total of 516 medical students from different medical colleges of Madhya Pradesh voluntary participated in this study. Out of that majority of the participants were in 18-20 years' age groups, unmarried and belonged to rural areas. Most of them were worried about their MBBS studies due to COVID 19 pandemic. 71% of the medical students received two doses of the COVID 19 vaccination till 15the August, 2021. Conclusion(s): Medical students of Madhya Pradesh are worried about their MBBS course completion, examination and education shift towards online due to COVID 19 pandemic. There is a need of psychological counselling and awareness program regarding vaccination among medical students. Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.
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Background Online learning can play a vital role in the process of teaching and learning during Corona Virus Disease 2019 (COVID-19) pandemic. However, learners' satisfaction is extremely important in effective implementation of the online learning, especially at institutions where it is newly adopted. Objective To assess satisfaction towards online learning and its predictors among students at Chitwan Medical College, Bharatpur. Method A web-based cross-sectional survey was undertaken among 434 undergraduate and postgraduate students from various academic programs who had participated in the online classes started during this COVID-19 pandemic. A structured questionnaire consisting of 31 items (5-point Likert scale) covering four major student satisfaction domains (learners' dimensions, technological characteristics, instructors' characteristics and course management and coordination) was distributed to the students using Google Form. Result More than half (53.5%) of the students were satisfied with the online learning, while 29.7% gave neutral views. Bivariate analyses found that all four domains scores were positively correlated with each other as well as with the students' overall satisfaction towards learning. In multivariate analysis, female gender [aOR: 2.72, p = 0.013], WiFi as internet modality for learning [aOR: 3.36, p = 0.001) and learners' dimension score [aOR: 1.27, p<0.001] were the significant predictors of students' satisfaction. Conclusion Although recently adopted, the satisfaction of the students towards online classes appears good, and prioritizing the identified predictors and working on the weak links could assist in enhancing students' satisfaction and better outcomes. Copyright © 2020, Kathmandu University. All rights reserved.
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Background and Objective: Coronaviruses are important human and animal pathogens. At the end of 2019, a novel coronavirus was found as the cause of a bunch of pneumonia cases in Wuhan, China. It rapidly spread in the country of China resulting in an epidemic, followed by a global spread in whole world leading to the pandemic. In February 2020, the World Health Organization coined the term COVID-19, The objectives to carry out this study were 1) To determine incidence of Covid-19 in health care workers after partial or complete vaccination 2) To determine severity of Covid-19 in health care workers after partial or complete vaccination at Designated Covid Hospital and Medical College at North Gujarat, India Methods: A cross sectional retrospective study was carried out at Designated Covid Hospital and Medical College at North Gujarat, India through telephonic and personal interview of health care workers who had received partial or complete vaccination. Key variables of the study were profile of work of health care worker at medical facility, type of vaccine received and how was post vaccination covid-19 infection managed. Result(s): We enrolled total 210 health care workers with mean age of 31.5 years with 69 male and 141 female. Out of 210 health workers, 204(97.14%) were fully vaccinated with two dose of covid-19 vaccines,5(2.38%) were partially vaccinated. Symptomatic infection with Covid-19 occurred in total 12 (5.71%) health care worker >= 14 day after second dose of either vaccine. Only one required hospitalization with oxygen support, rest all are managed with home isolation. Interpretation &Conclusion: One in twenty health care workers got infected with covid-19 after vaccination in present study. Extended research required to get larger data for ascertaining predictors of infection mainly mutation in virus and effect of comorbidity on antibody response after vaccination and severity of disease. Copyright © 2022, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.
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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for global pandemic, and it has caused more than 2.3 million deaths. Persistence and stability of immunoglobulin G (IgG) response after recovery from COVID-19 infection is still uncertain. Method(s): We performed a longitudinal cohort study in healthcare workers (HCW) and their close contacts (Non-HCW) with known resolved SARS-CoV-2 infection and undiagnosed infection at Maulana Azad Medical College and associated Lok Nayak hospital, New Delhi. Baseline IgG antibody titers was determined and the participants were followed over a period of six months. We also examined relationship between SARS-CoV-2 immunoglobulin G (IgG) response and new symptomatic infection in HCW and Non-HCW over time. Result(s): 176 (70.9%) healthcare workers and 72 (29.0%) non-healthcare workers were recruited from two cohorts. 82 subjects recovered from SARS-CoV-2 infection and 166 undiagnosed for the infection having history of close contact with COVID-19 patients were followed up for a median of 227 days (interquartile range, 166 to 202) after a positive IgG antibody test. In the recovered subjects 70.7% (58) were seropositive for first anti-spike IgG assay at baseline, followed by 80.0%, 90.6% and 82.6% at three visits respectively. In undiagnosed subjects 37.3% (62) were seropositive at baseline, followed by 70.9%, 75.8% and 82.2% respectively. Also, 46.8% (29) were asymptomatic with no symptoms of COVID-19 and were seropositive at baseline. However, presence of IgG antibodies was associated with substantial reduced risk of re-infection over the follow up duration. Conclusion(s): Our data showed that the antibodies levels measured increased over the first three months and decreased slightly after that and remained at a plateau and relatively stable for at least a period of six months. Copyright © 2022 International Medical Sciences Academy. All rights reserved.
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Academic pipeline programs are designed to mitigate systemic barriers that have historically excluded individuals due to deep-rooted, structural inequities. The Student-centered Pipeline to Advance Research in Cancer Careers (SPARCC) was developed in 2018 to diversify the clinical research health professions workforce and has graduated three cohorts of scholars from 20192021. Due to COVID-19 and safety concerns, SPARCC evolved, pivoting to establish effective learning environments virtually and in-person to ensure the original curriculum of academic, research, and professional identity development were upheld. The program aims to a.) immerse students in the clinical cancer research environment, supporting immediate employment as a clinical research professional (CRP) and b.) to provide structured support and guidance for individuals intending to pursue advanced professional degrees. SPARCC programmatic evaluations included a multifactorial strategy utilizing the same three evaluative instruments each year. These included a 17-item knowledge, attitudes, and practices (KAP) survey specific to clinical cancer research, daily workshop evaluations, and clinical practicum rotation evaluations. The SPARCC KAP was distributed immediately prior to the start of the program, upon graduation from the program, and six months later. After exploratory factor analysis, items were grouped into three factors: knowledge of clinical research practice, knowledge of research practice, and knowledge of culturally responsive cancer care. Mixed ANOVAS were used to assess changes in factors based on time (pre-, post-, and 6-month follow up;within) and cohort (year of participation;between). Over three years 156 students applied, 65% of whom identified belonging to an underrepresented ace or ethnicity. Thirty-six scholars matriculated through the program: 14(39%) White;13(36%) Black;3(8%) Asian;3(8%) Native American;1 3%) Native American/Black;1(3%) Black/Asian;1(3%) Pacific Islander. Forty-four percent (16 scholars) identified as Hispanic/Latino/a. Six scholars (17%) entered the clinical research workforce within six months of graduating from the SPARCC program, all who identified as belonging to underrepresented groups. The KAP evaluations revealed that scholars' knowledge increased significantly after participation in the program in each of the three factors: knowledge of clinical research practice (p < .007);knowledge of research practice (p < .007);and knowledge of culturally responsive cancer care (p < .007). Within six months of graduation from SPARCC, 17% of scholars entered the clinical research workforce, and nearly 60% were enrolled in graduate-research degree programs or medical school. SPARCC demonstrated curricular flexibility and ingenuity when pivoting from entirely in-person to entirely virtual, and finally to a hybrid program over the first three years of the program. Through didactic, clinical, research, and career professional identity exploration, robust learning experiences engaged scholars despite limitations on in-person contact.
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Hollow viscous perforation is one of the most common emergency dealt by general surgeons worldwide. A high degree of suspicion is required and prompt management is warranted to reduce morbidity and mortality. Here we present a study of perforative peritonitis in our medical college at the outskirt of Udaipur city in the state of Rajasthan, India during the Covid-19 pandemic. During the one year study period from September 2020 to August 2021, a total of 16 cases of hollow viscous perforation admitted and treated. The number is relatively low because of the pandemic and there was a period of total lockdown with negligible patient footfall. All patient had free gas under diaphragm in plain x-ray and all of them were scheduled for emergency laparotomy after adequate resuscitation. Emphasis given on the location of perforation, etiology, organism on culture of peritoneal fluid and procedure undertaken. Copyright © 2022, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.
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INTRODUCTION: Online learning involves the delivery of educational instructions regarding a subject using the internet. Pathology is an experimental subject that requires students to learn about disease development via unpleasant photos and slides. This study aims to determine the rewards and struggles of online pathology learning during the coronavirus disease 2019 (COVID-19) pandemic at the Al-Qunfudah Medical College, Kingdom of Saudi Arabia. METHODS: Using an online questionnaire comprising three sections of 23 questions (12 questions about the positive perception of online teaching and 11 about the negative perception), we surveyed second and third-year pathology students about their perception of online education. The positive and negative perceptions of the students were compared using the chi-square test (p < 0.05). RESULTS: About 77% of the students (n = 85/110) responded to the survey. Female students (n = 43, 50.6%) had a significantly higher positive perception of online learning (p < 0.001); male students (n = 42, 49.4%) had a high negative perception of online teaching (p < 0.035). Nearly 70% of the students agreed that the Blackboard platform (Anthology Inc., Boca Raton, FL) made learning easy. About two-thirds of students agreed that the pre-lecture video produced by the teachers, when shared before the lesson, made the pathology lectures easy. CONCLUSION: Female students were more favorable toward online pathology learning. Extensive training provided to teachers can significantly increase the support given to students during online teaching.
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INTRODUCTION: Coronavirus disease (COVID-19), an infectious disease caused by a new coronavirus called SARS-CoV-02, causes mild to moderate respiratory illness, and patients with benign disease conditions recover without requiring special treatment. The best way to prevent and slow down transmission is to be well-informed about the COVID-19 virus, the disease, its causes, and how it spreads;hence a qualitative research tool using focus group discussion was carried out with the following objective. To determine various symptoms, awareness, course of the disease, and health care impact on COVID-19 cases seeking health care. METHODOLOGY: A cross-sectional qualitative study was conducted at a tertiaryhospital attached to a medical college in April 2020. Information about the discharge of patients with a number equal to or more than 12 patient groups and their ward numbers was obtained from the office of the hospital's CEO. The collective proportion of content analysis of all the groups interacted, Word cloud, text mining, and ATLAS-TI software were used for analysis. RESULT(S): The investigator interacted with the groups until saturation in reply was achieved. The average age group was 41 years. 91% of patients ranged from middle-aged adults. There were 62% male and 38 % female patients. The patients could recollect and guess the likely source of infection. A specific inquiry was made to remind them to obtain the answers. Those aware of the confirmed case, either in the family, relatives, workplace, neighbours, or mass testing of patients in their chawl, could guess the reason for their positivity. CONCLUSION(S): Health experts should remove the fear among the patient during such pandemic situations after the patients enter isolation. The patients experienced stigma from the society they lived in. Copyright © 2023 Authors. All rights reserved.
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Introduction: Longitudinal electives ("tracks") were introduced within the Heidelberg Curriculum Medicinale (HeiCuMed) in 2017. Participation in one of the 11 tracks is obligatory. Within the track "Interdisciplinary Oncology" (IO), > 150 participants can choose from > 170 courses each semester. Since students of all terms are allowed, previous knowledge and research experience are heterogeneous. Tus, medical students and participants have initiated a lecture series entitled "Insights in Research" to facilitate the entry of medical students into scientifc research. In addition, a student-led cofee meet-up ("DoktorandenCafe") was set up. Here we report on those student initiatives. Method(s): To allow medical students with a strong interest in oncology to get into contact with basic scientifc research groups at the University Hospital Heidelberg, the German Cancer Research Center (DKFZ), the Hopp Childrens' Cancer Center (KiTZ) and the National Cancer for Tumor Diseases (NCT), a seminar entitled "Insights in Research" is organized on a monthly basis by student representatives. Guest lecturers who are first or co-author of a respective paper are invited and their research work is discussed with all participants. To increase exchange between current and future medical doctoral students, the "DoktorandenCafe" was initiated by student representatives. Result(s): Since February 2020, > 70 students enrolled in the IO elective have participated in the seminars "Insights in Research" and "DoktorandenCafe". The seminar "Insights in Research" enables students to gain basic knowledge of scientifc research processes, facilitating the first contact of medical students with cancer research. Moreover, this seminar enables students to discuss scientifc topics in the field of oncology together with other participants of the course and with a researcher that actively participated in the presented research project. Additionally, the newly initiated cofee meet-up enables students who are writing or planning to write their doctoral thesis in the field of oncology to get in touch with each other and to discuss thesis-related issues. Due to the COVID-19 pandemic, both seminars were held virtually during the summer term 2020. Conclusion(s): The student-initiated seminars have a high participation rate. This indicates that student-initiated teaching initiatives should be encouraged and implemented into medical education to strengthen interest in basic and translational research.
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BACKGROUND: The usage of whole-slide images has recently been gaining a foothold in medical education, training, and diagnosis. OBJECTIVES: The first objective of the current study was to compare academic performance on virtual microscopy (VM) and light microscopy (LM) for learning pathology, anatomy, and histology in medical and dental students during the COVID-19 period. The second objective was to gather insight into various applications and usage of such technology for medical education. MATERIALS AND METHODS: Using the keywords "virtual microscopy" or "light microscopy" or "digital microscopy" and "medical" and "dental" students, databases (PubMed, Embase, Scopus, Cochrane, CINAHL, and Google Scholar) were searched. Hand searching and snowballing were also employed for article searching. After extracting the relevant data based on inclusion and execution criteria, the qualitative data were used for the systematic review and quantitative data were used for meta-analysis. The Newcastle Ottawa Scale (NOS) scale was used to assess the quality of the included studies. Additionally, we registered our systematic review protocol in the prospective register of systematic reviews (PROSPERO) with registration number CRD42020205583. RESULTS: A total of 39 studies met the criteria to be included in the systematic review. Overall, results indicated a preference for this technology and better academic scores. Qualitative analyses reported improved academic scores, ease of use, and enhanced collaboration amongst students as the top advantages, whereas technical issues were a disadvantage. The performance comparison of virtual versus light microscopy meta-analysis included 19 studies. Most (10/39) studies were from medical universities in the USA. VM was mainly used for teaching pathology courses (25/39) at medical schools (30/39). Dental schools (10/39) have also reported using VM for teaching microscopy. The COVID-19 pandemic was responsible for the transition to VM use in 17/39 studies. The pooled effect size of 19 studies significantly demonstrated higher exam performance (SMD: 1.36 [95% CI: 0.75, 1.96], p < 0.001) among the students who used VM for their learning. Students in the VM group demonstrated significantly higher exam performance than LM in pathology (SMD: 0.85 [95% CI: 0.26, 1.44], p < 0.01) and histopathology (SMD: 1.25 [95% CI: 0.71, 1.78], p < 0.001). For histology (SMD: 1.67 [95% CI: -0.05, 3.40], p = 0.06), the result was insignificant. The overall analysis of 15 studies assessing exam performance showed significantly higher performance for both medical (SMD: 1.42 [95% CI: 0.59, 2.25], p < 0.001) and dental students (SMD: 0.58 [95% CI: 0.58, 0.79], p < 0.001). CONCLUSIONS: The results of qualitative and quantitative analyses show that VM technology and digitization of glass slides enhance the teaching and learning of microscopic aspects of disease. Additionally, the COVID-19 global health crisis has produced many challenges to overcome from a macroscopic to microscopic scale, for which modern virtual technology is the solution. Therefore, medical educators worldwide should incorporate newer teaching technologies in the curriculum for the success of the coming generation of health-care professionals.
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Introduction: Covid 19 is a disease caused by a virus belonging to SARS Co V2 family of viruses. It primarily effects the lungs resulting in inflammation and pneumonia. Objective(s): The main objective of the study is to compare the outcomes and efficacy of solumedrol and dexamethasone in moderate to severe COVID disease. Material(s) and Method(s): This cross sectional study was conducted in Central Park Medical College and Teaching Hospital, Lahore and the duration of this study was from August 2021 to March 2022. The data was collected from 100 COVID-19 patients diagnosed with moderate to severe condition of the diseases. The data was collected through non-probability consecutive sampling technique. Result(s): The data was collected from 100 patients of moderate to severe COVID-19 condition. There were 35 patients in group I and 65 patients' group II. The mean age for dexamethasone (group II) was 55.41 +/- 10.4 years and solumedrol (group I) was 56.86 +/- 9.3 years. Conclusion(s): It is concluded that both drugs dexamethasone and solumedrol are effective in improving clinical and biochemical parameters of moderate to severe covid 19 disease. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
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Background. In 2015 emtricitabine-tenofovir (PrEP) was approved for use as a pre-exposure prophylactic medication for preventing HIV infections. In 2017, WHO declared PrEP to be an essential medicine, gaining widespread acceptance for outpatient care. In 2020, the COVID-19 pandemic disrupted the healthcare system, with several studies showing lower rates of PrEP prescriptions during the pandemic particularly among Black and Latinx groups. Methods. Medical records at Rutgers New Jersey Medical School (NJMS) were queried for PrEP prescriptions from 2017-2021. All duplicate entries, and all patients prescribed emtricitabine and tenofovir as part of HIV treatment were removed. Years 2017-2019 were defined as "pre-pandemic" and years 2020-2021 were defined as "pandemic." Results. Average annual prescriptions for PrEP at NJMS decreased by only 13% (157 to 137 p=0.53) for all ages and 25% (29 to 22 p=0.38) for adolescents and young adults (ages 16-24) (AYA) from pre-pandemic to pandemic years. The annual number of AYAs who had their PrEP prescribed by the Division of Adolescent and Young Adult Medicine practice(DAYAM)remained the same during the pandemic while the annual number of AYAs who had their PrEP prescribed by the Infectious Disease practice (IDP) decreased by over 50% (p = 0.07). PrEP prescriptions for trans-identifying individuals (over 90% prescribed by the IDP) increased by 15% (p = 0.58). PrEP Prescriptions for Adolescents and Young Adults Conclusion. Despite the national decline in PrEP prescriptions during the COVID-19 pandemic, NJMS experienced a non-statistically significant decrease in PrEP prescriptions despite serving a majority Black and Latinx population who have elsewhere suffered the most disruption in healthcare during the pandemic. At NJMS, the IDP provides primary care for trans-identifying individuals, and DAYAM provides primary care for AYAs. Average annual PrEP prescriptions for trans-identifying individuals increased and AYA PrEP prescriptions by the DAYAM remained the same throughout the pandemic emphasizing the key role primary care physicians have in PrEP access during the pandemic and may play a significant role in the strong continuation of PrEP program provided at NJMS throughout the pandemic. (Figure Presented).
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Background. Healthcare workers are at high risk of Covid-19 (C19) infection and received priority for C19 vaccinations. Therefore, we conducted a serosurvey to determine anti-C19 antibodies and evidence of C19 infection in health care employees who did or did not have direct contact with patients. Methods. 49 participants provided finger stick blood samples collected onto filter papers and tested for antibodies to C19 using Bio-Plex Pro Human SARS-CoV-2 IgG reagents. Antibodies to C19 nucleocapsid (N), receptor-binding domain (RBD), spike 1 (S1), and spike 2 (S2) were measured. Samples were collected 8 to 11 months after C19 vaccines were made available. Results. All participants received two doses of Pfizer BioNTech or Moderna RNA-based C19 vaccines, and all showed serological evidence of antibodies to C19 RBD, S1, and S2. Antibodies to N, considered a marker of C19 infection, were detected in 16 individuals, of whom 10 reported having a PCR documented C19 infections. 6 individuals had evidence of C19 infection of which they were not aware. Antibody levels were notably higher following infection and for not infected participants following Pfizer-BioNTech vaccination. There was a 20% higher infection rate in participants with direct patient contact. Conclusion. This vaccinated population had significant rates of strong antibody responses to C19 infection and a notable rate of C19 infections, most notable in those providing direct patient care.
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Background. Since the onset of the COVID-19 pandemic, opioid-related overdose deaths have increased. Buprenorphine, a medication for opioid use disorder (OUD), is safe and effective but is underutilized and requires qualifying physicians to obtain a waiver. Infectious diseases (ID) physicians are uniquely positioned to treat OUD, as persons with OUD may present with infectious complications from injection drug use. We sought to understand the proportion and distribution of ID physicians with waivers in the United States (US). Methods. This was a cross-sectional study merging data from the Centers for Medicare & Medicaid Services and the Drug Enforcement Agency Substance Abuse and Mental Health Services Agency. Our primary outcome was proportion of ID physicians who possess buprenorphine waivers. We used multivariable regression models to identify individual and county-level characteristics associated with buprenorphine waiver possession. We used geospatial analysis to describe county-level distribution of buprenorphine-waivered ID physicians. Results. Among 6439 ID physicians in the US, 170 (2.6%) possessed buprenorphine waivers. Overall, 57.2% of ID physicians were male with a median 23 (IQR 15-33) years since medical school. Most (97.3%) practiced in metropolitan counties. In multivariable analysis, medical school graduation beyond 20 years was associated with lower odds of waiver possession compared to those graduating within 20 years (OR 0.59, 95% CI 0.43-0.80). ID physicians practicing in counties with median income > 50,000/year and in counties with higher proportion of uninsured residents also had lower odds of having a waiver (OR 0.58, 95% CI 0.35-0.97;OR 0.93, 95% CI 0.90-0.97). Among counties with at least one ID physician (n=519), 86.6% had no buprenorphine-waivered ID physicians (Figure 1). Figure 1 County-Level Distribution of Infectious Diseases Physicians with Buprenorphine Waivers Conclusion. Fewer than 3% of ID physicians in the US have obtained waivers to prescribe buprenorphine, highlighting missed opportunities to treat individuals with OUD, especially in rural America. Education on OUD management should be integrated into ID continuing medical education, and policies are urgently needed to expand buprenorphine access to persons without insurance.
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Background: Academic leadership, such as through peer-reviewed scholarship, enables life-long learning. However, since the onset of the SARS-CoV-2 pandemic, faculty in Psychiatry, including C/L psychiatrists, lack the time or resources to balance their clinical workload with the academic mission. This opportunity cost drives burnout and leads to underrepresentation of women in senior academic roles [1]. Aim(s): To bolster academic achievement and enhance gender equity among Psychiatry faculty at a large, metropolitan academic medical center, we piloted an IRB-exempt quality improvement study to implement academic coordination: A coordinator assisted all faculty with administrative tasks related to academic advancement over a 6-month duration. Method(s): In the first two months, junior clinical faculty were offered access (n=50);thereafter, all additional faculty (n=35). We tracked hours of coordination;tasks requested by faculty;participant demographics;a Likert-scale assessment of perception of control over time and its impact on wellness [2], pre- and post-matched for the intervention;a Likert-scaled assessment of gains from the program;and a thematic evaluation of free-text responses on gains from the program. For the pre- and post-matched survey, we will use a paired t-test to analyze the data. For thematic evaluation of free-text responses, we will conduct a categorization which ultimately groups inductive codes sharing similar meaning into subthemes. Results (Preliminary): Participation rate: 26 faculty took the pre-program survey;23 faculty requested assistance with tasks;18 matched faculty completed the post-program survey. Pre-program demographics: 92% clinical;65% female and 35% male;4% lecturer, 81% instructor and 15% assistant professors;average years from residency graduation was 8.54 (range 0-47) and average age was 41 (range 32-74). Tasks: 38 tasks were completed through 275 hours of coordination with the majority of requests for academic CV or NIH bio-sketch updates. Additional requests were for background literature searches, reference formatting, journal review and selection, and manuscript formatting. Further data analysis is pending. Discussion(s): Preliminary data demonstrated higher utilization of academic coordination from junior, female faculty. This reveals an emerging opportunity to address gender disparities in professional equity. Conclusion(s): To assist C/L faculty in reconciling the work-work conflict from competing demands in the academic environment and to enhance life-long learning, administrative resources are critical. Further conclusions are pending. References: 1. Davis PB, Meagher EA, Pomeroy C, Lowe WL, Rubenstein AH, Wu JY, Curtis AB, Jackson RD. Pandemic-related barriers to the success of women in research: a framework for action. Nature Medicine. 2022 Mar;28(3):436-8. 2. Fassiotto M, Simard C, Sandborg C, Valantine H, Raymond J. An integrated career coaching and time banking system promoting flexibility, wellness, and success: a pilot program at Stanford University School of Medicine. Academic medicine: journal of the Association of American Medical Colleges. 2018 Jun;93(6):881. Copyright © 2022